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PostPosted: Sat Aug 04, 2012 5:19 am 
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Heart Foundation revises targets

Heart attack sufferers have a lower cholesterol target to meet under new guidelines set by the National Heart Foundation of Australia.

The foundation has lowered the target for bad cholesterol, or LDL, for people with heart disease from 2.0mmol/L to 1.8mmol/L.

The new target will affect the way doctors treat the estimated 300,000 Australians who have survived a heart attack.

'These new targets are not for healthy Australians,' said the foundation's clinical issue director, Dr Robert Grenfell.

'They are specifically for people who have already suffered a heart attack and are at high risk of a secondary event.'

There are two types of cholesterol. Low-density lipoprotein, or LDL, is regarded as bad and high-density lipoprotein, or HDL, is known as good cholesterol.

The amount of good and bad cholesterol made by the body is influenced by the type of foods people eat.

A diet high in saturated fat is the main cause of high cholesterol.

Switching from butter to margarine, choosing reduced fat dairy and trimming visible fat from meat are simple ways to cut back on saturated fats.

These can be replaced with healthy fats from nuts, plant-based oils, avocados and oily fish.

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PostPosted: Wed Aug 08, 2012 5:28 am 
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Midwife denies she delayed taking mother to hospital during 'unsafe' home birth

A MIDWIFE who took part in an attempted home birth has denied she delayed taking the mother to hospital when the baby's heart rate fell, despite medical opinion that her actions represented "gross mismanagement" in the events leading to the baby's death.

Private midwife Fiona Hallinan this morning continued her evidence at an inquest into the death of infant Joseph Thurgood-Gates.

His mother Kate Thurgood had wanted to have a home birth against the advice of doctors, who warned of possible complications including a uterine rupture.

She had delivered three children previously through caesarean section, and the inquest has heard it was likely a uterine rupture contributed to Joseph's death.

The inquest has heard Ms Thurgood was taken to hospital nearly six hours after her labour began at home.

A report by obstetrician John Campbell, given to coroner Kim Parkinson, says Ms Hallinan's role in the attempted home birth, and her apparent support for it, was "a serious departure from safe midwifery practice."

"Kate Thurgood would have been confident to continue her home birth plan while being supported by the midwife," Dr Campbell said, adding that a delay in getting to hospital once the foetal heart rate began to drop was "gross mismanagement by the midwife."

Ms Hallinan said she did not support Ms Thurgood's decision to persevere for a home birth, but did not expressly tell Ms Thurgood that she disagreed.

"At the end of the day I can't force a mother to do something she doesn't want to do," she said.

"I absolutely refute that there was any delay in transferring when there was a concern for the child.

"I have never delayed in responding appropriately or in as timely a manner as possible to any variation in foetal heart rate in 23 years."

Ms Hallinan said she had believed a hospital delivery would occur after Ms Thurgood presented at hospital bleeding a few days before labour.

"We had an agreement to go to the hospital," she told the inquest as Ms Thurgood shook her head.

The inquest continues. ... 6444836148

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PostPosted: Sun Aug 12, 2012 6:03 am 
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Doctors target gun violence as a social disease

MILWAUKEE (AP) — Is a gun like a virus, a car, tobacco or alcohol? Yes say public health experts, who in the wake of recent mass shootings are calling for a fresh look at gun violence as a social disease.

What we need, they say, is a public health approach to the problem, like the highway safety measures, product changes and driving laws that slashed deaths from car crashes decades ago, even as the number of vehicles on the road rose.

One example: Guardrails are now curved to the ground instead of having sharp metal ends that stick out and pose a hazard in a crash.

“People used to spear themselves and we blamed the drivers for that,” said Dr. Garen Wintemute, an emergency medicine professor who directs the Violence Prevention Research Program at the University of California, Davis.

It wasn’t enough back then to curb deaths just by trying to make people better drivers, and it isn’t enough now to tackle gun violence by focusing solely on the people doing the shooting, he and other doctors say.

They want a science-based, pragmatic approach based on the reality that we live in a society saturated with guns and need better ways of preventing harm from them.

The need for a new approach crystallized last Sunday for one of the nation’s leading gun violence experts, Dr. Stephen Hargarten. He found himself treating victims of the Sikh temple shootings at the emergency department he heads in Milwaukee. Seven people were killed, including the gunman, and three were seriously injured.

It happened two weeks after the shooting that killed 12 people and injured 58 at a movie theater in Colorado, and two days before a man pleaded guilty to killing six people and wounding 13, including then-Rep. Gabrielle Giffords, in Tucson, Ariz., last year.

“What I’m struggling with is, is this the new social norm? This is what we’re going to have to live with if we have more personal access to firearms,” said Hargarten, emergency medicine chief at Froedtert Hospital and director of the Injury Research Center at the Medical College of Wisconsin. “We have a public health issue to discuss. Do we wait for the next outbreak or is there something we can do to prevent it?”

About 260 million to 300 million firearms are owned by civilians in the United States; about one-third of American homes have one. Guns are used in two-thirds of homicides, according to the FBI. About 9 percent of all violent crimes involve a gun – roughly 338,000 cases each year.

Mass shootings don’t seem to be on the rise, but not all police agencies report details like the number of victims per shooting and reporting lags by more than a year, so recent trends are not known.

“The greater toll is not from these clusters but from endemic violence, the stuff that occurs every day and doesn’t make the headlines,” said Wintemute, the California researcher.

More than 73,000 emergency room visits in 2010 were for firearm-related injuries, the Centers for Disease Control and Prevention estimates.

Dr. David Satcher tried to make gun violence a public health issue when he became CDC director in 1993. Four years later, laws that allow the carrying of concealed weapons drew attention when two women were shot at an Indianapolis restaurant after a patron’s gun fell out of his pocket and accidentally fired. Ironically, the victims were health educators in town for an American Public Health Association convention.

That same year, Hargarten won a federal grant to establish the nation’s first Firearm Injury Center at the Medical College of Wisconsin.

“Unlike almost all other consumer products, there is no national product safety oversight of firearms,” he wrote in the Wisconsin Medical Journal.

That’s just one aspect of a public health approach. Other elements:

-”Host” factors: What makes someone more likely to shoot, or someone more likely to be a victim. One recent study found firearm owners were more likely than those with no firearms at home to binge drink or to drink and drive, and other research has tied alcohol and gun violence. That suggests that people with driving under the influence convictions should be barred from buying a gun, Wintemute said.

-Product features: Which firearms are most dangerous and why. Manufacturers could be pressured to fix design defects that let guns go off accidentally, and to add technology that allows only the owner of the gun to fire it (many police officers and others are shot with their own weapons). Bans on assault weapons and multiple magazines that allow rapid and repeat firing are other possible steps.

-”Environmental” risk factors: What conditions allow or contribute to shootings. Gun shops must do background checks and refuse to sell firearms to people convicted of felonies or domestic violence misdemeanors, but those convicted of other violent misdemeanors can buy whatever they want. The rules also don’t apply to private sales, which one study estimates as 40 percent of the market.

-Disease patterns, observing how a problem spreads. Gun ownership – a precursor to gun violence – can spread “much like an infectious disease circulates,” said Daniel Webster, a health policy expert and co-director of the Johns Hopkins Center for Gun Policy and Research in Baltimore.

“There’s sort of a contagion phenomenon” after a shooting, where people feel they need to have a gun for protection or retaliation, he said.

That’s already evident in the wake of the Colorado movie-theater shootings. Last week, reports popped up around the nation of people bringing guns to “Batman” movies. Some of them said they did so for protection. ... l-disease/

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PostPosted: Mon Aug 13, 2012 5:17 am 
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Five best moves for women's bodies

ARE you a busy modern woman who needs to make each workout really count?

Look no further! Fitness guru Damien Kelly reveals the very best moves for a fit-looking bod.

1. Decline lunges

Why? A great butt toner.
How? Stand with a bench about 1m behind you. Place the toes of your left foot on the bench so the foot is vertical. Bend your front knee and lower your back knee. Try to get your front thigh horizontal without the knee passing over your toes. Do all reps on one leg, then switch.
Sets and reps: 3-5 sets of 10-20 each leg.

2. Dead lifts

Why? These target the backs of the thighs, butt and lower back in one move. They also teach you to keep a neutral spine as you lift. Increase the weight every few weeks.
How? Stand, feet hip-width apart, holding a barbell in both hands. Brace your core and bend forward at the hips, knees bent, lowering the weight down your legs to the ground so your hamstrings feel a stretch. Keep your back neutral by looking forward, sticking your butt out and opening your chest. Pause at the bottom, then rise. At the top, push your hips forward and contract your glutes.
Sets and reps: 3-5 sets of 8-15.

3. Side bridge twists

Why? An exercise that targets your obliques and core is the best for tightening and shaping the stomach.
How? Lie on your side, leaning on your elbow, forearm pointing forward. Raise your body so you form a straight line from shoulder to feet. Reach up with your top arm, then sweep it down and as far under your torso as possible. Your top shoulder and upper torso will twist. Keep your hips high and body straight. Untwist and take your arm back to the start.
Sets and reps: 3-5 sets of 8-15 each side.

4. Burpees

Why? The beauty of a burpee is that it targets your whole body. It also strengthens and gets your heart rate up. It's a combination that burns serious fat.
How? Squat and place your hands on the ground 30cm in front of your feet. Step or jump your feet out behind you. With control, drop your torso to the ground. Immediately press up strongly so you are back on your hands and feet, then jump your feet back to your hands. Stand up, perform a small jump and go straight into your next rep.
Sets and reps: 3-5 sets of 10-20.

5. Raised push-ups

Why? Most women can't go all the way down in a toe push-up and knee push-ups are too easy. Raising your toes is the best compromise.
How? Place your hands shoulder-width apart, fingers forward, on a sturdy object. If you can't touch your chest to it, choose something higher. Lift your heels. Keep your gaze in front of your fingers and your body straight. Lower for 3 seconds, lightly touch your chest and rise over 2 seconds. Pause briefly at the top and bottom.
Sets and reps: 3-5 sets of 8-15. ... 6448751240

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PostPosted: Thu Aug 16, 2012 5:38 am 
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Cut the stress and drop kilos

THE Atkins diet, raw food diet, vegan diet, pills, potions, shakes and quick-fixes ... you name it, Aussies have tried it.

In the battle of the bulge, many of us have gone to extremes to outsmart those unloved love handles by relying on unwavering willpower and a strong determination to starve.

Quite simply, this doesn't work.

Apart from leaving you cranky, hungry and guilty, these quick-fixes may also be contributing to your weight gain.

This revelation came to Jon Gabriel who, having struggled with his weight for 12 years, realised that his body wanted to be fat.

And as long as his body wanted to be fat, it would be.

"Weight loss is not about willpower, not about discipline, not about counting calories, it's about understanding your body," Gabriel said.

What Gabriel learned is that our body has a mechanism that helps protect against famines or starvation. Gabriel calls this mechanism the "FAT programs" and they tell your body to hold on to weight.

"Certain stresses activate these FAT programs," Gabriel said.

"Dieting is a stress. My whole approach is designed on outlining all the stressors."

So while cutting calories and counting kilojoules may reap short-term success, the FAT programs will soon kick in, making you crave those sinful snacks with the added bonus of slowing your metabolism.

The solution? Make your body want to be thinner.

Gabriel, who has a history in biochemistry, immersed himself into finding an answer and as a result, lost more than 100kg without dieting and without surgery.

He subsequently wrote The Gabriel Method which has enjoyed international success.

"I lived with a body forcing me to gain weight. My message to the world is, this is not right," Gabriel said.

"I used to think weight loss was just about diets. It's not. Diets don't just not work for me, they don't work for anyone."

The Gabriel Method focuses on identifying the stressors which are forcing your body to hold on to weight and resolving them through stress management. And it has proven results.

"People read the book and said, 'I get it, but how do I apply this?'," Gabriel said.

He answered that with his second and latest book, The Gabriel Method: Super Delicious, Super Nutritious Recipe Book.

But don't expect recipes for lettuce leaf soup.

Gabriel's book is packed with meals, snacks and desserts and his main focus is on adding rather than subtracting foods.

"There are two reasons to eat - for nutrition and for calories. When you diet, all you're getting is calories," Gabriel said.

"The art of nourishing yourself is using good fats versus bad fats, good proteins versus bad proteins.

"Certain ingredients will nurture the body so the stress of being malnourished won't get to you."

Essentially Gabriel's recipe book has taken all your favourites (chocolate mousse, anyone?) and "Gabrielised" them by substituting the bad ingredients with good ones. Simple.

Now Gabriel wants to share his success with the world, as a teacher and a guide for those who are about to embark on their own weight loss journey.

Gabriel hosts online seminars to an audience of 700.

He has online six-week, step-by-step classes, lectures on the real cause of weight gain, holds three-day retreats and has a visualisation CD.

"The more support people have the more successful they are," Gabriel said.

Gabriel is collaborating with a doctor in the US on another book which will focus on childhood obesity.

Is this the secret to weight loss?

In Gabriel's words: absolutely.

Reviewer's Last Word

The Gabriel Method Recipe Book is a refreshing change from the "quick-fix" miracle solutions that flood the market.

He covers everything from the reasons behind weight gain and how to address obesity, to the logic behind his recipes and what ingredients to best stock in your pantry and fridge.

The recipes are simple and yummy and include household favourites such as butter chicken, chocolate mousse, cheesecake and chicken stir fry. A book for all the family. ... rop-kilos/

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PostPosted: Fri Aug 17, 2012 5:33 am 
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Energy drinks cut drunken risk-taking: study

The University of Tasmania (UTAS) surveyed more than 400 Australians aged between 18 and 35 years old who had mixed alcohol and energy drinks in the previous six months.

The research looked at the physical, psychological and risk-taking effects of mixing the two.

While the mix-drinkers had similar rates of impulse and novelty seeking, they were less likely to lose their inhibitions and engage in 26 separate risky behaviours.

The finding contradicts currently available international research.

The survey's author, UTAS School of Psychology PhD candidate Amy Peacock, says that difference was the most surprising result.

"That related to driving behaviours, sexual practices, illicit and licit drug use, antisocial behaviours, the whole range," she says.

The mixed drinks also made the participants less likely to suffer the telltale sedative effects of increasing intoxication, meaning there was less indication of how drunk they were becoming.

"They were less likely to experience nausea, walking difficulties, vision difficulties and slurred speech, compared to when drinking alcohol alone," Ms Peacock says.

The study also found those that mixed would consume on average 2.5 energy drinks in one session, which Ms Peacock says is above the recommended daily intake, while some consumed up to 10.

Mix-drinkers were less likely to experience exhaustion and fatigue and more likely to be irritable and tense.

The physical drawbacks were also increased when mixing alcohol and energy drinks.

"People actually had higher odds of experiencing heart palpitations, sleeping difficulties, tremors, agitation, increased speed of speech and 'jolt and crash episodes'," she says.

Ms Peacock hopes the results will hope to inform consumers about the consequences and potential side effects.

However she says more research needs to be done about how popular mixing is, especially in the 18-20-year-old age bracket and whether those under 18 are doing it too.

"Looking at information from poison centre calls, it seems like the number of calls relating to energy drinks have been increasing in the past few years," she says.

"But in regards to prevalence, we're not 100 per cent sure at the moment."

The researchers however say they are not suggesting people should mix alcohol with energy drinks to reduce the risks associated with drinking.

Ms Peacock says more work also needs to be done to explain the link between the two. ... 568533.htm

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PostPosted: Mon Aug 20, 2012 5:17 am 
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Injured fare better at metro hospitals

Patients treated at regional trauma centres in NSW are more likely to die than those admitted to major metropolitan centres, a study shows.

The University of Sydney research, published in the Medical Journal of Australia on Monday, said introducing Level 1 trauma centres in NSW had been effective in reducing deaths.

The study's authors said the higher survival rates at Level 1 centres could be explained by better resources, including the 24-hour availability of surgical staff.

"Regional trauma centres play an important role in the delivery of trauma care, but often lack specialty resources," they wrote.

In 2008, Ambulance NSW introduced a policy that major trauma patients should be taken straight to a Level 1 centre if transport time would be less than one hour.

Improved adherence to the transfer guidelines would contribute to patients' survival, the researchers said.

Government bodies should ensure all trauma centres were adequately resourced with well-trained staff, they wrote.

The study, the first statewide research of major adult trauma trends, analysed data from from the NSW Trauma Registry.

Eight Level 1 trauma centres and three regional centres were surveyed between January 2003 and December 2007.

In that time, 9,769 people admitted to trauma centres which were included in the registry.

Road trauma and falls were the most common injuries. ... -hospitals

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PostPosted: Tue Aug 21, 2012 5:34 am 
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Scott 'had inoperable brain cancer'

Film director Tony Scott was suffering from inoperable brain cancer when he jumped to his death from a bridge in Los Angeles, it has been reported.

The claim was made by ABC News in the United States, citing sources close to the Top Gun filmmaker, as tributes poured in for a man described as "one of the world's true originals".

The 68-year-old, originally from North Shields in England, was best known for action-packed Hollywood blockbusters, including Days Of Thunder and Beverly Hills Cop II.

Scott, younger brother of filmmaker Ridley Scott, leapt from the Vincent Thomas Bridge in LA.

Lieutenant Joe Bale, of the county coroner's office, said the death was being treated as a suicide.

British actress Keira Knightley, who worked with Scott on his 2005 film, Domino, in which she starred as a bounty hunter, said: "Tony Scott was one of the most extraordinary, imaginative men I ever worked with.

"It was a privilege to have spent the time I did with him. He was a firecracker and one of the world's true originals."

A dive team pulled Scott's body from the water several hours after members of the public alerted emergency services, having seen him jump from the bridge.

A suicide note is said to have been found at his office and he had left contact details in his black Toyota Prius parked close to the scene.

He was behind numerous slick action movies and worked with some of the biggest names in the film world, including Tom Cruise, Gene Hackman and Denzel Washington.

Scott, who lived in Beverly Hills, was married to actress Donna Scott, his third wife with whom he had twin sons.

He ran Scott Free Productions with his brother and the pair were working on a film called Killing Lincoln.

His other films included box office hits such as True Romance, Crimson Tide, Enemy Of The State and Man On Fire.

As well as his movie work, he also produced hit US television shows Numb3rs and The Good Wife.

Director Ron Howard also paid tribute to Scott, tweeting: "No more Tony Scott movies. Tragic day."

Stephen Fry said: "Deeply saddened to hear the news about Tony Scott. A fine film-maker and the most charming, modest man."

Shaun Of The Dead filmmaker Edgar Wright tweeted: "As I hope was evident in my work, I was big fan of his. Rest In Peace, sir."

Filmmaker Spike Lee offered his "prayers and blessings to the family of fellow director Tony Scott and brother Ridley".

Val Kilmer, who played Iceman in Top Gun, tweeted: "RIP Tony. You were the kindest film director I ever worked for. You will be missed."

Actress Susan Sarandon said she was "saddened" by his death. She described him on Twitter as "a wonderful filmmaker and a funny, sweet guy". ... loved-ones

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PostPosted: Fri Aug 24, 2012 5:17 am 
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Springtime is tired time

The sun is shining, the days are growing longer and the open-air season has begun. It is spring, but not everyone feels energetic. For some, it is a season of leaden limbs and fits of yawning, especially after the switch to daylight saving time.

"Springtime lethargy is a vegetative reaction to the changes in nature," said Angela Schuh, a professor of medical climatology at the University of Munich.

People, like animals, regulate their metabolism and hormone levels in tune with external stimuli such as light and temperature. When it is cold and dark outside, the body protects itself.

"Our core temperature in winter is a few tenths of a degree centigrade lower than in summer. This slows down metabolism" so the body goes into a kind of mini-hibernation, Schuh said.

"During these months, the body produces more of the sleep hormone melatonin," resulting in a pronounced need to sleep.

When spring comes, bringing longer and stronger hours of sunlight, the body must adjust. Body temperature rises, blood vessels dilate, blood pressure sinks. The light causes the body to release more of the "activity hormone" serotonin.

"The body can't manage the adaptation processes overnight, though.

It takes about two or three weeks," said Heidrun Holstein, a physician for the consumer advice centre of the German state of Baden-Wuerttemberg.

Factors other than processes in the vegetative (autonomic) nervous system can contribute to springtime lethargy. Infections are common during changes of season. Large day-night temperature swings put added strain on blood vessels and circulation.

Depending on climatic conditions, springtime lethargy and the switch to daylight saving time may coincide. Personal habits play a role too, such as how one organises one's day.

Springtime lethargy symptoms can vary widely: "Common complaints are tiredness, dizziness, irritability, headaches, mild sensitivity to changes in the weather and a tendency towards a sad mood," said Michael Stimpel, an internist and a professor in the University of Cologne's medical department.

Particularly at risk, he said, are the elderly and frail, women, and people with unstable blood circulation or those who have had very little exercise over the winter.

Those who suffer from springtime lethargy can alleviate their symptoms using simple means.

"You can act preventatively knowing that light stimulates the production of the activity hormone serotonin," Stimpel said. "You can spend a lot of time outdoors or undergo light therapy with special lamps which use filtered light."

Sauna baths, Kneipp hydrotherapy and contrast showers stabilise circulation and steel the vascular system so it is less susceptible to temperature fluctuations. Exercise activates the whole body.

"Eating plenty of fresh fruits and vegetables supplies the body with an extra portion of vitamins and minerals," Holstein said.

Drinking a sufficient amount of fluids was also part of a prevention program, she said. This makes the body fit for spring from the inside out. When springtime lethargy is especially acute, it helps to take a short break and get some fresh air.

"Applying cold water on the forearms or a damp cloth to the forehead banishes the symptoms," Stimpel said.

Schuh recommends giving the body time to adjust.

"Take it easy, and don't take the symptoms too seriously," she said.

According to Holstein, "it's like mild jet lag - the body has been brought out of its accustomed rhythm." ... 24nz5.html

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PostPosted: Sun Aug 26, 2012 5:34 am 
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In Indonesia, Big Tobacco hasn't got a worry

MANY people have seen the smoking baby on YouTube - the chubby, cheerful two-year-old from Sumatra with a pack-a-day habit. But Ardi Rizal was not a one-off curiosity. In the land of the child smoker, he is one of scores of toddlers and preschoolers addicted to nicotine.

Muhammad Dihan Awalidan is one. He's four years old, smoked his first cigarette at 2½, and gets through a pack of 25 a day. He started when he stole one of his father's cigarettes and lit it on the kitchen stove.

His parents, Iyan Ansori and mother Sulawati, are farmers from a hillside village in West Java. They know their son's habit is unhealthy, but feel powerless to stop him. He walks down to the local warung, or cafe, to buy his own cigarettes, sometimes staying for a coffee as well. If he's denied, ''it's like he's possessed, he really wants it'', says Iyan, who smokes a few cigarettes a day himself.

While the cigarette industry is beginning to lose its grip in developed nations - the federal government's victory on plain packaging legislation was hailed as an international breakthrough - health experts warn of a humanitarian disaster looming in poorer countries, particularly in the Asia-Pacific region.

''They [cigarette companies] are just wilfully imposing a pandemic on developing countries,'' says

Professor Mike Daube, a World Health Organisation tobacco control adviser and president of the Australian Council on Smoking and Health. ''They've known for more than 60 years that smoking kills. This is going to cause far more deaths than any wars we've ever seen.''

Four-year-old Muhammad Diha Awalidan smokes a cigarette in his parent's house in rural West Java. Photo: Michael Bachelard

Dihan does not play much with other children, and doesn't say much to strangers. But when asked what smoking is like, he says ''enak'' - an Indonesian word which in this context means both ''delicious'' and ''it makes me feel good''.

Australia's northern neighbour is the wild west of tobacco. It's one of the few countries that has not signed the World Health Organisation's Framework Convention on Tobacco Control, which means there are few restrictions on advertising, warnings or smoking indoors. Outdoor cigarette advertising, footnoted by the mildest of warnings, assaults you wherever you go.

About 90 per cent of smokers here favour ''kretek'', clove cigarettes that are an Indonesian product and regarded by some with nationalistic fervour. They can be high in tar (39 milligrams compared with 16 milligrams for the strongest cigarette in Australia) and are sold in packets or by the stick. Some stalls set up outside schools to attract students.

Despite the preference for kretek, the Marlboro man - literally and figuratively dead in the West - is also alive in Indonesia. Global giants Philip Morris and British American Tobacco have moved in to Indonesia in the past 10 years, attracted by sales of a massive volume of cigarettes - 270 billion a year, and growing fast.

About two-thirds of men smoke either cigarettes or some form of tobacco, vastly outnumbering women because of cultural taboos. But young, smart, city women are now appearing in smoking ads, and some are beginning to break with tradition in pursuit of what Andika Priyono, an official from the country's child protection agency, calls the ''three Bs'' of modern success. ''BlackBerry, braces and black menthol [cigarettes],'' she told the Jakarta Globe newspaper recently.

Smokers in Indonesia are also getting younger. The University of Indonesia's Demographic Institute found that 71,000 Indonesians aged 10 to 14 were smokers in 1995. By 2010, there were 426,000 at least. Local cigarettes often have sweetened tips, making them taste like sweets.

The child protection agency, Komnas Anak, gave The Sunday Age a list of 10 smoking children whose names and histories it could confirm. It says almost 2 per cent of Indonesian smokers start at the age of four - a number that's rising. Even for the poor it's affordable, with a pack of 20 cigarettes starting at about 90¢.

Sandi Adi Susanto has been smoking since he was 18 months old. Every morning he asks for a coffee and a cigarette. He drinks alcohol too, if he can get it, and his parents believe he is possessed by the hard-bitten spirit of his late grandmother.

Reno Ardiansyah has been smoking since he was 14 months old; Aldi Ilham is only eight, but has already been smoking for four years; and Falen is two and does not speak much but can distinguish between different brands of cigarettes. All of them, like Dihan, are surrounded by a culture steeped in tobacco.

''I think it's because of the environment,'' says father Iyan, ''because the village people always sit around together and he saw people smoking and wanted to try it.''

Dihan's fellow villagers, and his family, farm tobacco, among other things. But he shows no interest in the local product. What he likes is Sampoerna A, a smooth-tasting machine-made brand of kretek owned since 2005 by Philip Morris.

Philip Morris identifies Indonesia as its biggest growth market. At its results presentation on July 19, chief financial officer Hermann G. Waldemer boasted that Sampoerna A was the fastest-growing brand in Indonesia, up 1.2 points to be 13.1 per cent of the market. The company's other brands, including Marlboro, are also growing.

''We're just doing extremely well,'' Waldemer told analysts. ''The elements are all there for a very positive performance to continue in the Indonesian market.''

Part of the quality of tobacco companies' performance is that Indonesia's politicians are unwilling to take on the might of Big Tobacco.

A law proposed in 2009 tried to limit smoking and its promotion. If passed, it would empower local governments to designate and control smoke-free zones, limit advertising and include graphic pictorial warnings on cigarette packets.

But lobbying by the tobacco industry has left it on the backburner for three years because, according to Ignatius Mulyono, chairman of the House of Representatives' legislative body, it was ''very biased towards the anti-tobacco lobby''.

Human Rights Watch Indonesian representative Andreas Harsono says politicians do not want to take on the industry. Only 20 to 30 per cent of the industry's costs are in making cigarettes, he says, ''the rest goes to sponsoring, advertising and lobbying''. There are no electoral disclosure laws in Indonesia, but Harsono believes if there were, it would show money from tobacco flowing into the campaigns of politicians.

Sponsorship, particularly of sport and education, is another big part of the industry's influence. A recent survey showed tobacco companies sponsored 1042 events in Indonesia between 2009 and 2011. The Djarum Foundation, run by a private cigarette company, has given educational scholarships to more than 7000 university students since 1984.

Everything from badminton matches to schools themselves are sponsored - one public high school in East Java uses a tobacco company foundation logo as its school badge, says child protection commission spokeswoman Lisda Sundari.

These activities have made tobacco a powerful lobby, and highly resistant to the message from health practitioners. A recent book, Killing Indonesia: Global Conspiracy to Destroy Kretek, paints smoking almost as a nationalist requirement, and the health lobby as a conspiracy by American interests to kill the clove industry.

A community group, Komunitas Kretek, says the traditional cigarette, and Indonesia's sovereignty itself, is under threat both from ''white cigarettes'' (the non-clove variety pushed by the multinational companies) and the health lobby.

The group's national co-ordinator, Abhisan Demosa Makahekum, says cloves are good for health: ''People in Papua use clove to cure their toothache, in Kudus [Central Java] it is used to cure coughing.''

For Indonesians, the result of the cigarette epidemic is tragic, with 200,000 people dying every year, including 25,000 from passive smoking. And because they start smoking so young, they are dying younger.

Persahabatan Hospital is the national referral hospital for cancer. Specialist Dr Elisna Syahruddin says one-fifth of her patients are under 40. In the United States, by contrast, just 2.3 per cent of lung cancer cases occur in people under 44 years, and the median age for diagnosis is 72.

''I am very worried,'' Dr Syahruddin says. Kretek are actually worse than ''white cigarettes'', she says, because the cloves anaesthetise the throat, allowing smokers to draw deeper. The cancers she sees are at the further reaches of the lungs.

One of her patients, Rambe Partogi, is 31. She has fourth-stage lung cancer, and only a 50 per cent chance of surviving more than nine months.

He started smoking when he was 12 because all the men in his family smoked, and his friends too. ''It's a normal condition,'' he said. At 15, he changed to Marlboro after he won a competition and became part of the Marlboro Adventure Team, hiking and doing other activities in Yogyakarta.

''It wasn't about marketing and promotion, it was just about adventure,'' Rambe says. ''They didn't give us cigarettes, but then the program committee, they did smoke and of course we smoked too.''

His friends, still smokers, have come to visit him in hospital. ''I say to them: smoke and go to hell,'' Rambe says. ''Sometimes they listen.''

Another of Dr Syahruddin's patients, Dewi Husmawati, never smoked, but worked in an advertising office with 11 men who did.

''In Indonesia it's very difficult to make a definition of a passive smoker because smoke is everywhere - the office, stations, houses, restaurants,'' Dr Syahruddin says.

She allowed The Sunday Age carte blanche to tour the hospital, film her patients and ask questions because she is sick of waiting for the government to respond to what she sees as a crisis. ''If the politicians won't help,'' she says, ''maybe the media can.'' ... 24tlu.html

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PostPosted: Tue Aug 28, 2012 5:37 am 
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Black Dog measures just how content we are

WHAT is the Black Dog Index? It is a new measure of the nation's health, not in economic terms but in terms of our overall happiness.

It's an initiative of the depression research clinic the Black Dog Institute, with Newspoll and The Australian on board as partners.

The index aims to put a score -- at present 77 out of 100 -- on how happy Australians feel. And the news is really good.

Most of us are happy and the things that make us happy -- family, friends -- have little to do with money.

The index also seeks to measure how many of us are suffering depression and may in fact feel that life is simply not worth living.

More than 2300 Australians took their own lives last year. Suicide is a bigger killer of young Australians than even motor vehicle accidents.

The Black Dog Index is not a one-off; Newspoll will track the issues over time to see whether the score fluctuates alongside the unemployment rate or changes to interest rates and other major events.

The Australian hopes that others will refer to the Black Dog Index as an important measure of the nation's wellbeing, but also to start a conversation on a subject once considered taboo for media -- suicide, and how to prevent it. ... 6459377265

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PostPosted: Thu Aug 30, 2012 5:53 am 
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Forget health, happiness the best motivator

What would it take to persuade you to exercise? A desire to lose weight or improve your figure? To keep heart disease, cancer or diabetes at bay? To lower blood pressure or cholesterol? To protect your bones? To live to a healthy old age?

You'd think any of those reasons would be sufficient to get people exercising, but scores of studies have shown otherwise. It seems that public health experts, doctors and exercise devotees in the media have been using ineffective tactics to entice sedentary people to become, and remain, physically active.

Research by psychologists suggests it's time to stop thinking of future health, weight loss and body image as motivators. Instead, they recommend a strategy marketers use to sell products: portray physical activity as a way to enhance wellbeing and happiness.

''We need to make exercise relevant to people's daily lives,'' a research investigator at the Institute for Research on Women and Gender at the University of Michigan, Michelle Segar, says. ''Everyone's schedule is packed with nonstop to-dos. We can only fit in what's essential.''

Segar is among those who believe that people will not commit to exercise if they see its benefits as distant or theoretical.

''It has to be portrayed as a compelling behaviour that can benefit us today,'' she says. ''People who say they exercise for its benefits to quality of life exercise more over the course of a year than those who say they value exercise for its health benefits.''

Her idea for a public service advertisement to promote exercise for working women with families: a woman is shown walking around the block after dinner with her children and says: ''This is great. I can fit in fitness, spend quality time with my kids, and at the same time teach them how important exercise is.''

Based on studies of what motivates people to adopt and sustain activity, Segar is urging experts to stop framing moderate exercise as a medical prescription requiring 150 minutes of aerobic effort each week. ''Immediate rewards are more motivating than distant ones. Feeling happy and less stressed is more motivating than not getting heart disease or cancer, maybe, someday in the future.''

In a study of 252 office workers, two psychologists at Bangor University in Wales, David Ingledew and David Markland, found while many began to exercise to lose weight and improve their appearance, these motivations did not keep them exercising in the long term. ''The wellbeing and enjoyment benefits of exercise should be emphasised,'' they found.

Segar put it this way: ''Physical activity is an elixir of life, but we're not teaching people that. We're telling them it's a pill to take or a punishment for bad numbers on the scale.''

Other studies have shown that what gets people up and keeps them moving depends on age, gender, life circumstances and even ethnicity. For those of college age, for example, physical attractiveness typically heads the list of reasons to begin exercising, although what keeps them going seems to be the stress relief that regular exercise provides.

The elderly, on the other hand, might get started because of health concerns. Often what keeps them exercising are the friendships and sense of community that might be missing from their lives.

In a study of 1690 overweight or obese middle-aged men and women, Segar found that enhancing daily wellbeing was the most influential factor for the women. Men were motivated by more distant health benefits, although she suspects this might be because men feel less comfortable discussing their mental health needs.

Many people, if not most, start exercising because they want to lose weight. Often they abandon exercise when the kilograms fail to fall off. Study after study has found that without changes in eating habits, increasing physical activity is only somewhat effective for losing weight, though it helps maintain weight loss, and shedding even a few kilos, especially around one's middle, can improve health.

Researchers in Brisbane and in Leeds, England, studied 58 sedentary overweight or obese men and women taking part in a 12-week aerobic exercise program. Weight loss was minimal, but even so their waistlines shrunk, their blood pressure and resting heart rate dropped, and their aerobic capacity and mood improved. ''Exercise should be encouraged and the emphasis on weight loss reduced,'' the study concluded. ''Disappointment and low self-esteem associated with poor weight loss could lead to low exercise adherence and a general perception that exercise is futile and not beneficial.'' ... z24xzznkYz

PostPosted: Sat Sep 01, 2012 5:28 am 
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Ex-Marine kills 2, self at NJ supermarket

OLD BRIDGE, N.J. (AP) — An ex-Marine wearing military clothing opened fire at a New Jersey supermarket early Friday, killing two of his co-workers and himself as other terrified store employees hid in the back, authorities said.

The 23-year-old man left his shift at a Pathmark store in Old Bridge Township around 3:30 a.m. and returned a half-hour later to the closed store with a handgun and an AK-47 assault rifle, Middlesex County Prosecutor Bruce Kaplan said. About 12 to 14 workers were still there.

The man fired at least 16 rounds from the rifle at the first workers he saw, killing 18-year-old Christina LoBrutto and a 24-year-old Bryan Breen as other workers hid, officials said.

"I do not believe that they were specifically targeted. I believe everybody in the store was a target," said Kaplan.

The gunman then killed himself, said Kaplan.

He did not release the suspect's name, but a law enforcement official briefed on the investigation identified him as Terence Tyler, an ex-Marine who was discharged in 2010. The official spoke to The Associated Press on condition of anonymity because his agency is not in charge of the investigation.

Tyler, an infantryman from Brooklyn, never served overseas, said Marine spokeswoman Capt. Kendra Motz. She wouldn't comment on the circumstances of his discharge.

At the top of a Facebook page for a Terence Tyler who says he served in the Marines the same dates as the shooter has this slogan: "Be optimistic. All the people you hate are going to eventually die."

Tyler moved to an apartment near the Pathmark earlier this summer, neighbors said. Co-workers said he had been only working at the store for a few weeks.

Pathmark worker Miranda Miranda said she steered clear of Tyler. "The way he looked at me, he gave me an uneasy vibe," she said.

Miranda had regularly worked the overnight shift on Thursday but said LoBrutto agreed to take over the shift for her a few weeks ago.

"Right now, all I know is what keeps coming into my mind," she said. "That could've been me."

Tyler spent the July 4 weekend drinking at Jersey shore bars with Manase Acheantong, who said Tyler was his friend's cousin.

"We went out. We had drinks. He was a normal kid. He didn't start no fights. He didn't seem crazy," said Acheantong, 25, of Old Bridge.

John Niccollai, president of a foodworkers union that represents some store employees, said Pathmark officials and workers told him the gunman wore military clothing and had just punched out for the night before coming back into the store and opening fire.

Many of the employees escaped gunfire, Niccollai said, when an assistant manager, "who I would view as a hero," helped many workers to get out of the store through the back door.

Kaplan and police walked through the shooting scene at the supermarket Friday morning, with two long windows in the front completely shot through. Police kept onlookers away; a number of vehicles were in the parking lot outside, along with police cars.

The store and its parking lot were closed.

A spokeswoman for Pathmark's parent company, Montvale-based Great Atlantic & Pacific Tea Co. said Friday the company is "deeply saddened" by the shooting and is cooperating with investigators.

"We express our deepest sympathies to the families of the victims and our appreciation to local law enforcement," spokeswoman Mary Connor said.

Old Bridge is a bedroom community of about 65,000 just across the Raritan Bay from New York City's Staten Island.

A vigil was planned Friday at Old Bridge School for LoBrutto and Breen, who both graduated from the school. LoBrutto, who was a horn player in the school band, graduated this year, Schools Superintendent Timothy Brennan said. Breen graduated in 2006.

Sixteen-year-old Jessica Ruano knew Christina from school. "She was a really bubbly girl," Ruano said. "She was silly. She was sweet." ... c641419eca

PostPosted: Sun Sep 02, 2012 5:20 am 
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Social niceties: a burden or blessing in the digital age?

A FEW weeks ago, an old bloke who lives in my neighbourhood tripped on a gutter and stripped 30 centimetres of skin off his shin. It was a nasty graze for a 90-year-old man and one of my mates helped him to the local doctor's surgery, pressing a clean cotton baby wrap - donated by a passing mum - to his leg.

When they arrived, there were two people already in the waiting room: a woman my friend gauged to be in her 70s and a thirtysomething mother wrangling two kids under four.

Both of them watched as my mate helped this gent into a chair, his slip-on shoe rapidly filling with blood, the mum even chatting with them before she, then the elderly lady, proceeded to take their appointments with the doc ahead of the old man. Sure, they were waiting first, but you'd have thought a distressed, haemorrhaging nonagenarian might have occasioned them pushing back their schedules 15 minutes. It was not to be.

Shortly after this episode, I read an article by Sasha Burden, a female journalism student who'd written of the ''horrific'' internship she'd endured at one of this newspaper's competitors. Among a litany of complaints, Burden said men at the paper ''were also continuously and unnecessarily sexist, waiting for me to walk through doors and leave the elevator before them''.

It made me wonder if Burden would have let the old bloke jump the queue if she'd been waiting at the doctors' surgery, as well as just how obsolete ye olde-world rules of etiquette have become in a world where both sexes often use the same hairdressers and bathrooms, not to mention beauty products.

Would not all of us - young and aged, male and female - be served by an updating of what is the ''accepted'' thing to do in social situations? Although some people sneer at etiquette, considering it airs and graces from a bygone era, I believe it's largely a simple methodology for minimising conflict when living cheek by jowl in cities.

Knowing you wait for others to disembark from a bus before you board, that you let the car in front of you merge in traffic and, if you spill someone's drink, you offer to buy them another. We do these things to make life run more smoothly and to acknowledge physical practicalities - which is why we stand for the elderly and pregnant women on public transport. Another term for it might be ''common decency''.

There's no denying some etiquette is rooted in a rather dated, patronising world view that women require deference and pampering because of their ''fragile'' natures.

What can be confusing is that nascent, ''progressive'' attitudes such as Burden's aversion to door opening are not shared by many others; I dare say not by the mother and elderly lady my friend encountered in that doctor's waiting room. This is why the ''equality'' so many women demand in the more meaningful aspects of their lives is still not reflected by cultural niceties such as men condescendingly opening car doors for them in the rain and leaping in front of their girlfriends when a gunman shoots up a cinema.

The ''new etiquette'' would seem to be a natural idea for an e-book, distributed via smartphone app to schools and workplaces alike, so we can all avoid such discomforts as Burden and my 90-year-old neighbour needlessly endured.

For his part, the old bloke seemed pretty clear on the ''done thing''. After he'd been patched up, he shook my friend's hand, looked him in the eye and said ''thank you''. ... z25FPHn62d

PostPosted: Mon Sep 03, 2012 5:21 am 
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Attack in street leaves man dead

ONE man is dead and another is in hospital after being found unconscious on a footpath in Sydney's south-west following an apparent attack near a pub where they had been drinking.

Police found the pair, aged 39 and 41, about 2.15am yesterday at the intersection of Eucalyptus Drive and Berrigan Street in Macquarie Fields, and began CPR until paramedics arrived.

It is believed the men were attacked by an unknown number of assailants, but detectives are unsure what caused their injuries or what sparked the incident.

The 39-year-old was pronounced dead on arrival at hospital.

The Local Area Command crime manager at Macquarie Fields, Detective Chief Inspector Mark Brett, said the two men were mates and were drinking at the nearby Glenquarie Tavern before the attack.

He said the 39-year-old man was single and lived with his parents in Macquarie Fields.

Police do not believe the men's injuries were caused by a gun or knife, but won't know for sure until a post-mortem examination is performed. ... 258gk.html

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