BACKGROUND AND OBJECTIVES:The "ISSHOOs (Identifying Social factors that Stratify Health Opportunities and Outcomes) in pain research" project endeavored to address the paucity and inconsistency of equity-relevant, sociodemographic data collection and reporting in human adult pain research. The resulting "ISSHOOs Recommendations" provide a data collection tool that has practical utility and is globally and cross-culturally relevant, adaptable, and freely accessible. METHODS:This explanation and elaboration manuscript is a companion to the ISSHOOs Recommendations. It aims to elaborate on the published recommendations and provide practical guidance to broaden understanding and facilitate use. RESULTS:We provide item-specific information relevant to each of the eight items in Set A (the minimum dataset), including relevant background, rationale, and guidance for item tailoring to suit specific populations and contexts. We discuss the selection of a sub-set of relevant items from Set B (the extended, optional dataset) and suggest how the ISSHOOs data have the potential to complement efforts to address equity concerns in analyses, interpretation, and reporting. CONCLUSION:It is timely and important to improve and standardize the reporting of equity-relevant, sociodemographic data in pain research. The ISSHOOs recommendations, supported by this manuscript, have the potential to promote equity-relevant awareness and understanding and advance progress toward reducing health inequities for people with pain.

BACKGROUND:Staphylococcus aureus bacteremia is associated with high mortality. Whether cefazolin or an antistaphylococcal penicillin should be preferred for the treatment of methicillin-susceptible S. aureus bacteremia is unclear. METHODS:In an ongoing international Bayesian adaptive platform trial, we conducted an open-label, randomized comparison of cefazolin with an antistaphylococcal penicillin (flucloxacillin or cloxacillin) in adult patients with penicillin-resistant, methicillin-susceptible S. aureus bacteremia. The primary outcome, which was evaluated with a hierarchical Bayesian logistic-regression model, was death from any cause within 90 days after enrollment in the platform. We assessed the posterior probability of the noninferiority of cefazolin to flucloxacillin or cloxacillin (with the criterion for noninferiority prespecified as an adjusted odds ratio of <1.2, which approximates an absolute difference in mortality of <2.5 percentage points if mortality in the antistaphylococcal-penicillin group is 15%), as well as the posterior probability of superiority (with the criterion of an adjusted odds ratio of <1.0). Secondary safety outcomes included the development of acute kidney injury within 14 days. RESULTS:This domain of the ongoing trial was conducted between February 17, 2022, and August 7, 2024, by which time the criterion for noninferiority had been met. Mortality at 90 days among adults who could be evaluated was 15.0% (97 deaths among 645 patients) in the cefazolin group and 17.0% (109 deaths among 642 patients) in the antistaphylococcal-penicillin group (adjusted odds ratio, 0.81; 95% credible interval, 0.59 to 1.12; probability of noninferiority, 99.2%; probability of superiority, 89.8%). Acute kidney injury occurred in 92 of 660 patients (13.9%) in the cefazolin group, as compared with 127 of 648 (19.6%) in the antistaphylococcal-penicillin group (adjusted odds ratio, 0.67; 95% credible interval, 0.50 to 0.89; probability of superiority, 99.7%). CONCLUSIONS:In patients with methicillin-susceptible S. aureus bacteremia, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality and was associated with a lower incidence of acute kidney injury. (Funded by the National Health and Medical Research Council and others; SNAP ClinicalTrials.gov number, NCT05137119.).

Social determinants of health are upstream causes of unmet social needs, contributing to disparities in health and wellbeing outcomes. This study examines the unmet social needs of cancer patients living in a disadvantaged Australian region, revealing that 72% experienced at least one unmet need. This study highlights the complex and multifactorial social challenges facing a disadvantaged population undergoing cancer treatment.

Introduction Healthcare settings worldwide are adopting screening and referral interventions to address patients’ social needs. Some interventions provide one-off lists of resources (“light-touch” interventions) while others employ Health Navigators to provide ongoing assistance and advocacy with community organizations (“high-touch” interventions). Understanding the manner in which these interventions are integrated in hospital settings, and their effects on medical and social outcomes, is limited. Methods This systematic narrative review uses narrative synthesis to explore workflows for screening and referral interventions for social needs in hospital settings, and barriers and enablers to intervention success. Health and social science databases (Embase, CINAHL, PubMed, PsycInfo, Scopus, Web of Science) and grey literature (ProQuest) were searched. Conference abstracts and editorial papers were excluded. This review was prospectively registered in PROSPERO (registration number: CRD42023462535). Data were collected and analyzed from January 2023 to August 2024. Results All studies (n=37) occurred in the U.S. Interventions took place in emergency departments, inpatient and outpatient clinics, and hospital-based primary care clinics. Overall, studies were of moderate quality (n=22, 59%), and provided limited methodological data regarding workflows for screening and responding to social needs. High-touch interventions underreported caseload and other methodological data, and Health Navigator roles varied substantially. Few studies reported social needs outcomes, and intervention effects on outcomes were mixed. Discussion To improve the evidence base for hospital-based interventions, researchers should prioritize reporting methodological data and publishing in-depth protocols. Social needs outcomes should be consistently reported to better understand how these interventions may benefit disadvantaged populations, and trauma-informed principles should be applied to the collection and storage of social needs data.

There is increasing recognition of the need for routine measurement and reporting of data that can reveal social factors that contribute to health inequities for people with pain. Prioritising what data to collect and understanding how to collect it can be challenging, and no clear guidance exists. We conducted a 3-round Delphi study to develop consensus on the most important items to include in a minimum dataset of equity-relevant variables. An international panel of experts and interest-holders were invited to participate based on expertise in pain, social determinants of health and health equity, or a lived experience of persistent pain. In round 1, 168 participants rated the importance of an initial set of 43 equity-relevant items and categorised them according to the PROGRESS-Plus Framework. Twenty-nine items reached agreement for inclusion (based on a threshold of panel median of ≥7 of 9); none of the items were excluded. Participant comments were collated, and 21 new items were proposed. In round 2, 152 participants (90% of round 1) voted on 35 items, 25 of which reached agreement for inclusion. In round 3, 142 participants (93% of round 2) prioritised the 54 items that reached the threshold for inclusion within each category and rated the PROGRESS-Plus category importance. Our results indicated consistent agreement that it is important to collect data on a wide range of social factors and provide rich data to inform the development of a consensus-derived, globally applicable, “minimum dataset” that will be recommended for routine use in all human pain research.

Introduction: Posttransplant sleep disturbances may influence recovery, immunosuppressive adherence, and graft outcomes. This study examined sleep disruption in acute renal transplant recipients and its relationship with medication comprehension and hospital stressors. Methods/Approach: A mixed-methods, pilot prospective cohort study was conducted at a metropolitan hospital in Australia. Consecutive renal transplant patients were recruited. Perioperative sleep patterns were assessed using the American Academy of Sleep Medicine's sleep diary. The Kidney Transplant Understanding Tool evaluated medication comprehension. Qualitative data from semistructured interviews were analysed using inductive content analysis. Univariate linear regression assessed associations between sleep and perioperative outcomes (P ≤ .05). Findings: Ten recipients were recruited. Recipients averaged 5.2 hours of sleep per night with frequent disruptions. Sleep ranged from 0 to 10 hours per night, with the longest sleepless period being 41 hours. An inverse correlation was observed between sleep duration and medication comprehension scores(β=-8.736, P = .0232), suggesting recipients with less sleep had better medication comprehension. Qualitative analysis identified sleep disruptions due to hospital practices, environmental factors, transplant-related stress, and medication side effects. Conclusion: Perioperative sleep disturbances were multifactorial, influenced by hospital and procedural factors. The paradoxical association between reduced sleep and increased medication comprehension highlights a complex interplay between stress, sleep, and cognitive engagement. This pilot study suggested that addressing sleep disturbances and incorporating culturally sensitive education may enhance perioperative care. However, further research is needed to validate these findings in larger cohorts.

We aimed to compare disclosure of social risks according to self-report on an iPad versus face-to-face questions from a health professional and to explore carers’ experiences of screening. This two-arm, parallel group, randomized trial was conducted from January 19, 2021, to December 17, 2021, in a public hospital pediatric ward serving a disadvantaged area of an Australian capital city. Carers of children aged ≤ 5 years admitted to the Children’s Ward were eligible. The primary outcome was disclosure of social risks. The screener included nine items on food security, household utilities, transport, employment, personal and neighborhood safety, social support, housing and homelessness. Disclosure of social risks was similar between the self-completion ( n = 193) and assisted-completion ( n = 193) groups for all 9 items, ranging 4.1% higher for worrying about money for food (95% CI − 11.4, 3.1%) among the assisted-completion group, to 5.7% (−1.6, 13.0%) higher for unemployment among the self-completion group. In qualitative interviews, participants were positive about screening for social risks in the hospital ward setting and the majority indicated a preference for self-completion. Conclusion : Differences in the disclosure of social risks according to self- versus assisted-completion were small, suggesting that either method could be used. Most carers expressed a preference for self- completion, which is therefore recommended as the ideal mode for such data collection for Australian pediatric inpatient settings. Trial registration : Australia New Zealand Clinical Trial Registry ( www.anzctry.org.au ; #ACTRN12620001326987; date of registration 8 December 2020). What is Known: • Most evidence on screening of social risks in pediatric inpatient settings is from the USA. • Little is known about disclosure of social risks in countries with universal health care and social welfare. What is New: • Disclosure of social risks was similar for electronic compared with face-to-face screening. • Carers preferred electronic completion over face-to-face completion.

BACKGROUND:Frailty, malnutrition and low socioeconomic status may mutually perpetuate each other in a self-reinforcing and interdependent manner. The intertwined nature of these factors may be overlooked when investigating impacts on perioperative outcomes. This study aimed to investigate the impact of frailty, malnutrition and socioeconomic status on perioperative outcomes. METHODS:A multicentre cohort study involving six Australian tertiary hospitals was undertaken. All consecutive surgical patients who underwent an operation were included. Frailty was defined by the Hospital Frailty Risk Score, malnutrition by the Malnutrition Universal Screening Tool (MUST) and low socioeconomic status by the Index of Relative Socioeconomic Disadvantage. Linear mixed-effects and binary logistic generalised estimated equation models were performed for the outcomes: inpatient mortality, length of stay, 30-day readmission and re-operation. RESULTS:A total of 21 976 patients were included. After controlling for confounders, malnutrition and socioeconomic status, patients at high risk of frailty have a mean hospital length of stay 3.46 times longer (mean ratio = 3.46; 95% confidence interval (CI): 3.20, 3.73; P value < .001), odds of 30-day readmission 2.4 times higher (odds ratio = 2.40; 95% CI: 2.19, 2.63; P value < .001) and odds of in-hospital mortality 12.89 times greater than patients with low risk of frailty (odds ratio = 12.89; 95% CI: 4.51, 36.69; P value < .001). Elevated MUST scores were also significantly associated with worse outcomes, but to a lesser extent. Socioeconomic status had no association with outcomes. CONCLUSION:Perioperative risk evaluation should consider both frailty and malnutrition as separate, significant risk factors. Despite strong causal links with frailty and malnutrition, socioeconomic disadvantage is not associated with worse postoperative outcomes. Additional studies regarding the prospective identification of these patients with implementation of strategies to mitigate frailty and malnutrition and assessment of perioperative risk are required.

BACKGROUND:There is a lack of evidence regarding direct oral anticoagulant (DOAC) assay plasma concentrations and their association with bleeding events or transfusion requirements. This multicenter study aimed to characterize the use and plasma levels of DOAC assays of anticoagulated patients who present to emergency with a bleeding event and their association with bleeding severity. METHODS:A multicenter retrospective cohort study of consecutive emergency bleeding presentations with a DOAC assay over a five-year period was conducted. Linear regressions were performed for continuous outcomes, binary logistic regression for categorical outcomes. RESULTS:There were 86 patients on a DOAC, who presented with a major bleeding event, and had a DOAC assay performed. Assays were performed within a median time of 4.8 hours (IQR = 9,14.4) from presentation and had a median result of 122.9 ng/ml(IQR = 42,160). DOAC assay plasma level was not significantly associated with type or severity of bleed however, for every 10 unit increase in DOAC assay plasma level, the odds of administering reversal increases by 4% (OR = 1.04, 95%CI:1.00-1.08). CONCLUSION:A wide range of plasma levels can be expected in patients who present with bleeding events. Higher DOAC plasma levels do not necessarily confer a worse bleeding event or increased transfusion requirements; however, it is associated with an increased likelihood of anticoagulant reversal administration.

People living with HIV (PLHIV) are two to three times more likely to smoke tobacco compared to the general community. Evidence from the general population suggests that nicotine vaping products (NVPs) can be acceptable and effective smoking cessation aids, but there is limited evidence on the extent to which this is the case among PLHIV. This manuscript reports findings from the Tobacco Harm Reduction with Vaporised Nicotine (THRiVe) trial, a mixed-methods study investigating the feasibility of NVPs as smoking cessation aids among 29 PLHIV who smoked tobacco. Surveys and semi-structured interviews explored participants' experiences and perceptions of NVPs, their features and functions, and support for various NVP regulatory policy options. Participants described seven reasons why NVPs were acceptable cessation aids: they satisfied nicotine cravings; differences between NVPs and cigarettes facilitated habit breaking; fewer adverse effects compared to traditional cessation aids; NVPs allowed for a "weaning process" rather than requiring abrupt abstinence; tobacco became increasingly unpleasant to smoke; NVPs provided an increased sense of control; and participants experienced a deeper understanding of personal smoking behaviours. This study provides valuable insight into the preferred features of NVPs among PLHIV and reasons why NVPs may be effective for promoting smoking cessation among PLHIV.

Introduction Integrating health and social care to address unmet social needs is an emerging priority for health systems worldwide. Screening and referral interventions for unmet social needs in healthcare settings have shown promising results. Most screening and referral interventions are implemented in primary care, despite evidence that disadvantaged populations face substantial barriers to accessing such care. There are few social care interventions in hospital settings. To address this gap, we designed a hospital-based intervention screening an outpatient population for unmet social needs and using a Health Navigator to provide referrals and follow-up to appropriate community and government resources. Here we present a protocol for a feasibility and acceptability study of a hospital-based Health Navigator intervention. Methods and Analysis We will conduct a single-centre study to explore the feasibility and acceptability of screening and referral for unmet social needs for patients attending an outpatient cancer clinic at a major metropolitan hospital serving a disadvantaged population in South Australia. Eligible participants are 18 years of age or older receiving treatment at the Northern Adelaide Cancer Centre, with an expected prognosis of minimum six months. Eligible participants will be asked to complete unmet social needs screening and baseline assessments. Participants with unmet social needs who request assistance will be connected with a Health Navigator (HN). The HN will work with participants to prioritise their needs and provide referrals to community and government services with follow-up of over six months from enrolment. Post-HN intervention, all participants will be asked to complete repeat unmet social needs screening and repeat assessments. The primary criteria for determining feasibility success are: 1) recruitment rates will be successful if 80% of eligible participants agree to unmet needs screening, 2) intervention uptake will be successful if 80% complete follow-up, 3) reasons for not completing intervention and 4) participant and clinician acceptability of the intervention. Secondary outcomes include changes to clinical measures such as coping capacity, quality of life and patient-reported experience measures. Thematic analysis will be applied to focus groups with clinicians and participants to assess intervention acceptability. Secondary clinical outcomes will be reported as effect size estimates for future trial. As feasibility studies are designed to test whether an intervention is appropriate for larger studies, rather than finding specific associations or outcomes, no sample size calculation is necessary. Study findings will be used to optimise recruitment and intervention components, and develop suitable outcome measures for larger, randomized studies. Ethics and Dissemination The protocol has ethical approval from the Central Adelaide Local Health Network Human Research Ethics Committee (approval ID: 16448). Trial registration: ACTRN12622000802707p Protocol date and version: 07 June 2022, V1 Strengths and limitations of this study ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial ACTRN12622000802707p ### Funding Statement This study was funded by The Hospital Research Foundation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of The Central Adelaide Local Health Network Human Research Ethics Committee gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors

IntroductionIntegrating health and social care to address unmet social needs is an emerging priority for health systems worldwide. Screening and referral interventions for unmet social needs, also known as Health Navigator (HN) interventions, in healthcare settings have shown mixed but promising results, mostly due to a large variability in intervention design and outcomes assessed. Most HN interventions are implemented in primary care, despite evidence that disadvantaged populations face substantial barriers to accessing such care, and these interventions are limited in Australia. To address this gap, we designed a HN intervention to address the unmet social needs of a disadvantaged population living with cancer presenting at an outpatient cancer treatment facility in South Australia. To our knowledge, this paper presents a protocol for one of the first feasibility and acceptability studies of an HN intervention in an Australian healthcare setting.Methods and analysisWe will conduct a single-centre study to explore the feasibility and acceptability of screening and referral for unmet social needs for patients attending an outpatient cancer clinic at a major metropolitan hospital serving a disadvantaged population in South Australia. Eligible participants are 18 years of age or older receiving treatment at the Northern Adelaide Cancer Centre, with an expected prognosis of minimum 6 months. During recruitment, a researcher will ask eligible participants to complete unmet social needs screening and baseline assessments. Participants with unmet social needs who request assistance will be connected with an HN. The HN will work with participants to prioritise their needs and provide referrals to community and government services with follow-up of over 6 months from enrolment. Post-HN intervention, all participants will be asked to complete repeat unmet social needs screening and repeat assessments. The primary criteria for determining feasibility success are: (1) recruitment rates, where 80% of eligible participants agree to unmet needs screening; (2) intervention uptake, where 80% of participants who report unmet social needs consent to assistance from a HN; (3) intervention completion, where 80% of participants receive HN assistance complete follow-up; (4) reasons for not completing intervention; and (5) participant and clinician acceptability of the intervention. Secondary outcomes include changes to unmet social needs and coping with cancer ability, quality of life and patient-reported experience measures. Thematic analysis will be applied to focus groups with clinicians and participants to assess intervention acceptability. Secondary clinical outcomes will be reported as effect size estimates for future trials. Based on previous work in this area, we will aim to recruit 350 participants. Study findings will be used to optimise recruitment and intervention components and develop suitable outcome measures for larger, randomised studies.Ethics and disseminationThe protocol has ethical approval from the Central Adelaide Local Health Network Human Research Ethics Committee (approval ID: 16448). Findings will be disseminated in research publications and non-academic formats for a variety of audiences.Trial registration numberAustralian New Zealand Clinical Trial Registry (ACTRN12622000802707p).Protocol date and version: 07 June 2022, V1.

Deletion of Ccn1 in Col1A2-Cre-fibroblasts reduces tumor vasculature. A, Tumors in wild-type or mice deleted for Ccn1 in Col1A2-Cre-fibroblasts were perfused with a CT-contrast agent, as described in Materials and Methods. Volume (mL) of tumor occupied by vasculature was calculated. Mice lacking Ccn1 in their fibroblasts had significantly reduced vascular volume (t test, n = 3, P < 0.05). B, Tumors and associated stroma in wild-type or mice deleted for Ccn1 in fibroblasts were stained with anti-CD31 antibodies (t test; n = 3; *, P < 0.05).

Objective We describe aspects of social disadvantage in the northern Adelaide region, demonstrate how living with disadvantage impacts health outcomes to understand how the local health network can better serve this disadvantaged community. Design Using large scale, population-based data from the 2021 census we captured a snapshot of the disadvantage and health status of the community within the northern Adelaide region compared to the central and southern regions of Adelaide and other Australian capital cities. Results Northern Adelaide is a region of greater relative disadvantage, as shown by both the low Index of Relative Socio-Economic Disadvantage score (945) compared to the national average (1000) and scores above the national average for the central and southern Adelaide regions. Social determinants that contribute to this relative disadvantage include the proportion of people with no or limited education (26%) and those living on constrained income sources (e.g. unemployment benefits / aged pension, 10% and 72%, respectively). The northern Adelaide region has higher burdens of long-term health conditions including but not limited to diabetes, heart disease, kidney disease and lung diseases. The comparatively high prevalence of obesity (37%) for people in the north of Adelaide were associated with low numbers of people with adequate fruit intake (48%) and the higher proportion of people who currently smoke (16%) and who undertake low or no levels of exercise (73%). Conclusions Social disadvantage in the northern Adelaide region is associated with poorer health outcomes and higher levels of health risk behaviour compared to the less disadvantaged central and southern regions of Adelaide. Adapting health care to recognise this association may help improve the health of people living with disadvantage. Summary box ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: We analysed data from the Australian Bureau of Statistics (ABS), using the Social Health Atlas of Australia: 2021 Census and data by population health areas (PHA), updated throughout 2023. This data is available via the PHIDU website. https://phidu.torrens.edu.au I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes We analysed data from the Australian Bureau of Statistics (ABS), using the Social Health Atlas of Australia: 2021 Census and data by population health areas (PHA), updated throughout 2023. This data is publicly available via https://phidu.torrens.edu.au * ### List of Abbreviations ASR : Age-standardised rate CALHN : Central Adelaide local health network LGA : local government area LHN : local health network NALHN : Northern Adelaide local health network PHA : Public Health Area SALHN : Southern Adelaide local health network

Background: The objective of this study was to evaluate the impact of dysglycemia on perioperative outcomes, in patients with and without diabetes, and how prior glycemic control modifies these relationships. Methods: Consecutive surgical patients admitted to six South Australian tertiary hospitals between 2017 and 2023 were included. Blood glucose levels within 48 h pre- and post-operatively were assessed in an adjusted analyses against a priori selected covariates. Dysglycemia metrics were hyperglycemia (>10.0 mmol/L), hypoglycemia (<4.0 mmol/L), glycemic variability (standard deviation of mean blood glucose >1.7 mmol/L), and stress hyperglycemic ratio (SHR). The primary outcome was hospital mortality. Results: Of 52 145 patients, 7490 (14.4%) had recognized diabetes. Inpatient mortality was observed in 787 patients (1.5%), of which 150 (19.1%) had diabetes mellitus. Hyperglycemia was associated with increased mortality in patients with diabetes (odds ratio [OR] = 2.99, 95% CI: 1.63-5.67, p = 0.004) but not in non-diabetics, who instead had an increased odds of intensive care unit (ICU) admission if hyperglycemic (OR = 1.95, 95% CI: 1.40-2.72, p < 0.0001). Glycemic variability was associated with increased mortality in patients with diabetes (OR = 1.46, 95% CI: 1.05-2.01, p < 0.05) but not in non-diabetics. Preoperative glycemic control (HbA1c) attenuated both of these associations in a dose-dependent fashion. Hypoglycemia was associated with increased mortality in non-diabetics (OR = 2.14, 95% CI: 1.92-2.37, p < 0.001) but not in patients with diabetes. Conclusions: In surgical patients with diabetes, prior exposure to hyperglycemia attenuates the impact of perioperative hyperglycemia and glycemic variability on inpatient mortality and ICU admission. In patients without diabetes mellitus, all absolute thresholds of dysglycemia are associated with ICU admission, unlike those with diabetes, suggesting the need to use more relative measures such as the SHR. image

Internal Medicine JournalVolume 53, Issue 9 p. 1724-1725 Letter to the Editor Like a Surgeon? A letter commenting on Grosse and Thomas's 'Selection into training will always be an inexact process: a survey of Directors of Physician Education on selection into Basic Physician Training in Australia and New Zealand' Brandon Stretton, Brandon Stretton [email protected] orcid.org/0000-0002-7939-3489 Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorJoshua Kovoor, Joshua Kovoor orcid.org/0000-0002-3880-3840 Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorStephen Bacchi, Stephen Bacchi Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorAashray Gupta, Aashray Gupta Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, AustraliaSearch for more papers by this authorThomas Hugh, Thomas Hugh Surgical Education Research and Training, Royal North Shore Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorChristopher Dobbins, Christopher Dobbins Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorMarkus Trochsler, Markus Trochsler Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorPeter Hewett, Peter Hewett Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorWeng O. Chan, Weng O. Chan Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorSavio G. Barreto, Savio G. Barreto College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia Hepatobiliary and Liver Transplant Unit, Flinders Medical Centre, Adelaide, South Australia, AustraliaSearch for more papers by this authorChristopher Rayner, Christopher Rayner Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorMartin Bruening, Martin Bruening Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, AustraliaSearch for more papers by this authorRobert Padbury, Robert Padbury College of Medicine and Public Health, Flinders University, Adelaide, South Australia, AustraliaSearch for more papers by this authorNicholas J. Talley, Nicholas J. Talley School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, AustraliaSearch for more papers by this authorAdrian Anthony, Adrian Anthony Royal Australasian College of Surgeons, Melbourne, Victoria, AustraliaSearch for more papers by this authorMichael Horowitz, Michael Horowitz Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorGuy Maddern, Guy Maddern Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, AustraliaSearch for more papers by this authorMark Boyd, Mark Boyd Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this author Brandon Stretton, Brandon Stretton [email protected] orcid.org/0000-0002-7939-3489 Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorJoshua Kovoor, Joshua Kovoor orcid.org/0000-0002-3880-3840 Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorStephen Bacchi, Stephen Bacchi Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorAashray Gupta, Aashray Gupta Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, AustraliaSearch for more papers by this authorThomas Hugh, Thomas Hugh Surgical Education Research and Training, Royal North Shore Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorChristopher Dobbins, Christopher Dobbins Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorMarkus Trochsler, Markus Trochsler Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorPeter Hewett, Peter Hewett Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorWeng O. Chan, Weng O. Chan Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, AustraliaSearch for more papers by this authorSavio G. Barreto, Savio G. Barreto College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia Hepatobiliary and Liver Transplant Unit, Flinders Medical Centre, Adelaide, South Australia, AustraliaSearch for more papers by this authorChristopher Rayner, Christopher Rayner Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorMartin Bruening, Martin Bruening Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, AustraliaSearch for more papers by this authorRobert Padbury, Robert Padbury College of Medicine and Public Health, Flinders University, Adelaide, South Australia, AustraliaSearch for more papers by this authorNicholas J. Talley, Nicholas J. Talley School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, AustraliaSearch for more papers by this authorAdrian Anthony, Adrian Anthony Royal Australasian College of Surgeons, Melbourne, Victoria, AustraliaSearch for more papers by this authorMichael Horowitz, Michael Horowitz Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorGuy Maddern, Guy Maddern Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, AustraliaSearch for more papers by this authorMark Boyd, Mark Boyd Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this author First published: 24 September 2023 https://doi.org/10.1111/imj.16214Read 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 onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1Grosse A, Thomas J. 'Selection into training will always be an inexact process': a survey of directors of physician education on selection into basic physician training in Australia and New Zealand. Intern Med J 2023. https://doi.org/10.1111/imj.16083 10.1111/imj.16083 PubMedWeb of Science®Google Scholar 2Brennan P. Trainee Selection in Australian Medical Colleges. Medical Training Review Panel Commonwealth Department of Health and Family Services, Pub; 1998. Google Scholar 3 RACS Surgical Competence and Performance Framework – A Guide to Aid the Assessment and Development of Surgeons. 3rd ed, 2020. Australia: RACS. Available from URL: https://www.surgeons.org/-/media/Project/RACS/surgeons-org/files/Louise-Pfrunder/Surgical-Competence-and-Performance-Framework_V16.pdf?rev=120ec964eb9e4c26a1f266eba17eaf79&hash=BA49820B4620667CA9F007C72856E346 Google Scholar 4Oldfield Z, Beasley S, Smith J, Anthony A, Watt A. Correlation of selection scores with assessment scores during surgical training. ANZ J Surg 2013; 83: 412–416. 10.1111/ans.12176 CASPubMedWeb of Science®Google Scholar Volume53, Issue9September 2023Pages 1724-1725 ReferencesRelatedInformation