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Implicit doping attitude and athletes' accuracy in avoiding unintentional doping when being offered beverages with banned performance-enhancing substances
Get PDFObjectives
Implicit doping attitude reflects the strength of one's automatic or unconscious evaluation of doping. This cross-societal study examined how implicit doping attitude predicted athletes' accuracy in avoiding unintentional doping.
Design
A real-time experimental design with cross-sectional data from three geographical regions.
Methods
A total of 681 athletes (Mage = 28.21, SD = 8.43; female = 47.1 %) from Hong Kong (N = 177), Australia (N = 164) and the United Kingdom (N = 340) completed two real-time experimental tasks for measuring their implicit doping attitude (a brief single-category implicit association test) and the accuracy of avoiding unintentional doping (a novel canned beverage sorting task).
Results
Implicit doping attitude was significantly and negatively (β = − 0.09, p < .05, R2 = 0.03, 95 % CI of β = − 1.64 to − 0.15) associated with athletes' accuracy in avoiding unintentional doping by screening out beverages with banned performance-enhancing substances. This association was maintained when we statistically controlled for the effects of society.
Conclusions
Athletes with a positive implicit doping attitude were less accurate in determining whether unknown beverages with the possible presence of banned performance-enhancing substances should be consumed. The negative association between implicit doping and athletes' accuracy in avoiding unintentional doping appeared to be consistent across societies.Full Tex
Central venous access device management for children undergoing treatment for blood disorders and cancer: a descriptive international cross-sectional survey
Get PDFPurpose
This study aimed to explore current central vascular access device (CVAD) management practices in pediatric cancer care globally and compare practices across high-income and middle-income (i.e., upper middle-income and lower middle-income) countries.
Methods
A descriptive cross-sectional international survey was conducted between May 2022 and December 2023. Clinicians involved in CVAD insertion/management for pediatric cancer patients were invited to participate through established clinical networks globally. The survey covered CVAD management practices, including dressings, securements, routine care, and maintenance procedures.
Results
A total of 220 responses from 42 countries were received. Polyurethane dressings were most commonly used across all CVAD types (55–65/34.2–40.4). Bordered dressings were the primary securement method for all CVAD types (69–96/161, 42.9–59.6%). Routine practices varied, with 31/102 (30.4%) assessing CVADs hourly during infusion in high-income countries and 22 (37.3%) assessing every shift in middle-income countries. Heparin and normal saline were the commonly used solutions for flushing and locking. Chlorhexidine 2% in 70% alcohol was the predominant decontamination solution in high-income countries (64/102, 62.8%), while alcohol was more common in middle-income countries (22/59, 37.3%). Differences were observed between high-income and middle-income countries in the types of dressings, securements, and maintenance practices used.
Conclusion
This study revealed significant variability in CVAD management practices for pediatric cancer care globally, particularly between high-income and middle-income countries. These findings highlight the need for standardized, evidence-based guidelines considering resource availability and contextual factors to improve CVAD management in pediatric oncology across diverse healthcare settings.Full Tex
Defining Gaps in the Management of Familial Hypercholesterolaemia Using Electronic Health Records in Rural General Practice
Get PDFFamilial hypercholesterolaemia (FH) affects around 1:250 of the general population and, if untreated, results in premature cardiovascular disease (CVD) due to elevated levels of low-density lipoprotein cholesterol (LDL-C) [1].
Only 10% of FH patients are diagnosed, with the majority undertreated, resulting in poor achievement of target LDL-C levels [1]. Most Australian general practices have around 50–100 FH patients, the majority of whom can be detected using electronic health records (EHR) [2,3]. In a previous study of rural patients with severe hypercholesterolaemia, we found 2% of 17,612 patients had cholesterol levels >7.5 mmol/L and were likely to have FH [4].
Greater gaps in management of CVD risk factors occur in rural and remote compared with metropolitan areas [5]. Our aim was to investigate the management of FH in rural general practice as part of the Advanced Studies projects of third-year medical students during their rural attachments in the Flinders Rural Health SA program of Flinders University Medical School, SA, Australia.Full Tex
Multilevel structure fusion for community detection in heterogeneous graphs via disrupting heterophily
No full textExisting community detection methods of heterogeneous graphs focus on homophilous heterogeneous graphs, which generally use GNNs and HGNNs. In heterogeneous graphs with heterophily, the two nodes connected by metapaths often have different labels, and existing methods result in representation collapse among nodes from different communities. To address the challenges posed by structural heterophily and to enhance the strength of homophily, an unsupervised community detection method with multilevel structure fusion oriented by homophily, called SFCDH, is proposed. This method demonstrates a strong generalization capabilities across various homophilous and heterophilous heterogeneous graphs. Specifically, SFCDH consists of two modules named hierarchical structure fusion module based on homophily ratio sampling and the unsupervised graph representation learning module based on generative and contrastive learning. The first module constructs a fine-grained high-order fusion graph based on the network homophily and divides the community into multi-granularity via a hierarchical abstraction tree to improve the generalization ability of the model to different metapath subgraphs. Subsequently, the second module uses contrastive loss based on community prototypes to guide the graph in generating dynamic masks and enhances the ability of SFCDH to learn attributes and complex semantics by using graph autoencoder. Ultimately, node embeddings at the metapath level and the tree level are combined to achieve multilevel structural fusion for unsupervised community detection. Extensive experiments on six publicly available datasets demonstrate the superiority of SFCDH over state-of-the-art baselines. Notably, in the heterophilous heterogeneous graph IMDB, SFCDH outperforms the second-place model by 11% in accuracy, which further validating its effectiveness.No Full Tex
Sharing information about infectious diseases with disability group home communities
Get PDFInfectious disease outbreaks pose significant health risks and can exacerbate social inequalities for people with intellectual disabilities who live in group homes. Providing accessible information to these communities is crucial for managing these risks. This study, conducted during the COVID-19 pandemic in Australia (2021–2022) aimed to: (1) identify communication priorities for group home residents with intellectual disabilities during an infectious disease outbreak, and (2) develop a comprehensive, scalable strategy for effective communication during future outbreaks. The study employed a mixed-methods approach, including a scoping review of policies and academic literature; interviews with 6 group home residents, 10 support workers, and 2 disability accommodation managers; and observations in 2 group homes. Data were analysed collaboratively with project advisors, including disability sector representatives and community advocates. Additionally, a small e-Delphi study (n = 8) produced consensus recommendations for future practice. The research resulted in 19 best-practice guidelines to ensure inclusive and effective communication about infectious diseases in group home settings. Key drivers of success included capacity for accessible communication and supported decision-making, relevant policies, workload and workforce considerations, effective collaboration, accountability, and quality assurance. People with intellectual disability who live in a group home have the right to be informed during infectious disease outbreaks and to exercise autonomy based on that information. Systemic changes and meaningful engagement with all stakeholders will be essential for more effective and inclusive health communication during future outbreak events.Full Tex
Caffeine Consumption, Psychological Distress, and Insomnia in a Cohort of Individuals with Depression
No full textINTRODUCTION: Caffeine is a widely consumed psychoactive compound that can cause anxiety and sleep difficulties, in part due to genetic variation. We investigated the association between caffeine consumption, psychological distress, and sleep difficulties in a genetically informative cohort of individuals with a history of depression. METHODS: Survey data and genetic information were sourced from the Australian Genetics of Depression Study (AGDS [n = 20,689, %female = 75%, mean age = 43 ± 15 years]). Associations between caffeine consumption and symptoms of distress and sleep disturbance, as well as 9 genetic variants associated with caffeine consumption behaviour, were assessed using linear regression. RESULTS: The highest consumers of caffeine reported higher psychological distress measured by the Kessler 10 scale (β = 1.21, SE = 0.25, p = 1.4 × 10-6) compared to the lowest consumers. Consumption was associated with 2 genetic variants with effect sizes ∼0.35 additional caffeinated drinks/day between opposite homozygotes (p < 0.005). A deletion near MMS22L/POU3F2 was associated with 10% increased odds of reporting caffeine susceptibility (OR = 1.1 per deletion [95% CI: 1.04-1.17], p = 0.002). CONCLUSIONS: Higher rates of caffeine consumption were associated with higher levels of psychological distress, but not insomnia, in individuals with a history of depression. While the direction of causality is unclear, caffeine consumption may be a modifiable factor to reduce distress in individuals susceptible to mental health problems. Some of the previous findings of common variant associations with caffeine consumption and susceptibility were replicated.No Full Tex
A review of NovoSorb Biodegradable Temporising Matrix use over a 12-month period, with a focus on reconstructive salvage after free flap failure illustrated by a short case series
No full textWe present a retrospective, cross-sectional review of 12 patients who underwent surgical reconstruction with NovoSorb® Biodegradable Temporising Matrix (BTM) over 1 year for trauma, cancer resection, necrotising fasciitis and chronic wounds. We report an overall success rate of BTM in 83% of cases. Three key cases are described in detail to show how BTM was successfully used as a means of reconstructive salvage after total or partial free flap failures for circumferential soft tissue defects that might otherwise have required a second free flap or limb amputation. The indications for BTM in non-burns wound closure are growing and our experience demonstrates it can provide a reliable 'salvage' reconstruction where traditional free flaps have failed and further tissue transfer is judged to have a poor risk-benefit ratio. We highlight BTM as an increasingly versatile tool in the armamentarium of reconstructive surgeons faced with challenging wounds including in the failed free flap setting and encourage further research on these advanced applications.No Full Tex
Decent work for those with episodic disability: a long road to inclusion?
No full textThis chapter examines how and why those with episodic disability often lack decent work. It, therefore, fills an important gap given that the subject of disability and employment can tend to be sidelined in business and management journals. Episodic disability is a topical issue since many workers are dealing with the fluctuating symptoms and stigma associated with Long-COVID and facing the uncertainty that is similarly experienced by workers with myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), inflammatory bowel disease (IBD), HIV, or gynaecological and mental health conditions. Episodic disability can cause significant challenges to disabled workers as well as their line managers, trade union representatives, and colleagues. A better understanding of this topic might help to promote equal opportunities and outcomes, diversity management, and inclusion.No Full Tex
Artificial intelligence in forensic pathology: an Australian and New Zealand perspective
No full textArtificial intelligence application has gained popularity in the last decade. Its application is implemented into multiple industries including the health sector; however, discipline-specific artificial intelligence applications are not widely integrated into the day to day practice of forensic pathology in Australia and New Zealand. This article gives a brief overview of the medical school education, forensic pathology training and service and provides the authors views on the current state, potential applications, challenges and future direction in integrating artificial intelligence into forensic pathology in Australia and New Zealand for the Central European community.Full Tex
A Randomized Controlled Trial of Video-Assisted Electronic Consent Versus Standard Consent for Percutaneous Kidney Biopsy
No full textBackground:
Informed consent is crucial in healthcare, as it respects and honors patient autonomy. However, the process of consenting a patient to a procedure or intervention is often unstandardized, leading to gaps in comprehension, which in turn affects decision-making. This study aimed to assess the patient-reported benefits of video-assisted electronic consent (eConsent) compared with the usual consent practices for percutaneous kidney biopsies (PKB).
Methods:
In this single-center, open-label, randomized controlled trial, consecutive patients undergoing PKB between July 2021 and January 2024 were randomized (1:1) to either video-assisted eConsent (intervention) or usual practice of consent (control). The intervention group accessed an eight-minute explanatory animation on an online platform covering the procedure, its risks, and pre- and post-biopsy care before providing digital consent. The control group was consented to by clinicians in the usual manner and signed a paper form. The primary outcome was questionnaire-based patient comprehension, with secondary outcomes including patient-reported experience, anxiety, and satisfaction with the consent process.
Results:
Of 178 eligible patients, 120 were enrolled (60 in each group), with a median age of 52 (IQR 34-65) years, 56% were female, and 59% had less than 12 years of education. Comprehension scores were significantly higher in the eConsent group, with participants answering on average three more questions correctly out of nine compared to the control group (p<0.001). Comprehension did not differ significantly by sex or education level, but younger patients scored higher. The eConsent group also had better comprehension of pre- and post-PKB care. No significant differences were observed in patient-reported experience, anxiety, or satisfaction between groups.
Conclusions:
Video-assisted eConsent improves patient comprehension of PKB compared to usual consent practice without affecting patient experience, anxiety, or satisfaction.
Trial Registration:
Australian New Zealand Clinical Trials Registry (ACTRN12621000768897).Full Tex