To be effective in protecting health care staff from coronavirus disease 2019 (COVID19), N95 and P2 respirators must fit correctly1 because the infection can be transmitted by aerosolised particles.2 To achieve an adequate seal, two processes that fulfil similar but different purposes are needed: fit testing and fit checking. Fit testing, a formal component of respiratory protection programs, quantitatively or qualitatively determines which brand, model, and size of respirator provides a proper fit for an individual. Trained operators conduct fit testing, which should be undertaken each time a new brand, type or model, or size of respirator is used, even if someone has previously achieved a proper seal with respirators of the same size, brand, or type. Fit checking should be undertaken each time a respirator is donned to confirm a proper seal, as respirators that have passed fit testing may not provide a proper seal for an individual if incorrectly positioned, if the nose bridge is not properly formed, or if facial hair interferes with the seal. Fit checking training improves the ability of respirator users to achieve proper seals.3
{"title":"N95 respirators for health care workers: the importance of fit, comfort, and usability","authors":"M. Peters","doi":"10.5694/mja2.51618","DOIUrl":"https://doi.org/10.5694/mja2.51618","url":null,"abstract":"To be effective in protecting health care staff from coronavirus disease 2019 (COVID19), N95 and P2 respirators must fit correctly1 because the infection can be transmitted by aerosolised particles.2 To achieve an adequate seal, two processes that fulfil similar but different purposes are needed: fit testing and fit checking. Fit testing, a formal component of respiratory protection programs, quantitatively or qualitatively determines which brand, model, and size of respirator provides a proper fit for an individual. Trained operators conduct fit testing, which should be undertaken each time a new brand, type or model, or size of respirator is used, even if someone has previously achieved a proper seal with respirators of the same size, brand, or type. Fit checking should be undertaken each time a respirator is donned to confirm a proper seal, as respirators that have passed fit testing may not provide a proper seal for an individual if incorrectly positioned, if the nose bridge is not properly formed, or if facial hair interferes with the seal. Fit checking training improves the ability of respirator users to achieve proper seals.3","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131636542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Keay, Kam Chun Ho, Kris Rogers, P. McCluskey, Andrew J. White, N. Morlet, J. Ng, E. Lamoureux, K. Pesudovs, F. Stapleton, S. Boufous, Jessie Huang-Lung, A. Palagyi
To compare fall incidence, and visual acuity and refractive status, before surgery and after first and second eye cataract surgery.
比较第一眼和第二眼白内障手术前后的跌倒发生率、视力和屈光状态。
{"title":"The incidence of falls after first and second eye cataract surgery: a longitudinal cohort study","authors":"L. Keay, Kam Chun Ho, Kris Rogers, P. McCluskey, Andrew J. White, N. Morlet, J. Ng, E. Lamoureux, K. Pesudovs, F. Stapleton, S. Boufous, Jessie Huang-Lung, A. Palagyi","doi":"10.5694/mja2.51611","DOIUrl":"https://doi.org/10.5694/mja2.51611","url":null,"abstract":"To compare fall incidence, and visual acuity and refractive status, before surgery and after first and second eye cataract surgery.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"857 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131339112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seth Westhead, Quinton Appleby, Brittney Andrews, Tina Brodie, A. Brown, K. Canuto, Josh Cooke, Mahlia Garay, Thomas Harrington, Djai Hunter, Corey Kennedy, Jaeda Lenoy, Olivia Lester, Hannah McCleary, O. Pearson, Lorraine Randall, Rachel Reilly, Hamish Rose, Daniel Rosendale, Jakirah Telfer, P. Azzopardi
Adolescence (10– 24 years of age) is now recognised as a key developmental window for the health of individuals, their communities and the next generation.1 Onethird of the Aboriginal and Torres Strait Islander (Indigenous) population in Australia are adolescents,2 and our earlier work has shown that Indigenous adolescents have distinct health needs largely unmet by existing policies and services.3 Fundamentally, adolescence is a dynamic developmental phase characterised by transitions in the social and cultural determinants of health – — key targets for addressing health inequities experienced by Indigenous Australians. For these reasons, adolescent health is a core focus for health policy and action, not only for Indigenous peoples but all populations.
{"title":"The need for a roadmap to guide actions for Aboriginal and Torres Strait Islander adolescent health: youth governance as an essential foundation","authors":"Seth Westhead, Quinton Appleby, Brittney Andrews, Tina Brodie, A. Brown, K. Canuto, Josh Cooke, Mahlia Garay, Thomas Harrington, Djai Hunter, Corey Kennedy, Jaeda Lenoy, Olivia Lester, Hannah McCleary, O. Pearson, Lorraine Randall, Rachel Reilly, Hamish Rose, Daniel Rosendale, Jakirah Telfer, P. Azzopardi","doi":"10.5694/mja2.51592","DOIUrl":"https://doi.org/10.5694/mja2.51592","url":null,"abstract":"Adolescence (10– 24 years of age) is now recognised as a key developmental window for the health of individuals, their communities and the next generation.1 Onethird of the Aboriginal and Torres Strait Islander (Indigenous) population in Australia are adolescents,2 and our earlier work has shown that Indigenous adolescents have distinct health needs largely unmet by existing policies and services.3 Fundamentally, adolescence is a dynamic developmental phase characterised by transitions in the social and cultural determinants of health – — key targets for addressing health inequities experienced by Indigenous Australians. For these reasons, adolescent health is a core focus for health policy and action, not only for Indigenous peoples but all populations.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118199828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this article we ask: to what extent is person‐centred care truly embedded in our system, and are we making the most of the policy levers that could help? We describe person‐centred care, shine a light on deficits in the health system, and point to some policy enablers to support person‐centred care. Cultural change and a commitment to value‐based health care are required. We highlight the merit in adopting and acting on patient‐reported measures as an indicator of what matters to the patient, the need for integrated data systems, and the role of a co‐creation approach. Most importantly, we underscore the importance of funding reform and consumer leadership.
{"title":"Creating person‐centred health care value together","authors":"Paresh Dawda, Tina Janamian, L. Wells","doi":"10.5694/mja2.51531","DOIUrl":"https://doi.org/10.5694/mja2.51531","url":null,"abstract":"In this article we ask: to what extent is person‐centred care truly embedded in our system, and are we making the most of the policy levers that could help? We describe person‐centred care, shine a light on deficits in the health system, and point to some policy enablers to support person‐centred care. Cultural change and a commitment to value‐based health care are required. We highlight the merit in adopting and acting on patient‐reported measures as an indicator of what matters to the patient, the need for integrated data systems, and the role of a co‐creation approach. Most importantly, we underscore the importance of funding reform and consumer leadership.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131033585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelene True, Tina Janamian, Paresh Dawda, T. Johnson, Gary Smith
Australia’s primary health care system works well for most Australians, but 20% of people live with multimorbidity, often receiving fragmented care in a complex system. Australia’s 10‐year plan for primary health care recognises that person‐centred care is essential to securing universal health coverage, improving health outcomes and achieving an integrated sustainable health system. The Health Care Homes trial tested a new model of person‐centred care for people with chronic and complex health conditions. This model demonstrated that change can be achieved with dedicated transformational support and highlighted the importance of enablers and reform streams that are now established in the 10‐year plan.
{"title":"Lessons from the implementation of the Health Care Homes program","authors":"Angelene True, Tina Janamian, Paresh Dawda, T. Johnson, Gary Smith","doi":"10.5694/mja2.51537","DOIUrl":"https://doi.org/10.5694/mja2.51537","url":null,"abstract":"Australia’s primary health care system works well for most Australians, but 20% of people live with multimorbidity, often receiving fragmented care in a complex system. Australia’s 10‐year plan for primary health care recognises that person‐centred care is essential to securing universal health coverage, improving health outcomes and achieving an integrated sustainable health system. The Health Care Homes trial tested a new model of person‐centred care for people with chronic and complex health conditions. This model demonstrated that change can be achieved with dedicated transformational support and highlighted the importance of enablers and reform streams that are now established in the 10‐year plan.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129694379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tina Janamian, Paresh Dawda, G. Crawford, Angelene True, Melanie Wentzel, Donald Whaleboat, Tamieka Fraser, Christopher Edwards
The role of culture in palliative care for Aboriginal and Torres Strait Islander peoples builds on over 60 000 years of history and includes meaningful practices to support a good “finishing up”. The Gwandalan National Palliative Care Project aims to build capacity in those who deliver palliative care to embed culturally responsive care in all end‐of‐life settings. Community consultation, value co‐creation and user‐centred design ensured that diverse Aboriginal and Torres Strait Islander perspectives informed the Gwandalan curriculum. Emerging communities of practice serve as yarning circles where barriers to and enablers of service delivery can be shared and addressed collaboratively.
{"title":"Building capacity in those who deliver palliative care services to Aboriginal and Torres Strait Islander peoples","authors":"Tina Janamian, Paresh Dawda, G. Crawford, Angelene True, Melanie Wentzel, Donald Whaleboat, Tamieka Fraser, Christopher Edwards","doi":"10.5694/mja2.51528","DOIUrl":"https://doi.org/10.5694/mja2.51528","url":null,"abstract":"The role of culture in palliative care for Aboriginal and Torres Strait Islander peoples builds on over 60 000 years of history and includes meaningful practices to support a good “finishing up”. The Gwandalan National Palliative Care Project aims to build capacity in those who deliver palliative care to embed culturally responsive care in all end‐of‐life settings. Community consultation, value co‐creation and user‐centred design ensured that diverse Aboriginal and Torres Strait Islander perspectives informed the Gwandalan curriculum. Emerging communities of practice serve as yarning circles where barriers to and enablers of service delivery can be shared and addressed collaboratively.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132530863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janet R. Mccoll-Kennedy, Teegan Green, M. V. van Driel
In this article, we propose that value is a multidimensional construct, highlighting the need for a multi‐actor service ecosystem perspective of value in primary care clinics. We argue that different actors in the service ecosystem — for example, patients, their family members and carers, medical practitioners, practice managers, nurses, allied health workers, receptionists and practice owners — may value different aspects of health service delivery more highly than others. We describe ways in which value is perceived among actors in primary care, and highlight the need for a greater focus on a broader view of value involving the various stakeholders to realise better outcomes.
{"title":"Value in primary care clinics: a service ecosystem perspective","authors":"Janet R. Mccoll-Kennedy, Teegan Green, M. V. van Driel","doi":"10.5694/mja2.51524","DOIUrl":"https://doi.org/10.5694/mja2.51524","url":null,"abstract":"In this article, we propose that value is a multidimensional construct, highlighting the need for a multi‐actor service ecosystem perspective of value in primary care clinics. We argue that different actors in the service ecosystem — for example, patients, their family members and carers, medical practitioners, practice managers, nurses, allied health workers, receptionists and practice owners — may value different aspects of health service delivery more highly than others. We describe ways in which value is perceived among actors in primary care, and highlight the need for a greater focus on a broader view of value involving the various stakeholders to realise better outcomes.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126312207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irene Ng, B. Kave, F. Begg, C. Bodas, R. Segal, D. Williams
To compare the performance of four N95 respirator types with respect to quantitative fit test pass rate and health care worker‐rated usability and comfort.
比较四种N95口罩在定量贴合测试合格率和卫生保健工作者评价的可用性和舒适度方面的性能。
{"title":"N95 respirators: quantitative fit test pass rates and usability and comfort assessment by health care workers","authors":"Irene Ng, B. Kave, F. Begg, C. Bodas, R. Segal, D. Williams","doi":"10.5694/mja2.51585","DOIUrl":"https://doi.org/10.5694/mja2.51585","url":null,"abstract":"To compare the performance of four N95 respirator types with respect to quantitative fit test pass rate and health care worker‐rated usability and comfort.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114331553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We undertook a retrospective analysis of endoscopic procedures at Monash Health during the 2020 lockdowns (24 March – 1 May, 2 August – 28 September 2020) and the corresponding periods in 2019. All patients underwent preprocedure COVID19 screening (health questionnaire, polymerase chain reaction testing). We collected information on patient demographic characteristics, procedure type, COVID19 status, and endoscopic outcomes (cancer and polyp detection). We assessed differences in procedure volumes and rates during the 2019 and 2020 periods in χ2 tests; P < 0.05 was deemed statistically significant. The overall missing cancer number was estimated as the difference between the expected number of cancers (based on procedure volume and detection rate for 2019) and the number of cancers identified during the 2020 lockdowns.1 Our study was approved by the Monash Health Human Research Ethics Committee (QA/68490/MonH2020232763).
{"title":"Endoscopy volumes and outcomes at a tertiary Melbourne centre during the 2020 COVID‐19 lockdowns","authors":"Daniel Schneider, M. Swan, S. Hew","doi":"10.5694/mja2.51539","DOIUrl":"https://doi.org/10.5694/mja2.51539","url":null,"abstract":"We undertook a retrospective analysis of endoscopic procedures at Monash Health during the 2020 lockdowns (24 March – 1 May, 2 August – 28 September 2020) and the corresponding periods in 2019. All patients underwent preprocedure COVID19 screening (health questionnaire, polymerase chain reaction testing). We collected information on patient demographic characteristics, procedure type, COVID19 status, and endoscopic outcomes (cancer and polyp detection). We assessed differences in procedure volumes and rates during the 2019 and 2020 periods in χ2 tests; P < 0.05 was deemed statistically significant. The overall missing cancer number was estimated as the difference between the expected number of cancers (based on procedure volume and detection rate for 2019) and the number of cancers identified during the 2020 lockdowns.1 Our study was approved by the Monash Health Human Research Ethics Committee (QA/68490/MonH2020232763).","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132796374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jian Blundell, R. Gandy, Jacqueline Close, L. Harvey
To estimate the proportions of people aged 50 years or more with mild gallstone pancreatitis who undergo index cholecystectomy (during their initial hospital admission) or interval cholecystectomy (during a subsequent admission); to compare outcomes following index and interval cholecystectomy; and to identify factors associated with undergoing interval cholecystectomy.
{"title":"Cholecystectomy for people aged 50 years or more with mild gallstone pancreatitis: predictors and outcomes of index and interval procedures","authors":"Jian Blundell, R. Gandy, Jacqueline Close, L. Harvey","doi":"10.5694/mja2.51492","DOIUrl":"https://doi.org/10.5694/mja2.51492","url":null,"abstract":"To estimate the proportions of people aged 50 years or more with mild gallstone pancreatitis who undergo index cholecystectomy (during their initial hospital admission) or interval cholecystectomy (during a subsequent admission); to compare outcomes following index and interval cholecystectomy; and to identify factors associated with undergoing interval cholecystectomy.","PeriodicalId":221402,"journal":{"name":"The Medical Journal of Australia","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131199865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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