Volume 220 Issue 1

Among the many dire consequences of the Israel–Gaza war, the impact on the mental health of populations living in multicultural Western countries is significant

Susan J Rees · Batool Moussa

Unrelated findings on imaging studies are increasingly common and how to interpret and manage them is challenging

Ian A Scott · John Slavotinek · Paul P Glasziou

A call to action: the medical profession should advocate for a culturally inclusive health system

Neda So · Karen Price · Peter O'Mara · Michelle A Rodrigues

There is emerging evidence on peri-operative risk and retained gastric products with GLP-1 receptor agonists

Lisa M Raven · Campbell Brown · Jerry R Greenfield

A 41-year-old G1P1 woman presented with two days of dyspnoea four weeks postpartum

Jessica V Yao · Joshua Wong · Anu Aggarwal

The Royal Commission report into the neglect and exploitation of the disabled community must prompt immediate action

Bruce Powell · Joshua Powell

All health workers who have direct contact with trans people should be trained in inclusive care

Penelope Strauss

Training health care professionals in inclusive services for trans people could improve access to appropriate health care

Sav Zwickl · Tomi Ruggles · Alex FQ Wong · Ariel Ginger · Lachlan M Angus · Kalen Eshin · Teddy Cook · Ada S Cheung

Banning new wood heaters, phasing out existing units, and supporting clean energy can achieve major health and environmental benefits

Sotiris Vardoulakis · Fay H Johnston · Nigel Goodman · Geoffrey G Morgan · Dorothy L Robinson

Updated recommendations from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia for managing chronic cough in children and adults

Julie M Marchant · Anne B Chang · Emma Kennedy · David King · Jennifer L Perret · Andre Schultz · Maree R Toombs · Lesley Versteegh · Shyamali C Dharmage · Rebecca Dingle · Naomi Fitzerlakey · Johnson George · Anne Holland · Debbie Rigby · Jennifer Mann · Stuart Mazzone · Mearon O'Brien · Kerry‐Ann O'Grady · Helen L Petsky · Jonathan Pham · Sheree MS Smith · Danielle F Wurzel · Anne E Vertigan · Peter Wark

A cardiac arrest system with integrated ECPR is a promising intervention for patients with refractory cardiac arrest

For the National ECPR Working Group

Nicole TM Hill · Wai Chen · Jenny Downs

Jodie Bailie · George Disney · Claire Quilliam · Anne M Kavanagh

Eleanor Malbon · Ariella Meltzer · Gemma Carey

Jennifer Smith‐Merry

The latest issue of the Medical Journal of Australia is available now. MJA's Editor-in-Chief, Professor Virginia Barbour, said the first issue of the year explored the Israel–Gaza conflict and also highlighted the “voice of the patient”. “Our first issue of the year reflects several issues that are likely to be topics of ongoing discussion in the year ahead,” Professor Barbour said. “We have published a Perspective on the ‘invisible wounds’ of the Israel–Gaza conflict, reminding us of the war’s far-reaching effects. The article explores the mental health of populations living in multicultural Western countries who are affected by the conflict.” “We are proud to advocate for the ‘voice of the patient’ by publishing a Perspective calling for all Australian jurisdictions to act on the recommendations of the recent Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability.” “Cultural safety in health care is also critically important, which is highlighted in a Perspective published today.”

Sam Hunt

The alarm has been sounded about the dangers of wood heater smoke, with new research showing just how deadly exposure to the smoke is in the Australian Capital Territory (ACT). The research, published in the Medical Journal of Australia, states that domestic wood heaters are the predominant source of particulate air pollution in the ACT and across many areas of the southern states, producing fine particles (PM2.5), carbon dioxide, methane and black carbon. The health impact of wood heater smoke is significant, causing premature death and exacerbation of asthma and other respiratory and cardiovascular conditions. “As bad as the Black Summer bushfires” The researchers undertook a rapid health impact assessment of the effect of wood heater pollution on mortality in the ACT, using air quality data from three monitoring stations and existing population health statistics. “The consequence of current wood heater use in the ACT is 11–63 avoidable deaths, equivalent to $57–333 million in the annual cost of deaths, comparable with the 31 deaths in the ACT attributable to the bushfire smoke during the Black Summer of 2019–20,” Professor Sotiris Vardoulakis and colleagues wrote. Professor Vardoulakis is inaugural Professor of Global Environmental Health and Director of the Healthy Environments And Lives (HEAL) National Research Network at the Australian National University. The ACT Government announced in August 2023 that it would phase out wood heaters by 2045, with a ban on the installation of new wood heaters in some suburbs extended. “The ACT Government’s recent announcement of phasing out wood heaters in the ACT by 2045 is a positive development,” Professor Vardoulakis said. “Similar steps including not permitting the installation of new wood heaters and phasing out existing ones in residential areas of other jurisdictions can offer major health and environmental benefits in Australia. “Other effective measures include financial incentives or rebates to lower-income families to encourage people to replace wood heaters with cleaner alternatives that produce lower emissions, such as reverse cycle air conditioning systems powered by renewable energy.”

Sam Hunt

A decision to hand over water fluoridation decisions to local councils in Queensland a decade ago has resulted in more than a million Queenslanders having less access to fluoridated water, putting them at a greater risk of dental disease. New research, published in the Medical Journal of Australia, has found the 2012 decision to devolve responsibility for water fluoridation decisions and funding from the Queensland Government to local councils has put people at even greater risk of dental decay. As a result of the decision, 61 out of 77 local government areas in Queensland do not have fluoridated water, affecting 1 050 799 people. The research, co-authored by Christopher Sexton, a biostatistician at The University of Queensland, found a strong association between socio-economic status and access to fluoridated water. “In this study, we investigated area-level access to fluoridated drinking water in Queensland and its relationship with local socio-economic resources,” Mr Sexton and his colleagues wrote. “Access to fluoridated water can reduce inequalities in oral health by benefiting people at all socio-economic levels, but socio-economically advantaged regions often have access to fluoridated water sooner and for longer,” they wrote. The findings Their research found a strong association between socio-economic status and access to fluoridated water, with 79.4% of the Queensland population (4 050 168 people) having access to fluoridated water. It also found Queenslanders living in lower socio-economic status areas have less access fluoridated water, putting them at greater risk of dental decay (known as dental caries). “Our findings highlight the socio-economic differences that can exacerbate social gradients of dental health,” Mr Sexton and his colleagues wrote. “Water fluoridation cost-effectively reduces the prevalence of dental caries by 25–40%.” The researchers noted that the benefits of drinking fluoridated water would be of most benefit to people of lower socio-economic status, since these people are at greater risk of dental caries and less likely to have access to other forms of oral health care. Responsibility “must be returned” The responsibility for water fluoridation must be handed back to the state government, Mr Sexton and his colleagues argue. “The Queensland government should revise its water fluoridation policy and support local councils, especially in regional areas, to implement water fluoridation,” they wrote. “The alternative is to accept poorer access to fluoridated water in poorer areas of Queensland, where the burden of oral disease is already high.”

Sam Hunt