Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Desi...Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Design A retrospective cohort study using routinely collected general practice data.Logistic regression was used to compare odds of allied health referrals,adjusting for age,sex and socioeconomic status.Setting De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.Participants Data from 1153304 patients and 28667517 GP episodes of care were analysed.After merging records,693328 unique patients were identified,including 16610 patients with dementia.Subcohorts included patients with dementia,stroke,Parkinson’s disease and combinations of these conditions.Results The dementia cohort(n=16610)had a similar overall allied health referral rate(36.1%)to the control cohort(n=48977)(35.4%).Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke(adjusted OR(aOR)0.76,95%CI 0.72 to 0.80;p<0.001)or Parkinson’s disease(aOR 0.72,95%CI 0.66 to 0.78;p<0.001).Those with dementia and stroke were also less likely to receive referrals than those with stroke only(aOR 0.71,95%CI 0.61 to 0.82;p<0.001).No significant difference was found between dementia with Parkinson’s and Parkinson’s only groups(p=0.48).Patients with dementia were consistently less likely to be referred to key allied health services(p<0.05).Conclusion Despite strong evidence supporting allied health interventions for dementia,referral rates remain comparatively low.Enhancing GP referral resources and education,integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.展开更多
[Objectives]To observe the effects of Huanglian Jiedu Decoction on pain behaviors in rat models of postherpetic neuralgia(PHN)and analyze potential mechanisms.[Methods]Twenty SD rats with PHN models induced by intrapl...[Objectives]To observe the effects of Huanglian Jiedu Decoction on pain behaviors in rat models of postherpetic neuralgia(PHN)and analyze potential mechanisms.[Methods]Twenty SD rats with PHN models induced by intraplantar injection of 50μL(6×106)varicella-zoster virus(VZV)into the left hind paw were randomly divided into two groups(n=10 each)using a random number table:the model group(PHN group)and the Huanglian Jiedu Decoction group.From day 7 after inoculation,the Huanglian Jiedu Decoction group received oral gavage of Huanglian Jiedu Decoction twice daily for 14 days,while the PHN group received an equal volume of 0.9%saline.Thermal withdrawal latency(TWL)and mechanical withdrawal threshold(MWT)were measured at 1,4,7,14,and 21 d after inoculation.Pain-related behaviors(vocalization,scratching,and licking/biting of the hind paw)were recorded.[Results]Compared with the PHN group,the Huanglian Jiedu Decoction group exhibited significantly prolonged TWL and increased MWT at days 14 and 21(P<0.05).At day 4 post-inoculation,both groups showed marked pain-related behaviors(e.g.,vocalization,scratching,licking/biting).These behaviors persisted until day 21 in the PHN group but significantly decreased in the Huanglian Jiedu Decoction group at days 14 and 21(P<0.05).[Conclusions]Huanglian Jiedu Decoction reduces pain sensitivity and alleviates pain-related behaviors in PHN model rats.The mechanism may involve elevating pain thresholds and decreasing pain conduction velocity.展开更多
In this paper,we study the orthogonal time frequency space signal transmission over multi-path channel in the presence of phase noise(PHN)at both sides of millimeter wave(mmWave)communication links.The statistics char...In this paper,we study the orthogonal time frequency space signal transmission over multi-path channel in the presence of phase noise(PHN)at both sides of millimeter wave(mmWave)communication links.The statistics characteristics of the PHN-induced common phase error and inter-Doppler interference are investigated.Then,a column-shaped pilot structure is designed,and training pilots are used to realize linear-complexity PHN tracking and compensation.Numerical results demonstrate that the proposed scheme enables the signal to noise ratio loss to be restrained within 1 dB in contrast to the no PHN case.展开更多
基金funded by the Australian Government Medical Research Future Fund(MRFF),Grant number 2015947.
文摘Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Design A retrospective cohort study using routinely collected general practice data.Logistic regression was used to compare odds of allied health referrals,adjusting for age,sex and socioeconomic status.Setting De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.Participants Data from 1153304 patients and 28667517 GP episodes of care were analysed.After merging records,693328 unique patients were identified,including 16610 patients with dementia.Subcohorts included patients with dementia,stroke,Parkinson’s disease and combinations of these conditions.Results The dementia cohort(n=16610)had a similar overall allied health referral rate(36.1%)to the control cohort(n=48977)(35.4%).Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke(adjusted OR(aOR)0.76,95%CI 0.72 to 0.80;p<0.001)or Parkinson’s disease(aOR 0.72,95%CI 0.66 to 0.78;p<0.001).Those with dementia and stroke were also less likely to receive referrals than those with stroke only(aOR 0.71,95%CI 0.61 to 0.82;p<0.001).No significant difference was found between dementia with Parkinson’s and Parkinson’s only groups(p=0.48).Patients with dementia were consistently less likely to be referred to key allied health services(p<0.05).Conclusion Despite strong evidence supporting allied health interventions for dementia,referral rates remain comparatively low.Enhancing GP referral resources and education,integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.
文摘[Objectives]To observe the effects of Huanglian Jiedu Decoction on pain behaviors in rat models of postherpetic neuralgia(PHN)and analyze potential mechanisms.[Methods]Twenty SD rats with PHN models induced by intraplantar injection of 50μL(6×106)varicella-zoster virus(VZV)into the left hind paw were randomly divided into two groups(n=10 each)using a random number table:the model group(PHN group)and the Huanglian Jiedu Decoction group.From day 7 after inoculation,the Huanglian Jiedu Decoction group received oral gavage of Huanglian Jiedu Decoction twice daily for 14 days,while the PHN group received an equal volume of 0.9%saline.Thermal withdrawal latency(TWL)and mechanical withdrawal threshold(MWT)were measured at 1,4,7,14,and 21 d after inoculation.Pain-related behaviors(vocalization,scratching,and licking/biting of the hind paw)were recorded.[Results]Compared with the PHN group,the Huanglian Jiedu Decoction group exhibited significantly prolonged TWL and increased MWT at days 14 and 21(P<0.05).At day 4 post-inoculation,both groups showed marked pain-related behaviors(e.g.,vocalization,scratching,licking/biting).These behaviors persisted until day 21 in the PHN group but significantly decreased in the Huanglian Jiedu Decoction group at days 14 and 21(P<0.05).[Conclusions]Huanglian Jiedu Decoction reduces pain sensitivity and alleviates pain-related behaviors in PHN model rats.The mechanism may involve elevating pain thresholds and decreasing pain conduction velocity.
基金supported by the National Natural Science Foundation of China(62071097)the Sichuan Science and Technology Program(2023NSFSC0458).
文摘In this paper,we study the orthogonal time frequency space signal transmission over multi-path channel in the presence of phase noise(PHN)at both sides of millimeter wave(mmWave)communication links.The statistics characteristics of the PHN-induced common phase error and inter-Doppler interference are investigated.Then,a column-shaped pilot structure is designed,and training pilots are used to realize linear-complexity PHN tracking and compensation.Numerical results demonstrate that the proposed scheme enables the signal to noise ratio loss to be restrained within 1 dB in contrast to the no PHN case.
