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PostPosted: Thu Nov 13, 2014 1:04 pm 
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Life and death: the challenges for anaesthetists

We all want a life – and its corollary, a death – free from incurable pain and suffering. A "do not resuscitate" request by a patient can be legally fulfilled under certain, stringent circumstances, if resuscitation would only prolong incurable suffering or would be futile.

But how do clinicians and carers ensure that these stringent circumstances have been met, especially in emergencies? Not for resuscitation (NFR) orders takes us into the bleak frontier of life and death decision-making where the fine print is all in grey unless wishes are explicit.

It is increasingly common for patients with significant chronic disease to participate in their own advanced-care planning. This is a process in which a patient, in consultation with healthcare providers and family members, makes decisions about their own future healthcare, should he or she become incapable of participating in medical treatment decisions. This kind of planning has been shown to improve the quality of end of life care and ease the burden of grief borne by loved ones.

An NFR order, increasingly a feature of advanced care planning, may be documented in the hospital records of patients whose underlying medical condition is severely compromising their quality of life, or is so debilitating as to make resuscitation attempts futile. If the order is at the patient's request, attempting to resuscitate the patient from an imminent or established heart or respiratory failure related to their underlying disease would be against the patient's wishes and could subject them to a loss of dignity and privacy that they had actively sought to avoid. It would not comply with the Good Medical Practice codes or guidelines of the Medical Board of Australia. Moreover, in the unlikely event that the resuscitation was successful, it may cause harm or prolong or increase the patient's suffering. For these reasons, all clinicians involved in a patient's care should respect an NFR order.

The situation is changed subtly, however, if the patient undergoes a surgical or other procedure that requires an anaesthetic. Examples could be palliative or pain relieving procedures. The patient may consent to the procedure and anaesthesia but wish the NFR order to continue. This poses particular challenges for the anaesthetist. Anaesthetists have a duty to intervene when a patient has an adverse reaction to anaesthesia, because these can occasionally be fatal. What if the adverse reaction (or imminent reaction) was not directly related to the patient's underlying medical condition? What if it were instead related to a recognised but easily reversible side effect of an anaesthesia drug? What if the patient already had intravenous access, airway protection and monitoring in place, and was likely to respond rapidly to resuscitative efforts without loss of privacy or dignity? Should resuscitation be withheld in these circumstances?

Providing anaesthesia for patients with NFR orders in place raises these and other questions. Several professional societies and organisations have guidelines on the decision to suspend or modify NFR orders in the pre and early post-operative period and we would argue that broader, more uniform guidelines should be developed and implemented as our population increases and ages.

As for all patients, patients with NFR orders should be reassured that their anaesthesia will be as safe as possible and that they will receive adequate pain relief following their procedure as well as optimal management of anaesthetic side effects. In addition they should be reassured that their wishes in relation to NFR orders will be respected. If they have provided informed consent to have the NFR orders maintained throughout the entire treatment, then any attempts at resuscitation will be limited to the management of adverse effects known (or suspected) to be caused by anaesthesia alone. They will not receive resuscitation from a cardiorespiratory arrest unrelated to the anaesthesia or surgery, and regardless of cause, resuscitation attempts will not be prolonged into the postoperative period counter to their requests.

In order to take the best care of ourselves and our loved ones the time to have the discussions about end-of-life care is before any urgent or critical decisions need to be made. It may not be possible to make a good decision and be happy with it later if the first time you have talked about the issues is, literally and figuratively, at knifepoint. ... 1l3lk.html

PostPosted: Sat Nov 15, 2014 2:16 pm 
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The ‘matchmaking’ service for babysitting and lift sharing

TWO women have created an online ‘matchmaking’ service for families looking to share school pick-ups and childminding responsibilities.

Faced with rising childcare costs and low vacancy rates at centres across Sydney, Katrina Clark and Lisa Robertson have launched a website that helps families connect with others struggling to find childcare.

Families who sign up to Connect4Care can see other members in their area who are willing to swap childminding at times agreed between themselves.

Ms Clark said their experiences of raising children had brought home the difficulties of parenting and working.

“We both had kids so we know how hard it is to juggle children and work or study, and we also used each other for child minding,” she said.

“I think it will make a huge impact for families by not just allowing them to get a foot back in the workplace, but also giving parents free time for themselves.”

Mosman and North Sydney local government areas have some of the lowest vacancy rates in Sydney, with data showing of the 24 childcare centres in North Sydney, just 14 have available spots. There is a daily average of 40 vacancies. In Mosman, 11 of the 14 centres had vacant spots, with a daily average of 50.

Connect4Care is piloting the program with the Cammeray Public School community, and hopes to eventually expand across Sydney and Australia.

Editor-in-chief of parenting website Kidspot, Alex Brooks, said many families needed help balancing parenting with work and life.

“Families just have to rely on a smorgasbord of solutions. There’s no one thing that will be the silver bullet, but the more options people have the better as they can tailor them to their particular life and working hours,” she said.

There would be the same level of trust needed as hiring a babysitter or choosing a childcare centre, Ms Brooks said.

The website requires parents who sign up to undergo a working with children check, and Ms Clark said she encourages the families to meet before arranging any childminding times. ... 7123076254

PostPosted: Mon Nov 17, 2014 11:57 am 
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Vic govt outlines plan to battle bulge

The Victorian government will spend $127 million to battle obesity, diabetes and heart disease if re-elected.

The money will be spent to fight rising obesity rates and chronic illnesses including diabetes and cardiovascular disease.

Premier Denis Napthine says there is a clear overlap between diabetes, heart disease and chronic kidney disease and the government will target risk factors through prevention strategies.

The package includes $40 million to support community health services deliver primary and preventative healthcare; $22 million to support those at risk of developing diabetes, cardiovascular disease and other chronic conditions; and $32 million for anti-smoking initiatives. ... ttle-bulge

PostPosted: Wed Nov 19, 2014 11:57 am 
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Melbourne mum fights cancer in heartbreaking bid to have more time with baby girl

A brave Melbourne mother with terminal cancer who gave birth to her daughter three months premature hopes she will live long enough to bring her home.

Baby Ava Michelle Ansalone was born on Friday at the Royal Women’s Hospital to proud parents Michelle Bucholtz and Alex Ansalone at just 29 weeks.

Weighing just 1056 grams, tiny Ava was born by caesarean due to concerns her seriously ill mother would not be able to carry her full-term.

Mr Ansalone started an online fundraising campaign in a bid to give his fiancée as much time as possible with their daughter.

“We’ve been told her prognosis is not good and there’s no cure,” he told the Herald Sun.

“So having the baby has been the best thing at this stage. It has helped us push through.”

While the cancer is terminal, Ms Bucholtz wants to be here to take her daughter home.

She is currently preparing for another round of chemotherapy treatment for an aggressive form of breast cancer.

Staff who helped deliver Ava wept when she was born. It was a moment Mr Ansalone and Ms Bucholtz’s sister, who was also in the delivery room, will never forget.

“I felt mixed emotions,” Ms Bucholtz said.

“It was difficult to be totally happy initially, I was looking at her thinking ‘Oh my God I’m not going to be here’.

“But when they put her on my chest a couple of days later everything sank away.”

On her fundraising page, the McKinnon mother’s fiancé described her as the love of his life. Months after they met and fell in love in 2012, doctors discovered a stage four triple negative cancer tumour in her right breast.

“We were devastated and had to act quickly,” Mr Ansalone wrote.

Ms Bucholtz, who was pregnant at the time, lost her golden hair as she started her debilitating treatment. A blood test confirmed she was pregnant but the devastated parents had to made a decision to give Ms Bucholtz a chance to fight.

Before Ava, they were forced to terminate two pregnancies because of the aggressive treatment.

“Before the chemotherapy was administered we stored Michelle's eggs at the Melbourne IVF clinic,” he wrote.

“The toll on Michelle’s mental and physical wellbeing was starting to escalate.”

So far, more than $22,000 has been raised to help cover the costs of the expensive treatment.

The new parents have been overwhelmed by the support. ... -baby-girl

PostPosted: Fri Nov 21, 2014 9:30 am 
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Man Eats 'Healthy' Foods For 60 Days And Learns Just How Much Sugar Is Actually In Them (Video)

An actor and filmmaker wanted to find out how much sugar was in food that is widely believed to be healthy, so he set out on a mission that proved to yield shocking results.

Damon Gameau stars in 2015’s “That Sugar Film” in which he goes on a 60-day mission to eat only low fat food items to prove once and for all that low fat doesn’t necessarily mean healthy. Gameau had reportedly abstained from sugar for around three years prior, so reintroducing it into his diet proved to be difficult.

All of the food that Gameau eats in the film is considered to be a healthier option because of the lower amount of fat, but in each thing he eats, the sugar content is still outrageously high. After three weeks of eating the seemingly healthy foods, Gameau begins to feel sluggish, fatigued and on edge. Shockingly, a doctor visit confirmed that the actor was in the early stages of fatty liver disease.

“I had no soft drink, chocolate, ice cream or confectionery,” Gameau told Australian news program Sunrise. “All the sugars that I was eating were found in perceived healthy foods, so low-fat yogurts and muesli bars and cereals and fruit juices, sports drinks ... these kind of things that often parents would give their kids thinking they’re doing the right thing.”

All in all, Gameau added around four inches of visceral fat to his waist, and by the time he ate his final meal, doctors said he was on the fast track to obesity.

“We’re not being dogmatic and saying people having to quit sugar, it’s just being aware,” said Gameau. “Sugar’s now in 80 per cent of the processed food we’re eating. If we can remove that, that’s the first step towards making a change.”

Check out the trailer for “That Sugar Film” below. ... king-video

PostPosted: Sun Nov 23, 2014 9:07 am 
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Text neck is new curse of modern age

IN the 20th century we had housemaid’s knee and miner’s cough — or, if you were from a different social stratum, tennis elbow. Now it seems there is a new work affliction for a new age, and it troubles all classes equally.

It is born of a peculiarly modern habit: walking along the street, head down, checking messages. It goes by the name of text neck.

Spinal surgeons say they are increasingly concerned that smartphones are causing a crisis in posture, especially in teenagers, the effects of which will be seen long after they have forgotten quite why it was so important to check WhatsApp.

“The neck is a wonderful thing, and it can have a full range of motion — but if you keep your head down for four hours a day, it is going to stress it,” said Kenneth Hansraj, chief of spine surgery at New York Spine Surgery & Rehabilitation Medicine.

He has published a paper analysing the forces felt by the neck through having continually to support the head held at an angle.

His conclusion, in the journal Surgical Technology International, is that, when the head is held at 60 degrees, the spine feels the weight of the head as five times its actual mass. Dr Hansraj said he is already having to treat the consequences of this.

“I’m a spinal surgeon, I see 100 patients a week; over time, I must have seen 30,000 patients or more,” he said. “It just incrementally became an issue, especially among young people. They were coming in with neck and back pain.”

One recent case, he said, was particularly extreme.

“There was a man, I had operated on him but he still had tremendous back and neck pain. I applied all my strategies but none worked. One day we were chatting and he happened to say: ‘I spend four hours a day playing games on my iPad’. I asked him to show me how he did it. His head was down at 60 degrees.”

Dr Hansraj taught him how to play on the iPad while keeping his head vertical — and the pain went.

Jonathan Dearing, a consultant orthopedic surgeon and spokesman for the Royal College of Surgeons of Edinburgh, was not surprised by the idea that holding your head in a fixed position for a long time could cause problems.

“Any excessive activity in a certain position is bad for you,” he said. “Common sense dictates that if any part of your body is complaining, if something is aching, it’s your body’s way of saying that something is wrong, so you should be sensible and stop doing it.”

He added that holding this particular posture for a long period of time was not necessarily a new phenomenon: “You could replace a mobile phone with a book. People have been reading for a long time.”

If that does not convince, there is another corollary of text neck that a teenager might find more persuasive: too much texting may well leave them with a neck like a tortoise.

Nichola Joss is a skincare artist to the stars, and she says she has seen a very particular trend among her customers. “I am definitely seeing more clients with premature ageing on their necks as a result of using smartphones,” she said. “It’s not necessarily lines and wrinkles, but more sagging skin, which is very ageing.”

Luckily, Dr Hansraj says there is an easy solution, to both sore backs and sagging necks. “My goal is not to scare people away from this wonderful technology. I would just say there are better ways to view devices. You don’t have to bend your neck; just hold your smartphone a bit higher and angle your eyes down.”

Problem solved? Possibly. Except there is another ailment, cited recently in medical literature. It can be contracted irrespective of posture. It causes pain in the joints. The first reports are already in. Are you ready for iPad shoulder? ... 7131889411

PostPosted: Tue Nov 25, 2014 12:18 pm 
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Drug use twice as high in bush

AUSTRALIANS in remote areas are twice as likely to use methamphetamines, smoke daily or engage in risky drinking as those in cities, according to figures released on Tuesday.

The findings, published by the Australian Institute of Health and Welfare, are based on the National Drug Strategy Household Survey, which collected data from 24,000 people in the second half of 2013.

It found more than two in five Australians either smoked daily, drank alcohol in ways that placed them at risk of harm, or used an illicit drug in the previous 12 months.

Overall levels of meth use were stable between 2010, when the survey was last conducted, and 2013, but there was a change in the most popular form used, with crystal meth or ice replacing powder as the preferred form of the drug.

Among recent meth users, ice use increased from 22 per cent to 50 per cent.

There was also a trend to more frequent use, with 15.5 per cent of recent users using it daily of weekly, compared to 9.3 per cent in 2010.

People who mainly used ice were far more likely to use it on a regular basis than those who used meth in other forms. A quarter of ice users used the drug at least weekly, compared to 2.2 per cent of those who mainly used powder.

While the proportion of people who reported being offered cocaine rose from 4.4 per cent in 2010 to 5.2 per cent in 2013, the proportion of people who actually took the drug was unchanged at 2.1 per cent.

There was a significant rise in misuse of pharmaceuticals, with 900,000 people reporting using a pharmaceutical drug for non-medical purposes in the previous 12 months. Of these, almost 3 in 10 used weekly or more often.

The increase was mainly due to an increase in the misuse of these drugs by men in their 30s and women in their 40s. Painkillers were the most commonly misused pharmaceuticals.

Residents of NSW were more likely to use cocaine and less likely to use meth than the people in other states and territories. Victorians were less likely to drink at risky levels and use cannabis than people in other jurisdictions. ... 18153.aspx

PostPosted: Thu Nov 27, 2014 7:56 am 
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Strangers give $275k to save terminal cancer mum in Melbourne

A new mother battling terminal cancer has welcomed $275,000 in donations over the past week from strangers touched by her heartbreaking story, which made national headlines last week.

Melbourne woman Michelle Buchholtz, 38, and her fiancé Alex Ansalone, 37, say they have been overwhelmed by people's generosity.

The online fundraising effort to pay for Ms Buchholtz's ongoing medical costs, as breast cancer spreads to her bones, has pushed well beyond the $50,000 target.

But there are also the random acts of kindness, like the lady who approached them in a restaurant with a $100 bill, the restaurateur who waived the bill or the grandmother knitting a beanie for their premature baby Ava, News Corp reports.

Ava was born by caesarean on November 14, nearly three months premature, at the Royal Women's Hospital amid concerns her mother would not be able to carry her full-term.

Ms Buchholtz now hopes to spend as much time as possible with her daughter and dreams of staying alive long enough to take Ava home.

The baby has been gaining weight and her condition reportedly has improved each day, with the couple now able to spend extended periods of time bonding with her. ... cancer-mum

PostPosted: Sat Nov 29, 2014 12:09 pm 
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Diet showdown: Paleo, #IQS, the 5:2 diet and activated almonds

WHO would have thought activated almonds could cause such a fuss?

But there they were, back in late 2012, embroiled in their own Twittersphere controversy after celebrity chef Pete Evans mentioned them in a Sunday newspaper column.

The almonds were not the problem per se, but Evans copped plenty of flak on social media for claiming he liked to start his day by activating them. How pretentious! How ridiculous, came the cry from many on social media.

Two years on, and we are all so knee-deep in kale chips and green smoothies (sipped out of a jar and Instagrammed) that Evans’ enthusiasm for activated almonds doesn’t seem that extreme.

Food that would have been deemed downright wacky five years go — chia seeds, juiced sprouts, acai berries — are now perfectly respectable menu choices on our exhausting journey towards “wellness”.

Take, for instance, the veritable potpourri of lifestyle diets just waiting to put a serious dent in your wallet, with their attendant superfoods, seeds and special oils at eye-watering prices.

You can join the hordes avoiding the fructose component of sugar in Sarah Wilson’s I Quit Sugar program, eat grass-fed meat and vegetables alongside Evans on the Paleo diet, intermittently fast on the 5:2, adopt a whole foods approach or shun gluten.

Unfortunately, the range of alternative diets on offer doesn’t mean there’s harmony among the subverters of the food pyramid; indeed, turf wars often break out among the rival camps, as subscribers to one diet question the science behind another’s.

Evans has butted heads with the Heart Foundation and the Dietitians Association of Australia over the merits of the Paleo diet, which he vigorously defends but they warn is dangerous because it eliminates food groups.

One of Australia’s best-known nutritionists Dr Rosemary Stanton came to the defence of carbohydrates — at least those found in wholegrains and fruit — early this month when the ABC’s Catalyst program featured scientists claiming we should be eating more fat instead of carbs.

There are also plenty of food skirmishes occurring in our own homes and offices, as anyone who has ever tried one of these diets will attest.


BURWOOD mum-of-three Ivy Thompson switched to a Paleo diet four years ago after feeling sick and overweight after the birth of her third child.

Thompson, 34, is a changed woman these days, and not just because her Paleo diet has given her more energy and helped her lose her post-baby weight.

The experience of being one of the early Paleo adopters — she writes a blog called Paleo in Melbourne — exposed her to the thoroughly modern phenomenon of food shaming, most commonly delivered in nasty or jealous comments about another’s food choices.

People, Thompson realised, can be very quick to judge what others eat.

“Because I have a presence on social media, they will try and catch me out,” she says. “If you post a picture of a smoothie on Instagram someone may ask whether our ancestors made smoothies in the caves.

“But I don’t walk around with a badge on my chest that says ‘Paleo Police’. If I want to eat a slice of gluten-free bread, I will have it.

“My focus is on wholefoods and I often tell people it is really just meat and three veg and that takes the fear out of it.”

While these days her family is more accepting of her diet, she admits they took a while to come around.

“My family felt entitled to tell me what they thought of what I was eating,” she says. “That is the beauty — and the misery — of families.”

One of Thompson’s sisters, in particular, took a while to see the benefits of the diet — even refusing Thompson’s home-cooked meals for takeout pizza — but she has since adopted many of her healthy eating habits.

“She refused to eat anything I made for a while and then (weeks later) she called me and said, ‘OK, tell me everything about it’.”

Thompson admits she became “a bit preachy” during the early phases of the diet, and was guilty of boring her friends about the virtues of the Paleo movement.

“I don’t do anything by halves and I think once you start a new diet you are on your high horse for the first six months,” she says. “But now I have the perspective from having done something long-term, and I know these diets are not a straightforward road.

“I am not preachy about it any more and I can usually tell pretty quickly if people want information about it.

“You don’t know really what anyone else is going through and I would never judge now. I have found the balance in the diet that works for me.”


FELLOW Melbourne mum-of-three Julia Kelly, 40, lost 20kg when she gave up sugar three years ago.

She now runs a business selling sugar alternatives on her website, The Sugar Break-up, which she started a year ago, and has managed to convince her sister to go sugar-free, while another “is not as interested”.

Kelly had a light-bulb moment reading anti-sugar tome Sweet Poison by David Gillespie, but concedes not everyone around her has endorsed her lifestyle.

“But you have to know you are doing it for the right reasons and that is all that matters,” she says.

“I feel free now. I felt like I was imprisoned before because it was an addiction (to sugar).”

Kelly says some people have even tried to change her mind about going sugar-free, but she has remained steadfast.

“They don’t come right out and say it is wrong, but they will try to get me to eat a dessert at a restaurant or something they have made knowing it contains sugar, or they will ask questions heavy with judgment,” she says. “Sometimes people simply want to undermine you, but you have to realise that there are some people in the world who are just like that.

“You have to have confidence in yourself and know there will always be knockers.”

Nutritionist and author of Change the Way You Eat: The Psychology of Food Leanne Cooper says part of the problem is that some women don’t have confidence in their bodies, which is played out in the competitive arena of food choices.

Cooper argues that far too many women reduce their meal times to a series of equations, as they mentally tally up calories, Weight Watchers points and fat grams before they even take a bite.

“It is a very reductionist view of eating,” Cooper notes. “What people should be doing is really stepping back and looking at what is on their plate, whether the portions are too big, whether the food is nourishing.”

This, Cooper concedes, is unlikely as long as we compare ourselves to others or focus unduly on food being “good” or “bad”.

While women have long been focused on their weight, Cooper believes the obsession with making food choices has become much more of a problem in the past 10 years.

“These days food and body image are so closely related, and we think if we beat ourselves up on an (extreme diet) we will be able to fit into those size 10 jeans,” she says.

Partly, she notes, the phenomenon is to do with the demise of the experts, as we increasingly place our trust in lifestyle and celebrity bloggers to package the “science” for us.

“The problem with the more extreme lifestyle diets is that they demonise certain food groups and it only serves to send out that confusing message about certain foods being bad,” Cooper says.

“I meet people who tell me they don’t eat grains, or they don’t eat dairy, or they don’t eat fruit and you end up wondering what they do eat. You now see people who are even diagnosing themselves as gluten-intolerant. It has become a bit obsessive.”


SO what is the root cause of all this intense focus? Why have we become so consumed by what we — and others — consume?

At the heart of it all, Cooper suspects it is about women trying to find order in their lives.

“I think we have such chaotic lives these days that these women are saying to themselves, ‘Food is something I can control’,” she says.

When others upset the balance by failing to join them in their food choices, some feel annoyed or even betrayed by their friends. Which is where the shaming comes in.

“Sometimes others find it hard to see other women addressing their diet because they think they are saying they are better than everyone else,” Cooper says.

“It is almost like the tall poppy syndrome in that respect, and people who are not eating healthily want you to join them in their demise.”

Dr Rosemary Stanton agrees we have become a lot more judgmental about the food other people consume and she lays the blame at the feet of the food marketers.

“I don’t want to knock shows like MasterChef because I think they have been good for encouraging people to cook from scratch, but there is this whole marketing side that has sprung up around it,”
Stanton says.

“Food has become a spectator sport and a source of status, but a lot of these new niche products, such as coconut oil, are actually very expensive.

“But people think if something is expensive or elitist then you may look as good as the celebrity promoting it.”

Stanton notes that the sheer number of lifestyle diets to choose from has confused almost everyone, and she is regularly quizzed at barbecues about the veracity of the health claims some of the diets are making.

Dietary confusion has also led to more and more headline-grabbing health claims, she argues, such as those made on the Catalyst program.

“The dietary guidelines really haven’t changed that much over the years, but eating healthily is actually quite boring,” she says.

“The dietary guidelines are never going to be the latest fad.”

While Stanton regularly offers her views publicly on the strengths and weaknesses of the latest lifestyle diets, personally it is a different matter.

“I never judge my friends for what they eat,” she says.

“I have a friend on the 5:2 diet, but really we just joke about it.”

That has not meant others have been quite so gracious; indeed, Stanton admits she has been a victim of food shaming herself.

“I will be eating in a restaurant and people will walk up to me and ask me outright what I am eating,” she says.

“When my children were little, I remember buying them ice creams one day and a woman commented that she never thought in a million years I would give my kids ice cream.

“I mean, it was just a treat!”

Stanton believes we all need to be a little more understanding about why people — ourselves included — eat certain foods.

“There is evidence to suggest that many people in stressful caring roles eat a lot of sweets to comfort themselves,” she says.

“I would rather they use food than cigarettes or alcohol, and, either way, it is not my place to judge them.” ... 7136874667

PostPosted: Mon Dec 01, 2014 8:19 am 
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Canberra Hospital emergency department to undergo $23 million expansion

The ACT Government is about to embark on a $23 million expansion of the emergency department at the Canberra Hospital.

The department has been struggling to cope with the number of patients for some time and has been averaging more than 90 per cent occupancy.

In the last financial year it treated more than 70,000 people.

Chief Minister Katy Gallagher said a major rebuild of the entire hospital was on the cards for the coming years, but an short-term solution was required for the emergency department.

"This is the interim solution to provide an extra 12 beds through the emergency department," she said.

"(It will) improve the resuscitation bays and provide additional space... for mental health patients."

Patients warned to expect increased noise, vibration

The revamp will also include up to nine additional acute beds for patients with severe conditions and more beds for patients with less serious problems.

The Emergency Management Unit providing care for short-term patients will be expanded, as will the number of ambulance bays.

It is hoped a change to layout of the department will lead to a reduction in waiting times.

The project will take about 18 months and the department will remain open throughout construction.

Ms Gallagher said it would be a difficult project to manage, but the work would be completed as quickly as possible.

"There will be about six stages, the first of which will be some clip-ons to the existing emergency department to allow us to expand before we take over space in the current emergency department," she said,

"But it will be a 24-hour-a-day, seven-day-a-week construction job as well, so we're just going to pull out all stops to get it done as quickly as possible."

Patients, staff and visitors have been advised to expect increased noise and vibration from construction work. ... source=wan

PostPosted: Wed Dec 03, 2014 2:03 pm 
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Changes loom for cervical cancer guidelines

AUSTRALIA'S cervical cancer screening guidelines could once again be revised, following the release of new global recommendations by the World Health Organisation (WHO).

The WHO has recommended preventive HPV (human papillomavirus) testing for women, with women who test negative not required to be rescreened for cervical cancer for five years, saving costs to health systems worldwide.

It has also recommended girls aged nine to 13 years should receive two doses of the HPV vaccine instead of three, with two doses proven to be just as effective.

Cancer Council Queensland spokesperson Katie Clift said Australian health authorities would need time to consider the new recommendations.

"Australian experts will need time to consider these new recommendations in context of the Australian population and any specific cancer risks," Ms Clift said.

"While Australia already plans to introduce HPV testing in future, consistent with the WHO's recommendations, the change from three doses to two of HPV vaccine will need examination.

"The HPV vaccine has almost eliminated human papillomavirus in vaccinated Australians, protecting young men and women from cervical cancer."

The WHO report highlighted significant declines in the rate of cervical cancer in the developed world, compared to rising or stable rates in most developing countries.

"The recommendations in the WHO guide are important for cervical cancer control globally, giving more communities access to life-saving screening and treatment programs," Ms Clift said.

"The guide confirms two doses of the vaccination are as effective as the current three-dose schedule, making it more cost effective and easier to administer."

Ms Clift cautioned that until Australian health authorities adopt the two-dose schedule, young people should continue to receive the full three-dose course of the HPV vaccine.

"It's imperative that all eligible young people receive the current full course - taking preventive action against HPV is vital and could save a young person's life in years to come," she said.

"Australian experts will also need to examine the evidence for both boys and girls, with screening programs in place for all young people." Earlier this year, Cancer Council Queensland welcomed recommended changes to Australia's cervical screening program announced by Australia's Medical Services Advisory Committee.

Evidence shows a new HPV test every five years, which is recommended to become the primary cervical screening tool, would be more effective than a pap smear and just as safe.

"Until the HPV test is approved, which isn't likely before 2016, regular pap smears currently remain the best protection against cervical cancer," Ms Clift said.

"Through population screening at regular intervals, the pap smear test has the potential to reduce up to 90 per cent of cervical cancer cases nationally.

"If the changes are adopted, we will be urging all Queensland women to embrace the new HPV test, continuing Australia's record in the early detection and treatment of cervical cancer.

"For now, we encourage all eligible Queensland women to continue to undergo pap smear tests every two years."

Around 770 women across Australia are diagnosed with cervical cancer every year - 180 of these are from Queensland.

The WHO guide was launched today at the Union for International Cancer Control's World Cancer Congress in Melbourne.

More information about Cancer Council Queensland is available via Cancer Council Helpline 13 11 20 or ... s/2473269/

PostPosted: Fri Dec 05, 2014 8:39 am 
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Obesity – like father, like son

Fruit flies pass down changes in their metabolism from father to son

The consumption of a sugary banquet before sex can have far-reaching consequences for a fruit fly and its offspring: it makes the young flies more prone to obesity. Together with researchers from Spain and Sweden, scientists from the Max Planck Institute of Immunobiology and Epigenetics in Freiburg have discovered that even a brief change in the diet of male fruit flies triggers obesity in the next generation. Specifically, high-sugar nutrition consumed one to two days before mating causes the male offspring to accumulate more body fat – but only if the young insects have a particularly high-sugar diet.

Importantly, the international research team identified the first gene networks for generating such intergenerational responses. The food consumed by the father activates genes that can cause epigenetic changes in the genome. These changes are inherited and alter metabolic gene control in the next generation. Moreover, the researchers discovered a similar gene network in humans and mice which also predicts their susceptibility to obesity.

Our DNA is a determining factor in our weight – obesity is largely due to our genes. That said, environmental inputs, particularly in parents or during early development, can also affect body weight through epigenetic changes. These modifications can be inherited, although they do not change the genetic code.

The Max Planck scientists in Freiburg have now discovered that the diet of male fruit flies can influence the body weight of their offspring in this way. The researchers fed the adult male flies with food of varying sugar content two days before mating. The flies that hatched from the eggs were then given normal or high-sugar food. For technical reasons, the researchers only carried out the tests on male flies; comparable results, however, would probably have been obtained using female flies.

The fathers’ diet had no impact on sons that only consumed a balanced diet. However, the weight pattern was very different if the young flies had eaten particularly sugary food: the young animals whose fathers had consumed very low or high sugar food tended to be overweight; in other words the offspring were obesity susceptible. They had a higher proportion of body fat and also ate more than the sons of fathers that consumed a balanced diet. “So there is a U-shaped effect here: extreme sugar values in the father’s diet – be they high or low – have the greatest consequences for the next generation,” explains Anita Öst from the Max Planck Institute of Immunobiology and Epigenetics, who now researches at Linköping University in Sweden. The effect on body weight is not transmitted any further, however, as the scientists did not observe it in the grandchildren’s generation.

It appears that the inheritance of the father’s nutritional status is dependent on the methylation pattern in the proteins that package DNA. Methyl appendages, which are small chemical groups, control how compactly DNA is packaged. The level of gene expression depends on this. Genetically modified flies, in which different methylation enzymes are partly blocked, do not pass on their nutritional status to their sons. “We tested different fly mutants and identified seven genes which control the packaging of the DNA,” reports Adelheid Lempradl from the Freiburg-based Max Planck Institute. In the case of fathers with a high-sugar diet, the packaging of the DNA in the sons is loosened so that more metabolism genes can be expressed. This effect endures throughout the life of the fly.

It appears that a similar mechanism may also exist in humans. The researchers evaluated the data from tests on Pima Indians – a group of North American indigenous people who frequently suffer from obesity – and monozygotic twins. The two studies from 2005 and 2008 compare normal weight and obese individuals and their genes. “The data show that obese people have the same gene signature as the fruit flies. Thus, susceptibility to a high body weight in humans is also predicted by certain methyltransferases being less active,” explains J. Andrew Pospisilik, Group Leader at the Max Planck Institute of Immunobiology and Epigenetics. According to the researchers, the same genes also regulate weight in mice. ... e-son.html

PostPosted: Sun Dec 07, 2014 5:15 pm 
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Young Aussie with autism chained to bed for 14 days

THE parents of a young autistic man shackled to a hospital bed for 14 days have accused authorities of abandoning their son and pleaded with them to end their "nightmare" and allow him to return home.

James Pascoe, diagnosed with Autism Spectrum Disorder when he was two years old, spent his 21st birthday chained to a bed after he was taken to The Northern Hospital, Victoria on 21 November.

Parents Bronwyn and Allan Pascoe claim they repeatedly asked the Australian Department for Human Services for help treating James, who as a result of his autism can lash out when scared or anxious, but were ignored.

A petition in which they call started by the couple last week, soon after they discovered James' treatment, has already gathered more than 40,000 signatures.

He remains tied to his bed today, with the Herald Sun reporting a sixth constraint, across his stomach, had been added. It is one short of the legal limit.

His mother, who was a nurse, also claimed that he had been given heavy doses of drugs to sedate him.

"It sounds unbelievable. But it's the nightmare we've been living. The last 11 days we've had little sleep," Mrs Pascoe wrote on the petition.

In November, James was moved to a supported accommodation centre in Whittlesea where he lashed out causing staff to ring the police who took him to hospital on the 21.

Later the same day he panicked again and was hospitalised.

Writing on the petition Mrs Pascoe added: "It's heart breaking to think just 2 years ago he was happily walking around SeaWorld with his grandmother and Aunty.

"Now thanks to mistreatment he's anxious and lashes out in fear and anxiety and lack of coping due to his unresolved grief and loss."

James' behavioural therapist Jeanette Coombes told the Herald Sun: "In my professional perspective the longer he is in this environment the higher his trauma response will be".

"He is doing what he can to communicate his distress. He is scared and (anxious) and wants to be around people he knows - he just wants out," she said.

Mrs Pascoe's mother used to care for James - calming him down and providing a stabilising influence - but after her death from pancreatic cancer in 2012 James behaviour changed.

"He withdrew and became depressed and became obsessed with the fact that people died," Mrs Pascoe told Daily Mail Australia.

A spokesperson for the Department of Human Service told the Daily Mail Australia: "James was admitted to the Northern Hospital by his family. His family and a consulting physician are making decisions about his care while in hospital."

"While several options for support have been offered for James' long term care, these options have not so far been accepted by his family."

The statement continued: "The department will continue to work with James and his family to make sure he gets appropriate and quality care." ... s/2476930/

PostPosted: Tue Dec 09, 2014 12:26 pm 
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Obesity can take years off life expectancy

Obesity can reduce a person's life expectancy by up to eight years, which could lead to an adult losing around 19 years of healthy life, should they be diagnosed with type two diabetes or cardiovascular disease - according to a new study.

According to the NHS, obesity is a common problem in the UK that affects one in four adults and one in five children aged between ten and 11.

Excess body weight can lead to serious health implications, such as heart disease, diabetes and stroke.

In a new study, a team of researchers set out to investigate the relationship between obesity and both years of life lost and years of healthy life lost.

They analysed data from the US National Health and Nutrition Examination Survey, from which they created a disease-simulation model. This could estimate the risk of adults of different body weights developing diabetes and cardiovascular disease.

Next, the researchers calculated the role obesity or being overweight plays on years of life lost and years of healthy life lost in American adults aged between 20 and 79, in comparison to people of normal weight.

It was found that overweight participants were estimated to lose up to three years of life depending on gender and age, obese individuals were predicted to lose up to six years and very obese participants were calculated to lose up to eight years of life.

Dr Steven Grover, lead researcher of the study, said: 'The pattern is clear. The more an individual weighs and the younger their age, the greater the effect on their health, as they have many years ahead of them during which the increased health risks associated with obesity can negatively impact their lives.'

He concluded that a healthier lifestyle, such as changes to diet and regular exercise, should be enforced in order to tackle obesity.

The study has been published in The Lancet Diabetes and Endocrinology. ... -t116.html

PostPosted: Thu Dec 11, 2014 8:23 am 
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Australia may not sign up to Paris climate deal: Andrew Robb

Lima: Trade Minister Andrew Robb has told business leaders at climate change negotiations in Lima that Canberra may not sign up to a new global deal if major trade competitors are not pulling their weight, stating Australia will not "get it in the neck".

Mr Robb hosted the meeting for Australian business leaders on Tuesday - which Fairfax Media also attended - and said the Abbott government had to ensure anything agreed through the United Nations climate talks would not put Australia at a disadvantage to its immediate trade rivals.

The attendance of Mr Robb in Peru - who has been labelled a climate sceptic - has raised eyebrows after it was reported he was sent by Prime Minister Tony Abbott's office to watch over Foreign Minister Julie Bishop at the talks.

Tuesday was the first full day at the Lima negotiations for Australia's two ministerial representatives, with Ms Bishop announcing a $200 million contribution to the Green Climate Fund - to be taken from foreign aid.

Ms Bishop has previously said foreign aid should not be used on climate change initiatives. Prime Minister Tony Abbott has previously said Australia would not contribute to the fund, as it was "socialism masquerading as environmentalism".

Mr Robb told the meeting with business officials - which included representatives of BHP Billiton and the Business Council of Australia - Australia would make a particular effort to ensure trade competitors "are as ambitious as we will be."

"If we are not convinced they (trade competitors) are doing what they should, it will influence whether we sign up or not. Outcomes must be comparable…we are not going to get it in the neck and increase our costs for nothing," he said.

Mr Robb also said the government wanted to ensure developing countries understood that there would be no further money from Australia in the climate negotiations.

The government also wanted to ensure there were proper arrangements for developing countries to access the Green Fund, which was established to help poorer nations address climate change.

"We want a demonstration that they will use it to leverage private sector investment and identify real projects," he said.

"They can't just pocket the $10 billion (currently committed to the fund) and say 'now what is the next thing'."

Asked about his attendance in Peru, Mr Robb said: "I joined Julie because I wanted to soak up what is being discussed and how it impacts on all my trade negotiations and investment responsibilities. Economic risks coming out of negotiation are the things to focus on."

There is a belief in the Australian delegation that the contribution will give it more leverage in the negotiations, after being ostracised by other countries in the first week of the talks over its hardline climate change stance.

Despite the contribution, the two Australian ministers continued to take a tough position on other elements of the talks. During the day Mr Robb and Ms Bishop firmed up Australia's position in bilateral talks with other countries including China, the United States, Canada and Japan.

Alongside the Green Fund contribution, Ms Bishop also announced a taskforce in the Prime Minister's department to review other countries' pledges to cut emissions post-2020 in the lead-up to next year's climate negotiations in Paris, where a new global deal is due to be finalised.

It is understood that the new taskforce will particularly examine new commitments by China, the United States, Japan, Canada and Gulf countries in determining what new emissions pledge Australia should make in the first half of next year ahead of the Paris talks.

As a result, Australian negotiators have been focusing their efforts in the last week on ensuring that there is an agreement in Lima for countries to provide detailed information about their new emissions commitments before Paris next year to allow them to undertake the detailed review.

"Currently, there are different baselines, different timeframes and whilst we can analyse the comparisons, it would be far easier if there was a uniform approach," Ms Bishop told Fairfax Media.

"We are looking for a focus on transparency, accountability and pragmatism."

She also flagged the Government wanted to narrow the focus of the Lima agreement and next year's Paris deal. She backed concerns of some developed nations that the talks are becoming to unwieldy and could see some countries walking away from a deal.

Of particular concern was a proposal by Norway and Latin American countries to commit countries to reduce emissions to zero by 2050. Ms Bishop said the proposal would damage Australia economically.

"We wouldn't sign up to that," Ms Bishop said.

"How could one possibly commit to having fossil fuel free world by 2050 at best it is an aspiration. I am interested grounding our text in fact and reality.

"We would not sign up to targets that would damage our economy, would send jobs offshore, would close down manufacturing. It is in no one's interest for Australia to be damaged economically."

United Nations secretary-general Ban-ki Moon told delegates at the conference that the time had come to stop "tinkering" and reach a climate change agreement that would achieve "transformation".

"From Manhattan to Mumbai to Melbourne, hundreds of people marched for climate action," Mr Moon said.

"And Governments are responding in unprecedented ways. Despite these positive steps, I am deeply concerned that our collective action does not match our common responsibilities." ... 24fy8.html

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