Age-standardised incidence is continuing to increase and this, in combination with a shift to proportionately more in situ lesions, suggests that the stabilisation of mortality rates is due, in large part, to earlier detection. For primary prevention, after a substantial period of sustained effort in Queensland, there is some suggestive, but not definitive, evidence that progress is being made. Incidence rates are stabilising in those younger than 35 years and the proportionate increase for both in situ and invasive lesions appears to be lower for the most recent period compared with previous periods. However, even taking the most favourable view of these trends, primary prevention is unlikely to lead to decreases in the overall incidence rate of melanoma for at least another 20 years. Consequently, the challenge for primary prevention programmes will be to maintain momentum over the long term. If this can be achieved, the eventual public-health benefits are likely to be substantial.

Summary The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross‐government‐sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: ➢models of comprehensive primary health care consistent with the patient‐centred medical home model; ➢coverage of the Aboriginal population higher than 60% outside major metropolitan centres; ➢consistently improving performance in key performance on best‐practice care indicators; and ➢superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best‐practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.

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The placement of a ligature around the second maxillary molar of the conventional rat caused osteoclastic bone resorption and simultaneously, alveolar bone formation. The number of peripheral mononuclear cells in the blood and lymphoblastic transformation of spleen cells in response to concanavalin A increased. Cyclophosphamide (CY), an immunosuppressive agent, given shortly after placing the ligature suppressed the lymphoid reactions, spleen size, and bone formation and enhanced bone destruction. CY given in higher doses also suppressed the number of PMN cells. Septicemia developed in several of these animals. Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli were isolated from the blood and/or ligature. Antibiotics prevented bone destruction. Without placing a ligature, the high dose of CY did not result in bone loss. These findings suggest that 1) bone destruction of the ligature‐treated rat is of bacterial origin, 2) CY suppresses proliferation of osteoblasts but does not seem to interfere with the activity of osteoclasts, and 3) suppression of the host defenses greatly facilitates bone destruction.