Medical Journal of Australia最新文献

{"title":"Barriers and Facilitators to Timely Detection and Optimal Management of Chronic Wet Cough in Aboriginal Children Across Australia From the Perspective of Health Care Providers: A Qualitative Study","authors":"Gloria T. Y. Lau,&nbsp;Pamela Laird,&nbsp;Robyn Aitken,&nbsp;Melanie Barwick,&nbsp;Liam Bedford,&nbsp;Emily R. Bowden,&nbsp;Corey Dalton,&nbsp;Jamie Everingham,&nbsp;Angela Fuery,&nbsp;Reece Griffin,&nbsp;Neha Jain,&nbsp;Mina Kinghorn,&nbsp;Renae Knapp,&nbsp;Gabrielle B. McCallum,&nbsp;Peter Morris,&nbsp;Richard Norman,&nbsp;Peter C. Richmond,&nbsp;Aarti Saiganesh,&nbsp;Slade Sibosado,&nbsp;Maree Toombs,&nbsp;Roz Walker,&nbsp;Joan Wilson,&nbsp;Anne B. Chang,&nbsp;André Schultz","doi":"10.5694/mja2.70312","DOIUrl":"10.5694/mja2.70312","url":null,"abstract":"<div>\u0000 <section>\u0000 <h3> Objective</h3>\u0000 <p>To identify barriers and facilitators to the timely detection and optimal management of chronic wet cough (CWC) in children from the perspective of health care providers (HCPs) across primary care clinics providing services to Australian Aboriginal people in multiple, diverse communities.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Study Type</h3>\u0000 <p>Qualitative participatory action research study.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Setting and Participants</h3>\u0000 <p>Eight Australian primary care clinics across three states and territories. Semi-structured interviews and focus groups were conducted with 83 HCPs from eight primary care clinics across metropolitan, regional and remote health service settings between May 2021 and July 2023.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Main Outcome Measures</h3>\u0000 <p>Barriers to, and facilitators of, detection and optimal management of CWC in Aboriginal children in primary care settings.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Results</h3>\u0000 <p>Key barriers identified included limited condition-specific knowledge, time constraints and competing priorities. HCPs identified key facilitators, such as the need for additional training, educational resources and various modifications to clinic systems. Barriers and facilitators were similar across settings. Proposed solutions varied and were based on several factors, such as community size, availability of existing infrastructure and local preferences. In addition, HCPs highlighted the importance of a culturally secure environment in fostering engagement and communication with Aboriginal families.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Conclusion</h3>\u0000 <p>Although the barriers and facilitators to the detection and management of CWC in Aboriginal children were largely consistent across settings, solutions must be tailored to each community's unique circumstances. A comprehensive approach is required to overcome barriers and deliver the intervention within a culturally secure framework.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs of Delivering the Hep B PAST Model of Care in Remote Australia: A Retrospective Pre–Post Study","authors":"Hoa Nguyen,&nbsp;Anh Le Tuan Nguyen,&nbsp;Paula Binks,&nbsp;Melita McKinnon,&nbsp;Emily Vintour-Cesar,&nbsp;Karen Wills,&nbsp;Nicola Stephens,&nbsp;Benjamin Cowie,&nbsp;Joshua S. Davis,&nbsp;Yuejen Zhao,&nbsp;Peter Nihill,&nbsp;Julie A. Campbell,&nbsp;Andrew J. Palmer,&nbsp;Jane Davies,&nbsp;Barbara de Graaff","doi":"10.5694/mja2.70292","DOIUrl":"10.5694/mja2.70292","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To estimate the direct medical costs of the Hep B Partnership Program (Hep B PAST) model of care compared with chronic hepatitis B (CHB) usual care from the health system perspective (Northern Territory (NT) Department of Health and the Commonwealth).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Type&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Retrospective cohort study (2014–2023) that linked primary care with inpatient, emergency, outpatient and outreach datasets. Costs were applied using National Weighted Activity Units, the Pharmaceutical Benefits Scheme and NT Government costings. A pre- and post-implementation design from a health system perspective was applied, with costs in 2023 Australian dollars.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Remote communities in the NT, Australia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cohort included all First Nations people living with CHB who were attending a clinic in a remote community that had consented to the Hep B PAST program, and who received care between 1 July 2014 and 31 May 2023.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Annual mean and median healthcare costs per contact and per individual across service types, with comparisons of annual mean costs per individual between pre- and post-Hep B PAST using partially overlapping &lt;i&gt;t&lt;/i&gt;-tests.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 1063 First Nations individuals with CHB, annual median costs per individual were similar for usual care ($639 [interquartile range, $366–1156]) and Hep B PAST ($770 [interquartile range, $400–1272]); mean costs were also similar for usual care versus Hep B PAST ($1701 vs. $1970; &lt;i&gt;p&lt;/i&gt; = 0.12). By service type, annual median costs were similar for inpatient services ($7777 vs. $7795), primary care ($327 vs. $302) and outpatient visits ($1985 vs. $1858), and higher for Hep B PAST for emergency services ($1339 vs. $1672) and outreach care ($373 vs. $746).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In remote First Nations communities, Hep B PAST was delivered with a modest increase in direct medical costs compared with usual care. These findings can be used to inform future cost-effective evaluations. Future cost savings from decreased hepatocellular carcinoma and liver","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buruli Ulcer Acquired From Ringtail Possum Rescue","authors":"Daniel P. O'Brien,&nbsp;Naomi Clarke,&nbsp;Sara Bonnici,&nbsp;Mohammad A. Hussain","doi":"10.5694/mja2.70307","DOIUrl":"10.5694/mja2.70307","url":null,"abstract":"<div>\u0000 \u0000 <p>We describe the first reported Buruli ulcer case likely acquired from a ringtail possum scratch, which represents a newly recognised mechanism for Buruli ulcer acquisition. We aim to alert health practitioners of this possibility in order to educate patients and facilitate early Buruli ulcer diagnosis, which reduces morbidity and allows less complex treatment. We also aim to influence public health messaging around the risk of Buruli ulcer acquisition from handling sick or injured possums.</p>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Once Bitten’: A Case of Tetanus Following Snakebite in Australia","authors":"Adrian A. S. Doherty,&nbsp;Naomi N. E. Clarke,&nbsp;Sarah Fletcher,&nbsp;Sarah Huffam,&nbsp;Camille V. Awburn,&nbsp;Eugene Athan","doi":"10.5694/mja2.70308","DOIUrl":"10.5694/mja2.70308","url":null,"abstract":"<div>\u0000 \u0000 <p>We present a case of tetanus following a snakebite in Victoria, Australia. An otherwise healthy 58-year-old woman presented following suspected Tiger snake (<i>Notechis scutatus</i>) bite with envenomation. She was not up-to-date with tetanus vaccination and was not offered a booster vaccination. She re-presented 12 days later with features consistent with tetanus infection and was treated with tetanus immunoglobulin and metronidazole with clinical improvement. Snakebites remain a risk for tetanus infection and the assessment of tetanus risk should be included within clinical guidelines for Australian healthcare settings.</p>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty Liver Disease in Australia: A Narrative Review on the Epidemiology, Natural History, Prognostication and Management in People With Metabolic Dysfunction","authors":"Karl Vaz,&nbsp;Daniel Clayton-Chubb,&nbsp;William W. Kemp,&nbsp;Stuart K. Roberts,&nbsp;Ammar Majeed","doi":"10.5694/mja2.70310","DOIUrl":"10.5694/mja2.70310","url":null,"abstract":"","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mending the Road: A Way Forward From Silence and Silencing","authors":"Ayman Hamdan,&nbsp;Anisa J. N. Jafar","doi":"10.5694/mja2.70311","DOIUrl":"10.5694/mja2.70311","url":null,"abstract":"","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Fibrosis Stratification: Integrating Behavioural, Metabolic and Policy-Level Interventions in Metabolic Dysfunction-Associated Steatotic Liver Disease","authors":"Yousef Hakimi,&nbsp;Prarthana Thiagarajan,&nbsp;Michael Braude","doi":"10.5694/mja2.70309","DOIUrl":"10.5694/mja2.70309","url":null,"abstract":"","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Quality of Care for Aboriginal and Torres Strait Islander Peoples Treated by Emergency Medical Services for Stroke in Victoria, Australia: Retrospective Analysis of Linked Data","authors":"Candice Menezes,&nbsp;Ziad Nehme,&nbsp;Luke J. Burchill,&nbsp;Tegwyn McManamny,&nbsp;Angela Dos Santos,&nbsp;Michelle Crilly,&nbsp;Luke P. Dawson,&nbsp;Benjamin Clissold,&nbsp;David Anderson,&nbsp;Emily Nehme","doi":"10.5694/mja2.70303","DOIUrl":"https://doi.org/10.5694/mja2.70303","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To examine the epidemiology of stroke and transient ischaemic attack (TIA), and quality of care provided to Aboriginal and Torres Strait Islander (‘Indigenous’) patients presenting to emergency medical services (EMSs) with stroke or TIA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Retrospective population-based data linkage study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting, Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Victoria, Australia. Patients aged ≥ 18 years with hospital-confirmed stroke or TIA who presented to EMSs between 1 January 2015 and 30 June 2019 and were successfully linked with hospital or mortality datasets.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty- and 90-day mortality, crude and age-standardised incidence rates, EMS quality of care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 32,163 patients, 287 (0.9%) were Indigenous. Indigenous patients were younger than non-Indigenous patients (median age, 62 vs. 77 years, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Age-standardised incidence of EMS attendance was higher within the Indigenous population (343 vs. 144 per 100,000 person-years; incidence rate ratio, 2.383 [95% confidence interval (CI), 2.084–2.711]). Rates of call-taker identification of stroke or TIA and hospital diagnoses were comparable; however, Indigenous patients were less likely to receive a stroke assessment from paramedics (166/285 [58.2%] vs. 21,271/31,605 [67.3%]; &lt;i&gt;p&lt;/i&gt; = 0.001) and more frequently taken to stroke-capable hospitals (257/275 [93.5%] vs. 27,371/30,647 [89.3%]; &lt;i&gt;p&lt;/i&gt; = 0.027), but less frequently taken to endovascular thrombectomy-capable hospitals (67/275 [24.4%] vs. 10,015/30,647 [32.7%]; &lt;i&gt;p&lt;/i&gt; = 0.003). Adjusted mortality was similar between groups (30 days: hazard ratio, 0.814 [95% CI, 0.518–1.279]; 90 days: hazard ratio, 0.805 [95% CI, 0.534–1.214]). However, age-standardised incidence of 90-day mortality was higher within the Indigenous population (39 vs. 24 per 100,000 person-years; incidence rate ratio, 1.621 [95% CI, 1.031–2.398]). Indigenous patients also more often recontacted EMSs for any reason within 90 days (subdistribution hazard ratio, 1.548 [95% CI, 1.194–2.007]).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The age-standardised incidence of EMS attendance for stroke in the Indigenous population was more than double that for the non-Indigenous popu","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 10","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.70303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intranasal Adrenaline Use for the Management of Insect Venom-Induced Anaphylaxis","authors":"Thomas J. Young,&nbsp;Wilhelmina R. F. Johnson,&nbsp;Braydon L. Pennington,&nbsp;Troy Wanandy,&nbsp;Wun Y. Lau,&nbsp;Thanh-Thao A. Le","doi":"10.5694/mja2.70306","DOIUrl":"10.5694/mja2.70306","url":null,"abstract":"<div>\u0000 \u0000 <p>Intranasal adrenaline has recently become available in Australia as a needle-free alternative to adrenaline autoinjectors for anaphylaxis management. Intranasal adrenaline may be particularly suitable for patients with barriers to adrenaline autoinjector usage, such as needle aversion or poor compliance with autoinjector carriage. However, although the data supporting real-world efficacy of intranasal adrenaline for anaphylaxis are growing, there is no published evidence confirming its efficacy in insect venom anaphylaxis. We report three cases of intranasal adrenaline (neffy, CSL Seqirus, Victoria, Australia) used to treat insect venom-induced anaphylaxis. Clinicians should be aware of the availability and current level of evidence for intranasal adrenaline for anaphylaxis management.</p>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living Evidence for Australian Pregnancy and Postnatal Care (LEAPP): Transforming the Australian Pregnancy and Postnatal Care Guidelines","authors":"Miranda S. Cumpston,&nbsp;Anneliese Arno,&nbsp;Shaira N. Baptista,&nbsp;Shannon Barnes,&nbsp;Zoe Bradfield,&nbsp;Samantha P. Chakraborty,&nbsp;Caroline S. E. Homer,&nbsp;Stefan C. Kane,&nbsp;Nisha Khot,&nbsp;Steve McDonald,&nbsp;Steven McGloughlin,&nbsp;Tanya Millard,&nbsp;Jeremy J. N. Oats,&nbsp;Loyal Pattuwage,&nbsp;Matthew Quigley,&nbsp;Abdulbasit Seid,&nbsp;Rachel Silk,&nbsp;Alecia Staines,&nbsp;Anneliese Synnot,&nbsp;Alison Teate,&nbsp;Heath White,&nbsp;Tari Turner,&nbsp;the LEAPP Guideline Development Group","doi":"10.5694/mja2.70301","DOIUrl":"10.5694/mja2.70301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Living Evidence for Australian Pregnancy and Postnatal Care (LEAPP) program was established in 2023 to update and transition the <i>Australian Pregnancy Care Guidelines</i> into living guidelines and to establish new, living <i>Australian Postnatal Care Guidelines</i>. The program is a collaboration of the Australian Living Evidence Collaboration (ALEC), the Australian College of Midwives, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and 23 other Australian health organisations. The guidelines are developed using methods designed to meet the National Health and Medical Research Council standards. Clinical questions are prioritised by clinician and lived experience input. For each prioritised question, evidence is reviewed using systematic methods (existing published reviews or conducted de novo), contextual factors such as feasibility and equity are considered and new or updated recommendations are drafted. A lived experience panel and multidisciplinary clinical panels review draft recommendations. Unanimous endorsement by all 25 partner organisations is required before publication. Surveillance searches are conducted for most topic areas every 6 months. New and updated content is progressively added to the published guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Recommendations</h3>\u0000 \u0000 <p>As of August 2026 (version 11), the <i>Australian Pregnancy Care Guidelines</i> include 277 recommendations on more than 80 topics; 229 are new or updated since 2023. The new <i>Australian Postnatal Care Guidelines</i> include 149 recommendations on more than 20 topics. The guidelines are published online at https://livingevidence.org.au/living-guidelines/leapp/.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Changes in Management as a Result of the Guideline</h3>\u0000 \u0000 <p>New or updated recommendations include continuity of care, assessment and support on vaping, increased testing for syphilis, reduced testing for proteinuria, guidance on progesterone and cervical cerclage to prevent preterm birth, bereavement support, assessment and support for psychological birth trauma, screening for family violence, side sleeping in later pregnancy and a recommendation against vitamin D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"224 9","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}