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In This Issue

Ruth Armstrong
Med J Aust 2009; 190 (9): 466. || doi: 10.5694/j.1326-5377.2009.tb02517.x
Published online: 4 May 2009

Fit to drive?

A study using Australian antidepressant prescription data suggests a mismatch between need and provision for people living in remote areas and those with low socioeconomic status in some age groups. Page and colleagues examined antidepressant prescriptions under the Pharmaceutical Benefits Scheme in 2003-2005. Although boys predominated in childhood prescriptions, in all other age groups women had much higher rates of antidepressant use than men, and this increased with age in both sexes. Remote areas had the lowest prescription rates, and regional centres the highest. Use also varied with socioeconomic status. Although the study could not identify individual treatment gaps, the pattern of antidepressant use did not entirely correlate with that expected from known sociodemographic differences in depression rates (→ Sociodemographic correlates of antidepressant utilisation in Australia).

If a study by Robson and colleagues rings a bell, it’s because it was widely reported in the Australian media after being released as an MJA rapid online publication in February (→ Adverse outcomes of labour in public and private hospitals in Australia: a population-based descriptive study). According to the National Perinatal Data Collection, just under a third of births in Australia between 2001 and 2004 occurred in private hospitals. High rates of obstetric interventions in these hospitals are well known, but the study revealed what appeared to be a trade-off — lower rates of severe perineal injury in the mothers and less need for resuscitation, fewer low Apgar scores, and decreased likelihood of intensive care admission and perinatal death in the babies. The study is retrospective and therefore not perfect, warns Pesce in an accompanying editorial, but it does challenge the assumption that high rates of intervention are inherently bad. Two Letters to the Editor (Sutherland et al and Watson et al) are critical of the use of routinely collected data (which do not include some potentially important confounders) to address such an important and emotive issue.

If you’re looking for cutting edge, there are a few “don’t miss” items in this issue. As new public hospital initiatives continue to unfold, we have received a number of letters on the fallout from the Garling Inquiry (Matters arising, “In the wake of the Garling inquiry into New South Wales public hospitals: a change of cultures?”); there’s some up-to-the-minute advice on the use of new imaging techniques in breast cancer screening (Houssami et al, “Breast cancer screening: emerging role of new imaging techniques as adjuncts to mammography”); Strong canvasses the issue of “saviour siblings” (→ Informing patients about emerging treatment options: creating “saviour siblings” for haemopoietic stem cell transplant); and Van Nunen et al present a fascinating case series from Sydney’s northern beaches, comprising patients who presented with red meat allergy after experiencing large local reactions to tick bites (→ An association between tick bite reactions and red meat allergy in humans).

Another time . . . another place

Depressions may bring people closer to the church — but so do funerals.

Clarence Darrow

  • Ruth Armstrong



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