more_vertThe Lancet Editorial (Dec 23, 2017, p 2740)1 highlights the urgent need to protect the Rohingya from atrocities. The UN Security Council and member states have been called on to investigate these apparent crimes against humanity and impose appropriate sanctions against military forces, but the mental health status of the Rohinga also requires urgent attention. The outbreak of diseases such as diphtheria, cholera, and measles represents only a small part of the problem. The greater and more concerning challenge is protecting the mental health of individuals exposed to genocide and humanitarian crises.
Preference: Infectious Diseases and Parasitology
434
Additional research funding for rare cancers
The Federal Government has announced a $69 million boost to help medical researchers in their fight against rare cancers and rare diseases.
The funding is aimed at assisting patients who often have few options and poor life expectancy.
Health Minister Greg Hunt said the Government was committed to investing in research to find the answers to these challenges.
“This is a significant boost on the $13 million that was originally flagged when we called for applications and reflects the incredibly high calibre of medical research that is happening right here in Australia,” Mr Hunt said.
The new funding includes more than $26 million for 19 research projects as part of the landmark Medical Research Future Fund’s Rare Cancers, Rare Diseases and Unmet Needs Clinical Trials Program.
These projects will undertake clinical trials for devastating conditions like acute lymphoblastic leukaemia in infants, aplastic anaemia, multiple sclerosis and Huntington’s disease.
Researchers at the University of New South Wales will test a vaccine to target glioblastoma, a lethal brain cancer and the most frequent cause of cancer deaths in children and young people.
Another clinical trial at the University of Queensland will evaluate the benefits of medicinal cannabis for people with advanced cancer, and define the role of the drug for patients with cancer in palliative care.
Monash University is researching a new preventive treatment for graft versus host disease following a bone marrow transplant which could halve instances of the life-threatening complication, while a trial by the University of Western Australia to simultaneously compare a range of cystic fibrosis treatments may lead to improved care for this complex disease.
Other trials will explore the effectiveness and safety of aspirin compared to heparin to treat blood clots and test a new triple therapy regimen to target rare viral-driven brain lymphomas.
Prior to this announcement, rare and less common cancers received 12 per cent of the cancer research dollar, despite accounting for over 50 per cent of cancer deaths.
Details of the rare cancer projects that have received funding can be found here: www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2018-hunt008.htm
MEREDITH HORNE
AMA shines in Australia Day Honours
Former Australian Medical Association President Dr Mukesh Haikerwal has been awarded the highest honour in this year’s Australia Day awards by being named a Companion of the Order of Australia (AC).
He is accompanied by the current Editor-in-Chief of the Medical Journal of Australia, Laureate Professor Nick Talley, as well as longstanding member Professor Jeffrey Rosenfeld – who both also received the AC.
The trio top a long and impressive list of AMA members to receive Australia Day Honours this year.
AMA Federal Councillor, Associate Professor Julian Rait, received the Medal of the Order (OAM).
A host of other members honoured in the awards are listed below.
AMA President Dr Michael Gannon said the accolades were all well-deserved and made he made special mention of those receiving the highest Australia Day Honours.
“They have dedicated their lives and careers to helping others through their various roles as clinicians, researchers, teachers, authors, administrators, or government advisers – and importantly as leaders in their local communities,” Dr Gannon said.
“On behalf of the AMA, I pay tribute to all the doctors and other health professionals who were honoured today for their passion for their profession and their dedication to their patients and their communities.
“The great thing about the Honours is that they acknowledge achievement at the international, national, and local level, and they recognise excellence across all avenues of human endeavour.
“Doctors from many diverse backgrounds have been recognised and honoured again this year.
“There are pioneering surgeons and researchers, legends across many specialties, public health advocates, researchers, administrators, teachers, and GPs and family doctors who have devoted their lives to serving their local communities.
“The AMA congratulates all the doctors and other health advocates whose work has been acknowledged.
“We are, of course, especially proud of AMA members who are among the 75 people honoured in the medicine category.”
Dr Haikerwal, who was awarded the Officer in the Order of Australia (AO) in 2011, said this further honour was “truly mind-blowing” and another life-changing moment.
“To be honoured on Australia Day at the highest level in the Order of Australia is beyond imagination, beyond my wildest dreams and extremely humbling,” Dr Haikerwal said.
“For me to be in a position in my life and career to receive such an honour has only been made possible due to the unflinching support and unremitting encouragement of my closest circle, the people who have been with me through every step of endeavour, adversity, achievement, and success.”
CHRIS JOHNSON
AMA MEMBERS IN RECEIPT OF HONOURS
COMPANION (AC) IN THE GENERAL DIVISION
Dr Mukesh Chandra HAIKERWAL AO
Altona North Vic 3025
For eminent service to medical governance, administration, and technology, and to medicine, through leadership roles with a range of organisations, to education and the not-for-profit sector, and to the community of western Melbourne.
Professor Jeffrey Victor ROSENFELD AM
Caulfield North, Vic
For eminent service to medicine, particularly to the discipline of neurosurgery, as an academic and clinician, to medical research and professional organisations, and to the health and welfare of current and former defence force members.
Professor Nicholas Joseph TALLEY
Black Hill, NSW
For eminent service to medical research, and to education in the field of gastroenterology and epidemiology, as an academic, author and administrator at the national and international level, and to health and scientific associations.
OFFICER (AO) IN THE GENERAL DIVISION
Emeritus Professor David John AMES
East Kew, Vic
For distinguished service to psychiatry, particularly in the area of dementia and the mental health of older persons, as an academic, author and practitioner, and as an adviser to professional bodies.
Dr Peggy BROWN
Sanctuary Cove, Qld
For distinguished service to medical administration in the area of mental health through leadership roles at the state and national level, to the discipline of psychiatry, to education, and to health care standards.
Professor Creswell John EASTMAN AM
St Leonards, NSW
For distinguished service to medicine, particularly to the discipline of pathology, through leadership roles, to medical education, and as a contributor to international public health projects.
Professor Suzanne Marie GARLAND
Docklands, Vic
For distinguished service to medicine in the field of clinical microbiology, particularly to infectious diseases in reproductive and neonatal health as a physician, administrator, researcher and author, and to professional medical organisations.
Dr Paul John HEMMING
Queenscliff, Vic
For distinguished service to higher education administration, to medicine through contributions to a range of professional medical associations, and to the community of central Victoria, particularly as a general practitioner.
Professor Anthony David HOLMES
Melbourne, Vic
For distinguished service to medicine, particularly to reconstructive and craniofacial surgery, as a leader, clinician and educator, and to professional medical associations.
Dr Diana Elaine O’HALLORAN
Glenorie, NSW
For distinguished service to medicine in the field of general practice through policy development, health system reform and the establishment of new models of service and care.
MEMBER (AM) IN THE GENERAL DIVISION
Dr Michael Charles BELLEMORE
Croydon, NSW
For significant service to medicine in the field of paediatric orthopaedics as a surgeon, to medical education, and to professional medical societies.
Dr Colin Ross CHILVERS
Launceston, Tas
For significant service to medicine in the field of anaesthesia as a clinician, to medical education in Tasmania, and to professional societies.
Associate Professor Peter HAERTSCH OAM
Breakfast Point, NSW
For significant service to medicine in the field of plastic and reconstructive surgery as a clinician and administrator, and to medical education.
Professor Ian Godfrey HAMMOND
Subiaco, WA
For significant service to medicine in the field of gynaecological oncology as a clinician, to cancer support and palliative care, and to professional groups.
Dr Philip Haywood HOUSE
WA
For significant service to medicine as an ophthalmologist, to eye surgery foundations, and to the international community of Timor Leste.
Adjunct Professor John William KELLY
Vic
For significant service to medicine through the management and treatment of melanoma, as a clinician and administrator, and to education.
Dr Marcus Welby SKINNER
West Hobart, Tas
For significant service to medicine in the field of anaesthesiology and perioperative medicine as a clinician, and to professional societies.
Professor Mark Peter UMSTAD
South Yarra, Vic
For significant service to medicine in the field of obstetrics, particularly complex pregnancies, as a clinician, consultant and academic.
Professor Barbara S WORKMAN
East Hawthorn, Vic
For significant service to geriatric and rehabilitation medicine, as a clinician and academic, and to the provision of aged care services.
MEDAL (OAM) IN THE GENERAL DIVISION
Professor William Robert ADAM PSM
Vic
For service to medical education, particularly to rural health.
Dr Marjorie Winifred CROSS
Bungendore, NSW
For service to medicine, particularly to doctors in rural areas.
Associate Professor Mark Andrew DAVIES
Maroubra, NSW
For service to medicine, particularly to neurosurgery.
Dr David William GREEN
Coombabah, Qld
For service to emergency medicine, and to professional organisations.
Dr Barry Peter HICKEY
Ascot, Qld
For service to thoracic medicine.
Dr Fred Nickolas NASSER
Strathfield, NSW
For service to medicine in the field of cardiology, and to the community.
Dr Ralph Leslie PETERS
New Norfolk, Tas
For service to medicine, and to the community of the Derwent Valley.
Associate Professor Julian Lockhart RAIT
Camberwell, Vic
For service to ophthalmology, and to the development of overseas aid.
Mr James Mohan SAVUNDRA
South Perth, WA
For service to medicine in the fields of plastic and reconstructive surgery.
Dr Chin Huat TAN
Glendalough, WA
For service to the Chinese community of Western Australia.
Dr Karen Susan WAYNE
Toorak, Vic
For service to the community of Victoria through a range of organisations.
Dr Anthony Paul WELDON
Melbourne, Vic
For service to the community, and to paediatric medicine.
PUBLIC SERVICE MEDAL (PSM)
Dr Sharon KELLY
Yeronga, Qld
For outstanding public service to the health sector in Queensland.
Professor Maria CROTTY
Kent Town, SA
For outstanding public service in the rehabilitation sector in South Australia.
[The Lancet Commissions] The Lancet Commission on pollution and health
Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide—three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four.
Make a student’s week
BY ALEX FARRELL, PRESIDENT, AUSTRALIAN MEDICAL STUDENTS’ ASSOCIATION
For a medical student or junior doctor, one kind word can get you through the week. This year, as students start clinical rotations, remember that you have more influence than you think.
Placement as a medical student is a strange and wonderful world. It’s where we are finally exposed to the reality of practising medicine, and meet the doctors whom we aspire to be like one day. It is here that we set our expectations for the culture of medicine. We learn that medicine is a place of mentoring, compassion and respect. But it can also be tough, most students will recognise the near universal experience of feeling like a burden to their team.
Students want to work hard, but sometimes it is hard to know what is expected us, or how we can be of use to our team. You’ll recognise the almost painful amount of enthusiasm a student will put into a job you throw their waY – from grabbing a bluey to calling radiology, most students just want to be a helpful member of their team.
As medical students, we are very aware that teaching us takes time from doctors’ already packed days. We understand that treatment must be the first priority, and how frustrating it must be when students slow clinicians down. But like all doctors before us, we have to learn. Supervisors explaining a process or saying that a student did a good job only takes a second, but it can make a big difference to a student’s day.
Medical students will, invariably, get answers wrong. They will make a mess of simple procedures and they will take up time on days when the doctors on their team have none to spare. The supervisor who can tell them not just what they did wrong, but also how to improve, will be the teacher that they remember.
Positive experiences are important. I have heard many students extol an “incredible day”, simply because they felt like they were part of a team or that they could ask questions. Passion for medicine is infectious. In fact, many consultants have told me they are in their specialty because of a particularly influential mentor.
No doubt, it is high pressure being a doctor. Some days, circumstances make it tough to be the best supervisor, but never doubt the amount of good a quick acknowledgement can do for the medical student on your team.
There are great role models and teachers in every ward and clinic. For that we are grateful. Every one of you plays a role in shaping the doctors and medical culture of the future.
So this year, as medical students rotate in and out, keep in mind the doctors whose teaching made you the clinician you are today. Never underestimate the power of some thoughtful advice, a clear explanation, or a kind “you’ll get it next time”. We use your words to guide us, help us start off down the right path.
[Articles] Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study
Short-term exposure to traffic pollution prevents the beneficial cardiopulmonary effects of walking in people with COPD, ischaemic heart disease, and those free from chronic cardiopulmonary diseases. Medication use might reduce the adverse effects of air pollution in individuals with ischaemic heart disease. Policies should aim to control ambient levels of air pollution along busy streets in view of these negative health effects.
[Editorial] Editing the human genome: balancing safety and regulation
The international race to bring human genome editing into widespread use in clinical medicine is moving fast. On Jan 23, the National Institutes of Health Common Fund launched its Somatic Cell Genome Editing programme, committing approximately US$190 million of funding over the next 6 years to propel development of genome editing into medical practice. A worthy effort, but the USA and Europe still trail behind China. As many as 86 patients in China have already had their genes altered as part of clinical trials to treat a range of diseases, including solid cancers.
[Correspondence] Underestimation of the global burden of schistosomiasis
The Global Burden of Disease (GBD) Study aims to determine the cumulative global disability that is attributable to diverse diseases, the knowledge of which is essential in targeting public health responses, prioritising funding, and guiding research. The 2016 GBD study (Sept 16, 2017, p 1211)1 suggested that, of all 328 diseases considered, schistosomiasis showed the most pronounced reduction in age-standardised years lived with disability (YLD) between 2006 and 2016. Schistosomiasis was ranked in the top ten for YLDs in six sub-Saharan countries but was now reported to account for only 1·496 million YLD worldwide (down from the 2·472 million YLD estimated in the 2015 GBD Study);2 we think that the apparent drop is an artifact caused by underestimation of the effects of schistosoma infections and because of several limitations to the methods in the new GBD calculations.
[Seminar] Thalassaemia
Inherited haemoglobin disorders, including thalassaemia and sickle-cell disease, are the most common monogenic diseases worldwide. Several clinical forms of α-thalassaemia and β-thalassaemia, including the co-inheritance of β-thalassaemia with haemoglobin E resulting in haemoglobin E/β-thalassaemia, have been described. The disease hallmarks include imbalance in the α/β-globin chain ratio, ineffective erythropoiesis, chronic haemolytic anaemia, compensatory haemopoietic expansion, hypercoagulability, and increased intestinal iron absorption.
[Correspondence] Questions regarding the CONCERN trial – Authors’ reply
We thank Ricky Turgeon for his Correspondence regarding our CONCERN trial1 on the gastrointestinal safety of celecoxib plus esomeprazole versus naproxen and esomeprazole in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding.