The Medical journal of Australia
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Observational Study
Disparity of access to kidney transplantation by Indigenous and non-Indigenous Australians.
To compare the likelihood of Indigenous and non-Indigenous Australians being placed on the waiting list for transplantation of a kidney from a deceased donor; to compare the subsequent likelihood of transplantation. ⋯ Disparities between Indigenous and non-Indigenous patients with end-stage kidney disease in access to kidney transplantation are not explained by patient- or disease-related factors. Changes in policy and practice are needed to reduce these differences.
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Review
Contemporary approaches to the prevention and management of paediatric obesity: an Australian focus.
Of the 34 member countries of the Organisation for Economic Co-operation and Development, obesity prevalence is highest in the United States, with Australia ranking fifth for girls and eighth for boys. Curbing the problem is achievable and can be realised through a combination of smart governance across many sectors, community initiatives, the support of individual efforts, and clinical leadership. At 5 years of age, one in five Australian children are already affected by overweight or obesity; obesity prevention strategies must therefore start before this age. ⋯ A very low energy diet should be considered in adolescents with severe obesity or obesity-related comorbidities, and for adolescents who have not achieved weight loss following a more conventional dietary approach. Pharmacotherapy confers only small reductions in weight; for example, effect size for metformin is - 3.90 kg (95% CI, - 5.86 to - 1.94). Bariatric surgery should be considered in adolescents over 15 years of age with severe obesity (body mass index > 40 kg/m2, or > 35 kg/m2 in the presence of severe complications).