Topics

Loneliness has been described as an epidemic and is one of the most pressing public health concerns in Australia and internationally.1,2 In contrast to social isolation, which is an objective measure of social interactions and relationships, loneliness is defined as a subjective experience where one perceives a discrepancy between desired and actual social relationships in terms of quality or quantity.3 Although it is common and natural to feel lonely at times, prolonged and intense periods of loneliness have been linked to adverse health outcomes.4 Older adults are more prone to loneliness and social isolation compared with other age groups.5 Reasons for this include significant life transitions and events, such as retiring from work, increased financial difficulties, loss of friends and widowhood, changes in living arrangements (eg, transitioning to residential aged care), increase in solitary living, and a decline in both health and independence.5,6 Older people at particular risk of loneliness include those living on low incomes, living with a disability, living in rural areas or with housing stress, who are single, childless or living alone, who are vulnerable or at risk of elder abuse, and those with low levels of literacy or communication technology skills (Box).7 A growing body of evidence has highlighted the significant health burden associated with loneliness, with more recent studies also suggesting that loneliness has become an economic problem due to an increase in service use and demand for institutional care. This development requires both effective and cost‐effective strategies to tackle loneliness.11,12

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Monash University Health Economics Group (MUHEG), Monash University, Melbourne, VIC

Correspondence: cathy.mihalopoulos@monash.edu

Open access:

Open access publishing facilitated by Monash University, as part of the Wiley ‐ Monash University agreement via the Council of Australian University Librarians.

Competing interests:

No relevant disclosures.

1. Relationships Australia. Is Australia experiencing an epidemic of loneliness? Findings from 16 waves of the Household Income and Labour Dynamics of Australia Survey; working paper, September 2018. https://www.relationships.org.au/wp‐content/uploads/An‐epidemic‐of‐loneliness‐2001‐2017.pdf (viewed Jan 2024).
2. Office of the Surgeon General. Our epidemic of loneliness and isolation: the US Surgeon General's Advisory on the healing effects of social connection and community; 2023. https://www.hhs.gov/sites/default/files/surgeon‐general‐social‐connection‐advisory.pdf (viewed Jan 2024).
3. Lim MH, Badcok J, Smith B, et al. Ending loneliness together in Australia. Sydney: Ending Loneliness Together, 2020. https://endingloneliness.com.au/wp‐content/uploads/2020/11/Ending‐Loneliness‐Together‐in‐Australia_Nov20.pdf (viewed Jan 2024).
4. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med 2010; 40: 218‐227.
5. Lim MH, Eres R, Vasan S. Understanding loneliness in the twenty‐first century: an update on correlates, risk factors, and potential solutions. Soc Psychiatry Psychiatr Epidemiol 2020; 55: 793‐810.
6. Engel L, Brijnath B, Chong TWH, et al. Quality of life and loneliness post‐bereavement: Results from a nationwide survey of bereaved older adults. Death Stud 2023; 47: 994‐1005.
7. Mansour G. Ageing is everyone's business: a report on isolation and loneliness among senior Victorians. Melbourne: State of Victoria, Department of Health and Human Services; 2016. https://www.seniorsonline.vic.gov.au/services‐information/ageing‐everyones‐business‐report‐social‐isolation‐and‐loneliness‐among‐senior (viewed Jan 2024).
8. Gardiner C, Geldenhuys G, Gott M. Interventions to reduce social isolation and loneliness among older people: an integrative review. Health Soc Care Community 2018; 26: 147‐157.
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10. Butler SS. Evaluating the Senior Companion Program: a mixed‐method approach. J Gerontol Soc Work 2006; 47: 45‐70.
11. Kung CSJ, Kunz JS, Shields MA. Economic aspects of loneliness in Australia. Aust Econ Rev 2021; 54: 147‐163.
12. Mihalopoulos C, Le LK, Chatterton ML, ET AL. The economic costs of loneliness: a review of cost‐of‐illness and economic evaluation studies. Soc Psychiatry Psychiatr Epidemiol 2019; 55: 823‐836.
13. Chawla K, Kunonga TP, Stow D, et al. Prevalence of loneliness amongst older people in high‐income countries: a systematic review and meta‐analysis. PLoS One 2021; 16: e0255088.
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15. Gardiner C, Laud P, Heaton T, Gott M. What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta‐analysis. Age Ageing 2020; 49: 748‐757.
16. Badcock JC, Lim MH, Brophy L, et al. A guide to measuring loneliness for community organisations. Ending Loneliness Together, 2021. https://endingloneliness.com.au/wp‐content/uploads/2021/08/A‐Guide‐to‐Measuring‐Loneliness‐for‐Community‐Organisations_Ending‐Loneliness‐Together.pdf (viewed Jan 2024).
17. Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Health Soc Care Community 2017; 25: 799‐812.
18. Holt‐Lunstad J, Smith TB, Baker M, et al. Loneliness and social isolation as risk factors for mortality: a meta‐analytic review. Perspect Psychol Sci 2015; 10: 227‐237.
19. Cacioppo JT, Hawkley LC. Social isolation and health, with an emphasis on underlying mechanisms. Perspect Biol Med 2003; 46 (Suppl): S39‐S52.
20. Hajek A, Kretzler B, König HH. Multimorbidity, loneliness, and social isolation. A systematic review. Int J Environ Res Public Health 2020; 17: 8688.
21. Duncan A, Kiely D, Mavisakalyan A, et al. Stronger Together: loneliness and social connectedness in Australia. Focus on the States Series, No. 8/21; November 2021. Bankwest Curtin Economics Centre, 2021. https://bcec.edu.au/assets/2021/11/139532_BCEC‐Stronger‐Together‐report_WEB.pdf (viewed Oct 2023).
22. Gerst‐Emerson K, Jayawardhana J. Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults. Am J Public Health 2015; 105: 1013‐1019.
23. Hanratty B, Stow D, Collingridge Moore D, et al. Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing. Age Ageing 2018; 47: 896‐900.
24. Valtorta NK, Moore DC, Barron L, et al. Older adults’ social relationships and health care utilization: a systematic review. Am J Public Health 2018; 108: e1‐e10.
25. Engel L, Lee YY, Le LK‐D, et al. Reducing loneliness to prevent depression in older adults in Australia: A modelled cost‐effectiveness analysis. Mental Health and Prevention 2021; 24; https://doi.org/10.1016/j.mhp.2021.200212.
26. Barjaková M, Garnero A, d'Hombres B. Risk factors for loneliness: a literature review. Soc Sci Med 2023; 334: 116163.

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Narrative review

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Developing the green operating room: exploring barriers and opportunities to reducing operating room waste

Ludmilla Pillay, Kenneth D Winkel and Timothy Kariotis

Med J Aust || doi: 10.5694/mja2.52394
Published online: 19 August 2024

ARTICLE
AUTHORS
REFERENCES

Topics

Environment and public health

Surgical procedures, operative

Emergency medicine

Wounds and injuries

Health services administration

Summary

The Australian health care system contributes 7% of the national greenhouse gas emission footprint and generates massive waste streams annually. Operating rooms are a particular hotspot, generating at least 20% of the total hospital waste.
A systematic search of several global academic databases was conducted in mid‐2022 (articles from 1992 to 2022) for peer‐reviewed research relevant to waste management in the operating rooms. We then used thematic analysis to enumerate and characterise the strategies and barriers to sustainable waste management in the operating room.
The waste reduction strategies focused on avoidance of high carbon products; correct waste segregation and reduced overage; reusing, reprocessing, and repurposing devices; and improved recycling. The first barrier identified was a constrained interpretation of the concept of “first do not harm”, ingrained in surgeons’ practices, in prioritising single‐use surgical products. The second barrier was ineffective or insufficient waste education. The third barrier was the immediate cost of implementing waste management compared with the long term realisation of environmental and economic benefits. The last barrier to implementing institutional practice change was the lack of policies and regulations at the local hospital, federal and international levels.
We also evaluated the knowledge gaps in current surgical waste research, including lack of benchmarking data and standardised regulations concerning reusable or reprocessed devices, as well as the methods used to promote pro‐sustainability behavioural change.

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1 University of Melbourne, Melbourne, VIC
2 Centre for Health Policy, University of Melbourne, Melbourne, VIC

Correspondence: lpillay@student.unimelb.edu.au

Open access:

Open access publishing facilitated by The University of Melbourne, as part of the Wiley ‐ The University of Melbourne agreement via the Council of Australian University Librarians.

Acknowledgements:

We would like to acknowledge Forbes McGain (Western Health, Melbourne) for his invaluable knowledge and support on this research.

Competing interests:

No relevant disclosures.

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Priorities for planetary health equity in Australia

Sharon Friel, Katherine Trebeck, Nicholas Frank, Sandro Demaio, Megan Arthur, Chelsea Hunnisett and Francis Nona

Med J Aust || doi: 10.5694/mja2.52397
Published online: 19 August 2024

ARTICLE
AUTHORS
REFERENCES

Topics

Environment and public health

Social determinants of health

Much evidence exists showing the very real threats to human survival, premature deaths and poor health outcomes from the nexus between the impacts of climate change and economic and social inequities.1,2 Given this crisis of planetary health equity — defined here as the equitable enjoyment of good health in a stable Earth system — preventive action is needed to address the common underlying drivers of climate change and health inequities. These drivers are located within the consumptogenic system, which is the web of institutions, actors, policies, commercial activities and norms that encourages and rewards the exploitation of natural resources, production of fossil fuels, and hyperconsumerism of fossil fuel‐reliant goods and services, which results in environmental degradation, climate change, and social and health inequities.2 In this perspective article, we relay the urgency — identified by researchers, senior bureaucrats, politicians, former business leaders and civil society groups in a Planetary Health Equity Hothouse Policy Symposium3 — for transforming the consumptogenic system, with a focus on economic models, policy coherence, and advocacy. We highlight the opportunities for the health sector to provide leadership in these issues.

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1 Planetary Health Equity Hothouse, Australian National University, Canberra, ACT
2 Edinburgh Futures Institute, University of Edinburgh, Edinburgh, UK
3 Victorian Health Promotion Foundation (VicHealth), Melbourne, VIC
4 University of Melbourne, Melbourne, VIC
5 Climate and Health Alliance, Melbourne, VIC
6 Carumba Institute, Queensland University of Technology, Brisbane, QLD

Correspondence: sharon.friel@anu.edu.au

Open access:

Open access publishing facilitated by Australian National University, as part of the Wiley ‐ Australian National University agreement via the Council of Australian University Librarians.

Acknowledgements:

Sharon Friel receives funding through an Australian Research Council Laureate Fellowship.

Competing interests:

No relevant disclosures.

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2. Friel S. Climate change and the people's health. Oxford: Oxford University Press, 2019.
3. Planetary Health Equity Hothouse. Policy Symposium 2023: extinction thwarted? The nexus between climate change, social equity and health. Canberra: Australian National University, 2023. https://hothouse.anu.edu.au/event/policy‐symposium‐2023‐extinction‐thwarted‐nexus‐between‐climate‐change‐social‐equity‐and (viewed Oct 2023).
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Overcoming disparities in hepatocellular carcinoma outcomes in First Nations Australians: a strategic plan for action

Jessica Howell, Troy Combo, Paula Binks, Kylie Bragg, Sarah Bukulatjpi, Kirsty Campbell, Paul J Clark, Melissa Carroll, Jane Davies, Teresa de Santis, Kate R Muller, Bella Nguyen, John K Olynyk, Nicholas Shackel, Patricia C Valery, Alan J Wigg, Jacob George and Stuart K Roberts

Med J Aust || doi: 10.5694/mja2.52395
Published online: 12 August 2024

ARTICLE
AUTHORS
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Topics

Neoplasms

Digestive system diseases

Every year, about 1800 Australians die of hepatocellular carcinoma (HCC), the most common type of primary liver cancer.1

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1 St Vincent's Hospital, Melbourne, VIC
2 Burnet Institute, Melbourne, VIC
3 University of Melbourne, Melbourne, VIC
4 Monash University, Melbourne, VIC
5 Charles Darwin University, Darwin, NT
6 Southern Adelaide Local Health Network, Adelaide, SA
7 Miwatj Health Aboriginal Corporation, Nhulunbuy, NT
8 Royal Darwin and Palmerston Hospitals, Darwin, NT
9 University of Queensland, Brisbane, QLD
10 Princess Alexandra Hospital, Brisbane, QLD
11 John Hunter Hospital, Newcastle, NSW
12 Flinders University, Adelaide, SA
13 Fiona Stanley Fremantle Hospital Group, Perth, WA
14 Curtin University, Perth, WA
15 Edith Cowan University, Perth, WA
16 Launceston General Hospital, Launceston, TAS
17 QIMR Berghofer Medical Research Institute, Brisbane, QLD
18 Storr Liver Centre, Westmead Millenium Institute, Sydney, NSW
19 Westmead Hospital, Sydney, NSW
20 University of Sydney, Sydney, NSW
21 Alfred Hospital, Melbourne, VIC

Correspondence: jess.howell@monash.edu

Open access:

Open access publishing facilitated by Monash University, as part of the Wiley ‐ Monash University agreement via the Council of Australian University Librarians.

Acknowledgements:

Jessica Howell's salary is supported by an NHMRC Investigator Fellowship, NHMRC Program grant, Burnet Institute Program grant and University of Melbourne strategic grant. We gratefully acknowledge First Nations Australians as the original custodians of this land, who have generously shared their wisdom and stories that led to and informed this work.

Competing interests:

Jessica Howell has received speaker fees and participated in advisory boards for Eisai, Astra Zeneca, Roche and Gilead; and received competitive grant funds from Gilead Sciences and Eisai. Troy Combo has participated in an advisory board for Astra‐Zeneca. Paula Binks has participated in advisory boards for Eisai and Astra‐Zeneca. Kylie Bragg has participated in an advisory board for Astra‐Zeneca. Kate Muller has participated in an advisory board for Astra‐Zeneca. Alan Wigg has participated in advisory boards for Eisai. Jacob George has participated in advisory boards and received honoraria for talks from Novo Nordisk, Astra‐Zeneca, Roche, BMS, Pfizer, Cincera, Pharmaxis, Boehringer Mannheim. Stuart Roberts has participated in advisory boards for Eisai, Astra‐Zeneca and Roche.

1. Australian Institute of Health and Welfare. Liver cancer statistics. 2018. https://www.canceraustralia.gov.au/cancer‐types/liver‐cancer/statistics (viewed Mar 2024).
2. Wigg AJ, Narayana SK, Hartel G, et al. Hepatocellular carcinoma amongst Aboriginal and Torres Strait Islander peoples of Australia. EClinicalMedicine 2021; 36: 100919.
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4. Lubel JS, Roberts SK, Strasser SI, et al. Australian recommendations for the management of hepatocellular carcinoma: a consensus statement. Med J Aust 2020; 214: 475‐483. https://www.mja.com.au/journal/2021/214/10/australian‐recommendations‐management‐hepatocellular‐carcinoma‐consensus
5. Howell J, Ward JS, Davies J, et al. Hepatocellular carcinoma in Indigenous Australians: a call to action. Med J Aust 2021; 214: 201‐202. https://www.mja.com.au/journal/2021/214/5/hepatocellular‐carcinoma‐indigenous‐australians‐call‐action
6. Howell J, Pedrana A, Cowie BC, et al. Aiming for the elimination of viral hepatitis in Australia, New Zealand, and the Pacific Islands and Territories: where are we now and barriers to meeting World Health Organization targets by 2030. J Gastroenterol Hepatol 2019; 34: 40‐48.
7. Hong TP, Gow P, Fink M, et al. Novel population‐based study finding higher than reported hepatocellular carcinoma incidence suggests an updated approach is needed. Hepatology 2016; 63: 1205‐1212.
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11. Davies J, Bukulatjpi S, Sharma S, et al. Development of a culturally appropriate bilingual electronic app about hepatitis B for Indigenous Australians: towards shared understandings. JMIR Res Protoc 2015; 4: e70.
12. Hosking K, De Santis T, Vintour‐Cesar E, et al. “The most culturally safe training I've ever had”: the co‐design of a culturally safe Managing hepatitis B training course with and for the Aboriginal health workforce of the Northern Territory of Australia. BMC Health Serv Res 2023; 23: 935.
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16. Hla TK, Bukulatjpi SM, Binks P, et al. A “one stop liver shop” approach improves the cascade‐of‐care for Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in the Northern Territory of Australia: results of a novel care delivery model. Int J Equity Health 2020; 19: 64.
17. Australian Bureau of Statistics. National Aboriginal and Torres Strait Islander health survey. Dec 2019. https://www.abs.gov.au/statistics/people/aboriginal‐and‐torres‐strait‐islander‐peoples/national‐aboriginal‐and‐torres‐strait‐islander‐health‐survey/latest‐release (viewed Mar 2024).
18. Howell J, Pedrana A, Schroeder SE, et al. A global investment framework for the elimination of hepatitis B. J Hepatol 2021; 74: 535‐549.
19. Lubel JS, Strasser SI, Thompson AJ, et al. Australian consensus recommendations for the management of hepatitis B. Med J Aust 2022; 216: 478‐486. https://www.mja.com.au/journal/2022/216/9/australian‐consensus‐recommendations‐management‐hepatitis‐b
20. Pedrana A, Howell J, Scott N, et al. Global hepatitis C elimination: an investment framework. Lancet Gastroenterol Hepatol 2020; 5: 927‐939.
21. Cooke GS, Andrieux‐Meyer I, Applegate TL, et al. Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2019; 4: 135‐184.
22. European Association for the Study of the Liver. EASL clinical practice guidelines on non‐invasive tests for evaluation of liver disease severity and prognosis ‐ 2021 update. J Hepatol 2021; 75: 659‐689.
23. Parikh ND, Singal AG, Hutton DW, Tapper EB. Cost‐effectiveness of hepatocellular carcinoma surveillance: an assessment of benefits and harms. Am J Gastroenterol 2020; 115: 1642‐1649.
24. Cancer Council Australia. Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia. 2023 [website]. https://www.cancer.org.au/clinical‐guidelines/liver‐cancer/hepatocellular‐carcinoma (viewed Mar 2024).
25. Best J, Bechmann LP, Sowa JP, et al. GALAD score detects early hepatocellular carcinoma in an international cohort of patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 2020; 18: 728‐735.
26. Bernardes CM, Martin J, Cole P, et al. Lessons learned from a pilot study of an Indigenous patient navigator intervention in Queensland, Australia. Eur J Cancer Care (Engl) 2018; 27. https://doi.org/10.1111/ecc.12714.
27. Australia and New Zealand liver and intestinal transplant registry. 34th Annual report ANZLITR, report on liver and intestinal transplantation activity to 31/12/2022. https://www.anzlitr.org/wp‐content/uploads/2024/04/ANZLITR_34th_Annual.pdf (viewed July 2024).
28. Sabesan S, Poxton M. Health equity in clinical trials for regional, rural and First nations communities: need for networked clinical trial system, through a values and purpose‐aligned system culture. Aust J Rural Health 2024; 32: 588‐591.
29. Panozzo S, Bryan T, Mason T, et al. Bridging cultures in palliative care: a qualitative study of the care of Indigenous Australians with advanced illness. Palliat Med 2023; 37: 498‐507.
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31. D'Aprano A, Lloyd‐Johnson C, Cameron D, et al. Trusting relationships and learning together: a rapid review of Indigenous reference groups in Australian Indigenous health research. Aust N Z J Public Health 2023; 47: 100051.

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Notification rates for syphilis in women of reproductive age and congenital syphilis in Australia, 2011–2021: a retrospective cohort analysis of national notifications data

Belinda Hengel, Hamish McManus, Robert Monaghan, Donna B Mak, Amy Bright, Ximena Tolosa, Kellie Mitchell, Lorraine Anderson, Jackie R Thomas, Nathan Ryder, Louise Causer, Rebecca J Guy and Skye McGregor

Med J Aust || doi: 10.5694/mja2.52388
Published online: 29 July 2024

ARTICLE
AUTHORS
REFERENCES

Topics

Infectious diseases

Pediatric medicine

Environment and public health

Abstract

Objectives: To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia.

Study design: Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data.

Setting, participants: Women aged 15–44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011–2021.

Main outcome measures: Numbers and rates of infectious syphilis notifications, by Indigenous status and age group; numbers and rates of congenital syphilis, by Indigenous status of the infant; antenatal care history for mothers of infants born with congenital syphilis.

Results: During 2011–2021, 5011 cases of infectious syphilis in women aged 15–44 years were notified. The notification rate for Aboriginal and Torres Strait Islander women rose from 56 (95% confidence interval [CI], 45–65) cases per 100 000 in 2011 to 227 (95% CI, 206–248) cases per 100 000 population in 2021; for non‐Indigenous women, it rose from 1.1 (95% CI, 0.8–1.4) to 9.2 (95% CI, 8.4–10.1) cases per 100 000 population. The notification rate was higher for Aboriginal and Torres Strait Islander women than for non‐Indigenous women (incidence rate ratio [IRR], 23.1; 95% CI, 19.7–27.1), lower for 15–24‐ (IRR, 0.7; 95% CI, 0.6–0.9) and 35–44‐year‐old women (IRR, 0.6; 95% CI, 0.5–0.7) than for 25–34‐year‐old women, and higher in remote regions than in major cities (IRR, 2.7; 95% CI, 2.2–3.8). During 2011–2021, 74 cases of congenital syphilis were notified, the annual number increasing from six in 2011 to a peak of 17 in 2020; the rate was consistently higher among Aboriginal and Torres Strait Islander infants than among non‐Indigenous infants (2021: 38.3 v 2.1 per 100 000 live births). The mothers of 32 infants with congenital syphilis (43%) had not received antenatal care.

Conclusions: The number of infectious syphilis notifications for women of reproductive age increased in Australia during 2011–2021, as did the number of cases of congenital syphilis. To avert congenital syphilis, antenatal screening of pregnant women, followed by prompt treatment for infectious syphilis when diagnosed, needs to be improved.

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1 The Kirby Institute, Sydney, NSW
2 University of Notre Dame Australia, Fremantle, WA
3 Communicable Disease Control Directorate, Western Australia Department of Health, Perth, WA
4 Office of Health Protection, Australian Department of Health, Canberra, ACT
5 Public Health Intelligence Branch, Queensland Department of Health, Brisbane, QLD
6 Kimberley Aboriginal Medical Services Council Inc, Broome, WA
7 Sexual Health Pacific Clinic, Hunter New England, Newcastle, NSW

Correspondence: bhengel@kirby.unsw.edu.au

Open access:

Open access publishing facilitated by University of New South Wales, as part of the Wiley – University of New South Wales agreement via the Council of Australian University Librarians.

Data sharing:

Applications for access to the data we analysed for this study should be directed to the Australian Department of Health and Aged Care.

Acknowledgements:

We acknowledge the contribution and valuable insights of the Kirby Institute Aboriginal and Torres Strait Islander Reference Group, and State and Territory Health Department surveillance officers.

Competing interests:

No relevant disclosures.

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Lessons from practice

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Group A streptococcal colitis: an under‐recognised entity?

Samuel W L‐W Baumgart, Suzanne English, Tony Sebastian, Sarika Suresh and Timothy J Gray

Med J Aust || doi: 10.5694/mja2.52382
Published online: 29 July 2024

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Infectious diseases

Digestive system diseases

In August 2023, an otherwise healthy 54‐year‐old woman presented to hospital with acute onset fevers and sweats, followed by four days of nausea, vomiting, generalised severe abdominal pain and diarrhoea. The diarrhoea was non‐bloody, with more than ten bowel motions per day. The patient worked as a support worker for older people, and denied previous diarrhoeal illness, sick contacts, consumption of undercooked food, and recent travel.

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Concord Repatriation General Hospital, Sydney, NSW

Correspondence: samuel.baumgart@health.nsw.gov.au

Patient consent:

The patient provided written consent for publication.

Acknowledgements:

We thank the Microbial Genomics Laboratory, NSW Health Pathology – Institute of Clinical Pathology and Medical Research, for genomic analysis of the isolate.

Competing interests:

No relevant disclosures.

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3. Birrel JM, Boyd R, Currie BJ, et al. Socio‐environmental and clinical features of invasive group A streptococcal disease in the Northern Territory of Australia. Commun Dis Intell (2018) 2023; 47; https://doi.org/10.33321/cdi.2023.47.39.
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National pharmacovigilance of seasonal influenza vaccines in Australia

Megan O'Moore, Belinda Jones, Megan Hickie, Catherine Glover, Lucy Deng, Yuanfei Huang, Michael Dymock, Evelyn Tay, Julie A Marsh and Nicholas Wood

Med J Aust || doi: 10.5694/mja2.52381
Published online: 29 July 2024

ARTICLE
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Topics

Pharmaceutical preparations

Environment and public health

Infectious diseases

Statistics, epidemiology and research design

The early detection of adverse events following immunisation (AEFI) is essential to protect public health and to maintain confidence in vaccination. Vaccine pharmacovigilance — the monitoring, detection, investigation and actioning of vaccine safety signals — occurs across a collaborative landscape that includes the Therapeutic Goods Administration (TGA), the nationally funded surveillance initiative AusVaxSafety, and state and territory health departments.

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1 Therapeutic Goods Administration, Canberra, ACT
2 National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, NSW
3 Telethon Kids Institute, Perth Children's Hospital, Perth, WA
4 Wesfarmers Centre of Vaccine and Infectious Diseases, Telethon Kids Institute, Perth, WA
5 University of Sydney, Sydney, NSW
6 Children's Hospital at Westmead, Sydney, NSW

Correspondence: megan.omoore@health.gov.au

Acknowledgements:

AusVaxSafety surveillance is funded under a contract with the Australian Department of Health and Aged Care. The authors acknowledge the participants and staff at the surveillance sites, state and territory health departments, and Telethon Kids Institute, and the contribution of the surveillance tools SmartVax, Vaxtracker, and Microsoft COVID Vaccine Management System. The authors also wish to thank the Therapeutic Goods Administration staff of the Vaccines Surveillance Section, Adverse Event and Medicine Defects Section, and Technical and Safety Improvement Section, who support the safety surveillance of influenza vaccines.

Competing interests:

No relevant disclosures.

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2. Therapeutic Goods Administration, Department of Health and Aged Care. TGA safety monitoring of medicines. Canberra: Commonwealth of Australia, 2018. https://www.tga.gov.au/safety/safety/safety‐monitoring‐medicines/tga‐safety‐monitoring‐medicines (viewed Mar 2024).
3. Australian Technical Advisory Group on Immunisation (ATAGI), Department of Health and Aged Care. Statement on the administration of seasonal influenza vaccines in 2024. Canberra: Commonwealth of Australia, 2024. https://www.health.gov.au/sites/default/files/2024‐02/atagi‐statement‐on‐the‐administration‐of‐seasonal‐influenza‐vaccines‐in‐2024.pdf (viewed Mar 2024).
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Mimics of inflammatory bowel disease: commonly encountered differentials of an uncommon condition

Kathryn Demase and Mark G Ward

Med J Aust || doi: 10.5694/mja2.52372
Published online: 22 July 2024

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Digestive system diseases

Australia has one of the highest rates of inflammatory bowel disease (IBD) in the world; its prevalence has increased significantly over the past 20 years and is projected to increase by > 250% from 2010 to 2030, to then affect 1% of the population.1 Although advances in clinical practice have led to increased identification, this increase is thought to be due to urbanisation of communities, with changes in sanitation and dietary practices. Such changes seen in Asia over the past 20 years have mirrored the rapidly increasing rates of IBD in the Western society, lending support to the “hygiene hypothesis”, and explaining, in part, the increasing burden of IBD on Australian health care due to our high rates of immigration.1,2

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

Correspondence: mark.ward@monash.edu

Open access:

Open access publishing facilitated by Monash University, as part of the Wiley ‐ Monash University agreement via the Council of Australian University Librarians.

Competing interests:

Mark Ward has received educational grants and speaker fees from AbbVie, Takeda and Ferring; travel grants from Pfizer; and has served on advisory boards for AbbVie.

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Pagination