Healthy Lifestyle Care vs Guideline-Based Care for Low Back Pain: A Randomized Clinical Trial.

Importance: An unhealthy lifestyle is believed to increase the development and persistence of low back pain, but there is uncertainty about whether integrating support for lifestyle risks in low back pain management improves patients' outcomes.

Objective: To assess the effectiveness of the Healthy Lifestyle Program (HeLP) compared with guideline-based care for low back pain disability.

Design, Setting, And Participants: This superiority, assessor-blinded randomized clinical trial was conducted in Australia from September 8, 2017, to December 30, 2020, among 346 participants who had activity-limiting chronic low back pain and at least 1 lifestyle risk (overweight, poor diet, physical inactivity, and/or smoking), referred from hospital, general practice, and community settings.

Repurposing Licensed Drugs with Activity Against Epstein-Barr Virus for Treatment of Multiple Sclerosis: A Systematic Approach.

Background: Epstein-Barr virus (EBV) is implicated as a necessary factor in the development of multiple sclerosis (MS) and may also be a driver of disease activity. Although it is not clear whether ongoing viral replication is the driver for MS pathology, MS researchers have considered the prospect of using drugs with potential efficacy against EBV in the treatment of MS. We have undertaken scientific and lived experience expert panel reviews to shortlist existing licensed therapies that could be used in later-stage clinical trials in MS.

Disseminated nontuberculous mycobacterial infection in the context of interferon-gamma autoantibody syndrome: A case report and review of the literature.

Interferon-gamma (IFN-γ) autoantibody syndrome is an emerging clinical entity that has been associated with disseminated non-tuberculous mycobacterial infection (dNTM) particularly in healthy young people, a population not previously thought to be at particular risk. A 29-year-old South-East Asian man presented with several weeks of fever, cough, lymphadenopathy, and constitutional symptoms while working on an international cargo ship, deteriorating rapidly with a sepsis-like syndrome. Eventually lymph node and sputum cultures revealed a diagnosis of dNTM infection with growth of both Mycobacterium persicum and Mycobacterium abscessus.

Preventative self-regulatory primary care leadership in urban China: impact on physician well-being and medical service quality.

Purpose: The study aims to address the gap between leaders' preventative self-regulatory focus and its impact on Chinese primary care physicians (PCPs) well-being, measured by work-family spillover stress and work exhaustion and on healthcare quality, measured by preventive service delivery and clinical guideline adherence.

Design/methodology/approach: This paper conducted a cross-sectional in-person survey with 38 leaders and 224 PCPs in 38 primary health centers (PHCs) in Jinan, Tianjin, Shenzhen and Shanghai. Guided by the regulatory focus theory, this paper built hierarchical linear regression models to examine the association between the leadership's regulatory focus and physician burnout, work-family conflict, clinic guideline adherence and preventive service delivery.

Patient Experiences of Receiving Stroke Discharge Information in Accordance With Preferences.

Aims: To examine survivors' experiences of discharge information including risk communication after hospitalisation for a stroke and the characteristics associated with receiving information in accordance with their preferences.

Background: With advances in acute stroke care and an ageing population, the number of survivors of stroke is increasing. It is important that healthcare providers ensure patients have adequate information after a stroke-related hospitalisation.

Section 19(2) of the Health Insurance Act 1973 Prevents Prisoners Accessing Medicare: Fact or Fiction?

This article explores the origins and operation of s 19(2) of the Health Insurance Act 1973 (Cth) and argues that it may not now and may never have created a barrier to Medicare access for prisoners as is commonly thought. Advocates have long asked for a s 19(2) exemption to allow Medicare access in custody. However, even if such an exemption were granted, it may not provide the access to Medicare necessary to have meaningful benefit for prisoners and may have other unintended consequences.

A Comparison of Glucose and Additional Signals for Three Different Exercise Types in Adolescents with Type 1 Diabetes Using a Hybrid Closed-Loop System.

To compare glycemic outcomes during and following moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with type 1 diabetes (T1D) using a hybrid closed-loop (HCL) insulin pump while measuring additional physiological signals associated with activity. Twenty-eight adolescents (average age 16.3 ± 2.

Oral microbiome dysbiosis is associated with precancerous lesions and disorders of upper gastrointestinal tract: A population-based study.

Background And Aims: Oral microbiota may contribute to the development of upper gastrointestinal (UGI) disorders. We aimed to study the association between the microbiome of saliva, subgingival and buccal mucosa, and UGI disorders, particularly precancerous lesions. We also aimed to determine which oral site might serve as the most effective biomarker for UGI disorders.

Biomarkers.

Background: Interest and consumption of plant-based diets (PBD) in the 21 century continued to increase, particularly in western societies, with the perception that PBDs are associated with beneficial health outcomes and a reduced environmental footprint. Evidence suggests that PBDs may be protective against neurodegenerative diseases, such as Alzheimer's disease (AD). Health effects of PBDs such as reduction of inflammation, shift in gut microbiota composition, reduced risk of type 2 diabetes and cardiovascular disease are all believed to attribute to reduced AD risk.

Biomarkers.

Background: The variability in the regional distribution of Aβ-PET signal and its relation to clinical features is debated. We used data-driven approaches to uncover heterogeneity in cortical Aβ-PET signal from a large representative sample collected through the IDEAS study.

Methods: We analysed cross-sectional Aβ-PET collected from 10,361 patients with MCI or mild dementia scanned in 295 PET facilities using one of the 3 FDA-approved tracers.

Biomarkers.

Background: Alzheimer disease (AD) related cognitive decline occurs at relatively young ages in individuals with Down syndrome (DS, early-mid 50s) and in those with autosomal dominant mutations (ADAD, 40-50s). Both groups show similar patterns of amyloid accumulation. We examined if brain volumes are similarly affected by AD pathology in individuals with DS and ADAD.

Public Health.

Background: Dementia may not be imminent for most young adults, however, lifestyle choices in early and midlife can play a significant role in dementia risk. Improving knowledge around modifiable factors and encouraging protective behaviours across the lifespan provides one important approach to lowering dementia incidence. This study aimed to test whether a short educational video, developed specifically for young adults, could improve knowledge of dementia risk factors and shift perceptions around when behaviour change may be relevant.

The inductive effect does not explain electron density in haloacetates: are our textbooks wrong?

The inductive effect is a central concept in chemistry and is often exemplified by the p values of acetic acid derivatives. The reduction in p is canonically attributed to the reduction in the electron density of the carboxylate group through the inductive effect. However, wave functional theory calculations presented herein reveal that the charge density of the carboxylate group is not explained by the inductive effect.

Application of Dragonnet and Conformal Inference for Estimating Individualized Treatment Effects for Personalized Stroke Prevention: Retrospective Cohort Study.

Background: Stroke is a major cause of death and disability worldwide. Identifying individuals who would benefit most from preventative interventions, such as antiplatelet therapy, is critical for personalized stroke prevention. However, traditional methods for estimating treatment effects often focus on the average effect across a population and do not account for individual variations in risk and treatment response.

Awareness of cardiovascular disease risk and care received among Australian women with a history of hypertensive disorders of pregnancy: a cross-sectional survey.

Background: Women with a history of hypertensive disorders of pregnancy (HDP), including chronic hypertension, gestational hypertension, and preeclampsia have an increased risk of cardiovascular disease (CVD). Current research suggests that general practitioners are unaware of women's HDP history, and although ideally placed to follow-up with these women, there is limited understanding of current CVD prevention practices in women after HDP. Additionally, preeclampsia confers a higher CVD risk compared to other types of HDP, and Australian research suggests that lower socioeconomic status (SES) is associated with a higher incidence of both HDP and CVD.

Exploring the experiences of women and people with diabetes in pregnancy in metropolitan and rural Australia: a national survey.

Background: Women and people diagnosed with diabetes in pregnancy, are recommended to have frequent monitoring and careful management for optimal pregnancy outcomes. This health care management should be supported by a multidisciplinary healthcare team. For individuals living in rural areas, there are increased barriers to healthcare access, with subsequent worse health outcomes compared to those in metropolitan regions.

An evaluation of parents' and caregivers' preferences managing fever in children based on experiences in using ibuprofen and paracetamol: A systematic review.

Objective: This review aims to investigate parents' preference for and use of Ibuprofen and Paracetamol in managing and treating children's fevers as well as the factors influencing their decision-making and practices.

Introduction: Parents globally face concern over managing children's fever, seeking relief while ensuring safety, often relying on accessible medications like Paracetamol and Ibuprofen.

Inclusion Criteria: The review included quantitative studies involving parents and caregivers managing fever in children aged 0-17 years.

Insights from a publicly funded homebirth program.

Background: There are high levels of consumer demand for homebirth in Australia, however access is limited due to a wide range of factors, including associated costs of a private midwife and the limited number of publicly funded homebirth models. Homebirth with a qualified midwife, networked into a health system, is a safe option for women with a low-risk pregnancy. This paper has two aims.

Priorities for research on improving health behaviours for optimal mental health of Australian university students: A twin-panel Delphi study.

Issue Addressed: University students are at risk of poor health behaviours which negatively affect mental health and wellbeing. Informing the implementation of appropriate strategies to support Australian university students' health and wellbeing, requires quality evidence. This study aimed to identify research priorities for improving health behaviours to optimise mental health of Australian university students.

Barriers and enablers to engagement with a type 2 diabetes remission project in the North East of England: qualitative perspectives of patients.

This qualitative research sought to identify factors influencing patient choice of, and patient-related internal and external enablers and barriers to engagement with, type 2 diabetes (T2D) remission strategies offered by the Remission in diabetes (REMI.D) project. Patients had a choice of three diets: Total Diet Replacement (TDR)-Formula Food Products, TDR-Food, and Healthy lifestyle approach; and three activity pathways: Everyday life, General Practitioner referral, and Social hub.

A retrospective analysis of cardiovascular outcomes of clozapine treated individuals within Hunter New England.

Background: Clozapine has demonstrated superiority in improving both positive and negative symptoms of treatment-resistant schizophrenia; however, there are associated treatment-limiting side effects, including myocarditis, cardiomyopathy and agranulocytosis.

Aim: This retrospective cohort study describes the prevalence of myocarditis, left ventricular (LV) dysfunction, cardiovascular risk factors and outcomes in a cohort of patients maintained on clozapine therapy.

Methods: Data were retrospectively collated from patients who had a diagnosis of schizophrenia, had been managed with clozapine at any stage during their care and undergone at least one echocardiogram.

Intracerebroventricular B7-H3-targeting CAR T cells for diffuse intrinsic pontine glioma: a phase 1 trial.

Diffuse intrinsic pontine glioma (DIPG) is a fatal central nervous system (CNS) tumor that confers a median survival of 11 months. As B7-H3 is expressed on pediatric CNS tumors, we conducted BrainChild-03, a single-center, dose-escalation phase 1 clinical trial of repetitive intracerebroventricular (ICV) dosing of B7-H3-targeting chimeric antigen receptor T cells (B7-H3 CAR T cells) for children with recurrent or refractory CNS tumors and DIPG. Here we report results from Arm C, restricted to patients with DIPG.

Neurosteroid replacement therapy using tiagabine and zuranolone restores cerebellar neurodevelopment and reduces hyperactive behaviour following preterm birth.

Preterm birth exposes the neonate to hypoxic-ischaemic and excitotoxic insults that impair neurodevelopment and are magnified by the premature loss of placentally supplied, inhibitory neurosteroids. The cerebellum is a neuronally dense brain region, which undergoes critical periods of development during late gestation, when preterm births frequently occur. We propose that neurosteroid replacement therapy using tiagabine and zuranolone will protect the cerebellum against preterm-associated insults.