Volume 196 Issue 10

Clear guidance is needed on what information should be publicly available, and for how long. One of the fundamental realignments that has occurred to the doctor–patient relationship is the capacity of patients to acquire information from the internet and, on the basis of it, interact with their practitioners in new and different ways. Some of the ...

Ian R Freckelton BA(Hons), LLB, PhD

Direct antiviral agents may hold the key to eradication, but only if they reach those who will benefitIn this issue of the Journal, Dore outlines the astonishing recent progress in the treatment of hepatitis C virus (HCV) infection,1 largely triggered by the approval in 2011 by regulatory bodies, both overseas and in Australia, of the first ...

Geoffrey W McCaughan MB BS, PhD, FRACP

The full content of this article is available by downloading the PDF.

The full content of this article is available by downloading the PDF.

Rachel Nowak explains why improving communication standards will be essential in the drive to speed research translationPssst ... Want your research findings or health guidelines to change how doctors treat patients? Then take a tip from an ex-journo: Use plain English. Keep it short. Tell stories. Journalists have, for centuries, used these tools first to hook ...

Rachel E Nowak BSc, MA, PhD

Disease-awareness campaigns on low testosterone and ageing highlight the need for changes to regulations. Currently, direct-to-consumer advertising of prescription-only medicines is legal in only two industrialised countries, the United States and New Zealand. However, in countries where direct-to-consumer advertising is not allowed, including Australia, Canada and countries in the European Union, pharmaceutical companies have found ways ...

Agnes I Vitry PharmD, PhD · Barbara Mintzes PhD

The moral panic surrounding human embryo research has fuelled unrealistic public expectations for the imminent success of induced pluripotent stem cell therapyTraditionally, treatment for chronic degenerative conditions revolved around reducing symptoms and improving physiological functioning in the hope of gaining some (often limited) increase in life expectancy. However, in the past decade, the advent of ...

Ronald K F Fung BSc(Adv) · Ian H Kerridge MPhil, FRACP, FRCPA · Loane L C Skene LLB(Hons), LLM, LLD · Megan J Munsie BAppSc, MRepSc, PhD

To the Editor: A 62-year-old woman was admitted on 10 January 2012 for cardiac monitoring after her implantable cardioverter–defibrillator (ICD) discharged four times over a few hours. She had a history of ventricular tachycardia due to ischaemic cardiomyopathy, and had had an ICD (D284DRG Maximo II DR, Medtronic, Minneapolis, Minn, USA) inserted 6 years earlier. Her ICD had ...

Bo Xu · Howard Connor · Robert Ziffer

To the Editor: The report by Scott and colleagues on the “demographic characteristics, diagnostic category, stage of illness, as well as psychosocial and vocational impairment” of 1260 patients presenting to two Sydney headspace centres1 is problematic for several reasons. No convincing data were presented to support the authors’ conclusion that the research demonstrated that “well designed youth ...

Jon N Jureidini

To the Editor: The study of headspace attendees by Scott and colleagues1 illustrates problems common in articles being used for lobbying purposes in the Australian mental health policy arena. These include misrepresentation of evidence, inappropriate medicalisation, and undeclared competing interests. The authors refer to un(der)employment, lack of engagement in study, and receipt of income support as ...

Melissa Raven

In reply: The detailed demographic, diagnostic and disability data we presented1 responds directly to the critics of headspace clinics. Following the initial establishment phase,1 our two centres now provide services to 390 and 411 young people per month, respectively (data from July to September 2011). Each of the 30 established headspace services now assesses an average of 265 clients ...

Ian B Hickie · Daniel F Hermens · Elizabeth M Scott

To the Editor: An important and controversial article authored by Haines and Lowenthal1 was recently published in the Internal Medicine Journal. The authors challenged evidence used by Ian Gawler on his website (iangawler.com) and in his book2 to support meditation and dietary interventions as cancer therapy. Publication of the article was subsequent to initial submission ...

Emma S McBryde

In reply: The article referred to by McBryde was submitted to the MJA in 2011. Patient consent was requested, following standard MJA practice for all manuscripts containing potentially identifying patient data or images, but this was not provided by the authors. We agree that all the information was already publicly available, and it was for ...

Annette G Katelaris

The next decade will be a crucial period in the public health response to hepatitis C virus (HCV) infection. The rapid development of direct-acting antiviral therapy for HCV infection has brought considerable optimism to the HCV sector, with the realistic hope that therapeutic intervention will soon be more effective and offer shorter treatment duration. ...

Gregory J Dore MPH, PhD, FRACP

Objective: To determine hepatitis C (HCV) treatment effectiveness and predictors of response in the “real-world” Australian clinic setting. Design, setting and participants: Patients with chronic HCV, who were HCV-treatment-naive at enrolment, and were then treated with standard therapy (pegylated interferon-α plus ribavirin), were recruited prospectively through a national network of 24 HCV clinics ...

Heather F Gidding MAppEpid, PhD · Matthew G Law PhD · Janaki Amin PhD · George Ostapowicz BMed, MD, FRACP · Martin Weltman PhD, FAChAM, FRACP · Graeme A Macdonald MB BS, PhD, FRACP · Joe J Sasadeusz MB BS, PhD, FRACP · Paul AW Haber MD, FRACP, FAChAM · Jacob George MB BS, PhD, FRACP · Gregory J Dore MPH, PhD, FRACP

Objectives: To develop a mathematical model to project the potential impact of hepatitis C virus (HCV) treatment on HCV infection prevalence among people who inject drugs (PWID). Design and setting: An existing model of HCV transmission among PWID was parameterised using data from Victoria, Australia, including specific parameter estimates of the number ...

Margaret E Hellard PhD, FRACP, FAFPHM · Rebecca Jenkinson BEng(Geol), MEpid, PhD · Peter Higgs BSW, MA, PhD · Mark A Stoové BaAppSci(Hons), GradDip(Ed), PhD · Rachel Sacks-Davis BA BSc(Hons[Arts]) · Judy Gold BBiomedSci(Hons), PhD · Matthew Hickman MSc, PhD, FFPH · Peter Vickerman DPhil, BSc · Natasha K Martin PhD

Objective: To describe patterns of testosterone prescribing in Australia over the past two decades by state or territory and by product type.Design and setting: Observational analysis of testosterone prescribing data obtained from two independent data sources — the Pharmaceutical Benefits Scheme (PBS) and IMS, a source of commercial pharmaceutical sales data.Main ...

David J Handelsman MB BS, FRACP, PhD

Objective: To report the perspectives of optometrists, ophthalmologists and patients on a model of shared care for patients with chronic eye diseases. Design, setting and participants: Qualitative study of a model of shared care between optometrists and ophthalmologists for patients with stable age-related macular degeneration, diabetic retinopathy and glaucoma, trialled by the ...

Patricia M O’Connor PhD · C Alex Harper MB BS, FRANZCO · Cathy L Brunton BNurs · Sandra J Clews RN · Sharon A Haymes BScOptom, PhD, MPH · Jill E Keeffe OAM, PhD

A full course of HBV vaccine results in protective levels of neutralising antibody to HBV (anti-HBs, ≥ 10 IU/L) in over 90% of adults.1 Rare cases of “vaccine breakthrough” infection in actively vaccinated individuals, mainly involving “vaccine escape mutants”, have been documented.2-4 The infecting strain usually carries mutations in the major antigenic region of HBsAg that result ...

Clive R Seed BSc, PhD · Ngaire T Jones MB BS, MMSc · Anne M Pickworth MB BS · Wendy R Graham MB BS

Medical education reform can make an important contribution to the future health care of populations. Social accountability in medical education was defined by the World Health Organization in 1995, and an international movement for change is gathering momentum. Priority community needs are generally not well reflected in existing medical curricula. Medical schools have often ...

Richard B Murray MB BS, MPHTM, FACRRM · Sarah Larkins MB BS, MPHTM, PhD · Heather Russell BMedSci(Hons), MB BS · Shaun Ewen BAppSc(Physio), MMIL, DEd · David Prideaux BA(Hons), MEd, PhD

Fiona hated the hospital, especially at night. The noises it made then were particularly unbearable: trolleys being wheeled down never-ending corridors, the hurried click of heels across a slick and tiled floor. On the wards, sleepless patients listened to the hushed laughter of the nurses and watched flashlights dance like fireflies behind ghostly blue curtains.

Melanie S Cheng MB BS(Hons), FRACGP

Emergency physicians are acute generalists who see patients at their most vulnerable

Sophie McNamara

Dr Phillip Webster, first-year advanced trainee in emergency medicine, Gosford Hospital, and deputy chair of the Australasian College for Emergency Medicine trainee committee.

Dr Phillip

Dr Sally McCarthy is president of the Australasian College for Emergency Medicine and a senior staff specialist in the emergency department at Prince of Wales Hospital in Randwick, Sydney. A graduate of the University of Sydney medical school, Dr McCarthy is also medical director of the Emergency Care Institute New South Wales.

Sophie McNamara

Urologist Professor Mohamed Khadra wields both scalpel and pen with precision.

Amanda Bryan

Take the scalpel to your tax bill with these tips from the experts

Amanda Bryan

Correction Potentially misleading statement and incorrect data: In “Splenectomy sequelae: an analysis of infectious outcomes among adults in Victoria”, published online first on 14 May and in the 21 May issue of the Journal (Med J Aust 2012; 196: 582-586), there was a potentially misleading statement. Under the heading “Mortality (all-cause)” (page 584), the second sentence should read: “The median survival for patients who died during the follow-up period after splenectomy was 3.1 years (interquartile range [IQR], 1.3–5.3).” In the same article, there was also an error in the Abstract (page 582). Under “Results”, the fourth sentence should read: “The risk of severe infection was highest among patients aged > 50 years (10.1 per 100 person-years; 95% CI, 9.3–11.1) and those splenectomised for malignancy (14.2 per 100 person-years; 95% CI, 11.8–17.1).” o

David F M Looke FRACP, FRCPA, MMedSci · Naomi J Runnegar MB BS, FRACP, FRCPA