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Pharmaceutical company payments to Australian doctors reported to Medicines Australia, 2019–22: a cross-sectional analysis Med. J. Aust. (IF 11.4) Pub Date : 2024-04-16 Malcolm Forbes, Yeshna Bhowon, Barbara Mintzes
To promote their products, pharmaceutical companies make payments to doctors and other health care professionals, typically as consultancy fees, sponsorship to attend educational events, and the coverage of travel, accommodation, and other hospitality expenses.1 Until recently, disclosure of the details of such payments was limited. In 2016, the industry body that represents most pharmaceutical companies
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2023 Australian guideline for assessing and managing cardiovascular disease risk Med. J. Aust. (IF 11.4) Pub Date : 2024-04-16 Mark R Nelson, Emily Banks, Alex Brown, Clara K Chow, David P Peiris, Nigel P Stocks, Rebecca Davies AO, Natalie Raffoul, Lisa Kalman, Emily Bradburn, Garry Jennings
The 2023 Australian guideline for assessing and managing cardiovascular disease risk provides updated evidence-based recommendations for the clinical assessment and management of cardiovascular disease (CVD) risk for primary prevention. It includes the new Australian CVD risk calculator (Aus CVD Risk Calculator), based on an equation developed from a large New Zealand cohort study, customised and recalibrated
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The Health4Life e-health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled trial Med. J. Aust. (IF 11.4) Pub Date : 2024-04-12 Siobhan O'Dean, Matthew Sunderland, Nicola Newton, Lauren Gardner, Maree Teesson, Cath Chapman, Louise Thornton, Tim Slade, Leanne Hides, Nyanda McBride, Frances J Kay-Lambkin, Steve J Allsop, David Lubans, Belinda Parmenter, Katherine Mills, Bonnie Spring, Bridie Osman, Rhiannon Ellem, Scarlett Smout, Karrah McCann, Emily Hunter, Amra Catakovic, Katrina Champion
To investigate the effectiveness of a school-based multiple health behaviour change e-health intervention for modifying risk factors for chronic disease (secondary outcomes).
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Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia Med. J. Aust. (IF 11.4) Pub Date : 2024-04-11 Peter AB Wark, Julie M Marchant
In reply: We thank Prentice1 for his comments on the CICADA position statement on chronic cough in Australia.2 He highlights some rare causes of chronic cough that we agree have not received much attention regarding cough pathogenesis. He brings to the attention of readers the potential for neurological mechanisms to play a role in driving chronic cough, including Arnold's nerve irritation, giant cell
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Should voluntary assisted dying in Victoria be extended to encompass people with dementia? Med. J. Aust. (IF 11.4) Pub Date : 2024-04-03 Paul A Komesaroff, Michael Chapman, Geetanjali Lamba, Ian H Kerridge, Cameron L Stewart, Alex Holmes, Sophie Lewis, Jennifer Philip
The Victorian Voluntary Assisted Dying Act 2017 came into effect in 2019 after a prolonged and fierce public debate.1 Other Australian states soon followed, and legislation has now been passed allowing the territories also to legalise voluntary assisted dying (VAD). Although opposition persists in some quarters, VAD schemes now command broad acceptance — or at least, acquiescence — among both practitioners
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Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia Med. J. Aust. (IF 11.4) Pub Date : 2024-04-04 Richard Turner, Surinder Birring
To the Editor: The recent publication in this Journal of the position statement summary on cough in children and adults is welcome and timely.1 Much has changed in the understanding of chronic cough since the last Australian guideline was published in 2010, reflected not least in the recent approval in Europe of gefapixant, the first successful drug developed specifically for chronic cough.2 Compared
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Genetic testing in cardiovascular disease Med. J. Aust. (IF 11.4) Pub Date : 2024-04-04 Michael P Gray, Diane Fatkin, Jodie Ingles, Elizabeth N Robertson, Gemma A Figtree
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally and is responsible for an estimated 32% of deaths.1 An effort over many decades targeting modifiable risk factors has resulted in significant improvements in mortality and age-adjusted prevalence. However, the improved medical management and decreased mortality have also resulted in a 193% increase in overall CVD
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Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia Med. J. Aust. (IF 11.4) Pub Date : 2024-04-04 Julie M Marchant, Anne B Chang, Peter AB Wark
In reply: We thank Turner and Birring1 for their interest in our updated position statement on cough in children and adults,2 particularly for identifying its strength in separating evidence-based strategies for children and adults. We also appreciate their comments on our efforts to highlight the importance of identifying and treating chronic cough in Australian First Nations people. We agree and
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Ambient maximum daily temperature and mental health-related presentations to a western Sydney emergency department, 2015–2019: analysis of hospital and meteorological data Med. J. Aust. (IF 11.4) Pub Date : 2024-04-03 Wen Yu Claire Ooi, Taylor A Braund, James Elhindi, Anthony WF Harris
Climatic heat extremes cause heat-related illnesses such as heat stroke, exacerbate other medical conditions, and can lead to death.1 However, the effect of heat on the number of people who present to emergency departments with mental illness is less well explored. We therefore examined the effects of temperature, humidity, and air pollution on presentations with mental health problems to the emergency
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Private equity investment in health care delivery, Australia, 2008–2022 Med. J. Aust. (IF 11.4) Pub Date : 2024-04-02 Victoria L Berquist
To examine the scale of private equity investment in Australian health care delivery assets (clinics, hospitals, imaging facilities, other doctor-led health care services).
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Erratum Med. J. Aust. (IF 11.4) Pub Date : 2024-03-31
Brown, KGM, Ansari, N, Solomon, MJ. Contemporary management of advanced colorectal cancer: the Australian experience. Med J Aust 2024; https://doi.org/10.5694/mja2.52218 In this Perspective, the Provenance line should read: “Commissioned; externally peer reviewed.”
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Towards national paediatric clinical practice guidelines Med. J. Aust. (IF 11.4) Pub Date : 2024-03-26 Mike Starr
Clinical practice guidelines (CPGs) are intended to improve the quality of clinical care by promoting evidence-based care, reducing inappropriate variation, and producing optimal outcomes for patients. The Royal Children's Hospital (RCH) in Melbourne, Australia, has a long history of developing and implementing CPGs to ensure the provision of high quality care for children and young people. A CPG committee
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The 2023 report of the MJA–Lancet Countdown on health and climate change: sustainability needed in Australia's health care sector Med. J. Aust. (IF 11.4) Pub Date : 2024-03-24 Paul J Beggs, Stefan Trueck, Martina K Linnenluecke, Hilary Bambrick, Anthony G Capon, Ivan C Hanigan, Nicolas Borchers Arriagada, Troy J Cross, Sharon Friel, Donna Green, Maddie Heenan, Ollie Jay, Harry Kennard, Arunima Malik, Celia McMichael, Mark Stevenson, Sotiris Vardoulakis, Tran N Dang, Gail Garvey, Raymond Lovett, Veronica Matthews, Dung Phung, Alistair J Woodward, Marina B Romanello, Ying
Globally, 2022 was the eighth warmest year on record, with a persistent La Niña event resulting in a cooler year than would otherwise have been the case. In Australia, the La Niña event contributed to 2022 being the ninth-wettest year on record. Sydney had its wettest year on record in 2022, with its 2530 mm of rainfall being 121% higher than the average in recent decades.1 Records continued to fall
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The impact of tightened prescribing restrictions for PBS-subsidised opioid medicines and the introduction of half-pack sizes, Australia, 2020–21: an interrupted time series analysis Med. J. Aust. (IF 11.4) Pub Date : 2024-03-24 Forrest C Koch, Jake Olivier, Jonathan Brett, Nicholas A Buckley, Natasa Gisev, Sallie Pearson, Benjamin Daniels
To evaluate the impact of the tightened Pharmaceutical Benefits Scheme (PBS) prescribing rules for immediate release (IR) and controlled release (CR) opioid medicines (1 June 2020), which also eliminated repeat dispensing without authorisation for codeine/paracetamol and tramadol IR and introduced half-pack size item codes for IR formulations.
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Hypervirulent Klebsiella pneumoniae causing emphysematous pyelonephritis: a life-threatening pathogen within Australian communities Med. J. Aust. (IF 11.4) Pub Date : 2024-03-21 Katherine GC Ong, John R Dyer, Dickon Hayne
Clinical record A 65-year-old man of Indonesian ethnicity with type 2 diabetes mellitus and hypertension first presented to a peripheral hospital in March 2023 with fevers and diabetic ketoacidosis. He was treated for urosepsis, with Klebsiella pneumoniae isolated in urine and blood cultures. Computed tomography (CT) scan showed multifocal, bilateral thickened perirenal infiltrates, which were discussed
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The Australian Health Care Homes trial: quality of care and patient outcomes. A propensity score-matched cohort study Med. J. Aust. (IF 11.4) Pub Date : 2024-03-21 Duong T Tran, Michael O Falster, Jim Pearse, Deniza Mazevska, Patrick McElduff, Sallie Pearson, Kees C van Gool, Jane Hall, Louisa Jorm
To assess the impact of the Health Care Homes (HCH) primary health care initiative on quality of care and patient outcomes.
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Long COVID in a highly vaccinated but largely unexposed Australian population following the 2022 SARS-CoV-2 Omicron wave: a cross-sectional survey Med. J. Aust. (IF 11.4) Pub Date : 2024-03-20 Mulu Woldegiorgis, Gemma Cadby, Sera Ngeh, Rosemary J Korda, Paul K Armstrong, Jelena Maticevic, Paul Knight, Andrew Jardine, Lauren E Bloomfield, Paul V Effler
To estimate the prevalence of long COVID among Western Australian adults, a highly vaccinated population whose first major exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was during the 2022 Omicron wave, and to assess its impact on health service use and return to work or study.
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Medicare-funded reproductive genetic carrier screening in Australia has arrived: are we ready? Med. J. Aust. (IF 11.4) Pub Date : 2024-03-17 Alice P Rogers, Lara Fitzgerald, Jan Liebelt, Christopher Barnett
Reproductive genetic carrier screening (RGCS) is a preventive health strategy performed to identify healthy couples and individuals who are at increased chance of having a child affected by a serious, childhood onset autosomal recessive or X-linked genetic condition (Box 1). Box 1. Inheritance patterns relevant to reproductive genetic carrier screening When provided before conception or early in pregnancy
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First implantable cardiac defibrillator insertions in New South Wales, 2005–2020: an analysis of linked administrative data Med. J. Aust. (IF 11.4) Pub Date : 2024-03-17 Lin Zhu, Andrew Hayen, Bianca Blanch, Nathan Engstrom, Jenny A Doust, Christopher Semsarian, Katy JL Bell
To determine the annual numbers of first ICD insertions in New South Wales during 2005–2020; to examine health outcomes for people who first received ICDs during this period.
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Mainstreaming genomic testing: pre-test counselling and informed consent Med. J. Aust. (IF 11.4) Pub Date : 2024-03-13 Michaela Cormack, Kathryn B Irving, Fiona Cunningham, Andrew P Fennell
There is unprecedented, increasing demand for genomic testing in Australia.1, 2 Recent developments in paediatric neurology alone include Medical Benefits Schedule, industry and research sponsored testing for monogenic causes of epilepsy, neuromuscular disorders, and syndromic intellectual disability, among others. To be ethically and legally valid, patients must undergo pre-test counselling before
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Psychological safety in medicine: what is it, and who cares? Med. J. Aust. (IF 11.4) Pub Date : 2024-03-13 Mina Sarofim
Psychological safety is a contemporary concept which refers to an individual's perception of the consequences of taking an interpersonal risk. Such an environment allows individuals to feel comfortable being themselves, expressing concerns, asking questions, and offering innovative ideas without fear of backlash or ridicule. Originally explored by Professor Amy Edmondson of Harvard Business School
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Australian consensus statement on doxycycline post-exposure prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual and other men who have sex with men Med. J. Aust. (IF 11.4) Pub Date : 2024-03-13 Vincent J Cornelisse, Benjamin Riley, Nicholas A Medland
Doxycycline post-exposure prophylaxis (doxy-PEP) involves consuming 200 mg of doxycycline up to 72 hours after a condomless sex act to reduce the risk of bacterial sexually transmitted infections (STIs). Recent clinical trials of doxy-PEP have demonstrated significant reductions in syphilis, chlamydia and, to a lesser degree, gonorrhoea among gay, bisexual and other men who have sex with men (GBMSM)
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Response to the ASHM 2023 statement on the use of doxy-PEP in Australia: considerations and recommendations Med. J. Aust. (IF 11.4) Pub Date : 2024-03-13 Sara F E Bell, Emma L Sweeney, Fabian Y S Kong, David M Whiley, Catriona S Bradshaw, Jacob A Tickner
In September 2023, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) released the 2023 Consensus statement on doxycycline prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual, and other men who have sex with men in Australia,1 which appears in this issue of the MJA.2 The Statement addresses important considerations for
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Australia's mental health commissions: evaluating a natural experiment Med. J. Aust. (IF 11.4) Pub Date : 2024-03-12 Sebastian P Rosenberg
In September 2023, Minister for Health Mark Butler presented the findings of the investigation into the National Mental Health Commission.1 No evidence of fraud or maladministration was reported and no findings against any individuals were made. However, the report found the Commission plagued by high levels of organisational distress, low morale, and deep divisions. It also found the Commission incapable
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Gestational diabetes mellitus screening and diagnosis criteria before and during the COVID-19 pandemic: a retrospective pre–post study Med. J. Aust. (IF 11.4) Pub Date : 2024-03-11 Paul P Glasziou, Jenny A Doust
To the Editor: Meloncelli and colleagues1 have provided clear evidence that a fasting venous plasma glucose (FVPG) assessment may be used to decrease the number of unnecessary oral glucose tolerance tests (OGTTs) for low risk women. This would be a very welcome step forward. However, it does not directly address the problem of the discrepant results and false positives when only the OGTT is used for
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Gestational diabetes mellitus screening and diagnosis criteria before and during the COVID-19 pandemic: a retrospective pre–post study Med. J. Aust. (IF 11.4) Pub Date : 2024-03-11 Susan J de Jersey, Michael C d'Emden, Adrian G Barnett, H David McIntyre
In reply: We thank Glasziou and Doust1 for their interest in our evaluation of gestational diabetes mellitus (GDM) screening in Queensland during the COVID-19 pandemic,2 which suggested that a fasting venous plasma glucose (FVPG) assessment may be a reasonable first step for GDM screening. Women with an FVPG value < 4.7 mmol/L do not appear to have an increased risk of pregnancy complications even
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The role of medical colleges and member organisations in advancing women in health care leadership Med. J. Aust. (IF 11.4) Pub Date : 2024-03-07 Jenny Proimos, Jacqueline A Boyle, Belinda Garth, Erwin Loh, Helena J Teede
There is broad recognition of the under-representation of women in health care and medical leadership.1-4 The World Health Organization landmark report Delivered by women, led by men5 showed women make up 70% of the global health workforce but only 25% of the leadership. Decades of parity in men and women graduating from medical schools have not translated to gender equality in medical leadership,6
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Erratum Med. J. Aust. (IF 11.4) Pub Date : 2024-03-04
Tunnicliffe, DJ, Bateman, S, Arnold-Chamney, M, et al. Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary. Med J Aust 2023; https://doi.org/10.5694/mja2.52114 In this Guideline summary, the author Ro-Anne Stirling-Kelly was accidentally removed from the authors list. The complete list should read: David J Tunnicliffe1,2 Samantha Bateman3,4 Melissa
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Minimising harm: avoiding intubation for psychogenic non-epileptic seizures Med. J. Aust. (IF 11.4) Pub Date : 2024-03-04 Stephen Bacchi, Santosh Verghese, Mark Slee
Clinical record A 25-year-old man presented to the emergency department of a tertiary hospital following a seizure. His past medical history included epilepsy, for which he was taking levetiracetam 1000 mg and valproate 1000 mg, each twice daily. While the patient was in the department, an emergency code was activated by nursing staff. On review, he was unresponsive, with waxing and waning bilateral
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The uptake of long-acting depot buprenorphine for treating opioid dependence in Australia, 2019–2022: longitudinal sales data analysis Med. J. Aust. (IF 11.4) Pub Date : 2024-03-04 Nicholas Lintzeris, Victoria Hayes, Adrian J Dunlop
Opioid agonists, such as methadone and buprenorphine, are effective for treating opioid dependence. In 2022, more than 55 000 Australians were receiving opioid agonist treatment on any day.1 As alternatives to sublingual buprenorphine and buprenorphine–naloxone formulations, two long-acting depot buprenorphine products, requiring subcutaneous injection once a week or month, were listed by the Pharmaceutical
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Good's syndrome associated with multiple basal cell carcinomas Med. J. Aust. (IF 11.4) Pub Date : 2024-02-29 Jacques Zimmer, Markus Ollert
To the Editor: Wu and colleagues1 present an interesting case report about a patient they consider to be affected by Good's syndrome accompanied by multiple large basal cell carcinomas (BCCs). This remarkable observation points to the potential problem that there are still no sufficiently precise criteria for the diagnosis of this rare disease. The consensus definition of Good's syndrome is thymoma
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Call to end shackling of hospitalised palliative prisoner patients Med. J. Aust. (IF 11.4) Pub Date : 2024-02-29 Lara Pemberton, Stacey Panozzo, Jennifer Philip
In the face of an ageing prison population, there is growing pressure for correctional health staff to provide end-of-life care for the incarcerated.1 This article evaluates the literature and examines the practices surrounding the use of shackles and restraints in palliative prisoner patients cared for in the hospital setting. Although we recognise that the use of restraints is a reasonable strategy
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Women in medical leadership: has the COVID-19 crisis heightened the glass cliff? Med. J. Aust. (IF 11.4) Pub Date : 2024-02-28 Melissa A Wheeler, Laksmi S Govindasamy
For over 30 years, the Medical Journal of Australia has published articles identifying gender inequities that contribute to a persisting glass ceiling in women's representation in medical leadership.1, 2 The close of 2021 saw an unprecedented and welcome trend — women occupied many highly visible medical leadership roles in Australia and Aotearoa New Zealand. This included appointed roles, such as
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Expanding access to fracture liaison services in Australia for people with minimal trauma fractures: a system dynamics modelling study Med. J. Aust. (IF 11.4) Pub Date : 2024-02-26 Alicia R Jones, Danielle Currie, Cindy Peng, Peter R Ebeling, Jackie R Center, Gustavo Duque, Sean Lybrand, Greg Lyubomirsky, Rebecca J Mitchell, Sallie Pearson, Markus J Seibel, Jo-An Occhipinti
To project how many minimal trauma fractures could be averted in Australia by expanding the number and changing the operational characteristics of fracture liaison services (FLS).
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Who smokes in Australia? Cross-sectional analysis of Australian Bureau of Statistics survey data, 2017–19 Med. J. Aust. (IF 11.4) Pub Date : 2024-02-18 Jessica Yi Han Aw, Christina Heris, Raglan Maddox, Grace Joshy, Emily Banks AM
To assess the socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia.
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The Australian Child Maltreatment Study: National prevalence and associated health outcomes of child abuse and neglect Med. J. Aust. (IF 11.4) Pub Date : 2024-02-20 Leonie Segal, Emmanuel S Gnanamanickam
To the Editor: Mathews and colleagues1 recently reported on the prevalence of child maltreatment in Australia and its association with adverse outcomes, drawing on a population survey of 8503 people aged 16 years and over — the Australian Child Maltreatment Study (ACMS). Understanding the extent of child maltreatment and those most at risk is of considerable importance to policy and practice, noting
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Cutting the queue: the need for evidence-driven surgery Med. J. Aust. (IF 11.4) Pub Date : 2024-02-20 Jai N Darvall, Toby Richards
It is a tricky time for surgeons. Restrictions on elective surgery during the coronavirus disease 2019 (COVID-19) pandemic led to major backlogs on waiting lists. In Australia, 17% fewer people were admitted to public hospital for surgery during 2021–22 than in the preceding year, the result being that 9.6% of people on waiting lists had waited more than a year for treatment, compared with 2.1% in
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The Australian Child Maltreatment Study: National prevalence and associated health outcomes of child abuse and neglect Med. J. Aust. (IF 11.4) Pub Date : 2024-02-20 Ben Mathews
In reply: We welcome the correspondence by Segal and Gnanamanickam1 regarding the Australian Child Maltreatment Study (ACMS),2 and their endorsement of the need to understand the extent of child maltreatment. The authors pose the question of where society should set the threshold for defining child maltreatment, particularly to identify those most in need of support, and highlight the need for prudent
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Challenges for Medicare and universal health care in Australia since 2000 Med. J. Aust. (IF 11.4) Pub Date : 2024-02-16 Damien Linnane, Craig Cumming, Stuart A Kinner
To the Editor: People incarcerated in Australia are uniquely excluded from Medicare, although this exclusion is not widely understood or studied. In their article discussing challenges for Medicare in Australia since 2000, Angeles and colleagues explicitly excluded coverage of groups that lack Medicare access, including people in prisons.1 They did, however, note the lack of success in addressing the
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Catheter-related superior vena cava syndrome: an increasing problem Med. J. Aust. (IF 11.4) Pub Date : 2024-02-15 John J Harvey, John I Vrazas, Elhamy Bekhit, Chris Barnes, Philip J Robinson
Clinical record A 16-year-old female patient with cystic fibrosis developed recurrent pleural effusions, facial plethora and prominent chest wall veins. She was homozygous for the ΔF508 mutation in the CFTR gene and was receiving elexacaftor/tezacaftor/ivacaftor cystic fibrosis transmembrane receptor modulator combination therapy. She had a left internal jugular vein (IJV) approach totally implantable
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The provision of general surgery in rural Australia: a narrative review Med. J. Aust. (IF 11.4) Pub Date : 2024-02-15 Jessica Paynter, Kirby R Qin, Janelle Brennan, David J Hunter-Smith, Warren M Rozen
General surgery is the most common surgical specialty in rural Australia, providing breast, skin, endocrine, gastrointestinal, colorectal and trauma surgery. It requires knowledge of the whole field of surgery, particularly the ability to provide an extended scope of emergency care dependent upon community need.1, 2 Rural residents make up 29% of the Australian population; however, only 19.5% of general
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Screening and prevention of ovarian cancer Med. J. Aust. (IF 11.4) Pub Date : 2024-02-14 Michail Sideris, Usha Menon, Ranjit Manchanda
Around 314 000 women worldwide are diagnosed with ovarian cancer annually and 207 000 women die of it.1 GLOBOCAN, the World Health Organization Global Cancer Observatory, predicts the number of ovarian cancer cases and deaths will rise globally by 36% and 47% respectively over 20 years.2 Correspondingly, the predicted increase in ovarian cancer cases and deaths in Australia is 42% and 55% respectively
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The effectiveness of maternal pertussis vaccination for protecting Aboriginal and Torres Strait Islander infants against infection, 2012–2017: a retrospective cohort study Med. J. Aust. (IF 11.4) Pub Date : 2024-02-14 Lisa McHugh, Heather A D’Antoine, Mohinder Sarna, Michael J Binks, Hannah C Moore, Ross M Andrews, Gavin F Pereira, Christopher C Blyth, Paul Van Buynder, Karin Lust, Annette K Regan
To evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age.
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Prosthetic joint infection diagnosis in an age of changing clinical patterns of infection and new technologies Med. J. Aust. (IF 11.4) Pub Date : 2024-02-13 Joshua S Davis, David Dewar, Laurens Manning
Joint replacement surgery is one of the most successful interventions in modern medicine, restoring joint function, mobility and quality of life in those with severe osteoarthritis. In 2022, 126 000 knee and hip replacements were performed in Australia,1 adding to the pool of about 1 million Australians currently living with one or more joint replacements in situ.2 Unfortunately, around 4000 Australians
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Who should get the last TAVI valve? Public versus private access to disruptive technologies in the Australian health care system Med. J. Aust. (IF 11.4) Pub Date : 2024-02-08 Jonathon B Ryan
“Who should get the last ventilator?” was an esoteric ethics question until footage emerged from inside the main hospital in Bergamo in Northern Italy at the start of the COVID-19 pandemic.1 While Australia was spared the horror of that reality, the need to ration finite health resources is a perennial problem that confronts all health care systems. Health technology assessment (HTA) is a formal multidisciplinary
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Artificial intelligence for surgical services in Australia and New Zealand: opportunities, challenges and recommendations Med. J. Aust. (IF 11.4) Pub Date : 2024-02-06 Joshua G Kovoor, Stephen Bacchi, Prakriti Sharma, Srishti Sharma, Medhir Kumawat, Brandon Stretton, Aashray K Gupta, WengOnn Chan, Amal Abou-Hamden, Guy J Maddern
Artificial intelligence (AI) is being rapidly taken up by society, including health care services, and will inevitably be used broadly within the surgical services of Australia and New Zealand. However, the process of AI implementation must be evidence-based, safe, and ethically cautious,1 and must adhere to recommendations of the international surgical data science community.2 AI has numerous limitations
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Enhanced recovery after surgery: an update for the generalist Med. J. Aust. (IF 11.4) Pub Date : 2024-02-04 Andrew G Hill, James Jin
General surgery has evolved almost beyond recognition over the past 50 years. While always a technical discipline, major advances in surgical technology have been made. Along with these technical advances there have been concomitant major changes in peri-operative care. The art and science of peri-operative care has almost become a specialty in itself, with surgeons, anaesthetists, medical specialists
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Changes in the numbers of hospital-based abortions and outpatient early medical abortions in Victoria, 2012–22: a retrospective cohort study Med. J. Aust. (IF 11.4) Pub Date : 2024-02-02 Melvin B Marzan, Eleanor Johnson, Patricia Moore, Heng Jiang, Lisa Hui
To assess changes in the monthly numbers of hospital-based abortions and outpatient early medical abortions in Victoria during January 2012 – March 2022, with a particular interest in the impact of the coronavirus disease 2019 (COVID-19) pandemic.
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The prevalence of and factors associated with prior induced abortion among women who gave birth in Victoria, 2010–2019 Med. J. Aust. (IF 11.4) Pub Date : 2024-02-02 Kristina Edvardsson, Kirsten I Black, Deborah Bateson, Wendy V Norman, Mridula Shankar, Leesa Hooker, Xia Li, Angela J Taft
To assess the prevalence of a history of induced abortion among women who gave birth in Victoria during 2010–2019; to assess the association of socio-demographic factors with a history of induced abortion.
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Presentations to selected Melbourne hospitals with cardiovascular disease by Indigenous and non-Indigenous people, 2011–19: a linked administrative data analysis Med. J. Aust. (IF 11.4) Pub Date : 2024-01-30 Eloise Price, Aneta Kotevski, Karen Lamb, Digsu Koye, Georgia Taylor, Gabrielle Ebsworth, Luke Burchill
The overall cardiovascular disease (CVD) mortality risk in Australia is 1.5 times as high for Aboriginal and Torres Strait Islander (Indigenous) people as for other Australians.1 The difference in risk in Victoria, however, is unknown: data for Indigenous Victorians have been excluded from national reports on Indigenous cardiovascular mortality because of concerns regarding the quality of Indigenous
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Contemporary management of advanced colorectal cancer: the Australian experience Med. J. Aust. (IF 11.4) Pub Date : 2024-01-28 Kilian GM Brown, Nabila Ansari, Michael J Solomon
Colorectal cancer (CRC) is the third most common cancer in Australia, with almost 16 000 new cases in 2022 accounting for 10% of new cancer diagnoses and 11% of cancer-related deaths.1 There has been a well documented increase in the incidence of CRC in people under the age of 50 years in Australia in recent decades, while the incidence in those older than 50 years has decreased over the same period
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Patient blood management guideline for adults with critical bleeding Med. J. Aust. (IF 11.4) Pub Date : 2024-01-28 Biswadev Mitra, Margaret Jorgensen, Michael C Reade, Anastazia Keegan, Anthony Holley, Shannon Farmer, Nichole Harvey, James Winearls, Michael Parr, Craig J French
The management of patients with critical bleeding requires a multidisciplinary approach to achieve haemostasis, optimise physiology, and guide blood component use. The 2011 Patient blood management guidelines: module 1 — critical bleeding/massive transfusion were updated and published. Systematic reviews were conducted for pre-specified research questions, and recommendations were based on meta-analyses
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The views of parents and carers on managing acute otitis media in urban Aboriginal and Torres Strait Islander children: a qualitative study Med. J. Aust. (IF 11.4) Pub Date : 2024-01-24 Jennifer S Reath, Sarah O'Brien, Letitia Campbell, Hasantha Gunasekera, Claudette A Tyson, Deborah A Askew, Wendy Hu, Tim Usherwood, Kelvin Kong, Peter Morris, Amanda J Leach, Robyn Walsh, Penelope A Abbott
To explore the views of parents and carers regarding the management of acute otitis media in urban Aboriginal and Torres Strait Islander children who are at low risk of complications living in urban communities.
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Inflammation: the next target for secondary prevention in coronary artery disease Med. J. Aust. (IF 11.4) Pub Date : 2024-01-21 Samia Kazi, James J H Chong, Clara K Chow
Coronary artery disease (CAD) remains the leading cause of death in the world. Secondary prevention including antiplatelet, antihypertensive and lipid lowering medicines, as well as behavioural and lifestyle interventions are established treatments, and their implementation continues to be a global health system challenge.1 Yet even if well implemented, residual elevated risk remains for recurrent
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Bronchiectasis among Indigenous adults in the Top End of the Northern Territory, 2011–2020: a retrospective cohort study Med. J. Aust. (IF 11.4) Pub Date : 2024-01-15 Claire Gibbs, Timothy Howarth, Adriana Ticoalu, Winnie Chen, Payi L Ford, Asanga Abeyaratne, Lata Jayaram, Gabrielle McCallum, Subash S Heraganahally
To assess the prevalence of bronchiectasis among Aboriginal and Torres Strait Islander (Indigenous) adults in the Top End of the Northern Territory, and mortality among Indigenous adults with bronchiectasis.
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Immune checkpoint inhibitor therapy for advanced cutaneous squamous cell carcinoma in Australia: a retrospective real world cohort study Med. J. Aust. (IF 11.4) Pub Date : 2024-01-11 Luke S McLean, Annette M Lim, Mathias Bressel, Jenny Lee, Rahul Ladwa, Alexander D Guminski, Brett Hughes, Samantha Bowyer, Karen Briscoe, Samuel Harris, Craig Kukard, Rob Zielinski, Muhammad Alamgeer, Matteo Carlino, Jeremy Mo, John J Park, Muhammad A Khattak, Fiona Day, Danny Rischin
To review the outcomes of immune checkpoint inhibitor (ICI) treatment of advanced cutaneous squamous cell carcinoma (CSCC) outside clinical trials.
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The participation of Aboriginal and Torres Strait Islander parents in Australian trials of parenting programs for improving children's health: a scoping review Med. J. Aust. (IF 11.4) Pub Date : 2024-01-08 Jake MacDonald, Myles Young, Briana Barclay, Stacey McMullen, James Knox, Philip Morgan
To assess the inclusion of Aboriginal and Torres Strait Islander parents in trials of parenting programs in Australia; the involvement of Indigenous fathers in such studies; and whether parenting programs are designed to be culturally appropriate for Aboriginal and Torres Strait Islander people.
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Hidden danger: maize starch excipient allergy Med. J. Aust. (IF 11.4) Pub Date : 2024-01-05 Lipin Lukose, Shrey Seth, Kamal Sud, Brian Nankivell, Mary Ann Nicdao, Ronald L Castelino
Clinical record A 77-year-old man with maize starch excipient allergy on peritoneal dialysis presented to the renal clinic with mild right groin pain for a week, blood pressure of 150/79 mmHg, and weight gain of 2 kg due to fluid retention. He was referred to the pharmacist to recommend a suitable diuretic in view of his known maize starch excipient allergy. The patient was diagnosed with maize starch
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Medical students: a potentially sustainable solution for our workforce crisis and future reforms in health care Med. J. Aust. (IF 11.4) Pub Date : 2023-12-26 Rebecca Goodall, Emily Matejin, Sean Fabri, Paul Eleftheriou
On 11 March 2020, coronavirus disease 2019 (COVID-19) was declared a global pandemic by the World Health Organization.1 Enormous strain was placed on hospital and health care systems around the world as patient numbers increased beyond the capacity of health care facilities to deal with them.1 The unpredictability and high transmissibility of the virus, combined with significant morbidity and mortality
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Baby steps in lobbying reform: opportunities and challenges in Queensland Med. J. Aust. (IF 11.4) Pub Date : 2023-12-27 Jennifer Lacy-Nichols, Katherine B Cullerton
Australia is lacklustre in its political transparency. This makes it challenging to see if commercial actors have undue influence over policy decisions, which is a risk for public health. Lobbying is an important public health strategy. It is defined as “any direct or indirect communication with a public official that is made, managed or directed with the purpose of influencing public decision-making”