The New Year is as good a time as any for a religious stoush. In this issue, Peach’s Viewpoint (page 86) examines the literature to see if religion makes a difference to health and if we should ask our patients about their religious beliefs or include spirituality in medical curricula. His conclusions are vigorously rebutted by Koenig, whose editorial (page 51) presents one view from America, where religion seems to matter more.
In the post-genome age, some of the implications of genetic testing are yet to be determined. For instance, how does genetic counselling or testing of women at risk of breast cancer affect them psychologically? Butow and colleagues (page 77) conducted a systematic review of the literature to find out.
In Letters, Staples et al (page 95) discuss the development of a core clinical data set for the systematic collection of clinical cancer data across Australia, while Harnett et al (page 92) describe an opportunistic GP-based bowel cancer screening program.
Fast and furious ...
. . . ran the correspondence (from page 91) in response to two previously published MJA items: a research paper on injuries caused by baby walkers (Med J Aust 2002; 177: 147-148) (see Martin) and the Charter of Medical Professionalism (Med J Aust 2002; 177: 263-265), drawn up by an international collaboration of physicians (see Breen).
Cultivating Indigenous health
This cultivar requires more far-reaching groundwork, say Ewald et al (page 65) after evaluating a multifaceted trachoma control program in a single community. Geography matters too, according to the first study of growth and morbidity markers in Aboriginal children, by Mackerras et al (page 56).
In their Clinical Update, Fisher and Huffam (page 82) provide a useful algorithm for primary care health workers caring for those with chronic hepatitis B infection in Aboriginal and Torres Strait Islander communities.
A skin thing
Would your clinical acumen make the diagnosis if someone presented with a palmar rash and hoarseness? Makkar and colleagues (page 75) report on the findings and happy outcome for one such patient in this issue’s Notable Case.
And what about the cause of scrotal erythema in the patient described by van Hal and Hardiman in the Snapshot on page 89?
No, this is not another type of discrimination, but a specialist in hospital medicine who manages a patient’s acute hospital course. Hillman’s editorial (page 54) considers whether we should develop such a specialty (similar to the US model) in Australia. A letter by Bolitho (page 96), President of the Internal Medicine Society of Australia and New Zealand, makes a similar case for preserving the role of the general internal medicine physician.
Extortion threats to two pharmaceutical companies led to paracetamol being recalled from retail shelves twice in Australia in 2000. This provided the opportunity for a natural experiment: an MJA article showed that the recalls had little effect on paracetamol poisonings, although poisonings from other analgesics increased (Med J Aust 2002; 176: 162-165). However, an article in this issue by Kisely and colleagues (page 72) appears to contradict those findings.
Within months of being put on the Pharmaceutical Benefits Scheme to assist smokers in quitting, bupropion was among the Scheme’s top 10 most costly drugs. Inevitably, it has also become another means for deliberate overdose in adults and accidental ingestion in children. Balit and colleagues (page 61) investigated the results of bupropion toxicity in a prospective case series.
The "Kamikaze School of Medicine"
Van Der Weyden (page 52) describes why a university department was dubbed as such in the 1950s, as his editorial comments on a further (Australian) chapter in self-experimentation by Landmann and Prociv (page 69). Their exploits in the name of science border on the heroic (it involves eating worms) and will have you “hooked”. Even in the new millennium, the worm has not turned...
Another time ... another place...
I think your solution is just, but why think? Why not try the experiment?
John Hunter (1728-1793)
Letter to Edward Jenner, August 2, 1775
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