Active deprescribing attitudes and practices in a large regional tertiary health service: a mixed methods study.

In this pilot study, we explored current attitudes and deprescribing practices of clinicians in a large regional health service through a mixed methods approach. Respondents included doctors, pharmacists and nurse practitioners, who outlined three themes including professional and organisational contexts, disconnect between goals and practices and factors influencing deprescribing.

Translating, Contexting, and Institutionalising Knowledge Translation Practices in Northern Australia: Some Reflections Comment on "Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis".

In this commentary, we reflect on how the three processes of , , and knowledge translation (KT) practices, as introduced in a critical interpretive synthesis on sustaining KT, might be drawn on to improve KT sustainability in the northern Australian health system, and some likely challenges. The synthesis provides a useful reminder that health systems are systems and offers an analytical framework against which to map approaches that aim to align knowledge production and utilisation. By positioning "places" of knowledge utilisation and actor roles and networks as key to KT sustainability, the framework also offers the potential to draw attention to non-clinical settings, actors, and relationships that are central to improving health, but that may be historically neglected in KT research and scholarship.

Democratising data to address health system inequities in Australia.

Understanding the health status of a population or community is crucial to equitable service planning. Among other uses, data on health status can help local and national planners and policy makers understand patterns and trends in current or emerging health and well-being, especially how disparities relating to geography, ethnicity, language and living with disability influence access to services. In this practice paper we draw attention to the nature of Australia's health data challenges and call for greater 'democratisation' of health data to address health system inequities.

Debilitating hip degeneration in trichothiodystrophy: Association with ERCC2/XPD mutations, osteosclerosis, osteopenia, coxa valga, contractures, and osteonecrosis.

Trichothiodystrophy (TTD) is a rare, autosomal recessive, multisystem disorder of DNA repair and transcription with developmental delay and abnormalities in brain, eye, skin, nervous, and musculoskeletal systems. We followed a cohort of 37 patients with TTD at the National Institutes of Health (NIH) from 2001 to 2019 with a median age at last observation of 12 years (range 2-36). Some children with TTD developed rapidly debilitating hip degeneration (DHD): a distinctive pattern of hip pain, inability to walk, and avascular necrosis on imaging.

The population health role of academic health centres: a multiple-case exploratory study in Australia and England.

Background: Academic health centres (AHCs) are organisations that aim to mobilise knowledge into practice by improving the responsiveness of health systems to emerging evidence. This study aims to explore the population health role of AHCs in Australia and England, where AHCs represent novel organisational forms.

Methods: A multiple-case study design using qualitative methods was used to explore population health goals and activities in four discrete AHCs in both countries during 2017 and 2018.

"We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research": A Research Impact Evaluation at a Regional Australian Hospital and Health Service.

Background: Research is central to high functioning health services alongside clinical care and health professional training. The impact of embedded research includes delivery of high-quality care and improved patient outcomes. Evaluations of research impact help health service leadership ensure investments lead to the greatest healthcare benefits for patients.

Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context.

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of 'Health for All'. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework.

Anorectal Melanoma Misdiagnosed as Hemorrhoids: A Case Report and Review of the Literature.

Anorectal melanoma is a rare and aggressive malignant neoplasm with an indolent course, manifesting with nonspecific symptoms and a poor prognosis. We present a case of anorectal melanoma that was initially treated as hemorrhoids and correctly diagnosed after lower gastrointestinal endoscopy. We also present the latest findings in the literature about anorectal melanomas and discuss updates about treatment options and management.

24-7 Dressing Technique to Optimize Wound Healing After Mohs Micrographic Surgery.

Postoperative wound care can be troublesome, time consuming, and expensive. Patients often are unable to personally take proper care of their wounds at home, leading to complications. We describe the use of a comfortable, effective, and simple technique for wound dressings after dermatologic surgery in patients who are vulnerable to wound complications.

Academic Health Science Centres as Vehicles for Knowledge Mobilisation in Australia? A Qualitative Study.

Background: Despite increasing investments in academic health science centres (AHSCs) in Australia and an expectation that they will serve as vehicles for knowledge translation and exchange, there is limited empirical evidence on whether and how they deliver impact. The aim of this study was to examine and compare the early development of four Australian AHSCs to explore how they are enacting their impact-focused role.

Methods: A descriptive qualitative methodology was employed across four AHSCs located in diverse health system settings in urban and regional locations across Australia.

Health service delivery and workforce in northern Australia: a scoping review.

Introduction: Delivering health services and improving health outcomes of the 1.3 million people residing in northern Australia, a region spanning 3 million km2 across the three jurisdictions of Western Australia, Northern Territory and Queensland, presents specific challenges. This review addresses a need for systems level analysis of the issues influencing the coverage, quality and responsiveness of health services across this region by examining the available published literature and identifying key policy-relevant gaps.

Evaluating research investment and impact at a regional Australian Hospital and Health Service: a programme theory and conceptual framework.

Background: Health systems in Australia and worldwide are increasingly expected to conduct research and quality improvement activities in addition to delivering clinical care and training health professionals. This study aims to inform a research impact evaluation at a regional Australian Hospital and Health Service by developing a programme theory showing how research investment is expected to have impact.

Methods: This qualitative study, representing the first phase of a larger mixed methods research impact evaluation at the Townsville Hospital and Health Service (THHS), adopts a realist-informed design involving the development of a programme theory.

"'Academic' is a dirty word": Intended impact pathways of an emerging academic health centre in tropical regional Australia.

Background: The Tropical Australian Academic Health Centre (TAAHC) is being established in northern Queensland across a vast rural geography. The study aim is to identify intended impact pathways and beneficiaries of TAAHC as well as experienced and anticipated challenges.

Methodology: The study is an empirical case study nested within a comparative multi-case study on academic health centres (AHCs).

"We are everything to everyone": a systematic review of factors influencing the accountability relationships of Aboriginal and Torres Strait Islander health workers (AHWs) in the Australian health system.

Background: Health policy in Australia positions Aboriginal and Torres Strait Islander Health Workers (AHWs) as central to improving Aboriginal and Torres Strait Islander peoples' health, with high expectations of their contribution to closing the gap between Indigenous and non-Indigenous health outcomes. Understanding how AHWs' governance and accountability relationships influence their ability to address such health inequities has policy, programme and ethical significance. We sought to map the evidence of AHWs' experiences of accountability in the Australian health system.

The role of academic health centres in improving health equity: a systematic review.

Purpose Academic health centres (AHCs) are organisations that pursue a "tripartite" mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity.

The role of academic health centres in building equitable health systems: a systematic review protocol.

Introduction: Academic health centres (AHCs) are complex organisations often defined by their 'tripartite' mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants. Reflective of this paradigm shift is a growing interest in the role of AHCs in addressing health disparities and improving health system equity.