The Medical journal of Australia
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While the Australian National Health and Medical Research Council guideline document of 2009 on reducing health risks from drinking alcohol provided sensible advice for public policy on alcohol, it appeared to dismiss the cardiovascular benefits of low to moderate consumption. Undue prominence was given to a hypothesis from a single research group that the well documented J-curve relationship of lower risk of ischaemic heart disease events with low to moderate intake alcohol consumption may have been due to a misclassification of drinking patterns. ⋯ Recent studies have separated recent abstainers from lifetime abstainers and the misclassification hypothesis has not been confirmed as an explanation for the J-shaped curve. The J-shaped relationship between alcohol consumption and cardiovascular risk has been studied and confirmed in multiple studies; while it complicates the formulation of public policy on alcohol consumption, it cannot be dismissed.
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To describe risk factors for recurrence after exclusive surgical treatment of Mycobacterium ulcerans infection. ⋯ Recurrence rates after exclusive surgical treatment of M. ulcerans disease in an Australian cohort are high, with increased rates associated with immunosuppression or positive histological margins.
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To describe trends in hospitalisation for sport-related concussion. ⋯ The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 2013s. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia.
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To define current patterns of flexible (part-time) surgical training in Australasia, determine supply and demand for part-time positions, and identify work-related factors motivating interest in flexible training. ⋯ There is a striking mismatch between demand for flexible surgical training and the number of trainees currently in part-time training positions in Australia and New Zealand. Efforts are needed to facilitate part-time surgical training.
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Open disclosure (OD) after adverse health care events is the subject of a national standard that has been implemented in state health policy documents, and is included in the Medical Board of Australia's code of conduct for doctors. Nevertheless, doctors have been slow to embrace the practice of OD. ⋯ There are a number of barriers to the better uptake and implementation of OD, including perceptions of legal risk, lack of education and training, reluctance to admit error, uncertainty concerning what and how much to disclose, and the variations in state and territory "apology laws". The implementation of OD could be improved by making apology laws consistent across jurisdictions, including providing "blanket" cover for admissions of fault; by preventing insurers voiding contracts when apologies are made, either through self-regulation or legislation; and by inserting OD obligations into different structures within the health system.