Article Types
Perspectives
Doctors in support of law reform for voluntary euthanasia
People who are suffering and who will continue to suffer should have the right to request assistance to die gently and, if possible, at a time they choose, say the Doctors for Voluntary Euthanasia Choice.
on behalf of Doctors for Voluntary Euthanasia Choice
Clinical effectiveness research: a critical need for health sector research governance capacity
The barriers to conduct of clinical research will require solutions if we are to implement evidence-based health care reformReforms in the funding of health services, such as “activity-based” funding initiatives, seek to facilitate changes in how health care is delivered, leading to greater efficiency while maintaining effectiveness. However, often these changes in treatment strategies and service provision evolve without evidence demonstrating effectiveness in terms of ...
Ian D Davis MB BS, PhD, FRACP · Derek P B Chew MB BS, MPH, FRACP
The National Health Performance Authority
Why is performance reporting necessary? Is there any evidence of benefit? And how can it help busy doctors, nurses and allied health clinicians?
Diane Watson PhD
Clinical registries: the urgent need to address ethical hurdles
Clinical registries are at a crossroads. Will we continue the current patchwork approach or will we make the changes that are needed to improve the efficiency and effectiveness of data collection and drive the quality of care?
Sue M Evans MClinEpi, PhD · Bebe Loff BA LLB, MA(MedLaw · Peter A Cameron MB BS, MD
General practice-based clinical trials
Trials conducted in the general practice setting by general practitioner researchers to inform the practice of general practice.
Mark R Nelson MB BS(Hons), FRACGP, PhD
Rethinking psychotropics in nursing homes
While research supports use of psychotropic medications by nursing home residents in some clinical situations, we use them too often, for too long, at doses too high, in dangerous combinations and without adequate consent.
Sarah N Hilmer MB BS(Hons), FRACP, PhD · Danijela Gnjidic BSc(Hons), PhD, MPH
Gestational diabetes needs to be managed
Delays in a uniform approach to detecting gestational diabetes mellitus and providing adequate management represent a missed opportunity to improve pregnancy outcomes and maternal health.
H David McIntyre MD, FRACP · Jeremy J N Oats DM, FRCOG, FRANZCOG
Real-time monitoring of Schedule 8 medicines in Australia: evaluation is essential
A real-time reporting system for controlled drugs may improve the safety of Schedule 8 medicinesOver the past decade, increased prescribing of pharmaceutical opioids in a number of countries has raised professional and public concern about iatrogenic opioid dependence and fatal opioid overdoses. Most fatal drug overdoses in the United States are now from opioids.1 Although not as high as in the US in absolute terms, the ...
Fiona L Shand BSc(Hons)(Psych), MClinPsych, PhD · Gabrielle Campbell BA(Psych), MCrim · Wayne Hall BSc(Hons) (Applied Psych), PhD · Nicholas Lintzeris BMedSci, MB BS, PhD · Milton Cohen MD, FRACP, FFPMANZCA · Louisa Degenhardt BScHon, MClinPsych, PhD
The United Kingdom’s broken promises on health
Complex reforms and increasing financial strains on the UK National Health Service make it almost inevitable that patient care will suffer.
Tony Kirby BSc(Biological Chemistry)
Managing diabetes and preventing complications: what makes the difference?
Greater emphasis is needed on behavioural and psychosocial aspects in research and clinical practiceWednesday 14 November marks World Diabetes Day, the birthday of Sir Frederick Banting, whose research led to the discovery of insulin in 1922. In the 90 years since, there have been other significant landmarks. The Diabetes Control and Complications Trial (DCCT)1 and United Kingdom Prospective Diabetes Study (UKPDS)2 showed that the devastating complications of ...
Jane Speight PhD, CPsychol, AFBPsS
Australia’s dietary guidelines and the environmental impact of food “from paddock to plate”
A draft revision of Australia’s dietary guidelines is comprehensive with respect to nutrition but contains minimal reference to the environmental impact of the food supply, and the choices consumers can make to minimise this impact.
Linda A Selvey MB BS(Hons), PhD, FAFPHM · Marion G Carey MB BS(Hons), MPH, FAFPHM
HIV progress ... dropping slow
Australia should use its influence as a United Nations Security Council member to advance a clear global strategy to tackle HIV, says the Honourable Michael Kirby.
The Honourable Michael D Kirby AC, CMG
Birth of a cohort — the first 20 years of the Raine study
Participant engagement and careful planning are key to a successful cohort studyIn the beginning there was an idea ... and funding. The project might never have started if not for a serendipitous meeting between an accountant for the Raine Medical Research Foundation and a young obstetrician. The Foundation had been established 30 years earlier by the bequest of Mary Raine (Box 1), a successful businesswoman who ...
Charlotte M McKnight MB BS · John P Newnham MB BS, MD, FRANZCOG · Fiona J Stanley MB BS, MD, MSc · Jenny A Mountain MBA, MClinEpi · Louis I Landau MB BS, MD, FRACP · Lawrence J Beilin MB BS, MD, FRACP · Ian B Puddey MB BS, MD, FRACP · Craig E Pennell MB BS, PhD, FRANZCOG · David A Mackey MB BS, MD, FRANZCO
How should we regulate smokeless tobacco products and e-cigarettes?
Less harmful forms of nicotine have harm reduction potential that is worth investigatingConcern has been expressed about the possible increased use of smokeless forms of tobacco, such as low-nitrosamine smokeless tobacco (SLT) and electronic nicotine delivery systems (ENDS), also known as e-cigarettes (Box).1 Domestic sale of SLT was banned pre-emptively in 1991 in response to overseas marketing of these products to youth. Currently, Australians are permitted ...
Coral E Gartner PhD · Wayne D Hall PhD · Ron Borland PhD
The roadmap to close the gap for vision
Indigenous Australians have six times more blindness than the national average, but 94% of the vision loss is preventable with eye examinations and timely access to treatment. The Roadmap emphasises regional needs-based planning for service delivery and accountability.
Hugh R Taylor MD, FRANZCO, AC · Andrea I Boudville MIH · Mitchell D Anjou MScOptom
Gamete donor medical records: whose information is it?
Is it ethical, moral and feasible to release gamete donors’ medical records to conceived offspring?This year, the Law Reform Committee of the Parliament of Victoria released recommendations from an inquiry into various aspects of donor conception, including the ability of donor-conceived people to access identifying and medical information about their donors.1 The Committee recommended that donor-conceived people gain retrospective access to such information, similar to ...
Damian H Adams BBiotech(Hons)
Learning from journalists’ experiences of the H1N1 pandemic
Good working relationships with journalists are needed during public health crises but many journalists believe that health departments could do a better job of meeting their information needs, both in content and timeliness.
Melissa A Sweet BA, MA · Kate E Holland PhD · R Warwick Blood PhD
The media and public health: complexity, controversy and combat
The overt role of journalists is to provide information to an interested or concerned public. But journalists also have a shadow role — generating entertainment value to enhance advertising and shareholder revenue. Likewise the overt role of public health officials is to disseminate accurate, timely information to inform an interested populace; but health officials too have a shadow role — to minimise the political risks of the elected branch of government
Craig B Dalton BMed, MMSc, FAFPHM
Can we feel it in our waters? Antimicrobials in aquaculture
Eating fish once or twice a week is promoted as good for your health — but is there a downside as well? With the global decline in wild fish stocks, there is an ever-increasing demand for aquaculture-produced fish and other aquatic foods. The aquaculture industry is relatively new but is growing rapidly in ...
Mary D Barton BVSc, PhD, FACVS · Olasumbo L Ndi BSc, MSc, PhD
Exploring the economics of helicopter rescue in Australia
Helicopter emergency medical services (HEMS) have a considerable history in Australia, with operations in Sydney dating back to 1973. HEMS have evolved from their original use in water-based search and rescue to become an established mode of medical transport in the local health system, helping to alleviate the “tyranny of distance” that restricts equitable access to health ...
Colman B Taylor BPhEd, MND · Stephen Jan BEc, MEc, PhD · John A Myburgh PhD, FCICM, FAICD
Take a deep breath . . . and talk
Eighty fewer deaths were recorded in the year following the adoption of the 4-hour rule by the emergency departments (EDs) of three tertiary hospitals in Western Australia1 — equivalent to almost half the state road toll. This remarkable result is regarded by some as preliminary. But if it stands the test of time, it will be testament to what is achievable with good up-front resourcing from a health department, plus improved communication — in this case, between the ED and the wards ...
Rachel E Nowak BSc, MA, PhD
The definite health risks from cutting power outweigh possible bushfire prevention benefits
On 2 January 2012, during a period of extremely hot weather, a South Australian electricity distributor deliberately cut power to several thousand homes because it was concerned that its electricity assets might cause a bushfire. Its action raises an important question: when does the risk of electricity assets causing a bushfire outweigh the benefits of having a power supply? ...
Richard A Broome MA, MB BS, MSc · Wayne T Smith MPH, FAFPHM, PhD
It’s not about choice: the supermarket and obesity
Supermarket design and strategy encourages shoppers to buy large quantities of high-profit-margin products. The emergence of supermarkets as a form of retailing and increasing reliance on manufactured foods have paralleled the increase in the rate and severity of obesity. So, it makes sense to examine supermarkets and how they successfully market these now widely used goods to the community. Supermarkets have an almost universal captive market — ...
Molly E Bond BBiotech(Hons), DipLang · Brad R Crammond MA(Hons), LLM · Bebe Loff LLB, MA, PhD
Automated office blood pressure measurement for routine clinical practice
Good correlation with out-of-office readings, virtual elimination of white-coat effectAn accurate blood pressure (BP) reading can be obtained if measurement guidelines are followed properly. However, BP readings recorded in routine clinical practice are often inaccurate and much higher than mean awake ambulatory BP values and readings obtained by home measurement. In studies that have included data on office BP readings that were recorded manually in ...
Martin G Myers MD, FRCPC · Mark R Nelson MB BS(Hons), PhD, FRACGP · Geoffrey A Head BSc(Hons), PhD
Improving effectiveness of clinical medicine: the need for better translation of science into practice
Published research evidence does not automatically diffuse into clinical practice but requires active processes of translation that start with clinicians’ awareness of the science and end with patient adherence to the recommended care. Many barriers thwart the uptake of valid and clinically important research into practice, with cognitive, motivational and sociological factors on the part of health professionals being among the most important. ...
Ian A Scott FRACP, MHA, MEd · Paul P Glasziou MB BS, FRACGP, PhD