In This Issue

Melbourne drivers still engaged

Talking on handheld mobile telephones while driving is still de rigueur in Melbourne, despite increased penalties for, and policing of, this distracting practice. In a 4-year follow-up of their 2002 study, Taylor et al observed a rate of 16.3/1000 drivers with clearly visible mobiles held to the ear in Melbourne streets — a non-significant decrease from 18.5/1000 4 years earlier (→ Handheld mobile telephone use among Melbourne drivers). Of course, there are now more gadgets than ever to provide distraction in the car. In “Look what I can do while I’m driving: implications for road safety in Australia”, McEvoy points out that the effects on driving of MP3 players, personal digital assistants and wireless email are largely unknown. There are also a growing number of promising in-car technologies designed to improve driving safety, and innovative research techniques to determine the benefits and drawbacks of technology in the car.

HIV risk behaviour on the increase

All Australian states need effective, innovative and evidence-based programs for HIV prevention, particularly among men having male-to-male sex. This was the conclusion of Guy et al, in an important study published on the eMJA at the end of July. The article found a downward trend in HIV diagnoses between 1993 and 1999, followed by increasing rates between 2000 and 2006 (→ HIV diagnoses in Australia: diverging epidemics within a low-prevalence country). There were state differences: New South Wales, which has always had the highest rates, remained stable after 2000, while the rates in Victoria, Queensland, Western Australia and South Australia increased significantly, possibly reflecting geographic differences in risk perception and behaviour.

Case by case

If you’re finding this issue a little too public health-oriented, turn to our two case reports, both of which present challenging clinical scenarios. Swaraj et al enunciate several Lessons from Practice in “Breast implant mimicking pericardial effusion in a cancer patient undergoing gated heart pool radionuclide study”, garnered from their experience in interpreting a gated heart pool radionuclide study in a patient undergoing treatment for breast cancer. And when a teenage boy presented with rapidly progressive ascending paralysis shortly after eating raw salmon, Gunja et al were faced with a Diagnostic Dilemma, which ultimately revealed that some associations really are coincidental (→ Raw salmon or red herring: ascending paralysis with suspected seafood poisoning).

Obesity coverage a bit thin

Television news and current affairs stories about obesity generally concentrate on individual factors, neglecting the societal and environmental determinants of the problem, say Bonfiglioli et al (→ Choice and voice: obesity debates in television news). To determine the content of Australian TV news stories, they analysed 50 items that went to air over 6 months in 2005. One-fifth of all reports were about new medical or surgical treatments for obesity, and one in 10 were human interest weight-loss stories. Most (36/50) framed the problem in terms of nutrition, and individuals or parents were presented as primarily responsible for obesity in all but 11 reports. While ack-nowledging the role of individual lifestyle choice in obesity, the authors believe that greater media advocacy for socio-cultural and environmental change would aid the public health response to the problem.

Live on Aussie, live on

According to Ring and O’Brien’s analysis of recent data from OECD countries, Australia’s mortality rate could be the lowest in the world in the foreseeable future if we concentrate on some of the preventable causes of disease, and racial and socioeconomic inequalities (→ Our hearts and minds — what would it take for Australia to become the healthiest country in the world?). At the moment, Japan is in the longevity lead, but Australia looks like rivalling Switzerland for overall number 2 ranking.

Beached

Readers of the MJA will be familiar with the work of the Bettering the Evaluation and Care of Health (BEACH) program, an ongoing study of general practice activity in Australia and arguably the best source of data about doctors’ prescribing practices. In “The Bettering the Evaluation and Care of Health (BEACH) program may be left high and dry”, Russell and Leeder report that BEACH’s federal funding is currently under threat. A rescue or a rethink would appear to be in order.

Another time . . . another place

The Battle of the Bulge

This year an ocean trip I took, and as I am a Scot
And like to get my money’s worth I never missed a meal
In spite of Neptune’s nastiness I ate an awful lot,
Yet felt as fit as if we sailed upon an even keel.
But now that I am home again I’m stricken with disgust;
How many pounds of fat I’ve gained I’d rather not divulge:
Well, anyway, I mean to take this tummy down or bust,
So here I’m suet-strafing in the Battle of the Bulge.