How should we fund integrated primary care for children in Australia? A resource allocation study.

Objectives: Integrated primary care provides health and social care services to intervene early and support children and families. Funding of integrated care is a barrier to care provision, but evidence is limited for which funding models are most appropriate. Our study aimed to provide expert judgement on what funding model, or mix of models, are most likely effective for integrating primary care for families with children aged 0-12 years in Australia.

Guidelines for management of actual or suspected inadvertent intra-arterial injection of sclerosants.

Background: Inadvertent intra-arterial injection of sclerosants is an uncommon adverse event of both ultrasound-guided and direct vision sclerotherapy. This complication can result in significant tissue or limb loss and significant long-term morbidity.

Objectives: To provide recommendations for diagnosis and immediate management of an unintentional intra-arterial injection of sclerosing agents.

A comment on "Height and the standard of living in Puerto Rico from the Spanish Enlightenment to annexation by the United States, 1770-1924".

Using prisoner height data, Moreno-Lázaro (2023) claims that Puerto Rican living standards declined after US annexation and stagnated for decades. This conclusion is not supported by the prisoner data and is inconsistent with other welfare measures that show dramatic improvement, such as per capita GDP, life expectancy, and literacy.

Futile treatment - when is enough, enough?

Objective This paper examines two aspects of treatment decision making: withdrawal of treatment decisions made by a patient; and decisions to not proceed with treatment by a health professional. The paper aims to provide an overview of the law relating to the provision of treatment, then highlight the uncertainty as to the meaning of and costs associated with futile treatment. Methods The paper reviews the current legal and medical literature on futile treatment.

Analysis of Part 1 of the latest Austroads Guidelines, June 2022.

The Austroads Fitness to Drive Guidelines were updated in 2022. Most of the focus to date has been on Part 2 of the Guidelines, which provide guidance as to specific medical conditions. Less attention has been paid to Part 1 of the Guidelines, which cover a medical practitioner's ethical and legal obligations.

The COVID Positive Pathway: a collaboration between public health agencies, primary care, and metropolitan hospitals in Melbourne.

Objectives: To assess the capacity of the COVID Positive Pathway, a collaborative model of care involving the Victorian public health unit, hospital services, primary care, community organisations, and the North Western Melbourne Primary Health Network, to support people with coronavirus disease 2019 (COVID-19) isolating at home.

Design, Setting, Participants: Cohort study of adults in northwest Melbourne with COVID-19, 3 August - 31 December 2020.

Main Outcome Measures: Demographic and clinical characteristics, and social and welfare needs of people cared for in the Pathway, by care tier level.

Investigation and Management of Apparently Sporadic Central Nervous System Haemangioblastoma for Evidence of Von Hippel-Lindau Disease.

Haemangioblastomas are rare, highly vascularised tumours that typically occur in the cerebellum, brain stem and spinal cord. Up to a third of individuals with a haemangioblastoma will have von Hippel-Lindau (VHL) disease. Individuals with haemangioblastoma and underlying VHL disease present, on average, at a younger age and frequently have a personal or family history of VHL disease-related tumours (e.

Fitness to drive and seizures - Recent medicolegal considerations to tell or not to tell? - THAT IS THE QUESTION!

This paper reviews a Coroner's inquest into the deaths of two people. The deaths were caused when a driver had a seizure, and lost control of his car, which then plowed into a café. The Coroner reviews the roles and responsibilities of primary and tertiary caregivers, with special focus on the question of who has the responsibility to inform the Drivers' Licensing Authority of a patient's unfitness to drive - the patient or the practitioner? The Coroner recommends the establishment of a multi-agency committee to advance work in this area.

Trust, trustworthiness and sharing patient data for research.

When it comes to using patient data from the National Health Service (NHS) for research, we are often told that it is a matter of trust: we need to trust, we need to build trust, we need to restore trust. Various policy papers and reports articulate and develop these ideas and make very important contributions to public dialogue on the trustworthiness of our research institutions. But these documents and policies are apparently constructed with little sustained reflection on the nature of trust and trustworthiness, and therefore are missing important features that matter for how we manage concerns related to trust.

Medical certificates attesting fitness to drive.

Few if any sanctions have been imposed on doctors for inappropriate certification of fitness to drive. This paper reviews a recent Tribunal decision on inappropriate certification of fitness to drive. This paper reviews the facts of the case of Medical Board of Australia v Andrew and discusses the legal implications for doctors who certify patients as fit to drive.

Field measurement of beef pen manure methane and nitrous oxide reveals a surprise for inventory calculations.

Few data exist on direct greenhouse gas emissions from pen manure at beef feedlots. However, emission inventories attempt to account for these emissions. This study used a large chamber to isolate NO and CH emissions from pen manure at two Australian commercial beef feedlots (stocking densities, 13-27 m head) and related these emissions to a range of potential emission control factors, including masses and concentrations of volatile solids, NO, total N, NH, and organic C (OC), and additional factors such as total manure mass, cattle numbers, manure pack depth and density, temperature, and moisture content.

Interaction between physical and psychosocial risk factors on the presence of neck/shoulder symptoms and its consequences.

This study aimed to quantify the interaction between physical and psychosocial factors on the presence of neck/shoulder symptoms (NSS) and its consequences (reduced activities and absenteeism) among 1294 coal mining workers in Indonesia. A self-administered questionnaire was used to obtain information on current workplace exposure and NSS and its consequences. Participants were grouped into one of four combination exposure groups: low physical and low psychosocial (as the reference group); low physical and high psychosocial; high physical and low psychosocial, and high physical and high psychosocial (HPhyHPsy).

Interaction between physical and psychosocial work risk factors for low back symptoms and its consequences amongst Indonesian coal mining workers.

This study assessed the interaction between physical and psychosocial factors for low back symptoms (LBS) and its consequences (reduced activities and absenteeism) in a developing country. A sample of 1294 Indonesian coal mining workers reported occupational exposures, LBS and its consequences using a self-administered questionnaire. Respondents were placed into one of four combination exposure groups: high physical and high psychosocial (HPhyHPsy); high physical and low psychosocial (HPhyLPsy); low physical and high psychosocial (LPhyHPsy), and; low physical and low psychosocial (LPhyLPsy).

The combined effect of physical, psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences.

This study assessed the combined effect of physical and psychosocial/organisational and/or environmental factors on the presence of musculoskeletal symptoms (MSS) and its consequences (reduced activities and absenteeism due to MSS) in a random sample of 3003 workers in New Zealand. By telephone interview, participants reported their current workplace exposures and MSS (neck/shoulder, arm/elbow, wrist and low back) and its consequences. Data were analysed using multivariable logistic regression.

Psychosocial job strain and sleep quality interaction leading to insufficient recovery.

The purpose of the study was to assess the impact of job strain and sleep quality on the diurnal pattern of cortisol reactivity, measured by awakening and evening (10 PM) saliva cortisol. The sample consisted of 76 British white-collar workers (24 women, 52 men; mean age 45.8 years).

The relationship between work-related rumination and evening and morning salivary cortisol secretion.

The perseverative cognition hypothesis suggests that worry/ruminative thinking prolongs stress-related physiological activation. This study explored the association of work-related rumination with salivary cortisol sampled at 10 pm and the cortisol awakening response (CAR) the following morning. On a mid-week evening, 108 school teachers completed a small diary about their work-related thoughts and gave a saliva cortisol sample at 10 pm.

Prevalence of low back symptoms and its consequences in relation to occupational group.

Background: The purpose of this study was to examine: (1) the prevalence of low back symptoms (LBS) and its consequences (reduced activities and absenteeism); (2) the association between occupational group and LBS; and (3) the association between LBS and its consequences.

Methods: A self-administered questionnaire was used to determine the prevalence of LBS in 1,294 Indonesian coal mining workers. A Cox proportional hazards model was developed to quantify the 12-monthly hazard of LBS.

Why do students fail to disclose health problems?

Background: At the university where this study took place, pre-qualifying healthcare students had previously been enrolled on programmes and were found to have pre-existing and ongoing health problems, which caused difficulties for some students during clinical placements.

Aim: To develop a web-based information zone dealing with students' concerns about fitness-to-practise issues.

Method: A three-stage study involving an online student survey, in-depth student interviews and development of a university web-based information zone was carried out.

Raising awareness of psychosocial factors in the occurrence of low back symptoms in developing countries.

Although there is strong evidence that single physical, psychosocial and organisational risk factors are each independent predictors of low back symptoms (LBS), little is known about their combination/interaction, particularly in those working in developing countries. A total of 1294 Indonesian coal mining industry workers reported information about physical, psychosocial, and organisational factors using self-reported questionnaires and were placed into one of four combination exposure groups: 1) high physical (working with bent trunk; whole body vibration exposure; lifting) and high psychosocial (high effort; low reward; work stress), 2) high physical and low psychosocial, 3) low physical and high psychosocial, and 4) low physical and low psychosocial (as the reference group). The odds of LBS in the high physical and high psychosocial group was 5.

Prevalence and work-related risk factors for reduced activities and absenteeism due to low back symptoms.

Although quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selected from the New Zealand Electoral Roll, were interviewed by telephone about self reported physical, psychosocial, organizational, environmental factors and the consequences of LBS (i.e.