Rapid review: Guides and frameworks to inform planetary health education for health professions.

ISSUE ADDRESSED: Human actions have led to a range of global environmental changes. Health professionals must be prepared to deliver systemic changes to mitigate and adapt to the ecological crisis. This rapid review aimed to describe exemplar frameworks that inform planetary health education across health professions. METHODS: The rapid review methodology was informed by a scoping review process. A targeted search strategy was conducted using one representative database and additional strategies such as expert consultation and citation searching were used. Results are described narratively. RESULTS: Of the 11 637 articles, 17 were eligible for inclusion. The frameworks differed, with many recently developed for health professions broadly using a range of methodologies, including qualitative research, opinion/consensus data, literature reviews, and adaptation of previous models. Models such as metric-based scoring indicators and Sustainable Quality Improvement were featured in the frameworks, as were the application of First Nations Natural Laws. CONCLUSION: This rapid review identifies and showcases accessible, interdisciplinary frameworks to inform the integration of planetary health in curricula, highlighting a rapidly evolving field through which interdisciplinary collaborations in healthcare are important to inform its pedagogy and application. Health education is an important component of health promotion; and thus this rapid review offers a range of approaches that health professionals, health promotion practitioners, and educators can use to inform the integration of planetary health, including sustainable healthcare, into curricula. SO WHAT?: Educational frameworks are informed by research and practice and provide key guidance to practitioners and educators; summarising key available planetary health education frameworks consolidates and guides effective education and builds on the existing body of knowledge to support urgent pro-environmental change.

Room service in a public hospital improves nutritional intake and increases patient satisfaction while decreasing food waste and cost.

BACKGROUND: Room service (RS) is a hospital foodservice model that is traditionally unique to the private sector. It allows patients to order meals compliant to their nutritional requirements from a single integrated menu at a time that suits them. Meals are prepared and delivered within 45 min of order. Following implementation in a private adult facility in 2013, Mater Group implemented the first RS in a public adult facility in Australia in 2016. In a pre-post study comparing RS with a traditional foodservice model (TM), key outcomes were measured and analysed. METHODS: A retrospective analysis of quality assurance data audits in a pre-post study design was undertaken to assess patient nutritional intake, plate waste, satisfaction and meal costs before and after RS implementation. RESULTS: Comparison of nutritional intake between TM (n = 84) and RS (n = 103) showed statistically significant increases with RS in both energy (5513 kJ day-1 versus 6379 kJ day-1 , P = 0.020) and protein (53 g day-1 versus 74 g day-1 , P < 0.001) intake, as well as energy and protein intake as a percentage of requirements (64% versus 78%, P = 0.002 and 70% versus 99%, P < 0.001, respectively). Total average plate waste decreased from 30% to 17% (P < 0.001). Patient satisfaction indicated an improvement with RS, with 98% of patients scoring the service good to very good, compared to 75% for TM (P < 0.04). Patient food costs decreased by 28% per annum with RS. CONCLUSIONS: This research provides insight into the benefits achievable with RS in the public hospital setting, confirming that a patient-centred food service model can cost-effectively improve clinical outcomes.

Increased 5-HT2C receptor responsiveness occurs on rearing rats in social isolation.

To investigate whether isolation rearing alters 5-hydroxytryptamine2C (5-HT2C) receptors, the effect of the serotonin agonist m-chlorophenylpiperazine (mCPP) was examined on elevated plus-maze behaviour, plasma corticosterone and brain 5-HT2C receptor protein levels in rats. There was no distinction between behaviour or corticosterone levels in drug-free isolates or socially housed rats exposed to the elevated plus-maze. The anxiogenic response to mCPP (decrease in open arm entry and time and an increase in stretch attend postures) on the elevated plus-maze was greater in isolation than in socially reared controls without any concomitant difference in the hypolocomotor effect of mCPP in the two groups. mCPP produced a greater elevation in plasma corticosterone in isolates than in group-housed controls. Hippocampal 5-HT2C receptor protein-like immunoreactive levels were significantly lower following mCPP than saline only in rats reared in isolation. These results indicate that increased 5-HT2C receptor responsiveness accompanies isolation-rearing and may contribute to the enhanced response to stress and the increased neophobia seen in this animal model of trait anxiety/depression. In isolation reared rats, rapid down-regulation of supersensitive 5-HT2C receptors may occur in the hippocampus following 5-HT agonist challenge.

Treatment of persistent painful nodules of hidradenitis suppurativa with cryotherapy.

We report outcomes for 10 patients with persistent painful nodules of hidradenitis suppurativa treated with cryotherapy. Eight patients reported improvement and to date have had no recurrence of lesions at the treated sites. Most patients had significant pain during and after treatment. Eight patients had post-treatment ulceration, infection or both. The average number of days for the treatment areas to heal was 25. Seven patients rated cryotherapy as better than oral antibiotics and eight patients would consider this treatment again in the future. Cryotherapy can be an effective treatment for patients who have limited but persistent painful nodules. However, patients must be warned about pain, prolonged healing time and risk of infection after the procedure.