A little bit country
We know that if doctors or their partners come from the country, they're more likely to return to practise in the country. Many rural medical workforce initiatives have therefore centred on attracting country kids to the profession. In searching for other possible determinants of rural practice, Peach et al hit upon internship, which, in Victoria, can be undertaken in rural Ballarat as well as metropolitan areas. On (→ A case for more year-long internships outside metropolitan areas?) they report whether this taste of country life affects eventual place of practice.
While this study calls to mind the proverbial (free range) chicken and egg, Wearne and Wakerman (→ Training our future rural medical workforce) believe it’s time we saw more of the rural internship — with a few provisos . . .
(I can't get no) satisfaction
These famous Rolling Stones lyrics would be apt for many people re-presenting with asthma to hospital emergency departments (EDs). Yet why do these patients re-present? In a study that most GPs and ED and respiratory physicians will find relevant, Goeman and colleagues (→ Back for more: a qualitative study of emergency department reattendance for asthma) explored people’s reasons for reattendance and identified potentially preventable ones.
A previously healthy 46-year-old man presents with purpuric rash and polyarthritis. Ignoring the alliterative ailment exhibited by this columnist, what’s your diagnosis for the patient? Turn to (→ Palpable purpura, polyarthritis and abdominal pain) for more clues to this Diagnostic Dilemma, reported by Mukhopadhyay et al.
The postemptive strike
The facts of the case are these: a patient tells her doctor that her right fallopian tube and ovary were removed in an appendicectomy years ago. The doctor performs a left tubal ligation, noting that the right tube and ovary are not visible. Five years later, the woman gives birth to a healthy baby boy — the sterilisation had failed. Was the High Court right to uphold the decision that the child’s parents are entitled to the costs of raising him? Read Gerber’s article (→ Failed sterilisations and the unwanted child: a new medicolegal minefield?) and judge for yourself . . .
Devastating sudden deaths, compounded by their occurrence in the young, is the subject of a forensic review by Doolan and colleagues (→ Causes of sudden cardiac death in young Australians). They reviewed the autopsy reports of people who had died at age 35 years or younger from sudden cardiac death to determine the causes and incidence of these deaths.
Worth the effort
Keep up (or start) the good work in blood glucose control, say Davis and Colagiuri to patients with diabetes and their doctors, in an editorial on the UK Prospective Diabetes Study (→ The continuing legacy of the United Kingdom Prospective Diabetes Study). At an international meeting last year, early findings from 5 years' post-study monitoring of more than 3000 study participants were presented. Our editorialists conclude that early, aggressive blood glucose control certainly pays off.
The wild wild Web
In the uncharted territories of the Internet and its apparently infinite possibilities, St George and colleagues (→ Overseas-based online pharmacies: a source of supply for illicit drug users?) mark out a new frontier — online pharmacies as a source of drugs. They are motivated to write when a patient gives them a blow-by-blow account of how to get such drugs without a script.
The editorial by Gijsbers and Whelan (→ E-drug deals: part of the Wild West world of e-commerce) raises several issues: how big a problem is illicit online drug supply, especially compared with other sources of illicit drugs or even with the supply of licit drugs (such as tobacco)? Mightn't the biggest villains in the county be our supermarkets and pubs? Sending in marshals with guns blazing is clearly not the answer.
(Not) doing the Cam-Cam
New South Wales was rocked by recent revelations of poor patient care at Campbelltown and Camden hospitals in December 2003, thanks to the persistence of whistleblowers and a Health Care Complaints Commission report. But let’s look beyond individual blame, says Van Der Weyden (→ The "Cam affair": an isolated incident or destined to be repeated?) in response to the ministerial actions since.
MJA‘s greatest hits
An article published by the MJA on polycystic ovaries has been our highest-rating article every year since its publication in 1998 (see www.mja.com.au/public/issues/nov16/kidson/kidson.html). But will the latest on polycystic ovaries in our Practice Essentials: Endocrinology series (→ Norman et al, 4: Polycystic ovary syndrome) knock Kidson’s original article off its perch? Time will tell . . .
Another time ... another place...
The hospitals [in Utopia] are . . . supplied with everything needed to cure the patients who are nursed with tender and watchful care. Highly skilled physicians are in constant attendance . . . Hardly anyone in the city . . . would not rather be treated . . . at the hospital than at home.
Thomas More, Utopia. 1516
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