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    PPE for your mind: a peer support initiative for health care workers

    Tahnee L Bridson, Kym Jenkins, Kieran G Allen and Brett M McDermott
    Med J Aust 2021; 214 (1): . || doi: 10.5694/mja2.50886
    Published online: 18 January 2021

    Peer support initiatives can help health professionals experiencing mental health and wellbeing challenges during the COVID‐19 pandemic and beyond

    The coronavirus disease 2019 (COVID‐19) pandemic has placed the health care workforce under an unprecedented level of stress. No area of the health workforce is immune to COVID‐19‐related changes to usual work practices. The impact of this acute stress has occurred in the context of a health care profession that was already struggling with major work‐related challenges including anxiety, depression, secondary trauma, compassion fatigue and burnout. Importantly, these issues may have been exacerbated by the COVID‐19 pandemic due to the direct consequences of health care workers being infected, and the indirect consequences of the economic impact on their families and friends, the rigours of lockdown and the adverse effects on health and wellbeing felt across all aspects of society.

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    • 1 Hand‐n‐Hand Healthcare Workers Peer Support Network, Cairns, QLD
    • 2 Sunshine Coast Mental Health and Addiction Services, Sunshine Coast, QLD
    • 3 Council of Presidents of Medical Colleges, Canberra, ACT
    • 4 Monash Health, Melbourne, VIC
    • 5 College of Medicine and Dentistry, James Cook University, Townsville, QLD


    Correspondence: handnhandAU@gmail.com
    Acknowledgements: 

    We thank the many health care professionals who have enthusiastically supported the Hand‐n‐Hand initiative from its humble beginnings, those who have volunteered to support their colleagues during these challenging times and those who have helped to promote the importance of peer support in the health care sector.

    Competing interests:

    We are all founding members of the Hand‐n‐Hand peer support initiative. Kym Jenkins and Brett McDermott are also members of the #MindingCOVID writing group, which has provided resources for Hand‐n‐Hand.

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      COVID‐19 and residential aged care: priorities for optimising preparation and management of outbreaks

      Georgia E Aitken, Alice L Holmes and Joseph E Ibrahim
      Med J Aust 2021; 214 (1): . || doi: 10.5694/mja2.50892
      Published online: 18 January 2021

      Recommendations to guide residential aged care facilities in preparing for and managing infectious disease outbreaks

      The coronavirus disease 2019 (COVID‐19) pandemic is devastating the residential aged care facility (RACF; eg, care homes, nursing homes, long term care) population. Globally, older people living in RACFs comprise almost half (47%) of all deaths from COVID‐19,1 which now exceeds 1.4 million deaths (at 27 November 2020).2

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      • 1 Victorian Institute of Forensic Medicine, Melbourne, VIC
      • 2 Queen Elizabeth Centre, Ballarat, VIC


      Correspondence: Joseph.Ibrahim@monash.edu
      Acknowledgements: 

      This work was supported by the Ballarat Health Service and the Department of Forensic Medicine, Monash University. None of the funders influenced the design, methods, subject recruitment, data collection, analysis or preparation of the article. We thank all the medical practitioners and nurses who participated in this study at short notice, and Safer Care Victoria for hosting and Ballarat Health Service for supporting Joseph Ibrahim’s sabbatical leave.

      Competing interests:

      No relevant disclosures.

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        Health and climate change MJA–Lancet Countdown report: Australia gets another failing grade in 2020 but shows signs of progress

        Nicholas J Talley, Fiona J Stanley, Tamara Lucas and Richard C Horton
        Med J Aust 2021; 214 (2): . || doi: 10.5694/mja2.50895
        Published online: 21 December 2020

        At the end of 2019 and into 2020, catastrophic fires in Australia consumed homes, lives, wildlife and land. Just as the fires subsided, Australia, like the rest of the world, faced another emergency — the COVID‐19 pandemic.1 It is instructive to reflect on lessons from the health disasters of the past year.

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        • 1 University of Newcastle, Newcastle, NSW
        • 2 Editor‐in-Chief, Medical Journal of Australia, Sydney, NSW
        • 3 Telethon Kids Institute, Perth, WA
        • 4 University of Western Australia, Perth, WA
        • 5 Executive Editor, The Lancet, London, UK
        • 6 Editor‐in-Chief, The Lancet, London, UK


        Competing interests:

        A complete list of Nick Talley’s disclosures is available at https://www.mja.com.au/journal/staff/editor-chief-professor-nick-talley.

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          The year of the ‘rona: an uncontrolled trial in verse

          Rob D Mitchell
          Med J Aust 2020; 213 (11): . || doi: 10.5694/mja2.50878
          Published online: 14 December 2020

          These days of 2020
          Have seen ravages aplenty
          An “unprecedented” year born in ash and smoke and flame.

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          • 1 Emergency and Trauma Centre, Alfred Hospital, Melbourne, VIC
          • 2 Monash University, Melbourne, VIC


          Correspondence: ro.mitchell@alfred.org.au

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            What the forks? A longitudinal quality improvement study tracking cutlery numbers in a public teaching and research hospital staff tearoom

            Mark Mattiussi, Amelia Livermore, Annabel Levido, Therese Starr, Melissa Lassig‐Smith, Janine Stuart, Cheryl Fourie and Joel Dulhunty
            Med J Aust 2020; 213 (11): . || doi: 10.5694/mja2.50862
            Published online: 14 December 2020

            Abstract

            Objectives: To evaluate the circulation lifespan of forks and teaspoons in an institutional tearoom.

            Design: Longitudinal quality improvement study, based on prospective tracking of marked teaspoons and forks.

            Setting: Staff tearoom in a public teaching and research hospital, Brisbane.

            Participants: Tearoom patrons blinded to the purposes of the study.

            Intervention: Stainless steel forks and teaspoons (18 each) were marked with red spots and introduced alongside existing cutlery (81 items) in the tearoom.

            Main outcome measures: Twice weekly count of marked forks and teaspoons for seven weeks; baseline and end of study count of all utensils on day 45.

            Results: The loss of marked teaspoons (six of 18) was greater than that of forks (one of 18) by the conclusion of the study period (P = 0.038). The overall rate of utensil loss was 2.2 per 100 days for teaspoons and spoons, and –2.2 per 100 days for forks and knives.

            Conclusions: Teaspoon disappearance is a more substantial problem than fork migration in a multidisciplinary staff tearoom, and may reflect different kleptomaniacal or individual appropriation tendencies. If giving cutlery this Christmas, give teaspoons, not forks. The symbolism of fork rebirth or resurrection is appropriate for both Christmas and Easter, and forks are also mighty useful implements for eating cake!

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            • 1 Royal Brisbane and Women's Hospital, Brisbane, QLD
            • 2 The University of Queensland, Brisbane, QLD
            • 3 Centre for Clinical Research, The University of Queensland, Brisbane, QLD


            Acknowledgements: 

            This study was undertaken with in kind support by the Royal Brisbane and Women’s Hospital Critical Care and Clinical Support Services Directorate; Cheryl Fourie contributed OPI Got the Blues for Red nail lacquer. We extend special thanks to Gordon McGurk, chair of the Royal Brisbane and Women’s Hospital Human Research Ethics Committee, whose insightful comments feature in our report.

            Competing interests:

            No relevant disclosures.

            • 1. Lim MS, Hellard ME, Aitken CK. The case of the disappearing teaspoons: longitudinal cohort study of the displacement of teaspoons in an Australian research institute. BMJ 2005; 331: 1498–1500.
            • 2. Metro North Hospital and Health Service (Brisbane). Vision and values. Updated July 2018. https://metro​north.health.qld.gov.au/about​-us/visio​n-and-values (viewed July 2020).
            • 3. Metro North Hospital and Health Service (Brisbane). Shaun Drummond: values in action at Metro North HHS [video]. 8 May 2018. https://vimeo.com/26852​3248 (viewed July 2020).
            • 4. Moore C. Australia’s “Shawshank redemption”: Some of the country’s most violent criminals use spoons and forks to remove bricks from their cell before plans to dig their way out are thwarted. Daily Mail Australia, 16 Sept 2019. https://www.daily​mail.co.uk/news/artic​le-74670​87/Austr​alias​-Shaws​hank-Redem​ption​-Priso​ners-caugh​t-diggi​ng-Port-Phill​ip-Prison.html (viewed July 2020).
            • 5. Hoyle C. Who stole all the forks? The science of missing office cutlery. Stuff (Wellington, New Zealand), 15 Apr 2017. https://www.stuff.co.nz/busin​ess/91303​980/who-stole​-all-the-forks​-the-scien​ce-of-missi​ng-offic​e-cutlery (viewed July 2020).
            • 6. Leedo E, Beck AM, Astrup A, Lassen AD. The effectiveness of healthy meals at work on reaction time, mood and dietary intake: a randomised cross‐over study in daytime and shift workers at an university hospital. Br J Nutr 2017; 118: 121–129.
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            • 8. Kelly PJ. Utilitarianism and distributive justice: the civil law and the foundations of Bentham’s economic thought. Utilitas 1989; 1: 62–81.
            • 9. Murphy N. Immortality versus resurrection in the Christian tradition. Ann N Y Acad Sci 2011; 1234: 76–82.
            • 10. Nuño‐Maganda MA, Herrera‐Rivas H, Torres‐Huitzil C, et al. On‐device learning of indoor location for WiFi fingerprint approach. Sensors (Basel) 2018; 18: 2202.
            • 11. Hornyak R, Lewis M, Sankaranarayan B. Radio frequency identification‐enabled capabilities in a healthcare context: an exploratory study. Health Informatics J 2016; 22: 562–578.

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              Scientists in pyjamas: characterising the working arrangements and productivity of Australian medical researchers during the COVID‐19 pandemic

              David G Chapman and Cindy Thamrin
              Med J Aust 2020; 213 (11): . || doi: 10.5694/mja2.50860
              Published online: 14 December 2020

              Abstract

              Objective: To characterise the working arrangements of medical research scientists and support staff in Australia during the COVID‐19 pandemic, and to evaluate factors (in particular: wearing pyjamas) that influence the self‐assessed productivity and mental health of medical institute staff working from home.

              Design: Prospective cohort survey study, 30 April – 18 May 2020.

              Setting, participants: Staff (scientists and non‐scientists) and students at five medical research institutes in Sydney, New South Wales.

              Main outcome measures: Self‐assessed overall and task‐specific productivity, and mental health.

              Results: The proportions of non‐scientists and scientists who wore pyjamas during the day were similar (3% v 11%; P = 0.31). Wearing pyjamas was not associated with differences in self‐evaluated productivity, but was significantly associated with more frequent reporting of poorer mental health than non‐pyjama wearers while working from home (59% v 26%; P < 0.001). Having children in the home were significantly associated with changes in productivity. Larger proportions of people with toddlers reported reduced overall productivity (63% v 32%; P = 0.008), and reduced productivity in writing manuscripts (50% v 17%; P = 0.023) and data analysis (63% v 23%; P = 0.002). People with primary school children more frequently reported reduced productivity in writing manuscripts (42% v 16%; P = 0.026) and generating new ideas (43% v 19%; P = 0.030). On a positive note, the presence of children in the home was not associated with changes in mental health during the pandemic. In contrast to established researchers, early career researchers frequently reported reduced productivity while working at home.

              Conclusions: Our findings are probably applicable to scientists in other countries. They may help improve work‐from‐home policies by removing the stigma associated with pyjama wearing during work and by providing support for working parents and early career researchers.

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              • 1 Woolcock Institute of Medical Research, Sydney, NSW
              • 2 University of Technology Sydney, Sydney, NSW
              • 3 The University of Sydney, Sydney, NSW


              Acknowledgements: 

              We thank the survey respondents for their participation and time, and for the candid free text responses that provided much amusement to the researchers, no doubt alleviating the impact of the COVID‐19 pandemic on our own mental health (and hopefully theirs as well). We also thank the many electronic devices and children’s television shows that provided the necessary distraction for our children, allowing this research to be completed.

              Competing interests:

              No relevant disclosures.

              • 1. National Health and Medical Research Council. COVID‐19: Guidance on clinical trials for institutions, HRECs, researchers and sponsors. Mar 2020. https://www.nhmrc.gov.au/sites/default/files/documents/attachments/ctprg-statement-clinical-trials-covid.pdf (viewed Oct 2020).
              • 2. Servick K, Cho A, Guglielmi G, et al. Updated: labs go quiet as researchers brace for long‐term coronavirus disruptions. Science [online], 16 Mar 2020. https://www.sciencemag.org/news/2020/03/updated-labs-go-quiet-researchers-brace-long-term-coronavirus-disruptions (viewed Sept 2020).
              • 3. van der Lippe TL, Lippényi Z. Co‐workers working from home and individual and team performance. New Technol Work Employ 2020; 35: 60–79.
              • 4. Chan C, Oey NE, Tan EK. Mental health of scientists in the time of COVID‐19. Brain Behav Immun 2020; 88: 956.
              • 5. Delmas H, Batail JM, Falissard B, et al. A randomised cross‐over study assessing the “blue pyjama syndrome” in major depressive episode. Sci Rep 2017; 7: 2629.
              • 6. Oliver D. Fighting pyjama paralysis in hospital wards. BMJ 2017; 357: j2096.
              • 7. Ferrers RA. Enhancing NBN’s value: comparing NBN with Australia's top 10 trading partners and OECD. Journal of Telecommunications and the Digital Economy 2020; 8(2): 1–17.
              • 8. Barnett A, Mewburn I, Schroter S. Working 9 to 5, not the way to make an academic living: observational analysis of manuscript and peer review submissions over time. BMJ 2019; 367: l6460.
              • 9. Inouye DW, Underwood N, Inouye BD, Irwin RE. Support early‐career field researchers. Science 2020; 368: 724.
              • 10. Levecque K, Anseel F, De Beuckelaer A, et al. Work organization and mental health problems in PhD students. Research Policy 2017; 46: 868–879.
              • 11. Johnson RL, Coleman RA, Batten NH, et al. The quiet crisis of PhDs and COVID‐19: reaching the financial tipping point [preprint]; version 2, 7 July 2020. Research Square 2020; https://doi.org/10.21203/rs.3.rs-36330/v2.
              • 12. Paula JR. Lockdowns due to COVID‐19 threaten PhD students’ and early‐career researchers’ careers. Nat Ecol Evol 2020; 4: 999.
              • 13. Blume C, Schmidt MH, Cajochen C. Effects of the COVID‐19 lockdown on human sleep and rest–activity rhythms. Curr Biol 2020; 30: R795–R797.
              • 14. Adam H, Galinsky AD. Enclothed cognition. J Exp Soc Psychol 2012; 48: 918–925.
              • 15. Moore A. “FIT TO SIT” in the emergency department. Nurs Stand 2017; 32: 22–23.
              • 16. Fernandez C. 14 perfect work‐from-home outfits that feel like pajamas without looking like them. Business Insider Australia [online], 1 Apr 2020. https://www.businessinsider.com.au/work-from-home-loungewear-clothes-to-try-2020-3 (viewed July 2020).
              • 17. Pinho‐Gomes AC, Peters S, Thompson K, et al. Where are the women? Gender inequalities in COVID‐19 research authorship. BMJ Global Health 2020; 5: e002922.
              • 18. Myers KR, Tham WY, Yin Y, et al. Unequal effects of the COVID‐19 pandemic on scientists. Nat Hum Behav 2020; 4: 880–883.
              • 19. Johnston E; Office of the Chief Scientist. The impact of the COVID‐19 pandemic on women in the STEM workforce. May 2020. https://www.science.org.au/covid19/women-stem-workforce (viewed Oct 2020).
              • 20. Gewin V. The career cost of COVID‐19 to female researchers, and how science should respond. Nature 2020; 583: 867–869.

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                Health and medicine in a pandemic year: moving from the “winter of despair” to the “spring of hope”

                Nicholas J Talley
                Med J Aust 2020; 213 (11): . || doi: 10.5694/mja2.50861
                Published online: 14 December 2020

                Despite a year of floods, fires and pestilence, we approach 2021 with optimism

                It has been a strange and disturbing year. Here in Australia, we would usually now be looking forward to the long summer break, the barbeques and the parties, the leisure time at home. Many would be traveling overseas to visit friends and family. But these have not been normal times.

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                Correspondence: ntalley@mja.com.au
                Acknowledgements: 

                I thank the tireless efforts of the Editorial team throughout 2020, without which the quality and timely publication of our Journal in print and online would not be possible: our departing Head of Publishing Content, Lilia Kanna; our former Senior Deputy Medical Editor, Christine Gee; Deputy Medical Editors Francis Geronimo, Robyn Godding, Tania Janusic, Selina Lo, Wendy Morgan, Aajuli Shukla, and Zoë Silverstone; our Scientific and Structural Editors, Paul Foley, Graeme Prince, and Laura Teruel; our Consultant Biostatistician, Elmer Villanueva; our News and Online Editor, Cate Swannell; our Graphic Designer, Leilani Widya; and our Senior Publishing Coordinator, Kerrie Harding.

                Competing interests:

                A complete list of disclosures is available at https://www.mja.com.au/journ​al/staff/editor-chief-professor-nick-talley

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                  Enough seagulls! Rural and remote communities need local researchers living, walking and talking with locals

                  Ruth Stewart
                  Med J Aust 2020; 213 (11): . || doi: 10.5694/mja2.50857
                  Published online: 7 December 2020

                  Researchers who live and work in community can respond to local clinical questions and provide feedback to community on their findings

                  Australians enjoy some of the best health outcomes in the world1 and those benefits are concentrated in our urban centres. Australians who live in rural and remote Australia have poorer health than their urban peers. The more remote your residence, the shorter your life span and the greater the burden of disease carried by your community.2


                  • Australian Government Department of Health, National Rural Health Commissioner, Canberra, ACT


                  Correspondence: NRHC@health.gov.au
                  Competing interests:

                  No relevant disclosures.

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                    The short to medium term benefits of the Australian colorectal cancer screening program

                    Sasha Taylor, Farhad Salimi, Arul Earnest, Alexander G Heriot, John R Zalcberg and Susannah Ahern
                    Med J Aust 2021; 214 (2): . || doi: 10.5694/mja2.50859
                    Published online: 7 December 2020

                    In Australia, colorectal cancer is the second most frequently diagnosed cancer and one of the most common causes of cancer‐related death.1 Evidence that bowel cancer screening reduces mortality through early detection and treatment2 led to the introduction in 2006 of the Australian National Bowel Cancer Screening Program (NBCSP), offering faecal occult blood testing. The NBCSP has been progressively rolled out, from covering those aged 55 or 65 years in 2006 to screening every two years for all Australians aged 50–74 years by 2020.3 During 2016–17, 41% of people invited to participate in screening did so.4 A recent review of the NBCSP found that the risk of death from colorectal cancer was lower for invitees, and that those who had cancer were diagnosed at an earlier stage of disease.5

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                    • 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC
                    • 2 Epworth HealthCare, Melbourne, VIC
                    • 3 Peter MacCallum Cancer Institute, Melbourne, VIC
                    • 4 University of Melbourne, Melbourne, VIC


                    Correspondence: susannah.ahern@monash.edu
                    Acknowledgements: 

                    The Binational Colorectal Cancer Audit is supported by the Colorectal Surgical Society of Australia and New Zealand (CSSANZ).

                    Competing interests:

                    No relevant disclosures.

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                      The 2020 special report of the MJA–Lancet Countdown on health and climate change: lessons learnt from Australia’s “Black Summer”

                      Ying Zhang, Paul J Beggs, Alice McGushin, Hilary Bambrick, Stefan Trueck, Ivan C Hanigan, Geoffrey G Morgan, Helen L Berry, Martina K Linnenluecke, Fay H Johnston, Anthony G Capon and Nick Watts
                      Med J Aust 2020; 213 (11): . || doi: 10.5694/mja2.50869
                      Published online: 3 December 2020

                      Summary

                      • The MJA–Lancet Countdown on health and climate change was established in 2017, and produced its first Australian national assessment in 2018 and its first annual update in 2019. It examines indicators across five broad domains: 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.
                      • In the wake of the unprecedented and catastrophic 2019–20 Australian bushfire season, in this special report we present the 2020 update, with a focus on the relationship between health, climate change and bushfires, highlighting indicators that explore these linkages.
                      • In an environment of continuing increases in summer maximum temperatures and heatwave intensity, substantial increases in both fire risk and population exposure to bushfires are having an impact on Australia’s health and economy. As a result of the “Black Summer” bushfires, the monthly airborne particulate matter less than 2.5 μm in diameter (PM2.5) concentrations in New South Wales and the Australian Capital Territory in December 2019 were the highest of any month in any state or territory over the period 2000–2019 at 26.0 μg/m3 and 71.6 μg/m3 respectively, and insured economic losses were $2.2 billion.
                      • We also found growing awareness of and engagement with the links between health and climate change, with a 50% increase in scientific publications and a doubling of newspaper articles on the topic in Australia in 2019 compared with 2018. However, despite clear and present need, Australia still lacks a nationwide adaptation plan for health. As Australia recovers from the compounded effects of the bushfires and the coronavirus disease 2019 (COVID‐19) pandemic, the health profession has a pivotal role to play. It is uniquely suited to integrate the response to these short term threats with the longer term public health implications of climate change, and to argue for the economic recovery from COVID‐19 to align with and strengthen Australia’s commitments under the Paris Agreement.

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                      • 1 University of Sydney, Sydney, NSW
                      • 2 Macquarie University, Sydney, NSW
                      • 3 Institute for Global Health, University College London, London, UK
                      • 4 Queensland University of Technology, Brisbane, QLD
                      • 5 University Centre for Rural Health, University of Sydney, Sydney, NSW
                      • 6 Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
                      • 7 Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
                      • 8 Monash Sustainable Development Institute, Monash University, Melbourne, VIC


                      Correspondence: ying.zhang@sydney.edu.au
                      Acknowledgements: 

                      We thank Robert Fawcett, John Nairn, and Elizabeth Ebert (from the Australian Bureau of Meteorology) for indicators 1.1 and 1.2. We thank Yang Liu (Emory University) and Bryan Vu (Emory University) for the Australian data used for indicator 1.3. Finally, we thank Marina Romanello (University College London) and Bradley Graves (Macquarie University) for assistance with visualisation of the indicator 1.3 data.

                      Competing interests:

                      No relevant disclosures.

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