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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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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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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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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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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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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, Philip Morgan, Briana Barclay, Stacey McMullen, James Knox
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”
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Socio-economic status and access to fluoridated water in Queensland: an ecological data linkage study Med. J. Aust. (IF 11.4) Pub Date : 2023-12-27 Christopher T Sexton, Diep H Ha, Thu Le, Ratilal Lalloo, Pauline Ford, Loc G Do, Nicole Stormon
To investigate the relationship between access to fluoridated drinking water and area-level socio-economic status in Queensland.
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Too much versus too little: looking for the “sweet spot” in optimal use of diagnostic investigations Med. J. Aust. (IF 11.4) Pub Date : 2023-12-26 Ian A Scott, Carmel Crock, Matthew Twining
Failure to order diagnostic tests when indicated, or misinterpreting their results, can lead to diagnostic errors and adverse outcomes.1 In contrast, overuse of tests generates more false positive results, increases risk of immediate harm (eg, allergic contrast reaction) and promotes overdiagnosis of benign incidental abnormalities, resulting in unnecessary disease labelling and further test and treatment
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The Australian Government's new vaping policy should be part of a larger plan towards a tobacco endgame Med. J. Aust. (IF 11.4) Pub Date : 2023-12-26 Samantha Howe, Driss Ait Ouakrim, Tony Blakely, Coral E Gartner
The Australian Minister for Health and Aged Care, Mark Butler, made a strong push to address the growing problem of youth vaping in his speech at the National Press Club in May 2023.1 While new approaches to controlling youth vaping are urgently needed, it is critical that policy reforms to end the tobacco cigarette epidemic are also pursued with equal vigour — otherwise we risk shifting people currently
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Why clinical artificial intelligence is (almost) non-existent in Australian hospitals and how to fix it Med. J. Aust. (IF 11.4) Pub Date : 2023-12-26 Anton van der Vegt, Victoria Campbell, Guido Zuccon
In-hospital clinical artificial intelligence (AI) encompasses learning algorithms that use real-time electronic medical record (EMR) data to support clinicians in making treatment, prognostic or diagnostic decisions. In the United States, the implementation of hospital-based clinical AI, such as sepsis or deterioration prediction, has accelerated over the past five years,1 while in Australia, outside
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Skin fragility disorder misdiagnosed as child abuse: a cautionary tale Med. J. Aust. (IF 11.4) Pub Date : 2023-12-21 Anneliese Willems, Lauren Weston, Susan Robertson
Clinical record A two-year-old girl presented in distress after a minor fall in a sandpit at a childcare facility. On examination, she had large superficial erosions of the medial buttocks in a kissing distribution (Box 1). Further examination revealed multiple linear and round atrophic scars with post-inflammatory hyperpigmentation affecting the trunk, left flank, buttocks and legs (Box 2, A–C). She
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The Alfred Health post-COVID-19 service, Melbourne, 2020–2022: an observational cohort study Med. J. Aust. (IF 11.4) Pub Date : 2023-12-21 Anne E Holland, Daniel Fineberg, Tunya Marceau, Melissa Chong, Jessica Beaman, Lisa Wilson, Jo-Anne Buchanan, Jacqueline Uren, Simone Dal Corso, Natasha A Lannin, Mariana Hoffman, Christie R Mellerick, Kathya Fernando, Janet Bondarenko
To determine the uptake of the Alfred Health Post-COVID service among people hospitalised with coronavirus disease 2019 (COVID-19) or referred by general practitioners; to describe their characteristics and symptoms at eight weeks and the clinical services they required.
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Steatotic liver disease in rural and regional Victoria, according to the NAFLD and newer diagnostic criteria: retrospective cohort analyses of 2001–03 and 2016–18 data Med. J. Aust. (IF 11.4) Pub Date : 2023-12-19 Karl Vaz, William W Kemp, Ammar Majeed, John Lubel, Dianna Magliano, Kristen Glenister, Lisa Bourke, David Simmons, Stuart K Roberts
The global prevalence of non-alcoholic fatty liver disease (NAFLD) among adults is 25–30%,1 and it is fast becoming the most frequent indication for liver transplantation.2 Its increasing prevalence is linked with the rise in that of obesity.3 The suggestion by an international expert panel that NAFLD be re-termed “metabolic dysfunction-associated fatty liver disease” (MAFLD)4 has been widely endorsed
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Providing Australian children and adolescents with equitable access to new and emerging therapies through clinical trials: a call to action Med. J. Aust. (IF 11.4) Pub Date : 2023-12-19 Michelle S Lorentzos, David Metz, Andrew S Moore, Laura K Fawcett, Paula Bray, Lani Attwood, Craig F Munns, Andrew Davidson
Opportunities for children to benefit from novel therapies have increased substantially over the past decade. Change is needed to maximise these opportunities, particularly in the paediatric trial environment. Investment and a coordinated national approach are needed to prevent Australian children falling behind their international peers. There is international recognition that collaborative approaches
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Implications of voluntary assisted dying for advance care planning Med. J. Aust. (IF 11.4) Pub Date : 2023-12-12 Ben P White, Madeleine Archer, Casey M Haining, Lindy Willmott
Voluntary assisted dying is now lawful in all Australian states, with territories likely to follow.1 As this new end-of-life choice becomes more widely available and known, we should anticipate it arising during end-of-life care discussions with patients. In Australia, unlike some international models,2, 3 voluntary assisted dying is not available to people without decision-making capacity. Therefore
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The importance of cultural humility and cultural safety in health care Med. J. Aust. (IF 11.4) Pub Date : 2023-12-04 Neda So, Karen Price, Peter O'Mara, Michelle A Rodrigues
Cultural competency is the concept of understanding diverse cultural groups to provide high quality patient-centred care that is respectful of and aligned with the patient's cultural health beliefs, practices and value systems.1 Application of this concept aims to alleviate health disparities affecting minority groups, including vulnerable populations such as immigrants, refugees, racial and ethnic
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Rationale and plan for a focus on First Nations urban health research in Australia Med. J. Aust. (IF 11.4) Pub Date : 2023-11-29 Janet Stajic, Adrian Carson, James Ward
Urbanisation is a global phenomenon. The World Health Organization reported in 2015 that 55% of the global population lived in cities and is predicting this to increase to 68% by 2050.1 First Nations peoples globally are disproportionately affected by urbanisation, with major drivers being climate change, deforestation and increased pressures created by globalisation. Despite this, there is limited
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Wood heater smoke and mortality in the Australian Capital Territory: a rapid health impact assessment Med. J. Aust. (IF 11.4) Pub Date : 2023-11-29 Sotiris Vardoulakis, Fay H Johnston, Nigel Goodman, Geoffrey G Morgan, Dorothy L Robinson
To estimate the number of deaths and the cost of deaths attributable to wood heater smoke in the Australian Capital Territory.
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Brain injury community: seeking action on Royal Commission findings. Med. J. Aust. (IF 11.4) Pub Date : 2023-11-27 Bruce Powell,Joshua Powell
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First do no harm in responding to incidental imaging findings Med. J. Aust. (IF 11.4) Pub Date : 2023-11-27 Ian A Scott, John Slavotinek, Paul P Glasziou
You order a computed tomography pulmonary angiogram (CTPA) for a patient with suspected pulmonary thromboembolism. The radiology report states that no pulmonary thromboembolism is seen but notes an unrelated lung nodule. What should you do with this incidental finding, or “incidentaloma”? Incidentalomas are lesions, usually asymptomatic, serendipitously detected in patients undergoing imaging for an
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Considerations of delayed gastric emptying with peri-operative use of glucagon-like peptide-1 receptor agonists Med. J. Aust. (IF 11.4) Pub Date : 2023-11-27 Lisa M Raven, Campbell Brown, Jerry R Greenfield
Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), such as semaglutide, dulaglutide and liraglutide, augment glucose-dependent β-cell insulin release, suppress glucagon secretion, and slow gastric emptying. In Australia, they are available as daily (liraglutide) or weekly (dulaglutide, semaglutide) subcutaneous injections; internationally, semaglutide is also available in a daily oral preparation
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Endocrinology then and now Med. J. Aust. (IF 11.4) Pub Date : 2023-11-21 Virginia Barbour
This issue of the MJA focuses on endocrinology, taking both historical and more modern views. The medical history article by Sophie Templer reminds us that 100 years ago, type 1 diabetes was a fatal disease, with the only treatment a “starvation diet”, and even that was not effective for long (doi: 10.5694/mja2.52137). It's hard to underestimate the profound importance of the discovery of insulin in
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Disruption of gender-affirming health care, and COVID-19 illness, testing, and vaccination among trans Australians during the pandemic: a cross-sectional survey Med. J. Aust. (IF 11.4) Pub Date : 2023-11-23 Sav Zwickl, Tomi Ruggles, Alex FQ Wong, Ariel Ginger, Lachlan M Angus, Kalen Eshin, Teddy Cook, Ada S Cheung
To assess rates of disruption of gender-affirming health care, of coronavirus disease 2019 (COVID-19) illness, testing, and vaccination, and of discrimination in health care among Australian trans people during the COVID-19 pandemic.
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The burden of occupational injury attributable to high temperatures in Australia, 2014–19: a retrospective observational study Med. J. Aust. (IF 11.4) Pub Date : 2023-11-22 Blesson M Varghese, Alana Hansen, Nick Mann, Jingwen Liu, Ying Zhang, Tim R Driscoll, Geoffrey G Morgan, Keith Dear, Anthony Capon, Michelle Gourley, Vanessa Prescott, Vergil Dolar, Peng Bi
To assess the population health impact of high temperatures on workplace health and safety by estimating the burden of heat-attributable occupational injury in Australia.
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Advancing the Australian global health community's commitment to climate change and global health Med. J. Aust. (IF 11.4) Pub Date : 2023-11-21 Angie Bone, Prabhleen Kaur, Anthony Capon, Vivian Kwang-wen Lin, Sione Tu'itahi, Kathryn Bowen, Nick Watts, Jane RW Fisher, Paul J Stewart, Helen Evans, Selina Namchee Lo
The Australian Global Health Alliance, on behalf of the Australian global health community, stands united, deeply concerned about the health impacts of climate change across the world. The Alliance is the member-based peak body for Australian global health organisations, with a mandate to strengthen the global health ecosystem through national and global connections, supporting research and innovation