In This Issue

ABC breast cancer cluster

In 2007, an Independent Review and Scientific Investigation Panel reported an increased risk of breast cancer among women working at the Australian Broadcasting Corporation (ABC) studios in Toowong, Brisbane. No cause for the increased risk was identified, but the Panel recommended investigation to determine whether there was an increased risk of breast cancer in women at ABC studios elsewhere in Australia, in case a common contributor might be involved. Sitas and colleagues (→ Breast cancer risk among female employees of the Australian Broadcasting Corporation in Australia) confirmed the excess risk of breast cancer among ABC employees in Queensland but did not find any statistically significant excess risk of breast cancer among ABC employees nationally compared with the general population. The implications of these findings are discussed in a linked editorial by Stewart (→ The ABC breast cancer cluster: the bad news about a good outcome).

The internet and mental health

Despite recent moves to promote seeking help, and changes to approaches to treatment in primary care, a significant proportion of Australians with mental health problems are not being reached by traditional health care services. In an editorial introduction to the supplement accompanying this issue of the Journal, Christensen and Hickie (→ E-mental health: a new era in delivery of mental health services) outline how internet-based services may help overcome some of the geographical, attitudinal and financial barriers to access to care. Topics in this internet and mental health supplement include the evidence for specific internet interventions for disorders such as depression, anxiety and substance misuse, as well as the experience of some online mental health service delivery models such as self-help and virtual clinics. It also includes the “in print” launch of Beacon, a new web portal to high-quality mental health websites for use by both health professionals and the public.

Cost of cholesterol lowering

Annual expenditure on Australia’s Pharmaceutical Benefits Scheme is currently about $7 billion, but Clarke and Fitzgerald (→ Expiry of patent protection on statins: effects on pharmaceutical expenditure in Australia) demonstrate that huge savings could be made if we increased our use of generic medications. Making comparisons with England, they calculated a potential saving of $1087 million over the nearly 5 years of their study if Australian doctors had prescribed generic statins at the same rate as that of their English counterparts. The authors also found that the Australian community paid $900 million more for generic statins than if we had paid English prices. They project that paying English prices for generic statins could save us up to $3.21 billion over 11 years.

The Australian DAFNE experience

Living with diabetes can mean a daily struggle between trying to achieve good glycaemic control and avoiding hypoglycaemia. The DAFNE (Dose Adjustment for Normal Eating) program, a structured education program for people with type 1 diabetes, may ease this burden. DAFNE has an emphasis on flexible diet, precise carbohydrate estimation and prandial insulin titration using insulin-to-carbohydrate ratios. McIntyre and colleagues (→ Dose adjustment for normal eating (DAFNE) — an audit of outcomes in Australia) found people who undertook DAFNE training had a significant improvement in glycaemic control as well as a significant reduction in severe hypoglycaemia.

The Human Variome Project

We mark the Australian Society for Medical Research (ASMR) Medical Research Week with an editorial by Cotton and Macrae (→ Reducing the burden of inherited disease: the Human Variome Project) about the Human Variome Project (HVP). Established in 2006, the HVP is a global initiative which aims to facilitate “the establishment and maintenance of standards, systems and infrastructure for the worldwide collection and sharing of all genetic variations effecting human disease”. The authors outline two pilot projects being undertaken by the HVP that will act as models for global collection of gene mutations and also describe the potential benefits of the HVP to individuals and the community. For more information regarding events during ASMR Medical Research Week, 4-11 June 2010, see http://www.asmr.org.au.

Not a harmless game

Swimming underwater as far as you can on a single breath is a common game played by children in pools across the nation. It may, however, have serious or even fatal consequences. Kumar and Ng (→ Don’t hold your breath: anoxic convulsions from coupled hyperventilation-underwater breath-holding) report two medical students who suffered seizure-like activity — thought to be due to cerebral hypoxia — while competing in a breath-holding dive competition. Both had hyperventilated before the dive.

Another time . . . another place

Cancerous tumors develop with greatest frequency in the breast of women . . .. Such unnatural tumors have their source in the black bile, a superfluous residue of the body.