Suffering in silence
Relieving pain is one of the most satisfying aspects of medical practice. Yet studies show that (despite being a “captive audience”) many residents of aged-care facilities lack adequate analgesia. Recognising the need for a simple system for detecting and managing pain in this group, McClean and Higginbotham (page 17) asked residents of nursing homes in northern NSW if they were presently in pain. Their answers, taken in the context of nursing and medication records, reveal some communication and action gaps. Melding (page 5) believes much of this suffering is unnecessary and provides suggestions for improvement.

A sporting chance
Orchard and Finch (page 38) say sports injuries cost the Australian community at least $1.65 billion per year. They argue the case for preventive strategies, using the New Zealand approach as an example. Speaking of sport, the potential for lightning strikes during sporting events is another neglected public health issue. Makdissi and Brukner have developed a set of lightning protection recommendations, which they present on page 35.

Truth and consequences
How often are patients with acute myocardial infarction treated contrary to clinical guidelines? Does it matter? Scott and Harper (page 26) examined the records of AMI patients admitted to two Queensland hospitals to answer these and other questions about the way we treat this group of patients.

A birth in Canberra
In 2004, after many years of asking and waiting, the Australian National University will welcome its first 60 medical students. Gatenby and Glasgow share their vision for the faculty on page 8.

Too much or too little?
The study of Sawyer et al on page 21 reports the rate of stimulant use and the prevalence of attention-deficit/hyperactivity disorder in Australian children, but may still leave you asking the above question. With the media polarised on the issue of whether stimulants are friend or foe, the report provides some welcome facts about their current use.

Ovarian cancer checkup
Improved ovarian cancer survival rates are largely due to advances in staging and treatment, for which there are accepted international standards. Grossi et al (page 11) surveyed doctors about their management of Victorian women with ovarian cancer, as well as patient outcomes. According to Proietto (page 4), the less than perfect results of the Victorian study highlight the need for all patients to be managed in dedicated gynaecological cancer centres. He looks to a future in which early diagnosis and even prevention may be possible.

Trial of a trial of a trial
RARE SALAMI might sound like something you can eat at the deli near the MJA’s new Pyrmont premises, but the ill-fated trial by the same name has been the subject of several articles in the Journal. On page 40 Kennedy takes another bite.

Riddle wrapped in a mystery
On the eve of National Endometriosis Awareness Week (July 8–14) Forbes outlines the unsolved mysteries of this enigmatic disorder (page 6).

Chain of information
The road to hospital (and back) may be paved with good intentions, but is rife with communication problems. Mant et al have tackled this issue in their Quality Use of Medicines program. On page 32 they present the results of a recent project designed to improve communication between Sydney GPs and hospitals.

Eye of newt . . . Wool of bat
If Macbeth’s witches had been gathering these ingredients in 21st-century Australia, they might have been at risk of certain emerging viral infections. McCormack and Allworth (page 45) discuss these in the latest of our Infectious Diseases series.

Duty of care
In a recent issue of the BMJ, a young doctor described her descent into mental illness and her futile attempts to resume her medical career in a hostile system. The supplement with this issue, The student and junior doctor in distress – "our duty of care”, examines ways in which we, in Australia, can support junior doctors, especially those with problems.

Another time ... another place...
Some walk with their pain like an open wound for all to see. The others crush it into themselves and do not let it turn into tears and words.
Dobrisa Cesaric, Poems, 1953