Marcel Chua

Background: Fragmented healthcare systems require patients and informal carers to collect, organise, transfer, and interpret personal health information across providers. This review examined the burdens of this work, its management methods, and the evidence for digital tools intended to reduce it. Methods: MEDLINE, Embase, CINAHL, and the Cochrane Library were searched for English-language primary studies published from January 2000 to 25 June 2026. Eligible studies examined patient- or carer-led management of personal health information in community, outpatient, or longitudinal care. Two reviewers independently screened records. The findings were synthesised narratively because of study heterogeneity. Results: Eleven studies published between 2005 and 2021 were included: seven from the United States, two from Italy, and one from Canada and Israel each. Ten used qualitative methods and one used mixed methods. Patients and carers managed medications, appointments, test results, correspondence, medical histories, and insurance information using folders, binders, handwritten notes, calendars, spreadsheets, memory, and, less commonly, digital portals. Reported burdens included time, administrative effort, cognitive demand, emotional distress, and responsibility for maintaining continuity between services. Burdens were greatest when information demands increased while illness reduced a patient’s capacity to manage them. Paper-based systems remained common because they were visible, portable, and easy to annotate. No study directly tested whether a digital intervention reduced information management burden, and none were conducted in Australia. Conclusions: Personal health information management (PHIM) is substantial but largely unrecognised patient and carer work arising partly from fragmented information exchange. The available evidence identifies design considerations for information management, but it does not establish that digital interventions can reduce burden.

Background: Head and neck cancer (HNC) survivors often experience significant physical and psychological challenges posttreatment, including functional impairments and social isolation. Peer support programs, where survivors share experiences and offer mutual support, can improve emotional well‐being, reduce isolation, and offer practical advice. Methods: This qualitative study involved in‐depth semistructured interviews with 25 HNC survivors recruited from a single health service. Participants provided insights into their experiences with their diagnosis and treatment, and preferences regarding peer support, including perceived benefits, challenges, and preferences for program design and delivery. Data were analyzed thematically, with key themes identified through coding of interview transcripts. Results: Participants highlighted several key themes: emotional and social support, information sharing, practical advice, and encouragement. The vast majority of participants (96%) believed peer support would have been beneficial during their treatment journey. However, some expressed concerns about potential negative effects, such as increased anxiety. Preferences were varied, with some preferring one‐on‐one sessions while others preferring group meetings. Most preferred in‐person delivery, and most preferred their peers be matched for relevant demographic and treatment characteristics. Conclusion: Peer support holds significant potential for improving the quality of life for HNC survivors, offering both emotional comfort and practical guidance. However, careful program design is needed to address potential drawbacks. Tailored, flexible peer support programs that account for individual preferences and needs may provide the most benefit for this population.

Objective: Burn injuries on farms are under‐recognised in Australia and New Zealand. Previous studies suggested children are at risk of burn injury, focusing on risk factors including unmodified farm work, risk‐taking behaviours, lack of supervision, and limited safety regulations. This study investigated the causes, characteristics, and outcomes of paediatric farm burns.Methods: Registry‐based retrospective cohort study.Design: Observational.Setting: Burns Registry of Australia and New Zealand (BRANZ).Participants: Paediatrics aged < 16 years and registered to the BRANZ between 2009 and 2021.Main Outcome Measures: The demographics, causes of burn injuries, pre‐ and in‐hospital management, severity, and outcomes.Results: Out of 10 936 paediatric burns, 186 were farm‐related (1.7%). Children sustaining farm‐related burns were older than those in non‐farm environments, with 78.8% aged ≥ 5 years. Most farm burns occurred during leisure (72.5%). Predominant causes were found to be contact (62.4%), followed by flame (19.9%) and friction (10.8%). Only 56.9% received gold‐standard first aid compared to 74.0% in non‐farm environments. Farm‐related burns were smaller but a greater proportion were full‐thickness injuries, requiring surgical management with skin grafts. The majority of farm‐related burns were discharged home (97.3%) with zero deaths.Conclusion: Farm‐related burns in children are distinct from burns in non‐farm environments. Despite children being well‐recognised participants in farm work, work‐related burns were relatively uncommon, and the occurrence of burns during leisure may explain low rates of recommended first aid. These insights can inform burn prevention and first aid strategies targeted at farm communities.

Complex regional pain syndrome (CRPS) is a multifaceted condition characterized by chronic neuropathic pain, allodynia, and hyperalgesia. The incidence of CRPS postoperatively is alarmingly high, particularly following carpal tunnel surgeries, Dupuytren’s fasciectomy, and repairs of wrist and hand fractures, with recurrence rates soaring in individuals with a history of CRPS. Despite extensive research, the management of CRPS remains complicated, highlighting the urgent need for effective prevention strategies. This scoping review aimed to consolidate current evidence surrounding the efficacy of perioperative anesthetic techniques in preventing new-onset or recurrent CRPS, focusing on the application of various anesthetic interventions. Through a comprehensive literature search, eight articles were identified, discussing a spectrum of techniques, including wide awake local anesthesia no tourniquet (WALANT) and various regional blockade methods. This review revealed that the WALANT technique, with its simplicity and lower costs, exhibited promising results in preventing CRPS. Conversely, techniques involving intravenous regional and axillary plexus blocks showed variable efficacy, necessitating further investigation. The scarcity of high-quality evidence underscores the critical need for meticulously designed, large-scale randomized controlled trials to validate these findings and explore the potential of stellate ganglion block in the prevention of recurrent CRPS.

Introduction: Combined ventral hernia repair and abdominoplasty treat risk factors such as high body mass index and weak abdominal musculature, providing excellent intraoperative exposure and improved patient outcomes. Unfortunately, a combination of traditional procedures is unfeasible as the umbilical blood supply would be compromised, leading to increased umbilical necrosis risk. This narrative review aimed to identify new techniques and solidify evidence in preserving umbilical blood supply and associated level of evidence. Methods: Two authors conducted a thorough literature search on PubMed, Scopus and Cochrane CENTRAL databases from January 1901 to July 2023, adhering to the methodologies of the preferred reporting items for systematic reviews and meta-analyses. Studies were reviewed for their surgical technique and quality of evidence. The primary outcomes of interest consisted of umbilical complications of this combined procedure. Results: Six techniques were identified that included laparoscopic, pre-rectus, unilateral, distal bilateral, proximal bilateral, and inferior midline approaches. All techniques demonstrated as viable options in preserving umbilical blood supply as reported complications were few, minor, and compounded by risk factors. However, all included techniques were limited to low-to-moderate-quality evidence. Conclusion: Despite the lack of high-quality evidence, all techniques remain viable options for combined ventral hernia repair and abdominoplasty. Large-scale high-quality RCTs are required to compare the effectiveness of various approaches with additional outcomes of hernia recurrence rates, intraoperative time, and patient- and surgeon-reported satisfaction. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Introduction: The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It’s quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT’s reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages. Methods: A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool. Results: This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of −0.71. Conclusion: Our findings underscore the TT’s high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT’s use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.