Letters

To the Editor: A 62-year-old woman was admitted on 10 January 2012 for cardiac monitoring after her implantable cardioverter–defibrillator (ICD) discharged four times over a few hours. She had a history of ventricular tachycardia due to ischaemic cardiomyopathy, and had had an ICD (D284DRG Maximo II DR, Medtronic, Minneapolis, Minn, USA) inserted 6 years earlier. Her ICD had ...

Bo Xu · Howard Connor · Robert Ziffer

To the Editor: The report by Scott and colleagues on the “demographic characteristics, diagnostic category, stage of illness, as well as psychosocial and vocational impairment” of 1260 patients presenting to two Sydney headspace centres1 is problematic for several reasons. No convincing data were presented to support the authors’ conclusion that the research demonstrated that “well designed youth ...

Jon N Jureidini

To the Editor: The study of headspace attendees by Scott and colleagues1 illustrates problems common in articles being used for lobbying purposes in the Australian mental health policy arena. These include misrepresentation of evidence, inappropriate medicalisation, and undeclared competing interests. The authors refer to un(der)employment, lack of engagement in study, and receipt of income support as ...

Melissa Raven

In reply: The detailed demographic, diagnostic and disability data we presented1 responds directly to the critics of headspace clinics. Following the initial establishment phase,1 our two centres now provide services to 390 and 411 young people per month, respectively (data from July to September 2011). Each of the 30 established headspace services now assesses an average of 265 clients ...

Ian B Hickie · Daniel F Hermens · Elizabeth M Scott

To the Editor: An important and controversial article authored by Haines and Lowenthal1 was recently published in the Internal Medicine Journal. The authors challenged evidence used by Ian Gawler on his website (iangawler.com) and in his book2 to support meditation and dietary interventions as cancer therapy. Publication of the article was subsequent to initial submission ...

Emma S McBryde

In reply: The article referred to by McBryde was submitted to the MJA in 2011. Patient consent was requested, following standard MJA practice for all manuscripts containing potentially identifying patient data or images, but this was not provided by the authors. We agree that all the information was already publicly available, and it was for ...

Annette G Katelaris

To the Editor: In their editorial, MacLennan and Morrison1 listed Curtin University’s Evidence Based Complementary Medicine as a pseudoscientific unit. This citation was completely unjustified. The unit, which is part of both the Bachelor of Pharmacy and Master of Pharmacy (graduate entry) degrees, was developed for the sole purpose of providing pharmacy graduates with the knowledge, ...

Jeffery D Hughes · Liesl A Blott

To the Editor: Clinical pathways and guidelines are the inevitable consequence of evidence-based medicine and, in general, have been a force for good in terms of patient care. However, the experiences of Nanan et al1 and Dietz and Stokes,2 and my own experience of working with countless exasperated colleagues in clinical practice, suggest that the ...

Paul M McGurgan

To the Editor: Your focus on obesity in the 20 February 2012 issue of the Journal expresses the frustration of many of us working in this area. After 25 years, it is clear that we have achieved little in reducing the problem at the population level and that the existing model for dealing with obesity, based on personal ...

Garry J Egger

To the Editor: We congratulate Green and Maiorana1 on their recent article highlighting the value of exercise in obesity management. The urgent need for action to prevent further weight gain in adults and to reduce the proportion of the population that is obese was recognised 25 years ago. However, despite massive public health efforts to reduce obesity ...

Rosemary A McGinnes · Judy A Lowthian

To the Editor: We read Scott and Harris’s1 article with great interest and agree that new funding models for diabetes care must be carefully designed to ensure that interventions are effective. For this reason, the Diabetes Care Project2 (formerly the Coordinated Care for Diabetes Pilot) developed pilot interventions following reviews of international trials and extensive ...

Tim Fountaine · Jonathan E Shaw · Paul Z Zimmet

To the Editor: We read with interest the article by Geelhoed and de Klerk1 regarding the mortality benefits of a policy that ensures high numbers of patients are admitted to hospital within 4 hours of arrival at an emergency department (ED). The proof of improved performance following service intervention within a complex institution requires careful consideration. ...

Dylan J Toh · Campbell H Thompson · Josephine S Thomas · Jeffrey Faunt

In reply: We thank Mitra and Cameron, and Toh and colleagues for their remarks. Comments from some physicians that the 4-hour rule might increase mortality provided the initial stimulus for us to look at data related to its introduction in Western Australia. Given our results, their hypothesis seems unlikely to be true. Mitra and Cameron point ...

Gary C Geelhoed · Nicholas H de Klerk

To the Editor: Extensive rainfall in Queensland from December 2010 to January 2011 led to much of the state being declared a disaster zone. We report on a cluster of patients requiring hospitalisation with an acute febrile illness after exposure to floodwater in Central Queensland. During the height of the flood emergency, four adults (23–56 years of age) from ...

Hugh Wright · Katie Goot · Benjamin Rogers

To the Editor: The HIV epidemic in Australia is changing. The number of new infections attributed to heterosexual contact has increased, and people from culturally and linguistically diverse (CALD) backgrounds account for a significant proportion of these diagnoses. In the period 2005–2009, 41% of new HIV diagnoses linked to heterosexual transmission were in people from ...

Augustine D Asante · Henrike Körner

To the Editor: Two aspects of developing or renewing medical curricula that were highlighted recently by Goulston and Oates1 deserve further qualification: the dynamic nature of a medical curriculum; and wide consultation with a broad range of academics. Because medical curricula are continually evolving, it is crucial to appoint and support the right people to lead ...

David A Kandiah

To the Editor: The recent letter by McLaren1 focuses attention on conflicts of interest which can arise from public, rather than private, relationships. We, as authors of a recent article on developing guidelines about conflicts ...

Dev A S Kevat · Michael J Williams · Bebe Loff

To the Editor: Clinical training opportunities are a vital component of medical student education.1 The yearly intake of medical students into Australian universities has more than doubled since 2000.2 There is a need for increased ...

Mark K D Tiong · Michele R Levinson · John C Oldroyd

To the Editor: Vertical transmission of Toxoplasma gondii can result in significant morbidity in the fetus and newborn, although it is rare in Australia.1 Antenatal testing has shown seroprevalence of 23%–35%,2,3 which is possibly lower ...

Jude C Jayamaha · Peter Robertson · William D Rawlinson

To the Editor: Strongyloidosis in Australia has been reported in Indigenous Australians, war veterans who have served in South-East Asia and travellers and immigrants from regions in which strongyloidosis is endemic.1,2 The condition is caused by ...

Hannah M Soulsby · Saliya Hewagama · Stephen Brady

To the Editor: From 2007 to 2009 in Australia, a three-dose course of quadrivalent human papillomavirus (HPV) vaccine was offered to all females aged 12–26 years through school and primary health care settings, with coverage recorded on the ...

Bianca Barbaro · Julia M L Brotherton · Dorota M Gertig

To the Editor: The possible extension of the Australian preadolescent female vaccination program against human papillomavirus (HPV) to preadolescent males is not a sensible use of public health resources. In Australia, 71% of 15-year-old girls completed ...

Peter D Massey · David N Durrheim