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We performed a systematic review and meta-analysis with the aim to answer whether operative laparoscopy is an effective treatment in a woman with demonstrated endometriosis compared with alternative treatments. Moreover, we aimed to assess the risks of operative laparoscopy compared with those of alternatives. In addition, we aimed to systematically review the literature on the impact of patient preference on decision making around surgery. Data Sources: We searched MEDLINE, Embase, PsycINFO, ClinicalTrials.gov, CINAHL, Scopus, OpenGrey, and Web of Science from inception through May 2019. In addition, a manual search of reference lists of relevant studies was conducted. Methods of Study Selection: Published and unpublished randomized controlled trials (RCTs) in any language describing a comparison between surgery and any other intervention were included, with particular reference to timing and its impact on pain and fertility. Studies reporting on keywords including, but not limited to, endometriosis, laparoscopy, pelvic pain, and infertility were included. In the anticipated absence of RCTs on patient preference, all original research on this topic was considered eligible. Tabulation, Integration, and Results: In total, 1990 studies were reviewed. Twelve studies were identified as being eligible for inclusion to assess outcomes of pain (n = 6), fertility (n = 7), quality of life (n = 1), and disease progression (n = 3). Seven studies of interest were identified to evaluate patient preferences. There is evidence that operative laparoscopy may improve overall pain levels at 6 months compared with diagnostic laparoscopy (risk ratio [RR], 2.65; 95% confidence interval [CI], 1.61−4.34; p <.001; 2 RCTs, 102 participants; low-quality evidence). Because the quality of the evidence was very low, it is uncertain if operative laparoscopy improves live birth rates. Operative laparoscopy probably yields little or no difference regarding clinical pregnancy rates compared with diagnostic laparoscopy (RR, 1.29; 95% CI, 0.99−1.92; p = .06; 4 RCTs, 624 participants; moderate-quality evidence). It is uncertain if operative laparoscopy yields a difference in adverse outcomes when compared with diagnostic laparoscopy (RR, 1.98; 95% CI, 0.84−4.65; p = .12; 5 RCTs, 554 participants; very-low-quality evidence). No studies reported on the progression of endometriosis to a symptomatic state or progression of extent of disease in terms of volume of lesions and locations in asymptomatic women with endometriosis. We Ben W. Mol reports consultancy for OvsEva, Guerbet, and Merck; grant support from Merck; travel support from Guerbet; and holds a Practitioner Fellowship from National Health and Medical Research Council. Tal Z. Jacobson reports a minor shareholding in, and clinical service fees from, Virtus Health. Neil P. Johnson reports consultancy for Myovant Sciences, Vifor Pharma, and Guerbet and research funding from AbbVie and Myovant Sciences. All remaining authors declare they have no conflict of interest.

Objective: We recently proposed a sequential processing schema for the equiprobable auditory Go/NoGo task, based on a principal components analysis (PCA) of event-related potentials (ERPs) from a university student sample. Here we sought to replicate the schema, and use it to explore processing in well-functioning older adults. Methods: We compared behavioural responding and ERPs of 20 independent-living older adults (M age = 68.2 years) to data from a sex-and handedness-matched group of university students (M age = 20.4 years). ERPs had substantial latency differences between the groups, and hence were subjected to separate group temporal PCAs. Results: Component latencies were systematically increased in the older group by some 26%, with no significant increase in RT or error rates. Despite some differences in their identified components, each group displayed differential component responsivity to Go versus NoGo; this was reduced in the older participants. Conclusion: The results support our processing schema, and provide insight into the processing stages in well-functioning older adults. Significance: Understanding the perceptual and cognitive processing stages in normal ageing is a pre-requisite for research on mild cognitive impairment and dementia. This study may also provide a simple paradigm and schema suitable for further exploration of functionality in ageing. Highlights• A PCA derived sequential processing Go/NoGo schema was confirmed in young adults, with similar processing in healthy older adults.• Older adults had comparable Go RT and Go/NoGo error rates, increased latencies and smaller, less differentiated Go/NoGo P3s, and N2c was absent.• Go/NoGo processing by Older adults may reflect less specialist processing regions, requiring more effort. ABSTRACT Objective:We recently proposed a sequential processing schema for the equiprobable auditory Go/NoGo task, based on a principal components analysis (PCA) of event-related potentials (ERPs) from a university student sample. Here we sought to replicate the schema, and use it to explore processing in well-functioning older adults. Methods:We compared behavioural responding and ERPs of 20 independent-living older adults (M age = 68.2 years) to data from a sex-and handedness-matched group of university students (M age = 20.4 years). ERPs had substantial latency differences between the groups, and hence were subjected to separate group temporal PCAs.Results: Component latencies were systematically increased in the older group by some 26 %, with no significant increase in RT or error rates. Despite some differences in their identified components, each group displayed differential component responsivity to Go versus NoGo; this was reduced in the older participants. Conclusion:The results support our processing schema, and provide insight into the processing stages in well-functioning older adults.Significance: Understanding the perceptual and cognitive processing stages in normal ageing is a pre-requisite for research on mild cognitive impairment a...

Background: Overweight/obesity are strongly implicated in breast cancer development, and weight gain postdiagnosis is associated with greater morbidity and all-cause mortality. The aim of this study was to describe the prevalence of overweight/obesity and the pattern of weight gain after diagnosis of breast cancer amongst Australian women. Methods: We collected sociodemographic, medical, weight and lifestyle data using an anonymous, selfadministered online cross-sectional survey between November 2017 and January 2018 from women with breast cancer living in Australia. The sample consisted mainly of members of the Breast Cancer Network Australia Review and Survey Group. Results: From 309 responses we obtained complete pre/post diagnosis weight data in 277 women, and calculated pre/post Body Mass Index (BMI) for 270 women. The proportion of women with overweight/obesity rose from 48.5% at diagnosis to 67.4% at time of survey. Most women were Caucasian with stage I-III breast cancer (n = 254) or ductal carcinoma in situ (DCIS) (n = 33) and mean age was 59.1 years. The majority of women (63.7%) reported they had gained weight after diagnosis with an average increase of 9.07 kg in this group. Of the women who provided complete weight data, half gained 5 kg or more, 17.0% gained > 20 kg, and 60.7% experienced an increase in BMI of >1 kg/m 2. Over half of the women rated their concern about weight as high. Of those women who gained weight, more than half reported that this occurred during the first year after diagnosis. Two-thirds (69.1%) of women aged 35-74 years gained, on average, 0.48 kg more weight per year than age-matched controls. Conclusions: Although the findings from this survey should be interpreted cautiously due to a limited response rate and self-report nature, they suggest that women in Australia gain a considerable amount of weight after a diagnosis of breast cancer/DCIS (in excess of age-matched data for weight gain) and report high levels of concern about their weight. Because weight gain after breast cancer may lead to poorer outcomes, efforts to prevent and manage weight gain must be prioritized and accelerated particularly in the first year after diagnosis.

Background: Timely diagnosis of dementia has a wide range of benefits including reduced hospital emergency department presentations, admissions and inpatient length of stay, and improved quality of life for patients and their carers by facilitating access to treatments that reduce symptoms, and allow time to plan for the future. Memory clinics can provide such services, however there is no 'gold standard' model of care. This study involved the co-creation of a model of care for a new multidisciplinary memory clinic with local community members, General Practitioners (GPs), policy-makers, community aged care workers, and service providers. Methods: Data collection comprised semi-structured interviews (N = 98) with 20 GPs, and three 2-h community forums involving 53 seniors and community/local government representatives, and 25 community healthcare workers. Interviews and community forums were audio-recorded, transcribed verbatim, and coded by thematic analysis using Quirkos.Results: GPs' attitudes towards their role in assessing people with dementia varied. Many GPs reported that they found it useful for patients to have a diagnosis of dementia, but required support from secondary care to make the diagnosis and assist with subsequent management. Community forum participants felt they had a good knowledge of available dementia resources and services, but noted that these were highly fragmented and needed to be easier to navigate for the patient/carer via a 'one-stop-shop' and the provision of a dementia key worker. Expectations for the services and features of a new memory clinic included diagnostic services, rapid referrals, case management, education, legal services, culturally sensitive and appropriate services, allied health, research participation opportunities, and clear communication with GPs. Participants described several barriers to memory clinic utilisation including transportation access, funding, awareness, and costs.