Palliative care development in primary care is crucial worldwide. This study reports on the secondary outcomes of a study that evaluated whether a complex intervention in primary care for patients with palliative care needs impacted their healthcare utilization.

A before-after study was conducted with family physicians and patients with palliative care needs. Physicians received palliative care training and implemented a new primary palliative care consultation model. Healthcare utilization in the 12 weeks before, during, and after the intervention was compared.

We analysed healthcare utilization for 33 patients with advanced disease. Pre-intervention, there were high rates of no medical consultations, emergency visits, hospital admissions, and outpatient referrals (84.8%, 75.8%, 81.8%, and 84.8%, respectively). Despite slight reductions during and after the intervention, the differences were not statistically significant.

The reduction in healthcare utilization was not statistically significant, but the data inform sample size calculations for future economic analyses.

ClinicalTrials.gov ID – NCT05244590. Registration: 14th February 2022.

This study sought to explore how food company representatives perceive the food industry’s role in responding to and driving consumer demand for healthy and unhealthy foods.

Semi-structured interviews were conducted in 2022 by 2–3 researchers to explore food company representatives’ perspectives related to consumer demand for healthy and unhealthy food. Detailed field notes, including verbatim quotes, were recorded, and the data were analysed thematically.

This study was part of a government-funded 12-month intervention programme to assess the impact of tailored support for food companies on company nutrition-related policies and practices.

Thirty-two food company representatives from thirteen large food and beverage manufacturers in Australia.

Six themes were identified. Company representatives acknowledged that manufacturers actively shaped demand for both healthy and unhealthy foods. Healthy reformulation and aspects of nutrition labelling were constrained by anticipated consumer resistance, while demand for ‘less healthy’ products was driven by non-health attributes such as taste, comfort and affordability. Internal company marketing teams held significant influence regarding product development, promotion and labelling. Supermarkets were perceived as shaping demand via their marketing strategies. The competitive landscape, driven by the pursuit of market share, was seen to fuel an ongoing cycle of promotion of ‘less healthy’ products.

Food companies acknowledge playing an active role in influencing consumer demand for healthy and unhealthy food and beverages. A whole-of-system response, including changes in government regulation and practice change by the food industry, is needed to drive stronger action and accountability from food companies to support healthier diets.

Emotional-approach coping (EAC), including emotional expression (EE) and emotional processing (EP), may impact stress and quality of life (QOL) in cancer populations, with some evidence that EAC effects vary by sex.

Men (n = 85) and women (n = 63) with renal cell carcinoma (RCC) completed the EAC Scale, Perceived Stress Scale (PSS), and 36-item Medical Outcomes Study Short Form Survey (SF-36) physical component scale (PCS) and mental component scale (MCS) at study entry and 10 months later. The PROCESS macro (model 7) was used to examine the indirect effect of baseline EAC (EE, EP) on 10-month QOL (PCS, MCS) via baseline PSS, with sex as a moderator of the association between EAC and PSS (i.e., four models of moderated mediation).

Bootstrap estimates of indirect effects revealed significant moderated mediation, such that, for female participants, greater EE at study entry was associated with lower PSS, which in turn was associated with higher PCS and MCS 10 months later; whereas for males, EE was not associated with PSS and was not indirectly associated with physical and mental health-related QOL via PSS. Models examining the indirect effects of EP on QOL via PSS were nonsignificant for male and female participants.

EE is an important correlate of perceived stress for females but not males with RCC. Perceived stress early in treatment has a robust association with subsequent health-related QOL. Interventions aimed at supporting EE for females with RCC may have long-term QOL benefits.

To evaluate the impact of a tailored organizational intervention on the support for family caregivers.

A convergent mixed-methods study was conducted in 17 organizations (6 hospices, 5 home care organizations, 3 nursing homes, 2 hospitals, 1 transmural organization) between November 2021 and August 2023. The intervention comprised a structured practice improvement trajectory during which each organization conducted a structured workshop to define organization-specific goals to improve their support for family caregivers and to develop an action plan to achieve those goals. The action plan was implemented over 1 year with intermittent evaluations. Pre- and post-intervention surveys were distributed among healthcare professionals (paired) and bereaved family caregivers (non-paired) to assess provided and received support. Data were analyzed with mixed models and regression analyses. Post-intervention focus groups with project team members and final evaluation reports were analyzed with qualitative content analysis.

Survey respondents were 97 healthcare professionals (83% nursing staff), 123 family caregivers pre-intervention, and 99 family caregivers post-intervention. Only healthcare professionals of home care organizations reported a significant increase in attending to family caregivers’ wellbeing and needs (scale 0–20; β = 3.65; 95%CI: 1.33–5.97). Family caregivers’ reports of healthcare professionals attending to their wellbeing and needs did not change (scale 0–2; β = 0.17; 95%CI: −0.04–0.38). Across settings, healthcare professionals evaluated the care they provided more positively post-intervention (scale 0–8; β = 0.65, 95%CI: 0.38–0.97). In home care, family caregivers also evaluated care more positively (scale 0–8; β = 2.12; 95%CI: 0.89–3.34). Four focus groups and 17 evaluation reports indicated improvements at 3 levels: the support for family caregivers (increased awareness of healthcare professionals, changes in work processes, more structured support), the healthcare team (more skills, confidence, available tools), and the organization (fostering sustainability).

A tailored organizational intervention can strengthen the support of family caregivers in healthcare organizations.

DeGAUSS is a privacy-preserving application that ingests addresses and generates output that includes latitude, longitude, census tract, deprivation index and drive times to major hospitals. The application uses a complex command line interface and a container management platform to perform analysis. Our objective was to develop a user-friendly DeGAUSS-based application that simplifies place-based analysis. We also enabled automated geomarker generation by providing an API modality to DeGAUSS.

We developed a self-service platform based on the DeGAUSS application. The application was linked to user authentication platforms. The self-service application can be implemented as an API, enabling high-volume geocoding transactions. We surveyed active users for feedback.

The self-service geomarker application was deployed at Children’s Mercy and the University of Kansas Medical Center. During the period evaluated, more than 2 million addresses were geocoded for 24 users through the user interface and more than 15 million addresses through the API. Users expressed high satisfaction with the system. All respondents used the census block group feature and the core geocoding. Most respondents, 60%, used the deprivation index and 30% used the drive time feature. Population health and social determinants of health were the most common uses (80% each) followed by health equity analyses (70%).

Population health and social determinants of health research require access to precise geographic information about patients or research subjects. The self-service geomarker capability enables users who may not be comfortable with a command line interface to generate geocoded addresses in support of their research and analysis.