In This Issue

To P or not to P

In the lead-up to Christmas last year, a spate of young driver (and passenger) deaths sparked public debate about how to save novice drivers from themselves. Various strategies are currently under discussion in several Australian states. In “We need restrictions on night driving and peer passenger numbers for novice drivers”, Stevenson makes the argument for two measures that have proven successful overseas.

My beating heart

As well as being Valentine’s Day, February 14 is Congenital Heart Disease Awareness Day. In a timely editorial, Winlaw et al describe how geneticists and developmental and molecular biologists have coordinated their efforts in recent years to improve our understanding of why this condition strikes so many Australian families, often seemingly at random (→ Progress and challenges in the genetics of congenital heart disease).

Good advice

Geneticists have to work fast to keep up with all the new developments in their discipline, and to provide the most up-to-date advice for patients and other health professionals. To discover whether this is happening, Bonke et al. led an international team in testing whether geneticists and genetic counsellors in four countries had learned how to take the carrier status of relatives (who have already been tested) into account when counselling people regarding their risk (or an offspring’s risk) of Huntington’s disease (→ Genetic risk estimation by healthcare professionals).

The art of interrogation

Now that 2005 is in full swing, there will be a new crop of junior doctors awaiting mentoring and instruction. Your students will learn more when they are involved in the teaching episode. Drawing them in with questions is a good way to do this. However, before you seek to entrap them with such classics as "List the causes of metabolic acidosis", read Lake’s tips for effective questioning in Part 7 of our Teaching on the run series (→ Teaching on the run tips 7: effective use of questions).

Chemo crisis

A man with myasthenia gravis from a thymoma commences chemotherapy. Within 24 hours he develops a myasthenic crisis with respiratory failure. The trigger factor becomes clear as Ng’s Notable Case unfolds (→ Myasthenia gravis and a rare complication of chemotherapy).

More than a headache?

Last year, Dutch researchers published a study that found an excess of brain infarctions and white-matter lesions in people with migraine, causing some to conjecture that migraine might lead to long-term brain damage. In “Is migraine a progressive disorder?”, Goadsby comments on how this research might affect how we treat (and what we tell) our patients with migraine.

Autism numbers

The lack of a national autism register in Australia has made it difficult to plan for the large number of resources needed to help children with autism and their families. Researchers in New South Wales and Western Australia have recently combined forces and databases to crunch the numbers in these two states (→ Incidence of autism spectrum disorders in children in two Australian states).

As good as it gets

What does "continuous improvement" mean to you? According to Kilham these two innocent words, when used as a management term, have spawned an uncontrolled juggernaut of change for change’s sake (→ Continuous improvement and "Continuous Improvement").

Cancer gaps

Given the number of studies that reveal poorer outcomes for patients with cancer in rural areas, it is not surprising to discover, as Coory and Baade did, that prostate cancer is no exception. Despite overall decreases in mortality from their disease, the rural-urban divide is widening. Rather than simply restating the problem, however, their study also provides data on possible reasons for the observed discrepancy.

Indigenous people with any cancer are twice as likely to die from it than other Australians. A recent national discussion forum in Darwin included oncologists, epidemiologists, Aboriginal and Torres Strait Islander health workers, cancer survivors and others — all focusing on achieving equity in this area (→ Reducing the impact of cancer in Indigenous communities: ways forward).

Fighting the puppy

The 5-year-old you are about to vaccinate before school entry looks decidedly chunky for her age. Is she overweight and, if so, by how much and does it matter? As our Paediatrics Practice Essentials series resumes, Batch and Baur take us from the public health aspects of childhood obesity to a practical approach to dealing with individual children and their families (→ 3. Management and prevention of obesity and its complications in children and adolescents).

Armed with foresight

In “Bilateral acute angle closure caused by supraciliary effusions associated with venlafaxine intake”, de Guzman et al remind us of an infrequent but unpleasant adverse reaction to serotonergic antidepressant drugs. Why does it happen and how can it be avoided? Read on...

Another time ... another place

The hemicrania, or pain of one half of the head, was very early distinguished by medical writers from the other species of headaches: but we have not yet advanced much in knowing how this differs from other pains of the head.