Clinical Trial Protocol for VIOLET: A Single-Center, Phase I/II Trial Evaluation of Radioligand Treatment in Patients with Metastatic Castration-Resistant Prostate Cancer with [Tb]Tb-PSMA-I&T.

[Lu]Lu-PSMA is an effective class of therapy for patients with metastatic castration-resistant prostate cancer (mCRPC); however, progression is inevitable. The limited durability of response may be partially explained by the presence of micrometastatic deposits, which are energy-sheltered and receive low absorbed radiation with Lu due to the approximately 0.7-mm mean pathlength.

Combination Strategies and Targeted Radionuclide Therapies.

Combination models utilising treatments from two or more therapeutic classes are well established in cancer care. In the new era of theranostic (theragnostic) medicine there is an ongoing need to identify and refine novel combination strategies to optimise multidisciplinary care for conditions commonly encountered in nuclear medicine such as neuroendocrine neoplasms (NEN), prostate cancer (PCa), and thyroid cancer, along with seeking advancements in molecular imaging and therapy techniques for other tumour streams. This concise review explores the background of theranostic monotherapy, established approaches to combination strategies in theranostics, and emerging targeted radionuclide therapies in use or under active investigation, with a focus on Australian-led studies.

Quantitative calibration of Tb-161 SPECT/CT in view of personalised dosimetry assessment studies.

Background: Terbium-161 (Tb)-based radionuclide therapy poses an alternative to current Lutetium-177 (Lu) approaches with the additional benefit of secondary Auger and conversion electron emissions capable of delivering high doses of localised damage to micro-metastases including single cells. Quantitative single-photon emission computed tomography, paired with computed tomography (SPECT/CT), enables quantitative measurement from post-therapy imaging. In view of dosimetry extrapolations, a Tb-161 sensitivity SPECT/CT camera calibration was performed using a method previously validated for Lu.

The International Initiative to Measure Perceived Risk in Arthroplasty: The Results From a Multinational Survey.

Background: There is an inherent moral imperative to avoid complications from arthroplasty. Doing so at ideal cost is also associated with surgeon reputation, and, increasingly in health care delivery systems that measure and competitively score outcomes, reimbursement to the surgeons and their hospitals. As a result, patients who are perceived to be in higher risk comorbidity groups, such as the obese and diabetics, as well as those challenged by socioeconomic factors may face barriers to access elective arthroplasty.

Patient-Reported Outcomes in Total Ankle Arthroplasty: Patient Specific Versus Standard Instrumentation.

Background: Total ankle arthroplasty (TAA) can now be performed using patient-specific instrumentation (PSI). Advantages include the ability to preoperatively plan and reduce the number of intraoperative surgical steps. The aim of this study was to compare PSI with standard instrumentation (SI) in a nonrandomized retrospective cohort study with respect to patient-reported outcome measures (PROMs).

Can improvement in delivery of smoking cessation care be sustained in psychiatry inpatient settings through a system change intervention? An analysis of statewide administrative health data.

Objective: This study evaluated maintenance of improved delivery of smoking cessation assistance in adult acute psychiatry inpatient units 3 years post statewide implementation of a system change intervention through analysis of a statewide administrative health dataset.

Method: Rates of documenting smoking status and providing a brief smoking cessation intervention (the Smoking Cessation Clinical Pathway) in all eligible Queensland public adult acute psychiatry inpatient units ( = 57) during the implementation phase (October 2015-September 2017) of a system change intervention were compared to the maintenance phase (October 2017-October 2020) using interrupted time series analysis.

Results: Across implementation and maintenance phases, the percentage of discharges from psychiatry inpatient units that had a smoking status recorded remained high with the statewide average exceeding 90% (implementation phase 93.

AlphaBet: Combination of Radium-223 and [ Lu]Lu-PSMA-I&T in men with metastatic castration-resistant prostate cancer (clinical trial protocol).

Background: [Lu]Lu-PSMA is a radioligand therapy used in metastatic castration-resistant prostate cancer (mCRPC). Despite a survival benefit, the responses for many patients receiving [Lu]Lu-PSMA are not durable, and all patients eventually develop progressive disease. The bone marrow is the most common site of progression.

A prediction model for treatment decisions in distal radial physeal injuries: A multicenter retrospective study.

Background: There are no clearly defined guidelines for the management of distal radial physeal injuries. We aimed to identify the risk factors for patients with distal radial physeal trauma for the risk of deformity, physeal closure, and revision procedure and develop a predictive model.

Methods: The retrospective study included patients less than 16 years old with displaced distal radial physeal injuries treated between 2011 and 2018 across five centers in the United Kingdom.

Novel bone grafting technique in stand-alone ALIF procedure combining allograft and autograft ('Northumbria Technique')-Fusion rate and functional outcomes in 100 consecutive patients.

Introduction: Successful ALIF surgery depends upon achieving solid fusion, whilst avoiding significant complications. Herein, we present the 'Northumbria Technique' of combining allograft with autograft in order to achieve solid interbody fusion.

Materials And Methods: A single-surgeon series of 100 consecutive patients undergoing stand-alone ALIF from 2016 to 2019 was studied.

Electroconvulsive therapy, personal protective equipment and aerosol generating procedures: a review to guide practice during Coronavirus Disease 2019 (COVID-19) pandemic.

Objective: To review the literature on the definition of aerosol-generating procedures (AGPs), identify high-risk AGPs, guidelines to use personal protective equipment (PPE) and review evidence to see if electroconvulsive therapy (ECT) is a high-risk AGP requiring the use of PPE.

Methods: Existing guidelines and research data were reviewed to answer the questions.

Results: There is consensus about the type of anaesthesia used during ECT, what constitutes AGPs and what PPE should be used.

Queensland smoking care in adult acute mental health inpatient units: Supporting practice change.

Objective: To review a clinical practice improvement approach to statewide implementation of smoking care in adult acute mental health inpatient units across public mental health services in Queensland.

Method: Queensland public mental health services, with adult acute inpatient units, joined a statewide collaborative to work together to increase the routine screening of smoking and delivery of a Smoking Cessation Clinical Pathway brief intervention to identified smokers.

Results: Over a 2-year period, statewide improvements were demonstrated in the recording of smoking status (88-97%) and in the provision of a brief smoking cessation intervention to smokers (38-73%).

Revisiting the role of electroconvulsive therapy in schizophrenia: Where are we now?

Objective: The purpose of this opinion article is to review the recent evidence base in relation to the role of electroconvulsive therapy (ECT) in the management of patients with schizophrenia. Specifically, we explore the efficacy and safety of ECT. Furthermore, consideration is given to the profile of patients who benefit most from ECT, the role of maintenance ECT and what happens when ECT is not given.

Evidence of a Causal Relationship Between Smoking Tobacco and Schizophrenia Spectrum Disorders.

There has been emerging evidence of an association between tobacco smoking and schizophrenia spectrum disorders (SSD). Two meta-analyses have reported that people who smoke tobacco have an ~2-fold increased risk of incident schizophrenia or psychosis, even after adjusting for confounding factors. This study aimed to critically appraise the research which has examined the association between tobacco smoking and SSD against the Bradford Hill criteria for causality, to determine the strength of the evidence for a causal relationship.

Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice.

To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted.

Mental health services planning for G20 summit in Brisbane and assessment of impact.

Objective: The objective of this study was to inform planning for similar events, our aim was to describe planning undertaken by Brisbane Mental Health Services for the 2014 G20 Summit and the impact of the Summit on service use.

Methods: We analysed routinely collected service data comparing presentations and discharges for the same time period in two consecutive years.

Results: While presentations to mental health services increased from the previous year across a five-month period (including the month of G20), the week of the G20 Summit showed little change.

Way Forward: an Indigenous approach to well-being.

Objective: Aboriginal and Torres Strait Islander individuals are overrepresented in mental health services in the state of Queensland (QLD), Australia; indicating greater prevalence and less preventative management of mental illness. This paper describes a project to enhance the model of care to improve mental health, alcohol and other drug outcomes for Aboriginal and Torres Strait Islander Community members in two metropolitan Hospital and Health Services, in Brisbane, Australia.

Methods: Individual and focus group consultations were conducted with stakeholders, to determine key themes.

A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

Objective: The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland.

Method: Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service.

Results: Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%.

A model for managing the mentally ill fixated person at major events.

Objective: The main risk of serious harm at major public figure gatherings comes not from terrorists or criminal activity but from fixated persons, many of whom have a serious mental illness. This paper reviews a collaborative mental health-police diversionary model for assessing and managing mentally ill individuals who attend major events because of their fixation on a dignitary or some idiosyncratic cause.

Method: We examine the role of a multidisciplinary fixated threat assessment service during the pre-operational, operational and post-operational phases of major events in Queensland in 2014, including the G20 World Leaders' Summit.

Monitoring and management of metabolic abnormalities: mixed-method evaluation of a successful intervention.

Objective: To describe the process and impact of a service-level intervention on metabolic monitoring and follow-up of patients of a mental health service who were prescribed clozapine, and describe the metabolic health of these patients.

Methods: The intervention - Let's Get Physical - involved designating two months annually as 'physical health months', during which revised service protocol required metabolic monitoring for all eligible patients. Mixed methods were used to assess rates of monitoring at baseline, during the two physical health months, and follow-up and factors influencing practice.

Clinical Practice Improvement Payments: incentives for delivery of quality care.

Objective: In 2008, Queensland Health mental health services participated in a quality incentive payment scheme referred to as the Clinical Practice Improvement Payment. Services across the state engaged in local improvement projects with the collective aim of improving the number of consumers, diagnosed with schizophrenia, followed up within seven days post discharge. This paper describes the application of this approach over two and a half years.

Long acting risperidone in Australian patients with chronic schizophrenia: 24-month data from the e-STAR database.

Background: This observational study was designed to collect treatment outcomes data in patients using the electronic Schizophrenia Treatment Adherence Registry (e-STAR).

Methods: Patients with schizophrenia or schizoaffective disorder in Australia who were prescribed risperidone long-acting injection (RLAI) between 2003 and 2007 were assessed 12-months retrospectively, at baseline and 24-months prospectively at 3-monthly intervals. The intent-to-treat population, defined as all patients who received at least one dose of RLAI at baseline, was used for the efficacy and safety analyses.