Topics

Older patients may never need kidney replacement therapy, but their other medical conditions require attention

Chronic kidney disease (CKD) is a public health problem worldwide.1 An estimated 1.7 million Australian adults, about 10% of the population, have biomedical signs of CKD,2 but more than half are unaware of their condition. People at particular risk include those over 60 years of age, Aboriginal and Torres Strait Islander people, and people with hypertension, diabetes mellitus, obesity, established cardiovascular disease, a personal history of acute kidney injury or smoking, or a family history of kidney disease. CKD is associated with higher all‐cause mortality, higher rates of cardiovascular disease, and reduced overall quality of life.3,4

Monash Medical Centre, Melbourne, VIC

Correspondence: peter.kerr@monash.edu

Competing interests:

No relevant disclosures.

1. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 709–733.
2. Australian Institute of Health and Welfare. Chronic kidney disease (Cat. no. CDK 16). Updated 15 July 2020. https://www.aihw.gov.au/getmedia/0372ad7a‐7297‐4e7b‐a3e4‐5681c342ed2f/Chronic‐kidney‐disease.pdf.aspx?inline=true (viewed Sept 2021).
3. Levey AS, Coresh J. Chronic kidney disease. Lancet 2012; 379: 165–180.
4. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004; 351: 1296–1305.
5. Keith DS, Nichols GA, Gullion CM, et al. Longitudinal follow‐up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 2004; 164: 659–663.
6. Ravani P, Quinn R, Fiocco M, et al. Association of age with risk of kidney failure in adults with stage IV chronic kidney disease in Canada. JAMA Netw Open 2020; 3: e2017150.
7. Jose MD, Raj R, Jose K, et al. Competing risks of death and kidney failure in a cohort of Australian adults with severe chronic kidney disease. Med J Aust 2022; 216: 140–146
8. Cherney DZ, Repetto E, Wheeler DC, et al. Impact of cardio‐renal‐metabolic comorbidities on cardiovascular outcomes and mortality in type 2 diabetes mellitus. Am J Nephrol 2020; 51: 74–82.
9. Australia and New Zealand Dialysis and Transplant Registry. 42nd report, chapter 3: Mortality in end stage kidney disease. Adelaide: ANZDATA, 2019. https://www.anzdata.org.au/wp‐content/uploads/2019/09/c03_mortality_2018_ar_2019_v1.0_20191202.pdf (viewed Dec 2021).
10. Foote C, Kotwal S, Gallagher M, et al. Survival outcomes of supportive care versus dialysis therapies for elderly patients with end‐stage kidney disease: a systematic review and meta‐analysis. Nephrology 2016; 21: 241–253.
11. Kidney Health Australia. Chronic kidney disease (CKD) management in primary care. 4th edition. Melbourne: Kidney Health Australia, 2020. https://kidney.org.au/health‐professionals/ckd‐management‐handbook (viewed Sept 2021).

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Perspectives

Acting on better data for general medical care will help solve our acute hospital access crisis

Harvey H Newnham

Med J Aust 2022; 216 (3): . || doi: 10.5694/mja2.51385
Published online: 21 February 2022

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Topics

General medicine

Health services administration

Smarter measures for general medicine are needed to improve hospital access

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1 Alfred Health, Melbourne, VIC
2 Monash University, Melbourne, VIC

Correspondence: H.Newnham@alfred.org.au

Acknowledgements:

I thank my many colleagues clinical and non‐clinical from local, national and international units and boards who have contributed to the ideas discussed in this article: in particular, Richard Coates, Daniel Fineberg, Felice Borghmans, Lara Kimmel and Andrew Way of Alfred Health for creating space for, and leading, conversations that matter.

Competing interests:

No relevant disclosures.

1. Statewide General Medicine Network. Reducing low benefit care. Brisbane: Queensland Health, 2020. https://www.imsanz.org.au/documents/item/1337 (viewed Apr 2021).
2. Lim SM, Island L, Horsburgh A, Maier AB. Home first! Identification of hospitalized patients for home‐based models of care. J Am Med Dir Assoc 2021; 22: 413–417.
3. Werner RM, Greenfield S, Fung C, Turner BJ. Measuring quality of care in patients With multiple clinical conditions: summary of a conference conducted by the Society of General Internal Medicine. J Gen Intern Med 2007; 22: 1206–1211.
4. Wilcox N, McNeil JJ. Clinical quality registries have the potential to drive improvements in the appropriateness of care. Med J Aust 2016; 205: 21–26. https://www.mja.com.au/journal/2016/205/10/clinical‐quality‐registries‐have‐potential‐drive‐improvements‐appropriateness
5. Levine DM, Ouchi K, Blanchfield B, et al. Hospital‐level care at home for acutely ill adults: a randomized controlled trial. Ann Intern Med 2020; 172: 77–85.
6. Wales K, Clemson L, Lannin N, Cameron I. Functional assessments used by occupational therapists with older adults at risk of activity and participation limitations: a systematic review. PLoS One 2016; 11: e0147980.
7. Robertson‐Preidler J, Biller‐Andorno N, Johnson TJ. What is appropriate care? An integrative review of emerging themes in the literature. BMC Health Serv Res 2017; 17: 452.
8. Kremers MNT, Zaalberg T, Van Den Ende ES, et al. Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes. BMJ Open Qual 2019; 8: e000736.
9. Bohmer R, Shand J, Allwood D, et al. Learning systems: managing uncertainty in the new normal of Covid‐19. N Engl J Med Catalyst 2020; 16 July. https://catalyst.nejm.org/doi/full/https://doi.org/10.1056/CAT.20.0318 (viewed June 2021).
10. Rosen MA, Diazgranados D, Dietz AS, et al. Teamwork in healthcare: key discoveries enabling safer, high‐quality care. Am Psychol 2018; 73: 433–450.
11. Victorian Managed Insurance Authority. Internal audit clinical tool (IACT) kit. Melbourne: VMIA, 2017. https://www.vmia.vic.gov.au/tools‐and‐insights/tools‐guides‐and‐kits/internal‐audit‐risk‐tool‐kit (viewed Apr 2021).
12. Duckett S, Cuddihy M, Newnham H. Targeting zero: supporting the Victorian hospital system to eliminate avoidable harm and strengthen quality of care. Report of the Review of Hospital Safety and Quality Assurance in Victoria. Melbourne: State of Victoria, 2016. https://www.dhhs.vic.gov.au/sites/default/files/documents/201610/Hospital%20Safety%20and%20Quality%20Assurance%20in%20Victoria.pdf (viewed Apr 2021).
13. Hollnagel E, Wears RL, Braithwaite J. From Safety‐1 to Safety‐II: a white paper. 2015. https://www.england.nhs.uk/signuptosafety/wp‐content/uploads/sites/16/2015/10/safety‐1‐safety‐2‐whte‐papr.pdf (accessed Apr 2021).
14. Van Gelderen SC, Zegers M, Boeijen W, et al. Evaluation of the organisation and effectiveness of internal audits to govern patient safety in hospitals: a mixed‐methods study. BMJ Open 2017; 7: e015506.
15. Australian Government Department of Health. About the Victorian Aged Care Response Centre. https://www.health.gov.au/initiatives‐and‐programs/victorian‐aged‐care‐response‐centre/about‐the‐victorian‐aged‐care‐response‐centre (viewed June 2021).

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Retraction

Retracted: Preparing Australasian medical students to practise environmentally sustainable health care

Med J Aust 2022; 216 (2): . || doi: 10.5694/mja2.50585
Published online: 7 February 2022

ARTICLE
AUTHORS
REFERENCES

Topics

Environment and public health

Global health

Medical education

Retraction: Madden DL, Horton GL and McLean M. Preparing Australasian medical students to practise environmentally sustainable health care. Med J Aust 2020; https://doi.org/10.5694/mja2.50585.

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Correspondence:

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Editorials

Reducing the number of unplanned returns to hospital after treatment for peripheral artery disease

Bethany Stavert and Sarah Aitken

Med J Aust 2022; 216 (2): . || doi: 10.5694/mja2.51369
Published online: 7 February 2022

ARTICLE
AUTHORS
REFERENCES

Topics

Vascular diseases

Environment and public health

Health services administration

Improved, integrated care for older patients with complex medical needs could avert some modifiable causes of readmission

The incidence of peripheral artery disease (PAD) is rising around the world as populations age and the prevalence of diabetes, obesity, and cardiovascular disease increase.1 The clinical manifestations of lower limb PAD range from asymptomatic atherosclerosis and exertional pain caused by intermittent claudication, to chronic limb‐threatening ischaemia with rest pain, ulceration, and necrosis. Long term survival is poorer for patients with PAD than for people with many common cancers,1 and quality of life and patient‐reported outcomes are impaired.2 A recently published analysis of Global Burden of Disease Study data found that lower limb amputation rates were higher in Australia than in eighteen other high income countries, highlighting the need to improve outcomes for people with PAD.3

1 Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, NSW, Australia
2 Concord Clinical School, University of Sydney, Sydney, NSW, Australia

Correspondence: sarah.aitken@sydney.edu.au

Competing interests:

No relevant disclosures.

1. Fowkes FGR, Rudan D, Rudan I, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 2013; 382: 1329–1340.
2. Abaraogu UO, Ezenwankwo EF, Dall PM, Seenan CA. Living a burdensome and demanding life: a qualitative systematic review of the patients experiences of peripheral arterial disease. PLoS One 2018; 13: e0207456.
3. Hughes W, Goodall R, Salciccioli JD, et al. Trends in lower extremity amputation incidence in European Union 15+ countries 1990–2017. Eur J Vasc Endovasc Surg 2020; 60: 602–612.
4. Woelk V, Speck P, Kaambwa B, et al. Incidence and causes of early unplanned readmission after hospitalisation with peripheral arterial disease in Australia and New Zealand. Med J Aust 2022; 216: 80–86.
5. Smith SL, Matthews EO, Moxon JV, Golledge J. A systematic review and meta‐analysis of risk factors for and incidence of 30‐day readmission after revascularization for peripheral artery disease. J Vasc Surg 2019; 70: 996–1006.e7.
6. Thillainadesan J, Aitken SJ, Monaro SR, et al. Geriatric comanagement of older vascular surgery inpatients reduces hospital‐acquired geriatric syndromes. J Am Med Dir Assoc 2021; https://doi.org/10.1016/j.jamda.2021.09.037 [online ahead of print].
7. Thillainadesan J, Yumol MF, Hilmer S, et al. Interventions to improve clinical outcomes in older adults admitted to a surgical service: a systematic review and meta‐analysis. J Am Med Dir Assoc 2020; 21: 1833–1843.
8. Vogel TR, Kruse RL. Risk factors for readmission after lower extremity procedures for peripheral artery disease. J Vasc Surg 2013; 58: 90–97.e1‐4.
9. Anand SS, Caron F, Eikelboom JW, et al. Major adverse limb events and mortality in patients with peripheral artery disease: the COMPASS trial. J Am Coll Cardiol 2018; 71: 2306–2315.
10. Paige E, Doyle K, Jorm L, et al. A versatile big data health system for Australia: driving improvements in cardiovascular health. Heart Lung Circ 2021; 30: 1467–1476.
11. Medicare Benefits Schedule Review Taskforce. Vascular Clinical Committee report. Updated 28 May 2021. https://www.health.gov.au/resources/publications/taskforce‐findings‐vascular‐clinical‐committee‐report (viewed Dec 2021).

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Perspectives

High value health care is low carbon health care

Alexandra L Barratt, Katy JL Bell, Kate Charlesworth and Forbes McGain

Med J Aust 2022; 216 (2): . || doi: 10.5694/mja2.51331
Published online: 7 February 2022

ARTICLE
AUTHORS
REFERENCES

Topics

Environment and public health

Health services administration

Diagnostic techniques and procedures

Nutritional and metabolic diseases

Culling low value care will cut health care carbon emissions

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1 University of Sydney, Sydney, NSW
2 Northern Sydney Local Health District, Sydney, NSW
3 Western Health, Melbourne, VIC
4 University of Melbourne, Melbourne, VIC

Correspondence: alexandra.barratt@sydney.edu.au

Acknowledgements:

Alexandra Barratt received funding from the National Health and Medical Research Council (grant no. 1104136).

Competing interests:

No relevant disclosures.

1. Beggs PJ, Zhang Y, McGushin A, et al. The report of the MJA–Lancet Countdown on health and climate change: Australia increasingly out on a limb. Med J Aust 2021; https://doi.org/10.5694/mja2.51302.
2. Cunsolo A, Ellis NR. Ecological grief as a mental health response to climate change‐related loss. Nat Clim Chang 2018; 8: 275–281.
3. Malik A, Lenzen M, McAlister S, et al. The carbon footprint of Australian health care. Lancet Planet Health 2018; 2: e27–e35.
4. Tennison I, Roschnik S, Ashby B, et al. Health care’s response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health 2021; 5: e84–e92.
5. Brownlee SM, Chalkidou KMD, Doust JP, et al. Evidence for overuse of medical services around the world. Lancet 2017; 390: 156–168.
6. Braithwaite J, Glasziou P, Westbrook J. The three numbers you need to know about healthcare: the 60–30‐10 Challenge. BMC Med 2020; 18: 102–02.
7. Gordon L, Waterhouse M, Reid IR, et al. The vitamin D testing rate is again rising, despite new MBS testing criteria. Med J Aust 2020; 213: 155–155.e1. https://www.mja.com.au/journal/2020/213/4/vitamin‐d‐testing‐rate‐again‐rising‐despite‐new‐mbs‐testing‐criteria
8. Services Australia. Medicare group reports. http://medicarestatistics.humanservices.gov.au/statistics/mbs_group.jsp (viewed Oct 2021).
9. Zhi M, Ding EL, Theisen‐Toupal J, et al. The landscape of inappropriate laboratory testing: a 15‐year meta‐analysis. PLoS One 2013; 8: e78962.
10. McAlister S, Barratt AL, Bell KJL, McGain F. The carbon footprint of pathology testing. Med J Aust 2020; 212: 377–382.e1. https://www.mja.com.au/journal/2020/212/8/carbon‐footprint‐pathology‐testing
11. McGain F, Muret J, Lawson C, et al. Environmental sustainability in anaesthesia and critical care. Br J Anaesth 2020; 125: 680–692.

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Perspectives

3D printing: potential clinical applications for personalised solid dose medications

Liam Krueger, Jared A Miles, Kathryn J Steadman, Tushar Kumeria, Christopher R Freeman and Amirali Popat

Med J Aust 2022; 216 (2): . || doi: 10.5694/mja2.51381
Published online: 7 February 2022

ARTICLE
AUTHORS
REFERENCES

Topics

Pharmaceutical preparations

Three‐dimensional printing or additive manufacturing has the potential to transform personalised medicine

Personalised medicine aims to move gold‐standard care away from empiric prescribing for a typical patient towards tailored treatment for the patient as an individual.1 It is well known that the effect of a medicine on an individual can vary based on factors including sex, genetics and even hormones. Currently, the personalisation of medicines to adjust for factors such as these is limited by the doses and combinations that are commercially available. This inflexibility makes it difficult for clinicians to tailor the medication for individual needs. One technology that could revolutionise personalised medicine is a process called additive manufacturing. In this process, a three‐dimensional (3D) object is produced by fusing thin layers of materials on top of each other until the complete object is formed. This 3D printing method could be applied to medicines to include several drugs in a single tablet at entirely customisable doses set by the clinician, such as the proof of concept five‐in‐one polypill developed in 2015.2

1 University of Queensland, Brisbane, QLD
2 Australian Centre for Nanomedicine, University of New South Wales, Sydney, NSW
3 Metro North Hospital and Health Service, Brisbane, QLD

Correspondence: a.popat@uq.edu.au

Acknowledgements:

Amirali Popat is the recipient of a National Health and Medical Research Council (NHMRC) Career Development Fellowship (GNT1146627) and receives funding from the School of Pharmacy, University of Queensland. Tushar Kumeria pays respect to the Bedegal people who are the traditional owners of the land on which the University of New South Wales Kensington campus is situated. Tushar Kumeria also acknowledges the support from the NHMRC Early Career Fellowship (GNT1143296) and the University of New South Wales for support and Scientia Grant.

Competing interests:

No relevant disclosures.

1. Seyhan AA, Carini C. Are innovation and new technologies in precision medicine paving a new era in patients centric care? J Transl Med 2019; 17: 114.
2. Khaled SA, Burley JC, Alexander MR, et al. 3D printing of five‐in‐one dose combination polypill with defined immediate and sustained release profiles. J Control Release 2015; 217: 308–314.
3. Prasad LK, Smyth H. 3D printing technologies for drug delivery: a review. Drug Dev Ind Pharm 2016; 42: 1019–1031.
4. Okwuosa TC, Pereira BC, Arafat B, et al. Fabricating a shell‐core delayed release tablet using dual FDM 3D printing for patient‐centred therapy. Pharm Res 2017; 34: 427–437.
5. Souto EB, Campos JC, Filho SC, et al. 3D printing in the design of pharmaceutical dosage forms. Pharm Dev Technol 2019; 24: 1044–1053.
6. NPS MedicineWise. Consumer medicine information: Panadol osteo [website]. https://www.nps.org.au/medicine‐finder/panadol‐osteo‐modified‐release‐caplets (viewed Jan 2021).
7. NPS MedicineWise. Consumer medicine information: Pristiq [website]. https://www.nps.org.au/medicine‐finder/pristiq‐extended‐release‐tablets (viewed Jan 2021).
8. Australian Medicines Handbook. Cardiovascular drugs. https://amhonline.amh.net.au/ (viewed Jan 2021).
9. Australian Medicines Handbook. Psychotropic drugs. https://amhonline.amh.net.au/ (viewed Jan 2021).
10. Maher RL, Hanlon JT, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf 2014; 13: 57–65.
11. Kuźmińska M, Pereira BC, Habashy R, et al. Solvent‐free temperature‐facilitated direct extrusion 3D printing for pharmaceuticals. Int J Pharm 2021; 598: 120305.
12. Lau ETL, Steadman KJ, Cichero JAY, Nissen LM. Dosage form modification and oral drug delivery in older people. Adv Drug Deliv Rev 2018; 135: 75–84.
13. Wheate N, Schubert E. I’ve heard COVID is leading to medicine shortages. What can I do if my medicine is out of stock? The Conversation 2021, 21 Jan. https://theconversation.com/ive‐heard‐covid‐is‐leading‐to‐medicine‐shortages‐what‐can‐i‐do‐if‐my‐medicine‐is‐out‐of‐stock‐153628 (viewed Feb 2021).
14. Therapeutic Goods Administration. Dipyridamole — medicine shortage information [website]. https://apps.tga.gov.au/Prod/msi/Search/Details/dipyridamole (viewed Jan 2021).
15. Goh GD, Sing SL, Yeong WY. A review on machine learning in 3D printing: applications, potential, and challenges. Artif Intell Rev 2021; 54: 63–94.
16. Coles‐Black J, Chao I, Chuen J. Three‐dimensional printing in medicine. Med J Aust 2017; 207: 102–103. https://www.mja.com.au/journal/2017/207/3/three‐dimensional‐printing‐medicine

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Editorials

E‐liquids and vaping devices: public policy regarding their effects on young people and health

Ira N Advani, Mario Perez and Laura E Crotty Alexander

Med J Aust 2022; 216 (1): . || doi: 10.5694/mja2.51362
Published online: 17 January 2022

ARTICLE
AUTHORS
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Topics

Environment and public health

Poisoning

Knowledge about the composition and physiological effects of e‐liquids is essential for assessing their effects on health

The popularity of electronic cigarettes (e‐cigarettes) has surged in the past few years, and it is estimated that 1.2% of Australians now use them.1 While the main premise in support of e‐cigarettes is that they are safer for smokers than conventional tobacco products, a considerable proportion of users are, unfortunately, never‐smokers or young people.2,3 In 2020, about 3.6 million young people in the United States reported current e‐cigarette use,2 and in 2017, 14% of secondary school students in Australia were reported to have ever used e‐cigarettes.3

1 University of California San Diego, San Diego, CA, United States of America
2 VA San Diego Healthcare System, San Diego, CA, United States of America
3 University of Connecticut, Farmington, CT, United States of America

Correspondence: lcrotty@ucsd.edu

Acknowledgements:

Laura Crotty Alexander was supported by VA Merit, National Heart, Lung, and Blood Institute R01, and Tobacco‐Related Disease Research Program pilot awards.

Competing interests:

No relevant disclosures.

1. Chan G, Leung J, Gartner C, et al. Correlates of electronic cigarette use in the general population and among smokers in Australia: findings from a nationally representative survey. Addict Behav 2019; 95: 6–10.
2. Wang TW, Neff LJ, Park‐Lee E, et al. E‐cigarette use among middle and high school students: United States, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 1310–1312.
3. Greenhalgh EM, Jenkins S, Scollo MM. InDepth 18B: Electronic cigarettes (e‐cigarettes). In: Greenhalgh EM, Scollo MM, Winstanley MH editors. Tobacco in Australia: facts and issues. Melbourne: Cancer Council Victoria; 2021. https://www.tobaccoinaustralia.org.au/chapter‐18‐harm‐reduction/indepth‐18b‐e‐cigarettes/18b‐3‐extent (viewed Nov 2021).
4. Larcombe E, Allard S, Pringle P, et al. Chemical analysis of fresh and aged Australian e‐cigarette liquids. Med J Aust 2022; 216: 27–32.
5. Myers ML; Campaign for Tobacco‐Free Kids. New study shows continuing popularity of Juul and other flavored e‐cigarettes among youth; underscores why FDA and other policymakers must eliminate all flavored e‐cigarettes [media release]. 7 June 2021. https://www.tobaccofreekids.org/press‐releases/2021_06_07_jama‐network‐open‐study (viewed Nov 2021).
6. Diaz MC, Donovan EM, Schillo BA, Vallone D. Menthol e‐cigarette sales rise following 2020 FDA guidance. Tob Control 2021; 30: 700–703.
7. Bitzer ZT, Goel R, Reilly SM, et al. Effect of flavoring chemicals on free radical formation in electronic cigarette aerosols. Free Radic Biol Med 2018; 120: 72–79.
8. Therapeutic Goods Administration (Australian Department of Health). Guidance for Therapeutic Goods (Standard for Nicotine Vaping Products) (TGO 110) Order 2021 and related matters. Updated Sept 2021. https://www.tga.gov.au/resource/nicotine‐vaping‐products‐and‐vaping‐devices (viewed Nov 2021).
9. National Health and Medical Research Council. Electronic cigarettes. 2020. https://www.nhmrc.gov.au/health‐advice/all‐topics/electronic‐cigarettes (viewed Nov 2021).
10. Medicines and Healthcare Products Regulatory Agency. E‐cigarettes: regulations for consumer products. GOV.UK, updated 15 Nov. 2021. https://www.gov.uk/guidance/e‐cigarettes‐regulations‐for‐consumer‐products (viewed Nov 2021).
11. US Food and Drug Administration. Funding opportunities [tobacco science and research]. Updated 11 Sept 2021. https://www.fda.gov/tobacco‐products/research/funding‐opportunities (viewed Nov 2021).

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Editorials

Welcome to 2022: the Year of the Tiger!

Nicholas J Talley

Med J Aust 2022; 216 (1): . || doi: 10.5694/mja2.51366
Published online: 17 January 2022

ARTICLE
AUTHORS
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Infectious diseases

Environment and public health

Information science

We need strength and courage to live with COVID‐19, and still more to overcome chronic social and planetary neglect

Welcome to 2022! According to the Chinese zodiac, we are entering the Year of the Tiger, a symbol of strength — and danger. Despite nearly two years of the coronavirus disease 2019 (COVID‐19) pandemic, there is much to celebrate, including the huge uptake of vaccination by Australians that has saved many lives and made the return to a more open lifestyle possible. However, the pandemic has not yet passed, and health and medical professionals will need both strength and resilience during the coming year as we navigate the post‐pandemic recovery phase.1 But as I write this editorial (December 2021), it is clear that Europe and the United States will have tough COVID‐19 winters, and the implications of the new Omicron variant of the virus are unclear. We too need to prepare for the possibility of more difficult months ahead as winter approaches. So please get your booster dose of the vaccine when it is due (I have!), celebrate, rest up, re‐charge, and gear up for the year ahead!

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Editor‐in‐Chief, Medical Journal of Australia

Correspondence: ntalley@mja.com.au

Competing interests:

A complete list of disclosures is available at https://www.mja.com.au/journal/staff/editor‐chief‐professor‐nick‐talley

1. Duckett SJ, Sutton B. On entering Australia’s third year with COVID‐19. Med J Aust 2021; 215: 509–510. https://www.mja.com.au/journal/2021/215/11/entering‐australias‐third‐year‐covid‐19
2. Wiley; Council of Australian Universities Librarians. CAUL and Wiley sign transformative open access agreement that represents the largest in the ANZ region by article output [media release]. 4 Nov 2021. https://www.caul.edu.au/news/caul‐and‐wiley‐sign‐transformative‐open‐access‐agreement‐represents‐largest‐anz‐region‐article (viewed Nov 2021).
3. Caly L, Druce J, Roberts J, et al. Isolation and rapid sharing of the 2019 novel coronavirus (SARS‐CoV‐2) from the first patient diagnosed with COVID‐19 in Australia. Med J Aust 2020; 212: 459–462. https://www.mja.com.au/journal/2020/212/10/isolation‐and‐rapid‐sharing‐2019‐novel‐coronavirus‐sars‐cov‐2‐first‐patient
4. COVID‐19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID‐19 pandemic. Lancet 2021; 398: 1700–1712.
5. Batterham PJ, Calear AL, McCallum SM, et al. Trajectories of depression and anxiety symptoms during the COVID‐19 pandemic in a representative Australian adult cohort. Med J Aust 2021; 214: 462–468. https://www.mja.com.au/journal/2021/214/10/trajectories‐depression‐and‐anxiety‐symptoms‐during‐covid‐19‐pandemic
6. Burrell AJ, Pellegrini B, Salimi F, et al. Outcomes for patients with COVID‐19 admitted to Australian intensive care units during the first four months of the pandemic. Med J Aust 2021; 214: 23–30. https://www.mja.com.au/journal/2021/214/1/outcomes‐patients‐covid‐19‐admitted‐australian‐intensive‐care‐units‐during‐first; erratum: https://www.mja.com.au/journal/2021/214/10/erratum
7. Grout L, Katar A, Ait Ouakrim D, et al. Failures of quarantine systems for preventing COVID‐19 outbreaks in Australia and New Zealand. Med J Aust 2021; 215: 320–324. https://www.mja.com.au/journal/2021/215/7/failures‐quarantine‐systems‐preventing‐covid‐19‐outbreaks‐australia‐and‐new
8. Hill NT, Witt K, Rajaram G, et al. Suicide by young Australians, 2006–2015: a cross‐sectional analysis of national coronial data. Med J Aust 2021; 214: 133–139. https://www.mja.com.au/journal/2021/214/3/suicide‐young‐australians‐2006‐2015‐cross‐sectional‐analysis‐national‐coronial
9. Negin J, Bell J, Ivancic L, et al. Gun violence in Australia, 2002–2016: a cohort study. Med J Aust 2021; 215: 414–420. https://www.mja.com.au/journal/2021/215/9/gun‐violence‐australia‐2002‐2016‐cohort‐study
10. Freeman CR, Scott IA, Hemming K, et al. Reducing Medical Admissions and Presentations Into Hospital through Optimising Medicines (REMAIN HOME): a stepped wedge, cluster randomised controlled trial. Med J Aust 2021; 214: 212–217. https://www.mja.com.au/journal/2021/214/5/reducing‐medical‐admissions‐and‐presentations‐hospital‐through‐optimising
11. Koczwara B, Meng R, Miller MD, et al. Late mortality in people with cancer: a population‐based Australian study. Med J Aust 2021; 214: 318–323. https://www.mja.com.au/journal/2021/214/7/late‐mortality‐people‐cancer‐population‐based‐australian‐study
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Retracted: Preparing Australasian medical students to practise environmentally sustainable health care

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Second SARS‐CoV‐2 infections twelve months after initial infections in Australia, confirmed by genomic analysis

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