Objective: Design, setting and subjects: An analysis of the health records of 720 of the 7375 people in detention in the financial year 1 July 2005 – 30 June 2006, with oversampling of those detained for > 3 months. Main outcome measures: Health encounters and health condition categories; estimated incidence rates of new health conditions, new mental health conditions, and new injuries for each cohort (defined by time in, and reason for, detention). Results: People in detention had an estimated 1.2 (95% CI, 1.18–1.27) health encounters per person‐week. Those detained for > 24 months had particularly poor health, both mental and physical. Asylum seekers had more health problems than other people in detention. The main health problems varied depending on the length of time in detention, but included dental, mental health, and musculoskeletal problems, and lacerations. Both time in, and reason for, detention were significantly related to the rate of new mental health problems (P = 0.018 and P < 0.001, respectively). The relationship between these variables and the incidence rates of physical health problems was more complex. Conclusion: People in immigration detention are frequent users of health services, and there is a clear association between time in detention and rates of mental illness. Government policies internationally should be informed by evidence from studies of the health of this marginalised and often traumatised group.

This study investigates why some patients with apparently less urgent conditions present to emergency departments (EDs). We report on a survey of "potential primary-care" ED patients, who were asked about their reasons for choosing the ED over GPs. The sample consisted of 397 patients (with a response rate of 99% = 397/400), recruited in the former Illawarra Health Area. The three main reasons selected were: self-assessed urgency; being able to see the doctor and having tests or X-rays done in the same place; and self-assessed seriousness or complexity. The results do not appear to be sensitive to two potential sources of bias (fixed question ordering and non-random sampling). The results suggest a number of potential policy levers for encouraging some people to present to GPs rather than EDs. However, the main conclusion is that the majority of "potential primary-care" patients appear to be presenting for appropriate reasons. Thus "inappropriate attendances" do not seem to be the cause of EDs being under stress. We also argue that the results are useful for drawing inferences more broadly than just in relation to the Illawarra.

Introduction24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap.Methods and analysisSUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study.Ethics and disseminationThe SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

Objective: To investigate the effect of incontinence on clinical outcomes and costs for patients in subacute care. Design: Retrospective analysis of data collected over a 3‐month period in 1996. Setting: 54 medical facilities in Australia and New Zealand providing subacute care in an inpatient setting. Patients: 6773 episodes of care provided to 6455 rehabilitation and geriatric evaluation and management patients. Main outcome measures: Urinary continence status, treatment outcomes, length of stay, discharge destination, and nursing and allied healthcare costs. Results: Discharge destination differed between incontinent and continent patients (57% compared with 82%, respectively, discharged home, and 29% compared with 12%, respectively, discharged to a nursing home or to further care). There was a difference in cost between patients who were continent and those who were incontinent throughout their episode of care (rehabilitation: $185.60 [95% CI, $181–$190] per day for incontinent and $156.82 [95% CI, $153–$160] for continent patients; and geriatric evaluation and management: $164.62 [95% CI, $157–$172] for incontinent and $121.40 [95% CI, $114–$129] for continent patients). However, multilevel analyses showed that, after allowing for age and level of functional independence, the contribution of continence status to the cost of care depended on the functional independence of the patient (cognitive function for orthopaedic patients [P < 0.01] and motor function for stroke patients [P = 0.04]). Conclusion: The relationship between continence status and cost of care is complex. However, the cost differences found in our study need to be considered in payment systems, allocation of staff levels on wards and in development of casemix classifications.

This study reports on an assessment system for school-leavers with disabilities to identify their capacity for work and the type of transition-to-work programme best suited to each person. Participants were 1,556 high school students in four cohorts who left school between 1999 and 2002. Each school-leaver was assessed by rehabilitation counsellors for functional ability and capacity for work. In a supplementary study, the 2002 cohort was assessed by special transition teachers using a short screening tool. The results demonstrate that there is a predictable hierarchy of functional acquisition among school-leavers with disabilities and that the single best predictor of future capacity for work and need for transition-to-work programmes among this group of young people is the capacity to manage activities of daily living. The results also demonstrate that a short screen used by teachers, together with a behavioural assessment, is sufficient to stream school-leavers with a disability into a range of transition-to-work programmes.