Series: Volume 11, Issue 1 2022

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Feature Articles

A bioethical case against using human challenge trials for COVID-19

Abstract

COVID-19 is a global health emergency for which vaccines are a key solution. A human challenge trial (HCT) is a way of studying vaccine efficacy where healthy volunteers are deliberately infected, in contrast to traditional phase III trials. Nearly 40 000 people worldwide have expressed willingness to participate in COVID-19 HCTs in hopes of accelerating vaccine development. This essay argues that HCTs may not only fail to deliver on this aim, but violate the bioethical principles of autonomy, beneficence, non-maleficence, and justice. For now, in the case of COVID-19, HCTs are inferior to tried-and-true phase III trials, which have already generated several vaccines at unprecedented speed.

Learning Points

  1. COVID-19 is a global health emergency for which vaccines are a key solution.
  2. The risks of human challenge trials for COVID-19 outweigh their benefits in terms of the bioethical principles of autonomy, beneficence, non-maleficence, and justice.
  3. Since traditional phase III trials have generated COVID-19 vaccines at unprecedented speed, there is currently negligible role for human challenge trials for COVID-19.

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Uncategorized Book Reviews

Book review – Are you passionate about paediatrics?

Over the last half century, the practice of primary care for children has evolved tremendously. Although paediatrics is a relatively young field compared to other specialties, like a child, it has grown to become an integral part of the heath system. The previous international award-winning third edition, Paediatrics and Child Health [1]is succeeded by the latest edition Essential Paediatrics and Child Health [2], which includes twenty-six chapters that are covered in a 520-page textbook. This beautifully presented book combines Prof. Mary Rudolf’s four decades of experience as a consultant paediatrician and Professor of Child Health at Leeds University with that of Prof. Anthony Luder and Dr. Kerry Jeavons who both are experts in the field of paediatric medicine.

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Categories
Case Reports

An unusual presentation of perforated appendix mimicking a liver abscess in an Aboriginal male

A case report of a 26-year-old Aboriginal male in Alice Springs with an unusual presentation of perforated appendix mimicking a liver abscess.

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Categories
Case Reports

Skin Rash In a Patient Using Antiepileptic Medications, What It Could Be?

Abstract

Introduction:  Rash is one of the commonest presentations that doctors can be asked to review. Studying this case strengthens the understanding about how to review a patient with rash and how to formalise differential diagnosis based on the clinical condition. This is an educational article that seeks to improve medical students understanding and clinical applications around rashes and to establish an approach that will differentiate between medications evoked rash and rash provoked by other causes.

Case overview: This case study will provide a systemic approach when evaluating a skin rash in a patient, especially in a person who cannot communicate and who has been exposed to rash provoking medications.

Discussion overview: Antiepileptic medications are known to evoke rash. It is important to take that in consideration when evaluating rashes in patients who are using those medications; however we should keep in mind that there are other conditions that can be the cause.

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Uncategorized

Case Report: When trauma meets infection in a lower income country

Abstract

Introduction: Healthcare-associated infections (HAI) are particularly prevalent in low- and middle-income countries (LMICs). HAIs cause a serious threat to patient wellbeing and have been associated with increased patient morbidity and mortality, longer hospital admission times, increased risk of antibiotic resistance, and higher healthcare costs.

Case: A case of a 23-year-old polytrauma patient in Zambia reveals the devastating outcomes of lack of resources, HAIs, and delayed treatment in LMICs. Discussion: Research demonstrates the negative influence of LMIC status on health care and patient related outcomes. This report, in conjunction with the literature, emphasises the importance of prompt trauma management and strict infection control. The critical need for more knowledge around infection prevention and control (IPC) and resources to implement IPC processes in LMICs are highlighted

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Categories
Feature Articles

COVID-19 as a valuable learning opportunity

Abstract

Most medical students do not receive much public health exposure during their medical education, either in the form of theoretical teaching or practical placement experiences. At the University of Adelaide, students can elect to undertake a public health elective during winter school in addition to limited lectures with a public health focus, but there was not much opportunity for such placements prior to COVID-19. Following the interruption of clinical placements during the peak of the pandemic in South Australia, a modified academic structure saw the introduction of a twelve-week public health placement at the Department for Health and Wellbeing for final-year medical students. This article reflects on the author’s immersive experience at the Department for Health and Wellbeing during the COVID-19 pandemic and includes a brief description of the department’s services along with how it fits into the broader COVID-19 response. Public health placements can impact medical graduates’ understanding and passion for health and society and their role as health advocates. Both of these are included in the Australian Medical Council’s Graduate Outcomes statement. Public health placements are therefore worthwhile pursuing.

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Uncategorized Review Articles

COVID-19: Adaptations to Primary Care in Australia

Abstract

Introduction

The Australian Government has implemented its National Primary Care Response action plan to combat the growing threat of the COVID-19 pandemic across the country. The plan recognises the integral role of primary care services in protecting the most vulnerable citizens of our nation and recommends a number of interventions aimed at reducing transmission, including expanding telehealth services, physical distancing measures, and the use of personal protective equipment. The efficacy of these suggested measures needs to be evaluated to ensure everything is being done to maximise the safety of Australia’s primary care system while maintaining the highest level of care possible.

Summary

This review article delves into the benefits and limitations of the interventions suggested in the National Primary Care Response action plan and formulates recommendations on each intervention based on the currently available literature. Based on the literature findings, recommendations have been made to implement telehealth, physical distancing, and face masks in primary care settings across Australia to curb the transmission of COVID-19 across the country.

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Categories
Feature Articles COVID

Social distancing and domestic violence: an exploration of the paradoxical impact of our public health response to COVID-19

Public health responses and policies implemented during the COVID-19 pandemic have had a substantial impact on the incidence of domestic violence globally. Whilst regulations are in place to protect lives and livelihoods, an evaluation of these reveal the paradoxes embedded within such actions and the effects on vulnerable individuals. A consideration into the catalysts which prompt such a rise in rates of interpersonal abuse due to increased psychosocial pressures are discussed. Furthermore, strategies which could be implemented on a legislative and social level to counter these issues are deliberated.

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Feature Articles

Climate emergency in Australia and the need for inclusion of Indigenous peoples in solutions

Resolving the high-level barriers to Aboriginal and Torres Strait Islander inclusion will facilitate Australia overcoming race and greenhouse gas emissions challenges

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Feature Articles

Continuity of care; a final year medical students professional and personal experience in rural Australia whilst on a longitudinal placement in Broken Hill, New South Wales.

Abstract: A final year medical students professional and personal experience of a longitudinal rural placement in Broken Hill, New South Wales, Australia. The placement was 18 months in duration and highlighted some of the hardships of working and living in a rural area. The particular area of note was the accessibility to services and the continuity of healthcare in this isolated location. Continuity is a difficult concept to teach and one that hopefully all medical students will be able to appreciate through rural and remote placements.

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