Perspectives

Lifting the special drug status applied to medical abortion medications will enable equitable access

Caroline M de Costa · Kirsten I Black · Darren B Russell

There have been many advances in sexual and reproductive health and rights in Australia but we must also recognise the gaps that affect our most vulnerable populations

Deborah J Bateson · Kirsten I Black · Shailendra Sawleshwarkar

Australia urgently needs a new and fairer approach to the provision of quality Medicare‐funded psychological services

Sebastian P Rosenberg · Ian B Hickie

Lack of national abortion data impedes development of sexual and reproductive health care policies and programs for young Australians

Jennifer L Marino · Susan M Sawyer

New technologies and collaborative care are improving the quality of life of patients with glaucoma

Yu Xiang George Kong · Annie Gibbins · Anne Brooks

Australia's implementation of the Sustainable Development Goals must advance the nation's health and wellbeing transparently and inclusively

Claire E Brolan · Nina Hall · Sandra Creamer · Ingrid Johnston · Jaya AR Dantas

What are the problems in rural health service delivery and what can we do about them?

John Wakerman · John S Humphreys

Intersectoral collaboration is needed to engage communities and design effective culturally and age‐appropriate interventions

Angela Titmuss · Elizabeth A Davis · Alex Brown · Louise J Maple‐Brown

Individualised dosing is important in cancer treatment in real‐world settings and may require departure from trial‐based protocols

Angelina Tjokrowidjaja · Elizabeth Hovey · Craig R Lewis

Although hand transplantation has the potential to transform lives, the procedure is not without risk

Karen M Dwyer · James D Burt · Tim Bennett

How is Australia responding to the trends in pharmaceutical opioid utilisation and opioid harms?

Gabrielle Campbell · Nicholas Lintzeris · Natasa Gisev · Briony Larance · Sallie Pearson · Louisa Degenhardt

Climate plays an important role in human health and it is well established that climate change can have very significant impacts in this regard. In partnership with The Lancet and the MJA, we present the inaugural Australian Countdown assessment of progress on climate change and health. This comprehensive assessment examines 41 indicators across five broad sections: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. These indicators and the methods used for each are largely consistent with those of the Lancet Countdown global assessment published in October 2017, but with an Australian focus. Significant developments include the addition of a new indicator on mental health. Overall, we find that Australia is vulnerable to the impacts of climate change on health, and that policy inaction in this regard threatens Australian lives. In a number of respects, Australia has gone backwards and now lags behind other high income countries such as Germany and the United Kingdom. Examples include the persistence of a very high carbon-intensive energy system in Australia, and its slow transition to renewables and low carbon electricity generation. However, we also find some examples of good progress, such as heatwave response planning. Given the overall poor state of progress on climate change and health in Australia, this country now has an enormous opportunity to take action and protect human health and lives. Australia has the technical knowhow and intellect to do this, and our annual updates of this assessment will track Australia’s engagement with and progress on this vitally important issue.

Ying Zhang · Paul J Beggs · Hilary Bambrick · Helen L Berry · Martina K Linnenluecke · Stefan Trueck · Robyn Alders · Peng Bi · Sinead M Boylan · Donna Green · Yuming Guo · Ivan C Hanigan · Elizabeth G Hanna · Arunima Malik · Geoffrey G Morgan · Mark Stevenson · Shilu Tong · Nick Watts · Anthony G Capon

Engaging clinicians through trials networks may represent a critical and cost-effective investment that improves quality of care, patient outcomes and standards of care even before the results of trials are known

John R Zalcberg · Michael Friedlander

Although medicinal cannabis can now be prescribed for CINV, high quality clinical trial evidence is required to determine its efficacy and safety

Antony J Mersiades · Martin R Stockler · Ian N Olver · Peter Grimison

We still await well conducted RCTs of CO₂ laser therapy for vaginal atrophy; in the meantime, topical vaginal oestrogen therapy remains the gold standard

Melissa J Buttini · Christopher Maher

A system-wide change, involving individuals, medical schools and colleges, which supports doctors’ physical and mental health is required to tackle the problem of suicide in the health workforce

Ann I McCormack

Despite widespread calls for action, investment and interventions to change unprofessional behaviour in the health system have been ineffective

Johanna Westbrook · Neroli Sunderland · Victoria Atkinson · Catherine Jones · Jeffrey Braithwaite

To provide high quality patient care in rural and remote health settings, it is essential to invest in clinical supervision and explore models that enhance team building and improve recruitment and retention

Priya Martin · Tarun Sen Gupta · John M Douyere

Children need outdoor play but safety standards alone will never prevent all injuries; robust data are required to guide risk minimisation strategies

Ruth A Barker · David Eager · Lisa N Sharwood

It is crucial to facilitate cross-sectoral coordination, collaboration and investment to improve outcomes for adolescents and young adults with rare and low survival cancers

Adam Walczak · Pandora Patterson · David Thomas

Effective responses in policy and practice are essential to manage overdiagnosis and the sustainability of the health system

Ray Moynihan · Alexandra L Barratt · Rachelle Buchbinder · Stacy M Carter · Thomas Dakin · Jan Donovan · Adam G Elshaug · Paul P Glasziou · Christopher G Maher · Kirsten J McCaffery · Ian A Scott

Medical assistance in dying may disrupt therapeutic relationships and will challenge beliefs

Leeroy William

A new Australian strategy should finally reduce the significant national burden of diabetes-related foot disease

Peter A Lazzarini · Jaap J van Netten · Robert A Fitridge · Ian Griffiths · Ewan M Kinnear · Matthew Malone · Byron M Perrin · Jenny Prentice · Paul R Wraight

Worldwide, over 100 organisations are using the Grading of Recommendations Assessment, Development and Evaluation approach; it is thus essential that clinicians using formal guidelines become familiar with the GRADE approach

Waleed Alhazzani · Gordon Guyatt