Relative to their young counterparts, older adults are poorer at recognizing facial expressions. A 2008 meta-analysis of 17 facial emotion recognition data sets showed that these age-related difficulties are not uniform. Rather, they are greatest for the emotions of anger, fear, and sadness, comparative with happiness and surprise, with no age-effect found for disgust. Since then, there have been many methodological advances in assessing emotion recognition. The current comprehensive meta-analysis systematically tested the influence of task characteristics (e.g., photographs vs. videos). The meta-analysis included 102 data sets that compared facial emotion recognition in older and young adult samples (N = 10,526). With task type combined, the pattern of age-effects across emotions was mostly consistent with the previous meta-analysis (i.e., largest age-effects for anger, fear, sadness; no effect for disgust). However, the magnitude and direction of age-effects were strongly influenced by elements of task design. Specifically, videos produced relatively moderate age-effects across all emotions, which indicates that older adults may not exhibit a positivity effect for facial emotion recognition. For disgust recognition, older adults demonstrated superior accuracy to young adults for the most common image set (Pictures of Facial Affect). However, they were poorer than young adults at recognizing this emotion for all other stimulus formats and image sets, which suggests that they do not retain disgust recognition. We discuss the implications that such diversity in the age-effects produced by different facial emotion recognition task designs has for understanding real-world deficits and task selection in future emotion recognition studies.

Objective The aim of this study was to assess the acceptability of a novel, integrated general practitioner (GP)–paediatrician model of care, aiming to reduce referrals to hospitals and improve primary care quality. Methods A pre-post study was conducted with five general practice clinics in north-west Melbourne. Over 12 months, 49 GPs and 896 families participated in the intervention that included weekly to fortnightly paediatrician–GP co-consultation sessions at the general practice, monthly case discussions and telephone or email clinical support for GPs. GPs and families completed surveys or interviews at three time points (before the intervention, after running the model for 4 months and at the end of the implementation). Non-identifiable consultation data were extracted from general practice medical records. Results All GPs found the model acceptable. Although not significant, there was a trend towards a lower proportion of referrals to private paediatricians after the intervention (from 34% to 20%) and emergency departments (from 19% to 12%). Outpatient clinic referrals remained steady, and then increased as the paediatrician left the clinics (31% vs 47% before and after the intervention respectively). Unnecessary prescribing of acid suppression medications decreased by 20% (from 29% to 9%). GPs reported improved confidence in paediatric care (88% vs 100% before and after the intervention respectively). Families reported increased confidence in GP care (78% vs 94% before and after the intervention respectively). Model cost estimates were A$172 above usual care per child seen in the co-consultations. Conclusions This novel model of care is acceptable to GPs and families and may improve access and quality of paediatric care. What is known about the topic? A GP–paediatrician integrated model of care appears effective in reducing hospital burden in England, but has not been implemented in Australia. What does this paper add? This pilot, an Australian first, found that a GP–paediatrician integrated model of care is feasible and acceptable in Australia’s primary healthcare system, improves GP confidence and quality of paediatric care, may reduce paediatric referrals to outpatient clinics and emergency departments and improves family confidence in, and preference for, GP care. What are the implications for practitioners? This model may reduce hospital burden and improve quality in GP paediatric care while potentially producing cost savings for families and the healthcare system.

Objective This study determined caregivers’ evaluations of telehealth consultations for their child, preference over in-person consultations and potential cost savings by child condition, family socioeconomic status and location. Methods A survey was conducted of 2436 caregivers attending a telehealth consultation with their child for a broad group of conditions between 3 June and 25 August 2020 at a tertiary paediatric hospital in Melbourne, Australia. Results Most caregivers found telehealth consultations convenient, acceptable, safe and private, and capable of answering their questions and concerns. However, caregivers who spoke a language other than English and patients attending for behavioural and mental health, developmental or other (e.g. allied health) concerns were more likely to prefer in-person consultations over telehealth. Mean (±s.d.) reported cost savings on caregiver time were A$144.98 ± 99.04 per family per consultation, whereas mean (±s.d.) transport cost savings were A$84.90 ± 100.74 per family per consultation. Cost savings were greatest for families living in low and middle socioeconomic areas and regional or rural areas. Conclusions Paediatric telehealth video consultations were largely viewed favourably by caregivers, except for those attending for behavioural and mental health or developmental concerns. What is known about the topic? Adult consumers of telehealth consultations view them as useful, convenient and cost saving, but less is known about caregivers’ evaluations of telehealth consultations and potential cost savings for paediatric patients, and whether these differ by family location, socioeconomic status or child condition. What does this paper add? This is the first Australian paper to report on caregivers’ evaluations across a range of paediatric conditions and locations. Most caregivers found telehealth consultations convenient, safe, acceptable, able to answer their questions and concerns about their child’s health and cost saving. What are the implications for practitioners? Caregivers of children with behavioural, mental health or developmental problems were less likely to prefer telehealth over in-person consultations, so practitioners should consider providing such consultations in person.

vulnerability: life course perspectives Prospective memory (PM) is a critical determinant of whether a person is able to lead an independent life. Because PM declines in late adulthood, an important question is therefore whether, and if so, which types, of PM interventions might lead to meaningful benefits. In the present study, we randomly assigned older adults to one of four conditions, in three of which participants received a structured PM intervention (Restorative, Compensatory, and Combined Restorative and Compensatory); the fourth was an Active Control condition. The results showed that there were significant gains on the PM training task used for both the Restorative and Combined conditions. We then analyzed change in PM tasks that were independent of the PM training task (Near Transfer). Only the Combined condition led to post-training improvement. Finally, we analyzed performance on measures of untrained cognitive abilities and everyday functioning: Far transfer effects were not evident for any intervention. These data align with prior literature in showing that interventions that target a single cognitive ability do not reliably generate far transfer effects, and additionally extend our understanding of these effects in two important ways. Firstly, they indicate that, even when the memory challenges that older adults are most concerned about are the direct target of restorative training, transfer effects to untrained cognitive domains may be difficult to achieve. Secondly, they indicate that for older adults whose primary goal is to enhance PM function, combining Restorative and Compensatory approaches is an effective approach.

Objective: Early during the coronavirus disease 2019 (COVID-19) pandemic, Australian EDs experienced an unprecedented surge in patients seeking screening. Understanding what proportion of these patients require testing and who can be safely screened in community-based models of care is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns. Methods: In this cross-sectional survey, we screened patients presenting to a COVID-19 screening clinic in a tertiary ED. We assessed the proportion of patients who met testing criteria; self-reported symptom severity; reasons why they came to the ED for screening and views on community-based care. Results: We include findings from 1846 patients. Most patients (55.3%) did not meet contemporaneous criteria for testing and most (57.6%) had mild or no (13.4%) symptoms. The main reason for coming to the ED was being referred by a telephone health service (31.3%) and 136 (7.4%) said they tried to contact their general practitioner but could not get an appointment. Only 47 (2.6%) said they thought the disease was too specialised for their general practitioner to manage. Conclusions: While capacity building in acute care facilities is an important part of pandemic planning, it is also important that patients not needing hospital level of care can be assessed and treated elsewhere. We have identified a significant proportion of people at this early stage in the pandemic who have sought healthcare at hospital but who might have been assisted in the community had services been available and public health messaging structured to guide them there.