Letters

To the Editor: For several years, the Australian Bureau of Statistics (ABS) has cautioned data users of likely underreporting of suicide statistics due to delays in coronial processes and (since 2006) exclusive reliance on the National Coronial Information System, which often contains incomplete information on cause of death.1 In 2009, the ABS introduced data revision processes that allowed additional information received to be added in ...

Jerneja Sveticic · Samara McPhedran · Diego De Leo

To the Editor: There is significant concern about drinking patterns and alcohol-related harm among young people. A comprehensive approach to preventing harm from alcohol is needed, with population approaches including curbs on alcohol promotion.1 The National Preventative Health Taskforce has recommended phasing out alcohol promotions “from times and placements which have high exposure to young people”.1 Exposure to alcohol advertising influences young people; research consistently shows ...

Hannah L Pierce · Julia M Stafford · Mike Daube

To the Editor: The recent study by Thomas1 documents the change in smoking intensity of Australian Indigenous people between 1994 and 2008. A significant overall reduction in heavy smoking was observed with a corresponding increase in the proportion of light smoking. This is an interesting epidemiological observation but it should not be misinterpreted as a public health achievement or as a desirable goal in itself. As Thomas ...

Colin P Mendelsohn · Gillian S Gould

In reply: Nowhere in my article do I promote reducing the number of cigarettes patients smoke, rather than smoking cessation, as a goal for clinicians. Mendelsohn and Gould have created their own straw man with which to argue. I explain in the third paragraph of the Discussion that the population changes in smoking intensity may have been caused by previously heavy smokers cutting down (with only ...

David P Thomas

To the Editor: Cyclones, floods and bushfires are experienced in Australia every year, and Australia’s management of natural disasters centres on prevention, preparedness, response and recovery.1 Although access to safe food is a basic human need, during the 2010–2011 Queensland floods there was minimal information available to guide household food preparedness and food supply to communities.2 To ensure that Queensland is better prepared for future natural ...

Elizabeth J Good · Amanda J Lee · Fiona L McKenzie Lewis

To the Editor: It is pleasing to see Curtis and colleagues report injury trends and mortality across New South Wales,1 but the data are old and precede major changes to the NSW trauma system. We are concerned that the conclusions of this study will be misapplied by policymakers, leading to unnecessary out-of-area transport of injured patients. The authors concluded that there is a survival benefit when ...

Stuart G Stapleton · Rod O Bishop · James L Mallows

In reply: In our study,1 we allocated the numbers and type of trauma centres according to New South Wales Department of Health terminology and the Royal Australasian College of Surgeons Trauma Verification Committee model resource criteria. The latter reflected the resource availability of 24-hour, 7-day per week specialty services such as plastic surgery, cardiothoracic surgery and neurosurgery at those centres during the study period,2,3 as ...

Kate A Curtis*

In recognition of Palliative Care Week (19–25 May), we are reminded that, “Palliative care is everyone’s business”. It is a timely and relevant slogan.

Ian Maddocks · Yvonne Luxford

A fan of our “Stamps of greatness” series takes the connection between philately and medicine a step further, with an account of a chance moment in history.

Robert M Parker

To the Editor: Reducing the time from presentation to cholecystectomy in patients with acute cholecystitis has been shown to benefit patients (eg, by reducing the duration of patient discomfort before surgery) and to be cost-effective.1-3 Benefits have also been shown for performing cholecystectomy during the index admission for gallstone pancreatitis.4 Geelong Hospital (in regional Victoria) introduced daily general surgery emergency theatre sessions in February 2011. We ...

Daniel P McGlade · David A Watters · Douglas A Stupart

To the Editor: Harris and colleagues report failure to obtain reduction in several important risk factor-based intermediate outcomes for vascular disease from their lifestyle intervention in the Health Improvement and Prevention Study (HIPS).1 Using intention-to-treat analysis, if only 117 of 384 participants completed at least two of six group sessions, a positive result could not be expected. We know that interventions for prevention of cardiovascular disease (CVD) ...

James A Dunbar · Edward D Janus · Erkki Vartiainen

In reply: The Health Improvement and Prevention Study (HIPS) and the Greater Green Triangle study are not comparable. HIPS was a cluster randomised controlled trial of a pragmatic intervention that was delivered by general practitioners (through Divisions of General Practice) and was analysed on an intention-to-treat (ITT) basis.1 The Greater Green Triangle study was a pre–post study of patients recruited in GP waiting rooms who ...

Mark F Harris

DMAA was recently banned in Australia and other countries owing to toxicity, lack of health benefits, and concerns about long-term safety and potential for misuse. A trawl of the NSW Poisons Information database confirms the wisdom of the ban and suggests an expanded role for the database in future.

Jared A Brown · Nick A Buckley

Trauma registry data on patients admitted to Sydney hospitals following bicycle or motorcycle accidents reveal the protective effect of wearing a helmet.

Michael M Dinh · Kate Curtis · Rebecca Ivers

To the Editor: Surfboard riding is an iconic pastime in Australia. Injuries to the head and face constitute a considerable proportion of surfing injuries;1-5 26% of acute surfing injuries are to the head and face, and these make up 42% of emergency department presentations by surfers.3 We conducted a retrospective review at our tertiary referral hospital of patients who underwent medical imaging for injuries sustained to ...

Simon J Dimmick · Patrick V Sheehan · Mark Gillett · Suzanne E Anderson

A national survey found that many respondents were under the false impression that solariums are safer since regulations were introduced to ban their use by certain vulnerable groups of people, backing calls for a complete nationwide ban on solariums.

Suzanne J Dobbinson · Angela Volkov · Melanie A Wakefield

To the Editor: We would like to add a cautionary note to O’Neil’s support for the inclusion of “depression and other psychosocial factors” in the updated National Vascular Disease Prevention Alliance guidelines for assessing cardiovascular disease (CVD) risk. Her statement “it is now clear that depression is also an important risk factor for CVD” is premature.1 Different authors have challenged the suggested relationship and, given ...

Hans G Stampfer · Dana A Hince · Simon B Dimmitt

In reply: I thank Stampfer, Hince and Dimmitt for their response. While I acknowledge that there are aspects of the relationship between cardiovascular disease (CVD) and depression that remain undetermined, recent evidence clearly supports the role of depression as an independent risk factor for CVD and is indeed convincing.1-3 This is especially true in studies that assess depression using diagnostic criteria.4 We know that the ...

Adrienne E O’Neil

Given the link between high sodium intake and hypertension, gathering information on salt consumption among Indigenous Australians should be a public health priority.

Christopher G Lawrence*

Improved education and support for patients and general practitioners and, preferably, active follow-up by health departments of all notifications is needed in place of the current haphazard approach to contact tracing for hepatitis B notifications.

Karin Leder

To the Editor: I share Mahar’s concern regarding any future screening of prospective medical students for signs that they are likely to develop mental or physical impairment.1 Although Wilson and colleagues do acknowledge that screening may not be ethical, the separate issue of their seeming conflation of likelihood of illness with impaired ability to practise in the long term is problematic.2 Mental illness, and particularly ...

Dev A Kevat

Public health posters about flu transmission prevention need to reflect current best practice: cough or sneeze into your sleeve rather than your hands if tissues are not available.

Guy D Eslick

Australia must continue to support learning in emergency medicine through sufficient resourcing for emergency departments — the most appropriate setting for such training — and via robust accreditation standards.

Andrew D Gosbell · Rob D Mitchell · Victoria A Brazil · Alana M Killen