This project will establish a nationally consistent and ethically defensible approach to embed genomic testing in Australian primary care. Many non-genetic health professionals (eg, general practitioners (GPs) and other specialists) have limited experience with such testing. Current tests—both subsidised and consumer-paid—target a range of genes and conditions, making appropriate selection challenging. A structured implementation approach is therefore crucial. We will develop, test, refine and evaluate internationally relevant tools to support GPs and consumers in using genomics effectively.

Aims of the project are to (1) develop, implement and evaluate key supports for GPs offering tests through three interventions: primary health point-of-care resources, a practical guide to dealing with ethical issues affecting clinicians and established recommendations for a national approach for genetic counsellors to support GPs providing genetic testing; (2) develop and evaluate consumer resources and plan the implementation strategies; (3) evaluate real-world utilisation and equity of access to genetic testing in primary care using linked Medicare and population data.

This project will focus on two genomic applications recently made available in Australia on the universal insurance scheme (Medicare): a reproductive genetic carrier screen (an example of the role of genetics in reproductive testing) and genetic testing for familial hypercholesterolaemia (an example of a condition-specific test). Both tests can be complex for GPs to understand and explain to consumers and have potential implications beyond the purpose of the test (eg, personal health implications for carriers and results are also relevant to genetic relatives). Developing a robust clinical pathway and process for these tests will prepare GPs for future more complex applications of clinical genomics. The study will take place from January 2024 to December 2026.

Ethical approval for this work has been received from the Macquarie University Human Research Ethics Committee (Ref: 520241849560183) and the Royal Children’s Hospital Research Ethics and Governance (HREC/112451). Findings will be disseminated via publications, conferences and engagement with primary care networks and policymakers.

Over the last decade, a growing number of health interventions (eg, medical assistance in dying and mitochondrial donation) have become legalised or decriminalised globally. Newly legalised health interventions share characteristics that are distinct from other health interventions, making their implementation more challenging. They are often highly emotive, controversial and associated with strong opinions and ethical dilemmas, with some of them being high-stake and irreversible. This study aimed to identify, systematise and map the factors that affect the implementation of health interventions that have recently been legalised.

A systematically conducted review.

PubMed, Scopus, EMBASE and CINAHL were searched to identify studies published between 2014 and 2024.

We included studies if they evaluated the implementation of health interventions that were newly legalised or newly decriminalised.

Data were extracted and synthesised through descriptive analysis. Both deductive and inductive thematic analyses were applied to map the barriers, facilitators and implementing strategies that influence the implementation of newly legalised health interventions in healthcare settings.

The search strategy yielded 1510 publications, of which 78 were included in this review. Findings showed that several newly legalised health interventions, including medical assistance in dying (n=56 studies); medical abortion (n=13); assisted human reproduction (n=3); psychedelic-assisted therapies (n=3); use of medical cannabis (n=2) and use of biosimilars (n=1) were addressed. The analysis identified a total of 880 diverse barriers, facilitators and strategies in five domains across system, organisational and individual levels: (1) patients/service users/consumers; (2) healthcare providers; (3) healthcare organisation; (4) legal processes and (5) system. These were further divided into 27 themes of barriers, 18 themes of facilitators and 17 themes of strategies.

Implementing newly legalised health interventions is complex. Our findings can support the development of an implementation plan for the spread and scaling of future health interventions, maximising the impact of interventions and making them accessible to more people and health organisations.

Older adults admitted to intensive care units (ICUs) following elective surgery face heterogeneous trajectories of recovery spanning the physical, cognitive and social domains. Biological ageing processes, including cellular senescence, may modulate these outcomes. Here, we present the protocol for an analytic prospective observational cohort study integrating biopsychosocial assessments and senescence-associated biomarkers to identify predictors of health-related quality of life (HRQoL) and post-ICU recovery.

Single-centre, prospective cohort study at the University Hospital Halle (Saale), Germany. Adults aged 60 years or older scheduled to undergo elective surgery and who have a planned postoperative stay in the ICU of at least 24 hours and who are able to provide consent will be enrolled. Baseline pre-ICU data will include the following: medical history, comorbidity, medications, routine laboratory values and a comprehensive geriatric assessment (eg, frailty, mobility, handgrip strength, Timed Up & Go, cognition, mood, loneliness, social status and EuroQol 5-Dimension 5-Level, EQ-5D-5L). A 5 mL serum sample will be collected for a senescence-associated secretory phenotype panel and additional ageing biomarkers. Skin autofluorescence will be used to estimate advanced glycation end-products. Telephone follow-ups at 3 and 6 months ascertain HRQoL, functional outcomes, psychosocial outcomes, rehospitalisations and institutionalisation. The primary endpoint is defined as a stable or improved HRQoL (EQ-5D-5L) at 3/6 months vs baseline. We intend to use multivariable predictive modelling with elastic-net regularisation and conduct internal validation using bootstrap resampling and cross-validation.

This study has been approved by the Ethics Committee of the Medical Faculty, Martin-Luther-University Halle-Wittenberg (No. 2025-112). Written informed consent is obtained from all participants. The results of this study will be reported in a peer-reviewed journal.

DRKS00037969.