“
“The National Health and Hospitals Reform Commission (NHHRC) has recommended that Australia develop a “single health system”, governed

by the federal government. Steps to achieving this include: a “Healthy Australia Accord” to agree on the reform framework; the progressive takeover of funding of public hospitals by the federal government; and the possible implementation selleck of a consumer-choice health funding model, called “Medicare Select”.\n\nThese proposals face significant implementation issues, and the final solution needs to deal with both financial and political sustainability.\n\nIf the federal and state governments cannot agree on a reform plan, the Prime Minister may need to go to the electorate for a mandate, which may be shaped by other economic issues such as tax reform and intergenerational challenges.”
“Background: Patellofemoral osteoarthritis (PFOA) is a common form of knee OA in middle and older age, but its relation to PF disorders and symptoms earlier in life is unclear. Our aim was to conduct a systematic review

to investigate the strength of evidence for an association between anterior knee pain (AKP) in younger adults and subsequent PFOA.\n\nMethods: The search strategy included electronic databases (Pubmed, EMBASE, AMED, CINAHL, Cochrane, PEDro, SportDiscus: inception to December 2009), reference lists of potentially eligible studies and selected reviews. Full text articles in any language, -identified via English titles and abstracts, were included if Pevonedistat ic50 they were retrospective or prospective in design and contained quantitative data regarding structural changes indicative of PFOA, incident to original idiopathic selleck kinase inhibitor AKP. Eligibility criteria were applied to titles, abstracts and full-texts by two independent reviewers. Data extraction included study location, design, date,

sampling procedure, sample characteristics, AKP/PFOA definitions, follow-up duration and rate, and main findings. Foreign language articles were translated into English prior to examination.\n\nResults: Seven articles satisfied eligibility (5 English, 2 German). Only one case-control study directly investigated a link between PFOA and prior AKP, providing level 3b evidence in favour of an association (OR 4.4; 95%Cl 1.8, 10.6). Rough estimates of the annual risk of PFOA from the remaining six small, uncontrolled, observational studies (mean follow-up range: 5.7 to 23 years) ranged from 0% to 3.4%. This was not the primary aim of these studies, and limitations in design and methodology mean this data should be interpreted with caution.\n\nConclusions: There is a paucity of high-quality evidence reporting a link between AKP and PFOA. Further, well-designed cohort studies may be able to fill this evidence gap.