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Abstract Assessing future demand for a wide range of services requires good quality population forecasts. Unfortunately, many past forecasts of the Aboriginal and Torres Strait Islander (Indigenous) population of Australia have proved highly inaccurate. This is due to poor data quality, missing data, and demographers’ incomplete understanding of Indigenous population change. In addition, because Indigenous population estimates are published only every 5 years and long after the reference date, forecasts are often used as preliminary population estimates. These form the denominators of various metrics used to monitor programmes aimed at improving health and social outcomes. The aim of this paper is to present an evaluation of alternative forecasting models and forecasts of the Indigenous population of Australia’s States and Territories by age and sex. Four models, differing substantially in complexity, were evaluated: (1) the simple Hamilton–Perry method, (2) the synthetic migration cohort-component model, (3) a uniregional cohort-component model with net migration, and (4) a bi-regional cohort-component model. The population forecasting methods were evaluated against several criteria, including forecast accuracy over the 2016–21 period, input data requirements, conceptual adequacy, output detail, time required to prepare, ability to create scenarios and select alternative assumptions, and ease of implementation. The Hamilton–Perry and synthetic migration cohort-component models provided greater forecast accuracy and scored well against the evaluation criteria. In the challenging data environment for modelling Indigenous populations, simpler forecasting methods offer several practical advantages and are likely to produce more accurate forecasts than more data-intensive models.

Abstract Background Indigenous peoples globally continue to be underrepresented in biomarker, genomic, and biobanking research. The aim of this study was to identify core components of culturally safe and ethical biomarker and genomic research with Indigenous peoples in Australia, Aotearoa/New Zealand, Canada and the USA. Methods A scoping review with a systematic search strategy was conducted utilising electronic databases MEDLINE, EMBASE, PsychINFO, CINAHL and Global Health. Key search terms included ‘biomarkers’ and ‘genomics’ research involving Indigenous peoples in relation to ethical and legal principles of respect, sovereignty, governance and existing policies. Original research studies published from the year 2000 to the 1st of August 2023 were reviewed in a systematic manner. Components of culturally safe and ethical research processes were identified and synthesised descriptively. The quality of included studies was assessed using an Aboriginal and Torres Strait Islander Quality Appraisal Tool through an Indigenous lens. Results Seven interrelated research components were identified from seventeen studies as core processes to enhance the cultural safety of biomarker and genomic research. These included building relationships and community engagement, learning, research coordination, logistics, consent, samples and biospecimens, biobank structures and protections and policy. The importance of ensuring self-determination, ownership and decision-making power is emphasised in processes to establish and conduct biomarker and genomic research with Indigenous peoples. Conclusions Components that contribute to the cultural safety of biomarker and genomic research processes identified in this scoping review were assembled into a theoretical framework to guide research practice. Further evaluation is required by Indigenous peoples and communities to appropriate and adapt this framework for local use to promote the cultural safety of research processes and minimise barriers to Indigenous peoples’ participation in biomarker and genomic research.

Abstract Background Rates of dementia for Aboriginal and Torres Strait Islander peoples are three to five times greater compared to non-Indigenous Australians, with earlier age of onset. However, the risk and protective factors that drive these higher rates vary across existing cohort studies, with minimal findings on the role of vascular risk factors beyond stroke. Harmonisation of data across studies may offer greater insights through enhanced diversity and strengthened statistical capabilities. This study aims to combine three landmark cohort studies of Aboriginal and Torres Strait Islander participants to better understand the determinants of cognitive health and dementia. Methods/design Three cohort studies - the Kimberley Healthy Adults Project (KHAP, N = 363), Koori Growing Old Well Study (KGOWS, N = 336) and Torres Strait Dementia Prevalence Study (TSDPS, N = 274) - share a similar research methodology with demographic, medical history, psychosocial factors, cognitive tests and consensus clinical diagnoses of cognitive impairment and dementia. Associations between risk and protective factors of interest and the presence of dementia and/or cognitive impairment diagnoses will be evaluated by univariable and multivariable logistic regression in a harmonised cross-sectional cohort of 898 participants. Factors associated with incident dementia and/or cognitive impairment will be assessed in a subset of KHAP (n = 189) and KGOWS participants (n = 165) who were available in longitudinal follow-up, after exclusion of those with baseline dementia or cognitive impairment. Analyses in relation to outcome measure of death or dementia will be conducted to account for the competing risk of death. Logistic regression will be used to evaluate the association between the individual components of the 16-component Kimberley Indigenous Cognitive Assessment (KICA) tool and the presence of dementia and cognitive impairment determined by independent consensus diagnoses. Multivariable binary logistic regression will be used to adjust for the effect of confounding variables. Results will be reported as odds ratios (OR) with 95% confidence intervals (95% CI). Discussion Greater understanding of risk and protective factors of dementia and cognitive impairment relevant to Aboriginal and Torres Strait Islander peoples may improve approaches across the life course to delay cognitive decline and reduce dementia risk.

Introduction Aboriginal and Torres Strait Islander peoples are the First Peoples of Australia. Up to 45% of dementia in these populations is due to potentially modifiable risk factors. The Dementia Prevention and Risk Management Program for Aboriginal Australians (DAMPAA) is an Aboriginal Health Practitioner led programme that aims to reduce cognitive decline and functional impairment in older Aboriginal people.Methods Design: DAMPAA is a multisite, randomised controlled trial aiming to deliver and evaluate a culturally appropriate risk factor management programme. Population: Community-dwelling Aboriginal people aged 45–90 years. Intervention: Participants will be randomly assigned to either usual care (control) or to a group programme comprising exercise and health education yarning sessions and pharmacist-delivered medication reviews delivered over a 12-month period. Primary outcome: Cognitive function (Kimberley Indigenous Cognitive Assessment (KICA)-Cog score), daily function (KICA-Activities of Daily Living (ADL) score) and quality of life (Good Spirit, Good Life and EQ-5D-5L scores). Secondary outcomes: Process evaluation interviews, cardiovascular risk factors, falls and death. Process evaluation will be conducted with qualitative methods. Quantitative outcomes will be analysed with generalised linear mixed models.Ethics and dissemination The study was approved by the Western Australian Aboriginal Health Ethics Committee and the University of Western Australia Human Research Ethics Committee. Study results will be published in peer-reviewed journals and presented at scientific meetings. We will also develop and disseminate a comprehensive DAMPAA toolkit for health services. The study’s findings will guide future prevention strategies and outline a comprehensive process evaluation that may be useful in other Aboriginal health research to contextualise findings.

Background:. Recent sociocultural trends show numerous patients requesting more curvaceous profiles. Abdominoplasty techniques had evolved into a combination of fascial plication with liposuction of the lateral torso, but often left patients with “boxy” profiles. The senior author performs 360-degree liposuction of abdomen and back, hip expansion with structural fat grafting, excision of redundant soft tissue, and wide plication of abdominal fascia to create the desired profile. Methods:. Retrospective review of patient charts and CosmetAssure claims of female patients treated from January 2014 through May 2022 identified 1125 patients with a minimum 6-month follow-up who underwent abdominoplasty using 360-degree liposuction of waist, back, and flanks; wide plication of the rectus abdominis muscle; and hip expansion with fat grafting. Authors reviewed pre- and postoperative photographs to evaluate the technique’s effectiveness. Results:. Hip expansion with fat grafting combined with abdominoplasty was successfully achieved in 1125 cases. Average age was 38 years. Average body mass index was 29 kg per m2. Average amount of aspirated fat was 1896 mL. Average amount of fat injected into the bilateral hips was 493 mL. Complication rates were comparable to those observed in similar abdominoplasty series reported in the literature. Conclusions:. Abdominoplasty combining liposuction of the waist, back, abdomen, and flanks followed by wide fascial plication and expansion of the hips with fat grafting is a safe, reproducible technique for female patients. This technique prioritizes the hip anatomical area as an aesthetic consideration in abdominoplasty and facilitates creating a harmonious hip-to-waist ratio characteristic of a feminine figure.

Abstract Background Aged-care programs that are based in First Nations worldviews are believed to translate to improved quality of life for First Nations Elders. First Nations perspectives of health and well-being incorporates social and cultural determinants in addition to traditional Western biomedical approaches. This is exemplified by the Good Spirit Good Life (GSGL) framework, which comprises 12 strength-based factors determined by First Nations Elders as constituting culturally appropriate ageing. Our objective was to conduct a systematic review of existing aged care models of practice to determine the degree of alignment with the GSGL framework. Recommendations of the national Australian Royal Commission into Aged Care Quality and Safety informed this work. Methods We conducted a systematic search of academic and grey literature in the PubMed, Scopus, Ovid Embase, and Informit online databases. Inclusion criteria comprised English language, original research describing the implementation of First Nations culturally appropriate aged care models, published before August 2022. Research that was not focused on First Nations Elders’ perspectives or quality of life was excluded. We subsequently identified, systematically assessed, and thematically analyzed 16 articles. We assessed the quality of included articles using the Aboriginal and Torres Strait Islander Quality Assessment Tool (ATSIQAT), and the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research. Results Most studies were of medium to high quality, while demonstrating strong alignment with the 12 GSGL factors. Nine of the included studies detailed whole service Models of care while 7 studies described a single program or service element. Thematic analysis of included studies yielded 9 enablers and barriers to implementing models of care. Conclusions Best-practice First Nations aged care requires a decolonizing approach. Programs with strong adherence to the 12 GSGL factors are likely to improve Elders’ quality of life.

Students are often encouraged to learn 'deeply' by abstracting generalizable principles from course content rather than memorizing details. So widespread is this perspective that Likert-style inventories are now routinely administered to students to quantify how much a given course or curriculum evokes deep learning. The predictive validity of these inventories, however, has been criticized based on sparse empirical support and ambiguity in what specific outcome measures indicate whether deep learning has occurred. Here we further tested the predictive validity of a prevalent deep learning inventory, the Revised Two-Factor Study Process Questionnaire, by selectively analyzing outcome measures that reflect a major goal of medical education--i.e., knowledge transfer. Students from two undergraduate health sciences courses completed the deep learning inventory before their course's final exam. Shortly after, a random subset of students rated how much each final exam item aligned with three task demands associated with transfer: (1) application of general principles, (2) integration of multiple ideas or examples, and (3) contextual novelty. We then used these ratings from students to examine performance on a subset of exam items that were collectively perceived to demand transfer. Despite good reliability, the resulting transfer outcomes were not substantively predicted by the deep learning inventory. These findings challenge the validity of this tool and others like it.

IntroductionSeroma development is a known complication following extremity and trunk soft-tissue sarcoma (STS) resection. The purpose of this study is to evaluate and characterize seroma outcomes and the development of associated complications.MethodsA retrospective review of 123 patients who developed postoperative seromas following STS resection at a single institution was performed. Various patient and surgical factors were analyzed to determine their effect on overall seroma outcomes.Results77/123 seromas (62.6%) were uncomplicated, 30/123 (24.4%) developed infection, and 16/123 (13.0%) were symptomatic and required aspiration or drainage for symptom relief at an average of 12.2 months postoperatively. 65/123 (52.8%) seromas resolved spontaneously at an average time of 12.41 months. Seromas in the lower extremity (p=0.028), surgical resection volume >864 cm3, (p=42 cm3 (p=864 cm3 and a large seroma volume >42 cm3 are risk factors for complications.

Abstract Parkinson’s disease is a neurodegenerative disorder characterized by different motor, vegetative, behavioral, and cognitive impairments, with worsening quality of life. Virtual reality devices have given promising results in neurorehabilitation as they can provide multisensory stimulation in a realistic environment. This study aims to test the efficacy of virtual reality training by using Computer Assisted Rehabilitation Environment in cognitive impairment in a sample of PD. 31 patients affected by PD were enrolled. All PD patients underwent 24 sessions of Computer Assisted Rehabilitation Environment training. The participants were assessed at baseline (T0) and after two months (T1). Our results suggested that Computer Assisted Rehabilitation Environment training may be effective in the cognitive and emotional domains, particularly by improving executive function, anxiety, and depressive symptoms. These changes have helped to improve self-efficacy and coping strategies. These results indicate greater cognitive and physical effort to overcome stressors. Our results show that Computer Assisted Rehabilitation Environment training was beneficial in improving cognitive functions. Longer duration training may be especially beneficial for patients with mild cognitive impairment. Our findings open the door to tailored personalized treatments based on the patient's motor and cognitive profiles.

Rapidly assessing how ill a patient is based on their immediate presentation--colloquially termed 'eyeballing' in practice--serves a vital role in acute care settings. Yet surprisingly little is known about how this diagnostic skill is learned or how it should be taught. Some authors have pointed to a dual-process model, suggesting that assessments of illness severity are driven by two distinct types of processing: an intuitive, fast, pattern recognition-like process (Type 1) that depends on many prior patient encounters and outcomes being stored in memory; and a deliberate, slow, analytic process (Type 2) characterized by additional data gathering, data scrutiny, or recollection of rules. But prior studies have supported a dual-process model for the assessment of illness severity only insofar as experienced clinicians chiefly displayed what was presumed to be Type 1 processing. Here we further explored a dual-process model by examining whether less experienced clinicians displayed both types of processing when assessing illness severity across a series of cases. Consistent with the model, a dissociation between Type 1 and Type 2 processing was observed through resident reports of deliberation, response times, and three eye tracking metrics associated with diagnostic expertise. We conclude by discussing potential implications for the training of this enigmatic diagnostic skill.

: Objective: To examine the demographic drivers contributing to the future growth in the population of older migrants in Australia living with dementia. Methods: Using birthplace‐specific cohort‐component projection models, we projected the number of older migrants living with dementia. ABS data on births, deaths, migration and birthplace were used, alongside Australian Institute of Health and Welfare (AIHW) estimates of dementia prevalence with birthplace dementia weights calculated from administrative data. Results: The number of older migrants living with dementia is projected to increase from about 134,423 in 2016 to 378,724 by 2051. Increases in populations with dementia varied considerably, from a slight decrease for those born in Southern & Eastern Europe to over 600% increases amongst the South‐East Asia, Southern & Central Asia, and Sub‐Saharan Africa‐born populations. Conclusions: Cohort flow is the primary driver increasing the number of older migrants living with dementia. This growth is largely inevitable because the cohorts are already living in Australia as part of the migrant population, but currently at ages below 60 years. Implications for public health: High relative growth and shifting birthplace composition in the number of migrants living with dementia poses implications for culturally appropriate care, health care access and workforce needs to support migrant families, carers and their communities., Despite declines in the age‐specific incidence of dementia in several high‐income countries (HICs), some studies suggest dementia rates may be considerably higher among migrant groups compared to the non‐migrant population.[sup.1,2] [...]

Abstract Objective: To examine the demographic drivers contributing to the future growth in the population of older migrants in Australia living with dementia. Methods: Using birthplace‐specific cohort‐component projection models, we projected the number of older migrants living with dementia. ABS data on births, deaths, migration and birthplace were used, alongside Australian Institute of Health and Welfare (AIHW) estimates of dementia prevalence with birthplace dementia weights calculated from administrative data. Results: The number of older migrants living with dementia is projected to increase from about 134,423 in 2016 to 378,724 by 2051. Increases in populations with dementia varied considerably, from a slight decrease for those born in Southern & Eastern Europe to over 600% increases amongst the South‐East Asia, Southern & Central Asia, and Sub‐Saharan Africa‐born populations. Conclusions: Cohort flow is the primary driver increasing the number of older migrants living with dementia. This growth is largely inevitable because the cohorts are already living in Australia as part of the migrant population, but currently at ages below 60 years. Implications for public health: High relative growth and shifting birthplace composition in the number of migrants living with dementia poses implications for culturally appropriate care, health care access and workforce needs to support migrant families, carers and their communities.

Background The consultation process, where a clinician seeks an opinion from another clinician, is foundational in medicine. However, the effectiveness of group diagnosis has not been studied. Objective To compare individual diagnosis to group diagnosis on two dimensions: group size (n=3 or 6) and group process (interactive or artificial groups). Methodology Thirty-six internal or emergency medicine residents participated in the study. Initially, each resident worked through four written cases on their own, providing a primary diagnosis and a differential diagnosis. Next, participants formed into groups of three. Using a videoconferencing platform, they worked through four additional cases, collectively providing a single primary diagnosis and differential diagnosis. The process was repeated using a group of six with four new cases. Cases were all counterbalanced. Retrospectively, nominal (ie, artificial) groups were formed by aggregating individual participant data into subgroups of three and six and analytically computing scores. Presence of the correct diagnosis as primary diagnosis or included in the differential diagnosis, as well as the number of diagnoses mentioned, was calculated for all conditions. Means were compared using analysis of variance. Results For both authentic and nominal groups, the diagnostic accuracy of group diagnosis was superior to individual for both the primary diagnosis and differential diagnosis. However, there was no improvement in diagnostic accuracy when comparing a group of three to a group of six. Interactive and nominal groups were equivalent; however, this may be an artefact of the method used to combine data. Conclusions Group diagnosis improves diagnostic accuracy. However, a larger group is not necessarily superior to a smaller group. In this study, interactive group discussion does not result in improved diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Introduction: Perinatal palliative care (PPC) is a rapidly growing and essential reproductive health care option for pregnant persons with a diagnosed life‐limiting fetal condition who continue their pregnancy. The provision of PPC is within the scope of basic midwifery competencies, and midwives are well‐positioned to make unique and valuable contributions to interprofessional PPC teams. However, little is known about midwives' past or current involvement in PPC in the United States. Methods: This scoping review of the literature investigated what is known about the role of midwives in PPC in the United States. Multiple databases of published literature were used for this review: PubMed, CINAHL, Embase, Web of Science, ProQuest, Google Scholar, and relevant citations from identified studies. All types of English language publications addressing midwives' involvement in PPC in the United States were included, without any limitations on publication date. Results: The role and contributions of midwives in PPC is not well represented in existing literature. Of the 259 results identified, 7 publications met criteria for inclusion. These included 5 case reports, one quantitative research article, and one conference abstract. Midwives are involved in PPC through the provision of direct clinical care (including antepartum, intrapartum, postpartum, neonatal, bereavement, postmortem, and follow‐up care) and care planning and coordination as part of an interprofessional team. Discussion: Despite midwives being uniquely positioned to provide holistic, family‐centered, and person‐centered care in situations of pregnancy with life‐limiting fetal conditions, there is limited literature about their involvement in PPC in the United States. PPC should be incorporated into midwifery education and training programs. Midwives should play a central role in shaping future research and policies to ensure the accessibility and quality of PPC. [ABSTRACT FROM AUTHOR]

Background: Self-inflicted gunshot wounds (SIGSWs) produce devastating facial defects that are challenging to reconstruct, but are rarely reported in large cohorts in the literature. This study sought to characterize these injuries, and identify parameters influencing complications and outcomes among survivors following facial reconstruction. Methods: A retrospective cohort study was performed identifying 22 patients with SIGSWs to the face reconstructed at our center from 2009 to 2019. Charts were reviewed for patient, injury, and reconstructive details and course. Outcomes were statistically compared to various parameters. Results: The most common firearm, orientation, and injured structure were the handgun (40.9%), submental (59.1%), and mandible (68.2%), respectively. Patients averaged a 21.7-day length of stay (LOS), 17.4 h to debridement, 2.6 days to bony fixation, 5.4 reconstructive surgeries, and 7 (31.8%) patients received at least one free flap. Fifteen (68.2%) patients had at least one major complication, although functional outcomes were ultimately relatively good overall. Notable outcome associations included submental orientation with a longer LOS (p = 0.027), external fixation with a longer LOS (p = 0.014), financial stressors with a shorter LOS (p = 0.031), and severe soft tissue injury with an increased total number of reconstructive surgeries (p = 0.039) and incomplete reconstruction (p = 0.031). There were no cases of suicidal recidivism. Conclusions: Reconstruction following facial SIGSW is challenging for both patient and surgeon, and carries a high rate of complications. However, patients can regain substantial function following reconstruction and the achievement of satisfactory outcomes.

Abstract Aims and objectives To trial three mobile translation apps in the healthcare setting to address language barriers in everyday care between healthcare staff and older people with limited English proficiency (LEP). Design A mixed‐methods exploratory study. Methods A two‐month trial of three translation apps was conducted across four aged‐care hospital wards. Observed interactions during use of translation apps were recorded, and staff surveys regarding the use of translation apps were collected at the end of the trial. Data were analysed using descriptive statistics and thematic content analysis of open‐ended responses in the surveys and observations. Findings from the thematic content analysis are reported using the Standards for Reporting of Qualitative Research (SRQR) checklist. Results Translation apps were mostly used for identifying pain and assisting with activities of daily living. Qualitative findings revealed that translation apps aided staff in providing care and improved rapport; however, practical shortcomings were identified.

Background Traumatic amputees commonly experience residual limb pain (RLP) and phantom limb pain (PLP) which present major barriers to rehabilitation. An evolving treatment, targeted muscle reinnervation (TMR), shows promise in reducing these symptoms. While initial data are encouraging, existing studies are low power, and more research is needed to assess the long-term outcomes of TMR. We present the results of self-reported outcome surveys distributed to major-limb amputees more than 1 year post-TMR which were compared with similar data from a landmark randomized control trial for context. Methods Data was obtained from 17 adult traumatic amputees who were more than 1 year post-TMR using a numerical rating scale and the Patient-Reported Outcomes Measurement Information System survey tool. Results were compared with a 2019 randomized control trial by Dumanian et al which assessed TMR versus standard care (SC) after major limb amputation and demonstrated improvement in pain scores 1 year post-TMR. Results There was a statistically significant reduction in this cohort of TMR amputees' RLP worst pain scores relative to the comparison study's SC amputees (without TMR). In general, there was no significant difference in outcomes between TMR cohorts. However, PLP worst pain was significantly higher in this cohort relative to the comparison study's TMR group. Conclusion These findings support the use of TMR for reducing RLP in traumatic amputees. Relative to a similar group treated without TMR in the comparison study, this cohort's RLP was significantly improved. Future studies should aim to recruit more amputees to allow for analysis of functional outcomes, especially in upper limb amputees.

When compared with other developed nations, the United States (U.S.) has the highest maternal mortality rate. Furthermore, in the U.S. Black women are dying during pregnancy or the postpartum period at a rate three times higher than that of white women. This disparity points to the question of why inequities in maternal healthcare exist and, of critical importance, what is being done to combat them. The stark reality is that systemic racism is at the core of these health disparities and must be addressed by both the individuals providing care and the healthcare systems themselves. The underpinnings of systematic racism in maternal healthcare, as well as ways to both dismantle this racism and move forward with constructive changes, are explained in this practice update. Specifically, the positive impact that midwifery care has on maternal health outcomes will be discussed.

IntroductionPeach (Prunus persica (L.) Batsch,) and nectarine fruits (Prunus persica (L.) Batsch, var nectarine), are characterized by a rapid deterioration at room temperature. Therefore, cold storage is widely used to delay fruit post-harvest ripening and extend fruit commercial life. Physiological disorders, collectively known as chilling injury, can develop typically after 3 weeks of low-temperature storage and affect fruit quality.MethodsA comparative transcriptomic analysis was performed to identify regulatory pathways that develop before chilling injury symptoms are detectable using next generation sequencing on the fruits of two contrasting cultivars, one peach (Sagittaria) and one nectarine, (Big Top), over 14 days of postharvest cold storage.ResultsThere was a progressive increase in the number of differentially expressed genes between time points (DEGs) in both cultivars. More (1264) time point DEGs were identified in ‘Big Top’ compared to ‘Sagittaria’ (746 DEGs). Both cultivars showed a downregulation of pathways related to photosynthesis, and an upregulation of pathways related to amino sugars, nucleotide sugar metabolism and plant hormone signal transduction with ethylene pathways being most affected. Expression patterns of ethylene related genes (including biosynthesis, signaling and ERF transcription factors) correlated with genes involved in cell wall modification, membrane composition, pathogen and stress response, which are all involved later during storage in development of chilling injury.DiscussionOverall, the results show that common pathways are activated in the fruit of ‘Big Top’ nectarine and ‘Sagittaria’ peach in response to cold storage but include also differences that are cultivar-specific responses.

This protocol describes the methodology and methods for a collaborative project with eight Aboriginal and Torres Strait Islander primary health care (PHC) organisations, across three Australian states and one territory, to increase clinical service performance and access to preventive health and health promotion services for preventing, identifying, treating, and managing dementia risk in Aboriginal and Torres Strait Islander communities. Aboriginal participatory action research (APAR) methodology will be the framework for this project, incorporating continuous quality improvement (CQI), informed by research yarning with stakeholder groups, comprising community members and PHC staff and service providers and data collected from the auditing of client health records and the mapping of existing clinical processes and health services at each partnering PHC organisation. The qualitative and quantitative data will be summarised and discussed with stakeholder groups. Priorities will be identified and broken down into tangible PHC organisation deliverable strategies and programs, which will be co-developed with stakeholder groups and implemented cyclically over 24 months using the Plan, Do, Study, Act model of change. Key project outcome measures include increased clinical service performance and availability of preventive health and health promotion services for safeguarding against dementia. Project implementation will be evaluated for quality and transparency from an Indigenous perspective using an appropriate appraisal tool. The project processes, impact, and sustainability will be evaluated using the RE-AIM framework. A dementia safeguarding framework and accompanying tool kit will be developed from this work to support Aboriginal and Torres Strait Islander PHC organisations to identify, implement, and evaluate dementia safeguarding practice and service improvements on a broader scale.

Background: This review focuses on the prognostic role of resting-state functional magnetic resonance imaging (fMRI) in disorders of consciousness (DOCs). Several studies were conducted to determine the diagnostic accuracy in DOC patients to identify prognostic markers and to understand the neural correlates of consciousness. A correct diagnosis of consciousness in unresponsive or minimally responsive patients is important for prognostic and therapeutic management. Functional connectivity is considered as an important tool for the formulation of cerebral networks; it takes into account the primary sensorimotor, language, visual and central executive areas, where fMRI studies show damage in brain connectivity in the areas of frontoparietal networks in DOC patients. Methods: The integration of neuroimaging or neurophysiological methods could improve our knowledge of the neural correlates of clinical response after an acquired brain injury. The use of MRI is widely reported in the literature in different neurological diseases. In particular, fMRI is the most widely used brain-imaging technique to investigate the neural mechanisms underlying cognition and motor function. We carried out a detailed literature search following the relevant guidelines (PRISMA), where we collected data and results on patients with disorders of consciousness from the studies performed. Results: In this review, 12 studies were selected, which showed the importance of the prognostic role of fMRI for DOCs. Conclusions: Currently there are still few studies on this topic. Future studies using fMRI are to be considered an added value for the prognosis and management of DOCs. [ABSTRACT FROM AUTHOR]