Environmental health

The PNG cholera crisis highlights the need for more investment in infrastructure, particularly in the area of water, sanitation and hygiene, and more locally appropriate and responsive health systems in PNG.

John J Hall MB BS, MTH, FAFPHM · James A Gillespie BA(Hons), PhD · Alexander Rosewell BSc, MIPH, MAE · Pilly Mapira MB BS, MSc

A physician partners with a filmmaker to create an educational video for clinicians, and reflects on the possibilities and pitfalls of using social media for medical education.

Joseph E Ibrahim MB BS, PhD, FRACP · Prateek Bandopadhayay MB BS, LLB, LLM

We may have at least 11 patron saints devoted to food, but what we really need is a patron saint of public health diplomacy.

Stephen Leeder

Bicycling as a mode of transport has great health benefits, but the rate of serious injury to bicyclists is a concern in Australia. Recent research findings contribute to the evidence for promoting the wearing of helmets as one means of reducing serious head injuries and deaths.

Peter A Cameron MB BS, MD, FACEM · Frank McDermott MB BS, MD, FRACS · Jeffrey V Rosenfeld MB BS, MD, FRACS

Alongside the current clinical approaches to reduce the duration of mental disorders, it is time to focus on a complementary approach to reduce their incidence.

Anthony F Jorm PhD, DSc · Nicola J Reavley PhD

Halloween is becoming increasingly popular in Australia, but what are the public health implications?The use of fictional characters and festivals to sell unhealthy commodities is well established. Both Santa Claus and the Easter bunny have been employed to influence people, especially children, towards unhealthy behaviour.1,2 Each year, on 31 October, an increasing number of witches and wizards darken the doors of Australian households, demanding free junk ...

Gillian P Porter MB BS, DCH · Nathan J Grills MB BS, DPhil, MPH

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 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

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

In Victoria, a high proportion of medical certificates recommend complete absence from work, particularly for patients with mental health conditions. These trends present major challenges in terms of return to work and issues such as viability of the compensation system, and are important given the growing evidence on the health benefits of work.

Alex Collie BA, BAppSc(Hons), PhD · Rasa Ruseckaite BSc, MSc, PhD · Bianca Brijnath BA(Hons), PhD · Agnieszka A Kosny BA, MA, PhD · Danielle Mazza MD, FRACGP

It is time that the environmental cost of doing medicine is brought into the whole equation; that Big Pharma are brought on board; and that doctors are educated to give this some priority.

Peter M J Fisher BSc(Hons), PhD · David A Smith BSc · Peter J Collignon MB BS(Hons), BSc(Med)

Evidence from a recent population breast screening trial shows improved detection with integrated 2D and 3D mammography. Will enhanced detection translate into improved outcomes for women?

Nehmat Houssami FAFPHM, PhD

Repeated warnings from health experts have fallen on deaf ears. So, yet again, strategy and action to prevent the looming diabetes apocalypse are being called for.

Paul Z Zimmet AO, MD, PhD, FRACP