Health policy

Objectives Develop a roadmap of contextualised strategies to support international medical graduates (IMGs) on the pathway into satisfying rural general practitioner careers in Australia.DesignRealist evaluation approach.Setting, ParticipantsOnline semi-structured interviews, focus groups and intermittent feedback cycles developed, refined and confirmed a contextualised roadmap of strategies between 1 November 2024 and 27 July 2025. Participants were purposefully selected for IMG background and different pathways into rural general practice careers across Australia. This included a 10-person project advisory group and 31 external participants covering decision-makers, training teams, supervisors and trainees. Questions explored practical strategies to drive comfort, confidence, competence, belonging and bonding.Main Outcome MeasuresContextualised strategies for IMGs to achieve satisfying rural general practice careers.ResultsThe roadmap identified that when migrating and acclimatising, providing IMGs with centralised resources and information on rural general practice training and careers promotes comfort and empowerment. When moving to new workplaces and communities, providing IMGs with supportive workplaces for early supervised practice, skill bridging and opportunities to connect with other doctors', families and communities stimulates IMG confidence, competence and sense of community belonging. When training to become a general practitioner rurally, providing IMGs with family-focused, equitable training matched to the IMG and the community, and training that builds on IMG capabilities, promotes a sense of professional belonging and bonding. We identified that early intervention and a continuity of supports are important for more comprehensively supported IMGs.ConclusionsOngoing timely support, when multi-layered, tailored and integrated, may assist IMGs to gain specialist general practice qualifications, feel valued and to settle in rural general practice roles. The roadmap provides a basis for planning coordinated longitudinal support by distributed agencies.

Belinda G. O'Sullivan, Kim J. Omond, Neysan Sedaghat

The end of the year is a good time to reflect on why a journal like the MJA does what it does, who supports the Journal's work, and the headwinds that journals are navigating. The MJA publishes high quality research and commentary that aims to inform health policy and influence medical practice in Australia. Our process is largely one of curation of what is submitted to us, combined with commissioning on issues we identify as important. We prioritise for publication articles that report on or discuss conditions with a high burden of disease, that are likely to have an effect on policy or practice, support Aboriginal and Torres Strait Islander health and wellbeing, and articles that report on uniquely Australian topics. Articles go through a rigorous process that includes editorial assessment, peer review, author revision in response to peer review, and, after acceptance, expert structural editing. We hope that this process — essentially a collaboration between authors, editors and reviewers — will ensure that, by the time an article is published, it is the best representation of the authors’ work. In the 12 months to 31 October 2024, the MJA received 1598 articles, of which 196 were accepted; we publish around 10–12 in each issue. Each issue is a curated mix of content; some, such as the theme issues on surgery (https://www.mja.com.au/journal/2024/220/5), general practice (https://www.mja.com.au/journal/2024/220/9), women's health (https://www.mja.com.au/journal/2024/221/7), infectious diseases (https://www.mja.com.au/journal/2024/221/4), child and adolescent health (https://www.mja.com.au/journal/2024/221/10), and the special issue on Indigenous health (https://www.mja.com.au/journal/2024/221/1), have a specific focus. This end of year issue has no specific theme; its diversity, however, collectively reflects the Journal's priorities. We hope these articles will interest you as readers and support you in your clinical practice or research as much as we were fascinated by them as editors. The research articles include an analysis of the cost of treating hypertension (https://doi.org/10.5694/mja2.52522), participation in the national bowel screening program by people with severe mental illness (https://doi.org/10.5694/mja2.52521), an analysis of out‐of‐hospital cardiac arrests (https://doi.org/10.5694/mja2.52532), and an analysis of the Northern Territory health workforce (https://doi.org/10.5694/mja2.52507). Perspectives include the need for targeted prevention and treatment of stroke in young women (https://doi.org/10.5694/mja2.52516), and a review of the evidence of persistently replicating SARS‐CoV‐2 as a driver of long COVID (https://doi.org/10.5694/mja2.52517). We are proud to also publish in this section a thoughtful article, “Decolonisation, Indigenous health research, and Indigenous authorship: sharing our teams’ principles and practices” (https://doi.org/10.5694/mja2.52509), by a collective of Aboriginal and non‐Indigenous researchers, who work together in two Aboriginal‐led research teams. In the decisions we make at the MJA, we are supported on a daily basis by many reviewers who give their time and expertise to help us provide what we think is an essential service: high quality evidence‐based research and commentary to support decision making in health care. In the past 12 months, they submitted between them 855 reviews. We provide below a list of the reviewers who have reviewed for us in the past 12 months and we are grateful to all of them for what they do to support the MJA. We are also very grateful to the members of our Editorial Advisory Group, who provide ongoing expert advice. This year we are especially grateful to the Guest Editors for the July special issue on Indigenous health that we published in association with the Lowitja Institute (https://www.mja.com.au/journal/2024/221/1). Their work in curating this special issue is one that we were very proud to support as part of the MJA's ongoing commitment to excellence and leadership in Aboriginal and Torres Strait Islander led health research. In 2024, more than 100 countries, representing about half of the world's population, have had the chance to vote in regional, national or local elections. Perhaps, more than ever before, the evidence base for science and medicine have been on the ballot and it is not clear that it has been on the winning side in every case. In reflecting back on what we do, the role of peer‐reviewed journals such as the MJA will be even more crucial over the next few years in helping navigate the vast amount of medical information that exists. We are very grateful for everyone that supports the work that we do at the MJA, and who does work themselves in evidence‐based health research and policy making. Now, more than ever, this work is crucial to support a functioning and evidence‐informed society. The MJA Editorial Advisory Group, November 2024 The MJA Editorial Advisory Group members are eminent clinicians and scholars who are valuable sources of ideas for the content of the Journal. They provide constructive criticism of the format and content of the Journal, and provide independent advice to the MJA Editorial Committee on appeals of editorial decisions, problematic articles, and complaints about the editorial process. John Attia Lilon G Bandler Anthony Capon Flavia M Cicuttini Paul B Colditz Brendan S Crabb Jaya Dantas Anne Duggan David A Ellwood Alex Farrell Peter G Gibson Marc Gladman Charles Guest Claire L Jackson Cheryl A Jones Zsuzsoka Kecskes José Florencio Fabella Lapeña, Jr Christopher Levi C Raina MacIntyre Jennifer Martin Patrick D McGorry Catriona McLean Lucy Morgan Peter L Munk Debra Nestel Ian N Olver Wilfred Peh Anna Ralph Toby Richards Christobel Saunders Susan Sawyer Jeong‐Wook Seo Lambert W Schuwirth Joseph Sung Helena Teede Philip G Truskett Robyn Ward Steve Wesselingh Paul S Worley Catherine Yelland Neville D Yeomans Jeffrey Zajac MJA reviewers, 31 October 2023 – 1 November 2024 Jason Abbott Lisa M Abbott Karen Adams Oyelola Adegboye Barbara‐Ann Adelstein Stephen Adelstein Hossein Adibi John Adie Susannah Ahern Chris Alderman Sarah Ali Nicole L Allard Penny L Allen Janaki Amin David John Amor Craig S Anderson Robert Anderson Catarina Ang Nigel R Armfield Amit Arora Kingsley Asiedu Deborah A Askew Eugene Athan John J Atherton David N Atkinson John R Attia Oyekoya Taiwo Ayonrinde Leon A Bach Kathryn Backholer Tony Badrick Michael Baigent Jannine Bailey Suzanne Bain‐Donohue Ross I Baker Eileen Baldry Zoe Baldwin Lilon G Bandler Bridget Barber Ruth A Barker Kristine Kay Barlow‐Stewart Rahul D Barmanray Amanda Barnard Adrian G Barnett Dylan Dominic Barth Tarun Bastiampillai Marijka Batterham Malcolm W Battersby Frank H Beard Kenneth Beath Lorri Beatty Paul J Beggs Justin Beilby Katy JL Bell Scott C Bell Simon Bell Derrick A Bennett Julie Bennett Jill Benson Stephanie Best Neera Bhatia Laurent Billot Justin Bilszta Marie M Bismark Habtamu Bizuayehu Deborah A Black J Andrew Black Kirsten I Black Christopher F Bladin Tony Blakely Paul Blaschke Melissa Jane Bloomer Peter Boan Angie Bone Michael A Bonning Kade Booth Jeffrey Boris Jessica Botfield Eric Bouffet Mark Boughey Lisa Bourke Asha C Bowen Simon D Bowler Annette J Braunack‐Mayer Ruanne Brell Bruce J Brew Fraser J Brims Peter J Bristow Julia M L Brotherton Anthony James Brown Katharine Brown Claudia Bruno Jamie Bryant David J Buckley Liz Buckley Nicholas A Buckley T Jared Bunch Hayden Burch Luke Burchill Sally A Burrows Jane A Buxton Oyungerel Byambasuren Gerard J Byrne Dominique A Cadilhac Rosemary Calder Emily Joy Callander Ian D Cameron Peter A Cameron Anna Campain David G Campbell Lewis Campbell Ben J Canny Karla J Canuto Cheryl Carcel Phillip J Carson Judith Cashmore Gillian E Caughey Elena Cavazzoni Blake S Cavve Steven J Chadban Leanne Chalmers Sonia Chanchlani Manju Chandrasegaram Jenny Chang Jack Chen Bernard Man Yung Cheung Derek P Chew Angela L Chiew HuiJun Chih Philip MC Choi Stephanie KY Choi Clara K Chow Eric P F Chow Intifar Chowdhury Kate Churruca Tainya Clarke David Coghill Neale D Cohen Paul B Colditz Catherine Coleborne Jacinta M Coleman Samantha Colledge‐Frisby Alex Collie Peter J Collignon Philippa Collin Josielli Comachio Robert James Commons Luke B Connelly Mark S Cooper Matt Cooper Michael D Coory Vincent J Cornelisse Colin Hilton Cortie Christopher Coulter Sean Cowlishaw Stephen Cox Terry J Coyne Simon Craig Susanna Cramb Gregory Crawford Julia L Crilly Philip Crispin Simon R Crouch Andrew Crowden Mark Crowther Alana R Cuthbert Mark Daglish Eleonora Dal Grande Kathryn Daley Carlton D Dampier Benjamin Daniels Jaya A R Dantas Jai N Darvall Mike Daube A James M Daveson Stephanie J Davies Ian D Davis Joshua S Davis Stephanie Davis Susan R Davis Angela Dawson Carolyn A Day John F de Campo Caroline M de Costa Barbara de Graaff Bouke de Jong Anthony Dear Katrine Del Villar Anthony Delaney Clare Delany Sarah M Dennis Jane Desborough John A Devereux Haryana M Dhillon Terrence H Diamond Hugh G Dickson Christianna Digenis Joanna Dipnall George Disney Loc Giang Do Annette J Dobson Jodie M Dodd Xenia Dolja‐Gore Susan M Donath Katina D'Onise Paul J Douglas Jenny A Doust James Dowty Andrea Driscoll Olaf H Drummer Stephen J Duckett Johan A Duflou Pascal Duijf Gregory J Duncombe Karen Maree Dwyer John R Dyer Diana Egerton‐Warburton John W Eikelboom Robert H Eikelboom Paul Eleftheriou David H Ellis Pete M Ellis David A Ellwood Elissa Elvidge Jon D Emery Guy D Eslick David Espinoza Mohamed Estai Claudia Estcourt Sue M Evans Christopher K Fairley Kristy Fakes Michael O Falster Jonathon P Fanning Jillann F Farmer Michael Farrell Daniel M Fatovich Stuart Faulkner Jane Christine Fazio Deirdre Fetherstonhaugh David W Firman Matt Fisher Robert A Fitridge Gerard J FitzGerald John L Fitzgerald Arthas Flabouris Stephen C Flecknoe‐Brown John I Fleming Darran Foo Malcolm Forbes Kevin D Forsyth David Fraile Navarro Peter Franklin John K French Frank A Frizelle Lara Fuller Clara Gaff Nicholas Gall Seana Gall Edward J Gane Lydia Garside Coral E Gartner Gail Garvey Madlen Gazarian Alison Gibberd Nathan J Gibbs Peter G Gibson Peter R Gibson Gerard Francis Gill Stephen Dean Gill Lynn H Gillam Allan R Glanville Rebecca Glauert Stacy K Goergen Day Way Goh Lisa Gold Rimma Goldberg Matthew R Golden David E Goldsbury Judith Gomersall Phillip D Good Belinda Goodwin Alexandra S Gorelik Rebekah Grace Patricia Graves Melissa J Green Suetonia Green Tim J Green Jerry R Greenfield Trisha Greenhalgh Jennene Greenhill Jessica A Grieger Sonia R Grover Luke E Grzeskowiak Eric Guazzo Pascale Guitera Hasantha Gunasekera Monisha Gupta Lyle C Gurrin Thi Ninh Ha Dandara Haag Bronwyn B Haasdyk Mohsen Habibian Penny Hagen Sally Hall Dykgraaf Christian R Hamilton‐Craig Mark J Hanly Isabel Hanson Damian Harding Stephen Harfield David Harley Benjamin Harrap Ian A Harris Katie Harris Mark F Harris Jo Harrison Simon J Harrison Stephanie Harrison Roger J Hart Gunter F Hartel Mary Anne Hartley Lara Harvey Rubayyat Hashmi Alys Havard Andrew Hayen Christopher Hayes Richard B Hays Christopher H Heath Geoffrey S Hebbard Michael A Henderson Martin Hensher Subash Shanthakumar Heraganahally Ana Herceg Helen E Herrman Charlotte Mary Hespe Martha Hickey Peter Higgs Joanna Hikaka Andrew G Hill David R Hillman Kenneth M Hillman Sarah N Hilmer Dana A Hince Pravin Hissaria Danielle Hitch Peter G Hobbins Alberta Hoi Michael J Hollands Caroline SE Homer Preben Homoe Thai Phuoc Hong Gary Hooper John Hopper John D Horowitz Robert L Horvath Elizabeth D Hotham Paul Hotton Nehmat Houssami Jessica Howell Martin Howell Wendy Hu Catherine E Huggins Jaquelyne Hughes Lisa Hui Rod W Hunt Roger W Hunt Arnagretta Hunter Jennifer Hunter Peter C Hunter Elizabeth Hurrion Sarah J Hyde Zoë Hyde Jonathan A Hyett Susan Ieraci Maria C Inacio Warrick J Inder Joan Ingram Geoffrey K Isbister Katherine Z Isoardi Rowena G Ivers Christopher Jackson Claire L Jackson Melinda Jackson Theresa Jacques Farzana Jahan Sharon James Stacey K Jankelowitz Edward D Janus Edward Jegasothy Charles G Jenkinson Awachana Jiamsakul Liza Johannesson Sarah Johnson Brian D Johnston Alexandra Jones Michael P Jones Scott Jones Michelle Jongenelis Robert N Jorissen Matthew D Jose Joanne Joseph Preeti Avinash Joshi Manjul Joshipura Craig Phillip Juergens Nadarajah Kangaharan Jonathan Karnon Judith M Katzenellenbogen Margaret P Kay Karuna Keat Damien Kee June Keeling Michelle Kehoe Nicholas A Keks Justin Kenardy Debra S Kennedy Emma Kennedy Michelle Kennedy Suzanne Kennewell Danelle Kenny Katherine Kenny Dev A S Kevat Ehsan Khan Karen Kiang Ganessan Kichenadasse Hansoo Kim Joosup Kim Michael G Kimlin Lara Anne Kimmel Jeffrey Klausner Christopher S Kneebone Taryn Knox Jonathan Koea Pamela Konecny Kelvin M Kong Viola Korczak Zeff Koutsogiannis Leonard Kritharides Estie Kruger Eeva‐Katri Kumpula Ronald Labonte Luise Patricia Lago Vinay Lakra Stephen B Lambert Riki Lane Aleksandra Lange Alexander Larcombe Michael Larkin Sarah L Larkins Anne‐Marie Laslett Zohra Lassi Dennis Lau Namson Shon Chung Lau Kate Laver David M Lawrence Minh Le Cong Bernard Arnaud Leckning Karin Leder Adriene Lee James C Lee Stephen R Leeder Amy Legg James W Leitch Christopher N Lemoh Peter J Lewindon Xia Li Xue (Snow) Li Winston Spencer Liauw Michael Libman Leanne Liddle Susan Liew Vidya S Limaye Ivan Lin Anthea Lindquist Daniel Lindsay Damien Linnane Clare Littleton Dan Liu Andrew R Lloyd Serigne Lo David Long Derrick Lopez Susan M Lord Paula Lorgelly Jeanne Louw Michaela Lucas Guy L Ludbrook Sanja Lujic Ronald Ma Gustavo Machado Andrew I MacIsaac Heather G Mack John S Mackenzie Rona Macniven Richard Cawley Madden Guy J Maddern Parker John Magin Farah Magrabi Karen Magraith Robert Mahar Colin J Mahoney David Majewski Ashanya Malalasekera Allison Malcolm Arunima Malik James Leslie Mallows Linda Mann Jo‐Anne Elizabeth Manski‐Nankervis Danielle Manton Victoria J Mar Ben J Marais Tania P Markovic Susan Marks Nathaniel S Marshall Jennifer H Martin Kaka Martina Marianne Martinello Thomas H Marwick Lester Mascarenhas Siobhán Masterson Heather Mattner Richard Matzopoulos Danielle Mazza Scott McAlister Sally M McCarthy Peter McCluskey Stephen P McDonald Alison McEwen Forbes McGain Julie McGaughran Richard G McGee Peter McGeorge Steven McGloughlin Matthew Richard McGrail Iain McGregor Peter B McIntyre Andrea McKivett Donald McLeod Brendan McMullan Danielle McMullen Kathleen McNamee Ryan Mead‐Hunter Graham N Meadows Niamh Meagher Jacqueline K Mein Tracy Lee Merlin William J Milford Jeremy L Millar Robert Miller Llew Mills Rachel Milte Alyssa Milton Gita D Mishra David James Mitchell Geoffrey K Mitchell Francis Mitrou Michael Montalto Julia K Moore Michael J Moore Robyn Moore Philip Morgan Susan J Morgan Peter Morley Jedidiah Morton Robert G Moses Robert F W Moulds David Mountain Alison M Mudge James Muir Zachary Munn Cammi Murrup‐Stewart Danielle Muscat Vasi Naganathan Balakrishnan (Kichu) R Nair Sanjay Nandurkar Alison J Nankervis Natasha Nassar Merrilee Needham Amanda Louise Neil Mark R Nelson David A Newby Evan D Newnham John Newnham Yee Ching Ng Sam Ngan Son H Nghiem Danielle Ni Chroinin Gary Nicholls Suzanne Nielsen Rosemary L Nixon Antony Nocera Alicia Norman Robert Norton Vicki O'Donnell Patrick Oakley Jeremy J N Oats James O'beirne Carly Oboudiyat Penny O'Brien Anne O'Connor Daniel Bogale Odo Nicholas J Osborne Joshua Osowicki Jessica Pace Ellie Paige Andrew John Palmer Adriana Parrella Carmen Parter Nalini Pati Sue Pavord Christopher Pearce Odette Pearson Roxanna Pebdani Carmelle Peisah Yang Peng Jonathan Penm Charana Perera Gregory M Peterson Naomi Pfitzner Richard K S Phoon Robert W Pickles S Praga Pillay Dino Pisaniello Sabrina W Pit Michael Pollanen James Pollard C Dimity Pond Phillippa J Poole Michelle Porter Christopher John Poulos Jeffrey Presneill Karen Price Jenny Proimos Susanna Margaret Proudman Mark Putland Rennie Qin Helen E Quinn Steve Quinn Miia Rahja Eamon P Raith Satish Raj Anna P Ralph Geetha Ranmuthugala Jonas Ranstam Melissa Raven Jennifer S Reath Helen K Reddel Stephen Reddel Susan J Rees Christopher Reid Ian R Reid Joel Rhee Alice M Richardson Drew B Richardson Damien Riggs Malcolm D Riley Ian T Ring Marco Rizzi Vijay Roach Fiona Robards Kathryn Victoria Roberts Chris Robertson Iain K Robertson Paul G Robertson Jo Robinson Kerry Robinson Jenny M Robson Leigh Roeger Benjmain Rogers Margaret J Rogers Loreto Vanessa Tevah Rose Jacqueline Roseleur Sebastian P Rosenberg Andrew Ross Bronwen Ross Glynis P Ross Stacey L Rowe Bosco Rowland Amanda Roxburgh Darren B Russell Fiona Russell Courtney Ryder Bandana Saini Jonathan M Samet Mina Sarofim Sarah Sasson Christobel M Saunders John Saunders Rebecca B Saunderson Feby Savira Andrea L Schaffer Chris Schilling Markus Schlaich Violeta Schubert Tim Schultz Kate Scoles James G Scott Paul A Scuffham Holly Seale Deshan F Sebaratnam Paul J Secombe Rhiann Sue See Marie‐Claire Seeley Leonie Segal Tarun Sen Gupta Sanjaya N Senanayake Stefan Serban Hannah Seymour Anthony Shakeshaft Shokoofeh Shamsi Rashmi Sharma Md Shajedur Rahman Shawon Dinberu Shebeshi Daisy Shepherd Heather Shepherd Kirsty Short Alexis Leah Shub William Sievert Kyra Sim David Simmons Andrew H Singer Leda Sivak Dana Rose Marie Louise Slape Janet K Sluggett David P Smith Jane Smith Hayley Smithers‐Sheedy Jennifer Smith‐Merry Thomas L Snelling Hayden A Snow Jessamine Soderstrom Tania C Sorrell Denis Spelman Alicia J Spittle Geoffrey K Spurling Preeyaporn Srasuebkul Ingrid Stacey Andrew Staib Julia Steinberg Alexandre S Stephens Michele Sterling Mark Stevenson Adam Stewart Rob Stirling Martin R Stockler Nigel P Stocks Simone I Strasser Edward Strivens Bronwyn Gwenneth Ann Stuckey Elizabeth Ann Sturgiss Wei‐May Su Takemi Sugiyama Ahna Ballonoff Suleiman Clair Sullivan Anastasia S Suraev Tatiana Surzhina Georgina Sutherland Tom Sutherland Aaron L Sverdlov Arianne Sweeting Prue Talbot Nicholas J Talley Natassia Pinpin Tan Patrick Tansley Avelina Tarrago Amanda Taylor Adam G Testro Hiran Thabrew Mark AB Thomas Alexander Thompson Kelly Thompson Tilda Nell Thomson Karen Thorpe Matthew Tieu Kaylie Toll Shidan Tosif Stephen Craig Trumble Haitham Tuffafa Thomas Turnbull Stuart Turville Bep Uink Patricia C Valery Kees van Gool Leesa Van Niekerk Alicia Veasey Mark George Knox Veitch Rebecca Louise Venchiarutti Bala Venkatesh Deborah Verran Karin Verspoor Elmer V Villanueva Renuka Visvanathan Beverley Vollenhoven Amy Von Huben Kylie Vuong Zoe Wainer Dennis Walker Robert J Walker Richard Walton Michael B Ward Peter A B Wark David D Warrell Chelsea J Watego David I Watson Jared Watts Cora Weber‐Pillwax Peter Wein Barbara Weinstein Heidi Welberry Cameron Wells Aliza Werner‐Seidler Robb Wesselingh Juanita L Westbury Seth Westhead Melissa Anne Wheeler Sara Whitburn Cassandra White Christopher P White Jenni White Julian White Kate White David C Whiteman Alan John Wigg Kay A Wilhelm Garry J Wilkes Chris S Wilkinson Dominic J C Wilkinson Louise Wilkinson Carmel Williams Craig Williams Crystal Williams Megan Williams Robyn Williams Andrew Wilson Leon Winata Ingrid Winship Sarah Wise Gary A Wittert Vincent Wing Ming Wong Anna Wood Michael C Woodward AM Paul Worley Melina Gattellari Worthington Michael Wright Ian Wronski Rosemary Wyber Elizabeth J Wylie Jessica Yang Mark W Yates Margaret R Zacharin Ehud Zamir Christopher Zeitz Yuejen Zhao Nicholas A Zwar

Virginia Barbour

The MJA aims to prioritise studies that will “advance knowledge or practice with respect to medical problems of significance for Australia”. This is particularly inclusive of studies that not only have the potential to affect clinical practice, but also to help set, inform and improve our national health and social policies. In this issue of the MJA, we showcase several studies that have and will continue to inform national policy, help us understand how evidence can be used to best effect in the health policy process, and remind us of how and what is being done about other important national policy priorities. Australia's journey in regulating vaping, a relatively recent yet significant public health threat, especially to younger people, has taken a positive turn this year. The Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Act 2024 took effect in July 2024 and significant more regulation to access, packaging, and formulations of vapes was introduced nationally (https://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/bd/bd2324a/24bd061a). These changes are internationally recognised as bold attempts at curbing vaping among younger people and have been influenced by an enormous body of work and advocacy. It is work such as Jenkins and colleagues’ (https://doi.org/10.5694/mja2.52423) in this issue, which identified a synthetic nicotine analogue (6‐methylnicotine) in “non‐nicotine” vapes and accompanying inconsistent chemical reporting, that are the pillars of evidence required to inform our national legislative journey. As noted by Larcombe and Hunter (https://doi.org/10.5694/mja2.52422) in an accompanying editorial, loopholes in legislation will continue to be used by vape manufacturers and our regulatory bodies must keep up, or ideally get in front of their attempts at circumventing them using evidence like that presented by Jenkins and colleagues. This issue of the MJA also includes a compendium piece for readers of modelled economic evaluations by Chen and colleagues (https://doi.org/10.5694/mja2.52409). Economic evaluations are ubiquitous and critical to how Australia makes decisions about medicines, devices, and other health care services (https://www.sciencedirect.com/science/article/pii/S221210992030666X), yet not always clearly accessible to non‐health economist readers. Chen et al remind us that with more complex questions, interventions, heterogenous populations, and luckily more computational power, more sophisticated model‐based economic evaluations are required, unavoidable, and our understanding of them must evolve. Using two recent MJA studies as examples (https://doi.org/10.5694/mja2.51825, https://doi.org/10.5694/mja2.51860), Chen et al describe how model‐based evaluations compare to study‐based evaluation, major modelling choices with powerful visual representations of these models and advice on what to look out for when determining model robustness. In Engel and Mihalopoulos’ perspective (https://doi.org/10.5694/mja2.52414), we read about loneliness and its economic impact, an area of increasing national recognition and evolving health and social policies. Loneliness, affecting almost one‐third of adults over 60 years of age and two‐thirds of older adults living in residential care, needs cost‐effective national strategies. Although a bidirectional relationship between loneliness and chronic health problems is not surprising, the magnitude of its potential health effects (eg, 26% higher risk of death), and the increasingly obvious impact that it has on our health system ($2.7 billion annually) that Engel and Mihalopoulos cite is alarming. However, it is not all doom and gloom. Engel and Mihalopoulos suggest that research has identified some critical elements of successful loneliness intervention strategies, including holistic community‐based and ‐led health and social care, and several promising intervention types. Interestingly, one such proposed strategy to address loneliness is “social prescribing”, which Yadav and colleagues’ (https://doi.org/10.5694/mja2.52413) letter to the editor introduces as the “core business” of Aboriginal and Torres Strait Islander community‐controlled health organisations. Yadav et al's call to action that we should learn more from Indigenous models of social prescribing could not have come at a more pertinent time.

Maria Inacio

This issue of the MJA highlights areas where health and research can be affected — both positively and negatively — by national policies and approaches. Sexual and reproductive health are at a critical time globally with these rights under attack in so many places. Catriona Melville and Bonney Corbin highlight the areas where Australia has been “quietly making changes for the better” (doi: 10.5694/mja2.52194). These reforms are to be celebrated and are substantial. As they note, “we have seen more changes in the past six years than in the previous 60”. However, they pose critical questions on how these reforms can be protected and how can they be equitable. They conclude that although we are in the privileged position in Australia of no longer needing to noisily advocate for basic reproductive rights, “every one of us must reflect on our roles, responsibilities and power to reshape Australian health systems so that all people can choose if, how and when to parent”. Their message is reinforced in the editorial by Asvini Subasinghe and Seema Deb (doi: 10.5694/mja2.52210), who comment on two research articles on abortion in Victoria by Kristina Edvardsson and colleagues (doi: 10.5694/mja2.52202) and Melvin Marzan and colleagues (doi: 10.5694/mja2.52203). As their starting point, Subasinghe and Deb note the structural barriers to abortion care in Australia found by the 2023 Senate inquiry, and the lack of knowledge on equity of access. They note that “Support from peak bodies and the government for providing equitable access to early medical abortion has increased” but “much remains to be done to achieve equitable access for all Australian women”, and they make a case for a national abortion registry to support research into this area. The need for better research and coordination — this time for emerging therapies for children and adolescents — is the topic of a perspective by Michelle Lorentzos and colleagues (doi: 10.5694/mja2.52191). They highlight the need for collaboration and investment to ensure that children and adolescents access clinical trials and the many new therapies that are becoming available for diseases which have previously had few therapeutic options. The challenge with many of these diseases is their rarity, compounded in Australia by distance. The authors call for “the development of a national collaborative community of paediatric trials centres”, noting that “Given the rarity of many paediatric diseases and the complexity of emerging therapies, a national approach for complex trials in paediatrics is imperative”. They conclude that “without a change in approach to paediatric clinical trial delivery in Australia, paediatric clinical trials centres are at risk of failing to deliver equitable efficient access to novel treatment options”. Finally, a lesson from practice provides a timely reminder of an important infectious disease and the need for careful differential diagnosis and public health follow‐up. Caitlin Swift and colleagues describe a case of cutaneous diphtheria on the scalp of a man in conjunction with basal cell carcinoma (doi: 10.5694/mja2.52190). The case reinforces the importance of clinical vigilance and, for such an important disease, “prepared public health systems to enable a prompt response”. They conclude that “Maintaining high diphtheria vaccination coverage across all ages is crucial for protection against severe disease”.

Virginia Barbour