Volume 217 Issue 11

Time to celebrate another successful year in difficult times, but we are mindful of the challenges that remain

Nicholas J Talley

Implementation science based health care research is urgently needed for genomic and precision medicine in Australia

Rosie O'Shea · Alan S Ma · Robyn V Jamieson · Nicole M Rankin

Improving patient communication on fertility risk and cancer is vital for quality in oncofertility care

Violet Kieu · Catharyn Stern · Jessica Harris · Yasmin Jayasinghe · Natalie Bradford · Wanyuan Cui · Rebecca Deans · Tamara Hunter · Catherine Allingham · Stefan C Kane · Lei Shong Lau · Shanna Logan · Robert McLachlan · Kristen Neville · Michelle Peate · Marianne Phillips · Carla Saunders · Marianne Tome · Rita Upreti · Kate White · Antoinette Anazodo · Roger J Hart

Australia has effectively instituted a vaccination mandate while maintaining critical workforce capacity in aged care

Sally Hall Dykgraaf · Jane Desborough · Anne Parkinson · Elizabeth A Sturgiss · Paul Kelly · Michael Kidd

Strategies to increase and sustain the COVID-19 vaccination rate among Australian children are needed

Katelyn Barnes · Sally Hall Dykgraaf · Lucas Toca · Michael Wright · Michael Kidd

Enforceable indoor air quality standards are needed to minimise the risk of airborne infection transmission in shared indoor spaces

Lidia Morawska · Guy B Marks · Jason Monty

A 14-month-old girl was noted to have exfoliation of her peripheries on day 19 after orthotopic liver transplant for end-stage liver disease from extrahepatic biliary atresia

Jessica A Eldredge · Noel E Cranswick · Kathleen H McGrath

A 44-year-old man presented to the emergency department with left knee monoarthritis

Caitlin Paul · Joseph O'Brien · Sarah Huffam · Daryl Ridley

A 91-year-old man presented with a more than 10-year history of a slow growing horn- like lesion on the right side of the face

Li‐wen Zhang · Tao Chen

Medical practice weights clinical staging models, so why not a staging model for medical practitioners themselves?

Gordon B Parker

Choi PYI, Merriman E, Bennett A, et al. Consensus guidelines for the management of adult immune thrombocytopenia in Australia and New Zealand. Med J Aust 2022; 216: 43‐52. https://doi.org/10.5694/mja2.51284 In this Consensus statement article, the affiliations for Chee Wee Tan should be: “Royal Adelaide Hospital, Adelaide, SA; SA Pathology, Adelaide, SA; Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ), Melbourne, VIC”.

Weise JC, Srasuebkul P, Trollor JN. Potentially preventable hospitalisations of people with intellectual disability in New South Wales. Med J Aust 2021; 215: 31‐36. https://doi.org/10.5694/mja2.51088 The authors have identified three minor errors in the code used to define potentially preventable hospitalisations for people with intellectual disability: For diabetes complications, the use of level 3 instead of level 4 ICD‐10 codes. For the non‐vaccine preventable pneumonia, a missing decimal point for the J15.7 code (J157 instead of J15.7). For gangrene, the use of a principal diagnosis code for the R02 instead of any diagnosis code. The authors have re‐run their analysis and found minor changes to the rates and trends of potentially preventable hospitalisation for people with intellectual disability: Including diabetes complications has changed the overall rates of chronic disease; chronic disease admission rates are now higher for people with intellectual disability. A small increase in the number admissions related to non‐vaccine‐preventable pneumonia. No difference in the result for gangrene‐related admission, as the numbers remain too low to include in our results. The new information, which does not change the overall findings and discussion, is reflected in the changes to the Abstract, the Results section, Boxes 1 to 3, and the Supporting Information described below. In the Abstract, the Results paragraph should read: Results: The annual age‐standardised rate for people with intellectual disability ranged between 5889 and 7203 per 100 000 persons, and for the NSW population between 1278 and 1511 per 100 000 persons; the rate ratio (RR) ranged between 3.9 (95% CI, 3.7–4.1) in 2014–15 and 5.0 (95% CI, 4.6–5.4) in 2002–03. The difference was greatest for admissions with acute conditions (RR range: 5.4 [95% CI, 5.0–5.8] in 2014–15 to 8.1 [95% CI, 7.4–8.8] in 2002–03). By specific condition, the highest age‐standardised rate was for admissions with convulsions and epilepsy (all years, 2567 per 100 000 population; v NSW population: RR, 22.2; 95% CI, 21.3–23.1). In the Results section, page 32, the first paragraph should read: Between 2001–02 and 2014–15, the age‐standardised rate of potentially preventable hospitalisations of people with intellectual disability ranged between 5889 and 7203 per 100 000 persons; the age‐standardised rate for the NSW population ranged between 1278 and 1511 per 100 000 persons. RRs ranged between 3.9 (95% CI, 3.7–4.1) in 2014–15 and 5.0 (95% CI, 4.6–5.4) in 2002–03 (Box 1, Box 2, A; Supporting Information, table 2). In the Results section, page 32, the second paragraph should read: RRs for potentially preventable hospitalisations for vaccine‐preventable conditions ranged between 2.1 (95% CI, 1.6–3.0) in 2007–08 and 3.4 (95% CI, 2.2–5.2) in 2004–05 (Box 1, Box 2, B; Supporting Information, table 2). For acute conditions, RRs ranged between 5.4 (95% CI, 5.0–5.8) in 2014–15 and 8.1 (95% CI, 7.4–8.8) in 2002–03 (Box 1, Box 2, C; Supporting Information, table 2). For chronic conditions, RRs ranged between 2.0 (for several years) and 2.5 (95% CI, 2.1–2.8) in 2004–05 (Box 1, Box 2, D; Supporting Information, table 2). In the Results section, pages 32 to 33, the final two paragraphs should read: In each age group, the difference in rates of potentially avoidable hospitalisations for people with intellectual disability and for the general NSW population was greatest for convulsions or epilepsy (all ages: RR, 22.2; 95% CI, 21.3–23.1). The second greatest differences were for bronchiectasis for people aged 0–14years (RR, 10.0; 95% CI, 4.1–24.7), 15–24years (RR, 14.5; 95% CI, 5.2–40.5), or 25–44years (RR, 11.7; 95% CI, 4.6–29.7), diabetes complications for people aged 45–64years (RR, 6.5; 95% CI, 5.4–7.8), and pelvic inflammatory disease for people aged 65years or more (RR, 9.0; 95% CI, 1.2–65) (Box 3; Supporting Information, table 3). In each age group, potentially avoidably hospitalisations of people with intellectual disability for asthma were less frequent than for the general NSW population (all ages: RR, 0.4; 95% CI, 0.4–0.4) (Box 3; Supporting Information, table 3). Box 1 – Rate ratios (with 95% confidence intervals) for potentially preventable hospitalisations (per 100000 persons) of New South Wales people with intellectual disability and of all New South Wales people, by year* Year All conditions Vaccine‐preventable conditions Chronic conditions Acute conditions 2001–02 4.9 (4.5–5.3) 3.2 (2.2–4.7) 2.1 (1.8–2.5) 7.7 (7.0–8.4) 2002–03 5.0 (4.6–5.4) 2.6 (1.7–3.8) 2.0 (1.7–2.3) 8.1 (7.4–8.8) 2003–04 4.9 (4.6–5.3) 2.8 (2.1–3.8) 2.4 (2.0–2.7) 7.5 (6.9–8.3) 2004–05 4.9 (4.6–5.3) 3.4 (2.2–5.2) 2.5 (2.1–2.8) 7.5 (6.9–8.2) 2005–06 4.9 (4.6–5.3) 2.7 (1.8–4.1) 2.4 (2.1–2.8) 7.5 (6.9–8.1) 2006–07 4.9 (4.6–5.3) 2.2 (1.5–3.4) 2.3 (2.0–2.6) 7.7 (7.1–8.4) 2007–08 4.4 (4.1–4.6) 2.1 (1.6–3.0) 2.0 (1.7–2.2) 6.8 (6.3–7.4) 2008–09 4.4 (4.2–4.7) 2.6 (1.8–3.9) 2.1 (1.9–2.4) 6.9 (6.3–7.4) 2009–10 4.3 (4.1–4.6) 2.4 (1.8–3.2) 2.3 (2.0–2.6) 6.6 (6.1–7.1) 2010–11 4.6 (4.4–5.0) 2.3 (1.6–3.1) 2.2 (1.9–2.5) 6.5 (6.0–7.1) 2011–12 4.6 (4.3–4.9) 2.7 (1.9–3.7) 2.2 (1.9–2.5) 6.4 (6.0–7.0) 2012–13 4.5 (4.2–4.8) 2.8 (2.1–3.7) 2.0 (1.8–2.3) 6.5 (6.0–7.0) 2013–14 4.2 (3.9–4.4) 2.9 (2.3–3.8) 2.3 (2.1–2.6) 5.8 (5.4–6.2) 2014–15 3.9 (3.7–4.1) 2.8 (2.2–3.5) 2.2 (2.0–2.5) 5.4 (5.0–5.8) * All age‐adjusted rates of potentially preventable hospitalisations by category and year are available in the online Supporting Information, table 2. Box 2 – Age‐adjusted rates of potentially preventable hospitalisations, New South Wales, 2001–02 to 2014–15 Box 3 – Rate ratios (with 95% confidence intervals) for potentially preventable hospitalisations (per 100000 persons) of New South Wales people with intellectual disability and of all New South Wales people, 2010–11 to 2014–15, by age and condition* Condition All ages 0–14years 15–24years 25–44years 45–64years 65years or more Vaccine‐preventable Pneumonia and influenza 2.9 (2.6–3.3) 4.8 (3.9–6.0) 3.9 (2.2–6.8) 4.2 (2.8–6.4) 3.3 (2.2–4.8) 1.4 (0.9–2.1) Other 2.6 (2.2–2.9) 2.1 (1.7–2.7) 1.7 (0.8–3.6) 2.7 (1.9–3.8) 2.7 (2.0–3.6) 2.7 (1.5–5.0) Chronic conditions† Asthma 0.4 (0.4–0.4) 0.1 (0.1–0.1) 0.3 (0.2–0.3) 0.3 (0.2–0.4) 0.4 (0.3–0.6) 0.2 (0.2–0.4) Bronchiectasis 2.6 (2.1–3.2) 10.0 (4.1–24.7) 14.5 (5.2–40.5) 11.7 (4.6–29.7) 1.9 (1.1–3.6) 1.2 (0.7–2.1) Diabetes complications 3.3 (3.1–3.5) 1.6 (1.3–2.0) 2.2 (1.8–2.8) 8.3 (6.6–10.4) 6.5 (5.4–7.8) 3.2 (2.6–4.1) Chronic obstructive pulmonary disease 2.2 (2.1–2.4) 3.0 (1.2–7.5) 5.1 (1.3–20.9) 5.3 (3.0–9.2) 2.9 (2.4–3.4) 2.0 (1.8–2.3) Iron deficiency anaemia 1.8 (1.6–1.9) 3.3 (1.8–6.1) 1.3 (0.9–1.9) 1.9 (1.5–2.4) 1.8 (1.5–2.2) 1.2 (1.0–1.5) Rheumatic heart diseases 1.2 (0.8–1.6) 2.1 (0.7–6.6) 1.7 (0.3–9.8) 1.6 (0.4–6.6) 0.8 (0.3–1.9) 0 Acute conditions‡ Convulsions and epilepsy 22.2 (21.3–23.1) 14.8 (13.7–16.0) 22.6 (19.4–26.3) 25.7 (22.2–29.7) 25.4 (21.6–29.9) 11.9 (8.8–16.3) Dental conditions 5.6 (5.4–5.9) 3.1 (2.9–3.3) 7.2 (6.3–8.4) 11.1 (9.7–12.8) 6.4 (5.4–7.5) 2.3 (1.6–3.2) Ear, nose, throat infections 2.8 (2.7–2.9) 2.5 (2.3–2.7) 1.5 (1.3–1.9) 2.4 (1.9–3.1) 3.6 (2.5–5.3) 2.2 (1.3–3.7) Pelvic inflammatory disease 0.8 (0.7–0.9) 1.2 (0.1–10.7) 0.6 (0.4–1.0) 0.8 (0.5–1.1) 0.2 (0.1–0.4) 9.0 (1.2–64.7) Perforated/bleeding ulcer 1.8 (1.5–2.3) 2.7 (0.1–58.8) 1.6 (0.5–5.4) 1.6 (0.8–3.2) 2.7 (1.6–4.5) 1.4 (0.9–2.4) Pneumonia (not vaccine‐preventable) 2.7 (2.1–3.4) 2.0 (1.4–2.9) 2.8 (0.9–8.4) 4.9 (1.7–14.6) 3.5 (1.1–11.1) 2.1 (0.6–7.5) Urinary tract infections 3.4 (3.2–3.6) 2.4 (2.1–2.7) 2.2 (1.8–2.6) 4.1 (3.4–5.0) 5.3 (4.5–6.4) 2.6 (2.3–3.0) * All age‐adjusted rates of potentially preventable hospitalisations by category and year are available in the online Supporting Information, table 3. † Data for nutritional deficiencies not included because of small case numbers. ‡ Data for eclampsia and gangrene not included because of small case numbers. The category "Convulsions and epilepsy" is included under acute conditions in the National Healthcare Agreement list of potentially preventable hospitalisations.12

Future studies should determine if eating these specific types of cholate actually produces the same types of stool as those listed on the BSS

Guy D Eslick · Eloise G Eslick

Magical remedies should be incorporated into Muggle medicine to improve patient outcomes and to reduce burdens on healthcare systems

Vincent D Gaertner · Elia D Helwig · Brett J Manley · Omar F Kamlin · Andrea Kraus · Christoph M Rüegger

Many festive films portray a Western diet that can lead to dysbiosis

Olivia Yousef · Stephen De Souza