Background: The transition home after hospital discharge is critical, particularly for older patients with heart failure (HF), who have high readmission rates.
Aim: This study assesses the quality of transition-of-care (TOC) services for older patients with HF in Australia and identifies areas for improvement.
Method: A quantitative study was conducted using the Care Transition Measure (CTM-15) among patients with HF aged 60 and older who were discharged home after hospital discharge. Participants were recruited from Austin Health, a major regional hospital, and local GP clinics in Victoria. The analysis involved descriptive statistics, reliability testing (Cronbach's alpha), and inferential statistics.
Results: Out of the 130 participants, 52.3% were male, 77.7% were aged 70 or older, and 63.8% lived in regional areas. The majority (69.2%) spoke English as their first language. The Cronbach's alpha for the CTM-15 was 0.80. The mean total score for the CTM-15 was 48.28, with the highest score of 50.51 recorded in the "Secured Preferences" domain and the lowest score of 46.37 in the "Preparation for Self-Management" domain.
Conclusion and implications: The mean total CTM-15 score of 48.28 reflects unsatisfactory experiences regarding TOC service. The highest score in the “Secured Preferences” domain suggests that participants have established clear healthcare preferences that align with their values. Conversely, the lowest score in the “Preparation for self-management” domain indicates a potential area of concern. This gap suggests that while participants may know their preferences, they might not feel adequately prepared to manage their health and treatments independently. Addressing this disparity could involve developing educational programs that enhance self-management skills, which are critical for improving health outcomes and fostering autonomy. Overall, these findings highlight the need for tailored healthcare interventions that consider communication, support networks, and self-management capabilities.
Keywords: Heart failure, Transition of care, Older

Background
Overseas-born men account for an increasing proportion of new HIV diagnoses among men in Australia, yet remain under-engaged in HIV prevention services, such as pre-exposure prophylaxis (PrEP). This pilot study evaluated the feasibility and acceptability of using sexually transmitted infection (STI) case notifications to link men at increased risk of HIV to prevention services.

Methods
We conducted a pilot intervention at the South East Public Health Unit, Melbourne, between January and September 2025. Adult men living in the catchment with notifications of infectious syphilis, pharyngeal or anorectal gonorrhoea, or mpox were offered the intervention - contact by the sexual health nurse and personalised linkage to PrEP counselling, HIV testing, and vaccination services. Primary outcomes were pathway feasibility (participant retention, time taken and barriers) and acceptability (5-point Likert scale).

Results
Of 631 STI notifications received, 493 (78%) individuals were successfully contacted, 214 (43%) met eligibility and 61 (29%) were enrolled in the intervention. Among enrolled participants, 39 (62%) completed 6-week follow-up. All survey respondents (31/61, 55%), rated the intervention as acceptable and minimally burdensome. Time-motion analysis indicated that successful recruitment required approximately 1.0-2.2 hours of nurse time per participant over a 2-3 month period. Key feasibility challenges included incomplete contact information in case notification data, clinician gatekeeping (whereby entities have the ability to allow or deny access to resources), and participant preference for SMS over telephone contact.

Conclusions
While acceptable to participants who engaged in the intervention, this nurse-led STI notification pathway demonstrated limited scalability. Future approaches should prioritise completeness of surveillance data, hybrid models combining automated digital outreach with on-demand human support, partnerships with online STI testing services, and strengthening data linkage infrastructure.

Background: Serum uric acid (SUA) may influence neurodegeneration through oxidative stress and vascular pathways associated with cognitive decline. Evidence on the association between SUA and dementia risk is inconsistent, with studies reporting both protective and harmful associations, and prospective data in older adults are limited.
Methods: This prospective cohort study used data from the ASPREE-XT and the ASPREE Healthy Ageing Biobank. Participants with SUA measurements at baseline and 3-year follow-up were included, excluding users of anti-gout medications. Sex-stratified analyses were conducted a priori based on biological plausibility. Absolute 3-year change in SUA was calculated and categorised into quintiles as decline (Q1), stable (Q2–Q4), and increase (Q5). Dementia diagnoses were adjudicated by an expert panel according to DSM-IV criteria. Multivariable Cox proportional hazards regression models were used to estimate the associations of baseline SUA levels and longitudinal changes in SUA with the risk of incident dementia.
Results: Among 11,411 participants followed for a median of 9 years, 1,000 (8.8%) developed dementia, including 9.3% of males and 8.3% of females. Among females, the lowest SUA quintile was associated with higher dementia risk in adjusted models (HR:1.24, 95% CI:1.01–1.53), whereas no association was observed among males (HR:1.06, 95% CI:0.83–1.35). Longitudinal changes in SUA were not associated with dementia risk among females. Among males, greater decline in SUA over time was associated with higher dementia risk (HR:1.29, 95% CI:1.02–1.62). Effect modification by diabetes status was observed in males (P for interaction = 0.019).
Conclusion: Low SUA levels were associated with higher dementia risk among females, while declining SUA levels over time were associated with a higher dementia risk among males. These findings suggest sex-specific associations between SUA and dementia risk and support further investigation into the potential role of SUA as a biomarker of cognitive ageing.

Background: Genito-pelvic pain affects many people across their lifespan and can be associated with genito-pelvic pain/penetration disorder (GPPPD). GPPPD can make vaginal insertion from penetrative sex, fingers, menstrual products, cervical screening, and gynaecological examination painful, difficult, or impossible. It therefore extends beyond sexual or relationship functioning and impacts menstrual health, preventive care, and quality of life. Yet, there is lacking synthesis of patient-reported outcome measures (PROMs) to assess GPPPD. Hence, this systematic review identified PROMs used in GPPPD assessment and examined measurement gaps.

Methods: Following PRISMA guidelines, databases including PubMed, Scopus, ProQuest, CINAHL, and COSMIN were searched in 2026 for English-language studies reporting PROMs relevant to GPPPD symptomology. Additional bi-directional citation searching was undertaken. Sixteen eligible studies were included. Data were extracted and mapped against GPPPD diagnostic criteria.

Results: Six PROMs focused on GPPPD subtypes of vaginismus and dyspareunia. The remaining PROMs assessed broader sexual function or distress and only partially captured GPPPD symptomology. The PROMs largely focused on pain location and intensity, and negative cognitions related to penis-in-vagina (PIV) penetration. There was lacking measurement of non-PIV insertion experiences, co-occurring conditions commonly associated with GPPPD, and patients’ healthcare experiences and goals beyond sexual penetration.

Conclusions: The identified gaps in PROMs may contribute to under-recognition of GPPPD within healthcare systems. Future measure development and implementation should review non-PIV insertion experiences, healthcare interactions, and commonly co-occurring conditions. Such PROMs may better identify multimorbidity patterns and psychosocial impacts to support earlier detection, timely diagnosis, and whole-person care of GPPPD. This could improve recognition of GPPPD across diverse populations, including people who are not sexually active, non-heterosexual, or prioritising non-PIV vaginal insertion such as cervical screening or menstrual product use. Advancing inclusive and person-centred PROMs for GPPPD could improve preventive healthcare and enable public health systems to better support diverse healthcare needs.

Abstract
Background: Vaping among adolescents is increasing rapidly in Australia, generating significant health risks and potential for long-term nicotine dependence. General practitioners (GPs) and paediatricians are well-positioned to identify and address vaping among young people, yet little is known about how they approach these conversations in routine care. This study explored their experiences, challenges, and recommendations for improving vaping prevention and cessation support among adolescents.
Methods: In-depth semi-structured interviews were conducted with 10 Australian clinicians (GPs, n = 6; paediatricians, n = 4) practising in metropolitan, regional, and rural settings. Participants were recruited from a larger survey on clinician knowledge and attitudes towards adolescent vaping. Interviews were video-recorded or audio-recorded and transcribed verbatim. Thematic analysis was used to classify, describe, and report themes in the data.
Results: Participants reported using opportunistic and tailored screening approaches, often incorporating vaping questions into broader psychosocial assessments such as the HEEADSSS framework. They emphasised the importance of building trust and maintaining confidentiality to encourage honest conversations. Clinicians addressed misconceptions about vaping by adapting their messages to align with adolescent interests, including sports performance and personal appearance. Most had limited experience with cessation support, primarily due to low rates of adolescent help seeking behaviour. Motivational interviewing and harm reduction were the most common intervention strategies. Reported barriers included low motivation among adolescents, peer acceptance of vaping, parental influence during consultation, and the lack of specific cessation protocols for adolescents. Participants espoused the need for structured screening tools, youth-oriented educational materials, enhanced training in adolescent communication, and broader system-level supports, including partnerships between schools and community organisations.
Conclusions: Addressing knowledge gaps, enhancing communication skills, and embedding structured, developmentally appropriate interventions in primary care may strengthen early intervention efforts and reduce vaping uptake among Australian adolescents.

Engagement in hepatitis B care is below the national average in Barwon South West (BSW), Victoria. Recent local qualitative work identified enablers to providing hepatitis B care in general practice (GP) including a community of practice (CoP) for hepatitis B s100 prescribers and GP software audits to identify priority populations for hepatitis B testing and linkage to care. This study describes implementation of a hepatitis B CoP and GP software audits in BSW.

To establish the CoP, a working party was convened with clinicians, Cultura (multicultural support agency) and Western Victoria Primary Health Network (WVPHN). The integrated hepatitis nurse recruited hepatitis B s100 prescribers to the CoP and created a WhatsApp group with local specialists. CoP participants were offered funded secondments to specialist viral hepatitis clinics and BSW Public Health Unit to fulfil s100 professional development requirements.
With the support of WVPHN and ASHM, GP practice audits are in progress. Researchers are identifying how available audit tools can be utilised according to GP practice software and resources.

Six hepatitis B s100 prescribers have been recruited to the CoP and two have attended secondments to viral hepatitis clinic and BSW public health unit. As a result of this pilot, a viral hepatitis auditing tool is now available to GP practices across the region through WVPHN’s practice intelligence tool POLAR and has been used by one participating practice. As a data extraction tool, incomplete patient records are a barrier to optimal use, with country of birth not routinely recorded, but rather ethnicity, in keeping with Royal Australian College of General Practitioner standards.

Early signs are promising for the role of a CoP in informing initiatives to improve hepatitis B care. Engagement with local organisations that have a broad mandate to deliver healthcare and other essential services and key elements of the CoP.

Background
Adverse birth outcomes remain a significant public health concern in Australia. Despite a range of perinatal health interventions, no comprehensive review has explored the types of interventions, target populations, and inclusiveness. This scoping review synthesises existing evidence on perinatal health interventions available in Australia.
Methods
The scoping review was conducted using Arksey and O’Malley’s methodological framework, refined by the Joanna Briggs Institute (JBI). Literature searches were conducted in PubMed, Embase (Ovid), Scopus, Web of Science, and CINAHL for articles published since 2000. The review was structured using the Population-Concept-Context framework to explore the interconnections between adverse perinatal outcomes and perinatal health interventions in Australia. Interventions such as structured programs, models of care, or policy initiatives aimed at improving perinatal outcomes were included. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A narrative synthesis was conducted to map and summarise the intervention type.
Results
Of the 3,649 records identified from five databases and grey literature sources, 59 studies were included in the final analysis. Observational cohort designs were common 18 (30.5%). More than half, 31 (52.5%), of the study was conducted in New South Wales (NSW), Victoria, and Queensland, whereas a smaller proportion, 8 (13.6%), was conducted in remote settings. Midwifery continuity-of-care models were the most common interventions 16 (27.1%), followed by Clinical risk-targeted interventions 15 (25.4%). Preterm birth 12 (20.3%) was the most frequently reported early neonatal outcome. More than half (52.5%) of the studies reported positive outcomes based on the authors' reported findings. Only 23 (39%) studies focused specifically on First Nations women.
Implications
Australian perinatal interventions emphasise continuity of care and risk-based models, yet evidence is metropolitan-focused, with limited population-level impact data. Significant geographic, equity, and Indigenous gaps persist, requiring inclusive, culturally grounded, community-led approaches.

BreastScreen Victoria (BSV) conducted a Screening Shawl Trial with the goal of improving overall breast screening experiences for women, particularly those who face barriers related to past trauma, cultural safety, modesty and anxiety.

The trial was implemented at BSV’s Bendigo (rural) and Burgundy Street (metropolitan) services from October 2025 – February 2026, and all clients were offered a choice of 2 shawl designs to enhance privacy, comfort and dignity during screening.

Uptake reached 18.9%, with 1,035 clients choosing to use a shawl when screening. Our client feedback insights indicated that shawls reduced anxiety, improved perceptions of modesty and comfort.

This initiative was designed to improve breast screening experiences, through systems-level innovation, practical solutions for communities facing the greatest barriers to preventative care.

The Screening Shawls create simple, culturally sensitive modifications to screening processes to enhance comfort and support for women who might otherwise delay or avoid screening, so they can continue to live long, healthy lives.

Background: Despite increasing investment in digital health, Clinical Decision Support Systems (CDSS) have not consistently translated into improved clinical practice, largely due to variable clinician engagement and adoption across healthcare settings. While CDSS are designed to enhance evidence-based decision-making, their integration into routine practice remains challenging, particularly when systems do not align with clinical workflows and professional judgement.

Objective: This study explores how healthcare professionals perceive, engage with, and respond to CDSS and identifies organisational and implementation factors that influence the effective and sustained use of CDSS.

Methods: A qualitative study was conducted using semi-structured interviews with 22 participants. Interviews were conducted with a heterogeneous group of healthcare professionals, including general practitioners (n=7), nurses (n=4), cardiologists (n=4), a consultant in emergency medicine (n=1), pharmacists (n=1), healthcare executives/managers (n=3) and academics (n=2), from public and private hospitals and clinics in Australia. Participants were purposively sampled to capture variation in roles, experience levels, and organisational contexts. Data were analysed using reflexive thematic analysis through an iterative coding process to inductively generate themes.

Results: Five interrelated themes shaped clinician engagement with CDSS: (1) autonomy in decision-making, (2) trust and confidence in recommendations, (3) cognitive burden and alert management, (4) workflow integration and time constraints, and (5) safety-net functions supporting risk management. Engagement varied across roles and experience levels, younger participants reported relying on CDSS, whereas more senior clinicians more frequently overrode recommendations. Poor workflow integration and excessive alerts contributed to alert fatigue and disengagement, whereas systems perceived as reliable and supportive of patient safety enhanced use.

Conclusions: CDSS effectiveness depends not only on technical design but also on alignment with workflow, trust, and professional autonomy. Findings highlight the importance of co-designed, context-sensitive implementation strategies. These insights inform scalable digital health implementation and have implications for improving healthcare quality, patient safety, and system performance.

Background: Health professionals (HPs) are important sources of information and support for patients who smoke and vape, with brief intervention shown to increase cessation. Unfortunately, HPs report barriers to providing support in clinical practice, including lack of knowledge, skills, and confidence. Better training may improve HP capacity to offer evidence-based cessation advice. Among other interventions, the Incentive 2 Quit (I2Q) program provides training to health/community service staff across the Northern Adelaide Local Health network on how to deliver brief smoking/vaping cessation advice.

Model of care: Based on the Ask, Advise, Help (AAH) model, training aimed to develop HP skill, knowledge, and confidence in providing brief advice, addressing issues specific to priority group support. Training was delivered in-person by experienced researchers. Questionnaires were completed pre- and post-training, including Likert scales to evaluate confidence, knowledge, and attitude.

Results: The initial engagement target was quadrupled, with n=341 HPs attending at least 1 training session. This evaluation contains data from n=162 pre-training questionnaires, and n=119 matched pre/post questionnaires. Pre-training, 81.3% of respondents reported never receiving smoking/vaping cessation training. Training significantly improved measures of knowledge, skills, and confidence to provide smoking/vaping cessation support to their patients.

Conclusion and Next Steps: I2Q training was successful in improving knowledge, skills, and confidence of HPs to provide smoking and vaping cessation support to patients. This model should be tested for efficacy in larger research studies of high methodological rigour, and policymakers should consider training HPs in behaviour change interventions for other public health issues.