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In This Issue

Med J Aust 2003; 179 (10): .
Published online: 17 November 2003

A healthy investment

If you're wondering whether the $27 million price tag of the current Pharmaceutical Benefits Scheme Community Awareness Campaign represents money well spent, you're not alone. Doran and Henry believe emphasising wastage by patients as a cause for the PBS’s ills misrepresents a complex situation. Their "prescription for a healthy campaign"? — read on (→ The PBS community awareness campaign: how helpful is blaming patients?).

McNeil et al believe the PBS wastes money each year on funding drugs that have not been subject to large-scale morbidity and mortality trials. They say redirecting some public monies to fund such research, rather than relying on the results of industry-funded trials, will be money well spent in the long run (→ Public funding of large-scale clinical trials in Australia).

A screener’s dream?

About one in every 200 people is homozygous for the gene mutation associated with hereditary haemochromatosis. The test is inexpensive and the disease is relatively simple to diagnose and treat. However, Gertig et al caution that there are a few issues to consider before rushing in to screen the general community (→ Population genetic screening for hereditary haemochromatosis).

Facing the music

Before your next toothache (or next patient who has one), you'd better read Lessons from Practice by Aquilina and Lynham (→ Serious sequelae of maxillofacial infections). When is an odontogenic infection likely to cause the unpleasant complications they describe (such as cerebral abscess and mediastinitis)?

Holistic intent

There is good evidence that access to multidisciplinary care improves survival and quality of life after breast cancer. What does this mean, and how can it be achieved in Australia where many rural women do not have regular access to doctors, let alone the specialist and ancillary services of multidisciplinary care? Zorbas et al explain how, with a little will, imagination and technology, every woman can have the benefit of this approach (→ Multidisciplinary care for women with early breast cancer in the Australian context: what does it mean?).

$500k/day habit

According to the calculations of Girgis and Ward, that’s what smoking means in terms of hospital costs in NSW. Their article will provide hospital administrators with a strong business case for spending money on tobacco- control programs (→ A financial case to enable state health jurisdictions to invest in tobacco control.).

Genesis goes hi-tech

Carl Wood, pioneer of in-vitro fertilisation in Australia in the early 80s, is part of a group that has researched community attitudes to assisted reproductive technology. What’s the approval rating now for issues like embryo donation, IVF surrogacy and using donor sperm for single or lesbian women? Turn to “Community attitudes to assisted reproductive technology: a 20-year trend” to see how our views have changed over the decades.

Taking things to an even more contentious plane, Tuch et al discuss how human fetal tissue has been used in Australian research (→ Use of human fetal tissue for biomedical research in Australia, 1994-2002). How has its use benefited us, and what are the ethical safeguards preventing its misuse?

Weight for it

Research in the past decade or so has shown that the lower your weight at birth, the higher your risk of cardiovascular disease as an adult. The first study to show this association in an Aboriginal community, by Singh and Hoy, appears in this issue of the Journal (→ The association between birthweight and current blood pressure: a cross-sectional study in an Australian Aboriginal community).

The stayers

Everyone from the patient to the treasurer is interested in reducing hospital length of stay (HLOS), so the study of Liew et al in this issue should be well read (→ Emergency department length of stay independently predicts excess inpatient length of stay). The finding of a direct correlation between time spent in the emergency department and HLOS leaves many questions unanswered, but, according to Richardson, there is a single compelling reason for reducing the amount of time patients spend in the emergency department. Looking downstream, he says, will keep the emergency department in readiness for those who need it most (→ Reducing patient time in the emergency department).

Seen at the summit

Back in August this year, government representatives met with health experts, and industry and other stakeholders, proving that the NSW Alcohol Summit was more than just an election promise. In “NSW Alcohol Summit: getting a better grip on our favourite drug” Haber et al outline the process and some of the important recommendations coming out of the meeting.

Another time ... another place...

After a man has taken wine or other spiritous liquors he is at once revived and restored. The reason is that in the mouth, oesophagus and stomach there are certain vital and animal spirits constantly scattered, roaming and, as it were, keeping watch. [Because these spirits are] analogous and proportionate to (those) in wine . . . they readily mix. Then, taking their new guests by the hand, as it were, convey them to the heart and brain.

Thomas Willis, 1621–1675



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