Over the past five years, the application of artificial intelligence (AI) including its significant subset, machine learning (ML), has significantly advanced pharmaceutical procedures in community pharmacies, hospital pharmacies, and pharmaceutical industry settings. Numerous notable healthcare institutions, such as Johns Hopkins University, Cleveland Clinic, and Mayo Clinic, have demonstrated measurable advancements in the use of artificial intelligence in healthcare delivery. Community pharmacies have seen a 40% increase in drug adherence and a 55% reduction in missed prescription refills since implementing artificial intelligence (AI) technologies. According to reports, hospital implementations have reduced prescription distribution errors by up to 75% and enhanced the detection of adverse medication reactions by up to 65%. Numerous businesses, such as Atomwise and Insilico Medicine, assert that they have made noteworthy progress in the creation of AI-based medical therapies. Emerging technologies like federated learning and quantum computing have the potential to boost the prediction of protein–drug interactions by up to 300%, despite challenges including high implementation costs and regulatory compliance. The significance of upholding patient-centred care while encouraging technology innovation is emphasised in this review.

BACKGROUND:Paramedics are exposed to many infectious diseases in their professional activities, leading to a high risk of transmitting infectious diseases to patients in out-of-hospital settings, possibly leading to health care associated infections in hospitals and the community. The COVID-19 pandemic highlighted the importance of infection prevention and control in health care and the role of paramedics in infection control is considered even more critical. Despite this, in many countries such as Australia, research into infection prevention and control research has mainly been focused on in-hospital health care professionals with limited out-of-hospital studies. METHODS:This scoping review was based upon Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Literature on knowledge and awareness of infection prevention and control in paramedics in Australia and other countries was evaluated. RESULTS:Based upon selection criteria applied, six papers were identified for inclusion in this review. In many studies, infection prevention and control was identified as being important, however compliance with hand hygiene practices was low and most studies highlighted the need for more education and training on infectious disease for paramedics. CONCLUSION:Current evidence suggests that paramedics have poor compliance with recommended IPC practices. The profession needs to improve IPC education, training, and culture.

Aggressive behaviors of people with dementia pose a significant challenge to employees in nursing homes and aged care facilities. Aggressive behavior is a result of psychomotor agitation in dementia (BPSD). Globally, psychotropic interventions are the preferred treatment for BPSD. However, it is still unclear which psychotropic should be prescribed. The purpose of this systematic review is to compare pharmacological interventions for psychomotor agitation and psychosis symptoms. Method: The studies were extracted from databases, such as PubMed, OVID, and Cochrane, with a date restriction from 2000 to present, and in English. PRISMA steps were used to refine the extracted data. The RCTs extracted for this systematic review compared active ingredient medications to one another or to a placebo. Results: PRISMA was used to assess all selected trials comprehensively. Four trials are being conducted on quetiapine, two on haloperidol, one on olanzapine, three on risperidone, one on brexpiprazole, one on pimavanserin, and two on aripiprazole. Compared to typical antipsychotics, quetiapine showed tolerable adverse effects and did not worsen parkinsonism. Psychosis symptoms and behavioral improvements can be improved with haloperidol. Among elderly patients with psychosis, risperidone reduces angriness, paranoia, and aggression, as well as improves global functioning. As compared with other antipsychotics, aripiprazole provides a lower risk of adverse effects and demonstrated improvement in agitation, anxiety, and depression associated with psychosis. While olanzapine improves hostile suspiciousness, hallucinations, aggression, mistrust, and uncooperativeness, it worsens depression symptoms. Psychosis was treated effectively with pimavanserin without adverse effects on motor functions. Psychosis symptoms are well tolerated by brexpiprazole, but insomnia, headache, and urinary tract infections are common side effects. Conclusions: In this systematic review, we provide an overview of how to choose the correct antipsychotics and dosages for the management of BPSD and emphasize the importance of safe and conservative use of these drugs.

Background: Psychomotor agitation as part of the behavioral and psychological symptoms of dementia (BPSD) is one of the common issues found in aged care facilities. The current inadequate management strategies lead to poor functional and medical outcomes. Psychotropic interventions are the current preferred treatment method, but should these medications be the prescribers’ first preference? This review aims to compare pharmacological interventions for psychomotor agitation, judging them according to their effectuality and justifiability profiles. This is to be achieved by retrieving information from Randomized Control Trials (RCTs) and systematic reviews. Objectives: This review evaluates evidence from RCTs, systematic reviews, and meta-analyses of BPSD patients who have taken agitation treatments. Assessing the efficacy of citalopram, other selective serotonin reuptake inhibitors (SSRIs) and antipsychotic treatments were compared to each other for the purpose of improving agitation outcomes and lowering patient side effects. Methods: This review includes RCT that compared citalopram with one or more atypical antipsychotics or with a placebo, along with systematic reviews comparing citalopram (SSRI) with antipsychotics such as quetiapine, olanzapine, and risperidone. Studies were extracted by searching and accessing databases, such as PubMed, OVID, and Cochrane with restrictions of date from 2000 to 2021 and published in the English language. Conclusion: There are still a limited number of studies including SSRIs for the treatment of agitation in BPSD. SSRIs such as citalopram were associated with a reduction in the symptoms of agitation, and lower risk of adverse effects when compared to antipsychotics. Future studies are required to assess the long-term safety and efficacy of SSRI treatments for agitation in BPSD.

Health-related knowledge, skills and attitudes that translate to behaviours are important foundations for healthy living. However, deficiencies in any one of these factors have the potential to impact quality of life. This study investigates how Australian children perceive and manage their food allergy as they transition through childhood onto adolescence. To measure this, children aged 12 years and under completed an online survey [under 8 years and 8–12 years] on knowledge, skills and attitudes. Although recruitment involved advertisements to over 700 Australian pre-schools, 44 allergy specialists and multiple representations to the patient support group, Allergy & Anaphylaxis Australia, completion relied on parental notification and/or guidance. Of the 139 participants recruited, 114 commenced the survey with 65 participants under 8 years (58%) and 49 between 8 and 12 years. Results showed participants recognised different ways to keep safe with children under 8 years ( N = 65) 100% cognisant of the need to check with ‘Mum/Dad’ or teachers if they could safely eat food as well as the importance of not swapping lunches, while there was a slight change in compliance for those aged 8–12 years as three (6.1%, n = 3/49) children did not see the necessity of asking an adult/teacher if a food item was safe to eat. Older children were also less likely to tell friends about their food allergy even if they thought they were having an allergic reaction, despite children under 8 years more likely to feel different to friends (38%, n = 24/64) compared to those aged 8–12 years (31%, n = 14/45). Although both groups disliked parents’ fussing, for children under 8 years, there was a strong association between this and ‘feeling different to friends'. Results from this study highlight the importance of normalising food allergy at home and in the community, so children are confident in telling others about their food allergy.

This was a case of an 81-year-old female, an amputee, who presented at hospital with a fractured neck of femur after a fall in the nursing home. The patient was being treated for several complex chronic conditions for which 30 regular medicines were prescribed and 100 tablets were being taken per day. The patient was fluid limited to 1500 mL per day but the need to swallow such a high number of tablets meant that there was no fluid allowance available for any other drinks, not even a cup of tea. In the nursing home, the patient had multiple prescribers, not all from the one surgery. The pharmacist conducted a multifaceted review of the patient's medication and lifestyle factors. Working collaboratively with the wider health care team, the intervention was able to reduce the number of medications and improve the patient's quality of life through improving the effectiveness of other lifestyle factors. This case not only showcases pharmacist interventions but also the synergistic benefit of interprofessional working with patients with chronic and complex conditions. This is arguably more critical in rural or remote areas where there is commonly a paucity of most health practitioners, health assistants and technicians.

Work-integrated learning (WIL) is central to the delivery of high quality student learning that provides students with the knowledge, skills, attitudes and professional networks for successful careers. In rural and regional Australia WIL placements can be particularly challenging to source due to limited clinical supervision capacity. This article reports regional Allied Health clinical supervisors' perceptions of enablers and barriers to engaging with interprofessional student WIL. A phenomenology of practice framework was used to interpret the data, highlighting three key themes: introducing an interprofessional lens early; tapping into unique possibilities; and setting up for success, balancing challenges with opportunities. The study identified key elements that may contribute to successful Allied Health interprofessional WIL placements in rural and regional settings, including incorporating early student placement opportunities, using shared interprofessional supervision to foster the development of junior clinicians' supervisory skills, and ensuring clarity around the purpose and processes of each interprofessional placement.

Pediatric Allergy and ImmunologyVolume 31, Issue 3 p. 321-325 LETTER TO THE EDITOR Perception of food allergy symptom severity differs across stakeholders Debbi Stockhammer, Debbi Stockhammer School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, AustraliaSearch for more papers by this authorConstance H. Katelaris, Constance H. Katelaris Immunology & Allergy Unit, Campbelltown Hospital, Campbelltown, NSW, AustraliaSearch for more papers by this authorMaree D. Simpson, Maree D. Simpson School of Biomedical Sciences, Charles Sturt University, Orange, NSW, AustraliaSearch for more papers by this authorThiru Vanniasinkam, Corresponding Author Thiru Vanniasinkam tvanniasinkam@csu.edu.au orcid.org/0000-0001-9318-3982 School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia Correspondence Thiru Vanniasinkam, School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia. Email: tvanniasinkam@csu.edu.auSearch for more papers by this author Debbi Stockhammer, Debbi Stockhammer School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, AustraliaSearch for more papers by this authorConstance H. Katelaris, Constance H. Katelaris Immunology & Allergy Unit, Campbelltown Hospital, Campbelltown, NSW, AustraliaSearch for more papers by this authorMaree D. Simpson, Maree D. Simpson School of Biomedical Sciences, Charles Sturt University, Orange, NSW, AustraliaSearch for more papers by this authorThiru Vanniasinkam, Corresponding Author Thiru Vanniasinkam tvanniasinkam@csu.edu.au orcid.org/0000-0001-9318-3982 School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia Correspondence Thiru Vanniasinkam, School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia. Email: tvanniasinkam@csu.edu.auSearch for more papers by this author First published: 22 November 2019 https://doi.org/10.1111/pai.13178Citations: 3 The peer review history for this article is available at https://publons.com/publon/10.1111/pai.13178 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume31, Issue3April 2020Pages 321-325 RelatedInformation

Aim: this scoping review was designed to identify studies that assess adverse drug reactions (ADRs) for older people in Australian aged care facilities. This review critically evaluates each published study to identify the risk of, or actual, adverse drug events in older people. Inclusion criteria: this review considered any clinical studies that examined the adverse effects of medications in older people who were living in aged care facilities. This review considered qualitative studies, analytical studies, randomized controlled trials (RCTs), descriptive cross-sectional studies, and analytic observational studies that explored the use of medications and their adverse effects on older people in clinical settings (including aged care facilities). Methods: an initial search of the PubMed (United State National Library of Medicine), OvidSP, EBSCOHost, ScienceDirect, Wiley Online, SAGE, and SCOPUS databases, with full text was performed, followed by an analysis of the article’s title and abstract. Additionally, MeSH (Medical Subject Headings) was used to describe the article. The initial round of the database search was based on inclusion criteria from studies that assessed tools or protocols aiming to identify the adverse effects of medications on the elderly population suffering chronic conditions or multiple co-morbidities. Two reviewers screened the retrieved papers for inclusion. The data presented in this review are in tabular forms and accompanied by a narrative summary which aligns with the review’s objectives. Results: seven studies were identified, and the extracted data from these studies were grouped according their characteristics and the auditing results of each study. Conclusion: it would be beneficial to design a comprehensive or broadly adverse drug reaction assessment tool derived from Australian data that has been used on the elderly in an Australian healthcare setting.

Continuing professional development (CPD) is an essential component of professional practice for registered health practitioners to maintain and enhance knowledge, skills and abilities. There are many topics that practitioners may pursue relevant to their practice environment, and, in recent years, providing culturally safe and respectful practice is an emerging area of need. Unfortunately, many health professionals, whilst willing to offer cultural safe healthcare, may be uncertain of how to enact that practice. The World Health Organisation recognises attainment of the highest possible standard of health as a basic human right, and cultural safety is increasingly becoming an expectation of health professionals. To address this need and the insufficiency of support in the literature, the authors have presented a discussion paper on various aspects of cultural safety and the underlying constructs, such as cultures, that support it. The discussion takes into account core constructs that signpost the path to cultural safety and recognises the role and accountability of all levels of the healthcare system, not merely the practitioner. Finally, we propose a model program for a cultural humility CPD activity incorporating pre-work, online modules, interactive workshop, reflection on professional practice and a post-workshop evaluation.

Aim: this scoping review was designed to identify studies that assess the adverse drug reactions (ADRs) for older people in Australian aged-care facilities. This review critically evaluated each published study to identify the risk of, or actual adverse drug events in older people. Inclusion criteria: This review considered any clinical studies that examined the adverse effects of medications in older people who were living in aged-care facilities. This review considered qualitative studies, analytical studies, RCTs, descriptive cross-sectional studies, and analytic observational studies that explored the use of medications and their adverse effects on older people in clinical settings (including aged care facilities). Methods: An initial search of the PubMed, OvidSP, EBSCOHost, MEDLINE, ScienceDirect, Wiley Online, SAGE, and SCOPUS databases, with full text was performed, followed by an analysis of the article’s title and abstract. Additionally, MeSH was used to describe the article. The initial round of the database search was based on inclusion criteria from studies that assessed tools or protocols aiming to identify the adverse effects of medications on the elderly population suffering chronic conditions or multiple co-morbidities. Two reviewers screened the retrieved papers for inclusion. The data presented in this review are in tabular forms and a narrative summary which aligns with the review’s objectives. Results: Seven studies were identified, and the extracted data from these studies were grouped according their characteristics and the auditing results of each study. Conclusion: There was no comprehensive or broadly adverse drug reaction assessment tool derived from Australian data that has been used on the elderly in an Australian healthcare setting.

Introduction: Food allergy affects up to 10% of Australian children, and living with food allergic children can be challenging for parents. This study explored parental perceptions and knowledge as they navigate a new reality of keeping their child safe. Methods: Parents of children with food allergies completed an online food allergy survey in 2015. Questions explored health knowledge, skills, and attitudes (KSAs) as well as quality of life (QoL) through the inclusion of the Food Allergy Quality of Life - Parental Burden instrument (FAQL-PB). Notification of the survey included advertisements to more than 700 randomly selected Australia-wide preschools, 44 allergy specialists, and Allergy & Anaphylaxis Australia. Responses were tabulated and analysed. Results: Of the 400 participants who logged on, 357 commenced the survey and 318 finished. Questionnaire analysis showed that 44.1% of parents (n = 135) hesitated to use an adrenaline auto-injector and may be influenced by a classification system where symptom severity is not universally understood. While 79% would sign up to a national Anaphylaxis Registry, intention to participate in clinical trials using vaccines was disclosed by only 56%. Allergen labelling and community acceptance continue to be the most challenging aspects of managing a food allergy, and 50% of parents reported that food allergy played a role in choosing a preschool or primary school. Overall, quality of life for participants was influenced more by gender (male) and age of the child than where they lived - capital city or regional location; however, regional participants were more frustrated over lack of appreciation relating to the seriousness of food allergy (p = 0.010). Conclusion: Results highlight the need for educational strategies for both the food allergy community and public, particularly in regional areas, since there is a perceived lack of appreciation as to the seriousness of food allergy. Educational resources and relevant networks are required to support parents and caregivers in the management of children with food allergy.

Introduction: In the health professions, self-assessment and reflective practice are required professional competencies. Student capacity to reflect on and self-assess their preparedness for practice as they transition from an undergraduate student into a graduate health professional requires scaffolding these skills in their academic programs. Drawing on medical education, we evaluated the usefulness of a previously validated tool to measure student perceptions of preparedness in a problem-based undergraduate physiotherapy degree. Methods: Rasch and factor analyses were applied to a modified version of the Preparedness for Practice Questionnaire (PHPQ) to ascertain the construct validity of the instrument and to assess the effect of teaching method on students' perceived preparedness for practice. Results: The PHPQ should be considered as a set of subscales rather than an instrument that measures a single construct. Some subscales were found to be valid and evidenced a significant effect of the teaching pedagogy. However, the "collaboration" subscale could not be validated, and several others were only partially validated and require further refinement. Conclusions: This study has implications for the future use of the PHPQ in similar contexts in terms of student self- assessment of preparedness and suggests that students are really self-assessing a number of capabilities rather than an overall sense of preparedness. Although this reflection is still useful for practice, it lacks face validity at the moment when the current PHPQ is used. The PHPQ requires further refinement in order to be used confidently as a self-assessment tool for students to evaluate their preparedness for practice as physiotherapists.

The Arabic-speaking immigrant group, which makes up the fourth largest language group in Australia, has a high prevalence of cardiovascular disease. The objective of this study was to explore the health care challenges and needs of Arabic-speaking immigrants with cardiovascular disease (CVD), using a comparative approach with English-speaking patients with CVD as the comparable group. Methods: Participants were recruited from community settings in Melbourne, Australia. Face-to-face semi-structured individual interviews were conducted at the recruitment sites. All interviews were audio-taped, transcribed, and coded thematically. Results: 29 participants with CVD were recruited; 15 Arabic-speaking and 14 English-speaking. Arabic-speaking immigrants, and to a lesser extent English-speaking patients with CVD may have specific health care challenges and needs. Arabic-speaking immigrants' health care needs include: effective health care provider (HCP)-patient communication, accessible care, participation in decision-making, and empowerment. English-speaking participants viewed these needs as important for CVD management. However, only a few English-speaking participants cited these needs as unmet health care needs. Conclusion: This study suggests that Arabic-speaking immigrants with CVD may have unique needs including the need for privacy, effective HCP-patient communication that takes into account patients' limited English proficiency, and pharmacist-physician collaboration. Therefore, there may be a need to identify a health care model that can address these patients' health care challenges and needs. This, in turn, may improve their disease management and health outcomes.