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.

The 2024-2025 Commonwealth Budget for Mental Health: Funding unproven initiatives and stings in the tail.

We discuss the ramifications of the Commonwealth of Australia Budget allocations for mental healthcare for 2024-2025. There is funding for population-based mental health initiatives for milder anxiety and depression but no direct funding of services for the most severe and disabling forms of mental illness, other than pre-existing state/territory disbursements from the Commonwealth for state-based health services. There are substantial concerns that the Commonwealth funding has potentially been misallocated to ineffective interventions that are unlikely to reduce the population prevalence of mild anxiety and depression in Australia.

Revisiting the effects of rTMS over the dorsolateral prefrontal cortex on pain: An updated systematic review and meta-analysis.

Background: Our previous study synthesized the analgesic effects of repetitive Transcranial Magnetic Stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) trials up to 2019. There has been a significant increase in pain trials in the past few years, along with methodological variabilities such as sample size, stimulation intensity, and rTMS paradigms.

Objectives/methods: This study therefore updated the effects of DLPFC-rTMS on chronic pain and quantified the impact of methodological differences across studies.

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 Norm Is to Not Openly Collaborate': Using the Lens of Co-Production to Evaluate the Development of a COVID-19 ICU Triage Policy.

Introduction: In 2020, surging cases of COVID-19 meant that health services had to plan for crisis-level triage. In the Australian Capital Territory, the Clinical Health Emergency Coordination Centre sought to develop a triage policy in collaboration with a range of consumer, carer and community groups. This study aims to map the collaborative development of the COVID-19 ICU triage policy onto the principles of co-production.

Remote sensing mental health: A systematic review of factors essential to clinical translation from validation research.

Background: Mental illness remains a major global health challenge largely due to the absence of definitive biomarkers applicable to diagnostics and care processes. Although remote sensing technologies, embedded in devices such as smartphones and wearables, offer a promising avenue for improved mental health assessments, their clinical integration has been slow.

Objective: This scoping review, following preferred reporting items for systematic reviews and meta-analyses guidelines, explores validation studies of remote sensing in clinical mental health populations, aiming to identify critical factors for clinical translation.

The travails of women with severe mental illness and pregnancy.

Women with severe mental illness and pregnancy suffer substantial travails in accessing care for mental and perinatal health. Women with psychotic illnesses such as schizophrenia face higher risks of pregnancy and postnatal complications. Similarly, lack of access to holistic psychiatric care presents particular perils for these women and their children.

Behind the curtain of : The practice of a medical journal and a call for reviewers.

The process of medical scientific journal publishing merits further explanation for authors and readers. Prospective authors need to understand the scope of the journal and the article types that are published. We give an overview of the editorial process, including selection of reviewers, peer review and decisions regarding revision, acceptance and rejection of papers for .

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.

First-line treatment with ceftriaxone for infection less likely to be prescribed to patients with a penicillin allergy label: a retrospective audit of medical records.

Background Gonorrhoea notifications have increased substantially in Australia over the past decade. Neisseria gonorrhoeae is already highly resistant to several antibiotics and so, alternatives to first-line treatment are generally strongly discouraged. The penicillin allergy label (AL) on patient medical records has previously been shown to influence prescribing practices, to the detriment of best-practice management and antimicrobial stewardship.

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.

When the WRENCH turns a few heads: Expectation and semantic relatedness in inattentional blindness.

Semantic relatedness and expectation were investigated in inattentional blindness-failure to perceive an unexpected object in plain sight when attention is engaged elsewhere. Participants named primary-task pictures and ignored distractor pictures. Four trials preceded a 'critical' trial where an unexpected six-letter-word appeared at fixation, simultaneously with the pictures.

The Transitioning From Pediatric to Adult Inflammatory Bowel Disease Services: A Qualitative Study of Adolescents and Their Parents.

Background: Inflammatory bowel disease (IBD) often has its onset during late childhood and adolescence, a time of significant change. Young people may be required to transition from a pediatric to an adult IBD service during this time. The transition from pediatric to adult services can be a high-risk period for poor outcomes for emerging adults with IBD.

Measuring what counts in Aboriginal and Torres Strait Islander care: a review of general practice datasets available for assessing chronic disease care.

Background Large datasets exist in Australia that make de-identified primary healthcare data extracted from clinical information systems available for research use. This study reviews these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples, and the extent to which the principles of Indigenous Data Sovereignty are reflected in data collection and governance arrangements. Methods Datasets were included if they collect primary healthcare clinical information system data, collect data nationally, and capture Aboriginal and Torres Strait Islander peoples.

More than sport: A social-identity intervention to support transitions out of elite sport.

Elite athletes often make large personal sacrifices to pursue excellence, but there is insufficient support for them when they leave elite sport. Identity loss is central to athletes' transition trajectories and hence the management of identity change is a crucial area for support. The More Than Sport (MTS) program is a novel digital intervention that aims to provide this support-helping athletes manage identity change in the process of leaving elite sport.

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'.

Acute neuroinflammation promotes a metabolic shift that alters extracellular vesicle cargo in the mouse brain cortex.

Neuroinflammation is initiated through microglial activation and cytokine release which can be induced through lipopolysaccharide treatment (LPS) leading to a transcriptional cascade culminating in the differential expression of target proteins. These differentially expressed proteins can then be packaged into extracellular vesicles (EVs), a form of cellular communication, further propagating the neuroinflammatory response over long distances. Despite this, the EV proteome in the brain, following LPS treatment, has not been investigated.

Listening quality leads to greater working alliance and well-being: Testing a social identity model of working alliance.

Objectives: Characterization of psychotherapy as the "talking cure" de-emphasizes the importance of an active listener on the curative effect of talking. We test whether the working alliance and its benefits emerge from expression of voice, per se, or whether active listening is needed. We examine the role of listening in a social identity model of working alliance.

The Association between Lymphocytic Thyroiditis and Papillary Thyroid Cancer Harboring Mutant : A Systematic Review and Meta-Analysis.

Papillary thyroid cancer (PTC) and lymphocytic thyroiditis (LT) co-occur with a prevalence of about 30%. PTC harboring (PTC-) confers a worse prognosis, but it is unclear if LT alters prognostic features and recurrence of PTC. We compared the prevalence of PTC- with and without LT.

High resolution imaging and analysis of extracellular vesicles using mass spectral imaging and machine learning.

Extracellular vesicles (EVs) are potentially useful biomarkers for disease detection and monitoring. Development of a label-free technique for imaging and distinguishing small volumes of EVs from different cell types and cell states would be of great value. Here, we have designed a method to explore the chemical changes in EVs associated with neuroinflammation using Time-of-Flight Secondary Ion Mass spectrometry (ToF-SIMS) and machine learning (ML).