'Growing your own' a case study of a collaborative training program in medical radiation science.

INTRODUCTION: Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice. METHODS: A cross-sectional 22-item online survey including open-ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations. RESULTS: 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0). CONCLUSIONS: Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs.

The Australian pharmacist workforce: distribution and predictors of practising outside of metropolitan and regional areas in 2019.

OBJECTIVE: This study describes the distribution of the Australian pharmacists' workforce using a range of indicators and identifies predictors of practising outside of metropolitan and regional areas. METHODS: A cross-sectional description of the 2019 pharmacy workforce. Pharmacists who completed the 2019 workforce survey as reported in the Australian National Health Workforce Dataset (NHWDS). The main outcome measures were the number of pharmacists per 100 000, the proportion working less than 35 h a week, the proportion with primary qualification from overseas (outside of Australia and New Zealand) and the proportion aged 65 years or older. Additionally, predictors of practising outside of metropolitan and regional areas were also identified. KEY FINDINGS: Nationally, there were 102 pharmacists/100 000 with one-third working less than 35 h a week. About 10% of pharmacists obtained their primary qualification from overseas and 4% were 65 years old or older. Males were more likely to practise outside of metropolitan and regional areas [OR, 1.40 (1.30-1.50); P < 0.001], while younger people were less likely to practise outside of these locations [OR, 0.71 (0.66-0.76); P < 0.001]. Those who had obtained their primary qualification overseas were also more likely to practise outside of metropolitan and regional areas. CONCLUSIONS: Analysis of the 2019 NHWDS suggests an uneven distribution of the pharmacist workforce. Also, three predictors of practising outside of major cities and regional centres were identified.

Identifying features of quality in rural placements for health students: scoping review.

OBJECTIVES: To explore and synthesise the evidence relating to features of quality in rural health student placements. DESIGN: Scoping review. DATA SOURCES: MEDLINE, CINAHL, Embase, ProQuest, Informit, Scopus, ERIC and several grey literature data sources (1 January 2005 to 13 October 2020). STUDY SELECTION: The review included peer-reviewed and grey literature from Organisation for Economic Co-operation and Development listed countries that focused on quality of health student placements in regional, rural and remote areas. DATA EXTRACTION: Data were extracted regarding the methodological and design characteristics of each data source, and the features suggested to contribute to student placement quality under five categories based on a work-integrated learning framework. RESULTS: Of 2866 resulting papers, 101 were included for data charting and content analysis. The literature was dominated by medicine and nursing student placement research. No literature explicitly defined quality in rural health student placements, although proxy indicators for quality such as satisfaction, positive experiences, overall effectiveness and perceived value were identified. Content analysis resulted in four overarching domains pertaining to features of rural health student placement quality: (1) learning and teaching in a rural context, (2) rural student placement characteristics, (3) key relationships and (4) required infrastructure. CONCLUSION: The findings suggest that quality in rural health student placements hinges on contextually specific features. Further research is required to explore these findings and ways in which these features can be measured during rural health student placements.

Smad2/4 Signaling Pathway Is Critical for Epidermal Langerhans Cell Repopulation Under Inflammatory Condition but Not Required for Their Homeostasis at Steady State.

Epidermal Langerhans cells (LCs) are skin-resident dendritic cells that are essential for the induction of skin immunity and tolerance. Transforming growth factor-ß 1 (TGFß1) is a crucial factor for LC maintenance and function. However, the underlying TGFß1 signaling pathways remain unclear. Our previous research has shown that the TGFß1/Smad3 signaling pathway does not impact LC homeostasis and maturation. In this study, we generated mice with conditional deletions of either individual Smad2, Smad4, or both Smad2 and Smad4 in the LC lineage or myeloid lineage, to further explore the impact of TGFß1/Smad signaling pathways on LCs. We found that interruption of Smad2 or Smad4 individually or simultaneously in the LC lineage did not significantly impact the maintenance, maturation, antigen uptake, and migration of LCs in vivo or in vitro during steady state. However, the interruption of both Smad2 and Smad4 pathways in the myeloid lineage led to a dramatic inhibition of bone marrow-derived LCs in the inflammatory state. Overall, our data suggest that canonical TGFß1/Smad2/4 signaling pathways are dispensable for epidermal LC homeostasis and maturation at steady state, but are critical for the long-term LC repopulation directly originating from the bone marrow in the inflammatory state.

Is exposure to personal music players a confounder in adolescent mobile phone use and hearing health studies?

OBJECTIVE: This study was performed to determine whether exposure to personal music players (PMPs) in the immediate morning prior to hearing testing confounds the association between mobile phone use and hearing thresholds of adolescents. DESIGN: In this cohort study of cognitive function in year 7 students (median age 13 years, range 11-14), information regarding the weekly use of mobile phones and the use of PMPs was assessed by a questionnaire. Pure-tone audiometry was used to establish hearing thresholds for all participants. RESULTS: Among a cohort of 317 adolescents (60.9% females), 130 were unexposed to PMP use while 33 were exposed to PMP use in the morning prior to hearing testing. No statistically significant difference in hearing threshold shifts was found between adolescents who were and were not exposed to PMP use prior to hearing testing. Likewise, the difference in the use of mobile phones according to the PMP use status was not statistically significant. CONCLUSION: Exposure to PMPs prior to hearing testing did not introduce confounding in the present study of mobile phone use and hearing loss among adolescents.

Research Techniques Made Simple: Single-Cell RNA Sequencing and its Applications in Dermatology.

RNA sequencing is one of the most highly reliable and reproducible methods of assessing the cell transcriptome. As high-throughput RNA sequencing libraries at the single cell level have recently developed, single cell RNA sequencing has become more feasible and popular in biology research. Single cell RNA sequencing allows investigators to evaluate cell transcriptional profiles at the single cell level. It has become a very useful tool to perform investigations that could not be addressed by other methodologies, such as the assessment of cell-to-cell variation, the identification of rare populations, and the determination of heterogeneity within a cell population. So far, the single cell RNA sequencing technique has been widely applied to embryonic development, immune cell development, and human disease progress and treatment. Here, we describe the history of single cell technology development and its potential application in the field of dermatology.

Cordless telephone use: implications for mobile phone research.

Cordless and mobile (cellular) telephone use has increased substantially in recent years causing concerns about possible health effects. This has led to much epidemiological research, but the usual focus is on mobile telephone radiofrequency (RF) exposure only despite cordless RF being very similar. Access to and use of cordless phones were included in the Mobile Radiofrequency Phone Exposed Users Study (MoRPhEUS) of 317 Year 7 students recruited from Melbourne, Australia. Participants completed an exposure questionnaire-87% had a cordless phone at home and 77% owned a mobile phone. There was a statistically significant positive relationship (r = 0.38, p < 0.01) between cordless and mobile phone use. Taken together, this increases total RF exposure and its ratio in high-to-low mobile users. Therefore, the design and analysis of future epidemiological telecommunication studies need to assess cordless phone exposure to accurately evaluate total RF telephone exposure effects.

Predictors of mobile telephone use and exposure analysis in Australian adolescents.

AIM: Australian adolescents are increasingly using mobile telephones (MP) while the debate on MP safety persists. This group is not generally engaged in full-time employment, suggesting that their MP use is not work related. We investigated possible predictors of MP use in young people. METHODS: We assessed exposure to radiofrequency energy from MP by means of a self-administered questionnaire adapted from INTERPHONE--an international case-control study of adult brain, head and neck tumours. We investigated possible determinants of MP use in adolescent Australians using self-reported number of incoming and outgoing voice calls as exposure metric. RESULTS: There is a high prevalence of MP use amongst Australian adolescents (94%). Males were significantly younger than females at age of first uptake of MP (P= 0.02). Participants without siblings were significantly younger at age of first uptake. Personality traits were associated with regular MP usage: higher psychoticism scores were associated with regular use (IRR = 1.06, P= 0.03); there was a tendency for students with higher extraversion scores to report more MP use. Parental socio-economic status was associated with MP use, but parents who expressed moderate/high level concerns about possible health risks of use were more likely to have children who used MP (OR = 4.06, P= 0.05). CONCLUSIONS: Almost all adolescent Australians use MP, but regular exposure was associated with personality traits. Parental socio-economic status and perceived health risks of MP use were also associated with use of phones. Longitudinal studies are needed to assess the predictors of mobile phone use in the long term.

A new method to determine laterality of mobile telephone use in adolescents.

OBJECTIVES: As more children use mobile (cellular) telephones, public anxiety grows about the possible adverse health effects of radiofrequency (RF) exposure upon developing nervous systems. Most epidemiological studies investigating the health effects of mobile telephones have relied on self-reports from questionnaires. While there are some validation studies investigating the accuracy of self-reported mobile phone use in adults and adolescents, self-reported laterality of use has not been validated at any age. Although this study mainly sought to validate the accuracy of self-reported laterality of mobile telephone use in adolescents, investigation also covered number and duration of calls. METHODS: We monitored 455 calls in 30 students, mean age (SD) 14 (0.4) years. For 1 week, participants used hardware modified phones (HMPs) which logged dosimetric parameters such as laterality (side of head), date, number and duration of calls. These 'gold standard' measurements were compared with questionnaire self-reported laterality and estimated typical weekly phone use. RESULTS: Agreement between HMPs and self-reported laterality was modest (kappa=0.3, 95% CI 0.0 to 0.6). Concordance between HMP measured and self-reported number of calls was fair (intraclass correlation coefficient (ICC)=0.38, 95% CI 0.07 to 0.69), but poor for duration (ICC=0.01, 95% CI 0.00 to 0.37) with wide limits of agreement for both. CONCLUSIONS: These results suggest that adolescent self-reported laterality was of limited validity. Adolescent self-reported phone use by number and duration of calls was generally inaccurate but comparable to recent adult studies. Epidemiological studies of mobile phone use based on self-reported information may underestimate true associations with health effects.

Mobile telephone use is associated with changes in cognitive function in young adolescents.

As part of the Mobile Radiofrequency Phone Exposed Users' Study (MoRPhEUS), a cross-sectional epidemiological study examined cognitive function in secondary school students. We recruited 317, 7th grade students (144 boys, 173 girls, median age 13 years) from 20 schools around Melbourne, Australia. Participants completed an exposure questionnaire based on the Interphone study, a computerised cognitive test battery, and the Stroop colour-word test. The principal exposure metric was the total number of reported mobile phone voice calls per week. Linear regression models were fitted to cognitive test response times and accuracies. Age, gender, ethnicity, socio-economic status and handedness were fitted as covariates and standard errors were adjusted for clustering by school. The accuracy of working memory was poorer, reaction time for a simple learning task shorter, associative learning response time shorter and accuracy poorer in children reporting more mobile phone voice calls. There were no significant relationships between exposure and signal detection, movement monitoring or estimation. The completion time for Stroop word naming tasks was longer for those reporting more mobile phone voice calls. The findings were similar for total short message service (SMS, also known as text) messages per week, suggesting these cognitive changes were unlikely due to radiofrequency (RF) exposure. Overall, mobile phone use was associated with faster and less accurate responding to higher level cognitive tasks. These behaviours may have been learned through frequent use of a mobile phone.

How well do adolescents recall use of mobile telephones? Results of a validation study.

BACKGROUND: In the last decade mobile telephone use has become more widespread among children. Concerns expressed about possible health risks have led to epidemiological studies investigating adverse health outcomes associated with mobile telephone use. Most epidemiological studies have relied on self reported questionnaire responses to determine individual exposure. We sought to validate the accuracy of self reported adolescent mobile telephone use. METHODS: Participants were recruited from year 7 secondary school students in Melbourne, Australia. Adolescent recall of mobile telephone use was assessed using a self administered questionnaire which asked about number and average duration of calls per week. Validation of self reports was undertaken using Software Modified Phones (SMPs) which logged exposure details such as number and duration of calls. RESULTS: A total of 59 adolescents participated (39% boys, 61% girls). Overall a modest but significant rank correlation was found between self and validated number of voice calls (rho = 0.3, P = 0.04) with a sensitivity of 57% and specificity of 66%. Agreement between SMP measured and self reported duration of calls was poorer (rho = 0.1, P = 0.37). Participants whose parents belonged to the 4th socioeconomic stratum recalled mobile phone use better than others (rho = 0.6, P = 0.01). CONCLUSION: Adolescent recall of mobile telephone use was only modestly accurate. Caution is warranted in interpreting results of epidemiological studies investigating health effects of mobile phone use in this age group.

Comparison of measuring instruments for radiofrequency radiation from mobile telephones in epidemiological studies: implications for exposure assessment.

The debate on mobile telephone safety continues. Most epidemiological studies investigating health effects of radiofrequency (RF) radiation emitted by mobile phone handsets have been criticised for poor exposure assessment. Most of these studies relied on the historical reconstruction of participants' phone use by questionnaires. Such exposure assessment methods are prone to recall bias resulting in misclassification that may lead to conflicting conclusions. Although there have been some studies using software-modified phones (SMP) for exposure assessment in the literature, until now there is no published work on the use of hardware modified phones (HMPs) or RF dosimeters for studies of mobile phones and health outcomes. We reviewed existing literature on mobile phone epidemiology with particular attention to exposure assessment methods used. Owing to the inherent limitations of these assessment methods, we suggest that the use of HMPs may show promise for more accurate exposure assessment of RF radiation from mobile phones.