Letters

Smoking cessation measures and tobacco control are cost-effective means of reducing deaths from lung cancer, and more progress is needed before national lung cancer screening can proceed.

Henry M Marshall · Kwun M Fong · Rayleen V Bowman

Can assessing risk factors for suicide attempts help in predicting suicide risk?

Michael S Gordon · Glenn A Melvin

In reply: It is not possible to usefully divide patients who present in psychological crisis into those at higher or lower risk of eventual suicide. Categorising patients in this way cannot assist in determining their management. Acknowledging this, Gordon and Melvin speculate that it might be possible to usefully divide such patients into those at higher or lower risk of eventual suicide attempt. That seems unlikely. ...

Christopher J Ryan · Matthew M Large · Sascha Callaghan

Heightened international surveillance efforts mean that direct CJD transmission through contaminated surgical instruments has not been clearly documented for 36 years.

Robert A Hodgson

In reply: We thank Hodgson for sharing his concerns, affording us the opportunity to reassure the medical and non-medical communities about the utility of recently revised infection control guidelines for Creutzfeldt–Jakob disease (CJD).1 We reiterate that sporadic CJD is already endemic in Australia, necessitating guidelines that are regularly updated to ensure relevant scientific developments are incorporated, and that variant CJD (a zoonosis related to “mad ...

Steven J Collins · Eugene Athan · Ann P Koehler

Checking whether an individual has registered consent for organ donation before discussing donation with the family can make a difference to the family’s decision.

Hugh O Stephens · David V Pilcher · Helen I Opdam

MERS-CoV has reached nine countries, and the risk to Australian Hajj pilgrims should not be underestimated.

Harunor Rashid · Osamah Barasheed · Robert Booy

More than half of female Australian GPs experience sexual harassment from patients, while less than 7% report ever receiving training on this issue.

Peter A Bratuskins · Heather A McGarry · Stephen J Wilkinson

To the Editor: We agree with Selvey and Carey1 that minimising the environmental impact of the food supply chain is vital. However, we disagree with recommendations that target some food categories. Variation in environmental footprint within a food category can be more important than the variation between categories.2 Research on environmental modelling systems needs to address complex trade-offs between factors such as carbon emissions, water, land ...

Manny Noakes · Bradley G Ridoutt · Gilly Hendrie · Brian A Keating

To the Editor: We agree that nutritious food choices should also be sustainable, but Selvey and Carey’s portrayal of seafood production1 is incorrect. The 2012 assessment of Australia’s fisheries found that only two of the 111 fish stocks classified (1.8%) were overfished, rather than the 40% claimed by Selvey and Carey, and one of these (bluefin tuna) is rebuilding rapidly.2 Assuming 15 million Australians eat two 100 g portions of seafood every week, our annual seafood requirements are 156 000 tonnes from the 241 100 tonnes of current sustainable fishing and aquaculture production. Globally, current fishing pressure is sustainable in 70% of world fish stocks.3 Demonising seafood based on discredited science claiming the world will run out of fish by 20484 does not help in making nutritious food choices. All food production has an environmental impact. We and others have applied the life-cycle analysis methods advocated by Selvey and Carey to several seafood industries. The amount of carbon dioxide produced by fisheries is lower than that from chicken, pork or beef production.5 Wild fisheries use little water and no fertilisers, pesticides or antibiotics,5,6 which makes seafood a healthy and sustainable choice for people and the environment.

Bridget S Green · Anna K Farmery · Colin D Buxton

To the Editor: We agree that nutritious food choices should also be sustainable, but Selvey and Carey’s portrayal of seafood production1 is incorrect. The 2012 assessment of Australia’s fisheries found that only two of the 111 fish stocks classified (1.8%) were overfished, rather than the 40% claimed by Selvey and Carey, and one of these (bluefin tuna) is rebuilding rapidly.2 Assuming 15 million Australians eat two 100 g portions ...

Caleb Gardner

To the Editor: Selvey and Carey infer that the consumption of imported seafood by Australian consumers is evidence that Australian seafood production is unsustainable.1 However, trade in canned and frozen seafood is extensive because these products are stable and because of the comparative advantage of production between countries. The same process results in Australia’s reliance on imported electronics, clothes and cars — it does not ...

Alexandra McManus

To the Editor: The two contributions by Gray and colleagues1 and Loblay and colleagues2 on the topic of salicylate intolerance illustrate that absence of evidence does not equate to evidence of absence.3 Neither paper quotes the admittedly sparse European peer-reviewed literature on the topic, including an understanding of the basic biochemistry,4,5 a diagnostic test, and clinical prevalence studies of intolerance to dietary salicylate.5-7 A wealth ...

Richard F Heller · C Ann Heller · Jane Heller

To the Editor: I am concerned that the recent articles on salicylate diets in the Journal1,2 may be seen as a current position statement on the usefulness of a low-chemical elimination diet. An elderly psychiatrist colleague said in 1976, “In 20 years time many parents will not be giving their children red cordial but scientists will still be discussing the issue!” The discussion continues, not because ...

Joan C Breakey

In reply: We are pleased that our publication has generated discussion regarding the benefits of low salicylate diets. However, the correspondence and references from Heller and colleagues and Breakey do not provide any further evidence for the use of such diets and simply reaffirm the lack of good-quality data in this area. Until such data are available, the use of salicylate elimination diets remains an ...

Paul E A Gray*

To the Editor: Despite concerns about suspected reductions in general practitioner visits for Australian children,1,2 there has been a lack of research to investigate trends in GP visits over the past decade. We explored trends in GP visits using linked data between the Medicare Benefits Schedule (MBS) database and the consecutive biannual survey (2004–2010) of two cohorts — the infant cohort (aged 0–1 years in 2004) and ...

Lixin Ou · Jack Chen · Kenneth Hillman

Serotype 15A’s abrupt appearance in the Victorian population, along with its high-level antimicrobial resistance and increased mortality rate show the importance of continued enhanced surveillance of invasive pneumococcal disease.

Janet E Strachan · Stacey L Rowe · Eileen M Dunne · Geoffrey G Hogg

To the Editor: The National Human Papillomavirus Vaccination (HPV) Program Register was established in June 2008 as Australia’s first national adult vaccination register.1 School-based HPV vaccination is now in its 7th year, and from February 2013 includes boys. States and territories report information about HPV vaccination at schools to the Register. This information is used to prepare coverage reports for program management, to provide completion statements to ...

Julia M L Brotherton · Michael Batchelor · Karen Winch

New South Wales prisons data add to previous findings which show that Indigenous and non-Indigenous Australians achieve similar hepatitis C treatment outcomes.

Jeffrey J Post · Andrew R Lloyd · Denise Monkley

To the Editor: Leptospirosis in Victoria can be acquired locally or overseas. The clinical manifestations range from asymptomatic disease to multiorgan failure. We performed a retrospective case review of 147 notifications of leptospirosis to the Victorian Department of Health during the period 2002–2012. We aimed to investigate the epidemiology, clinical features and outcomes of leptospirosis in this population and identify any differences between patients who acquired ...

Jason A Trubiano · Brett A Sutton · Lucinda J Franklin