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Gaining awareness of psychosis (i.e., insight) is linked to depression, particularly in the post-acute phase of psychosis. Informed by social rank theory, we examined whether the insight-depression relationship is explained by reduced social rank related to psychosis and whether self-compassion (including uncompassionate self-responding [UCS] and compassionate self-responding [CSR]) and mindfulness buffered the relationship between social rank and depression in individuals with first episode psychosis during the post-acute phase. Participants were 145 young people (Mage = 20.81; female = 66) with first episode psychosis approaching discharge from an early psychosis intervention centre. Questionnaires and interviews assessed insight, depressive symptoms, perceived social rank, self-compassion, mindfulness and illness severity. Results showed that insight was not significantly associated to depression and thus no mediation analysis was conducted. However, lower perceived social rank was related to higher depression, and this relationship was moderated by self-compassion and, more specifically, UCS. Mindfulness was related to depression but had no moderating effect on social rank and depression. Results supported previous findings that depressive symptoms are common during the post-acute phase. The role of insight in depression for this sample is unclear and may be less important during the post-acute phase than previously considered. Supporting social rank theory, the results suggest that low perceived social rank contributes to depression, and reducing UCS may ameliorate this effect. UCS, social rank and possibly mindfulness may be valuable intervention targets for depression intervention and prevention efforts in the recovery of psychosis.

Case description: 59 year old female with complex medical history (including Ollier's disease and metachondromatosis) but normal baseline renal function, underwent a resection of a left scapula chondrosarcoma. 2 days post operation was admitted to ICU with multiorgan failure with distributive shock and subsequent acute renal impairment requiring haemofiltration. She was treated empirically for infection and eventually discharged off dialysis but with significant persistent renal impairment. Procedures performed: The initial investigations included a mobile renal tract ultrasound, contrast enhanced CT abdomen and pelvis, Renal MAG3 study, and a subsequent renal DMSA several months later. Finding(s): The ultrasound demonstrated increased cortical echogenicity with preserved renal sizes. The post contrast CT, demonstrate irregular hypo enhancement of the renal cortex consistent with cortical necrosis. Mag 3 study demonstrated markedly reduced perfusion, cortical uptake, with significant asymmetry 67% : 33% (L:R). Renal DMSA with SPECT/ CT, confirms the findings of bilateral cortical necrosis (R>L). Outcome(s): The imaging findings confirmed the diagnosis of Bilateral Renal Cortical Necrosis. Although haemofiltration was ceased, the persistently reduced renal function (eGFR = 20), means the patient is likely to require renal replacement therapy in the future. Discussion(s): Acute renal cortical necrosis is the most catastrophic of all types of acute kidney injury; most commonly described after obstetrical complications and snake bite. Renal recovery depends on the amount of viable cortical tissue. The underlying cause is unclear, but is thought to result from prolonged ischaemia with vasospasm of small vessels and / or toxic capillary endothelial damage. It is a rare condition, usually diagnosed with biopsy and/or contrast CT. We present a case where the classical findings are demonstrated on renal DMSA SPECT/CT. This technique could prove a useful where biopsy or contr

Case description: 56 year old man with history of hormonally resistant metastatic prostate cancer presented for follow up of his known multifocal glioblastoma. He had a history of previous radium treatment and Lutetium PSMA treatment. Imaging and Procedures performed: A series of MRI brain (Aug 2018, Oct 2018 and Jan 2019), [18F]DCFPyL-PET - Pre and Post Lu PSMA treatment (Oct 2017 and Mar 2018) , [18F]FDG PET (Oct 2017) and Radium Treatment x6 (Mar - Jul 2017) Findings: Given his history of metastatic prostate cancer and subsequent diagnosis of GBM, we reviewed his previous [18F]DCFPyL-PET and [18F]FDG PET imaging. The retrospective review of the most recent [18F]DCFPyL-PET (Post Lu PSMA), demonstrates subtle focal intracranial uptake, in the region of the occipital horn of the right lateral ventricle. This corresponds to the site of the GBM subsequently identified on MRI 5 months later. The pre treatment [18F]DCFPyL-PET study 5 months earlier, demonstrates no uptake in this region, confirming interval development of this glioblastoma between the two studies. Outcome(s): This study occurred early in the introduction of PSMA receptor imaging in our institution. This subtle uptake was not appreciated or recognised to be abnormal, and thus was missed opportunity for an earlier asymptomatic diagnosis. Discussion(s): The prostate specific tracers [18F]DCFPyL-PET and [68Ga]PSMA is recognised for its affinity to prostate cancer. It is increasingly recognised to have potential uptake in other tumour types, including gliomas, HCC, renal cell carcinoma and lung. Uptake in unexpected sites, eg solitary in CNS lesion, should prompt for evaluation to exclude a synchronous malignancy.

In training to become a registered psychologist in Australia, as with many other countries, there is a requirement for students to attend placements, where they work with clients in an apprenticeship model under the guidance of qualified supervisors. In the context of COVID-19, tertiary sector psychology educators responsible for facilitating these placements, which typically require face-to-face client work, have been challenged to arrange or maintain practica. During the pandemic, across Australia, most placements have been affected through cancellation, postponement, or modification (e.g., using telehealth, supported by the Australian Federal Government). In this paper we describe a collaborative initiative by members of the psychology profession across 15 providers of Australian postgraduate professional training programs. The initiative aimed to identify ways in which to develop and innovate psychological placement offerings, specifically using simulation-based learning. Although simulation-based learning in psychology training programs in Australia is a widely employed pedagogy for the scaffolding of theory into psychological practice, there is paucity of clear and comprehensive guidelines for the use of simulation to both optimize competency-based training and ensure public and student safety. The overarching aim of the group, and the focus of this paper, is to provide standardized guidelines for the inclusion of simulation-based learning in psychology training in Australia both during and post-COVID 19. Such guidelines may be equally valuable for psychology training programs globally.

In training to become a registered psychologist in Australia, as with many other countries, there is a requirement for students to attend placements, where they work with clients in an apprenticeship model under the guidance of qualified supervisors. In the context of COVID-19, tertiary sector psychology educators responsible for facilitating these placements, which typically require face-to-face client work, have been challenged to arrange or maintain practica. During the pandemic, across Australia, most placements have been affected through cancellation, postponement, or modification (e.g., using telehealth, supported by the Australian Federal Government). In this paper we describe a collaborative initiative by members of the psychology profession across 15 providers of Australian postgraduate professional training programs. The initiative aimed to identify ways in which to develop and innovate psychological placement offerings, specifically using simulation-based learning. Although simulation-based learning in psychology training programs in Australia is a widely employed pedagogy for the scaffolding of theory into psychological practice, there is paucity of clear and comprehensive guidelines for the use of simulation to both optimize competency-based training and ensure public and student safety. The overarching aim of the group, and the focus of this paper, is to provide standardized guidelines for the inclusion of simulation-based learning in psychology training in Australia both during and post-COVID 19. Such guidelines may be equally valuable for psychology training programs globally.

Pulmonary hypertension (PH) is a debilitating and potentially life threatening condition in which increased pressure in the pulmonary arteries may result from a variety of pathological processes. These can include disease primarily involving the pulmonary vasculature, but more commonly PH may result from left-sided heart disease, including valvular heart disease. Chronic thromboembolic pulmonary hypertension (CTEPH) is an important disease to identify because it may be amenable to surgical pulmonary artery endarterectomy or balloon pulmonary angioplasty. Parenchymal lung diseases are also widespread in the community. Any of these disease processes may result in adverse remodeling of the right ventricle and progressive right heart (RH) failure as a common final pathway. Because of the breadth of pathological processes which cause PH, multiple imaging modalities play vital roles in ensuring accurate diagnosis and classification, which will lead to application of the most appropriate therapy. Multimodality imaging may also provide important prognostic information and has a role in the assessment of response to therapies which ultimately dictate clinical outcomes. This review provides an overview of the wide variety of established imaging techniques currently in use, but also examines many of the novel imaging techniques which may be increasingly utilized in the future to guide comprehensive care of patients with PH.