Diagnostic testing in psychiatry: insights and examples from a Bayesian perspective.

Objective: To demonstrate the application of Bayes' theorem to diagnostic testing in clinical settings, especially with respect to rare diseases, enhancing an understanding of pre-test probability and its implications.

Conclusion: Bayes' theorem enables the revision of the conditional probabilities of an event occurring when new information is acquired. It demonstrates that when the prevalence of a disease is very low, there are a high number of false positives, thereby reducing the clinical utility and cost benefit profile of the diagnostic test, even in the presence of relatively high sensitivities and specificities of the chosen test.

Medicare-reimbursed psychiatric consultations before and after telehealth expansion in Australia: a time series study.

Objective Telepsychiatry consultations grew rapidly with increased total consultations and reduced face-to-face consultations following the pandemic-triggered expansion of Medicare Benefits Schedule (MBS) telehealth items. It was unclear how much telehealth expansion independently impacted overall and face-to-face consultation trends after accounting for lockdown severity. Methods We extracted monthly MBS Item Reports for psychiatric consultations (January 2012-December 2023).

Workplace bullying of psychiatric trainees: systematic review.

Aims And Method: We aimed to systematically review primary studies exploring workplace bullying of psychiatric trainees, including rates, forms of bullying, perpetrators and help-seeking. We searched Ovid MEDLINE, PubMed, CINAHL, PsycINFO and Embase using PRISMA guidelines. The inclusion criterion was primary research papers surveying or interviewing psychiatry trainees with respect to perceived workplace bullying by staff members.

Rivaroxaban, in combination with low-dose aspirin, is associated with a reduction in proinflammatory and prothrombotic circulating vesicle signatures in patients with cardiovascular disease.

Background: Despite secondary prevention with aspirin, patients with stable cardiovascular disease (CVD) remain at elevated long-term risk of major adverse cardiovascular events. The Cardiovascular Outcomes in People Using Anticoagulant Strategies (COMPASS) double-blind, randomized clinical trial demonstrated that aspirin plus low-dose rivaroxaban (COMPASS regime) significantly decreased the incidence of major adverse cardiovascular events by 24% compared with aspirin alone. However, the mechanisms underlying these potential synergistic/nonantithrombotic effects remain elusive.

Cybersecurity lessons from the Vastaamo psychotherapy data breach for psychiatrists and other mental healthcare providers.

Objective: The Vastaamo psychotherapy data breach in Finland is perhaps the largest cybersecurity incident in mental healthcare to date, resulting in significant patient harm. There are specific lessons for mental healthcare providers from an analysis of the incident.

Method: Case study of this specific electronic health record data breach, based on detailed media reporting.

Cluster-doping in silicon nanocrystals.

Creating tin-alloyed silicon nanocrystals with tailored bandgap values is a significant challenge, primarily because a substantial concentration of tin is essential to observe useful changes in the electronic structure. However, high concentration of Sn leads to instability of the silicon-tin nanocrystals. This work introduces a completely new approach to doping and the modification of the electronic structure of nanoparticles by incorporating few-atom clusters in nanocrystals, deviating from isolated atom doping or attempting alloying.

Psychosocial workplace safety in mental health services - Commentary and considerations to improve safety.

Objectives: Psychosocially unsafe workplaces are related to burnout, especially amongst trainees and psychiatrists. Burgeoning research on psychosocial workplace safety indicates the importance of organisational governance to reduce adverse professional, and consequently patient, outcomes in healthcare by balancing job demands and resources. We provide a brief commentary on the relevance of the concept of the Psychosocial Safety Climate model for mental health services and healthcare workers, and considerations for action.

Deprescribing antidepressants for depression - what is the evidence for and against?

Objective: Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view.

Methods: We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression.

Bullying within specialist medical training in Australia: Analysis of the medical training survey, 2020-2023.

Objective: Bullying is common in medical specialist training in Australia. To understand bullying rates across medical specialist training programs, we analyse the recent Medical Training Survey, administered by the Medical Board of Australia to all registered medical practitioners.

Methods: Medical Training Survey data were extracted and averaged from 2020 to 2023.

Comparing the trends of MBS telepsychiatry and consultant physician telehealth services from 2017 to 2022: A retrospective study.

Objective: The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation.

Methods: Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports.

The RANZCP Workforce Report: Action is needed, now.

Objective: The RANZCP conducted an anonymous survey of 7200 members (trainees and psychiatrists) in December 2023, receiving 1269 responses, representing the views of roughly 1 in 6 members, and of the respondents, three quarters reported experiencing burnout in the last 3 years. We provide a commentary, citing evidence from relevant previous research, discussing the implications and proposing potential interventions.

Conclusions: Members of the RANZCP reported worsening workforce shortages, with 9 in 10 respondents stating that these negatively impacted patient care, and 7 in 10 experiencing symptoms of burnout.

Questionable evidence and argumentation regarding alleged misuse of Medicare.

What is known about this topic? We discuss a recently published paper that alleges clinicians are causal agents of non-compliant billing of Medicare. What does this paper add? The paper's arguments are partially supported by unreferenced assertions, potential logical fallacies, inaccurate reporting of referenced material and unsubstantiated rhetoric. What are the implications for practitioners? Due to the lack of substantive evidence, it cannot be concluded that clinicians are the causal agents of non-compliant billing of Medicare.

Rivastigmine for treatment-refractory posttraumatic stress disorder: a systematic review.

We conducted a systematic review evaluating the efficacy of rivastigmine augmentation for treatment-refractory posttraumatic stress disorder (PTSD). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The databases Ovid MEDLINE, PubMed, CINAHL, and EMBASE were searched using key words: 'rivastigmine' OR 'Exelon' OR 'rivastigmine augmentation' OR 'Exelon augmentation' AND 'posttraumatic stress disorder*' OR 'post-traumatic stress disorder*' OR 'PTSD' OR 'combat disorder*' OR 'post-traumatic symptoms'.

Healthcare provider data breaches - framework for crisis communication and support of patients and healthcare workers in mental healthcare.

Increasing numbers of healthcare data breaches highlight the need for structured organisational responses to protect patients, trainees and psychiatrists against identity theft and blackmail. Evidence-based guidance that is informed by the COVID-19 pandemic response includes: timely and reliable information tailored to users' safety, encouragement to take protective action, and access to practical and psychological support. For healthcare organisations which have suffered a data breach, insurance essentially improves access to funded cyber security responses, risk communication and public relations.

Personalized transcriptome signatures in a cardiomyopathy stem cell biobank.

Background: There is growing evidence that pathogenic mutations do not fully explain hypertrophic (HCM) or dilated (DCM) cardiomyopathy phenotypes. We hypothesized that if a patient's genetic background was influencing cardiomyopathy this should be detectable as signatures in gene expression. We built a cardiomyopathy biobank resource for interrogating personalized genotype phenotype relationships in human cell lines.

Extracellular vesicles in disorders of hemostasis following traumatic brain injury.

Traumatic brain injury (TBI) is a global health priority. In addition to being the leading cause of trauma related death, TBI can result in long-term disability and loss of health. Disorders of haemostasis are common despite the absence of some of the traditional risk factors for coagulopathy following trauma.

A level playing field? Evaluation of the virtual Objective Structured Clinical Examination in Psychiatry and Addiction Medicine: A mixed methods study.

Objective: The Objective Structured Clinical Examination (OSCE) has been used for clinical assessment of a broad range of medical student competencies in Psychiatry and Addiction Medicine. However, there has been little research into online assessments. We investigated the virtual OSCE (v-OSCE) from the user perspective to better understand its acceptability, usefulness, benefits, challenges and potential improvements.

Telepsychiatry in Australia: A Scoping Review.

Telepsychiatry formed part of the Australian mental health response to COVID-19, but relevant reviews pre- and post-pandemic are sparse. This scoping review aimed to map the literature on telepsychiatry in Australia and identify key research priorities. We searched databases (Medline, PubMed, PsycINFO, Scopus, Web of Science, EBSCO Psychology & Behavioral Sciences Collection, Proquest databases, and Cochrane Central Register of Controlled Trials) and reference lists from January 1990 to December 2022.

Comparison of the out-of-pocket costs of Medicare-funded telepsychiatry and face-to-face consultations: A descriptive study.

Objective: Telepsychiatry items in the Australian Medicare Benefits Schedule (MBS) were expanded following the COVID-19 pandemic. However, their out-of-pocket costs have not been examined. We describe and compare patient out-of-pocket payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the differential out-of-pocket cost burden for patients across these modalities.

Flexible Bifunctional Electrode for Alkaline Water Splitting with Long-Term Stability.

Progress in electrochemical water-splitting devices as future renewable and clean energy systems requires the development of electrodes composed of efficient and earth-abundant bifunctional electrocatalysts. This study reveals a novel flexible and bifunctional electrode () by hybridizing macroscopically assembled carbon nanotube ribbons () and atmospheric plasma-synthesized NiO quantum dots (QDs) with varied loadings to demonstrate bifunctional electrocatalytic activity for stable and efficient overall water-splitting (OWS) applications. Comparative studies on the effect of different electrolytes, e.