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PostPosted: Mon Oct 20, 2014 8:17 am 
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If You Live In Regional Australian, The More Likely You Are To Die If You Get Cancer

Cancer health inequalities between regional and urban Australia remain despite recent progress, according to a report in the Medical Journal of Australia.

Rural Medical Oncologists Peter Fox and Adam Boyce called on state and federal governments to “ensure equitable cancer care for all Australians, regardless of where they reside”.

Cancer survival rates drop the further the patient is from urban settings, as evidence over the past 20 years clearly shows, Fox and Boyce write.

Over the decade to 2010, the disparity between rural and urban patients has remained unchanged with a 7% higher cancer mortality, equating to almost 9,000 additional rural deaths.

The disparity was greatest with oesophageal cancer and melanoma.

Despite the establishment of the regional cancer centre initiative announced by the federal government in 2010, significant inequalities remain, and “novel approaches are being increasingly adopted”.

Those approaches include telehealth, shared care and surgical oncology networks, Fox and Boyce write.

The authors also recommended the adoption of a national standard staffing profile for rural oncology units in order to “deliver uniform care”. ... er-2014-10

PostPosted: Wed Oct 22, 2014 8:05 am 
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A pint of beer a day 'can double men's fertility': But coffee and being vegetarian cuts odds of conceiving

If you fancy a pint after work then this might be the perfect excuse. Because according to researchers, drinking a pint of beer a day doubles a man’s odds of becoming a father.

But the same study showed that if you want to start a family, it could be a good idea to cut down on coffee – as just two cups a day seemed to slash a couple’s odds of having a baby.

A second study has also shown that vegetarians have lower sperm counts than other men - with the sperm they made was of poorer quality.

In the first study, researchers from the Massachusetts General Hospital in Boston studied 105 men whose wives and girlfriends were undergoing IVF.

The men, who had an average age of 37, filled in an extensive dietary questionnaire that included questions about alcohol intake and caffeinated drinks.

Being vegetarian could damage a man’s fertility, doctors have warned.
A study found that vegetarians and vegans had lower sperm counts than other men. And the sperm they made was of poorer quality.
The Reproductive Medicine conference in Honolulu heard that soy products eaten as meat and dairy substitutes could be the problem. Dr Eliza Orzylowska, from the Loma Linda University Medical Centre in California, said: ‘We found diet significantly affects sperm quality. Vegetarian and vegan diets were associated with much lower sperm counts.
‘It’s hard to tell people not to be vegetarians if they are trying to conceive, but I would caution against soy.’

The amount of alcohol consumed by the would-be fathers was relatively moderate, with the biggest drinkers downing just under three units a day on average. A pint of Stella Artois has 2.7 units.

The tests showed that there was no link between the amount of caffeine or alcohol they took in and the quality of their sperm.

But those who had the most alcohol had a 57 per cent chance that a session of IVF would result in a baby being born. This was twice the 28 per cent success rate of those who drank the least.

When the researchers looked at caffeine intake, they found that birth rates plummeted from 52 per cent among those who had very little caffeine to just 19 per cent for those who had the most. The damage was done above 265mg of caffeine a day. A mug of filter coffee contains 140mg.

The American Society for Reproductive Medicine’s annual conference in Honolulu heard that the results could not be explained away by factors such as the men’s age or weight.

Researchers were unsure why caffeine and alcohol had such a noticeable effect on birth rates when it seemed to have no impact on the quality of the prospective fathers’ sperm.

However Dr Allan Pacey, from Sheffield University, said: ‘Moderate social drinking can be of benefit for couples trying to conceive either naturally or during assisted conception because it helps to reduce stress.’

Researcher Anatte Karmon suggested that caffeine could damage sperm in a way that is not currently picked up by tests. She called the increase in pregnancy rates ‘very impressive’, but said more tests would be needed to confirm the finding – and pointed out that none of the men was a heavy drinker. ... iving.html

PostPosted: Fri Oct 24, 2014 8:25 am 
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Vet uses vodka filled drip to save attacked cat's life

A British cat's life was saved by a drip filled with vodka after it was doused in anti-freeze by a group of thugs.

Missey the cat reportedly came home sopping wet, but her owner Paul Stephenson, 47, and his daughter Sara, 27, thought she was just covered in water.

The next morning Missy became violently ill and the Stephensons rushed her to the vet, Metro reports.

Missy was prescribed a drip filled with vodka, to be fed directly into her mouth. Her owners were told that the ethanol inside the spirit would help break down the poison.

The unorthodox treatment worked, but left Missy completely wasted.

"When we heard about the treatment I was just shocked. I had no idea you could even give an animal vodka," Sara Stephenson told Metro.

"Missey was totally blind drunk after being fed the vodka on a drip. She was treated over the course of two days and got through half a litre bottle of 37.9 per cent vodka."

Metro reports Missey made a full recovery. ... fe-6115722

PostPosted: Sun Oct 26, 2014 12:05 pm 
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Depression: One woman’s honest account

THIRTY-year-old Daile Kelleher still gets butterflies in her stomach every time she has to see a psychologist.

She first saw one five years ago, after a suicide attempt “began my personal journey of depression, medication and psychologists.

“I can only speak from my experience with my personal depression,” she writes on her blog. “Not all mental illness is the same. Not all people who suffer will one day get help/medication/fairydust and everything will be ‘better’. Not all people with mental illness are suicidal or will ever be. Not all people will survive their mental illness.

“I have no shame telling people I am seeing a psychologist. I care too much about myself now not to admit when I might need help.”

Here, Daile candidly shares about her experience seeing a psychologist, a woman she’s dubbed Dr D.

“Getting help is not easy,” she writes. “Admitting you need help is even more difficult. Try to keep that in mind if you know anyone with a mental illness and remember to be kind to each other.”

“I HAVE an appointment with my psychologist this afternoon. It’s probably a strange thing to admit, but I actually get a bit of anxiety about seeing her. My heart races, my palms sweat and my belly is filled with very active butterflies. I dread every appointment and my head goes through a multitude of excuses of why I shouldn’t attend the appointment.

I don’t like to cry. I always cry at my psychologist. She is the one person I can be 100% honest with and not fear any repercussions. She doesn’t care about me like a friend or family member. She won’t judge my ability to perform as a professional in my career. All she wants to do is help me with what is happening in my brain.

That scares the sh*t out of me.

I first saw her — let’s call her Dr D — in November 2009. It wasn’t by choice that I sought medical help for my depression. After my suicide attempt, the condition of my discharge from hospital was a follow up with doctors and support people coming to my home and assisting me. For a few weeks, the medical and psychological appointments were the only break I got from the never ending pyjama and ‘Scrubs’ marathon that was being held at my house.

Thanks to Citalopram, Valium, a bottle of wine and a packet of cigarettes a day, I was functioning. I was waking up, staying awake to watch TV and drinking myself to sleep. There were no tears because I was too numb and drugged up for emotions. But I wasn’t trying to kill myself again so that was a positive I guess.

Obviously that lifestyle was not sustainable. It was also f***ing horrible. I didn’t want to be that person. I didn’t particularly like that person. She was not fun to hang around at all. There was nothing anyone could do to help no matter how much they wanted to.

I learned to talk to people about what I was going through. My experiences, my emotions. But ultimately it was only Dr D that I could tell everything to. I told her that I wished I had gone through with it. I told her that I wanted to crash my car in to a pole. I told her that I hated everyone being so careful with me. I told her that I couldn’t see the point of being around. That I had lost everything.

I cried. More than I had ever let myself cry before. Full ugly cry with sobbing and snot and grossness. This was more real than the numbness. This was actually feeling something.

I saw Dr D for 2 years. We worked on my feelings of responsibility to my family, the way I dealt with my mother’s death and my relationships with men as well as my friends. I started to regain confidence in myself and have pride in my life. I stopped trying to be everything to everyone and allowed myself to be a little bit selfish. I spent more time on self care. I had always had confidence in the sense I knew I was a fun friend and an attractive female. But I started to feel more sure of myself as a person. I valued myself more.

This affected everything in my life. I had better romantic relationships, I was more determined in my achievements and goals and I could be a more present friend. I had honest conversations with my family about what I needed from them. I didn’t put up with bull***t (most of the time).

Seeing a psychologist helped me immensely through my recovery from depression. It assisted me to equip myself with tools to utilise if I ever find myself in a confronting situation. I worry all the time about being depressed again because my last experience with depression ended up with me wanting to end my life. I am confident I won’t get back to that point. Not with the external support I have, but also because of the internal strength I now possess.

I have no shame telling people I am seeing a psychologist. I made the decision after a particularly rough time in the past few months that it would be a good idea to check back in. Have a chance to let it all out and make sure I am dealing with everything effectively. I care too much about myself now not to admit when I might need help.

I am not the poster child for mental health. I am one example of what can happen. How a terrible situation can have a relatively positive outcome. But that the journey of depression is never really over. And that even though I am perfectly fine with talking about my experiences … I still get sweaty hands every time I have to see my psychologist. Getting help is not easy. Admitting you need help is even more difficult. Try to keep that in mind if you know anyone with a mental illness and remember to be kind to each other. You never know what battle anyone else is going through, or what they have had to experience to be the person you see before you.” ... 7102294777

PostPosted: Tue Oct 28, 2014 1:32 pm 
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Time to tackle alcohol abuse

Alcohol misuse is one of Australia's major health issues. Alcohol-related harm pervades society. It is not just a problem of George Street in Sydney or Lygon Street in Melbourne or Fortitude Valley in Brisbane. The devastating consequences of alcohol misuse extend from our cities into rural and remote areas and the number of alcohol-related assaults tops 70,000 a year.

As doctors, we deal with the terrible results - the fractured jaws, the facial lacerations from glassings, the eye injuries that cause blindness, and more. We see the head injuries, including those from the now infamous Coward's Punch.

Many of these people are, of course, not the ones who consume alcohol in a dangerous way. The people with the injuries are often the innocent victims.

I remember a New Year's Eve at Westmead, treating a young man, drunk, who had fallen off a balcony. He survived the fall, but was quadriplegic: a young person lying paralysed on a spinal board, in a hard collar and the room is full of the smell of consumed alcohol, often made worse by vomiting.

Then someone like me has to tell the parents that their son is quadriplegic - all because of a drunken night out. Alcohol-related harm doesn't stop at the front door. It enters people's homes. The number of cases of alcohol-related domestic violence is 24,000.

For far too long, we have not talked enough about domestic violence. That is changing. Part of that conversation needs to include the contribution of alcohol as a factor. In addition, there is also the fact that harmful alcohol consumption can lead to sexual assault or rape.

Another awful statistic is the number of substantiated cases of alcohol-related child abuse. The figure is at least 20,000 a year. That is staggering.

As is the case for victims of alcohol-related cases of domestic violence, the victim is not the person drinking alcohol. It is, of course, another case of the innocent victim.

That really gets to me. As a paediatric neurosurgeon, I frequently see the results of abuse of a child's brain. The brain swells dramatically. And if we do save the child, the brain often melts away on follow-up scans, and the child is permanently disabled. It's not even a matter of drunken violence.

Unsafe drinking behaviours by pregnant women have continued, and fetal alcohol spectrum disorder is increasingly recognised as a problem. There is no level of safe alcohol consumption during pregnancy.

Alcohol has been causally linked to more than 60 different medical conditions, including cirrhosis of the liver, inflammation of the gut and pancreas, heart and circulatory problems, sleep disorders, eye diseases and alcohol dependence. Alcohol consumption also raises the overall risk of cancer, including cancer of the mouth, throat and oesophagus, breast cancer and bowel cancer.

Alcohol-related problems, whether it be alcohol-related violence or health consequences of chronic misuse, are an enormous burden on the Australian health care system at all levels.

If we are serious about saving costs in health care, then prevention - including prevention of alcohol-related harms - must be a priority for the Government.

If the social and human costs were not enough to justify action, the economic costs certainly are, ranging from $16 billion to $36 billion.

Too many times we hear that it's all about personal responsibility. We have heard politicians talk about that before. It's rubbish.

Tell the child who is a victim of alcohol-related neglect or violence that it's a matter of personal responsibility. Tell that to the mother who lives in fear of her drunken husband. Tell that to the family of the victim of the drunk driver.

Personal responsibility is important but, unfortunately, we can't rely on the personal choices and behaviour of others for our own safety and health.

Governments can influence behaviour through deterrents but, most importantly, and more effectively, through shaping individual and societal attitudes to alcohol.

A person's attitude to alcohol is shaped by the action of their family and friends, by their community, by their education, and by marketing and advertising - including through sport. Harmful alcohol behaviour or consumption is also influenced by availability and by price.

All of these factors are able to be influenced by governments - both state and federal. We are exposed to alcohol marketing at an unprecedented level.

Alcohol marketing has had a profound influence not only on our behaviour, but also on the way we view ourselves. To drink beer is to be Australian. In fact, not to drink heavily is almost un-Australian.

We have learnt to pride ourselves on our ability to consume alcohol. Is that a view of Australia we want to perpetuate? I think we have been sold a dud. Australia is a much more sophisticated society than that.

Marketing of alcohol is increasingly sophisticated and multidimensional, integrating online and offline promotions with the sponsorship of music and sporting events, the distribution of branded merchandise, and the proliferation of new alcoholic brands and flavours.

There is an urgent need to tackle this problem with more robust and rigorous policy and regulation to supplement parental oversight and responsibility.

Self-regulation and voluntary codes are not effective in stemming inappropriate and irresponsible promotion of alcohol to young people. The regulation of alcohol marketing and promotion should be statutory, and independent of the alcohol and advertising industries - and should carry meaningful sanctions for non-compliance.

The dependence of sport on alcohol advertising needs to end. It pervades many of our major sports. Instead of being a contest between the best players from Queensland and NSW, the NRL's State of Origin was more like a game between Four X and VB.

For many Australian children, their cricket, AFL or NRL or A-League stars are their heroes. These walking alcohol ads are their role models. That needs to change. It is time to transition sport away from its dependence on alcohol advertising.

Deaths from alcohol-related causes among Indigenous Australians compared with non-Indigenous Australians are almost eight times greater for males and 16 times greater for females.

The level of alcohol-attributable deaths among Indigenous Australians aged 15-24 is almost three times greater than that for non-Indigenous Australians of the same age. There is no doubt that there is an issue with illegal drugs like ice, and we need to tackle that, too.

But in many, many cases, alcohol is the primary issue. The use of illegal drugs cannot be used as an excuse for abdicating responsibility for action on alcohol-related harms.

There will be claims that we don't have the evidence that proposed strategies are effective. The evidence is there. In NSW, the Baird Government's strategies for lockouts and early closing times, among others measures, in the Sydney CBD and Kings Cross areas, are working.

No longer can we tolerate people, including young men and women, even children, being injured or dying because of harmful alcohol consumption.

To not act would be neglect. We must have a plan and we must have action from both federal and state governments.

Brian Owler is the president of the Australian Medical Association. This is an edited version of a speech given on Tuesday to the AMA National Alcohol Summit. ... 1czbk.html

PostPosted: Thu Oct 30, 2014 8:18 am 
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NSW doctor disqualified from practising

A NSW drug-addicted doctor has been disqualified from practising after prescribing 'bizarre' treatment to patients and pretending to pick up scripts on their behalf.

The Health Care Complaints Commissions took Dr Kim Street to the NSW Civil and Administrative Tribunal seeking to prevent the 61-year-old from practising due to professional misconduct.

In a hearing on the matter this year, Dr Street admitted he had battled with an addiction to drugs of varying intensity from 2002 to 2012.

From 2004 to 2006 the former psychiatrist said he was so 'deeply in the throes' of amphetamine addiction that he was taking up to 75 tablets a day of the prescription drug dexamphetamine.

In a bid to support his addictive behaviour, the tribunal heard that from 2010 to 2011 Dr Street embarked on a sustained pattern of deceptive conduct.

He fabricated patient prescriptions and pretended to pick up medication on their behalf from pharmacists.

He also prescribed dexamphetamine to patients suffering from post-traumatic stress disorder (PTSD).

In retrospect, Dr Street conceded it was 'bizarre treatment' and he would 'absolutely not' consider prescribing the drug for patients with PTSD in the future.

In handing down their decision on Wednesday, the tribunal said Dr Street's conduct was of the 'gravest kind'.

'Not only did Dr Street engage in self-abusive behaviour that affected his competence to practise, he also implicated unknowingly his patients in his pattern of deception,' it said.

Over the past two years Dr Street had shown remorse, taken proactive steps to rehabilitate himself and had won the confidence of colleagues to return to work, it found.

But the tribunal said it was still 'too early' for him to resume practice and ordered that he be disqualified from practising for at least 18 months. ... ising.html

PostPosted: Sat Nov 01, 2014 12:54 pm 
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Don’t fancy growing a mo’ this Movember? Show your support for a good cause with these quirky homewares

IT’S that time of the year again. The time of the year when men (or should that be Mo Bros) the world over throw away the razor for a month and grow some impressive — and, at times, outlandish — facial hair all in the name of charity.

The Movember movement has grown from a small group of 30 friends in Melbourne to a worldwide phenomenon with more than four million supporters raising $580 million since the initiative’s inception in 2003.

Not only has it earned unprecedented support for men’s health organisations such as the Prostate Cancer Foundation of Australia and Beyond Blue, but Movember is also responsible for bringing the moustache back into fashion.

So much so, that moustaches aren’t just confined to men’s faces anymore.

Mo’s of all shapes and sizes are now making their way into our living spaces, bedrooms and home offices with the humble ‘tache spotted adorning everything from cushions to unique feature lights.

Fans of quirky homewares have jumped on this trend (which is also making its mark in fashion) with aplomb, but for the more conservative among us, there are plenty of subtle ways to get on board.

Mugs, paperclips and chalkboard labels for the pantry are among some of the more understated ways to embrace the season’s mo movement.

And if you’re hosting a Movember party, there’s lots to keep your ‘tache bash’ on-message with paper straws, cupcake wrappers, biscuit moulds, candle holders and wall decals among some of the most popular mo-inspired items.

No matter how you choose to display your mo though, don’t forget to make a donation to the Movember Foundation or sponsor a friend growing a moustache. ... 7106292002

PostPosted: Mon Nov 03, 2014 12:02 pm 
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Australian Story: Woman falls in love with sperm donor

IT is the story of an improbable modern family - a back-to-front love affair in which a woman seeks out and falls in love with an anonymous sperm donor who fathered her baby daughter.

‘How I Met Your Father’ which airs on ABC’s Australian Story tonight tells the tale of this intriguing romance.

Advertising professional, Aminah Hart, met Scott Andersen, a farmer, just before their daughter Leila’s first birthday.

Aminah had lost two baby boys to a genetic disorder passed on from mother to son. At 42 and newly single, she felt anonymous sperm donation and IVF was her last chance to mother a healthy child.

“It takes the romance out of it a bit, doesn’t it, when you decide to take on donor sperm to try and have a baby,” Aminah said.

Three bits of paper that outlined the features of each potential donor were all she had to go on.

Of the five donors, one stood out. He described himself as happy and healthy, tipping the scales in his favour for Aminah who hadn’t had much of either in recent times.

Scott Anderson, a twice-divorced father of four himself, spends his days artificially inseminating cattle, so helping someone else make a family didn’t seem such a stretch. But he told no one about it, never expecting anyone to come looking for him until he was elderly.

“A lot of people think, you know ‘He’s a shocker, that bloke you know?’ And I got a little bit of that so it’s kinda good to tell the real story so people know. Cos you couldn’t make that up,” Scott said.

When Aminah’s blonde haired, blue eyed baby, Leila, was born two years ago, Aminah — who had never known her own West Indian father— became curious about the anonymous man who had helped make her.

Once Aminah’s mother declared she was sure she had found Leila’s biological father by googling clues to his identity, Aminah made a formal request for contact. And the rest is history with the pair now together, a year into a happy relationship.

Scott had been in a relationship with another woman when Leila and Aminah came into his life, but the woman believed he shouldn’t be spending so much time with the baby he helped conceive, so they broke up. Not long afterwards, Aminah and Scott began a romantic relationship.

“It’s real Mills and Boon stuff isn’t it? It’s a bit of a fairy story really. But it’s real so that’s good. It’s not just a dream you know,” said Helen Marshall, Aminah’s mother.

“I thought this must be the first time this has ever happened in the world. What are the chances of that happening?,” said Julie Buxton a friend. ... 7110658307

PostPosted: Wed Nov 05, 2014 11:25 am 
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Money raised for fake cancer mum Elizabeth Edmunds will go to sick kids at Westmead Children’s Hospital

MONEY raised for a Central Coast woman who lied about having ­terminal cancer to scam donations will be donated to Westmead Children’s Hospital.

Elizabeth ‘‘Elle’’ Edmunds, a ­mother of six, claimed she was diagnosed with ovarian cancer in April, prompting an outpouring of donations from friends and strangers.

But her heart-wrenching story was exposed as a lie when a man, believed to be her partner, took to Facebook this week, telling her supporters ‘‘she has never had cancer’’.

In her apparent struggle against the disease — detailed on Facebook — she shaved her head and posted about dreaming of her funeral.

Police are still investigating the scam but are yet to lay charges.

Jessica McKay, who helped raise money for Ms Edmunds, described her actions as ‘‘evil’’.

Yesterday, she collected donation tins from local grocery stores, where $412 had been donated to Ms ­Edmund’s treatment by members of the public. Ms McKay said all the money raised would be donated to Westmead Children’s Hospital.

“A big thanks to (all) who donated ... what has happened with Elle faking cancer and trying to scam money off people hasn’t gone unnoticed,’’ Ms McKay said. ‘‘We hope to help some sick kids in need at Westmead.’’ ... 7112786465

PostPosted: Fri Nov 07, 2014 9:20 am 
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92% of emergency staff abused by drunks, poll finds

Pushing, punching, spitting and biting are all behaviours emergency department staff have to deal with when treating drunk patients, a new survey has found - and a startling nine out of every 10 staff have been subjected to the abuse.

Drunk patients have even gone as far as knocking a male doctor unconscious, and verbally threatening a heavily pregnant nurse, the survey found.

The Australasian College for Emergency Medicine recently carried out Australasia's largest survey of alcohol harm in emergency departments in which more than 2000 ED doctors and nurses from Australia and New Zealand took part.

The survey found 92 per cent of respondents had experienced assaults or physical threats from drunk patients in the last 12 months.

It also found 87 per cent felt unsafe due to the presence of an alcohol-affected patient while working in their ED.

Australasian College for Emergency Medicine president Dr Anthony Cross said the college was calling on governments to take more action to prevent alcohol related harm. "We need a serious commitment to implement the policies we know can make a difference." ... d=11354513

PostPosted: Sun Nov 09, 2014 10:56 am 
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Premature babies: Resuscitation guidelines are under review

The tiniest babies to enter this world are alone at the beginning as they are at the end.

Each sleeps in a humidified crib slung with a blanket, hooked up to monitoring systems, oxygen tubes and catheters no wider than three strands of human hair.

When neonatologist Kei Lui puts his arm through the window of one bassinet, a skinny arm breaks free of its swaddle, reaching into the space like a beetle's feeler, before latching onto the doctor's finger.

None of these babies would survive without modern medicine, but the guidelines that determine which ones to resuscitate and when to administer palliative care are under review.

At 26 weeks, doctors will almost always resuscitate. At 22 weeks, the baby will certainly die.

But those born in "the grey zone" – between 23 and 25 weeks plus six days – live or die at the mercy of their parents, who must decide whether the baby's chance of survival is high enough to justify the trauma of resuscitation, and whether to keep them alive if they are likely to have profound and lifelong disabilities.

The decision must be made ahead of delivery, often with very little time, and doctors have no guarantees as to the baby's prospects, only probabilities.

"We don't have a crystal ball," says Dr Lui, who is the medical director of neonatal care at the Royal Hospital for Women in Randwick.

"Our crystal ball has a bit of colour, a bit of mist and it's not possible to see properly."

The Australian and New Zealand Neonatal Network is planning to depart from conventional wisdom by taking into account the myriad factors that predict mortality and morbidity, rather than rely on gestational age alone.

It will be similar to the risk matrix used in the United States, which takes into account weight, gender, multiple birth status and whether the mother has taken antenatal corticosteroids.

The Australian version would use local data and also consider whether the baby was to be born in a hospital with an intensive care unit.

It will be a useful tool to predict mortality and help counsel parents through what may be the most difficult decision of their lives.

But there will still be a "zone of parental discretion" based on the percentage that it produces.

And it will not replace the internal risk matrix that the parents of these borderline babies must apply to their own circumstances.

For end-of-life care, the cost of keeping somebody alive must be pressed against the sum total of their experiences, the people that they love, their imprint on the world, to reach an impossible estimation on the value of their life. With premature babies this process is performed in reverse. What maythis little person become, and should we give her or him that chance if it could mean condemning the baby to something worse than death?

At what point do our fears clamour out our hopes? What value a human life?

"We're dealing with real people," says Dr Lui. "We're not talking about a product we can reject on the production line. It's hard."

For some people, a 10 per cent chance of long-term damage is too high. For others, a 90 per cent chance of disability is worth rolling the dice.

"The parents have to decide, not for themselves, but for their babies," Dr Lui says. "It's harder than deciding for yourself.

"We have parents who say, 'Yes, resuscitate', but sometimes say later that if they could live through it again they would say 'No'.

"A lot of them choose not to resuscitate but wish they had said yes. 'Maybe I should have given my baby a chance.' There's always a chance of regret."

Margie Parmenter was 23 weeks and five days pregnant when she was admitted to the Royal Hospital for Women with a shortened cervix, whereupon doctors from the Neonatal Intensive Care Unit [NICU] listed the possible consequences of her giving birth to a baby at that age.

"They really did lay out everything in terms of all the potential issues and things that could happen," Parmenter says.

"It was extremely overwhelming. My husband and I were like, 'Oh my God'."

But Parmenter had already lost two babies, both around 18 weeks, and she had already decided that this one would live.

After allowing the information to sink in, the couple decided to keep to the plan. Parmenter was confined to hospital bed rest and they hoped the baby would stick a bit longer.

"The 24-week mark was always front and centre of our minds in terms of viability," she says.

"Both of our previous babies were absolutely perfect – we had full autopsies – it was just the incompetent cervix."

They edged past the 24-week mark and then past the 25-week mark.

At 25 weeks and six days, Archie entered the world weighing just 940 grams – a Goliath for his gestational age. He thrived.

Still not even due to be born until December 3, he has since graduated to the final stage of the intensive care unit and been cleared of neurological damage.

"He's just a normal little baby now," Parmenter says. "I tell you, they're little fighters."

More premature babies are being born in Western countries as a result of older mothers, more twins and more maternal illness, and medical technology means that more of them are surviving.

A major advance occurred in the early 1980s with the advent of antenatal steroids to advance lung capacity.

Until the alveoli are formed in a baby's lungs about 28 weeks, they breathe through the bronchials, which start appearing around 22 weeks.

When mothers with high-risk pregnancies are given antenatal steroids, the babies' chances of survival from 23 weeks are much improved.

Surfactant replacement therapy has also vastly improved the prospects of preterm infants.

Many babies used to die of lung disease. Now doctors pour surfactant down their wind pipes when respiratory distress is detected, saving countless lives.

Other developments include improved intravenous nutrition, continuous positive airways pressure and specialised maternal foetal care specialists for high-risk pregnancies.

The rationalisation of services in the late 1980s also played a role.

Instead of trying to do everything everywhere, resources are concentrated in big tertiary hospitals.

But prematurity continues to be the most common cause of death in childhood.

There are 247 neonatal deaths in NSW every year, of which 210 are preterm.

Neonatologist Robert Guaran, who is also a board member of the Miracle Babies Foundation support group, says the parents of premature babies are more likely to have depression or post-traumatic stress syndrome a year after the birth.

Parents who have been asked to play judge with their baby's life continue to carry the burden.

"The main thing is giving them information," Dr Guaran says.

"It might be that the family's biggest fear is death, and they want life at all cost.

"For some families their greatest fear is having a child with a severe disability and the impact that will have on the child."

On occasions, neonatologists will override the decisions of the parents, either in choosing to stop administering intensive care when the parents are desperate to continue, or in keeping the baby alive when the parents have decided against.

"I myself probably wouldn't ever do that but some have, because we all act in the best interests of the child.

"The family is the default consenter but nobody owns the child."

Parag Mishra has observed the agony of families from outside and within. He works as a neonatologist at the Royal Hospital for Women and his wife delivered their baby daughter at 29 weeks.

At 750 grams, her birth weight was the equivalent of a 26-weeker, and she had been at risk of an early delivery since 25 weeks.

"It was difficult decision for us because I know that at 25 weeks the chances of neurological outcomes are 50 per cent," Dr Mishra said.

"But the decision to resuscitate or not was completely out of my hands.

His dual responsibilities in the NICU – to his daughter and to his patients – led to some confusion.

Observing him on his tours of the ward, some parents complained that "one of the fathers" was interfering with the other babies.

He gained a new appreciation of what the parents endure, though his own daughter – now a healthy toddler – was robust compared to the smallest babies in the NICU, some of whom weigh just 400 grams at birth.

"It's quite frightening," Dr Mishra says. "It's not a very easy thing for the parents to see."

The babies are born in a foetal position, with their hands and feet together, small enough to fit into the palm of an adult hand.

Even at 23 weeks, they will attempt to breathe and their hearts will beat.

Their skin is so fragile that it will break even if it is stretched a little harshly.

They lose heat and water quickly and these days doctors put them into what looks identical to a plastic freezer bag, though it comes in sterile hospital packaging.

When Margie Parmenter gave birth to Archie it was one of the most anxious and happiest and overwhelming days of her life.

He was obscured at first behind the sheet that is held between mothers and their babies in caesarian operations, then whisked away for the NICU staff to put him into his plastic bag and hook him up to ventilation.

Once he was stable they brought him back in blankets, and she gently touched his face.

"He is just beautiful," she says. "We know that there are going to be ups and downs but we're extremely grateful to be on the road." ... 1hf47.html

PostPosted: Tue Nov 11, 2014 12:45 pm 
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Robin Williams autopsy reveals no alcohol or illegal drugs in actor's body

Robin Williams' autopsy found no alcohol or illegal drugs were in his body when he took his own life at his Northern California home in August, sheriff's officials said on Friday.

The autopsy results released by the Marin County sheriff's office found that the actor had taken prescription medications, but in "therapeutic concentrations".

The coroner ruled Williams' death a suicide.

Sheriff's officials have said Williams was found in the bedroom of his home in Tiburon on the morning of August 11. His death had been preliminarily ruled a suicide.

Sheriff's Deputy Stewart Cowan said on Friday that his office was not releasing further information from the report.

Williams' wife, Susan Schneider, has said the actor and comedian was struggling with depression, anxiety and a recent Parkinson's diagnosis when he was found dead by his personal assistant at his Marin County home.

Williams had publicly acknowledged periodic struggles with substance abuse. He had entered a substance abuse rehabilitation program shortly before his death.

The results of Williams' autopsy, including toxicology tests, were originally slated to be released September 20. Marin County officials later announced a November 3 release date, but the report was further delayed. Toxicology reports routinely take up to six weeks to complete. ... 1izlb.html

PostPosted: Thu Nov 13, 2014 12:57 pm 
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Teens losing sleep over bedtime technology

THE more teenagers use gadgets before bedtime, the worse their sleep patterns get, a study shows.

BUT researchers say parents need only cleanse their kids' bedrooms of technology in the most extreme cases.

Teens who used computers, mobiles or TV right before bedtime generally fell asleep and woke later than those who didn't, according to an online survey of 11,400 Australians aged 11-17.

They were also more likely to wake up later on weekends, indicating their body's need to catch up on missed sleep.

But only those who reported using technology in bed "nearly every night" had more serious sleep issues.

Those who almost always took their computers to bed were 2.5 times more likely to have shorter sleep than those who didn't, according to the research published in the journal PLOS ONE.

The results don't necessarily mean modern technology is causing poor sleep across the board, said co-author Dr Nat Marshall from Sydney's Woolcock Institute.

People might, for example, be using technology to fill the time when they can't sleep anyway, he said.

"Our parents might have listed to AM radio and our grandparents were burning down the barn by reading by candlelight."

He said a small minority had genuine issues with using technology too much.

"If you've got a kid who's genuinely not getting enough sleep because they can't stop themselves from using technology, you maybe should take it out of the bedroom," Dr Marshall said.

"But having a TV and a radio and cellphone in your room at night isn't going to automatically ruin your sleep."

Studies suggest about 25-40 per cent of teenagers will suffer from poor sleep at some point. ... 7121224379

PostPosted: Sat Nov 15, 2014 1:12 pm 
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Death in Alice Springs alcohol treatment facility

A DOCTOR has questioned the effectiveness of the Government’s Alcohol Mandatory Treatment programs after a woman died at the Alice Springs facility.

People’s Alcohol Action Coalition spokesman Dr John Boffa said the fact the death was not made public until two weeks after was typical of the secrecy surrounding the AMT programs.

“From the very start we’ve been very concerned about the lack of transparency around Alcohol Mandatory Treatment,” he said. “This just highlights the risks of institutionalising people who have serious medical conditions.”

Dr Boffa, a practising physician, said many questions around the viability of AMT remained unanswered.

“What are the outcomes being achieved? Who’s it working for? Who isn’t it working for?

“We need these questions answered to determine whether it is an effective and ethical form of treatment for alcohol treatment, and we’re no closer to answering those questions 18 months into AMT.” The Central Australian Aboriginal Alcohol Programs Unit, where detainees of the AMT program in Alice Springs are held, extended its condolences to the family of indigenous woman Kwementyaye, who passed away after a suspected seizure.

Unit chairman Eileen Hoosan said the board met immediately to ensure correct cultural protocols were in place at the tragic time.

Despite reports that Kwementyaye’s sister was not notified of her death, Ms Hoosan said the unit took “all possible steps to ensure family members and the community were informed about the sad passing”.

The Department of Health NT said it could confirm a death occurred at an Alcohol Mandatory Treatment facility in Central Australia last month but refused to provide further details. “The death has been reported to the coroner and it is therefore not appropriate to comment further,” a spokeswoman said.

The AMT facility in Katherine will not go ahead in the proposed location at the Industrial Park on Chardon St.

The NT News reported last month that businesses were opposed to the facility being built in the industrial estate.

Alternative sites are now being investigated. ... b1e88d8295

PostPosted: Sat Nov 15, 2014 1:16 pm 
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Walking your way to happiness

ONE in four Australians are not doing enough exercise and 85 per cent are not aware of daily physical activity recommendations, according to new research marking World Diabetes Day.

The AMR survey, commissioned by Diabetes Australia and the Pedestrian Council, showed one third of respondents reported only moderate intensity activity in the past week. Diabetes Australia revealed some 387 million people around the world are affected by the disease, and more than 4.9 million deaths are caused by diabetes.

In Australia almost 100,000 people have been diagnosed with diabetes in the past year alone.

Nutritionist Joanna McMillan and Federal Health Minister Peter Dutton joined CBD workers to walk across the Harbour Bridge for Diabetes Walk to Work Day yesterday.

“Not only does walking reduce the risk of type 2 diabetes, but it also works to prevent stroke and heart disease,” Dr McMillan said.

‘Epidemic of the 21st century’

“It’s also one of the easiest forms of exercise to build into our busy daily lives, and when joined with healthy eating, it’s a relatively simple approach to shed those excess kilos.” Mr Dutton said World Diabetes Day was an occasion to reflect on the national and global impact of diabetes, labeled the ‘‘epidemic of the 21st century’’.

“We know diabetes is not just a health issue and a threat to our health system and spiraling costs, it is an economic and productivity challenge,” he said, adding that the productivity impact of diabetes in Australia was $5.6 billion a year.

Diabetes Australia CEO Greg Johnson said Type 2 diabetes was one of the biggest threats to the health and productivity of all Australians. “Even if you have a healthy diet, being inactive increases your risk of type 2 diabetes,’’ he said.

“For the one in four people who have done no moderate or vigorous exercise, a short brisk walk is a great way to start.”

Pedestrian Council Chairman Harold Scruby said walking was one of the easiest forms of exercise to build into your life.

“People who walk before, during or after work are generally healthier, more productive and creative and are less likely to be absent or take sick leave.” ... 7123184937

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