Suboptimal care and inappropriate opioid use in chronic pain: A critical analysis of two case studies and healthcare expenditure burden.

Introduction: Chronic pain is a leading cause of chronic disease in Australia, with a 2020 report indicating that one in five Australians aged over 45 experience chronic pain. The high prevalence of chronic pain accounts for significant healthcare utilization and associated costs, with the economic impact of chronic pain estimated to be AUD$139 billion in 2018.

Case Presentations: This paper uses two exemplar cases to demonstrate inadequacies within the current systems supporting those with chronic pain and the associated impacts these inadequacies have on patient outcomes and healthcare costs.

Outcomes of procedures for abortions and early pregnancy loss among people with sickle cell disease: A single-center experience.

People with sickle cell disease (SCD) have an increased risk of pregnancy loss and severe maternal morbidity in pregnancy yet there is little data on the outcomes of abortions or pregnancy loss among these individuals. This retrospective review aimed to describe the clinical outcomes of procedurally managed abortions and early pregnancy losses among individuals with sickle cell disease at a single center. We identified 19 individuals with sickle cell disease who underwent 24 procedures for the management of abortion (n = 18) or pregnancy loss (n = 6) at our center from 2013 to 2022.

Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials.

Objective: We sought to develop consensus recommendations for measurement and analysis of data on contraceptive-induced menstrual changes (CIMCs) in contraceptive clinical trials. We built upon previous standardization efforts over the last 50 years and prioritized input from a variety of global experts and current regulatory authority guidance on patient-reported outcomes.

Study Design: We completed a formal consensus-building process with an interdisciplinary group of 57 experts from 30 organizations and 14 countries in five global regions who work across academia, nonprofit research organizations, the pharmaceutical industry, and funding agencies.

A technology-enabled collaborative learning model (Project ECHO) to upskill primary care providers in best practice pain care.

Background The South Australian (SA) Chronic Pain Extension for Community Healthcare Outcomes (ECHO) Network was established to upskill primary care providers in best practice pain care aligned to a patient-centred, biopsychosocial approach using didactic and case-based virtual mentoring sessions. The aims of this study were to assess: (a) participation, satisfaction (relevance, satisfaction with format and content, perceptions of the mentorship environment), learning (perceived knowledge gain, change in attitudes), competence (self-confidence) and performance (intention to change practice, perceived practice change) of the ECHO Network clinician participants; and (b) self-perceived barriers at the clinical, service and system level to applying the learnings. Methods A mixed methods, participatory evaluation approach was undertaken.

Bariatric surgeons' views on barriers and enablers to bariatric surgery in Australia and New Zealand: A qualitative content analysis.

Problem And Aims: Bariatric surgery can be an effective treatment for severe obesity, yet publicly-funded access is often limited. Bariatric surgeons contribute to decisions regarding consumer (non)progression to bariatric surgery. Still, little is known about their views on barriers and enablers to bariatric surgery in the Australian and New Zealand context.

A randomised double-blind trial to determine the bleeding profile of the prolonged-release contraceptive dienogest 2 mg/ethinylestradiol 0.02 mg versus an immediate-release formulation of drospirenone 3 mg/ethinylestradiol 0.02 mg.

Background: Dienogest (DNG) 2 mg/ethinylestradiol (EE) 0.02 mg is the first low-dose combined oral contraceptive (COC) with a prolonged-release formulation that allows stable plasma concentrations and has high contraceptive efficacy (Pearl index: 0.2).

A 3-year retrospective review of hospital admissions involving opioid toxicity in South Australia.

Introduction: This article aims to characterise hospital admissions involving opioid toxicity across South Australia to guide future implementation and evaluation of risk mitigation strategies.

Methods: International Classification of Diseases, 10th Edition codes (T40.0-T40.

Opportunities to optimise care and choice in joint replacement surgery using a digitally delivered, holistic PreHab pathway.

Purpose: To describe the implementation and evaluation of a hospital-initiated, community-based, digital prehabilitation program (: MPP for adults referred for elective joint replacement.

Methods: MPP was implemented July 2022 and comprises a personalised digital health screen that guides the provision of self-management resources. Adults (18 years) referred and accepted, or already waitlisted, for total knee/hip replacement surgery were eligible.

"Maybe if we weren't in the pandemic, I would have reconsidered": Experiences of abortion care-seeking during the COVID-19 pandemic in Maryland.

Objective: To understand the COVID-19 pandemic's impact on abortion care-seeking in Maryland, a state with Medicaid coverage for abortion, high service availability, and laws supporting abortion rights.

Methods: We conducted semi-structured telephone interviews with 15 women who had an abortion between January 2021 and March 2022 at a hospital-based clinic in a mid-sized Maryland city. We purposively recruited participants with varied pandemic financial impacts.

"It's different than a doctor saying 'You're making the right choice'": A qualitative study of chaplains' experience caring for patients undergoing abortion in Washington DC, Maryland, and Virginia.

Objectives: Health care chaplains are faith providers with theological education, pastoral experience, and clinical training who provide spiritual care to patients, their families, and medical staff. This study sought to characterize chaplains' experiences providing spiritual care for patients experiencing abortion and pregnancy loss and to explore how chaplains gain competency and comfort in providing pastoral care for this patient population.

Study Design: Researchers conducted in-depth, semistructured, qualitative interviews with currently-practicing chaplains recruited via convenience sampling in the Washington DC, Maryland, and Virginia region.

Factors associated with progression or non-progression to bariatric surgery in adults: A systematic review.

Access to bariatric surgery is limited, and the factors related to undergoing or not undergoing the procedure are poorly understood. To this end, a systematic review of PubMed, Embase, PsycINFO, and CINAHL was conducted to deduce the factors associated with progression or non-progression to bariatric surgery. Quantitative and qualitative English-language articles ranging in date from database conception to September 2023 were included.

Dialysis Needle-Related Distress: Patient Perspectives on Identification, Prevention, and Management.

Introduction: Needle-related distress is common among people receiving hemodialysis and affects quality of life and treatment decisions, yet little evidence exists to guide management. This study explored patients' experiences of needle-related distress to inform the development of prevention, identification, and management strategies.

Methods: Semistructured interviews concerning dialysis cannulation, needle-related distress, and potential solutions were conducted with people with current or recent experience of hemodialysis ( = 15) from a tertiary hospital-based service.

How Can Nurses Support Patients on Hemodialysis Who Experience Needle Fear? An Online Educational Intervention for Nephrology Nurses.

Nephrology nurses struggle to support patients on hemodialysis who experience needle fear due to absence of adequate programs or guidelines. Therefore, we have designed an educational intervention for nurses to learn techniques and strategies to support patients with needle fear and review best cannulation practices with minimal trauma to improve patients' experience of dialysis. A pre-post design measured self-reported confidence in nurses' ability to support patients on dialysis who have a fear of needles.

Development and evaluation of measures to assess self-determination in peripartum contraceptive decision-making.

Objectives: We aimed to adapt and validate person-centered measures to evaluate various contributors to self-determination in perinatal contraceptive decision-making.

Study Design: We developed and administered four scales adapted from existing measures in the context of Self-Determination Theory: the Treatment Self-Regulation Questionnaire (TSRQ), Perceived Competence Scale, modified Health Care Climate Questionnaire, and Important Other Climate Questionnaire. The TSRQ consists of three subscales: autonomous motivation, controlled motivation, and amotivation.

Nephrology nurses' perspectives working with patients experiencing needle-related distress.

Background: A key skill of nephrology nursing is cannulation of patients receiving haemodialysis. Traumatic and unsuccessful cannulation experiences, particularly in the initial weeks of haemodialysis, may contribute to the onset of needle distress for patients.

Objectives: To identify the key knowledge, skills and attitudes of nephrology nurses working with haemodialysis patients and the competencies relevant to nephrology nursing working with patients with needle-related distress.

Society of Family Planning Clinical Recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation: Jointly developed with the Society for Maternal-Fetal Medicine.

The objective of this Clinical Recommendation is to review relevant literature and provide evidence-based recommendations for medication abortion between 14 0/7 and 27 6/7 weeks of gestation, with a focus on mifepristone-misoprostol and misoprostol-only regimens. We systematically reviewed PubMed articles published between 2008 and 2022 and reviewed reference lists of included articles to identify additional publications. See Search Strategy for more details.

Society of Family Planning Clinical Recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation: Jointly developed with the Society for Maternal-Fetal Medicine.

The objective of this Clinical Recommendation is to review relevant literature and provide evidence-based recommendations for medication abortion between 14 0/7 and 27 6/7 weeks of gestation, with a focus on mifepristone-misoprostol and misoprostol-only regimens. We systematically reviewed PubMed articles published between 2008 and 2022 and reviewed reference lists of included articles to identify additional publications. See Search Strategy for more details.

Cervicovaginal mucus barrier properties during pregnancy are impacted by the vaginal microbiome.

Introduction: Mucus in the female reproductive tract acts as a barrier that traps and eliminates pathogens and foreign particles via steric and adhesive interactions. During pregnancy, mucus protects the uterine environment from ascension of pathogens and bacteria from the vagina into the uterus, a potential contributor to intrauterine inflammation and preterm birth. As recent work has demonstrated the benefit of vaginal drug delivery in treating women's health indications, we sought to define the barrier properties of human cervicovaginal mucus (CVM) during pregnancy to inform the design of vaginally delivered therapeutics during pregnancy.

Children's digital play as collective family resilience in the face of the pandemic.

In this article we explore how digital play as conducted through various social media and online meeting platforms facilitated resiliency and confidence building in children during the COVID-19 pandemic. Using day-in-the-life methodology and narrative inquiry, we disseminate and examine observations collected on children aged 2-10 during lockdown in a Newfoundland neighbourhood. Children utilized platforms such as TikTok, YouTube, and Zoom to embrace their agentic digital play in ways that repurposed the platforms to fulfil life milestones and social needs otherwise impacted and disrupted by pandemic restrictions.

An exploratory study of COVID-19-related changes in abortion service availability and use in Washington, DC, Maryland, and Virginia.

Objectives: This exploratory study aimed to assess COVID-19-related changes in abortion service availability and use in Washington, DC, Maryland, and Virginia.

Design: Data came from a convenience sample of eight abortion clinics in this region. We implemented a cross-sectional survey and collected retrospective aggregate monthly abortion data overall and by facility type, abortion type, and patient characteristics for March 2019-August 2020.

Lactobacillus-dominance and rapid stabilization of vaginal microbiota in combined oral contraceptive pill users examined through a longitudinal cohort study with frequent vaginal sampling over two years.

Background: Bacterial vaginosis (BV), a condition in which vaginal Lactobacillus spp. are in low abundance, is associated with vulvovaginal symptoms, obstetric outcomes and urogenital infections. Recurrent BV is difficult to manage, and emerging data indicate a reduced risk of BV with the use of hormonal contraception (HC).