Images of the recent “Live 8” concerts confirm grass-roots concern for basic humanitarian principles. Yet at government levels, most rich countries are contributing far less to their poorer neighbours than they could and should be. According to Zwi et al, recent changes to Australia’s official development assistance show a less than ideal shift in emphasis (→ Keeping track to keep Australia’s overseas aid on track).
An avoidable problem
Despite dire predictions during the early years of AIDS in Australia, we have not had the epidemic that was feared in our Indigenous communities. Some new data from Western Australia on the rates of major sexually transmitted infections may renew concerns (→ Fulfilling prophecy? Sexually transmitted infections and HIV in Indigenous people in Western Australia), but according to Bowden this is not the epidemic we have to have (→ Controlling HIV in Indigenous Australians).
The diagnosis of depression (and thus the path to effective treatment) often relies on the ability of the affected person and his or her close associates to recognise the symptoms. How good is the average Aussie at picking up the warning signs and knowing what to do? Goldney et al took it to the street as part of the South Australian Health Omnibus Survey (→ Changes in mental health literacy about depression: South Australia, 1998 to 2004).
Getting the pethidine message
Current evidence-based guidelines recommend limiting the use of pethidine in emergency departments because of safety concerns and the potential for abuse. In an attempt to encourage best practice, Kaye et al implemented a multi-centre drug use evaluation process in the emergency departments of 23 public hospitals (→ Pethidine in emergency departments: promoting evidence-based prescribing).
Over 7 million Australian sheep have been vaccinated against ovine Johne’s disease. However the vaccine is not very human friendly when accidently self-injected by sheep handlers, as Richardson et al explain (→ Gudair (OJD) vaccine self-inoculation: a case for early debridement).
A new era
The Australasian Creatinine Consensus Working Group would like to advise that there is now a simple way of estimating glomerular filtration rate, using the patient’s serum creatinine concentration, age, sex and race, and it’s coming soon to a lab near you (“Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: a position statement”). Chadban and Ierino agree that the new measure will be vastly more sensitive for kidney disease than monitoring creatinine levels alone and warns us all to prepare ourselves for an influx of new diagnoses (→ Welcome to the era of CKD and the eGFR).
Vietnam vets and beyond
The recent government announcement of a health survey of the children of Vietnam veterans has drawn attention to their needs. Peach argues that if we want to know more about interventions and policies that will help war veterans and their families, we need to broaden the scope of our research, to include those involved in other conflicts and sociological, life-course and transgenerational perspectives (→ Further support for the families of Australia’s war veterans requires a broad research strategy).
Up to 200 000 Australians have epilepsy. Advances in neuroimaging, neuropharmacology, neurosurgery and even genetics have somewhat changed our approach to this disorder. Bleasel provides an update and a glimpse of the future (→ Epilepsy in the new century).
Our Practice Essentials — Paediatrics series has covered many of the problems you will see in clinical practice. But every child has a context — in a family and society. In the last article in the series, Zwi and Henry take a look at how health inequalities affect children and how, as practitioners, we can get involved in the bigger picture (→ 13. Children in Australian society).
A randomised controlled trial published in the MJA last year showed benefit from a graded exercise program for people with chronic fatigue syndrome. The report raised questions about how to select and motivate patients to take part, and the details of the program itself. In “Exercise prescription for individuals with chronic fatigue syndrome”, Wallman et al fill in some of the gaps.
In the Notable Case by Shingde et al, a young man being investigated for symptoms of gastro-oesophageal reflux is incidentally found to have extremely high muscle enzyme levels. For the unusual reason behind this “CKopathy”, turn to “Macrophagic myofasciitis associated with vaccine-derived aluminium”.
If you review or write for the MJA , you may have noticed a difference recently in the way we handle manuscripts. In “Web-based peer review now standard for the MJA”, Bingham et al give an overview of our new web-based submission and tracking system. We’re prepared for a few bumps along the way but are hoping for a smoother, faster ride once we’re all onboard and up to speed with the new processes.
Another time ... another place
It is now possible to make precise measurements of the glomerular filtration rate, the effective renal blood flow and the capacity of the tubular cells to reabsorb or excrete certain compounds. Many of these measurements are too difficult at present for clinical purposes . . .
Alving AS, Miller BF
Arch Intern Med 1940; 66: 306-318
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