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Background The incidence of pancreatic cancer is rising. With improvements in knowledge for screening and early detection, earlier detection of pancreatic cancer will continue to be more common. To support workforce planning, our aim is to perform a model-based analysis that simulates the potential impact on the healthcare workforce, assuming an earlier diagnosis of pancreatic cancer. Methods We developed a simulation model to estimate the demand (i.e. new cases of pancreatic cancer) and supply (i.e. the healthcare workforce including general surgeons, medical oncologists, radiation oncologists, pain medicine physicians, and palliative care physicians) between 2023 and 2027 in Victoria, Australia. The model compares the current scenario to one in which pancreatic cancer is diagnosed at an earlier stage. The incidence of pancreatic cancer in Victoria, five-year survival rates, and Victoria’s population size were obtained from Victorian Cancer Registry, Cancer Council NSW, and Australian Bureau of Statistics respectively. The healthcare workforce data were sourced from the Australian Government Department of Health and Aged Care’s Health Workforce Data. The model was constructed at the remoteness level. We analysed the new cases and the number of healthcare workforce by profession together to assess the impact on the healthcare workforce. Results In the status quo, over the next five years, there will be 198 to 220 stages I-II, 297 to 330 stage III, and 495 to 550 stage IV pancreatic cancer cases diagnosed annually, respectively. Assuming 20–70% of the shift towards pancreatic cancer’s earlier diagnosis (shifting from stage IV to stages I-II pancreatic cancer within one year), the stages I-II cases could increase to 351 to 390 or 598 to 665 per year. The shift to early diagnosis led to substantial survival gains, translating into an additional 284 or 795 out of 5246 patients with pancreatic cancer remaining alive up to year 5 post-diagnosis. Workforce supply decreases significantly by the remoteness levels, and remote areas face a shortage of key medical professionals registered in delivering pancreatic cancer care, suggesting travel necessities by patients or clinicians. Conclusion Improving the early detection and diagnosis of pancreatic cancer is expected to bring significant survival benefits, although there are workforce distribution imbalances in Victoria that may affect the ability to achieve the anticipated survival gain.

ObjectivesThis research aimed to examine the perspectives, experiences and practices of international experts in community first response: an intervention that entails the mobilisation of volunteers by the emergency medical services to respond to prehospital medical emergencies, particularly cardiac arrests, in their locality.DesignThis was a qualitative study in which semistructured interviews were conducted via teleconferencing. The data were analysed in accordance with an established thematic analysis procedure.SettingThere were participants from 11 countries: UK, USA, Canada, Australia, New Zealand, Singapore, Ireland, Norway, Sweden, Denmark and the Netherlands.ParticipantsSixteen individuals who held academic, clinical or managerial roles in the field of community first response were recruited. Maximum variation sampling targeted individuals who varied in terms of gender, occupation and country of employment. There were eight men and eight women. They included ambulance service chief executives, community first response programme managers and cardiac arrest registry managers.ResultsThe findings provided insights on motivating and supporting community first response volunteers, as well as the impact of this intervention. First, volunteers can be motivated by ‘bottom-up factors’, particularly their characteristics or past experiences, as well as ‘top-down factors’, including culture and legislation. Second, providing ongoing support, especially feedback and psychological services, is considered important for maintaining volunteer well-being and engagement. Third, community first response can have a beneficial impact that extends not only to patients but also to their family, their community and to the volunteers themselves.ConclusionsThe findings can inform the future development of community first response programmes, especially in terms of volunteer recruitment, training and support. The results also have implications for future research by highlighting that this intervention has important outcomes, beyond response times and patient survival, which should be measured, including the benefits for families, communities and volunteers.

Historical objects on display in the National Gallery of Victoria's upcoming exhibition Pharaoh offer students the opportunity to extend their critical and creative thinking skills through object-based learning.

The National Gallery of Victoria (NGV) is partnering with the British Museum to present Pharaoh, a landmark exhibition celebrating 3000 years of ancient Egyptian art and culture.1 With more than 500 historical objects, including monumental sculpture, architecture, temple statuary, exquisite jewellery, papyri, coffins and a rich array of funerary objects, the exhibition will unpack the phenomenon of the pharaohs-those all-powerful kings who claimed a divine origin. Dividing into groups, students complete a scaffolded artefact analysis guide to help support their assessment of the mystery object.8 This type of activity also provides students with the opportunity to practise problem-solving through collaboration. Since the Old Kingdom (c. 2686-2181 BCE), tomb and temple walls were decorated with bird-hunting scenes where individuals used throwsticks. Because of the delicate nature of this material, it most likely had a ritual purpose and could not have survived being thrown. 8 Foran example of an artefact analysis guide see Analysing Historical Sources from the Women's Suffrage Movements,' National Gallery of Victoria, 9, https:// www.ngv.vlc.gov.au/ wp-content/uploads/ 2020/05/ART-HISTORY_ SUFFRAGE_F-l.pdf. 9 'Throwing-stick; Amuletic Wand,' The British Museum, https://www.brltlshmuseum. org/collection/object/ Y_EA34213. 10 'Pharaoh,'NGV International, https://www.ngv.vlc.gov.au/ exhibition/pharaoh.

The latter is most troubling, as newswires are full of corrections to error-ridden press releases. Most of the media contacts on these releases are C-level executives with titles unrelated to communications-oriented roles, which tells me that overworked owners of small-to-mid-sized firms are trying to handle the communications function themselves.

Table of contents I1: Trauma, Pre-hospital and Cardiac Arrest Care 2015 Pascale Avery, Leopold Salm, Flora Bird A1: Retrospective evaluation of HEMS 'Direct to CT' protocol Anja Hutchinson, Ashley Matthies, Anthony Hudson, Heather Jarman A2 Rush hour - Crush hour: temporal relationship of cyclist vs. HGV trauma admissions. A single site observational study Maria Bergman Nilsson, Tom Konig, Nigel Tai A3 Semiprone position endotracheal intubation during continuous cardiopulmonary resuscitation in drowned children with regurgitation: a case report and experimental manikin study Espen Fevang, Barge Hognestad, HÃ¥kon B. Abrahamsen A4 An audit of CO2 A-a gradient in non-trauma patients receiving pre-hospital anaesthesia Olivia V Cheetham, Matthew JC Thomas, Kieron D Rooney A5 Can the use of c-spine immobilisation collars be avoided in non-trauma patients presenting to the Emergency Department? Josephine Murray, Malcolm Tunnicliff A6 Curriculum mapping in ED point of care simulation Joseph W Collinson, Thomas Brown, Christopher Pritchett A7 Point of care multidisciplinary trauma team simulation & participant satisfaction in a geographically remote trauma unit in Cornwall Christopher SA Pritchett, Mark Jadav, Gareth Meredith, Jamie Plumb, Steve Harris, Roger Langford A8 Conservative management of head injury inpatients - the challenge of simplifying injury management in a non-neurosurgical hospital JG Hunter, A Sage, R Madden, O Flamank, B Broadbent, S Marsh, H Lewis, E Daniels, N Roberts A9 Improving the care of traumatic brain injury at non-neurosurgical hospitals: Introducing a head injury pathway and single place of care is associated with significant improvements in neurological observation JG Hunter, A Sage, R Madden, O Flamank, B Broadbent, S Marsh, H Lewis, E Daniels, N Lin, N Roberts A10 The experience of inter-disciplinary students undertaking cardiac arrest moulage training Samuel Bulford, Silas Houghton-Budd, Sam Pearson, Megan Clear-Hill A11 Impact brain apnoea - nine cases David J Menzies, James P Leonard, Conor Keogh, Ray Quinn, John D Hinds A12 Time well spent? Improving the performance improvement programme in a busy Trauma Unit N Roberts, D Ashton-Cleary, M Jadav A14 Clinical significant and outcome of pulmonary contusions in patients with blunt chest trauma Ismail Mahmood, Ayman El-Menyar, Basil Younis, Ahmed Khalid, Syed Nabir, Mohamed Nadeem Ahmed, Omer Al-Yahri, Hassan Al-Thani A15 Plastics operative workload in major trauma centres: a national prospective survey Katie Young, Susan A. Hendrickson, Georgina Phillips, Matthew D. Gardiner, Shehan Hettiaratchy A16 A survey to assess the accuracy of estimating height by pre-hospital clinicians: can we reliably predict those most at risk of serious injury? Alexandra Alice Crossland, Anthony Hudson A17 An audit of the cause, outcome and adherence to treatment Standard Operating Procedure (SOP) for all traumatic cardiac arrests at a Helicopter Emergency Medical Service over a 12-month period Nicholas C Brassington, Anthony Hudson, Emily McWhirter A18 Should we \"stay-and-play? A study of patient physiology in Norwegian Helicopter Emergency Services Bjarn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger A19 Training in resuscitative thoracotomy: have we cracked it? A survey of higher Emergency Medicine trainees in London Cara Jennings, Yasmin Kapadia, Duncan Bew A20 London's Air Ambulance (LAA): 25-years of drownings in an urban environment Jenny Townsend, Tom P Hurst, Elizabeth A Foster A21 Live patients in trauma simulation - more than just simulation on a shoestring? Thomas B Brown, Joseph Collinson, Christopher Pritchett, Toby Slade A22 Collecting core data in pre-hospital critical care using a consensus based template Kristin Tansager, Marius Rehn, Kjetil G.Ringdal, Andreas J.Krüger A23 Prehospital interventions before and after implementation of a physician staffed helicopter Rasmus Hesselfeldt, Sandra Wulffeld, Asger Sonne, Lars S. Rasmussen, Jacob Steinmetz A24 Duration of ventilation following prehospital drug assisted intubation; a retrospective review Thomas J Renninson, Nadine Thomson, Harvey Pynn, Timothy J Hooper A25 Non-haemorrhagic shock in trauma: a novel guideline for management in ED Anthony Hudson, Jacinta Dawson, Ashley Matthies A26 Patient-tailored triage decisions by anaesthetist-staffed pre-hospital critical care teams Morten Langfeldt Friberg, Leif RognÃ¥s A27 Anatomical accuracy and appropriate sizing of pre-hospital thoracostomies Jessica FG Wills, Anthony Hudson A28 Pre-hospital management of mass casualty civilian shootings Conor DA Turner, Marius Rehn A30 The prevalence of alcohol-related trauma recidivism: a systematic review James Nunn, Mete Erdogan, Robert S. Green A31 Development of a hospital-wide program for simulation-based training in trauma care and management Samuel Minor, Mete Erdogan, Kathy Hartlen, Robert S. Green A32 Out of Hospital Cardiac Arrests (OOHCA); lessons from Hollywood Ruth Bird, Rachael L. Grupping A33 Mechanism of injury as a predictor of severity of injury in road traffic collisions: a literature review Amelia M. Stacey, Marius Rehn, David J. Lockey A34 Lessons to be learned from prehospital airway intervention documentation? Are airway intervention documentation templates as successful in-hospital as prehospitally? S. Abiks, L. Cutler, K. Monaghan, A. Al-Rais, C. Hymers, R. Bloomer, Y. Kapadia A35 Novel biomarkers in prehospital management of traumatic brain injury (the PreTBI study protocol) Sophie-Charlott Seidenfaden, Ingunn S. Riddervold, Hans Kirkegaard, Niels Juul, Morten T. Batker A36 Hospital outcomes of traumatic railway incidents: a seven-year observational retrospective study of a major trauma centre Alice Gao, Zane Perkins; Gareth Grier, Alex Tzannes A37 Does taking a third crew member affect the on-scene time of HEMS jobs? Nathan Hudson-Peacock, Quentin Otto, Laurie Phillipson, Rik Thomas, Ainsley Heyworth A38 Does pre-hospital rapid sequence induction affect on-scene time of HEMS jobs? Quentin Otto, Nathan Hudson-Peacock, Laurie Phillipson, Ainsley Heyworth, Erica Ley A39 Code red: shock index as a prehospital indicator of massive haemorrhage Daniel Banner, Ainsley Heyworth, Erica Ley A40 Air ambulance tasking: how accurate are our current methods? Madeleine Benson, Nathan Hudson-Peacock, Tony Stone, Erica Ley, Louise Rousson, Ainsley Heyworth A41 Modern trauma burden in a district general hospital Beth A Lineham, Matthew J Lee, Martin Gough A42 Establishing a legal service for major trauma patients in two UK major trauma centres William H Seligman, Hannah E Thould, Andrew Dinsmore, Charlotte Tan, Julian Thompson, C Andy Eynon, David J Lockey A43 Prehospital assessment and care of patients - a study of the use of guidelines when assessing head trauma Rebecka M Rubenson Wahlin, Veronica Lindström, Sari Ponzer, Veronica Vicente A44 An audit of pre-hospital blood pressure management resulting from head injury Pamela Eligio, Anthony Hudson A45 The surgical contribution of surface shading volumetric rendering techniques in rib fracture management Robert Young, Dimitri Amiras, Ian Sinha

Thin films of ZrO2 were deposited on nanostructured anatase TiO2 electrodes via sol-gel route and utilised in the assembly of a dye-sensitised solar cells (DSSCs) forming nanostructured core-shell networks. The ZrO2-coated TiO2 electrodes were characterised by scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy and constructing a DSSC. The characterisation concluded that core-shell morphologies were produced with varying ZrO2 shell thickness without altering the anatase TiO2 core. When a DSSC was constructed from the ZrO2:TiO2 core-shell electrode, the efficiency increased to 2.27% from 0.42% for the uncoated TiO2 electrode. As the ZrO2 shell thickness increased, the cell efficiency was reduced.

Background Up to 70% of people diagnosed with upper gastrointestinal (GI) tract or hepato-pancreato-biliary (HPB) cancers experience substantial reductions in quality of life (QoL), including high distress levels, pain, fatigue, sleep disturbances, weight loss and difficulty swallowing. With few advocacy groups and support systems for adults with upper GI or HPB cancers (i.e. pancreas, liver, stomach, bile duct and oesophageal) and their carers, online supportive care programs may represent an alternate cost-effective mechanism to support this patient group and carers. iCare is a self-directed, interactive, online program that provides information, resources, and psychological packages to patients and their carers from the treatment phase of their condition. The inception and development of iCare has been driven by consumers, advocacy groups, government and health professionals. The aims of this study are to determine the feasibility and acceptability of iCare, examine preliminary efficacy on health-related QoL and carer burden at 3- and 6-months post enrolment, and the potential cost-effectiveness of iCare, from health and societal perspectives, for both patients and carers. Methods and analysis A Phase II randomised controlled trial. Overall, 162 people with newly diagnosed upper GI or HPB cancers and 162 carers will be recruited via the Upper GI Cancer Registry, online advertisements, or hospital clinics. Patients and carers will be randomly allocated (1:1) to the iCare program or usual care. Participant assessments will be at enrolment, 3- and 6-months later. The primary outcomes are i) feasibility, measured by eligibility, recruitment, response and attrition rates, and ii) acceptability, measured by engagement with iCare (frequency of logins, time spent using iCare , and use of features over the intervention period). Secondary outcomes are patient changes in QoL and unmet needs, and carer burden, unmet needs and QoL. Linear mixed models will be fitted to obtain preliminary estimates of efficacy and variability for secondary outcomes. The economic analysis will include a cost-consequences analysis where all outcomes will be compared with costs. Discussion iCare provides a potential model of supportive care to improve QoL, unmet needs and burden of disease among people living with upper GI or HPB cancers and their carers. Australian and New Zealand Clinical Trials Registry ACTRN12623001185651. This protocol reflects Version #1 26 April 2023.

We describe the expansion and adaptation of a frailty response team to assess older people in their usual place of residence. The team had commenced a weekend service to a limited area in February 2020. As a consequence of demand related to the COVID-19 pandemic, we expanded it and adapted the model of care to provide a 7-day service to our entire catchment area. Five hundred and ninety two patient reviews have been completed in the first 105 days of operation with 43 patients transferred to hospital for further investigation or management following assessment.