International collaboration in advanced practice education — a catalyst for workforce sustainability and health system resilience

Australia faces significant challenges in providing accessible, high-quality healthcare, particularly owing to workforce retention issues and the growing complexity of patient needs. This article provides a commentary on the collaboration between universities to develop a contemporary postgraduate programme for advanced practitioners in Australia. To support the development of advanced practitioner roles, the University of Canberra in Australia collaborated with Sheffield Hallam University in England to develop a sustainable programme tailored to Australia's diverse healthcare needs. This international collaboration involved an open exchange of knowledge and expertise. Unlike traditional, discipline-specific programmes, the new programme is inclusive of diverse healthcare professions and contexts, empowering them to provide advanced, evidence-based care

Best practice for patient-centred radiotherapy in clinical trials and beyond – a national multidisciplinary consensus

Aims Patient-centred radiotherapy refers to an approach where patients' needs and preferences are prioritised. Guidelines for this personalised approach are lacking. We present a multidisciplinary national consensus with the aim to provide recommendations for best practice in patient-centred radiotherapy for both clinical trials and routine practice. Materials and methods A multidisciplinary working group was formed, comprising of healthcare professionals and patient advocates with lived experience of radiotherapy. Three interlinking themes were identified around patient-centred radiotherapy: information, decision-making, and outcomes. Scoping reviews were carried out for each theme, considering current challenges and recommendations for best practice. Recommendations were shaped through consultation with 12 patient advocates. Results There is a pressing need to better support patients prior to, during, and following radiotherapy. Radiotherapy-related patient information is often complex and challenging to understand. Information resources should be cocreated with patient advocates and individualised wherever possible, including for patients from under-served groups. Shared decision-making (SDM) processes may enhance treatment satisfaction and reduce decision-regret, but these are not widely implemented. SDM requires prepared patients, trained teams, alongside adequate resources and should be offered as per patients' preferences. Healthcare system data offer complementary information to clinical trials, with the potential to provide additional insight into long-term benefits and risks of radiotherapy within ‘real-world’ conditions. Patient-reported outcome measures may provide greater insight regarding toxicity and impact on quality of life and should be used in synergy with clinician-reported outcomes. Outcome measures should be collected in the long term, and results should be widely disseminated to both the public and professional communities. Equity of access to radiotherapy, clinical trials, and survivorship services is a priority. Conclusion Patients rightly expect more from healthcare professionals, and it is important that the radiotherapy community recognises this and embraces changes which will enhance patient-centred care. Our recommendations aim to guide best practice for patient-centred radiotherapy

A national assessment of the drinking water infrastructure deficit in New Zealand by territorial authority and sociodemographic characteristics

The quality of drinking water reticulation networks is central to ensuring the provision of safe water. We conducted a national assessment of public drinking water reticulation condition in New Zealand (NZ) derived from information on pipe material and age and investigated regional and sociodemographic variations in the reticulation network. In total, 30.7% of the 57,174 km of drinking water pipes in NZ were in poor or very poor condition, while 18.5% were past their life expectancy. We identified wide variation in the proportion of pipes in poor or very poor condition amongst Territorial Authorities (TAs) and between areas of varying socioeconomic deprivation within TAs. Using nationally consistent data, our findings suggest that the current drinking water infrastructure deficit in NZ may be larger than previously estimated. Our results also highlight potential challenges to TA-based amalgamation of water services under the new legislation

Seeing Images, Reading Images: Circularity, Mirroring, and the Artwork in Dario Argento’s Cinema

Since Dario Argento’s directorial debut, The Bird with the Crystal Plumage, visual composition has played a key role in his work, as has the strict correlation between visual perception and image interpretation. Specifically, what emerges from Argento’s filmography since the early 1970s is the director’s ability to play with the ambivalence of pictorial images and techniques within a film in a specific duality that serves narrative purposes on the one hand, while challenging the self-enclosed mediality of classical cinematic narration on the other. In this regard, the diegetic art-historical repertoire, as well as the pictorial iconography and techniques displayed in Argento’s oeuvre, appear to transfer the dramatic tension from the narrative to the cinematic language, making the images the ultimate riddle to be solved. In a chosen corpus of the director’s work, it is evident that this ambivalence is already a prominent theme from the opening credit sequences. These sequences serve both a narrative and metanarrative function by foreshadowing the main themes of the films in question, and by serving as introductions to the aesthetic “textures” of the films through visual representation. The purpose of this article is to examine specific instances in Argento’s oeuvre, namely Four Flies on Grey Velvet, Deep Red, Trauma and, most notably, The Stendhal Syndrome, where the visual symbols and methods shown in the opening credit sequences serve the defined metanarrative objectives. Additionally, it aims to explore the extent to which this metanarrative function of artistic references extends beyond the opening credits in these films. The director’s cinema exhibits aesthetic and narrative circularity by repeatedly framing and reworking the same visual motifs developed in the opening credits in mirror-like sequences throughout key scenes. These motifs ultimately resurface in the epilogue, serving as a clear example of this circularity. This article demonstrates how these examples from Argento’s work exemplify the core of the director’s comprehensive production of a harmonious integration of narrative and visuals, which can effectively communicate a self-reflexive message about the essence of the shown images and their potential interpretation

Care Home Oral Care Toolkit (based on NG48)

A co-designed toolkit aimed to (1) refine the complex oral health intervention (NG48) to ensure it is practically, clinically and culturally acceptable to care home staff and residents; (2) understand the context and mechanisms for delivery by exploring the challenges of providing oral care practices in care homes; and (3) contribute to the embedment in best practice, thus translating the NG48 guideline into implementable practice. The resulting co-designed toolkit comprises of seven components, representing four themes: assessment, planning, implementation and evaluation. (1) Assessment - (1a) oral health assessment tool, and (1b) oral health needs, preferences and risk assessment (2) Planning - (2a) oral care plan, and (2b) informal care plan summary (3) Implementation - (3a) care practices poster, and (3b) care practices 'tips and tricks' pocket cards (4) Evaluation - (4) weekly care recor

Profile of outer membrane proteins of carbapenem-resistant Gram-negative bacilli in Ghana

Objective: Carbapenem resistance is a major global health threat, but insights on its molecular determinants are scanty in sub-Saharan Africa, the predominant global antimicrobial resistance hotspot. This study aimed to profile outer membrane proteins (OMPs) of 111 carbapenem-resistant Gram-negative bacteria recovered from a broad spectrum of clinical specimens from Ghana. Results: The OMPs of Pseudomonas aeruginosa produced decreased amounts of OprD or the porin was completely lost, except in 5.9% (n = 3) of the isolates which had high-level porins. For Acinetobacter baumannii, 96.8% (n = 30) expressed loss of OprF. One carbapenemase non-PCR-positive isolate with high-level porin expression was observed. In A. baumannii, the major and significant band on SDS-PAGE was ~ 35 kDa. There were substantial numbers of unrelated porin expression among the isolates. Particularly, OmpC/F or OmpK35/37 expression was deficient. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) analysis for Escherichia coli, Klebsiella aerogenes, Klebsiella pneumoniae, and other Enterobacterales had OmpC and OmpF absent or markedly reduced compared to the control strains. Overall, porin loss was a major mechanism underlying carbapenem resistance among the isolates, suggesting that in carbapenem-resistant organisms that seem to lack known carbapenem resistance genes, porin loss may be the underlying carbapenem resistance mechanism

Raman gas sensing technology: A new horizon?

The question in the title alludes to the importance of comprehending the relevance and manner of operation in the field of gas sensors, which is undeniably one of the most important scientific and economic interests. Despite being superior to several commonly used techniques, such as infrared (IR) spectroscopy, Nondispersive IR (NDIR) and gas chromatography coupled with mass spectrometry (GC-MS), Raman spectroscopy-based gas sensors are yet to be widely explored for real-world applications. Given the weak Raman effect, numerous innovative strategies have emerged to improve its utility in chemical sensing, biological imaging, and material characterization, among other applications. This review covers five important approaches with a high potential for use in Raman-based gas sensors: spontaneous (SRS), stimulated (StRS), coherent anti-Stokes (CARS), surface-enhanced (SERS), and tip-enhanced (TERS) Raman scattering spectroscopy. The initial strategy of this review is to provide the in-depth foundational knowledge necessary for the reader to grasp several types of Raman techniques, their advantages and limitations. This is followed by an overview of current competing technologies and their applications. The remainder of the paper focuses on recent major experimental findings based on the Raman techniques and their practical applications. As a comprehensive introduction to Raman spectroscopy, this review article also serves as a knowledge base for future developments in the field of gas sensors