Med. J. Aust. [JOURNAL]
Sun
200 papers
Reducing Nitrous Oxide Emissions Across the Melbourne Biomedical Precinct.
Robertson R, Downey A, Williams D … +5 more , Makein B, Dunne B, Ozturk T, Gu Y, McIntyre R
Med J Aust · 2026 Jul · PMID 42402525 · Publisher ↗
Nitrous oxide (NO) accounts for the majority of Australian healthcare's direct anaesthetic gas-related greenhouse gas emissions due to reticulated system leaks. Updated Australasian guidelines no longer mandate a reticul...
Nitrous oxide (NO) accounts for the majority of Australian healthcare's direct anaesthetic gas-related greenhouse gas emissions due to reticulated system leaks. Updated Australasian guidelines no longer mandate a reticulated NO supply. We present the efforts of four Melbourne hospitals to reduce NO emissions across diverse clinical contexts. Two have decommissioned reticulated NO and adopted cylinder supplies as required through clinical consultation and interdisciplinary collaboration. Two face ongoing high clinical demand for NO, with multiple locations sharing infrastructure, and are pursuing audits and trials to guide change. These case studies illustrate the diverse strategies and challenges involved in reducing NO emissions.
Still Treating Yesterday's Risk? Reconsidering Antiviral Use for Mild-to-Moderate COVID-19 Cases in a Broadly Immune Population.
Mudrik-Zohar H, Cutfield T, Morpeth S … +5 more , Hills T, Duffy E, Edwards LJ, Cheng AC, Tong SYC
Med J Aust · 2026 Jul · PMID 42387951 · Full text
Antivirals for mild-to-moderate coronavirus disease 2019 (COVID-19) were adopted for use based on trials in unvaccinated adults during the pre-Omicron period. In today's broadly immune populations, where the risk of hosp...
Antivirals for mild-to-moderate coronavirus disease 2019 (COVID-19) were adopted for use based on trials in unvaccinated adults during the pre-Omicron period. In today's broadly immune populations, where the risk of hospitalisation and death has decreased substantially, there is a lack of high-quality contemporary evidence to support routine antiviral use for mild-to-moderate disease. Comparing the Australian and New Zealand experiences in the evolving COVID-19 landscape highlights differences in policy and prescribing practice. Treatment guidelines should be informed by systematic evaluation of emerging data, given uncertainty regarding antiviral effectiveness in a context of widespread immunity and milder disease, which have altered the balance of risks and benefits.
Striving for Racial Equity in Oral Cancer Research: A Case Study.
Sethi S, Naylor S, Leane Dharug/Gabrigal C … +4 more , Garvey Kamilaroi G, Hedges Yamatji J, Jamieson LM, Reid Dharug/Gabrigal N
Med J Aust · 2026 Jul · PMID 42387840 · Full text
Racism impedes the achievement of equity in healthcare by permeating individual, community, societal and institutional levels. Cancer is the leading contributor to global mortality and continues to have a disproportionat...
Racism impedes the achievement of equity in healthcare by permeating individual, community, societal and institutional levels. Cancer is the leading contributor to global mortality and continues to have a disproportionately higher impact on First Nations Peoples. Research specific to First Nations Peoples, conducted in accordance with the principles of Indigenous research, is critical to justify the advocacy and delivery of measures that yield relevant, translatable outcomes and benefits. The following article presents a case study of a longitudinal cohort project assessing human papillomavirus-associated oral cancer in First Nations Peoples of South Australia. The article discusses decolonising methodologies, their application and relevance.
Progressing Cross-Sector Collaboration for People With Eating Disorders and Higher Weight: Priority Actions From an Expert Roundtable Using a Modified Nominal Group Technique.
Jebeile H, Brennan L, Burrows T … +14 more , de la Piedad Garcia X, Ralph AF, Saluja S, Atlantis E, Garnett SP, Harrison CJ, House ET, Lister NB, Moran L, Piya MK, Rieger E, Smith E, Hay P, Trobe S
Med J Aust · 2026 Jul · PMID 42387264 · Full text
INTRODUCTION: Eating disorders are more prevalent in people with higher weight than those with low weight. However, contention between the fields of obesity and eating disorders has prevented meaningful progress in resea...
INTRODUCTION: Eating disorders are more prevalent in people with higher weight than those with low weight. However, contention between the fields of obesity and eating disorders has prevented meaningful progress in research, prevention, identification and coordinated clinical services for people with co-occurring conditions. In Australia, public health approaches and provision of treatment services for people with eating disorders and clinical obesity are siloed, often resulting in contradictory messaging. To address this, a roundtable meeting was held in November 2024 in Sydney, Australia, with 28 experts in one or both of these fields, including researchers, clinicians and service leaders working across paediatric and adult care, and individuals with lived experience. Guided by the National Eating Disorders Collaboration stepped system of care framework, participants identified key challenges and possible solutions, and established five priority actions. MAIN RECOMMENDATIONS: The priority actions across sectors are: Health Campaigns focused on raising awareness of eating disorders at higher weight, using appropriate language and reducing weight stigma; improved Screening and Assessment using standardised protocols across healthcare settings; supporting Primary Healthcare and improving the use of Medicare items; Tailored Treatment Pathways including integrated care models; and building Workforce Capacity to upskill professionals to provide safe, person-centred care. CHANGES IN MANAGEMENT AS A RESULT OF THE STATEMENT: These actions aim to promote improved cross-sector collaboration and effective, safe, coordinated and integrated approaches to prevention, identification and treatment across the fields of obesity and eating disorders. They address the complex medical and psychological needs of those with co-occurring eating disorders and higher weight or clinical obesity through a skilled workforce and improved access to care. Effective integration, collaboration and coordination across services is essential for long-term recovery support.
Self-Poisoning With Prazosin and Its Off-Label Use in Australia, 2014-2024: Analysis of NSW Poisons Information Centre Data.
Lal OBE, Buckley NA, Cairns R
Med J Aust · 2026 Jul · PMID 42387257 · Full text
NSW Poisons Information Centre data identified 1030 deliberate prazosin self-poisonings over 11 years, rising from 13 to 170 per year (2014-2024). Young women predominated, likely due to expanded off-label (but accepted)...
NSW Poisons Information Centre data identified 1030 deliberate prazosin self-poisonings over 11 years, rising from 13 to 170 per year (2014-2024). Young women predominated, likely due to expanded off-label (but accepted) psychiatric use of prazosin. Better evidence on benefits of off-label use is needed to justify increasing risks.
Drivers of Vaccine Uptake for Aboriginal and Torres Strait Islander Children to Inform Tailored Strategies: A Qualitative Study Exploring Health Service Provider Perspective.
Middleton BF, Crooks K, Taylor K … +8 more , Harwood E, Clark KK, Kent C, McCrory K, Hefler M, Kaufman J, Durrheim DN, Danchin MH
Med J Aust · 2026 Jul · PMID 42383576 · Full text
OBJECTIVES: To identify drivers of routine vaccination for Aboriginal and Torres Strait Islander children, from a health service provider perspective, to increase and maintain uptake. DESIGN: This qualitative study was d...
OBJECTIVES: To identify drivers of routine vaccination for Aboriginal and Torres Strait Islander children, from a health service provider perspective, to increase and maintain uptake. DESIGN: This qualitative study was designed, analysed and guided by Indigenous data sovereignty and governance principles. Data were analysed using inductive content analysis. Subcategories were refined using Miro (Miro Inc), an online collaboration platform. Aboriginal and Torres Strait Islander worldviews were privileged, with Aboriginal researchers leading data analysis in New South Wales (NSW) and contributing to analysis in the Northern Territory (NT). SETTING: The study was conducted in NSW and the NT, Australia, with health service providers from urban, rural and remote settings. PARTICIPANTS: Individual and group interviews were undertaken in person or online between 2 May and 28 August 2024, with 18 health service provider participants in the Hunter New England Local Health District in NSW and 17 health service provider participants in the NT. RESULTS: We identified six key themes addressing drivers of vaccination for Aboriginal and Torres Strait Islander children for families (knowledge, attitudes and information sources; decision-making), health staff (workforce roles, responsibilities and relationships) and health services (improving access; health service operations; data for decision-making). Providers recommended strategies to improve uptake. CONCLUSIONS: Health service providers in urban, rural and remote locations in Australia can provide valuable insights to inform tailored strategies to improve declining vaccine coverage for Aboriginal and Torres Strait Islander children, aligned with the priorities of the National Immunisation Strategy 2025-2030.
Four Urgent Actions for the Rights to Culturally Safe Breastfeeding for Aboriginal and Torres Strait Islander Mothers and Babies to Breastfeed in Neonatal Intensive Care Environments.
Bennett J, Bryant J, Booth K … +1 more , Kennedy M
Med J Aust · 2026 Jul · PMID 42377111 · Full text
Breast milk provides both short-term and long-term health benefits and is critical for infants admitted to neonatal intensive care units (NICUs). Presently, there is a large focus on increasing breastfeeding rates among...
Breast milk provides both short-term and long-term health benefits and is critical for infants admitted to neonatal intensive care units (NICUs). Presently, there is a large focus on increasing breastfeeding rates among Aboriginal and Torres Strait Islander women; however, culturally safe breastfeeding support is under-recognised and inadequately addressed in the NICU setting. This perspective highlights cultural and structural barriers and calls for urgent action to include the following four proposed strategies: strengthening the Aboriginal lactation workforce, embedding culturally inclusive education, partnering with community-controlled services, and developing a culturally specific NICU breastfeeding policy to improve outcomes.
Intergenerational Child Protection Contact and Child Development Outcomes: A Whole Population Linked Data Study.
Forsyth M, Montgomerie A, Falster K … +4 more , Jeyaseelan D, Hotton P, Lynch J, Pilkington RM
Med J Aust · 2026 Jul · PMID 42366161 · Publisher ↗
OBJECTIVES: To investigate maternal child protection histories, and offspring child protection contacts and developmental outcomes, for children at age 5 years. STUDY DESIGN: Observational cohort study using linked South...
OBJECTIVES: To investigate maternal child protection histories, and offspring child protection contacts and developmental outcomes, for children at age 5 years. STUDY DESIGN: Observational cohort study using linked South Australian administrative birth, perinatal, child protection and child development data. PARTICIPANTS, SETTING: Children with a South Australian birth registration and a record in the 2009, 2012, 2015 or 2018 Australian Early Development Census (AEDC). MAIN OUTCOME MEASURES: Highest level of child protection system contact for children before starting school, and developmental vulnerability on one or more AEDC domains. RESULTS: Of 69,332 children, 7522 (10.8%) had a mother with a history of any child protection contact, and 1019 (1.5%) had a mother with at least one out-of-home care placement. Maternal child protection history was associated with increasing levels of socio-economic and health disadvantage around the time of birth. For example, overall there were 8245/69,332 (11.9%) children born into a home where the parent(s) were unemployed, compared with 549/1019 (53.9%) with a maternal out-of-home care history. For children whose mothers had child protection contact, 3793/7522 (50.4%) had their own child protection contact by age 5 years, compared with 7033/61,810 (11.4%) for children whose mothers had no contact. Of 6771 children whose mothers had child protection contact, 2724 (40.2% [95% confidence interval], 39.1%-41.4%) were developmentally vulnerable on one or more AEDC domains when they started school, compared with 12,002/58,165 (20.6% [95% confidence interval], 20.3%-21.0%) children with no maternal child protection history. CONCLUSION: Child protection contact is common in both mothers and children, and maternal child protection history carries an increased burden of poor development outcomes at school entry. The scale and intersection of child protection system contact, early life disadvantage and poor development outcomes have implications for appropriately resourcing health-led supportive responses as early as possible during the perinatal and early childhood periods.
Treatment and Survival Outcomes for Indigenous and Non-Indigenous Australians Within the Victorian Lung Cancer Registry: A Retrospective Cross-Sectional Cohort Study.
Wong M, Lloyd M, Zeng J … +31 more , Tissera S, Griffiths KE, Clark J, Gillies J, Briggs L, Lesage J, Wood T, Underhill C, Parakh S, Irving LB, Faisal W, Blum R, Richardson GE, Parente P, Caldecott M, Olesen I, Torres J, Samuel E, Lyne C, See K, Langton D, John T, Wright G, Conron M, Bartlett J, Adabi G, Moore M, Harden S, McQuilten ZK, Zalcberg JR, Stirling R
Med J Aust · 2026 Jul · PMID 42366160 · Publisher ↗
OBJECTIVES: Our goal was to explore and compare risk factors, patterns of management and survival outcomes in Indigenous compared with non-Indigenous Australian patients using the Victorian Lung Cancer Registry (VLCR). S...
OBJECTIVES: Our goal was to explore and compare risk factors, patterns of management and survival outcomes in Indigenous compared with non-Indigenous Australian patients using the Victorian Lung Cancer Registry (VLCR). STUDY TYPE: A retrospective observational cohort study of the VLCR. SETTING: Data collected from the VLCR between 18 January 2011 and 24 January 2024. PARTICIPANTS: Primary lung cancer patients in the VLCR. MAIN OUTCOME MEASURES: Patient, disease and management characteristics of Indigenous and non-Indigenous Australian patients. Impacts of patient and clinical variables on treatment and survival, measured by multivariable Cox regression and propensity-matched survival analysis. RESULTS: We included 186 Indigenous and 17,439 non-Indigenous Australian patients. Indigenous Australian lung cancer patients were younger in age {median, 62 years (interquartile range [IQR], 55-69 years) vs. median, 71 years (IQR, 63-77 years); p < 0.001}, had lower socio-economic status (lowest quintile, 57 patients [31%] vs. 3274 patients [19%]; p < 0.001), were more likely to be current smokers (118 patients [65%] vs. 5963 patients [35%]; p < 0.001) and had higher levels of respiratory comorbidity (64 patients [34%] vs. 4088 patients [23%]; p < 0.001). There were no statistically significant differences in receipt of guideline-concordant treatment (82 patients [51%] vs. 8036 patients [56%]; p = 0.12) and survival outcomes (median survival, 1.4 vs. 1.5 years; hazard ratio, 1.06 [95% confidence interval, 0.88-1.27]). CONCLUSION: We found lung cancer patients of Indigenous status were more likely to have demographic disadvantage and clinical risk factors that may contribute to discrepancies in management compared with patients of non-Indigenous status. Identifying barriers to healthcare and treatment in the Indigenous Australian population is an important research priority to improve disparities between the two populations.
Worsening Asthma Outcomes in Australian Adults: A Comparison of Stratified Sample Surveys in 2012 and 2021.
Reddel HK, Ampon MR, Poulos LM … +4 more , Davis SR, Toelle BG, Marks GB, Lee T
Med J Aust · 2026 Jun · PMID 42338170 · Full text
OBJECTIVES: To report patterns of asthma control, medications and healthcare utilisation in Australian adults with asthma in 2021, and assess changes since a similar survey in 2012. STUDY TYPE: Cross-sectional web-based...
OBJECTIVES: To report patterns of asthma control, medications and healthcare utilisation in Australian adults with asthma in 2021, and assess changes since a similar survey in 2012. STUDY TYPE: Cross-sectional web-based survey (February-March 2021; n = 5427), compared with a similar 2012 survey (n = 2686). SETTING/PARTICIPANTS: Adults (≥ 18 years) with asthma, recruited from large web-based panels, with enrolment stratified by age group, gender and state/territory. MAIN OUTCOME MEASURES: Asthma control test (ACT), healthcare utilisation and medications. RESULTS: Median age was 46 years; 59% of participants reported female gender. Compared with 2012, fewer participants had well-controlled symptoms (ACT ≥ 20: 2021, 48.0%; 2012, 54.4%; p < 0.001), and more had very poorly controlled symptoms (ACT 5-15: 2021, 26.8%; 2012, 22.9%; p < 0.001). Urgent asthma healthcare had increased (2021, 37.9%; 2012, 28.6%; odds ratio 1.53 [95% confidence interval, 1.37-1.69]; p < 0.001). Inhaled corticosteroid (ICS) use in the previous year was similar (2021, 60.9%; 2012, 60.8%) but adherence was lower (p < 0.001). Fewer participants had good symptom control while taking little/no ICS (2021, 33.4%; 2012, 40.1%), and more had uncontrolled symptoms with little/no ICS (2021, 38.1%; 2012, 25.6%; p < 0.001); among the latter group, urgent healthcare utilisation had increased (2021, 63.5%; 2012, 41.2%; p < 0.001). In 2021, 28.7% reported using oral corticosteroids for asthma in the previous year; only 42.0% of ICS users recalled their inhaler technique having been checked in the past 12 months. Overuse of short-acting beta-agonists was common: 56.3% adults obtained ≥ 3 inhalers in the previous year, and 10.5% obtained ≥ 12 inhalers. For symptom relief in the previous 4 weeks, only 13.3% adults reported using an anti-inflammatory reliever (ICS-formoterol). CONCLUSION: Our comparison of these two large nationally stratified sample surveys demonstrates significant worsening of key asthma indicators between 2012 and 2021, including worse symptom control and urgent healthcare use, but also indicates opportunities for improvement. The findings highlight an urgent need for system-wide implementation of the 2025 Australian asthma guidelines to reduce preventable morbidity. TRIAL REGISTRATION: ACTRN12620000977976p.
Stigmatising Attitudes Towards People With Depression, Bipolar Disorder, Borderline Personality, ADHD and Early and Long-Term/Untreated Schizophrenia: Representative Survey of Australian Adults.
Morgan AJ, Ross AM, McNaught G … +2 more , Green R, Reavley NJ
Med J Aust · 2026 Jun · PMID 42334100 · Full text
OBJECTIVES: To examine the prevalence in Australia of stigmatising attitudes towards people with six different mental health conditions: depression, early and long-term/untreated forms of schizophrenia, bipolar disorder,...
OBJECTIVES: To examine the prevalence in Australia of stigmatising attitudes towards people with six different mental health conditions: depression, early and long-term/untreated forms of schizophrenia, bipolar disorder, borderline personality disorder and attention-deficit/hyperactivity disorder (ADHD). DESIGN: Cross-sectional population-based survey using the probability-based online panel Life in Australia. Participants responded to one of six vignettes describing a person with a mental health condition. SETTING: Australia, 11-25 November 2024. PARTICIPANTS: Representative sample of 6032 adult residents of Australia. MAIN OUTCOME MEASURES: Proportions of participants who agreed or strongly agreed with 13 stigmatising attitudes and proportions who were definitely or probably unwilling to interact in five different social situations with the person in the vignette. RESULTS: Stigmatising attitudes were generally lowest for depression and highest for long-term schizophrenia and borderline personality disorder. Beliefs about unpredictability had the highest endorsement: 61.9% (95% confidence interval [CI], 58.2%-65.5%) for long-term schizophrenia; 56.3% (95% CI, 52.5%-59.9%) for borderline personality disorder; 52.8% (95% CI, 49.0%-56.6%) for early schizophrenia; 50.7% (95% CI, 47.0%-54.4%) for bipolar disorder; 29.2% (95% CI, 25.9%-32.7%) for ADHD and 23.3% (95% CI, 20.2%-26.7%) for depression. Forcing treatment was endorsed by 25.9% (95% CI, 22.6%-29.5%) for early schizophrenia and 24.1% (95% CI, 21.0%-27.6%) for long-term schizophrenia. For all conditions, at least 20% of participants did not agree that the person in the vignette was a person of worth, with agreement ranging from 78.5% (95% CI, 75.1%-81.6%) for early schizophrenia to 67.4% (95% CI, 63.8%-70.9%) for long-term schizophrenia. There were high levels of unwillingness for the person in the vignette to marry into the family: ranging from 29.7% (95% CI, 26.4%-33.2%) for ADHD to 64.4% (95% CI, 60.7%-67.9%) for long-term schizophrenia. CONCLUSIONS: Stigma related to mental health conditions remains prevalent in Australia and contributes to social and economic exclusion among those affected. Sustained action is needed across multiple sectors to address stigma, particularly towards conditions such as schizophrenia and borderline personality disorder, which are poorly understood within the community.
Continuity of Care in General Practice in Australia: A Whole-Of-Population Serial Cross-Sectional Study.
Welsh J, Freeman-Robinson R, Butler DC … +16 more , Eddowes R, Yazidjoglou A, Douglas A, Douglas KA, Lazarevic N, Law HD, Joshy G, Trevenar S, Tsheten T, Webster A, Frost M, Cropper B, Hall Dykgraaf S, Phillips CB, Banks E, Korda RJ
Med J Aust · 2026 Jun · PMID 42310274 · Full text
OBJECTIVE: To quantify continuity of care in general practice in the Australian population, including variation according to patient characteristics and over time, to support ongoing policy reforms directed towards impro...
OBJECTIVE: To quantify continuity of care in general practice in the Australian population, including variation according to patient characteristics and over time, to support ongoing policy reforms directed towards improving general practice care. DESIGN AND SETTING: Repeated cross-sectional analyses of linked whole-of-population data from the Medicare Benefits Schedule, the Medicare Consumer Directory and the Census of Population and Housing (2021). PARTICIPANTS: Continuity was assessed in people with at least four general practitioner visits in a 2-year period (about 80% of the population). MAIN OUTCOME MEASURE: Relational continuity of care in general practice, measured with the Usual Provider Index, for eight overlapping 2-year periods (2016-2017 to 2022-2023). High continuity was defined as having ≥ 70% of visits with one provider. RESULTS: About one-third of the population had high continuity of care (range: 31.3% in 2018-2019 to 37.2% in 2020-2021). After adjustment for age, sex and remoteness, high continuity was more common among those with greater care needs, including those who were older (≥ 70 years vs. 0-14 years: adjusted prevalence ratio [aPR], 1.88) or with health conditions (e.g., ≥ 3 vs. none: aPR, 1.14) and those who were living in more disadvantaged areas (e.g., most vs. least disadvantaged: aPR, 1.22), born overseas (e.g., born in Southern or Eastern Europe vs. born in Australia or New Zealand: aPR, 1.20) or not proficient in English (aPR, 1.29). However, it was less common for females compared with males (aPR, 0.90) and those living remotely (e.g., very remote vs. major cities: aPR, 0.43). CONCLUSION: While most people in Australia do not receive continuous care in general practice with a specific provider, those with greater healthcare needs are more likely to. With ongoing policy reforms, monitoring continuity of care may provide insights into the consequences for quality of care.
Short-Term Safety and Adverse Event Risk Profiles for SARS-CoV-2 Booster Vaccine Doses in Australian Adults: A Survey Study.
Tay E, Dymock M, Dawes L … +7 more , Deng L, Nguyen T, Leeb A, Marsh JA, Wood N, Macartney K, Snelling TL
Med J Aust · 2026 Jun · PMID 42304128 · Full text
OBJECTIVE: This study quantifies the short-term risk profiles of seven severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) vaccines-Comirnaty Bivalent BA.1, Comirnaty Bivalent BA.4-5, Comirnaty XBB.1.5, Sp...
OBJECTIVE: This study quantifies the short-term risk profiles of seven severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) vaccines-Comirnaty Bivalent BA.1, Comirnaty Bivalent BA.4-5, Comirnaty XBB.1.5, Spikevax Bivalent BA.1, Spikevax Bivalent BA.4-5, Spikevax XBB.1.5 and Nuvaxovid-administered as booster doses in Australia. DESIGN: This is a survey study using data collected from online surveys sent via AusVaxSafety, the Australian active vaccine safety surveillance system, 3 days post-vaccination, soliciting reports of adverse events following vaccination. PARTICIPANTS AND SETTING: Individuals 18 years and older who received a SARS-CoV-2 vaccine booster at an AusVaxSafety vaccine surveillance site between 1 January 2023 and 31 August 2024. MAIN OUTCOME MEASURES: Bayesian logistic regression was used to estimate risk of reported adverse events, seeking medical advice and impact on daily activities. RESULTS: Of 197,476 respondents, 59,089 (29.9%) reported at least one adverse event, of which the most commonly reported symptoms were injection site reaction (23.8% [46,988/197,476]) and fatigue (19.4% [38,352/197,476]). Symptom resolution was reported by 69.9% (41,299/59,089) by day 3 and 5.6% (11,006/197,476) reported any time lost from daily activities. The unadjusted proportion of respondents who sought medical advice was higher in those who received Spikevax XBB.1.5 (1.2% [212/17,551]) than the other vaccines (0.5% [379/69,493] to 0.7% [147/20,271]), but the modelled, adjusted mean risk of medical advice was similar (< 2.5%) across subgroups for vaccine brands, co-administered vaccines, medical conditions, age, sex and Indigenous status. The modelled risk of any adverse event at age 40 years ranged from 35.2% (95% credible interval [CrI], 32.2%-38.5%) for men who had received Comirnaty XBB.1.5 to 75.5% (95% CrI, 71.9%-78.8%) for women who had received Spikevax XBB.1.5. At age 80 years, this risk was lowest across all vaccines, ranging from 12.0% (95% CrI, 11.2%-13.0%) for men who had received Comirnaty BA4-5 to 36.7% (95% CrI, 34.6%-38.7%) for women who had received Spikevax XBB.1.5. CONCLUSIONS: The results of this study confirm the short-term safety and low impact on daily living of SARS-CoV-2 booster vaccine administration to Australian adults.
Hospital-Admitted Injection-Related Infections Among Incarcerated People Who Inject Drugs in Australia: A Retrospective Cohort Study.
Palmer A, Carter M, Yeo J … +8 more , Shim C, Connor J, Hayllar J, Holtmann G, Moy N, Playford EG, Runnegar N, Clark PJ
Med J Aust · 2026 Jun · PMID 42289398 · Full text
OBJECTIVES: To characterise the clinical, microbiological and economic burden of hospital-admitted, injection-related infections among incarcerated people who inject drugs. STUDY TYPE: Retrospective observational cohort...
OBJECTIVES: To characterise the clinical, microbiological and economic burden of hospital-admitted, injection-related infections among incarcerated people who inject drugs. STUDY TYPE: Retrospective observational cohort study. SETTING: Secure unit of the Princess Alexandra Hospital, Brisbane, Australia. PARTICIPANTS: Adults incarcerated in Queensland prisons who were admitted to hospital with an injection-related infection between 1 July 2019 and 30 June 2023. MAIN OUTCOME MEASURES: Types of injection-related infection, microbiological findings, requirement for surgical or radiological source control, hospital length of stay and inpatient healthcare costs. RESULTS: There were 321 hospital admissions for injection-related infection among 265 patients, accounting for 282 unique infections. Most patients were male (241; 90.9%), with a mean age of 33 years (standard deviation [SD], 7.4 years), and 76 (28.7%) identified as First Nations. The most frequent infections were soft tissue infections (77/282; 27.3%), acute hepatitis C (64/282; 22.7%) and cellulitis (43/282; 15.2%). Surgical or radiological source control was required in 95 infections (34.0%), and infectious diseases consultation occurred in 130 infections (46.1%). Among 39 true-positive blood cultures, Staphylococcus aureus was identified in 17 (43.6%), Burkholderia species in 10 (25.6%) and non-tuberculous Mycobacterium species in 3 (7.7%). Among the 218 non-acute hepatitis C infections, 50 (22.9%) were hepatitis C virus (HCV) RNA positive. Overall, HCV RNA was present in 114 of 282 infections (40.4%). The total inflation-adjusted inpatient cost was $8.39 million, with a median cost per infection of $11,602 (interquartile range, $7426-$34,544). CONCLUSION: Injection-related infections among incarcerated people who inject drugs were associated with substantial morbidity and healthcare costs in this large hospital cohort. A wide clinical spectrum was observed, including atypical pathogens, and clinically overt acute hepatitis C requiring hospital admission. These findings describe a significant burden of preventable disease in custodial settings and support the introduction of established primary prevention and harm-reduction interventions in prisons.
The Effects of Social Media on Adolescent Mental Health: Findings From a Population-Based Cohort Study in Australia.
Vijayakumar N, Dashti SG, Canterford L … +9 more , Ellul S, Parissi AJA, Goddings AL, Viner RM, Moran P, Borschmann R, Mundy LK, Robson EM, Sawyer SM
Med J Aust · 2026 Jun · PMID 42274377 · Full text
OBJECTIVES: To examine the effects of social media on future mental health problems (depressive symptoms, anxiety symptoms, poor well-being and self-harm) in adolescents aged 12-18 years, overall and stratified by sex an...
OBJECTIVES: To examine the effects of social media on future mental health problems (depressive symptoms, anxiety symptoms, poor well-being and self-harm) in adolescents aged 12-18 years, overall and stratified by sex and age periods (early, middle and late adolescence). STUDY TYPE: Prospective longitudinal study. SETTING: Participants were recruited in 2012 through schools in Melbourne, selected using stratified random sampling. In wave 1 (2012), 1239 Grade 3 students participated and have since completed annual surveys. PARTICIPANTS: The analysis used data up to wave 11 (2022). Participants with no data on mental health, social media and confounders were excluded, leaving a sample of 1195 (552 [46%] male participants). MAIN OUTCOME MEASURES: Exposure was self-reported duration of daily social media use at each wave, from waves 4 to 10 (ages 12-18 years). Outcomes (self-reported depressive symptoms, anxiety symptoms, well-being, self-harm) were assessed at the subsequent annual wave, from waves 5 to 11 (ages 13-19 years). RESULTS: Across adolescence, > 2 h versus < 1 h of daily social media use was associated with a small increase in risk of high depressive symptoms (risk difference [RD] per 100, 6.3 [95% CI, 2.7-9.9]) and poor well-being (RD, 4.9 [95% CI, 1.1-8.6]) at the subsequent annual wave. Estimated risks for all mental health problems were greatest in early adolescence (12-13 years), with the largest effects observed for high depressive symptoms in female participants (> 2 h vs. < 1 h: RD, 10.8 [95% CI, 2.7-18.9]). CONCLUSIONS: Higher levels of social media use were associated with small increases in future risk of high depressive symptoms and poor well-being across adolescence. The largest risks for all mental health problems were observed during early adolescence for both male and female participants, supporting the need to consider policies that mitigate the adverse effects of social media on the mental health of younger adolescents.
When 'Liver Enzymes' Are Not Hepatic: Late-Onset Pompe Disease.
Madigan S, England G, Rankin W
Med J Aust · 2026 Jun · PMID 42273982 · Full text
Elevated liver function tests are commonly attributed to hepatic disease but may reflect extrahepatic pathology. We describe the case of an 18-year-old athletic woman with a 2-year history of elevated aspartate aminotran...
Elevated liver function tests are commonly attributed to hepatic disease but may reflect extrahepatic pathology. We describe the case of an 18-year-old athletic woman with a 2-year history of elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) levels, initially investigated extensively for hepatic causes. Despite normal liver imaging and biopsy, ongoing abnormalities prompted metabolic evaluation, leading to the diagnosis of late-onset Pompe disease. This case highlights the diagnostic challenges of rare metabolic myopathies, the importance of recognising muscle-derived aminotransferase elevation and the need for broad diagnostic consideration when standard investigations are unrevealing.
Impact of the 2025 New South Wales Respiratory Syncytial Virus Prevention Program on Infant Notifications and Hospitalisations: A Population-Based Analysis.
Amin J, Ellis SL, Lambeth C … +2 more , Gugusheff J, Selvey C
Med J Aust · 2026 Jun · PMID 42272143 · Full text
The 2025 NSW RSV Prevention Program, which achieved an estimated coverage of 63% maternal vaccination and 18% for infant immunisation, led to more than 40% reduction in RSV notifications and hospitalisations among infant...
The 2025 NSW RSV Prevention Program, which achieved an estimated coverage of 63% maternal vaccination and 18% for infant immunisation, led to more than 40% reduction in RSV notifications and hospitalisations among infants aged younger than 6 months.
Interpreting Australian Stillbirth Rate Trends: Implications for Surveillance and Continuous Quality Improvement.
Wojcieszek AM, Sketcher-Baker K, Andrews C … +5 more , Coory M, Kettle I, Malivoire M, Ellwood D, Flenady V
Med J Aust · 2026 Jun · PMID 42272114 · Publisher ↗
Reports of rising stillbirth rates in Australia have generated concern among affected parents and other stakeholders. Review of the national data suggests that much of the rise is being driven by an increase in terminati...
Reports of rising stillbirth rates in Australia have generated concern among affected parents and other stakeholders. Review of the national data suggests that much of the rise is being driven by an increase in terminations of pregnancy after 20 weeks' gestation. This increase coincides with legislative changes expanding access to terminations beyond 20 weeks. Alongside publishing stillbirth rates according to the legal definition (stillbirths from 20 weeks' gestation including terminations of pregnancy), national reporting bodies should routinely publish stillbirth rates among births from 28 weeks' gestation excluding terminations of pregnancy as the latter is most relevant to Australia's current stillbirth prevention initiatives.
The Management of Withdrawal From Alcohol and Other Drugs in Australian Custodial Settings: A Consensus Statement.
FitzGerald G, Chan J, Cook J … +5 more , Stoove M, Curtis M, Nielsen S, Winter RJ, Naren T
Med J Aust · 2026 Jun · PMID 42272109 · Full text
INTRODUCTION: For many people entering custody, abrupt changes in alcohol or other drug use is associated with the risk of experiencing a withdrawal syndrome. Management of withdrawal from alcohol and other drugs in a cu...
INTRODUCTION: For many people entering custody, abrupt changes in alcohol or other drug use is associated with the risk of experiencing a withdrawal syndrome. Management of withdrawal from alcohol and other drugs in a custodial setting is complicated by both a limited evidence base and structural barriers to the delivery of best practice healthcare interventions to people in custody. MAIN RECOMMENDATIONS: A multidisciplinary expert panel representing all Australian states and territories participated in a modified Delphi process. The process generated 22 recommendations to custodial services, health services and government for the management of withdrawal from alcohol and other drugs in custodial settings across five domains: screening for withdrawal risk; assessment of withdrawal; management of withdrawal; specific considerations for the care of First Nations people; and organisational support. Notable recommendations include using universal and timely assessment for withdrawal at reception to custody; using validated clinical tools and evidence-based interventions to assess and manage withdrawal syndromes; and ensuring that the safest location for withdrawal from alcohol or other drugs is provided. CHANGES IN MANAGEMENT AS A RESULT OF THE STATEMENT: This statement presents best practice standards for the management of withdrawal from alcohol and other drugs in Australian custodial settings, as informed by evidence and expert consensus. Implementing the recommendations set out in this statement will improve the quality and consistency of withdrawal care provided to people entering Australian custodial settings and reduce harms associated with incarceration for people who use alcohol and other drugs. This statement has been endorsed by the Royal Australasian College of Physicians, the Australasian Professional Society on Alcohol and Other Drugs, the National Prisons Hepatitis Network, the Pharmaceutical Society of Australia and the Australian Injecting and Illicit Drug Users League. The statement is also approved as an Accepted Clinical Resource by the Royal Australian College of General Practitioners.
Embedding Rehabilitation as Core Cancer Care in Australia and New Zealand: A Health System Imperative.
Song K, Faux SG, Khan F
Med J Aust · 2026 Jun · PMID 42261787 · Full text
Cancer remains a global health challenge, with rising survivorship rates highlighting the need for integrated interdisciplinary rehabilitation care. Survivors frequently experience persistent physical, functional, psycho...
Cancer remains a global health challenge, with rising survivorship rates highlighting the need for integrated interdisciplinary rehabilitation care. Survivors frequently experience persistent physical, functional, psychological, cognitive and behavioural challenges, including fatigue, deconditioning, neuropathy, pain and psychological distress, with up to two-thirds reporting significant unmet needs and reduced quality of life. Interdisciplinary rehabilitation, encompassing exercise, education, nutrition, task-specific functional retraining, psychosocial support and vocational interventions, effectively mitigates these disabilities, improving function and promoting societal participation. Despite strong evidence, rehabilitation remains underutilised in Australia and New Zealand due to workforce, infrastructure, referral, funding and awareness barriers. Embedding rehabilitation as standard cancer care is essential to optimise survivorship outcomes and deliver sustainable health system benefits.
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