Volume 199 Issue 6

Misunderstanding of requirements and jurisdictional differences may explain why some deaths that should be reported are not. While education of all doctors is required, reporting should be an explicit responsibility of senior doctors.

Stephen M Cordner MA, FRCPA, FRCPath

Medical students’ values evolve over time, so a learning process involving meaningful feedback and immersion in a workplace culture that consistently promotes professional behaviour is desirable.

Ian M Symonds MD, FRCOG, FRANZCOG · Nicholas J Talley MD, PhD, FRACP

A recent case report from the United Kingdom highlights a sequence of events that is repeated with often devastating consequences from this rare but serious condition.

Alan J Cooper BSc, MB BS, FACD · Frank C Powell FRCP

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

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

Effective control requires timely and appropriate antibiotic treatment of patients with confirmed infection as well as their sexual partners, but only a minority of partners currently receive treatment.

Sarah E Huffam FAChSHM, MPH · Katherine M Brown MB BS, MSc, FAChSHM · Marcus Y Chen FRCP, FAChSHM, PhD · Christopher K Fairley FRACP, PhD

It is time that the environmental cost of doing medicine is brought into the whole equation; that Big Pharma are brought on board; and that doctors are educated to give this some priority.

Peter M J Fisher BSc(Hons), PhD · David A Smith BSc · Peter J Collignon MB BS(Hons), BSc(Med)

Tension between the need for an integrated national health system and the self-interest of states has led to negative consequences, including discrimination against junior doctors.

Dev A S Kevat · Fiona J Lander

To the Editor: Clinical practice is constantly evolving, and while doctors are accomplished in recognising the need for continual personal development and improvement, they traditionally have been difficult to engage in health care system redesign.1,2 Quality improvement (QI) initiatives are often met with disengagement, owing to a perception that they provide little clinical benefit and that resources could be better spent elsewhere.1 While QI initiatives certainly ...

Nicholas M Cheng · Ned W R Douglas

To the Editor: We thank Hoad and colleagues for presenting data from Australian states and territories regarding in-flight exposure to measles.1 The current cases in Queensland, Victoria and New South Wales, which have included domestic air travel,2 highlight the challenges measles still holds for Australia. Hoad et al’s report outlines the substantial public health response that such air travel events generate, despite the low likelihood of ...

Stephen B Lambert · Frank H Beard

To the Editor: The gluten-free (GF) diet for people with coeliac disease (CD) is complex, costly, and compliance with the diet is variable. Coeliac Australia, with the Australian Food and Grocery Council, are lobbying to increase the mandated gluten threshold for GF foods.1 The situation in Australia since 1995 has been that there must be “no detectable gluten” in foods labelled “gluten free”. The proposed new ...

Geoffrey M Forbes

It is very unlikely that there is any substance to the suggestion that calcium supplementation increases the risk of cardiovascular disease.

B E Christopher Nordin

Vitamin D3 in oral supplements is derived from animal sources, so it is important to address this when recommending vitamin D supplementation to a person who adheres to a vegetarian diet.

Bettina Douglas

In reply: People requiring a purely vegetarian source of vitamin D should use vitamin D2 (ergocalciferol), which is produced by ultraviolet irradiation of the plant sterol ergosterol, and not vitamin D3 (cholecalciferol), which is derived from animal sources. As cholecalciferol is derived from sheep’s wool, which does not involve the sheep being killed, several cholecalciferol supplements are certified as halal. Some capsules contain gelatine (an animal ...

Caryl A Nowson · Rebecca S Mason

By comparing administrative data for the 2010–11 and 2011–12 financial years, a 318% increase in “ice”-related ambulance attendances was found to underpin a substantial rise in amphetamine-related attendances.

Cherie Heilbronn · Caroline X Gao · Belinda Lloyd · Karen Smith · David Best · Dan I Lubman

To the Editor: Potentially avoidable hospital admissions are a key concern for every health care system. Admissions for ambulatory care-sensitive conditions (ACSCs) have been used as a proxy measure of potentially avoidable admissions in research and in policy and program development since the early 1990s. Older patients with chronic conditions are the greatest contributors to ACSC admissions, and hospital admissions for ACSCs are particularly burdensome ...

Jo M Longman · Megan E Passey · Dan P Ewald

To the Editor: As reported by patients and staff at the Sydney Adventist Hospital (SAH),1 we too at Epworth HealthCare in Melbourne have found overwhelming acceptance of medical student participation in the care of our patients. As Victoria’s largest not-for-profit health care group, we have been training medical undergraduate students from both Monash University and the University of Melbourne for the last 7 years at our ...

Geoffrey L Metz · John C Catford · Alan Kinkade

Blood transfusion is often lifesaving but not without risk, so it is important to avoid unnecessary transfusions. Hazards include sepsis from bacterial contamination and events due to clerical error. New national guidelines on patient blood management emphasise holistic approaches, including strategies to reduce transfusion requirements.

Sunelle Engelbrecht MB ChB · Erica M Wood MB BS, FRACP, FRCPA · Merrole F Cole-Sinclair MB BS, FRACP, FRCPA

Objective: To better understand the non-reporting of reportable deaths by determining the frequency and nature of reportable deaths referred to the Coroners Court of Victoria (CCOV) by the Registry of Births, Deaths and Marriages (BDM).Design and setting: Review of referrals from BDM to the CCOV between 2003 and 2011 where an external cause of death was recorded on the death certificate, with detailed ...

Sandra L Neate MB BS, DA(UK), FACEM · Lyndal C Bugeja BA(Hons), PhD · George A Jelinek MD, DipDHM, FACEM · Heather M Spooner LLB · Luke Ding BCom, LLB · David L Ranson BM BS, LLB, FRCPA

This qualitative study gained a clear picture of students’ dissatisfaction with current methods of teaching and assessing professionalism. Teaching methods need review in light of students’ preference for experiential learning and informal group reflection with their peers.

Hudson H Birden MPH, PhD · Tim Usherwood MD, FRACGP, FRCP

Over 60% of do-it-yourself home renovators reported exposure to asbestos during renovations, and more than 20% reported that their partner and children had also been exposed, with only 12% of renovators regularly using respiratory protection.

Eun-Kee Park MASc, PhD · Deborah H Yates MB BChir, MD, FRCP · Rebecca A Hyland MPH · Anthony R Johnson MB BS, MOHS, FRACP

Objective: To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services.Design: Retrospective cost–savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings.Participants and setting: Records of ...

Darshit A Thaker MB BS, FRACP, ClinDipPallMed · Richard Monypenny BIngAgr, PhD · Ian Olver MD, PhD · Sabe Sabesan BM BS, FRACP

More safety regulations are necessary to prevent and reduce the risks from quad bike-related injuries which cause deaths, hospital admissions and emergency department presentations, not least among children.

Angela J Clapperton MCounsel, GradDipEdPsych, BSc · Emily L Herde BNurs, BHSci, GradCertCFHN · Tony Lower BEd, MEd, PhD

We report the first known Australian case of probable neurobrucellosis, in a young feral-pig shooter who presented with episodic left-sided visual loss and left-sided numbness and headache. Treatment with intravenous ceftriaxone and oral rifampicin, doxycycline and trimethoprim–sulfamethoxazole resulted in a good clinical response.Clinical recordIn September 2011, a 29-year-old man from rural western Queensland suddenly developed left-sided visual loss. This lasted 15 minutes and was followed by ...

Wendy J Munckhof PhD, FRACP, FRCPA · Amy V Jennison BSc(Hons), PhD · John R Bates BAppSc, ADipComp · Ian Gassiep MB BS(Hons)

Performing computed tomography staging of a patient’s lung cancer revealed a rare abnormality.

Laura Lamprell · David G Johnson

Young physicians-in-training are so automatically programmed into believing that global health frameworks and health systems are broken beyond repair that a vicious cycle breeds. Breaking this cycle requires zeal fuelled by humanism.

Nilofer K Habibullah BMSc

CorrectionMissing data: In the letter “Stent insertion for palliation of advanced oesophageal carcinoma symptoms by level of socioeconomic disadvantage in urban New South Wales” in the 3 June 2013 issue of the Journal (Med J Aust 2013; 198: 531-532), some data were missing. Since publication, an additional nine cases of stenting during the study period have been identified. With these additional data, the corrected second paragraph and ...

Jason P Bentley · David E Goldsbury · Guy D Eslick · Michael R Cox · Dianne L O'Connell

There's been a recent shift in the balance of power when it comes to referral relationships, and practices are making efforts to adapt

Annabel McGilvray

This year’s Be Medicinewise Week will focus on how older Australians can get wiser about their health and medications.

Cate Swannell

Professor Timothy Welborn has been at the forefront of diabetes research and practice since the mid 1960s, from the Busselton Study to AusDiab and the formation of Diabetes Australia

Cate Swannell

Med J Aust 2013; 199 (6 Suppl).