Volume 220 Issue 5

The treatment of colorectal cancer has evolved dramatically in the 21st century, particularly for patients with advanced disease

Kilian GM Brown · Nabila Ansari · Michael J Solomon

Prosthetic joint infection diagnostic criteria have been progressively refined in recent decades, and novel approaches are emerging

Joshua S Davis · David Dewar · Laurens Manning

ERAS peri-operative care protocols have been as impactful as minimal access techniques in improving outcomes following major surgery

Andrew G Hill · James Jin

The failure of health technology assessments to bridge the federal–state divide contributes to public–private access gaps

Jonathon B Ryan

Artificial intelligence is being rapidly taken up by health care services, presenting opportunities and challenges for its use in the surgical services of Australia and New Zealand

Joshua G Kovoor · Stephen Bacchi · Prakriti Sharma · Srishti Sharma · Medhir Kumawat · Brandon Stretton · Aashray K Gupta · WengOnn Chan · Amal Abou‐Hamden · Guy J Maddern

A 16-year-old female patient with cystic fibrosis developed recurrent pleural effusions, facial plethora and prominent chest wall veins

John J Harvey · John I Vrazas · Elhamy Bekhit · Chris Barnes · Philip J Robinson

We need to investigate more than which interventions may be better: implementation research is important for optimising outcomes

Jai N Darvall · Toby Richards

Changing key FLS operational characteristics would only moderately reduce minimal trauma fractures among people aged 50 years or more

Alicia R Jones · Danielle Currie · Cindy Peng · Peter R Ebeling · Jackie R Center · Gustavo Duque · Sean Lybrand · Greg Lyubomirsky · Rebecca J Mitchell · Sallie Pearson · Markus J Seibel · Jo‐An Occhipinti

ICDs should be offered only to people for whom the potential benefit outweighs the potential harm

Lin Zhu · Andrew Hayen · Bianca Blanch · Nathan Engstrom · Jenny A Doust · Christopher Semsarian · Katy JL Bell

Improving general surgery in rural areas relies on an increase in workforce numbers, tailored models of care and an improved focus on the wider multidisciplinary team

Jessica Paynter · Kirby R Qin · Janelle Brennan · David J Hunter‐Smith · Warren M Rozen

Despite advances in treatment, ovarian cancer remains a lethal disease which lacks an established screening program, and surgical prevention remains the gold standard for women at increased risk

Michail Sideris · Usha Menon · Ranjit Manchanda

Leonie Segal · Emmanuel S Gnanamanickam

Ben Mathews

Damien Linnane · Craig Cumming · Stuart A Kinner

Australia needs a greater sense of urgency in tackling greenhouse gas emissions, including in the health sector, a new climate change score card has found. The MJA-Lancet Countdown on health and climate change also found good progress at both a government and community level. The article, co-authored by Associate Professor Paul Beggs from Macquarie University, praised the Australian Government’s move to release the country’s first National Health and Climate Strategy and welcomed the Western Australian Government’s preparation of a Health Sector Adaptation Plan. The Countdown, established in 2017, provides annual updates on progress tackling emissions, tracking 25 indicators across five broad areas. The MJA-Lancet Countdown highlighted the health and economic costs of inaction of health and climate change, with one example being major flooding in eastern Australia in 2022 which directly caused the deaths of 23 people, displaced thousands of people and cost $7.1 billion. It also stated the urgency of the need to improve Australia’s mitigation and adaption responses. “Australia’s energy system, and its health care sector, currently emit an unreasonable and unjust proportion of greenhouse gases into the atmosphere,” the article said.

Sam Hunt

There are urgent calls to abandon the restraining of prisoners receiving palliative care, with the ongoing practice blamed on the Australian justice and health systems colliding. Prisoners receiving palliative care in Australia, either in a hospital or a palliative care unit, may still be subject to prison policies regarding restraint even though care is being provided outside of a prison environment, experts say. “Health care professionals involved in caring for hospitalised prisoner patients [have] described a ‘seemingly opaque system’ around the protocols and points of contact for removing shackles,” wrote Lara Pemberton from the Biomedicine Discovery Institute at Monash University and colleagues in a Perspective, published in the Medical Journal of Australia today. The processes for getting the shackles removed from a restrained prisoner is also “time-consuming and deliberative — time that a dying person may not have,” Ms Pemberton wrote. In some jurisdictions in Australia, health care staff must follow formal pathways “to request a review of a patient’s risk assessment”. While palliative care for prisoners is in the spotlight this week, there are again calls for prisoners to no longer be excluded from Medicare and Pharmaceutical Benefits Scheme (PBS) subsidies.

Sam Hunt