Among women, pregnancy-associated melanomas may have a poorer prognosis than other melanomas, but evidence is inconsistent. We conducted a systematic review and meta-analysis to assess the effect on melanoma outcome of a coinciding pregnancy. The objective of the study was to conduct a systematic review and meta-analysis of risk of death from, or recurrence of, pregnancy-associated melanomas compared with other melanomas in women of reproductive age. Cochrane (1996-2013), MEDLINE (1950-2013), EMBASE (1966-2013), CINAHL (1982-2013), and PUBMED (1951-2013) databases were searched for studies assessing the risk of death and recurrence in pregnancy-associated melanomas. Eligible studies investigated melanoma outcomes in women with pregnancy-associated melanomas (diagnosed during pregnancy or in 12 months following pregnancy), included a comparison group and reported measures of risk of melanoma death or disease-free survival. Eligible study designs were cohort studies of women of childbearing age with confirmed diagnoses of cutaneous melanoma. Individual study effect estimates were pooled using the weighted average method. Studies that did not report a quantitative estimate were summarized narratively. Of 304 citations identified, 14 studies met the inclusion criteria, with assessed outcomes being melanoma death (7), recurrence (3), or both (4). Pooled estimates of mortality risk from four studies showed increased risk of melanoma death after adjustment for patient age and stage of melanoma (pHR 1.56, 95% CI 1.23-1.99) for pregnancy-associated melanoma compared with other melanomas. Based on limited quantitative evidence, pregnancy-associated melanomas appear to have poorer outcomes than other melanomas.

This study identified some of the common dermatological complaints presenting to rural and remote primary care doctors in Australia. The unique addition of professional development in Tele-Derm can be used as an adjunct to advice provided to the rural doctors seeking advice for patient management.

Background Junior doctors experience high rates of psychological distress and burnout. System‐level interventions are one strategy to reduce psychological distress in junior doctors. Unfortunately, few of these interventions have been evaluated. Aim To evaluate the acceptability and effectiveness of a resilience and well‐being programme designed for junior doctors. Methods A prospective cohort study of 24 medical interns at a teaching hospital in regional Queensland with a control group of 29 medical interns at a second teaching hospital in regional Queensland. Survey instruments to assess psychological distress, the ProQOL and K10, were completed at baseline, at the completion of the well‐being programme, and 3 months after the completion of the well‐being programme at both sites. Results The intervention site had an older cohort and fewer participants had a regular general practitioner compared to the control site. Both groups had moderate levels of psychological distress. Insufficient numbers of participants completing the instruments at the two sites meant that it was not possible to demonstrate differences between the groups; however, the trends were promising. Qualitative evaluation data supported these trends, indicating that the Resilience on the Run programme was positively received and provided useful skills to junior doctors. Conclusion Well‐being programmes benefit medical interns; introducing new knowledge and skills for effectively identifying and managing personal and workplace stressors that can contribute to psychological distress.