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What are the diagnoses attributed to persistent hip pain after hip arthroplasty?:A systematic review
No full textBackground Persistent hip pain after total hip arthroplasty has been reported in up to 23 % of cases. Despite routine clinical tests, the source of pain often remains unclear, and diagnosis requires extensive investigation with imaging or surgical exploration. Aims This systematic review aimed to identify the diagnoses attributable to the painful hip arthroplasty. The second aim was to identify diagnostic techniques used to identify them. Method Three databases (Medline, Scopus and CINAHL) were searched from 2012 to 2024 using keywords and medical subject headings (MeSH) including ‘persistent pain AND hip arthroplasty AND diagnoses’. Quality assessment was undertaken with the Joanna Briggs Institute checklist for case-series. Data extraction was performed by one author using Covidence software and crosschecked by another for accuracy. Data included age, sex, arthroplasty type, diagnostic method, and confirmed diagnosis. Data was synthesised to provide a quantitative overview of diagnoses and diagnostic methods. PROSPERO number CRD42022340158. Results The search and reference screening returned 285 papers of which seven high quality and two unclear quality case-series met the inclusion criteria. There was a total of 388 painful hip arthroplasties included. Prostheses loosening or infection was present in 28.6 % of cases. Iliopsoas impingement was present in 21 % of cases. Causes outside the hip accounted for 16.4 % of cases with referred pain from the lumbar spine (14.6 %) most common. Greater trochanteric pain syndrome (GTPS) was present in 13 %. The painful etiology remained unknown in 9.2 % of participants. The most common diagnostic imaging technique was x-ray (100 %) followed by magnetic resonance imaging (22 %). Conclusion Prosthesis loosening and infection remain a significant cause of pain despite preliminary screening to exclude them. Iliopsoas impingement and causes outside the hip require significant consideration due to high prevalence. Less common differential diagnoses have been identified. X-ray is an important front-line imaging tool while other advanced imaging is used selectively to identify a diagnosis
Australian Cultural Policy Unravelled:The Digital Demise of National Television Drama
No full textThis book explores the impacts of digitisation and sector internationalisation on national drama production, and their consequences for industry, audiences, and domestic storytelling. Using Australia as a case study, it provides a systematic evaluation of the efficacy of cultural policy intended to support the production and circulation of national drama from 2001-23.During the first two decades of the 21st century, new digital distribution technologies transformed the business of television worldwide, bringing conditions of abundance that ended mass media logics grounded in scarcity of content and providers. In doing so digitisation upended longstanding norms around the funding, production, and circulation of national television drama. In this period, the conditions for which cultural policy was first created changed radically due to digital distribution and sector internationalisation. This book’s analyses of the responses of policy makers, broadcasters, production companies and screen agencies to television’s distribution revolution evaluates their collective impacts on Australian television drama. It explains how 21st century dynamics undermined cultural policy supporting the production of Australian drama with cultural value, leading to a catastrophic fall in hours made. This book argues that the scale of disruption digitisation causes to television in the transnational and national space requires a bold re-imagining of cultural policy instruments intended to support Australian drama.This account will be of interest to screen industry practitioners, policy makers and scholars, and, more generally, to anyone wondering whatever happened to Australian drama
Comparative Analysis of Indoor Air Quality and Health Risk Assessment in Academic Workspaces in India and Australia
No full textIndoor air quality (IAQ) in workplaces significantly impacts occupational health and productivity, necessitating comparative evaluations across diverse environments. This study investigates particulate matter (PM) concentrations in indoor academic workspaces in Chennai, India, and Canberra, Australia, using the GRIMM 11D aerosol spectrometer. A 12-hour monitoring campaign was done in IIT Madras, India, and ANU, Australia for 3 days during the post-winter (Spring) season. It measured the PM1, PM2.5, PM4, and PM10 levels in the indoor workspaces offering insights into PM concentrations.The average PM concentrations in Chennai were significantly higher than in Canberra. Indian workplaces recorded PM1, PM2.5, PM4, and PM10 levels of 4.03±1.09, 8.28±2.15, 12.36±4.26, and 15.83±6.43 (µg/m³), respectively. Corresponding Australian values were notably lower, at 1.53±0.47, 2.82±1.02, 3.52±1.69, and 4.14±2.72 (µg/m³), respectively. Spikes in PM10 levels in both regions suggest occasional localized pollution events or episodic pollutant intrusions, influencing PM concentrations. Additionally, the fine PM fractions (PM1 and PM2.5) were more prominent in Canberra, indicating potential variations in pollutant sources and infiltration rates.Health risk assessments were performed by simulating lung deposition dosages for males and females using the ‘Symmetric Lung’ configuration within the Multiple Path Dosimetry Model (MPPD). The model revealed stark contrasts in PM lung deposition doses between the two regions, with Indian workplaces presenting significantly higher health risks. In Chennai, male dosages for PM1, PM2.5, PM4, and PM10 were 4.23, 22.16, 38.98, and 56.41 µg, respectively, while females experienced slightly lower dosages of 2.79, 12.99, 23.33, and 34.70 µg. In Canberra, the respective values for males were 1.61, 5.80, 9.14, and 12.33 µg, and for females, 1.05, 3.40, 5.41, and 7.46 µg. These findings highlight a significantly higher health risk for workers in Chennai, with females in both locations receiving lower doses due to smaller lung capacities and breathing rates.This pilot study brings out substantial regional differences in IAQ, shaped by environmental factors, building ventilation standards, and external pollutant sources and infiltration rates. Elevated PM concentrations in Chennai signal a pressing need for interventions to enhance workplace air quality, such as improved filtration and ventilation systems and awareness campaigns. Meanwhile, the finer PM fraction in Canberra warrants attention due to its deeper penetration into the respiratory tract and long-term health implications.Further research should address long-term exposure risks, seasonal variability, and effective mitigation strategies to improve IAQ and safeguard academic workforce health in diverse geographical settings
Reducing pathology testing in emergency departments:A scoping review
No full textBACKGROUND: Pathology testing in emergency departments (EDs) is often unnecessary, leading to avoidable financial and environmental costs without improving clinical care. This overview summarises interventions to reduce pathology testing in EDs, their effectiveness, and any resulting financial, environmental, patient, or staff impacts.METHODS: We searched multiple databases up to February 2025 and conducted citation searches. Eligible studies included intervention and aetiological observational studies of pathology tests in EDs. Secondary studies and conference abstracts were excluded.RESULTS: Of 1,755 records, 34 studies met inclusion criteria: 32 quality improvement studies, one cohort study, and one randomised controlled trial. Interventions included ordering system changes, education, audit & feedback, guideline development, penalties, and alternative care models. Significant reductions ranging from 1.5% to 99% (median: 29%) in targeted pathology tests were reported in 33 of 34 studies. All 25 studies reporting financial impacts found cost reductions, with potential savings up to AUS247,000 per year for nine studies reporting annual savings in US$). No adverse patient or staff impacts were found. No studies reported on environmental impacts.CONCLUSION: Nearly all interventions reduced test frequency with beneficial or no impacts on patient care and staff efficiency, along with notable cost savings. Future studies should include environmental impacts and assess clinical care co-benefits of reducing unnecessary pathology testing.</p
Food, nutrition and dining information on residential aged care facility websites:A website analysis
No full textObjective: High-quality food, nutrition and dining are essential tenets of residential aged care facilities (RACF). Residential aged care facilities provide website information on their services for prospective residents, which may offer insight into food, nutrition and dining practices. This study aimed to describe the food, nutrition and dining information on RACF websites. Methods: A cross-sectional website analysis was conducted on Southeast Queensland (SEQ) RACF websites. Food, nutrition and dining data were extracted verbatim under domains of nutrition care processes, food and menu planning, eating assistance and mealtime experiences, with further subdomains under each. Quantitative content analysis was conducted to describe the information reported on websites, descriptive statistics were used to describe RACF characteristics, and Pearsons χ2 analyses were performed to detect associations between different food, nutrition and dining practices and RACF characteristics. Results: A total of 268 websites were reviewed. Food, nutrition and dining information were limited, with no subdomains mentioned by all websites. The most frequently mentioned subdomains were the foodservice model (64%, n = 171), allied health services (72%, n = 173) and communal dining (73%, n = 193). Assistive/adaptive equipment to support independence (0%, n = 0), personalised nutrition care plan (0%, n = 1) and reference to food, nutrition or food safety standards (2%, n = 5) were the least mentioned subdomains. Facility characteristics had minimal associations with subdomains. Conclusions: There are opportunities for RACF to improve the information on food, nutrition and dining information on websites to increase transparency to future residents. The subdomains developed in this study could provide guidance to RACF to enhance online information.</p
Constructing a Typology of Learner Archetypes: Insights from Health Professionals’ Lived Experiences of Learning Genomics in the Workplace:Typology of Learner Archetypes
No full textInnovations, including genomics, will reshape the healthcare workforce’s practice. Workplace learning, fundamental in healthcare professional education and training, plays an important role in healthcare implementation and workforce preparedness. However, no empirical research has explored genomic workplace learning experiences. To address this gap, we explored doctors’ lived experiences and attitudes toward learning genomics in the workplace. Doctors working in hospitals in Victoria, Australia with access to clinical genetics were invited to participate in this longitudinal phenomenological study. After confirming eligibility, ten doctors representing a range of specialties, career stages, workplaces, and genomic experiences completed longitudinal semi-structured interviews and submitted monthly reflective narratives on genomic workplace learning experiences. Participant datasets were collected over five to thirteen months. We applied narrative analysis to construct a learner 'archetype' from each participant’s dataset. Deductive content analysis was then conducted to sort and synthesize the archetypes into a typology. Each participantreported unique genomic workplace learning experiences, primarily shaped bytheir work context. From each participant's dataset, we constructed ten meta-stories and ‘Archetypes’, capturing the essence of their lived experience. We then synthesized the Archetypes into four learner attitude groups, constructing the Typology of Genomic Learner Archetypes. Work contexts shape genomic workplace learning experiences and attitudes.This is the first empirical research demonstrating the utility of workplace learning as a pragmatic theory for innovation implementation. Constructed from lived experience data, the Genomic Learner Archetypes and Typology can inform and ensure interventions and supports are appropriately tailored to holistically address the workforce’s learning and work needs
Impact of COVID-19 on the psychological well-being of healthcare workers in India: A systematic review and meta-analysis.
Get PDFThis review aimed to synthesize the impact of COVID-19 on healthcare workers (HCWs) psychological well-being in India. During the COVID-19 pandemic, HCWs internationally experienced significant negative psychological impacts. India has been particularly affected due to its limited resources, health workforce challenges, and financial constraints. Learning from the impacts of COVID-19 is important to promote strategies to support the healthcare workforce in future pandemics. A systematic review and meta-analysis were undertaken. Papers were identified from a systematic search of electronic databases from January 2020 to June 2022. Papers were included if they were published in the English language and reported the psychological well-being of HCWs in India during the COVID-19 pandemic. Of the 20 papers included in the review, 19 described cross-sectional studies and one study used mixed methods. The overall prevalence of anxiety among all HCWs was 35.8% (95% confidence interval [CI] 23.2%, 49.4%). Interestingly, the subgroup analysis reported the prevalence of anxiety among other HCWs (27%) rather than doctors (26.8%) or nurses (29.2%). The prevalence of depression among all HCWs was 35.1% (95% CI 23.4%, 47.8%). Subgroup analysis demonstrated that the prevalence of depression was highest among other HCWs (40.3%) compared to nurses (32.8%) and doctors (26.9%). The prevalence of stress among all HCWs was 71.5% (95% CI 48.5%, 89.8%). A subgroup analysis demonstrated that the prevalence of stress was highest among doctors (70.9%), followed by other HCWs (52.3%) and lowest among nurses (38.8%). Based on the meta-analysis of all the articles included, there was a significant positive correlation between the prevalence of anxiety, depression, and stress with age, gender, and marital status. This systematic review demonstrates the significant pandemic impacts on the psychological well-being of HCWs in India. Understanding the differences in psychological impacts between different HCWs and associated demographic factors is important in informing interventions for future pandemic management. Providing evidence-based, comprehensive support for HCWs is crucial to safeguard their psychological well-being and promote workforce capacity during pandemic conditions
Development and validation of a questionnaire to assess quality of life in Australian adults with type 1 diabetes:a pilot psychometric study
No full textThe burdensome nature of managing type 1 diabetes (T1D) can influence psychological well-being and reduce quality of life (QoL). This pilot study aims to develop and validate a new questionnaire identifying factors impacting the QoL of Australian adults with T1D. Questionnaire development included literature review, pre-testing, semi-structured interviews, expert evaluation, and pilot testing. Questionnaire validation involved an exploratory factor analysis (EFA) to identify the initial factor structure. Confirmatory factor analysis (CFA) determined domain validity. Further statistical analysis included convergent, relative, predictive validity, and reliability. The initial questionnaire had 28-items relating to physical, psychological, social, and dietary well-being. CFA revealed ‘psychological’ and ‘social’ items underpinned the four questionnaire domains. The four domains identified were: (1) ‘Coping and Adjusting’ (4-items), (2) ‘Fear and Worry’ (4-items), (3) ‘Loss and Grief’ (3-items), and (4) ‘Social Impact’ (4-items). Significant correlations were revealed between ‘Coping and Adjusting’ and HbA1c (rs = − 0.44, p < 0.01) and ‘Social Impact’ and HbA1c (rs = 0.13, p < 0.01) respectively. Acceptable convergent validity and reliability (test–retest, internal consistency) was observed in all domains. Our study concludes that dietary well-being does not independently impact QoL but is interwoven with psychological factors.</p
Inspiratory muscle training for people with Parkinson's disease:A protocol for a mixed methods randomised controlled trial
Get PDFIntroduction Inspiratory muscle weakness is a known consequence of Parkinson's disease and could be a potential contributor to the dyspnoea experienced by many people living with the condition. Inspiratory muscle training is effective in improving inspiratory muscle strength and reducing dyspnoea in other chronic diseases. However, inspiratory muscle training has received little attention in people with Parkinson's disease, and it is unclear how this training affects inspiratory muscle strength, dyspnoea and quality of life. Methods and analysis This mixed methods, randomised controlled trial will recruit 50 participants with idiopathic Parkinson's disease who will be randomly allocated to either the experimental group, for 8 weeks, or the control group. Inspiratory muscle strength (maximum inspiratory pressure) will be the primary outcome. The secondary outcomes include motor experience of daily living (Movement Disorder Society-Unified Parkinson's Disease Rating Scale part II), rate of perceived exertion (modified Borg Scale), exercise capacity (6-minute walk test) and quality of life (39-item Parkinson's Disease Questionnaire). Quantitative data will be analysed using descriptive statistics. Semi-structured interviews will be conducted with participants who underwent inspiratory muscle training. Inductive reflexive thematic analysis will be used to explore the participants' experiences of inspiratory muscle training and its impact on dyspnoea, activities of daily living and overall quality of life.</p
Widening access to medicine: A realist review Journal: Medical Education
Get PDFWhile medical school selection research has largely focused on the validity of tools and processes, less attention has been paid to the quality and impact of widening access (WA) pathways. Existing studies are often limited in scope, focusing on single institutions or interventions. This study aimed to develop transferable insights into WA selection practices through a realist evaluation across four Australian medical schools.MethodsBuilding on a prior realist review, we employed the RAMSES II protocol to explore how contextual factors and mechanisms interact to influence WA outcomes through case studies at four medical schools. Data collection included institutional document and website reviews, semi-structured interviews and focus groups with 41 staff and 17 first-year students. The evaluation framework examined Context (diversity within sociocultural settings), Interventions (targeted pathways, adjusted selection scores), Mechanisms (institutional, dispositional, situational), and Outcomes (applicant diversity, selection success).ResultsTwo key interventions were identified as successful across all sites: (1) targeted pathways with selection score adjustments for under-represented groups (e.g., Indigenous, rural, low socio-economic backgrounds), and (2) sustained partnerships with these communities to raise awareness of medicine as a viable career. These partnerships aimed to enhance applicants’ dispositions and readiness for selection.DiscussionThe resulting programme theory identified five main mechanisms underpinning effective WA: visionary leadership, Indigenous cultural safety, longitudinal relational engagement, tailored applicant support, and preparation for selection processes. While demographic shifts, particularly in rural and Indigenous representation, were observed over a 12-year period, the scope of WA remains narrow. Structural changes within institutions pose significant risks to the sustainability of these efforts. ConclusionWe argue for a national, coordinated approach to WA in medical education, underpinned by long-term investment, robust evaluation, and a broader conceptualisation of equity in access. WA must be embedded as a core institutional commitment rather than a peripheral initiative. <br/