Issues
Volume 209 Issue 11
News
News briefs
Young people less satisfied with their GP experience Findings from the Australian Bureau of Statistics (ABS) Patient Experience Survey indicate that young people are less satisfied with their GP experiences than older patients. About 5.2 million people aged 15–34 years saw a GP in 2017–18, but only 67% felt that the GP always listened carefully to them, compared with 83% of those aged 65 years or more. Young people also less likely than older people to feel that the GP always showed them respect (75% v 87%) and less likely to feel that the GP always spent enough time with them (70% v 84%). Director of Health Statistics at the ABS, Louise Gates, said: “Further results from the survey show that as expected, young people aged 15–34 years generally used health services less often than older people, with 77% seeing a GP, 26% seeing a medical specialist, and 10% being admitted to hospital. This compared with 96%, 57% cent and 20% of people aged 65 years and over. However, those aged 15–34 years were twice as likely to have seen an after hours GP (10%) as those aged 65 years and over (5%). At the same time, people aged 15 to 34 years were three times more likely to delay seeing a medical specialist (27% compared with 9%) and nearly twice as likely to delay seeing a dental professional (35% compared with 20%) than those aged 65 years and over. In particular, younger people were more likely to delay or not use health services due to cost (13% v 2% of people aged 65 years or more). Similarly, 21% delayed or did not see a dental professional due to cost compared with 9% of people aged 65 years and over,” Ms Gates said. http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4839.0Main+Features12016-17?OpenDocument Evidence for value of low carbohydrate diet in maintaining weight loss A low carbohydrate diet could help people maintain weight loss by increasing the number of calories burned, according to US research published in The BMJ. The researchers say this effect may improve the success of obesity treatment, especially for people with high insulin secretion. Energy expenditure declines with weight loss as the body adapts by slowing metabolism and burning fewer calories, often leading to lost weight being regained. But little is known about how dietary composition influences this adaptive response in the long term. One hypothesis, the carbohydrate–insulin model, proposes that recent increases in the consumption of processed, high glycaemic load foods trigger hormonal changes that increase hunger, leading to weight gain. Researchers at the Boston Children’s Hospital compared the effects of diets with different carbohydrate-to-fat ratios on energy expenditure. The trial involved 234 overweight adults aged 18–65 years with a body mass index of 25 or higher who initially took part in a weight loss diet for about 10 weeks. After shedding 12% on the run-in diet, participants were randomly assigned to one of three test diets for 20 weeks: high (60%), moderate (40%) or low (20%) carbohydrate diets. Each participant was provided with fully prepared meals of similar protein and fat content. After adjusting for potentially influential factors, they found that total energy expenditure over the 20 weeks was significantly greater for participants on the low carbohydrate diet than for those on the high carbohydrate diet: 209–278 kilocalories more per day, or an increase of 50–70 kilocalories a day for each 10% reduction in the contribution of carbohydrates to total energy intake. For people with the highest insulin secretion at the start of the study, the difference in total energy expenditure between low and high carbohydrate diets was even greater: up to 478 kilocalories a day, consistent with the carbohydrate–insulin model. If this effect persisted, “it would translate into an estimated 10 kg weight loss after 3 years, assuming no change in calorie intake,” the authors noted. https://www.bmj.com/content/363/bmj.k4583
Cate Swannell
Editorials
From the curious case of Patient K to TOP GEAR and Bond
Celebrating a great year for the MJA with our 2018 holiday issue
Nicholas J Talley AC
Perspective
The MJA–Lancet Countdown on health and climate change: Australian policy inaction threatens lives(Summary)
Australia joins a global initiative to track progress on health and climate change
Paul J Beggs · Ying Zhang
The MJA–Lancet Countdown on health and climate change: Australian policy inaction threatens lives
Climate plays an important role in human health and it is well established that climate change can have very significant impacts in this regard. In partnership with The Lancet and the MJA, we present the inaugural Australian Countdown assessment of progress on climate change and health. This comprehensive assessment examines 41 indicators across five broad sections: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. These indicators and the methods used for each are largely consistent with those of the Lancet Countdown global assessment published in October 2017, but with an Australian focus. Significant developments include the addition of a new indicator on mental health. Overall, we find that Australia is vulnerable to the impacts of climate change on health, and that policy inaction in this regard threatens Australian lives. In a number of respects, Australia has gone backwards and now lags behind other high income countries such as Germany and the United Kingdom. Examples include the persistence of a very high carbon-intensive energy system in Australia, and its slow transition to renewables and low carbon electricity generation. However, we also find some examples of good progress, such as heatwave response planning. Given the overall poor state of progress on climate change and health in Australia, this country now has an enormous opportunity to take action and protect human health and lives. Australia has the technical knowhow and intellect to do this, and our annual updates of this assessment will track Australia’s engagement with and progress on this vitally important issue.
Ying Zhang · Paul J Beggs · Hilary Bambrick · Helen L Berry · Martina K Linnenluecke · Stefan Trueck · Robyn Alders · Peng Bi · Sinead M Boylan · Donna Green · Yuming Guo · Ivan C Hanigan · Elizabeth G Hanna · Arunima Malik · Geoffrey G Morgan · Mark Stevenson · Shilu Tong · Nick Watts · Anthony G Capon
Corrections
Correction
In “Disparity of access to kidney transplantation by Indigenous and non-Indigenous Australians” in the 17 September 2018 issue of the Journal (Med J Aust 2018; 209: 261-266), the confidence intervals (but not the hazard ratios) in Box 4 were incorrectly reported. The corrected figure (right) is available at mja.com.au; the changes do not influence the interpretation of the results.
Correction
In “Pre-conception care: an important yet underutilised preventive care strategy” in the 5 November 2018 issue of the Journal (Med J Aust 2018; 209: 389-391), there was a typographic error in the Box. The first sentence of the “Rationale and evidence base” for the item “Alcohol and illicit drug use” should read: “Evidence that ceasing alcohol and illicit drug use prior to conception is beneficial has not been reported.”
Reflections
Forty years of “Waltzing Matilda”: the history of the multichannel cochlear implant
The fascinating history of the multichannel cochlear implant and its inventor, Professor Graeme Clark
Joyce PK Ho · Hannah North · Narinder P Singh
Ignaz Philipp Semmelweis (1818–1865): herald of hygienic medicine
Commemorating the bicentenary of the doctor who championed aseptic practice in obstetric medicine
Edward A Carson · Nadeem Toodayan
Adding kindness at handover to improve our collegiality: the K-ISBAR tool
Handing over with kindness will help us create a culture of respect and trust in the workplace
David J Brewster · Bruce P Waxman
The guilty pleasure of Christmas cookies
Each year, as Christmas draws near, she calls in for a visit.
Ranjana Srivastava
Physician burnout: a recipe for disaster
Burnout seems to affect health care staff more than other professions
Fergus JW Morris
Book/media/app reviews
A comprehensive review of significant issues in health law
Tensions and traumas in health law
Andrew Alston
Everything you need to know in one short book
What it takes to be a doctor: an insider’s guide
Caroline M de Costa
Understanding the use of simulation in medical teaching
Manual of simulation in healthcare, 2nd edition
Benjamin B Symon
Challenges in community-based participatory research
Handbook of community-based participatory research
Fran Baum
Christmas competition
The emergence and characteristics of the Australian Mamil
Mamils provide mutual midlife support for each other but may not contribute to increasing overall physical activity levels among adult Australians
Adrian E Bauman · Katrina Blazek · Lindsey Reece · William Bellew
Licence to swill: James Bond’s drinking over six decades
Bond should seek professional help and find alternatives to drinking for managing on-the-job stress
Nick Wilson · Anne Tucker · Deborah Heath · Peter Scarborough
The Observational Physician and surGEon Automobile Response (TOP GEAR) survey
The “surgical personality” or personality type attracted to a career in surgery may influence automobile buying choices
Melissa Ellis · Michelle Sun · Megan Wood · WengOnn Chan
Carols by glow sticks: a retrospective analysis of Poisons Information Centre data
This epidemic of poisoning is perhaps due to mass seasonal synaesthesia
Rose Cairns · Jared A Brown · Andrew H Dawson · Wendy Davis · Nicholas A Buckley
C-ABC: cash before care in a private emergency department?
Good Communication, combined with expert Clinical Care by Consultants, backed by Courtesy and Compassion, followed by seamless Continuity of Care, will always supersede Cash
Stephen S Teo · Vijay Manivel
The Christmas e-list (an ode to big data)
’Twas the month before Christmas and all around town children could be seen busy writing ideas down
Stephanie A Prince
News
Cate Swannell
Regulatory and other responses to the pharmaceutical opioid problem
Gabrielle Campbell · Nicholas Lintzeris · Natasa Gisev · Briony Larance · Sallie Pearson · Louisa Degenhardt
Ensuring safety in public playgrounds is everybody’s business
Ruth A Barker · David Eager · Lisa N Sharwood
Medicinal cannabis for chemotherapy-induced nausea and vomiting: prescribing with limited evidence
Antony J Mersiades · Martin R Stockler · Ian N Olver · Peter Grimison
News briefs
Cate Swannell
The rising health, social and economic costs of Australia’s ageing prisoner population
Natasha A Ginnivan · Tony G Butler · Adrienne N Withall
The value of participating in clinical trials: the whole is greater than the sum of its parts
John R Zalcberg · Michael Friedlander
Glycaemic control apps for diabetes: lifting the lid
Rahul Barmanray · Esther Briganti