Letter from the editor
Editorial Team

The committee of the Medical Student Journal of Australia (MSJA) proudly presents Volume 4, Issue 2.  For this issue we have chosen the theme “salus mundi” which, in its Latin translation means “welfare of the world”.  The MSJA has continued to grow over the past four years and for this issue, the committee has aimed to gather more submissions from around Australia particularly from the allied health domains. We have even received international submissions for the first time.

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News & Topics of Interest
Clostridium Difficile: an emerging infectious disease threat
Ines Prasidha
Clostridium difficile is the most common cause of hospitalacquired and antibiotic-associated diarrhoea. The infection can range from asymptomatic colonisation to severe pseudomembranous or fulminant colitis, resulting in prolonged hospital stays with high morbidity and mortality, and extra cost and pressure to the healthcare system.

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Government policy on financial assistance to medical students discourages medical research
Corey B. Moore
The Social Security Act 1991 section 569(2)(b)(i) makes anyone who has completed a “degree of Doctor” ineligible for Austudy. The intention behind this rule is reasonable in that it limits the time taxpayers support an individual’s study. However for Bachelor of Medicine, Bachelor of Surgery (MBBS) training, it is discriminatory, discourages our country’s international medical research competitiveness, and reduces the quality of care that is delivered to individual patients and the community as a whole.

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Education
The medical student bedside mentoring program: a feasibility study
Emma Tucker, Dr Caroline Luke
Peer-assisted learning is an integral part of medical student training. It occurs in the informal situation of approaching a peer for assistance, with students more likely to approach peers than faculty, in organised study groups, and in formalised Problem Based Learning (PBL) sessions. Peer-assisted learning has been shown to be as effective as the training provided by experienced faculty in learning anatomy, communication and history taking skills, laboratory skills and clinical skills, as well as in the PBL setting.

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Life in the developing world as a foreign medical student
Corey B. Moore
In September 2010 I was dismayed to find out it would be at least 18 months until I could be accepted into and start medical school in Australia. I could be almost half way through my degree in that time. Worse still, what if I was not feeling so well on the day of the GAMSAT or the interview? I would then have to wait another 12 months to try again! What was I supposed to do for the next 18 to 30 months?

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Global Rural and Indigenous Health
Q Fever – cut the bull!
Stephanie Hendry
In Australia, Q fever is largely an occupation- associated infectious disease. It can result in significant morbidity and time off work. A relatively effective vaccine has been available since 1989, but there are still 300 cases reported annually. After introduction of the National Q Fever Management Program (NQFMP) there was a halving of reported cases, but with cessation of the vaccination program in 2006, a further drastic reduction cannot be expected. The aim of this article is to explore the impact of the NQFMP and review the available trends since its cessation. This helps to identify current gaps in the data on vaccination and Q fever, and therefore suggests further areas of research.

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Electives
Paediatrics in China: hospitals and orphanages
Cheryl Pui-Yan Au
With generous funding from the Australian Chinese Medical Association, I was able to go on a four week medical elective to Xi’an, China, with Shaanxi Agape Community Care Association. This is a Chinese non-profit, nongovernment organisation that works in partnership with local Chinese people and overseas volunteers to provide medical care within Shaanxi province. This organisation has a strong focus on providing community care to vulnerable populations in western China, especially orphans and children with disabilities. The organisation also provides services such as rehabilitation programs, counselling, community health education, child support as well as medical/nursing training for rural village doctors and community health workers.

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Surgeries and safaris in South Africa
Nushin Ahmed
"Are you mad? Do you know it has the highest rates of HIV/AIDS in the world? Did you realise that muggings occur every single day?" These were some of the comments people made when they learnt that I would be going to South Africa for my elective. Despite their warnings, I was still determined to go, even more so because of the lengthy application process!

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Tongan adventures
Kate Brown, Jessica Madden
In January 2012 we travelled to Tonga for a four week elective. Tonga is a collection of beautiful islands in the Pacific Ocean just a four hour plane trip from Sydney. We chose Tonga because we wanted to experience medicine in a developing country and also have a holiday. Also, Tonga is a cheap place to travel. We spent the first two weeks in the Vaiola Hospital on the main island, Tongatapu. In the hospital we spent a week on the paediatric ward and a week on the general medical ward.

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Feature Articles
A Médecins Sans Frontières career
Dr Nicholas Coatsworth
I had an argument once with a close friend of mine about the semantics of the word ‘career’. It was an odd discussion, mainly because I looked upon her career with some degree of envy, and as something that I wanted to aspire to, yet she seemed to view medicine very differently.

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My brilliant career (with apologies to Miles Franklin)
A/Prof. Lybus Hillman
I always wanted to be a doctor. I have no idea why. No one in my family had ever been in a profession, no one had gone to university. I grew up in a tiny town in southwest Western Australia and I think I was impressed by the local general practitioner’s kindness to a tiny tot.

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Medical career choices - a personal reflection
Dr Andres de Francisco
Medicine… what else..? was my first response when I was asked what I wanted to study. Not an astronaut, fireman or Formula 1 driver, but a Medical Doctor. Why? Well, the fact that my father, uncles, and grandfathers for many generations were in the medical field I guess put a bit of subliminal pressure on my 'free' choice.

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Original Research
An audit of investigation and prescribing practices in patients discharged with systolic heart failure in a tertiary referral hospital
Michael J. Bennett
Heart failure affects 1.5-2.0% of the Australian population with around 30,000 new cases diagnosed each year. Prevalence of the disease increases greatly with age. A 2006 population study of Canberra residents found the prevalence of symptomatic heart failure was 4.4 times greater among those aged 80-86 than 60-64 years.

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Multifactorial causation of stroke in Australia: a comparison between Indigenous and non-Indigenous populations
Daniel D. Dascombe
Stroke is a significant contributor to the global disease burden; it is second only to coronary heart disease as a cause of death and is a major source of disability. In the Australian community there are an estimated 350,000 people living with the deleterious effects of stroke, with 11,220 deaths attributed to it in 2009.

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Comparing the frequency of GP mental health diagnoses between rural and urban communities
B Cantwell, K Clifton, D O'Leary Counahan, L Dickson, J Gerlach, H Imamura, D Medek, E Sansoni
Mental health disorders are a common presentation managed by general practitioners (GPs) across Australia and there is sometimes an assumption that mental illness is more prevalent amongst rural populations when compared to urban.

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Law & Ethics
The ethics of preimplantation genetic diagnosis
Cheryl Pui-Yan Au
A couple in their early forties, Mr and Mrs R, came to the fertility clinic for their first consultation regarding In Vitro Fertilisation (IVF) treatment. Mrs R has a strong family history of colorectal, breast and ovarian cancers on her paternal side, with her father confirmed to have the Breast Cancer Type 1 Susceptibility Protein (BRCA1) mutation.

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Coercion in psychiatry – is seclusion ethical?
Cheryl Pui-Yan Au
Cooper is a 22 year old male with a three year history of paranoid schizophrenia on a background of chronic cannabis use. He has had a history of trouble with the law for aggression/violence. He is on a community treatment order (CTO) but has been non-compliant with his medication. His sister contacted the acute crisis team when he became verbally and physically aggressive towards her.

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In the absence of "ObamaCare" regulation, is ethics sufficient to guide American Allied Health practice?
Sarah L. Latham
The United States of America’s health care system is both complex and flawed with a convoluted history that has resulted in inflated health care costs without a paralleled ranking in performance or level of overall national health. President Barack Obama’s reforms however, have set in motion a significant regulatory overhaul of the US health care system primarily through the Patient Protection and Affordable Care Act (PPACA), informally referred to as "ObamaCare", which was signed into legislation on March 23, 2010.

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No longer shut out: The National Disability Insurance Scheme and improved access to care
Samuel M. Harkin
This emotive and disturbing quote comes from the report 'SHUT OUT: The Experience of People with Disabilities and their Families in Australia'. The report highlights not only the human rights abuses suffered by Australians living with a disability, but also the significant financial challenges faced under the current disability-funding model.

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The Vipeholm Dental Caries Studies and the Capacity for informed consent
Philip M. Gaughwin
In Sweden at the beginning of the 20th century, tooth decay had become increasingly prevalent as its population industrialised and shifted from a rural to an urban habitat. By the 1930s, dental caries were prevalent in 83% of children’s deciduous teeth, and in over 99% of army conscripts, a figure comparable to the general population.

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Student Life
Can we do it? Yes we can! The juggle: medical school and family
Sharmila Sambandam, Shaun Thayer
With an increasing number of postgraduate medical schools, the average age of medical students has increased compared to the past. This increase in average age has lead to more people entering medical school with pre-existing commitments.

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