Northwest Tasmania Research Articles

The readability of patient handouts from an inner regional hospital emergency department

Written patient handouts are commonly used in hospital emergency departments to supplement doctors’ oral instructions and provide patients with a hard copy they can retain for future reference. The handouts are typically one to two pages in length and given to patients as part of their discharge instructions. Preparing handouts can be challenging because they need to communicate often complex information in a way that is both intelligible and useful to the reader. Text that is difficult to read and understand – has low readability – may prevent people from actively participating in their own care and using health care services effectively. In the most recent Australian survey of health literacy, the 2006 Adult Literacy and Lifeskills Survey (ALLS), 63.4% of Tasmanians aged 15–74 years were found to have insufficient health literacy to understand and use health information.1 This was equal only to the Northern Territory as the lowest health literacy level across the nation. These data suggest the likelihood of a mismatch between the readability of patient handouts and the health literacy skills of the people required to use them. This short report is on a readability analysis conducted on patient handouts issued through an emergency department of an inner regional teaching hospital in North West Tasmania. It represents the first stage of a study that will determine whether the readability of the handouts appropriately matches the health literacy of the people required to use them.

Insights into the Liquid Bismuth Collector Model Through Analysis of the Bi-Au Stormont Skarn Prospect, Northwest Tasmania

The liquid bismuth collector model has previously been proposed to explain the common association between gold and bismuth seen in many ore deposits, and involves the scavenging of gold from hydrothermal fluid by liquid bismuth. Here, textural relationships and temperature and chemical conditions of mineralization at the Stormont Bi-Au skarn prospect in northwestern Tasmania are analyzed to investigate whether the liquid bismuth collector model can explain gold accumulation at this prospect. The calc-silicate skarn assemblage containing grandite, hedenbergite, actinolite, magnetite, epidote, quartz, and calcite suggests that initial metasomatism involved temperatures >400° to 500°C. Visible gold is associated with native bismuth, bismuthinite, maldonite, galena, and an unknown Bi-Te-S mineral. Native bismuth is directly associated with grandite, which formed during initial stages of metasomatism. This implies that bismuth would have precipitated from a hydrothermal fluid as a liquid. Heating experiments showed that bismuth alloy inclusions in garnet melt between temperatures of 250° and 288°C. The mineralization setting at Stormont and textural relationships suggest that gold was scavenged from hydrothermal fluids by liquid bismuth. Rhythmically zoned grandite crystals provide evidence for fluctuating hydrothermal fluid conditions, which may have contributed to dissolution and reprecipitation of gold, thus facilitating an ore zone refining process within the prospect. This refining process is made possible by the tendency of liquid bismuth to scavenge gold from significantly under-saturated fluids. Infiltrating gold-undersaturated fluids can dissolve gold not in contact with bismuth, which can then be preferentially redeposited upon encountering a bismuth droplet, enhancing the correlation between the two elements. A long-lived and focused fluid flow system would maximize the efficiency of this ore zone refining process, which is likely to be relevant to gold deposition at a range of deposit types.

Late Holocene changes in precipitation in northwest Tasmania and their potential links to shifts in the Southern Hemisphere westerly winds

Accurate projections of future climate changes in regions susceptible to drought depend on a good understanding of past climate changes and the processes driving them. In the absence of longer term instrumental data, paleoclimate data are needed. In this study we develop a precipitation reconstruction for Rebecca Lagoon (41°11′S, 144°41′E), northwest Tasmania. First, the relationship between scanning reflectance spectroscopy measurements of sediment cores in the visible spectrum (380–730nm) and instrumental precipitation record (1912–2009) was used to develop a model to reconstruct precipitation back in time. Results showed that the ratio of reflectance between 660 and 670nm (i.e., reflectance at 660nm/reflectance at 670nm; a measure of pigment diagenesis) was significantly related to annual precipitation. A calibration model was developed (R=−0.56, pauto<0.001, RMSEP=43.0mm yr−1, 5year triangular filtered data, calibration period 1912–2009). Second, this calibration-in-time model was used to reconstruct late Holocene precipitation changes over the last ~3000years. This showed relatively dry conditions from ca. 3100–2800cal yr BP, wet conditions from ca. 2800–2400cal yr BP, dry conditions from ca. 2400–2000calyr BP, and variable conditions after this. Relatively wet conditions occurred from ca. 500cal yr BP to the late AD 1800s (ca. 50cal. yr BP). The precipitation reconstruction indicates that conditions were relatively dry for the 20th century compared to the last ~3000years. In particular, the dry period measured in recent decades is one of the most intense in at least the last 500years. As precipitation in this region is primarily driven by the Southern Hemisphere westerly winds, these changes are discussed in terms of shifts in westerly wind strength and/or position.

Do transdermal opioids affect the personal socioeconomic costs of healthcare access in an Australian rural pain population? A comparison with oral opioids

To determine whether there are differences in the personal socioeconomic costs of healthcare access between transdermal (TD) and oral opioid use in a rural population with chronic noncancer pain (CNCP). An observational longitudinal study, measuring change in the self-reported personal time and expense of healthcare access by route of opioid administration over time (monthly for 1 year). Subjects were opioid treated patients with CNCP from North West Tasmania, Australia. Subjects completed monthly datasheets by recording all personal healthcare access time and expense, together with the route(s) of opioid administration. The outcome measures of mean monthly healthcare time (MHT) and expense (MHE), by route of opioid administration, were analyzed using generalized estimating equations with robust standard errors. The details of 10,564 healthcare contacts from 198 subjects were obtained during the study. Total mean MHT with oral opioids was 3.76 hours (95% confidence interval [CI] = 2.21-5.32) and unchanged (p = 0.59) with TD opioids at 3.48 hours (95% CI = 2.23-4.72). Total mean MHE with oral opioids was AU$ 92.72 (95% CI = 51.21-134.24) and unchanged (p = 0.81) with TD opioids atAU$ 89.12 (95% CI = 54.53-123.71). The personal socioeconomic costs of healthcare access for rural patients with CNCP are similar for TD and oral opioid use. The prolonged analgesic affect of TD opioids may be advantageous for rural population.

Ore Deposits and Metallogenesis of Tasmania

Tasmania contains a broad variety of economic mineral deposits, which includes several that have been known for over a century and are still operating today or were worked in the recent past. The Arthur Lineament, a belt of allochthonous amphibolite, carbonate rocks, psammite and pelite in northwest Tasmania hosts the Savage River magnetite deposit, which is now considered to be a Proterozoic carbonate replacement deposit with affinities to Kiruna-style iron-oxide Cu-Au deposits. The allochthon was formed during an early Cambrian collisional event between an east-facing passive margin sequence and an intraoceanic island arc. Post collisional, proximal submarine volcanism at c. 500 Ma in the Mount Read Volcanics followed and associated mineralisation includes world-class deposits. High grade Zn-Pb-Au-Ag-Cu massive sulfide deposits (e.g., Rosebery and Hellyer) were formed from seawater-dominated hydrothermal fluids. Disseminated Cu-Au-Ag deposits of the Mount Lyell field are associated with broad alteration zones that include phyllosilicate assemblages indicative of a component of oxidised magmatic fluid, as does the Henty Au deposit in the north. Orogenic Au is an important deposit style in northeast Tasmania and includes the Tasmania deposit, Australia's largest single Au reef. Largely post-orogenic granitic magmatism (Lower Devonian-Tournaisian) includes an important Sn-W-base metal ± magnetite mineralising event associated with reduced, fractionated granite in northeast and western Tasmania. World class Sn ± Cu sulfide skarn and vein deposits are the product of interpreted magmatic fluids exsolved from these granitic magmas. The highly unusual disseminated Avebury Ni deposit is associated with granite of this type. World class scheelite skarn deposits on King Island lie in the contact aureole of moderately oxidised, unfractionated Tournaisian granodiorite on King Island.

Resistance of pasture production to projected climate changes in south-eastern Australia

Climate change impact analysis relies largely on down-scaling climate projections to develop daily time-step, future climate scenarios for use in agricultural systems models. This process of climate down-scaling is complicated by differences in projections from greenhouse gas emission pathways and, in particular, the wide variation between global climate model outputs. In this study, a sensitivity analysis was used to test the resistance of pasture production to the incremental changes in climate predicted over the next 60 years in southern Australia. Twenty-five future climate scenarios were developed by scaling the historical climate by increments of 0, 1, 2, 3 and 4°C (with corresponding changes to atmospheric carbon dioxide concentrations and relative humidity) and rainfall by +10, 0, –10, –20 and –30%. The resistance of annual and seasonal pasture production to these climatic changes was simulated at six sites in south-eastern Australia. The sites spanned a range of climates from high rainfall, cool temperate in north-west Tasmania to the lower rainfall, temperate environment of Wagga Wagga in southern New South Wales. Local soil and pasture types were simulated at each site using the Sustainable Grazing Systems Pasture model. Little change or higher annual pasture production was simulated at all sites with 1°C warming, but varying responses were observed with further warming. In a pasture containing a C4 native grass at Wagga Wagga, annual pasture production increased with further warming, while production was stable or declined in pasture types based on C3 species in temperate environments. In a cool temperate region pasture production increased with up to 2°C warming. Compared with the historical baseline climate, warmer and drier climate scenarios led to lower pasture production, with summer and autumn growth being most affected, although there was some variation between sites. At all sites winter production was increased under all warming scenarios. Inter-annual variation in pasture production, expressed as the coefficient of variation, increased in the lower rainfall scenarios where production was simulated to decline, suggesting that changing rainfall patterns are likely to affect the variability in pasture production more than increasing temperatures. Together the results indicate that annual pasture production is resistant to climatic changes of up to 2°C warming. The approach used in this study can be used to test the sensitivity of agricultural production to climatic changes; however, it does not incorporate changes in seasonal and extreme climatic events that may also have significant impacts on these systems. Nonetheless, the approach can be used to identify strategies that may increase resilience of agricultural systems to climate change such as the incorporation of C4 species into the pasture base.

A remarkable case of mosaic parapatry in millipedes.

The parapatric boundary between Tasmaniosoma compitale Mesibov, 2010 and Tasmaniosoma hickmanorum Mesibov, 2010 (Polydesmida: Dalodesmidae) in northwest Tasmania was mapped in preparation for field studies of parapatry and speciation. Both millipede species can be collected as adults throughout the year, are often abundant in eucalypt forest and tolerate major habitat disturbance. The parapatric boundary between the two species is ca 100 m wide in well-sampled sections and ca 230 km long. It runs from sea level to 600-700 m elevation, crosses most of the river catchments in northwest Tasmania and several major geological boundaries, and one portion of the boundary runs along a steep rainfall gradient. The location of the boundary is estimated here from scattered sample points using a method based on Delaunay triangulation.

Best Practice Heritage Protection: Australia's National Heritage Regime and the Tarkine

In January 2004, the Australian Government introduced a new federal heritage regime based around the National Heritage List (NHL). This regime has a significant governance defect; the heritage minister controls the list rather than an independent heritage body, exposing it to political manipulation. This article reviews the NHL listing process and compares it to a ‘best practice’ model. A case study on the Tarkine, a wilderness area in north-west Tasmania, demonstrates how the NHL has been managed and the influence political factors have had on its administration. The case study reveals that the concerns about the politicisation of the NHL are well-founded and that changes ought to be made to ensure the regime fulfils its objectives.

Proglacial deposition and deformation in the Upper Carboniferous to Lower Permian Wynyard Formation, Tasmania: A process analysis

The Wynyard Formation of Tasmania, Australia, provides the youngest evidence of grounded ice during the Late Carboniferous–Early Permian in the Tasmania Basin of southeastern Gondwana during the late Paleozoic ice age. Within the Wynyard Formation, four facies associations are recognized: 1) massive diamictite, 2) stratified diamictite, 3) conglomerate and sandstone, and 4) deformed mudstone and fine sandstone. A detailed facies analysis was performed in order to interpret the depositional processes and environments. The massive diamictite facies association contains massive diamictite and sandstone and was deposited primarily by iceberg rain-out in a subaqueous morainal bank setting. The stratified diamictite facies association is composed of stratified diamictite, sandstone, and conglomerate, and was deposited by debris flows and iceberg rain-out, and deformed by glacial pushing. The conglomerate and sandstone facies association is made up of cross-stratified, channelized conglomerate and pebbly sandstone that were deposited by glacial outwash on grounding-line fans. The deformed mudstone and fine sandstone facies association is composed of pervasively deformed pebbly mudstone and fine-grained sandstone that exhibit volcano, flame, and dyke structures. This facies association was deposited by a combination of suspension settling, iceberg rain-out, and soft sediment deformation, in a quiet distal proglacial setting. The facies analysis supports the interpretation that the Wynyard Formation was deposited by a wet-based, tidewater glacier or glaciers. The depositing glacier(s) occupied a ~ 40 km-wide trough in northwest Tasmania. Based on the distribution of the Wynyard Formation and the presence of glacial deposits in other eroded troughs in Tasmania, glaciation occurred in the region within broadly eroded valleys. The Wynyard Formation and overlying mudstone of the Inglis Formation provide a glacial–postglacial signature similar to those in South Africa, Antarctica, and eastern Australia during the latest Carboniferous–Early Permian, therefore the climate warmed in southern Gondwana following this glacial interval. The continued glaciation in eastern Australia was a result of regional topography and oceanographic processes.

Asian migrants' lived experience and acculturation to Western health care in rural Tasmania

The study was designed to explore the lived experience of Asian migrants' health care-seeking behaviour in Tasmania, to discern the acculturation process by which Asian migrants are enabled to use the health system and to identify strategies, which assist migrants to understand and use the health system better. Qualitative research was adopted. Semistructured interviews were conducted with 36 Asian migrants residing in North, South and North West Tasmania, which were recruited through purposive sampling. Six main themes emerged from the interviews: the acculturation process, interactions with the health care system, access issues, culturally appropriate health care, positive health care in Tasmania and suggestions for improving health care. The findings indicated that Asian migrants' views affected their health care-seeking behaviours because of the lack of information, poor communication, limited access and choices in Tasmania. Interestingly, those married to local Tasmanians had the shortest trajectory to health system acculturation. The study recommended developing health and well-being for Asian migrants by increasing access to information regarding navigating the health system and improving access to and awareness of language services. In addition, ensuring adequate, appropriately written, culturally specific and congruent information should be available to assist migrants' transition into a new health care system. Lastly, greater cultural awareness within the health profession to meet the needs of culturally specific individuals and communities is required when they seek care.

Soil phosphorus effects on ryegrass (Lolium perenne L.) production on a Hydrosol in Tasmania

Soil phosphorus (P) concentrations in excess of those required to maximise pasture production impose unnecessary costs on farmers and potentially increase the risk of P runoff to waterways. The relationship between soil available P concentration and pasture production was examined on an Oxyaquic Hydrosol. Mean annual pasture production ranged from 18,415 to 21,834 kg DM/ha over the 3-year sampling period. There was no significant difference in the annual DM production at Olsen P concentrations of 23–81 mg/kg measured from the 0–75 mm sampling depth. Results show that there was no increase in pasture production when soil Olsen P concentrations exceeded 23 mg/kg (0–75 mm). The optimum soil Olsen P ranges determined in the current study are well below the mean paddock concentrations previously measured in northwest Tasmania (54 mg/kg) and suggest that such high concentrations are not justified in terms of optimising pasture growth.

Ferruginous thermal spring complexes, northwest Tasmania: evidence that far-field stresses acting on a fracture mesh can open and maintain vertical flow in carbonate terrains

Far-field stress changes in the southern Australian plate since 5 Ma have produced significant areas of uplift and seismicity. In northwest Tasmania, there is evidence that this stress reorientation to maximum horizontal NW–SE stress has influenced meteoric-derived thermal (15–20°C) discharge patterns of confined karstic aquifers, by placing pre-existing NW-trending faults/fractures into a dilated state or a critically stressed state. Previous studies have shown that spring discharge has operated continuously for at least 65,000 years, and has transported large volumes of solutes to the surface to be deposited as mounds of calcite-goethite-silica up to 7 m high. The thermal spring chemistry at one site, Mella, is consistent with descent to at least 1.2–1.5 km, although the hinterland within 50 km is less than 500 m elevation. Thermal spring chemistry is consistent with most of the deep water–rock interaction occurring in low-strontium Smithton Dolomite. While some of this water is discharged at springs, some instead intersects shallow zones of NE-fracture-controlled rock (2 × 4 km in area) with karstic permeability where, although confined and subject to a NE-directed hydraulic gradient, it circulates and cools to ambient temperature, with only minor mixing with other groundwaters.

What Makes a Good Farm for Wildlife

MY first impressions on flipping through the pages of this book are that the layout is superb and wellorganized, and the combination of text, good colour photos, diagrams and box text should appeal to a wide audience. Do we need another book on this topic and, if so, what makes this one different? As a conservation practitioner and ornithologist/ecologist living in north-west Tasmania what I like most about this book and what makes it different is the way David Lindenmayer and his team communicate their research findings to the lay public in a refreshing manner with clear, practical messages and interesting facets of plant-animal interactions of both vertebrates and invertebrates.

Occupational health-related experiences in rural Tasmania

This descriptive, explorative study sought to identify the occupational-related health experiences of community nurses in their workday within rural North West Tasmania. Tasmania is one of eight states and territories that form Australia. The findings indicate the majority of community nurses consider their health average or better, although 30% reported being overweight; 5% reported smoking; 60% reported feeling tense, anxious or depressed sometimes during the week. In the 12 months prior to survey 48% of participants had experienced a work-related injury or illness. At least two thirds of participants spent an average of 1.5 hours teaching nursing students and 2 hours teaching medical students, per week. Hazards (needlestick injury, items obstructing passageways, debris within homes), dogs and use of mobile telephones were regularly associated with weekly work incidents. Interestingly, more time was spent in a day on documentation than with clients or professional development.

Structure of the Tasmanian lithosphere from 3D seismic tomography

Seismic data from three separate experiments, a marine active source survey with land-based stations, and two teleseismic arrays deployed to record distant earthquakes, are combined in a joint inversion for the 3D seismic structure of the Tasmanian lithosphere. In total, travel-time information from nearly 14 000 source–receiver paths are used to constrain a detailed model of crustal velocity, Moho geometry and upper mantle velocity beneath the entire island. Synthetic reconstruction tests show good resolution beneath most of Tasmania with the exception of the southwest, where data coverage is sparse. The final model exhibits a number of well-constrained features that have important ramifications for the interpretation of Tasmanian tectonic history. The most prominent of these is a marked easterly transition from lower velocity crust to higher velocity crust which extends from the north coast, northeast of the Tamar River, down to the east coast. Other significant anomalies include elevated crustal velocities beneath the Mt Read Volcanics and Forth Metamorphic Complex; thickened crust beneath the Port Sorell and Badger Head Blocks in central northern Tasmania; and distinctly thinner, higher velocity crust beneath the Rocky Cape Block in northwest Tasmania. Combined with existing evidence from field mapping, potential-field surveys and geochemical data, the new results support the contention that east and west Tasmania were once passively joined as far back as the Ordovician, with the transition from lithosphere of Proterozoic continental origin to Phanerozoic oceanic origin occurring some 50 km east of the Tamar River; that the southeast margin of the Rocky Cape Block may have been a former site of subduction in the Cambrian; and that the Badger Head and Port Sorell Blocks were considerably shortened and thickened during the Cambrian Tyennan and Middle Devonian Tabberabberan Orogenies.

Preliminary investigation into the prevalence of mucormycosis in the platypus (Ornithorhynchus anatinus) in three catchments in north‐west Tasmania

To investigate the distribution and prevalence of mucormycosis in platypus (Ornithorhynchus anatinus) from the Inglis, Emu and Black-Detention catchment areas in north-west Tasmania. A field study was performed and resulted in the examination of 44 wild platypuses; in addition, one dead platypus and two live platypuses were examined after they were independently submitted to a local veterinary clinic. No cases of mucormycosis were conclusively diagnosed. One platypus with signs consistent with those previously described in cases of mucormycosis was captured in the Emu River catchment. However, laboratory tests did not provide a definitive diagnosis for the lesion. Two platypuses from the Inglis catchment area had signs very similar to those previously described in cases of mucormycosis, but laboratory tests found Corynebacterium ulcerans to be the likely cause of the cutaneous ulcers on one of these platypuses and an unidentified fungal agent to be the cause of a cutaneous nodule in the other. These findings do not prove that mucormycosis is absent from the populations studied. However, they may indicate that the prevalence of disease is low. The possibility that Mucor amphibiorum is present in a subclinical form in platypuses, or infecting another reservoir, is not excluded. The findings also suggest that caution should be exercised when diagnosing mucormycosis based on clinical findings alone and raise the possibility that some cases may have been incorrectly diagnosed.

Sources and processes of contaminant loss from an intensively grazed catchment inferred from patterns in discharge and concentration of thirteen analytes using high intensity sampling

Summary Contaminants in water from intensively grazed catchments have been shown to cause significant environmental impacts. Effective intervention to reduce contaminant loads depends on identifying their sources and processes of mobilisation and transport. In this study, flow (Q) and analyte concentrations (CA) from a 12 ha catchment in north-west Tasmania used for grazing dairy cattle were monitored at a fine temporal scale and used to infer sources and processes of loss. Three groups of analytes identified based on CA–Q relationships, which included hysteresis loops, demonstrated that the TP group (TP, DRP, TSS, TN, E. coli and Enterococcus) was transported by surface runoff processes while the behaviour of the NO3 group (NO3, TDS, Ca, Mg, Na) was explained by subsurface processes and pathways. The NH4 group (NH4, K) was dominated by the addition of large quantities of analyte from grazing. In addition to the CA–Q relationships, concentrations of most analytes decreased linearly over each season of runoff. NH4 and K concentrations decreased exponentially following grazing events while TP concentrations decreased linearly. The study demonstrated the importance of understanding surface water and groundwater interactions and that relationships between runoff events, analyte concentrations and management as revealed by a fine temporal sampling regime may yield significant insights to sources and processes of loss of analytes in surface flow, at a given scale.

Effects of irrigating forage turnips, Brassica rapa var. rapa, during different periods of vegetative growth. 1. Turnip yields, yield components and growth rates

The effects of applying irrigation to spring sown forage turnips, Brassica rapa var. rapa cv. Barkant, during four stages of vegetative growth on yields, yield components and growth rates, were investigated in two field experiments in north-west Tasmania during the 1999–2000 and 2000–01 spring–summer seasons as a basis for developing irrigation strategies for turnip that could improve their efficiency of water use. Increases in dry matter yield in response to irrigating during the four consecutive periods of vegetative growth were additive for all treatment periods and harvest times: the yield increases to irrigation during any period were independent of prior or subsequent levels of irrigation. Consequently, yield increases that are foregone because of the onset of moisture deficits during an earlier period cannot be recovered in a later period: there is no compensatory growth. The results also show that moisture deficits that restrict yields in a previous treatment period do not restrict yield response to irrigation in later periods: the turnip crop appears to respond immediately to the removal of a water stress.

QTL influencing growth and wood properties in Eucalyptus globulus

Regions of the genome affecting physical and chemical wood properties (quantitative trait loci (QTL)), as well as growth, were identified using a clonally replicated, outbred F2 family (112 genotypes, each with two ramets) of Eucalyptus globulus, planted in a field trial in north-west Tasmania. Traits studied were growth (assessed by stem diameter), wood density, cellulose content, pulp yield and lignin content. These traits are important in breeding for pulpwood, and will be important in breeding for carbon sequestration and biofuel production. Between one and four QTL were located for each trait, with each QTL explaining between 4% and 12% of the phenotypic variation. Several QTL for chemical wood properties were co-located, consistent with their high phenotypic correlations, and may reflect pleiotropic effects of the same genes. In contrast, QTL for density and lignin content with overlapping confidence intervals were considered to be due to independent genes, since the QTL effects were inherited from different parents. The inclusion of fully informative microsatellites on the linkage map allowed the determination of homology at the linkage group level between QTL and candidate genes in different pedigrees of E. globulus and different eucalypt species. None of the candidate genes mapped in comparable studies co-located with our major QTL for wood chemical properties, arguing that there are important candidate genes yet to be discovered.

Gastric fundic gland polyps: a clinico-pathological study from North West Tasmania

Fundic gland polyps (FGPs) of the stomach were originally described in association with familial polyposis syndromes. It is now known that the majority of these polyps occur in the sporadic setting and are incidentally seen in up to 1.9% of routine upper gastrointestinal endoscopes. The aim of this study was to look at the clinico-pathological features of the FGPs and to analyse their relationship to Helicobacter pylori infection, proton pump inhibitor treatment, colonic polyps and malignancy. A search of the histopathology records for a period of 10 years from 1997 to 2006 identified 120 patients with a histologically confirmed diagnosis of FGPs. The clinical history, upper gastrointestinal endoscopy findings, histopathology and colonoscopy findings were recorded from the medical records and analysed. FGPs were seen in 3.2% of patients undergoing routine upper gastrointestinal endoscopes. There was a definite association with long-term proton pump inhibitor treatment. There was a strikingly low incidence of H. pylori infection in the study population. Although there was no dysplasia or malignancy in any of these polyps, one patient had concomitant adenocarcinoma of the stomach. In the subgroup of patients who also had colonoscopy during the study period, 19% had associated colonic polyps and 6% had associated colonic malignancies. Every new patient diagnosed with FGPs should have a thorough clinico-pathological study to see if the polyps are part of a sporadic or syndromic setting. A long-term follow-up study of patients with FGPs and its association with colonic polyps may be warranted.