Following the COVID-19 pandemic, humanity reverted to the small world behaviours that leave us vulnerable, perched as we are on our increasingly dynamic and unpredictable planet. Late last year, we watched the climate conference, COP28, continue the slow walk of humanity’s response to the changing…

Death in older people can be a consequence of the natural processes of their decline in biological old age, and there is no need to impose a pathological explanation, writes Dr Will Cairns. Several weeks ago the Australian Institute of Health and Welfare (AIHW) released How long can Australians live?,…

When it comes to allocating finite health care resources, a focus on longevity and “glamorous” high-tech disease treatment has been distracting our attention away from the benefits of disease prevention. Opportunity cost is an economics term that I first heard at a workshop on palliative care and…

Around the country, private maternity hospitals are closing, with enormous implications for many Australians needing care and for the health system as a whole. The COVID-19 pandemic has had profound effects on Australia’s health system, not least of which has been the enduring pressure on our public…

The final report of the Aged Care Taskforce is on the right track to improve the sector, but there needs to be more clarity to make sure it’s viable for the future, experts say. Released in mid-March, the final report of the Aged Care Taskforce provides a comprehensive strategy with recommendations…

We must urgently allocate more resources to upskilling general practitioners to better diagnose and manage Parkinson disease, particularly in regional areas, writes Dr Shanna Fealy. Parkinson disease is the second most prevalent neurodegenerative disease globally, trailing only Alzheimer disease. In…

With Queensland health care workers facing alarming levels of workplace violence and aggression, it is essential for health organisations to adopt a safety culture to stop this bad behaviour in its tracks, writes Dr Elise Witter. A recent night shift I completed in the emergency department (ED) ended…

New research has found notable inconsistencies in how different medical schools approach the teaching of women’s cardiac health, prompting calls for more comprehensive education on this topic.   Ischaemic heart disease ranks as the second leading cause of death among Australian women (here),…

The World Health Organization Framework Convention on Tobacco Control Tenth Conference of the Parties will discuss next generation tobacco control policies, as the incoming New Zealand Government receives strong international condemnation for repealing recent tobacco control measures. In November, the…

Wood heater smoke in the Australian Capital Territory is estimated to cause similar mortality to the extreme smoke of the Black Summer Bushfires of 2019–20, new research has found. The alarm has been sounded about the dangers of wood heater smoke, with new research showing just how deadly exposure…

Despite endometriosis being common among women in Australia, it remains unknown which patients will benefit from surgery, prompting the need for more local research, write Dr Samantha Mooney and Associate Professor Sarah Holdsworth-Carson. Endometriosis is a condition where tissue similar to the lining…

An action plan is needed to care for people with lipid disorders in Australia to reduce the burden of cardiovascular disease. Cardiovascular disease (CVD) remains our nation’s biggest killer, with a frequency of one in four deaths due to CVD. In 2020, approximately 56 700 people aged 25 years and…

Veterans are exposed to challenging life circumstances after military service, and Australia’s lax gambling regulations make it too easy for veterans to gamble and fall on hard times, write Sean Cowlishaw, Olivia Metcalf and Nicole Sadler. Suicide is a major public health issue globally and in Australia,…

Health services are increasingly being encouraged to reduce their carbon footprint. The Intergovernmental Panel on Climate Change (IPCC)’s most recent report outlines the significant threat posed to human health by the climate crisis. In turn, health care professionals and organisations are recognising…

New research has found poisonings from modified release paracetamol has not significantly declined, despite being up-scheduled to Schedule 3 (pharmacist-only medicine). A research letter published in The Medical Journal of Australia explores the impact of up-scheduling modified release (MR) paracetamol…

Indigenous health advocates hope that the launch of a new, dedicated First Nations health journal will help Close the Gap, while in a small town in the Northern Territory, six students have made local history by graduating with qualifications in Aboriginal Primary Health Care. Six students have graduated…

In an imperfect world, hard decisions and sacrifices must be made in order to maintain equity when it comes to allocating the finite resources of our health care system, writes Will Cairns ... IT is not often that the challenges of resource allocation make it on to the front pages of the paper, into…

I AM not ashamed to say that huge swathes of 2022 have completely baffled me. Welcome to the last issue of InSight+ for the year, by the way. We’ve had a cracking year, with our readership growing by about 40% on 2021 by user numbers, and our articles being clicked on just shy of 895 000 times in…

ON a recent flight I sat next to a businessman who was bemoaning the difficulty for workers facing a two-week wait for an appointment with a GP in the small mining community where he does business. He said that the lack of access to GPs was stifling economic development in rural and remote areas because…

A robust system would protect those of us who do the right thing, and a transparent, fair system would take a lot of the stress out of an honest day’s work. That’s going to take time, and it cannot be an excuse for continued expectations that doctors carry the burden of implementing unannounced…

AT some point in their career most doctors will be asked by one of their patients: “Well doc, how long have I got?” This is a question that has many possible underlying meanings for the patient, and any numerical answer is almost certain to be wrong. Generally, we can best help the patient by exploring…

OVER the past few weeks, there has been a flurry of reports on the decline of bulk billing, the shortage of GPs, and the small proportion of medical students and junior doctors who see GP training as their career path of first choice. One might be forgiven for thinking that these problems emerged only…

WHERE you live should not determine if you survive a serious accident, yet people who live in rural and remote Australia are up to five times more likely to die from their injuries than those in major cities. Time is the real killer. The farther you are from a tertiary hospital, your risk of death after…

PROFESSOR Edward O Wilson, who died on 26 December 2021, was a biologist who translated his exploration of the natural world into consideration of why and how we humans have come to be the way that we are, and of our place in the ecology of life on earth. Wilson was at heart a naturalist. Starting as…

IT always feels like a relief moving towards the end of the year, doesn’t it? Like somehow viruses and other global players will take a break just because the calendar is counting down. But if 2021 has taught us anything, it’s that pandemics don’t have much respect for summer holidays. This is…

FEW of us would be happy boarding a flight if we knew that the pilots did not have the knowledge and skills to deal with both the predictable and the unexpected challenges that might threaten a safe landing. Recently, I had a conversation with a pilot friend who (like many of his colleagues) is in the…

OVER the past few weeks, I have noticed that social commentators and journalists have been invoking the “social contract” in their musings. Noisy protests, induced by COVID-19, economic distress and the activities of anti-vaxxers, are forcing us to think about the balance between the rights and…

THERE is an acknowledged disparity in the health and wellbeing of residents of Australia’s rural areas and metropolitan centres. One often overlooked aspect of health inequity is infectious disease transmission and prevention. This is especially true with respect to mosquito-borne diseases that affect…

MANY people have puzzled over why animal species (including us) each have their particular natural maximum lifespans; why it is they deteriorate and die when they do. A new article by Colchero and colleagues in Nature Communications sheds some light on this issue and can help us understand why further…

RECENTLY, I watched a lecture that addressed the impact of global climate change on the future of Australia’s Wet Tropics World Heritage Area. Up here in the north of Queensland, we have the highest mountains in the state, including Mt Bartle Frere (1622 m) and Mt Bellenden Ker (1593 m). Bellenden…

THE global pandemic of SARS-CoV-2 has cut a swathe through healthcare workers across the globe. Significant numbers have died from COVID-19 acquired at work, and each of them has left behind a much larger number of grieving and distressed colleagues, not to mention their families. Many have had their…

FIFTEEN months ago, under the looming shadow of the SARS-CoV-2 pandemic, I wrote an article for InSight+ about the variety of uncertainties in what lay ahead. We did not know how the disease itself (ie, morbidity and mortality) and its disruptive effects on society and the economy at large would play…

IN staffrooms around the country, there are conversations going on about gender equity in the workplace. Medicine is no different. Some say that we have achieved gender equity in medicine, as there are now more commencing female medical students than male (51.3%). They are wrong. Let’s talk facts:…

EVEN before the onset of the COVID-19 pandemic, we have advocated, along with many others, for the public availability in Australia of ethically informed guidelines and protocols for triage decision making in the event that disaster overwhelms our health systems (here, here and here).   These are not…

NOT long ago, I was scanning through a recent edition of New Scientist when I noticed a report on an analysis of ancient human DNA sequencing that described the P1104A allele (variant) of a gene (TYK2) that increases human susceptibility to and mortality from tuberculosis. Kerner and colleagues found…

BORN in 1949, I was a generally healthy child, apart from experiencing several of the then common communicable diseases of childhood – as an infant I had whooping cough and in primary school hepatitis A, mumps, chicken pox and measles. Each of these diseases can kill or cause serious complications…

WHEN I searched Volumes 1 to 3b of the recently released final report of the Royal Commission into Aged Care Quality and Safety for their perspective on the role of palliative care in aged care, I found only limited use of the keywords of my trade: death/dying, palliative care, advance care planning,…

MANY years ago, I looked after a man who was dying at home from a lower body malignancy. He had had significant pain but, choosing not to travel over 1000 km to Brisbane for palliative radiotherapy, accepted an epidural and was being cared for at home by the local domiciliary nursing service and with…

SUMMER holidays are for pondering the past and preparing for the future. At the end of every year, many of us reflect on the events of the previous year and sometimes hark back to simpler times. The past 14 months have given us a jolting reminder of our entanglement in the complexities of the ever-changing…

REMEMBER 2016? That was the year the world lost some greats – George Michael, Carrie Fisher, Debbie Reynolds, Leonard Cohen, Mrs Brady, R2D2, Gene Wilder, Elie Wiesel, Muhammad Ali, Prince, David Bowie, Alan Rickman, Jon English – it was teen hero carnage. We couldn’t wait to see the calendar…

GREATER understanding of the distinctions between palliative care and voluntary assisted dying (VAD) – among clinicians and the public -- is urgently needed, say experts who have highlighted the complexities in navigating VAD in palliative care in the MJA. VAD was legalised in Victoria in June, 2019,…

THE founder of modern triage systems is often said to be Dominique Jean Larrey, a surgeon in Napoleon’s army also credited with the introduction of ambulances to the battlefields of the late 18th century. A swashbuckling figure and master of emergency amputation, Larrey established a categorical rule…