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PostPosted: Sun May 13, 2012 6:37 am 
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Disability scheme is great, in theory

THE National Disability Insurance Scheme over-promises and is underfunded, under-prepared and - by the looks of things - inaccurately titled. It is without doubt one of the most prematurely crafted examples of policymaking rushed into a budget in this country in decades.

Labor wants credit for a scheme that it won't be around to make operationally viable.

Let's be perfectly clear: Bill Shorten deserves praise for putting this issue on the mainstream agenda. And rushing the implementation of the scheme will at least reduce the chances of it being sidelined by fiscal conservatism. But, boy, are there some unanswered questions about how the NDIS will operate and how it will be funded.

Julia Gillard is searching for a legacy Tony Abbott won't overturn. Politicians can have all the good intentions in the world, but if they pay scant regard to how to implement them, outcomes suffer.

What is so shameful about the way the NDIS is being over-sold for base political advantage is that it is giving false hope to hundreds of thousands of this country's most disadvantaged citizens. Most won't receive any money for years, and even those who do will be underfunded, according to what the Productivity Commission recommended people should get. The government is raising expectations above and beyond what it has delivered in the budget.

Tuesday's budget included $1 billion across four years to set up the NDIS. The Productivity Commission said doing so would require $3.9bn (albeit with a larger rollout). Of the (under) funding allocated, $650 million of it goes straight into administration, leaving only $350m to fund people in need over the forward estimates. Setting up a nationwide bureaucracy before the details to make it operational have been determined reminds me of the Yes Minister episode where Jim Hacker visited the well-maintained and well-run hospital that didn't have any patients in it. No budget planning exists for the longer-term cost of the scheme, estimated by the Productivity Commission to be $8bn annually once fully up and running (on top of $7bn of existing funding).

We have no idea whether the NDIS will run like an actual insurance scheme, with premiums and invested funds to pay for cases. More likely it will come out of consolidated revenue each year. Will there be a Medicare-style levy, for example? That sounds reasonable to me, but we don't know because the government doesn't want to make such an announcement for fear it will be attacked for imposing another tax. Rather, it wants to announce the scheme and receive praise for the basic idea.

The initial four-year implementation of the scheme includes a small number of targeted catchment areas where a limited number of people eligible for the NDIS will receive funding. There are 800,000 people on disability support pensions. The Productivity Commission estimated that 410,000 people would be eligible for the NDIS, not that the government has provided an eligibility framework at this time. The Prime Minister in her public utterances (including at Labor's national conference in December last year) has implied that as many as two million Australians may be eligible for support.

The scale of need contrasts sharply with the scale of detail and planning that has gone into this policy objective, not to mention the amount of money the commonwealth has committed.

In the first four years a maximum of 50,000 "cases" will receive NDIS funding. Everyone else will need to wait, for how long we do not know.

The Productivity Commission estimates that $35,000 per "package" is needed, and the Treasury agrees. The Commonwealth Actuary says that per package cost can be met by the current funding envelope, but only if the states come to the party. The politics of announcing the scheme before details have been agreed to makes that less likely.

We don't yet know what the funding mix will be between tiers of government. The Productivity Commission determined that the commonwealth should fund the NDIS entirely because of its capacity to raise revenue, unlike states, which are restricted to largely regressive taxation mechanisms (vertical fiscal imbalance and all of that).

But the commonwealth Treasury has told state treasuries that two options are on the table: a 60-40 split or a 50-50 split. No further details exist. States are being asked to sign up to a plan the scope of which they don't know, the portion of funding for which they will be responsible hasn't been advised yet, and details as to who will have control hasn't been determined.

Right now states are responsible for the bulk of disability services (about 70 per cent) and we have no framework for how that may change under a NDIS. Will duplication exist? Will it be a federated arrangement or a centralised one? If the commonwealth is seeking control, that is likely to cause disagreements with parochial states. At its last meeting, COAG determined to conduct further work on funding, governance and the scope of eligibility and support, in preparation for the next meeting, scheduled tentatively for July.

But Labor wanted to rush out the scheme's announcement Good processes should have meant laying out the parameters for the NDIS before committing to it, especially with an early timetable.

The Productivity Commission recommended a starting date of 2014, with a seven-year rollout. It didn't pluck the timeline out of thin air. The expert panel determined that was the time government would need to ensure quality implementation.

Labor announced that it would deliver the scheme a year ahead of schedule. But what's set to be delivered falls well short of public expectations and of what the Productivity Commission determined would be necessary.

The lack of planning and process concerning the introduction of the NDIS - announced with so much fanfare - outranks all previous examples, from the health reforms to the lack of processes followed in the Australia Network tender. Comfortably so.

During the leadership showdown between Gillard and Kevin Rudd in February, former health minster Nicola Roxon complained about the way Rudd rushed the health reforms to meet his media timeline. The minister responsible for the NDIS - Jenny Macklin - must feel 10 times as frustrated with the way she is being dictated to by Gillard. Her only solace would be that implementing the scheme is unlikely to be her problem. Getting voted out of office has its advantages.

The media and the disability sector have rushed to praise the NDIS. The opposition has also been quick to support the concept, as have state governments. Even John Howard praised the idea. But this worthy initiative needs meat on its bones. And the government must be called on the fact it has sought to win applause for the NDIS at the expense of taking the necessary time to get it implemented properly.

The only thing worse than inaction for people suffering from disabilities is over-promising and under-delivering.

http://www.theaustralian.com.au/news/op ... 6353261896


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PostPosted: Tue May 15, 2012 7:36 am 
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Cancer survival rates force major treatment rethink

Cancer is the single largest cause of death in Australia, but early detection and advances in treatment mean death rates are falling.

Almost two-thirds of those with the disease will live for at least five years after diagnosis, so a growing number of Australians are having to learn to live with cancer.

As cancer survivorship grows, patients are by necessity having more treatment over a longer period of time, and are less tolerant of outdated systems of treatment that are based around stand-alone specialists.

Bogda Koczwara, an oncologist, says specialists need to rethink how cancer is treated.

"Cancer care needs to be integrated and consolidated in one location, so that we will not deliver one good care just by one provider in one area and then send the person down the corridor to the next treatment. We really want to do much better than that," she said.

"Even though we will celebrate completion of treatment, the process of finishing your treatment and leaving a very intensive period of therapy and monitoring and scans ... that can be quite frightening and quite stressful.

"Suddenly you are left to your own devices."

Dr Koczwara has been practising for 20 years, and says the accepted mantra in the beginning was: "Kill the cancer at any cost".

Now advances, particularly in medicine, mean more than 60 per cent of her patients live past the five-year mark. With that development comes a greater emphasis on long-term management.

"There might be fatigue, there might be some bone loss as a result of cancer treatment and we need to recognise that we might eradicate the cancer," she said.

"But the patient might be left with osteoporosis, for example. So we as oncologists need to learn how to manage osteoporosis and recognise that that's a risk and factor."

Facing his demons

Ashleigh Moore is one of a growing number of Australians who survived cancer, and he now uses his experience to help others in similar circumstances.

His life took a turn for the worse after a tumour spread from his tonsils into his neck and head.

Almost six years after beating the disease it returned in a different form. He endured surgery that removed almost half his lungs.

"It was hard dealing with it with all of that knowledge as well. You knew that the statistics weren't very good, you knew all of that, because you'd been there before," he said.

"I thought all that was behind me, and I was looking forward to a rosy future and then all of a sudden [the relapse] happened. But then you've just got to get on with it and suck it in and get on with the treatment."

The physical rollercoaster of surviving cancer was matched by a wild emotional and psychological ride. Mr Moore left his work as an executive with the South Australian Government as restoring his health consumed vast amounts of his time.

He then returned at a much lower position, in part as a diversion from his illness.

Mr Moore addressed the anxieties about cancer by gathering together cancer survivors in a cycling team that now numbers more than 450. Collectively they share experiences and advocate for patients.

'A game-changer'

Mr Moore was guest of honour recently when a $28 million facility was opened at the Flinders Medical Centre in Adelaide's south.

Mr Moore, along with survivor Julie Marker, had acted as consultants, giving a patient's perspective for the layout of the treatment areas.

"I'm really optimistic that with the new building as well and the opportunities for putting in new technologies, that this will be a game-changer, I hope," Ms Marker said.

The centre's emphasis on survival means prevention strategies, research, treatment, counselling, nutrition and case management are all under one roof for the first time.

This trend toward broader treatment is reflected in a similar facility being built at Melbourne's Austin Hospital and a cancer survivors' centre being created in Sydney.

Within days of the euphoria of the new centre being opened, Mr Moore was back in hospital. Even after 19 months free of cancer, there remains the nagging fear of a relapse?

"I've had most of the things that are currently available for my type of cancer. I was told that if it does return, there's not a lot left," he said.

He agreed to allow 7.30 to film a pioneering procedure call narrow band imaging, where doctors search his lungs for potential cancer cells.

However, during the procedure, a sample of tissue was examined with the worst news. A 10 millimetre tumour was discovered in his lung.

The 53-year-old now faces surgery and an unknown future, but his story is not unusual.

More than 300 people are diagnosed with some form of cancer in Australia each day.

http://www.abc.net.au/news/2012-05-15/c ... nk/4010906


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PostPosted: Wed May 16, 2012 5:34 am 
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Hot Topic: Give us our daily burgers

READERS of heraldsun.com.au have been quick to defend fast-food outlets in the wake of suggestions to rate them out of business.
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THIS country is losing the plot. I'll choose what to eat and when I damn well want to eat it, and nobody is going to tell me otherwise. Stop telling people how they should or should not be living their lives.

Freedom of Choice

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SO are they going to jack up the rates of every bottle shop, pub or store that sells cigarettes? This is nothing more than a cash grab by the councils. What's more, are they going to give a rates discount to gyms, sports stores or fruit-and-veg stores that promote a healthier lifestyle?

Simon, Altona

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ROSEMARY Stanton, get away from my body. I will put in it what I choose. What gives you the right to want to control my life? As for that council, you people are unbelievable. What is happening to this country? Governments controlling our lifestyle choices through a climate tax, councils choosing what we eat? Where will it end?

Noelene Nicholas

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I DOUBT this is motivated by health concerns, more like a council cash grab. If the council said the rate rise was to cover the cost of cleaning up the litter around these fast-food joints, I'd support it.

Harry

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WHAT a load of garbage. The thought police and politically correct are at it again.

Joe

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SINCE when have the councils been concerned about the health or welfare of their ratepayers? Last time I checked, they only cared about people paying their rates on time or trying to fine me if my bushes were hanging slightly over the footpath. Sounds like a money grab.

Citizen, Melbourne

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THESE attacks on fast-food restaurants, while well intentioned, are not fair. It is not fair to penalise businesses because some of their customers cannot manage their health effectively.

Nita Dunn

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DO-gooders at it again. When was this a council's business? More like a revenue-raising con, given the council involved.

Peter H, Melbourne

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JUST another money grab from a typical greedy local council. Do they really think taxing fast-food restaurants is going to stop people from eating there? No, it's just another tax.

Glenn, Tarneit

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ONCE again, tax everyone into submission. If people were responsible for their own choices, there wouldn't be an issue.

Tax Tax Tax

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DAREBIN Council just wants to be a mum to its ratepayers. News for Darebin Council: at some point you have to let the children go it alone into the wild, nasty world.

Bob, Boronia

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STICK to dustbins, roadworks and footpaths. These are what the ratepayers pay and vote you in for. Is that too hard for you?

Dick Ashby

http://www.heraldsun.com.au/ipad/hot-to ... 6356600719


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PostPosted: Mon May 28, 2012 7:06 am 
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1.3m have undiagnosed kidney disease

ABOUT 1.3 million Australian adults are unaware they are living with kidney disease, according to a peak health body.

Kidney Health Australia national medical director Tim Mathew said about 1.7 million people over the age of 25 had kidney disease but it was estimated only one quarter of those had been diagnosed.

Kidney disease, characterised by reduced kidney function, is asymptomatic in mild cases but is linked to an increased risk of heart attack and stroke.

Dr Mathew said high blood pressure and cholesterol seemed to be prevalent in people with kidney disease, but that did not account entirely for the increased risk.

He said other factors affected the way blood vessels worked and made people with kidney disease more susceptible to heart attack and stroke.

"There is a definite independent risk that is not well understood, but which is real," Dr Mathew told AAP.

The number of Australians needing kidney transplants and dialysis is expected to soar in the next decade as the ageing population means more people are likely to develop end-stage kidney disease.

However the number of diabetics with the condition is also on the rise.

The Australian Institute of Health and Welfare has forecast the proportion of diabetics undergoing transplants or dialysis would rise to 64 per cent in 2020 from 45 per cent in 2009.

The total number of Australians being treated for end-stage kidney disease is forecast to rise by up to 80 per cent to about 4300 in the coming decade.

Dr Mathew said people at highest risk of developing kidney disease should be tested by their GP.

He said anyone with diabetes, high blood pressure, smokers, or who was obese or with a family history of kidney disease should be checked.

People over the age of 60, Aboriginal and Torres Strait Islanders and those with a history of heart attacks were also at greater risk, he said.

Currently more than 10,500 Australians receive dialysis and 1100 are waiting for a transplant.

http://www.news.com.au/breaking-news/m- ... 6368819679


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PostPosted: Sun Jun 03, 2012 6:59 am 
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How to lose weight and stay slim: Buy a mango and eat it all (even the skin you would normally throw away)

MANGOES could help you lose weight and stay slim – but only if you eat the skin you would normally throw away, a study suggests.

In tests, extracts from mango skin appeared to ‘inhibit the development of human fat cells’.

The secret is in phytochemicals that act as natural fat busters and are found only on the outside of the fruit, according to researchers in Australia.

Professor Mike Gidley, of the University of Queensland, said: ‘We know mangoes have many excellent nutritional properties but more work needs to be done to understand the complex natural compounds found in these and other fruits.

‘This research reminds us that we should be looking at the whole fruit when considering how to take advantage of natural goodness.’

The study could lead to the development of a supplement to fight obesity.

It is the second time in a week that Australian researchers have published findings which could help people lose weight.

Researchers at Northwestern University's Feinberg School Of Medicine found that simply removing yourself from the couch will make you eat less junk food.

Their study found that focusing on avoiding the couch rather than on losing weight will help reduce a person's 'saturated fat intake without even trying'.

The project, recorded in the Archives Of Internal Medicine, looked at 204 adults who were each assigned a lifestyle 'treatment' for three weeks.

The participants, of whom 40 per cent were not considered overweight, were each paid to stick to one of four treatments.

They included increasing fruit and vegetable intake and exercise, decreasing fat and sedentary leisure, decreasing fat and increasing exercise and increasing fat and sedentary behaviour.

The participants were asked to report their progress and thoughts and, when the three weeks were over, researchers found that five in six had tried to stick to their newly adopted behavioural changes.

http://www.dailymail.co.uk/health/artic ... -slim.html


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PostPosted: Wed Jun 06, 2012 7:39 am 
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Private health insurance: how the changes affect you

If you've long been bamboozled by the complexity of private health insurance, take a few deep breaths because from July 1, the rules change again.

The 10.5 million Australians taking out private health insurance currently have the cost subsidised by a government rebate. This rebate reduces the cost of premiums by 30 per cent for most adults (with those aged over 65 eligible for even higher reductions).

But from July 1 2012, this rebate will be progressively scaled back for those on higher incomes.

At the same time, there'll be another change to the system. At present, if you earn a higher income then you pay an extra tax if you don't take out private health insurance. This extra tax is known as the Medicare Levy Surcharge (MLS). (It's called a surcharge because it's on top of the 1.5 per cent Medicare Levy which most of us pay whether we have health insurance or not.)

But from July 1, the MLS will increase for some high income earners.

The bottom line is that many of us will be reassessing our health insurance options to see if the choices we've made in the past still make sense under the new rules.

But before you break out in a rash at the thought, remember the changes depend on your income.

"Only a fraction over 20 per cent of people with private health insurance are affected by the changes," says the Private Health Insurance Administration Council's CEO Shaun Gath.

Who is affected?

Your income for the 2012-13 financial year determines whether the changes affect you.

You're premiums will increase if you are:

a single person earning more than $84,000
a couple or family earning more than $168,000 (although the threshold for families depends on the number of dependent children).

Above those incomes, there will be three new "tiers" based on your income that influence how the changes affect you.

Depending on which income tier you fall into, your health insurance rebate will be reduced to either 20 per cent, 10 per cent or zero. This may mean a price hike of up to $1300 on a typical $4000 annual family policy.

If you don't have cover, you'll be looking at a MLS that will either stay at its current rate of 1 per cent of your income or it will be increased to 1.25 per cent or 1.5 per cent, again depending on your income.

A handy table summarising the income cut-offs for each tier, and how they affect changes to both the rebate and the MLS can be found here.

To ditch or not to ditch?

Health insurance premiums have already risen by an average of more than 5 per cent since April 2012.

So the rebate changes mean affected health fund members will be faced with forking out substantially more cash for their cover than this time last year.

If that's enough to make you think about ditching your cover altogether, the consumer group CHOICE has some advice. It says you'll likely still end up ahead by keeping your hospital cover, even with the reduced rebate, because of the changes to the MLS.

"There's probably a tendency to think 'oh, it's all too hard, I'll just dump my cover'. But the numbers we've crunched show that at the very least, you're probably better holding on to your hospital cover," CHOICE spokesperson Ingrid Just says.

To avoid paying the MLS, you need to have only basic hospital cover (ie cover that limits or excludes a range of services), which is cheaper than full hospital cover. The requirement for avoiding the surcharge is that the policy has an annual excess of up to $500 (single) or $1000 (family).

Even if you take out more expensive full hospital cover, CHOICE says it will normally cost you less than the MLS if you fall into higher income tiers, or are aged 65 or older and therefore eligible for a higher rebate.

You can also reduce the impact of the changes, by prepaying your annual premium before the end of June to cover the next 12 months or longer if your fund allows.

If you can't prepay, you should contact your insurer now to tell them which income tier you are in to avoid paying extra tax in the new financial year.

What about extras cover?

CHOICE is less clear cut about whether it will be worth hanging on to any cover you have for "extras" after July. (Extras, or ancillaries, is cover for non-hospital treatments not covered by Medicare such as dental, optical, physiotherapy, and some products such as glasses.)

The 30 per cent rebate applies to both hospital cover and extras, but unlike hospital cover, dropping extras won't see you pay extra tax through the MLS.

When considering your extras cover, CHOICE advises checking how much you've received in extras claims over the past year against what your new premium will be from July 1.

Depending on how often you use the extras services, you could be ahead by dropping the extras cover and simply paying the total amount for the services you use.

Alternatively, you might consider changing your extras cover. Just says many of us have combined hospital and extras policies that don't allow us to "cherry pick" the extras elements that best suit our needs.

"If you do want extras, you could consider going to a different provider for extras only cover, where you can tailor it to your needs," she says. "There's no point paying for extras with elements you're not going to claim against."

While natural therapies such as homeopathy, iridology and naturopathy are currently covered by some extras policies, the Federal Government has indicated this may change in future if there is not good evidence for their clinical effectiveness. A review has been announced but will take some time so is unlikely to affect policies in 2012/13.

Gath says you should reassess your private health insurance arrangements around every five years to make sure they still meet your needs.

He says the best place to get unbiased up-to-date information about the different policies on offer is the website run by the private health insurance ombudsman, privatehealth.gov.au.

http://www.abc.net.au/health/thepulse/s ... 518737.htm


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PostPosted: Sat Jun 09, 2012 6:57 am 
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Doctors hesitate to prolong their own lives to avoid pain

IT IS a common refrain from doctors doing the ward rounds in the intensive care unit of any major hospital: ''Please don't ever let this happen to me.''

Most often the words are uttered at hand-over time when the day-shift doctors brief the evening-shift doctors at the foot of an elderly patient.

''He might be 80 years old, severe dementia, type two diabetes, previous strokes and a bit of renal failure, and now he's fallen in the nursing home and suffered a head injury,'' says Ken Hillman, professor of intensive care at the University of NSW, ''and the family wants him continued on life support hoping for a miracle.''

There might be six specialists, eight junior doctors and when one finds the courage to say the words, ''We'll all nod,'' says Professor Hillman.

Professor Hillman believes many doctors would not put themselves through ''the same hell we often put other patients through''.

Professor Hillman is a speaker at a conference at NSW Parliament House next week on living well and dying well. The conference is organised by the non-profit organisation LifeCircle which helps people caring for loved ones at the end of their life. ''We support people having a good life right to the end with the conversations that will benefit the person dying and those they love,'' said Brynnie Goodwill, the chief executive of LifeCircle.

With daily reports of miracle cures and medical breakthroughs, many people with advanced life-threatening cancers and other terminal illnesses pursue every possible treatment, no matter how gruelling, in the hope of extending life.

But do doctors choose the same path for themselves? The silence around doctors' views was shattered earlier this year when Ken Murray, retired clinical assistant professor of family medicine at the University of Southern California, wrote in The Wall Street Journal that ''what's unusual about [doctors] is not how much treatment they get … but how little.'' He said doctors did not want to die any more than anyone else did. ''But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken.''

http://www.blacktownsun.com.au/news/nat ... 85307.aspx


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PostPosted: Sat Jun 16, 2012 7:46 am 
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Australians no longer crave junk food ads

Australians are fed up with junk food advertising on television, but are more willing to let genetically modified food on their plates, new research has shown.

Canberra academics found that three quarters of people want to ban junk food ads targeting kids, while 44 per cent believe controversial genetically modified foods are safe to eat.

The poll, conducted by the Australian National University, probed public views on household food security, eating-out habits, and genetically modified crops and more.

Professor Stewart Lockie, head of sociology at ANU, believes the research proves the need for change.

''It's reasonable to assume that people would consider children to be vulnerable to advertising,'' Professor Lockie said.

''[Research] shows that when children are presented with products that are associated with cartoon characters the children will express a preference for the product with the cartoon character.''

Australian Medical Association federal president Dr Steve Hambleton believes the change could not come at a better time.

''We know that 25 per cent of kids are overweight or obese, 60 per cent of adults are obese or overweight,'' Dr Hambleton said.

''I think that the public are starting to recognise that this is one of the contributors.''

The push comes after The Disney Corporation this month decided to remove junk food ads from its television channels, radio stations and websites.

The research also showed a desire to provide better labelling for GM foods, something Greenpeace has always campaigned for.

Julie Macken from Greenpeace said, ''We want labelling and if producers and manufacturers want to use genetically modified product in various food stuffs that poll suggests that 44 per cent of Australians are comfortable buying it''.

''[But] The poll also makes it clear that Australians want to know if it's there or not.''

While the push for removing junk food advertising is apparent, ANU advertising expert Mr Andrew Hughes believes getting children to eat right is up to parents.

''They're kids, they're not going to hop in a car down to the local [Woolworths] and buy something,'' Mr Hughes said.

''The nag factor's there - but hey you're a parent - I'm a dad … you've just got to resist the nag factor.''

http://www.canberratimes.com.au/act-new ... z1xtv4a4FO


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PostPosted: Sat Jun 23, 2012 7:26 am 
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More beating breast cancer but help lacking

WHEN Sharon Schroeter finished her breast cancer treatment, she was given a bill and sent out the door.

No follow-up care was mentioned to the Port Pirie woman, who is among the increasing number of Australian women who beat the disease each year.

University of Adelaide researchers will lead a new national study to find out what breast cancer survivors believe should happen next.

"When I finished all of my treatment, I was given a Medicare bill for $5500 from the radiographer and that was it," Ms Schroeter, 49, said. "I wondered, `well what do I do now?' There was nothing put into place."

Ms Schroeter, who will take part in the study, said cancer patients were so consumed with survival they were not prepared for when that treatment cycle ends.

Study supervisor and Professor of Cancer Medicine Dorothy Keefe said survivors had expressed a need for follow-up. "In the acute hospital setting, of course we focus on the treatment of the patients, but when they do finish their treatment sometimes they're left feeling quite bereft," Prof Keefe said.

"They've been coming for treatment - sometimes for years - and we need to provide for what happens next."

She said participants would be questioned on what follow-up they would like to support them and how. Evidence gathered in the study would help develop future follow-up care.

Study leader Dr Taryn Bessen, a radiologist and public health PhD student, said follow-up care was a critical issue for breast cancer survivors. "Outcomes of breast cancer treatment are improving, which is an excellent result for those women and their families affected by cancer - but it also means the pool of survivors is expanding," Dr Bessen said. "This study ... will help to provide insight into what type of follow-up services women would prefer, including the value of developing `drop-in' clinics to provide additional support."

http://www.adelaidenow.com.au/news/sout ... 6405967526


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PostPosted: Sun Jun 24, 2012 7:29 am 
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Denial worsens danger of cancer

Cancer survival rates have increased across NSW, a new report shows, but an attitude of denial about the symptoms is still causing many people to die unnecessarily.

The Cancer Institute NSW report, Cancer Survival in NSW 2002-06, to be released today, has found that patients diagnosed with cancer now have a 64.4 per cent chance of beating the disease over five years.

Just 30 years ago, cancer patients had less than a 50-50 chance of survival after five years.

Survival rates for men have shown a significant improvement - 63 per cent compared with 61 per cent in 1999-2003. The numbers for women, meanwhile, have remained steady at 66 per cent.

Survival rates over five years for some cancers are more than 90 per cent, including cancer of the testes, thyroid, lip and melanoma.

The institute's chief executive, David Currow, said the five-year survival rates were encouraging, but those who ignored symptoms were putting their lives at risk because early detection was important.

''A lot of people will be surprised that the message is so good,'' he said.

''What we as a community need to overcome is the attitude of, 'If I have symptoms of cancer I would rather do nothing and just not know about it'.

''The fact is, your chances of being successfully treated are quite high if the cancer is detected early.''

Survival rates after five years for patients with localised cancer are 84 per cent. Once the cancer has spread to other regions, however, survival rates drop to 63 per cent. If the cancer has progressed to a distant spread, the chances of survival after five years are only 14 per cent.

Professor Currow said the statistics should serve as a wake-up call to patients who would rather put their heads in the sand.

''Not wanting to know is a very human reaction and it's a coping mechanism many people use,'' he said.

''You would be surprised how many people turn up to their doctors in 2012 and say, 'I have had this for 18 months and I knew it would be bad news so I did nothing about it.'

http://www.dailyadvertiser.com.au/news/ ... 00802.aspx


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PostPosted: Sun Jul 01, 2012 7:23 am 
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Giving Health Care a Chance to Evolve

INTRADE, an online betting site with an excellent record for predicting events, pegged the odds of the Supreme Court overturning President Obama’s health care overhaul law at almost 80 percent.

When the court affirmed the law’s constitutionality on Thursday, many forecasters were astonished. The ruling came by the slimmest of margins and was defended, in places, by deeply flawed economic reasoning. But it has paved the way for an orderly rehabilitation of America’s gravely dysfunctional health care system.

It was a complicated case, in part because the reform legislation itself was seriously flawed. The law’s drafters could have proposed a simpler and more efficient system — something more like the single-payer systems that have been adopted by most industrial countries.

But that would have meant abandoning the nation’s current system of employer-provided health plans. That these plans are a catastrophically bad model for providing health care was beside the point. Forcing voters to abandon a status quo that most of them say they like would have doomed more ambitious proposals from the outset.

The important point is that because health reform had to be built atop the current system, each feature of the legislation upheld by the court was an essential precondition for that system’s improvement.

Nearly every economic analysis of the health care industry rests on the observation that individually purchased private insurance is not a viable business model for providing medical services. Such insurance is broadly affordable only if most policy holders are healthy most of the time.

The fundamental problem is that insurers can often identify specific people — like those with serious pre-existing conditions — who are likely to need expensive care. Any company that issued policies to such people at affordable rates would be driven into bankruptcy, its most profitable customers lured away by competitors offering lower rates made possible by selling only to healthy people.

Economists call this the adverse-selection problem. Because of it, unregulated private markets for individual insurance cannot accommodate the least healthy — those who most desperately need health insurance.

Many countries solve this problem by having the government provide health insurance for all. In some, like Britain, the government employs the care providers. Others, like France, reimburse private practitioners — as does the Medicare program for older Americans.

The United States probably would have adopted one of those models had it not been for historical accidents that led to widespread adoption of employer-provided plans in the 1940s. To control costs of World War II mobilization, regulators capped growth of private-sector wages, making it hard for employers to hire desperately needed workers.

But because many fringe benefits weren’t capped, employers spied a loophole: they could offer additional benefits, like health insurance. Its cost was deductible as a business expense, and in 1943 the Internal Revenue Service ruled that its value was not taxable as employee income. By 1953, employer health plans covered 63 percent of workers, versus only 9 percent in 1940.

Eligibility for favorable tax treatment hinged on the plans being available to all employees, a feature that mitigated a serious defect. Although hiring workers with pre-existing conditions meant paying higher premiums, tight labor markets made many employers willing to bear that cost, because insurance was an effective recruiting tool.

Employer plans are thus a significant improvement over individual private insurance, but they are still deeply flawed. If you lose your job, you can lose your coverage. This problem has been cast into sharp relief by the persistent high unemployment in the wake of the financial crisis. In no other industrial country do we see communities organizing bake sales to help defray the cost of an uninsured neighbor’s cancer treatments.

The decline in the number of workers covered by employer plans began long before the recent crisis. According to census data, 65 percent of workers had employer-backed plans in 2000, but only 55 percent were covered by 2010. This decline has been driven in part by rapid increases in health care costs.

Economists agree that no matter how those costs are apportioned on paper, any money spent on employer-sponsored plans ultimately comes at the expense of wages. Real wages have risen little in recent decades, and the prospect that they will keep stagnating portends further erosions in coverage. So even if we ignore the inherent failings of the employer model, it simply won’t be able to deliver broad health coverage.

Modeled after proposals advanced by the Heritage Foundation, the American Enterprise Institute and other conservative research organizations in the 1990s, the main provisions of the president’s health care law were intended to eliminate the most salient problems associated with the current system.

One provision establishes insurance exchanges, where participating companies must offer coverage to all customers, irrespective of pre-existing conditions. Another imposes a financial penalty on those who fail to obtain coverage — the individual mandate. And a third prescribes subsidies to make insurance more affordable for low-income families. (The Massachusetts plan engineered by Mitt Romney as governor in 2006 took an almost identical approach.)

WITHOUT each of its three main provisions, the law won’t work. The individual mandate, of course, is the most debated. Critics denounce it as a violation of our liberty. Paradoxically, the slim majority on the court that affirmed the mandate’s constitutionality seemed to embrace that view, likening the mandate to requiring citizens to eat broccoli for their own good. The court defended the constitutionality of the mandate by calling it a tax rather than a penalty.

But that interpretation will strike many economists as a misreading of the mandate’s purpose. It isn’t that people should buy health insurance because it would be good for them. Rather, failure to do so would cause significant harm to others. Society will always step in to provide care — though in much more costly and often delayed and ineffective forms — to the uninsured who fall ill. To claim the right not to buy health insurance is thus to assert a right to impose enormous costs on others. Many legal scholars insist that the Constitution guarantees no such right.

No one can be sure how the law will play out. But its critics would be unwise to assume that it would have been easy to draft superior legislation had the law been overturned. Any new attempt would have taken the employer-based system as a starting point.

What’s important now is how the health care sector will evolve under the new framework. And here, there are grounds for optimism. While the effects of the court’s Medicaid restrictions aren’t entirely clear, the law will certainly extend coverage to tens of millions who now lack it. In addition, new insurance exchanges will provide a broader array of care options. Increased competition tends to hold costs in check, even while enhancing service quality, and there’s no reason to expect the situation in health care to be different.

Many scholars have argued that private, nonprofit institutions like the Mayo Clinic are the most effective model of providing care, and not only because they can better coordinate across many specialties. They are also less likely than traditional fee-for-service practices to prescribe unnecessary tests and procedures. Given those advantages, such institutions, or ones that mimic them, might have spread even without health care reform. After all, employers have an interest in providing cost-effective care for their workers.

But no matter which model proves most effective, it is likely to spread faster in the competitive environment established by the insurance exchanges.

The new law will hardly be the final word on these issues. Though it takes tentative first steps on cost control, government budgets will be decimated unless we do much more to reduce inflation in medical services. And in Medicare, many tough decisions remain to be made about end-of-life interventions, and whether Medicare should become an optional form of coverage for those who aren’t elderly.

The point worth celebrating is that last week’s ruling will at last enable our distinctly dysfunctional health care system to evolve into something better.

http://www.nytimes.com/2012/07/01/busin ... wanted=all


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PostPosted: Sun Jul 08, 2012 6:44 am 
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Study reveals connection among sugar, cancer, and dependence on breathing machines

A new research report published online in the FASEB Journal reveals a connection among sugar, cancer, and dependence on breathing machines--microRNA-320a. In the report, Stanford scientists show that the molecule microRNA-320a is responsible for helping control glycolysis. Glycolysis is the process of converting sugar into energy, which fuels the growth of some cancers, and contributes to the wasting of unused muscles such as the diaphragm when people are using ventilators. Identifying ways to use microRNA-320a to starve tumors and keep unused muscles strong would represent a significant therapeutic leap for numerous diseases and health conditions.

"We hope that this discovery will yield a new avenue of molecular treatment for cancers, particularly lung cancer, which is the number one cause of cancer deaths worldwide," said Joseph B. Shrager, M.D., a researcher involved in the work who is a Professor of Cardiothoracic Surgery, and Chief of the Division of Thoracic Surgery at Stanford University School of Medicine, and VA Palo Alto Healthcare System in California. "We also hope it can lead to a treatment to be given to intensive care unit patients who require the breathing machine, reducing the length of time they require the machine, and thereby reducing complications and deaths."

http://www.news-medical.net/news/201207 ... hines.aspx


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PostPosted: Sat Jul 14, 2012 6:27 am 
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Getting back on track after surviving cancer

You've survived chemotherapy, radiation, even surgery in your battle with cancer. To the outside world, you're well on the mend.

But a new centre is tapping into the unmet needs of cancer survivors like 67 year old Bruce Larter.

"You don't realise the mental stress it puts on you, you can't work, you're tired, you feel sick," he said.

" I come here and it gives you a place to be where everyone understands."

The NSW Cancer Survivors Centre at Randwick is one of this year's Dry July's beneficiaries.

They currently helps cancer survivors of all ages, including children. They can access psychologists, participate in exercise programs and get medical advice.

Oncologist Dr Kate Webber works one on one with cancer survivors and also does research into how the medical system can better serve people post treatment.

Australian actress Heather Mitchell is on the centre's consumer advisory committee. She survived breast cancer eight years ago and says a centre like this one would have been a real boost when she was in recovery.

"When I was going to through cancer treatment, I wanted to help other people. I didn't want to go through it just as a patient," she said.

With money raised by Dry July, the centre hopes to buy exercise equipment and chairs and ipads to make people's time in the centre more comfortable.

They also hope to buy some special watches which can monitor patient sleep and exercise patterns.

http://blogs.abc.net.au/nsw/2012/07/get ... ancer.html


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PostPosted: Thu Jul 19, 2012 5:21 am 
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CrossFit is not just a fad

You may love it or you may hate it, but for those serious about fitness, there is no ignoring the phenomenal growth in the fitness brand that is CrossFit.

It even has even spawned its own official sports event; The CrossFit Games, which ran last week in California and features four days of hill runs, swimming, handstand push ups, box jumps, and 70kg overhead squats.

The CrossFit games were not covered by the Australian newspapers nor discussed across pubs, because the fact is that many Australians still don't even know what CrossFit is. So here is my take on it for those who are looking for a simple, intense, workout regime that guarantees results.

CrossFit is a community that's centred around fitness, and every person has one thing in common – they all like to exercise with intensity.

The brand was founded by Greg Glassman in 2000, who designed a strength and conditioning program where exercises are performed at a high intensity via functional movements.

Workouts (known as WODs – Workouts of the Day) are varied and typically short in duration… some may last only 5 minutes, and some may last up to 30 minutes.

Although the emphasis is on intensity, CrossFit athletes don't tend to be bloated budgie smugglers with fake tans, and you won't be watching Justin Bieber videos as you work out.

Nor will you see sales staff looking to sell you everything under the sun while asking for all your friends' email addresses.

A CrossFit gym (or 'box') is typically a warehouse space filled with pull-up bars, barbells and weights, jump ropes, rowers, and kettlebells.

After you lace your runners in a CrossFit box, you warm-up, then wait for the WOD as prescribed by either CrossFit HQ in California, or by the CrossFit trainer at your local box.

My first workout is one I will never forget. I entered the box and written on the wall was this: 3 rounds of 50 pull-ups, 50 push-ups, and 100 bodyweight squats with a 40minute time limit.

Next to that wall (common in most CrossFit boxes), is a painted picture of a clown projectile vomiting across the wall, with names/dates/WODs of the CrossFit members who most recently lost their lunch. I wondered whether my name would be next on that wall, then Rage Against the Machine blared and we all started the WOD to compete against the clock and each other to record times.

Many CrossFit WODs are named after women. 'Fran' sounds like an easy workout, but try putting your body through three rounds of 21 reps, 15, and then 9 of two exercises: 40kg squat thrusters followed by pull-ups. (At The CrossFit Games, Scott Panchik performed this workout in 2 minutes and 41 seconds).

But while it is hard core, it's not exclusive, because right next to me were men and women of all levels of fitness. Some were CrossFit junkies as fit as anyone on the rugby field, while others were weight loss clients, grandparents, and even some with physical disabilities looking to build strength.

But like all things, CrossFit has its critics. Donal Carr, from Place of CHI, is a Paul Chek lecturer, presenter, and former training and development manager for personal trainers at Fitness First.

He said, "I appreciate CrossFit as a sport, watching elite athletes perform intense workouts, however I am not a fan of CrossFit expanding at the local level where personal trainers are learning Olympic lifting in a weekend course. Complex movements within WODs are being picked out of a hat in the morning, and poor exercise selection with improper technique is leading to injuries."

I was fortunate when I learned CrossFit, because I was taught by Steve 'Commando Steve' Willis and Mick Shaw – some of Australia's top CrossFit trainers. But I understand Donal's point, because varied and intense workouts with a weighted load can lead to injuries for the average Joe and even for elite athletes.

But as CrossFit continues to grow (3,400 worldwide affiliates and climbing), I will always be a fan because the workouts don't require machines and there's no popcorn and popstar atmosphere. It's about moving your body with functionality and intensity via WODs that aren't lead by tanned gym bunnies. CrossFit is simple, intense, and guarantees results… and it will bring your mind and body to the pain threshold where you'll ask yourself: 'Do I continue on with this WOD? Or do I quit and hit the couch like everybody else would?'

CrossFit will take the average gym enthusiast on a ride they have never ridden to push the mind and body to the limit.

So is CrossFit a fad? I say no way. It's here to stay and expand worldwide.

http://www.theage.com.au/executive-styl ... 229ck.html


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PostPosted: Thu Jul 26, 2012 5:25 am 
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Policing Queensland doctors may require a 'heavier touch' from government

RICHARD Chesterman QC's report into the policing of Queensland doctors represents a serious test of Health Minister Lawrence Springborg's political and public administration skills.

The retired judge's investigation of a whistleblower's allegations of medical malpractice within the health system provides some degree of comfort for the Newman Government and the public to the extent that it finds no evidence of misconduct or any "systemic failure" of the existing processes for monitoring medical practitioners.

But nearly as worrying, Mr Chesterman found "excessive delays" in the processing of complaints and raised concerns about whether regulators were too soft on offending doctors or too ready to dismiss claims against them. In other words, he has identified serious issues about the way the three state and federal medical watchdog agencies - the Queensland Board of the Medical Board of Australia, the Health Quality Complaints Commission and the Australian Health Practitioner Regulation Agency - go about their business.

And this presents a big challenge for Mr Springborg because the Newman administration's aggressive cost-cutting regime effectively rules out one obvious remedy to the problem of "excessive delays" - hiring more staff to conduct investigations against allegedly dodgy doctors in a timely manner. This means the minister will have to work with what he has got, not only to make the existing bureaucracy work more efficiently but also to change a culture which, in some cases at least, applies what Mr Chesterman refers to as "light touch regulation".

Mr Chesterman offers several recommendations, which Mr Springborg says he is now considering, including reducing the number of doctors on the QBMBA. He also recommends that all doctors disciplined in the past five years over the death or serious injury of a patient be re-examined to determine if they should face criminal charges.

Mr Springborg hasn't yet formally agreed to Mr Chesterman's recommendations but does seem to be supportive, saying they "reflect concerns I have raised since my appointment". Whatever its next step, the Government must move quickly. Public confidence in the state's health system was badly damaged by the extended Jayant Patel affair and cannot once again be shaken by continuing concerns about the effectiveness of the now-complicated medical standards monitoring system that has been developed in recent years.

At very least it must make it easier for disgruntled patients to have their complaints heard quickly and fairly rather than having to wait, in some cases, years, for an outcome. The state must also maintain efforts to make sure its medical professionals - the overwhelming majority of them highly dedicated, selfless and well-trained - can deliver their essential services without the pressure of inhumanely long working hours or undue external pressure. The previous Labor government failed badly in this area. The Courier-Mail exposed how Queensland Health recklessly distributed advice for its doctors on the levels of caffeine to take to ensure they were as alert as possible as their marathon shifts dragged on.

The challenges continue for the Newman Government but its ministers have time to show they are up to serving Queenslanders well.

http://www.couriermail.com.au/news/opin ... 6434218091


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