Volume 199 Issue 5

Evidence from a recent population breast screening trial shows improved detection with integrated 2D and 3D mammography. Will enhanced detection translate into improved outcomes for women?

Nehmat Houssami FAFPHM, PhD

Is it jumping the gun to include tranexamic acid in trauma protocols? A forthcoming Australian trial aims to fill some of the evidence gaps.

on behalf of the PATCH-Trauma study investigators*

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

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

Women living near a remote PNG goldmine have experienced brutal sexual violence, amplified over the years by gross failures in justice and poor access to psychosocial support, amid other serious social, health and environmental concerns.

Sarah Knuckey BA, LLB, LLM

If these methods are cost-effective and highly acceptable to women of all reproductive ages, why do so few Australian women use them?

Kirsten I Black FRANZCOG, MFSRH, PhD · Deborah Bateson MA, MSc, MB BS · Caroline Harvey MB BS(Hons), FRACGP, DRANZCOG

Embedding research into patient care and education for health-related professionals is the right approach, but it requires flexible and tailored solutions to funding and governance.

Garry L R Jennings MD, FRACP · Michael K Walsh MB BS, BHA, MPA

To the Editor: Increased numbers of medical graduates in Australia over recent years are causing great concern about the capacity of current prevocational training systems to effectively absorb extra trainees.1 For example, in the Australian Capital Territory, 42 intern positions in 2007 increased to 96 in 2013 — an increase of 130%. ACT Health has seen this increase in intern and junior doctor numbers as an opportunity to improve current ...

Melanie Angstmann · Tobias J Angstmann · Tim McDonald

To the Editor: We are concerned that recent media reports about a 17-year-old Sydney boy who died after allegedly consuming 25B- or 25I-NBOMe might lead to an increase in the incidence of NBOMe toxicity among patients presenting to emergency departments. NBOMe was reported to be available online for as little as $1.50 per tab.1 The subsequent media interest is likely to have increased public awareness of ...

David G E Caldicott · Stephen J Bright · Monica J Barratt

Lead is toxic at picomolar concentrations, but what is the best basis for determining the intervention level for its concentration in blood?

Ian H Wilson · Simon B Wilson

In reply: In epidemiology, the weight-of-evidence approach is useful for reaching general conclusions, whereas details from selected studies are useful for understanding nuances. This is particularly important when evidence from human and experimental research is consistent across multiple studies and in populations with different characteristics, including Australia.1-3 There will always be limitations and unmeasured confounders, but, ultimately, we can rely on controlled laboratory studies which ...

Mark P Taylor · Bruce P Lanphear · Chris Winder

To the Editor: BCG is an effective vaccine to prevent tuberculosis (TB) in young children travelling to countries with a high prevalence of TB.1 Although it does not completely mitigate the risk of developing TB, nor the need for preventive therapy after a significant TB exposure, it provides about 80% protection against the severe forms of TB that affect infants and young children.2 In Australia, ...

Amanda Gwee · Ranmali Rodrigo · Dan Casalaz · Nicole Ritz · Nigel Curtis

To the Editor: I commend de Costa and Rane1 for highlighting a matter that has been causing me increasing concern over the past few years; namely, the decline in undergraduate education in obstetrics and gynaecology. Coincidentally, a couple of weeks before their article was published, I was the consultant on call at a rural hospital and was asked to see a young woman who turned out ...

Graeme J Dennerstein

To the Editor: In his article on the German Medical Association’s apology for medical crimes under Nazism, Weisz states “One can but hope that it will be soon followed by an apology from the Austrian Medical Association”.1 Having been in Vienna on the 75th anniversary of the Anschluss (the annexation of Austria by Germany in March 1938), I would like to comment as to why ...

Peter M Winterton

In reply: I thank Winterton for providing important information about Austria’s attitude towards its participation in Nazi atrocities. Nazi crimes perpetrated in Austria include those at the Mauthausen-Gusen concentration camp, where over a quarter of a million inmates perished. The Austrian government has acknowledged this by establishing the Mauthausen Memorial. However, the Austrian Medical Association remains silent. Recall Irmfried Eberl, the Austrian doctor who was the ...

George M Weisz

Twitter is being used to promote alcohol, and this includes promoting it to people who are underage; putting an end to this practice requires political will and international cooperation.

Ann M Dadich · Suzan M Burton · Alena Soboleva

In Victoria, from 2001 to 2011, 115 deaths were identified with codeine and ibuprofen co-detected in postmortem toxicological analysis or with codeine–ibuprofen analgesic misuse described in the coroners’ findings.

Jennifer L Pilgrim · Malcolm Dobbin · Olaf H Drummer

A young boy’s painful encounter with a moth playing possum.

John J van Bockxmeer · Jennifer Green

The fourth part of our Cardiology series provides the latest clinical information on pharmacological and other therapies for a complex clinical syndrome that affects about half a million Australians.

Henry Krum MB BS, PhD, FRACP · Andrea Driscoll MEd, PhD

Prospective clinical outcomes and patient experiences after medical management of missed miscarriage in women treated on an outpatient basis at a single maternity hospital suggest it is safe and effective.

Scott G Petersen MB BS, FRANZCOG, CMFM · Anneliese R Perkins FRANZCOG, MB BS · Kristen S Gibbons BInfoTech, BMaths(Hons), PhD · Julia I Bertolone BNurs · Kassam Mahomed MB BS, FRANZCOG

Comparing caesarean rates between hospitals and groups of women with differing pregnancy characteristics showed persistent variation after adjusting for casemix. Reducing variation in practice has potential to reduce the concerningly high caesarean rate in Australia.

Yuen Yi (Cathy) Lee BMathAdv(Hons), MBiostat · Christine L Roberts MB BS, DrPH · Jillian A Patterson BScAdv(Hons), MBiostat · Judy M Simpson BSc(Hons), PhD, CStat · Michael C Nicholl MB BS, FRCOG, FRANZCOG · Jonathan M Morris MB ChB, FRANZCOG, PhD · Jane B Ford BA(Hons), PhD

While improvements in drinking behaviour are apparent from the results of this study, women who are at high risk of having babies with alcohol-related birth defects need public health policies and programs that will reach them.

Cate M Cameron PhD, MPH, BSocWk(Hons) · Tamzyn M Davey PhD, MPH, BPsych(Hons) · Elizabeth Kendall BA, DipPsych, PhD · Andrew Wilson MB BS, PhD, FRACP · Roderick J McClure MB BS, BA, PhD

More than 40% of women taking parental leave during their specialist training experienced negative comments about their leave in the workplace, and more than 25% reported being questioned about their intentions for future pregnancies in relation to job applications.

Caroline M de Costa PhD, FRANZCOG, FRCOG · Michael Permezel MD, MRCP(UK), FRANZCOG · Louise M Farrell MB BS, FRANZCOG, FRCOG · Anne E Coffey MB BS, FRANZCOG · Ajay Rane PhD, MD, FRANZCOG

A case study highlights the need for collaboration between the insurance industry, government and researchers to ensure that consumer interests are protected.

Louise A Keogh BSc, MA, PhD · Margaret F A Otlowski LLB(Hons), PhD

The story of one woman’s journey through heartbreak to peace and acceptance.

Name withheld

John Hogg was a true all-rounder — sportsman, explorer, sailor and skier, as well as surgeon, devoted husband and father, and academic. He died at home on 1 March 2013 from metastatic melanoma. John was born in Sydney on 10 January 1943 and was educated at Trinity Grammar School, where his father, James Wilson Hogg, was headmaster. After graduating in medicine from the University of Sydney in 1967, he spent 2 years ...

Stephen E J Andersen

Good health literacy is vital in improving individual and population health. What can clinicians do to promote it?

Annabel McGilvray

The Dax Centre, a not-for-profit organisation promoting mental health and wellbeing through art and creativity, has launched its poetry collection after a two-year development period. Dr Jennifer Harrison, a child psychiatrist and published poet, is manager of the Dax Centre’s Poetry Collection and tells the MJA she and her staff of volunteers are curating around 50 poems for inclusion in the collection’s database. “We are working through the negotiation process with the poets about how they want their work represented and whether they want it just in print, or online as well”, Dr Harrison says. “Many are documentary poems, relating the mental health experiences of the poets. Many of them see poetry almost as a saving art form. “The process can be extremely important to a person’s sense of validity and identity, and for working through what the experience meant”, she says. “Many of the poets are interested in helping others to understand mental illness, because knowing more helps to stop the stigmatisation. “Poetry is fascinating because it inhabits the space between language and silence and opens up new ways of thinking and seeing.” The Dax Centre also incorporates the Cunningham Dax Collection — over 15 000 works on paper, ceramics, paintings and textiles created by people who have experienced mental illness or psychological trauma. The Dax Centre’s Poetry Collection will be holding a special event on 5 December — “Fairytales and fancy: the mind of the child in poetry”. There will be a panel discussion and poetry reading featuring Melbourne poet and psychologist Doris Brett, Dr Harrison and Nick Bland, children’s writer and illustrator, and 2013 winner of the Australian Book Industry Awards Book of the Year for Younger Children for The very hungry bear. For more information, email info@daxcentre.org or call (03) 9035 6258

Cate Swannell

Professor Neil Watkins gave up life in the intensive care unit for the wild world of small-cell lung cancer research, fruit fly signalling pathways and controversial hypotheses

Cate Swannell

Med J Aust 2013; 199 (5 Suppl).