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Dental staff fired for mocking cancer patient’s private diary

Shocking video has emerged of two dental staff reading a cancer patient's private diary aloud while laughing and mocking her concerns. The video which captured the American employees at Premier Dental Group (PDG) of Knoxville laughing as they read the private diary entries was captioned: "Found a patients journal and now it's story time lmao." The footage was reportedly filmed by another staff member who could be heard giggling throughout the video, according to the New York Post. A woman in black scrubs was filmed reading passages from the diary to others in the room and describing the radiation treatments the worried patient faces. Another woman was sitting cross-legged on the office floor and listening intently, a male employee was also in the room but he did not intervene or join in with the women. It’s not clear how staff obtained access to the patient’s private journal, or why they decided to read it. The video sparked outrage across social media, with Premier Dental Group of Knoxville having to share an apology on Facebook acknowledging the incident. "Premier Dental Group of Knoxville is aware of a recent incident involving an inappropriate video created and shared by some of our employees that addressed an individual’s medical condition in a disrespectful and unprofessional manner.” “We deeply regret this incident and the hurt [it] has caused,” they wrote in the statement which has now been deleted. A spokesperson for PDG confirmed to the New York Post the female employees involved in the incident were fired “effective immediately”. After an investigation it was determined that the male employee in the video did not participate and kept his job. “We are committed to maintaining a respectful and professional environment for everyone, and we will continue to take necessary actions to uphold these standards,” the practice said. Images: news.com.au

Caring

Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/leah-williams-veazey-1223970">Leah Williams Veazey</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> In the 2007 film <a href="https://www.imdb.com/title/tt0825232/">The Bucket List</a> Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades. Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common. You can read articles listing <a href="https://www.cnbc.com/2023/01/11/cities-to-visit-before-you-die-according-to-50-travel-experts-and-only-one-is-in-the-us.html">the seven cities</a> you must visit before you die or <a href="https://www.qantas.com/travelinsider/en/trending/top-100-guide/best-things-to-do-and-see-in-australia-travel-bucket-list.html">the 100</a> Australian bucket-list travel experiences. <figure><iframe src="https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life <a href="https://onlinelibrary.wiley.com/doi/10.1002/pon.4821">is regret</a> for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret. The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness. In a <a href="https://journals.sagepub.com/doi/10.1177/14407833241251496">study</a> published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel. <h2>Why is travel so important?</h2> There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important <a href="https://doi.org/10.1016/j.annals.2003.10.005">life transitions</a>: the youthful gap year, the journey to self-discovery in the 2010 film <a href="https://www.imdb.com/title/tt0879870/">Eat Pray Love</a>, or the popular figure of the “<a href="https://theconversation.com/grey-nomad-lifestyle-provides-a-model-for-living-remotely-106074">grey nomad</a>”. The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams. Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans: "We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed." For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse: "So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend." People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland. Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement: "In the last three years, I think I’ve lived more than a lot of 80-year-olds." <h2>But travel is expensive</h2> Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire. Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true. But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us: "We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind." Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet. Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said: "This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel." <h2>Something we ‘ought’ to do?</h2> Bucket lists are also a symptom of a broader culture that emphasises conspicuous <a href="https://www.youtube.com/watch?v=JH_Pa1hOEVc">consumption</a> and <a href="https://productiveageinginstitute.org.au/">productivity</a>, even into the end of life. Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “<a href="https://doi.org/10.1080/14461242.2021.1918016">ought</a>” to do. Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey. <hr /> Names of study participants mentioned in this article are pseudonyms.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leah-williams-veazey-1223970">Leah Williams Veazey</a>, ARC DECRA Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/paris-in-spring-bali-in-winter-how-bucket-lists-help-cancer-patients-handle-life-and-death-225682">original article</a>. </div>

Caring

Qantas apologises after rejecting cancer patient's refund request

Qantas has issued an apology for rejecting a cancer patient's refund request after his case allegedly did not qualify based on “compassionate reasons”. Neil Ross, 62, decided to book a holiday to Cairns with his wife for a couple of weeks, but two weeks later he was diagnosed with face cancer. “It hit me like a rock,” Mr Ross told news.com.au. “I wasn’t in the life of me, expecting that news.” The Brisbane local was initially told he had Bells Palsy, but was later diagnosed with cancer and had to undergo a 13-hour operation to remove the tumour, causing the right side of his face to be significantly disfigured. He underwent radiation almost every day for six weeks saying it “knocked him to no end”. “I was very thankful that my wife had helped me and still is helping me to get through this.” Ross is yet to be given the all-clear and is still undergoing treatments, including rehab following the loss of muscle mass. He will also undergo plastic surgery to reconstruct the right side of his face. “I had notified Flight Centre that I needed to cancel my flight due to finding out that I had cancer and that l needed treatment urgently,” he said. “As I said to the girl at Flight Centre – ‘look at my face, do you think I want to get a refund for the hell of it? I rather be healthy and go on holiday.” Ross said that the airline issued him a credit note until April 22 of this year, but with his current circumstances, he was unable to travel before that date and applied for a full refund. He also claims that despite sending two medical certificates - the first which stated that Ross was unfit to fly for 12 months, and the second which included detailed information about his condition - it “did not meet requirements on compassion”. “I thought ‘what the hell, what more can I do?’ This has done nothing but cause me a great deal of stress that I don’t need," he said. Ross submitted two different refund requests, one on March 20, which was rejected on the fourth of April, and another on April 9 which was rejected two weeks later. The email from a Flight Centre representative reportedly said: "They have advised that ‘the attached medical certificate does not fit into the GF guidelines for a refund due to compassionate reasons’." According to news.com.au, Qantas has since contacted Ross and issued a refund, after an error was made in processing the supplementary material, by not connecting it to the earlier application. “We apologise to Mr Ross for this experience and have let him know we’re processing a refund for him.” They have also reportedly apologised for any distress they may have caused and are investigating how the error occurred so that it doesn't happen again. Images: news.com.au/ Getty

Travel Trouble

How music is changing the way dementia patients think

New research has proven that music truly is the universal language, with experts discovering how the power of music is helping those suffering with dementia. Music therapists have shown that music brings dementia patients back to the present, with some even finding their voice thanks to the nostalgic memories of the past. According to Registered Music Therapist and Managing Director of music therapy company Music Beat, Dr Vicky Abad, the power of music is not to be overlooked when it comes to degenerative diseases. “Music is a window into people’s pasts,” she said. “It builds on strengths and abilities against a disease that can strip a person of their dignity, abilities and quality of life.” The team at <a href="https://www.tricare.com.au/">TriCare Aged Care and Retirement</a>, who see the devastating impact of dementia each and every day, also experience first-hand the impact music has on residents, with many noticing “unrecognisable” changes in personality when a nostalgic tune is played. Louis Rose, an 80-year-old dementia patient and TriCare resident, was diagnosed with dementia six years ago, and requires assistance with many aspects of day to day life. However, listening to music is one thing he can enjoy on his own. “I grew up in Mauritius and while we didn’t have a lot, we certainly had music. Listening to music has always been an escape for me and a way to relax,” Mr Rose said. “When your brain starts to slow down and you find yourself forgetting things, it can be quite frustrating and confusing. Listening to music has been a way to distract myself from what’s going on in my head, it has helped me so much.” Tamsin Sutherland is a regular live music performer at TriCare facilities across Queensland, and has been able to witness incredible moments with the residents as they come alive as soon as she starts to play. “Watching residents who are often non-verbal sing along to the words is incredible,” she said “It really is like they are coming back to life and reconnecting with who they once were. To be part of that is quite emotional for me.” According to Dr Abad, music can help prevent the restless behaviour that often leads to pacing and wandering, especially in the evenings, which are often difficult times for those battling the disease. “Sundowning usually occurs in the late afternoon as dusk approaches, a time that is also associated with what used to be a busy time period in people’s lives,” she noted. “Personalised music is a simple and effective tool to help residents feel validated in their emotions during this time and provides them an opportunity to experience a calmer state of mind”. Image credits: Getty Images

Mind

Groundbreaking approach offers ray of hope for ovarian cancer patients

In a twist of fate, 24-year-old Tora Murphy’s globetrotting adventure took an unexpected turn when her health journey began. What started as a quest to explore the world swiftly turned into a battle against ovarian cancer, a disease she never imagined would become a part of her reality. "I was looking pregnant, like I looked about six months pregnant," Murphy recounted <a href="https://www.9news.com.au/health/ovarian-cancer-groundbreaking-treatment-hope-mater-cancer-research-centre-brisbane/0f8ffed0-ec48-4ab7-8de5-28b9025d06d3" target="_blank" rel="noopener">to 9News</a>. "They basically told me that it was stage three cancer and I was just in shock." Her whirlwind journey abruptly halted as she returned to Brisbane to confront the daunting reality of her diagnosis. Ovarian cancer, a silent killer, had taken root in her body, presenting as a formidable 18cm tumour. Murphy’s resilience was put to the test as she underwent surgery to remove the tumour and ultimately a full hysterectomy. "I didn't even know that people like me could get cancer," she expressed, echoing the disbelief many young women feel upon receiving such a diagnosis. Ovarian cancer remains a formidable adversary, claiming the lives of 1000 Australian women each year, with a five-year survival rate hovering at a concerning 49 percent. For Murphy and countless others, the fear of recurrence looms large, casting a shadow over their lives. However, amidst the darkness, there shines a glimmer of hope. Pioneering research led by Mater Research scientists is illuminating new pathways in the fight against ovarian cancer. Their focus? Dendritic cells, a key component of the immune system. "We think that by focusing on that cell type in particular, that we'll be able to actually make a vaccine to help fight that disease and to eventually help prevent recurrence," explained Professor Kristen Radford from Mater Research. This groundbreaking approach offers a ray of hope for individuals like Murphy, offering the possibility of a future where ovarian cancer is not only treatable but preventable. The development of a vaccine holds the promise of transforming the landscape of ovarian cancer treatment and prevention. Fuelling this hope is the unwavering support of communities and organisations dedicated to combating ovarian cancer. The Ovarian Cancer Research Foundation, through its tireless fundraising efforts, has allocated $670,000 to support the vaccine development, part of a larger $2.4 million grant initiative. "These funds have been raised by our community, so that's people out there walking, running, baking, shaving their heads," says Georgie Herbert from the Ovarian Cancer Research Foundation. For Murphy, the outpouring of support from her partner, friends and the broader community serves as a symbol of strength during her darkest hours. As her loved ones prepare to walk 100km this coming May to raise funds in her honour, Murphy is buoyed by the knowledge that every step taken brings them closer to a future free from the grips of ovarian cancer. "Their money goes to such a good place," she remarked, underscoring the impact of collective action in driving progress in ovarian cancer research and treatment. As the fight against ovarian cancer continues, fuelled by groundbreaking research and unwavering community support, there is renewed optimism on the horizon for individuals like Tora Murphy and the thousands affected by this disease. Images: Facebook

Caring

What actually is palliative care? And how is it different to end-of-life care?

<a href="https://theconversation.com/profiles/samar-aoun-1437641">Samar Aoun</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> Although it is associated with dying, palliative care is an approach focused on improving <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405258/#:%7E:text=QOL%20can%20also%20be%20defined,QOL%20(2%E2%80%934).">quality of life</a> – or how people feel about and respond to facing a life-threatening illness. Palliative care aims to prevent and relieve physical, social, emotional, spiritual and existential distress. Palliative care also supports family caregivers during the disease journey and bereavement phase. You might have heard it mentioned for cancer, but it is beneficial for the majority of life-limiting conditions. It has been shown to reduce health-care costs by <a href="https://palliativecare.org.au/publication/kpmg-palliativecare-economic-report/">preventing</a> unnecessary hospital admissions. Palliative care is not voluntary assisted dying. It does not aim to hasten or prolong death. It is not just for people who are about to die and seeking palliative care does not mean “giving up”. In fact, it can be a profound and positive form of care that the World Health Organization (WHO) has <a href="https://www.who.int/news-room/fact-sheets/detail/palliative-care">recognised</a> as a basic human right. But what does it involve? <h2>Not just for someone’s final days</h2> Palliative care is often seen as a “last resort” rather than a service that empowers terminally ill people to live as well as possible for as long as possible. The full benefit of this holistic approach can only be realised if people are referred early to <a href="https://palliativecare.org.au/resource/what-is-palliative-care/">palliative care</a> – ideally from the time they are diagnosed with a terminal illness. Unfortunately, this rarely happens and palliative care tends to blur with <a href="https://www.nia.nih.gov/health/providing-comfort-end-life">end-of-life care</a>. The latter is for people who are likely to die within 12 months but is often left to the last few weeks. <figure><iframe src="https://www.youtube.com/embed/qMbq0fP9kr4?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Palliative is not just for the very end of someone’s life.</figcaption></figure> <h2>Palliative care can involve difficult conversations</h2> Palliative care provides a time to ask some usually taboo questions. What kind of death do you want to experience? Who is in your personal network? How will they respond to your life ending? What kind of support can they offer? Palliative care can be provided at home, hospital, hospice or residential aged care facility, depending on the preference and circumstances of patients and their family carers. In general, patients are referred by their treating specialist, health professional or GP. Patient preferences for care and what matters most to them are discussed with their doctor or other health professionals and with their loved ones with <a href="https://www.advancecareplanning.org.au/">advance care planning</a>. These discussions can include information on their preferred place of care, preferred place of death, personal care needs such as dietary preferences and religious and spiritual practices. This helps those caring to make decisions about the patient care when the patient cannot anymore. However, advance care planning can start at any time in life and without a diagnosis. <h2>How palliative care delivery has changed</h2> Once upon a time, we were born at home and we died at home. Death was a social event with a medical component. Now it is close to the opposite. But research indicates a solely clinical model of palliative care (mainly symptom management funded through the health system) is <a href="https://www.mdpi.com/2227-9032/9/12/1615">inadequate</a> to address the complex aspects of death, dying, loss and grief. A <a href="https://www.phpci.org/">public health</a> palliative care approach views the community as an equal partner in the long and complex task of providing quality health care at the end of someone’s life. It promotes conversations about patients’ and families’ goals of care, what matters to them, their needs and wishes, minimising barriers to a “good death”, and supporting the family post-bereavement. These outcomes require the involvement of family carers, friendship networks and not-for-profit organisations, where more detailed conversations about life and death can happen, instead of the “pressure cooker” rushed environment of hospitals and clinics. Investment could develop stronger <a href="https://pubmed.ncbi.nlm.nih.gov/29402101/">death literacy</a> and grief literacy in the community and among health professionals, who may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312518/#:%7E:text=Some%20struggle%20with%20the%20limitations,lead%20in%20opening%20a%20dialogue">reluctant</a> to raise or discuss these topics. This would likely see the take up of advance care planning increase, from the current low levels of <a href="https://www1.racgp.org.au/newsgp/clinical/advance-care-planning-in-an-ageing-population#:%7E:text=A%20paper%20exploring%20the%20cognitive,advance%20health%20directive%20in%20place.">less than 15%</a> of Australians (<a href="https://theconversation.com/only-25-of-older-australians-have-an-advance-care-plan-coronavirus-makes-it-even-more-important-144354">25% of older Australians</a> accessing health and aged-care facilities). One such successful approach is the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720808/">Compassionate Communities Connectors Program</a> in Western Australia, using trained <a href="https://comcomnetworksw.com/compassionate-connectors-program/">community volunteers</a> to enhance the social networks of terminally ill people. Our research trial trained 20 community volunteers (“connectors”) and 43 patients participated over 18 months. In sourcing others to help (who we called “caring helpers”), connectors built the capacity of the community and social networks around patients in need. Caring helpers assisted with transport, collecting prescriptions, organising meals and linked clients to community activities (such as choirs, walking groups, men’s shed). And they helped complete advance care planning documentation. About 80% of patients’ needs were social, particularly around reducing feelings of isolation. Patients in the trial had fewer hospital admissions and shorter hospital stays. <h2>Tailored to need</h2> Palliative care should be tailored to each person, rather than a one-size-fits-all clinical model that doesn’t respect autonomy and choice. Many people are dying in a way and a place that is not reflective of their values and their end-of-life is interrupted with preventable and costly admissions to hospital where control and even dignity are surrendered. Palliative care hospitalisations have <a href="https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia/contents/summary">increased</a> in recent years compared to all hospitalisations, with 65% of such admissions ending with the patient dying in hospital. It is unrealistic and unaffordable to have a palliative care service in every suburb. There needs to be a shift to a more comprehensive, inclusive and sustainable approach, such as Compassionate Communities, that recognises death, dying, grief and loss are everyone’s business and responsibility.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205488/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/samar-aoun-1437641">Samar Aoun</a>, Perron Institute Research Chair in Palliative Care, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-actually-is-palliative-care-and-how-is-it-different-to-end-of-life-care-205488">original article</a>.

Caring

Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

<a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, <a href="http://www.theconversation.com/">The Conversation</a> Australian of the Year and body positivity advocate Taryn Brumfitt has <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">called for</a> doctors to avoid discussing a patient’s weight when they seek care for unrelated matters. A 15-minute consultation isn’t long enough to provide support to change behaviours, Brumfitt says, and GPs don’t have enough training and expertise to have these complex discussions. “Many people in larger bodies tell us they have gone to the doctor with something like a sore knee, and come out with a ‘prescription’ for a very restrictive diet, and no ongoing support,” Brumfitt <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">told the Nine newspapers</a>. By raising the issue of weight, Brumfitt says, GPs also risk turning patients off seeking care for other health concerns. So should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts. Brett Montgomery - GP academic Yes, sometimes – but with great care. I agree that weight stigma is damaging, and insensitively raising weight in consultations can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251566" target="_blank" rel="noopener">hurt people's feelings and create barriers</a>to other aspects of health care. I also agree people can sometimes be “overweight” yet <a href="https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0287218" target="_blank" rel="noopener">quite healthy</a>, and that common measures and categories of weight are <a href="https://theconversation.com/bmi-alone-will-no-longer-be-treated-as-the-go-to-measure-for-weight-management-an-obesity-medicine-physician-explains-the-seismic-shift-taking-place-208174">questionable</a>. On the other hand, I know obesity <a href="https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf" target="_blank" rel="noopener">is associated with</a> heart disease, joint problems, diabetes and cancers. GPs should be ready to help people with their weight when they want help. <a href="https://www.bmj.com/content/377/bmj-2021-069719.full?ijkey=FnARkmvxLOMFvlb&keytype=ref">Our assistance somewhat effective</a>, though sadly dietary efforts often have minimal effect on weight in the long term. Meanwhile, treatments causing larger weight changes (<a href="https://insightplus.mja.com.au/2021/10/bariatric-surgery-public-system-access-still-terrible/">surgery</a> and <a href="https://www.nature.com/articles/s41366-022-01176-2">some medicines</a> are often financially inaccessible. I feel safe discussing weight when my patient raises the issue. Fearing hurting people, I often avoid raising it myself. I focus instead on health rather than weight, discussing physical activity and healthy diet – these are good things for people of any size. Emma Beckett - Nutrition scientist No. It’s not likely to succeed. Large systematic reviews bringing together multiple studies of multiple weight-loss diets show weight loss is not generally maintained long term (<a href="https://pubmed.ncbi.nlm.nih.gov/32238384/">12 months</a> to <a href="https://www.nature.com/articles/0802982">four years</a>). The idea that weight is about willpower is outdated. The current body of evidence <a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">suggests</a> we each have a weight set point that our body defends. This is determined by genetics and environment more so than education. There may be associations between weight and health outcomes, but losing weight <a href="https://theconversation.com/just-because-youre-thin-doesnt-mean-youre-healthy-101185">does not necessarily equate</a> with improving health. Fat stigma and fatphobia are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866597/">harmful too</a> and can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/">compromise access to health care</a>. Instead, consider asking a better question. Healthy eating reduces disease risk <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/">regardless of weight</a>. So maybe ask how many vegetables are your patients eating. Would they like to see a dietitian to discuss strategies for a better-quality diet? Liz Sturgiss - GP/researcher No. A <a href="https://pubmed.ncbi.nlm.nih.gov/33211585/">US study</a> estimates it would take a family doctor 131% of their work hours to implement all preventive health-care recommendations. It's impossible to address every recommendation for preventative care at every consultation. One of the key skills of a GP is balancing the patient and doctor agenda. <a href="https://www.obesityevidencehub.org.au/collections/treatment/weight-bias-and-stigma-in-health-care">Weight stigma</a> can deter people from seeking health care, so raising weight when a patient doesn't have it on their agenda can be harmful. A strong <a href="https://academic.oup.com/fampra/article/38/5/644/6244494?login=false">therapeutic relationship</a> is critical for safe and effective health care to address weight. Weight is always on my agenda when there is unexpected weight loss. If a patient has rapid weight loss, I am concerned about an undetected <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283307/">cancer</a> or infection. Additionally, I am increasingly seeing patients who are unable to afford food, who often have <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/introduction">poor oral health</a>, who lose weight due to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1747-0080.12580">poverty</a>. Weight loss for the wrong reasons is also a very concerning part of general practice. Nick Fuller - Obesity researcher Yes. GPs should play a role in the early detection of weight issues and direct patients to evidence-based care to slow this progression. <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Research</a> shows many people with obesity are motivated to lose weight (48%). <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Most</a> want their clinician to initiate a conversation about weight management and treatment options. However, this conversation <a href="https://pubmed.ncbi.nlm.nih.gov/32385580/">rarely occurs</a>, resulting in <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">significant delays to treatment</a>. Starting the conversation presents challenges. Although obesity is a complex disease related to multiple factors, it's still <a href="https://pubmed.ncbi.nlm.nih.gov/25752756/">highly stigmatised</a>in our society and even in the <a href="https://pubmed.ncbi.nlm.nih.gov/23144885/">clinical setting</a>. Sensitivity is required and the wording the clinician uses is important to make the patient feel safe and avoid placing blame on them. Patients often <a href="https://pubmed.ncbi.nlm.nih.gov/20823355/">prefer terms</a> such as “weight” and “BMI” (body mass index) over “fatness,” “size” or “obesity”, <a href="https://pubmed.ncbi.nlm.nih.gov/27354290/">particularly women</a>. Measuring weight, height and waist circumference should be <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">considered routine in primary care</a>. But this needs to be done without judgement, and in collaboration with the patient. Helen Truby - Nutrition scientist Yes. A high body weight contributes to many chronic conditions that negatively impact the <a href="https://www.aihw.gov.au/australias-health/summaries">quality of life and mental health</a> of millions of Australians. Not all GPs feel confident having weight conversations, given the sensitive nature of weight and its stigma. GPs' words matter – they are a <a href="https://doi.org/10.1111/nbu.12320">trusted source</a> of health information. It’s critical GPs gain the skills to know when and how to have <a href="https://doi.org/10.1186/s12875-019-1026-4">positive weight conversations</a>. GPs need to offer supportive and affordable solutions. But effective specialist weight management programs are few and far between. More equitable access to programs is essential so GPs have referral pathways after conversations about weight. GPs' time is valuable. Activating this critical workforce is essential to meet the <a href="https://www.health.gov.au/resources/publications/national-obesity-strategy-2022-2032?language=en">National Obesity Strategy.</a> <a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, Deputy Editor and Senior Health Editor, <a href="http://www.theconversation.com/">The Conversation</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-gps-bring-up-a-patients-weight-in-consultations-about-other-matters-we-asked-5-experts-209681">original article</a>.

Body

Astonishing report identifies Covid’s alleged “patient zero”

A bombshell report has claimed the infamous Covid-19 "patient zero” was a Wuhan scientist carrying out experiments on souped-up coronaviruses. The scientist in question, Ben Hu, was conducting risky tests at the Wuhan Institute of Virology with two colleagues, Ping You and Yan Zhu, the report states. It is understood that all three suffered Covid-like symptoms and required hospital care weeks before China broke the news of the virus outbreak to the rest of the world. The Sun reported that the name of “patient zero" has never been disclosed until now. Many US government officials have now identified the three scientists in a shocking report by journalists Michael Shellenberger and Matt Taibbi. Writing in the Substack newsletter Public, the pair alleged the scientists were experimenting with coronaviruses when they fell ill in 2019. Several experts and intelligence officials have long suspected scientists at the lab accidentally spread the virus during so-called “gain of function” experiments on bat coronaviruses. The naming of “patient zero” could prove to be the smoking gun, only adding to mounting circumstantial evidence of a lab leak. It is unclear who in the US government had the intelligence about the sick lab workers, how long they had it, and why it was not shared with the public. The Australian journalist and Sky News host Sharri Markson spoke to The Sun about the lab leak theory in 2021 and dubbed it an “explosive development”. Jamie Metzl, a former member of the World Health Organisation advisory committee on human genome editing, described it as a possible “game changer”. “It’s a game changer if it can be proven that Hu got sick with Covid before anyone else,” he said. “That would be the ‘smoking gun’. Hu was the lead hands-on researcher in (virologist Shi Zhengli’s) lab.” DRASTIC, an international team of scientists and sleuths attempting to piece together Covid-19’s origins, researched the three scientists in 2021. The Wuhan Institute of Virology’s website lists Hu’s biography showing he was working as an assistant researcher. He was said to be the “star pupil” of virologist Shi Zhengli — the virologist at the lab who became known as “batwoman” for her research on bat coronaviruses. Markson, the author of What Really Happened in Wuhan, said that Hu was running a state-funded project in 2019 to test if new coronaviruses could infect humans. The study involved souping up the viruses and experimenting with them on humanised mice. However, the results were never published and the study’s existence was erased from the internet as Covid-19 was spreading around the globe, which raised suspicion of a possible lab leak. A source told The Sun that footage from 2017 that was aired by Chinese state-run TV showed Hu working in the lab without protective gear. The same video shows scientists from the Wuhan lab searching for bat viruses with inadequate protective gear. Alina Chan, a molecular biologist at MIT and Harvard, told Public, “Ben Hu is essentially the next Shi Zhengli. “He was her star pupil. He had been making chimeric SARS-like viruses and testing these in humanised mice. “If I had to guess who would be doing this risky virus research and most at risk of getting accidentally infected, it would be him.” She noted, “If this info had been made public in May of 2020, I doubt that many in the scientific community and the media would have spent the last three years raving about a raccoon dog or pangolin in a wet market.” US scientist Dr Steven Quay, “He was always my first choice for one of the infected Wuhan Institute of Virology workers but it seemed too simple.” A bill signed by US President Joe Biden in 2023 called for the release of the names of the sick scientists, their symptoms, and whether they had been involved with or exposed to coronavirus research. The US is currently preparing to release previously classified material, which could include the names of the three Wuhan scientists. Earlier in 2023, FBI director Christopher Wray said, “the FBI has for quite some time now assessed that the origins of the pandemic are most likely a potential lab incident in Wuhan”. China has long been accused of attempting to cover up or distort its involvement with Covid-19, but they continue to deny claims. In March 2023, China’s former government scientist confessed the Wuhan lab leak theory shouldn’t be ruled out, sparking uproar in Beijing. Professor George Gao, the former chief of China’s Centre for Disease Control, played a key role in the efforts to trace the origins of Covid-19, insisting scientists should “suspect anything”. Speaking to the BBC Radio 4 podcast Fever: The Hunt for Covid’s Origin, Professor Gao said, “You can always suspect anything. That’s science. “Don’t rule out anything.” Professor Gao retired from the CDC in 2022 after playing a key role in the pandemic response and efforts to find the mysterious origin of the virus. He would have had access to highly classified government information on the outbreak of Covid-19. According to Professor Gao, a formal investigation into the Wuhan Institute of Virology was carried out by a government department. The government scientist claimed the “lab was double-checked by the experts in the field”. Investigators believe scientists were working with the Chinese military to develop a mutant virus and pursue bioweapons just as the pandemic began. The findings followed a team of US investigators who combed through top-secret intercepted communications and research. In 2016, researchers discovered a new fatal type of coronavirus in a mineshaft in Mojiang, Yunnan province. However, they kept it under wraps, with the sample then transported to the Wuhan lab and dubbed as classified work. The virus is the only known immediate relative of Covid-19 known to exist prior to the pandemic. Speaking to The Times, one US investigator said, “The trail of papers starts to go dark. “That’s exactly when the classified program kicked off. “My view is that the reason it was covered up was due to military secrecy related to the army’s pursuit of dual-use capabilities in virological biological weapons and vaccines.” The findings came after a scientist who worked closely with the Wuhan lab claimed the virus was genetically engineered and leaked from the facility. Image credit: Getty

Body

Aussie patient given new drug worth $5 million per dose

A potential cure for a rare genetic disease is being trialled, and it comes with a hefty price tag. Sydney’s Royal Prince Alfred Hospital is part of a groundbreaking new trial aimed at potentially curing haemophilia B – a hereditary bleeding disorder. Patients with haemophilia B have a mutation on the F9 gene, which causes excessive bleeding and damage to joins as they lack the protein that helps blood to clot. A mere 40 patients worldwide will be infused with the gene therapy, with each dose the equivalent of $5 million, or over $1,000 a drop. A safe virus carrying the F9 gene is infused into the body, sending it to the liver cells, where doctors hope the protein is made for the rest of the patient’s life. Professor John Rasko, Head of Cell and Molecular Therapies at RPA, said the process is a “thrilling moment in the history of gene therapy” "We are pushing the boundaries of medical technology hoping to bring cures to individuals," he said. "It's a massive international effort that takes time and money and ultimately the manufacturing alone costs millions and millions of dollars." Haemophilia B patients currently require three injections a week. This revolutionary treatment could mean just one infusion in a lifetime. The infusion on May 22 was the culmination of more than two decades of work. Image credit: Shutterstock

Caring

Ally Langdon breaks down in tears over 13-year-old life support patient

Ally Langdon has broken down in tears while hearing the heart-breaking story of 13-year-old Esra Haynes. The A Current Affair host was joined by Esra’s parents, who shared that their daughter had fallen victim to the dangerous practice of “chroming”. Chroming is when a person inhales solvents or other household chemicals, or aerosol deodorant in Esra’s case, to get high. Esra’s parents, Paul and Andrea, recalled receiving a phone call while their daughter was at a sleepover that changed their lives forever. Over the Easter long weekend, the teenager had gone into cardiac arrest as a call was made to the parents to “Come and get your daughter”. When Andrea arrived at the home, police and paramedics were trying to resuscitate the teen before she was taken to hospital and placed on life support. Just eight days later, Esra passed away. “We thought we would bring her home,” Andrea <a href="https://9now.nine.com.au/a-current-affair/esra-haynes-melbourne-family-open-up-to-ally-langdon-about-tragic-chroming-trend-that-killed-daughter/7b4fcf4e-662b-4a91-8875-76fa4024a31a" target="_blank" rel="noopener">told </a>Langdon. “We still had hope, we did not think the worst,” Paul said. Although her parents were optimistic their little girl would recover, a scan revealed Esra had sustained irreparable brain damage from the dangerous chemicals. The couple were forced to make the painful decision to turn off Esra's life support, and were told to bring in friends and family to say their final goodbyes to the teenager on her deathbed. “She was put onto a bed so we could lay with her,” a heartbroken Paul said. “We cuddled her until the end.” Langdon was visibly overwhelmed by the parents' memories of their final day with their daughter, and teared up alongside them. Andrea and Paul are now dedicating their time to educating young people about the dangers of chroming, which has claimed the lives of more than a dozen young Australians since 2009. <blockquote class="twitter-tweet"> The Haynes family have an unimaginable pain that they'll never recover from. After losing their 13-year-old loved one to a dangerous teen craze, they're now pleading with families across the nation to try and stop anyone else going through the same heartbreak. <a href="https://twitter.com/hashtag/9ACA?src=hash&ref_src=twsrc%5Etfw">#9ACA</a> <a href="https://t.co/zZt1MF6way">pic.twitter.com/zZt1MF6way</a> — A Current Affair (@ACurrentAffair9) <a href="https://twitter.com/ACurrentAffair9/status/1660529859897200640?ref_src=twsrc%5Etfw">May 22, 2023</a></blockquote> “It's unquestionable that this will be our crusade,” Paul told the <a href="https://www.heraldsun.com.au/news/victoria/lilydale-high-school-mourns-loss-of-muchloved-year-7-student-esra-haynes/news-story/4d58fa97b02019475bc830920f32c357" target="_blank" rel="noopener">Herald Sun</a>. “No matter how much you lead a horse to water, anyone can drag them away. It's not something she would have done on her own.” Esra’s family and friends have honoured her memory online, with a flood of tributes from her loved ones recalling her sweet nature. One of her closest friends wrote on Facebook, “There wasn't one day in the past three years you've not made my day by your contagious laugh and gorgeous smile.” “My heart aches and it doesn't feel real knowing I'll have to say goodbye to you Esra. You're so young. You were gone too soon.” Image credits: A Current Affair

Caring

Ambulance report contradicts Daniel Andrews’ car crash statement

A newly discovered ambulance report has contradicted Daniel Andrews’ statement about a 2013 car accident on the Mornington Peninsula that almost killed a teenager. The Victorian premier was being driven by his wife Catherine in their family Ford Territory when it collided with a bike being ridden by 15-year-old Ryan Meuleman. The incident occurred near the Melbourne Rd and Ridley St intersection in Blairgowrie around 1:30pm on January 7, 2013. Meuleman suffered a punctured lung, broken ribs, internal bleeding and was left with just 10 per cent of his spleen. He was in The Royal Children’s Hospital for 11 days. Mrs Andrews wasn’t breathalysed following the accident, and the teen wasn’t given a chance to give a statement to police. Mr Andrews and his wife have held up their claims that Mueleman was at fault as the premier told reporters in 2017 that the teen was “moving at speed” when he “absolutely T-boned the car”. However, a document obtained by the Herald Sun, put together by Ambulance Victoria paramedics who were present at the scene, challenges the couple’s claims that they came to a “complete stop” and “turned right from a stationary position” moments before the collision. The “Patient Care Report” reads, 15YO on bike. Struck on L side by car travelling 40 to 60kmh … PT onto bonnet, then onto windscreen which cracked on impact … thrown onto roadway.” The document has only now been uncovered as Mr Mueleman, now 25, has escalated legal action. Speaking to the Herald Sun, barrister Daryl Dealehr said, “The serious injuries to the left side of Ryan’s body and the observations made by the ambulance officers who attended the crash are completely inconsistent with the claims to police made by Mr Andrews and his wife that their vehicle was travelling at a low speed,” “The evidence appears completely at odds with what Daniel and Catherine Andrews have been claiming since the collision.” The outlet reported in late 2022, before the November state election, that Meuleman had contacted lawyers to re-examine the accident and the circumstances surrounding the investigation and legal settlement that followed. The ambulance report was not in the files that were originally handed over by law firm Slater & Gordon. According to the Herald Sun, The Meuelemans are seeking pre-trial discovery against the law firm and the Transport Accident Commission (TAC) in an attempt to uncover any further “missing” documents. After the accident, Mueleman was paid $80,000 by the TAC, though his family have raised “concerns” over the proceedings. The teen’s parents insist they never engaged Slater & Gordon, a Labor-aligned law firm, to represent their son while the firm refuses to reveal what led to its involvement. “I hadn’t seen this report until a week ago,” Mueleman told the Herald Sun. “The lawyers never showed it to me. They just told me to agree to the deal and kind of, you know, shut up. I was 15 years old, mate. I was a kid. Seriously, I was 15. I am pretty blown away to be honest. I just wish I had it to show everyone 10 years ago. It would have changed everything. People would have known that they hit me, not the other way around.” In 2017, the Independent Broad-based Anti-corruption Commission examined the police response to the crash, including failing to use a breathalyser after the crash. Mr Andrews and his wife were not formally interviewed until nearly a month after the incident. In November 2017, uncovered police photographs obtained by the saw the extent of damage to the vehicle. In his signed statement on February 2013, the Premier said, “We had turned right from a stationary position into Ridley St. Moments after we turned, a cyclist collided heavily with the side of our vehicle … the cyclist was travelling at speed and hit our car at a perfect right angle very heavily. I want to make it clear — the cyclist hit our vehicle.” In the statement, Mrs Andrews said, “I turned from Melbourne Rd after coming to a complete stop … just after we turned into Ridley St our car was struck heavily on the front driver’s side by a cyclist who it seems was attempting to cross Ridley St at speed from the bike path.” In a press conference in November, shortly after Mr Mueleman's new claims were revealed, Mr Andrew rejected several questions from reporters. “I’ve got nothing further to say,” he said. A spokesperson for the Premier said that the matter had been "dealt with" by Tourism Minister Steve Dimopoulos at a press conference that morning. “This is over a decade old,” Mr Dimopoulos told reporters. “The most appropriate authorities have investigated this thoroughly and have made no adverse findings. Beyond that, the Premier himself has answered questions on this almost as many times as he’s answered questions on Covid. This has been thoroughly examined and I really don’t have any more to say.” Image credit: Getty

News

"So like your mum": Chloe Lattanzi visits patients at ONJ Wellness Centre

Olivia Newton-John was known for many things: mostly for being a giant of the Australian entertainment industry. But according to her daughter Chloe, her most important legacy was the work she did at the Olivia Newton-John Cancer Wellness and Research Centre. Since her mother died in August 2022 after a 30-year journey with cancer, Chloe is determined to continue her extraordinary work, and joined <a href="https://9now.nine.com.au/a-current-affair/the-olivia-newton-john-cancer-wellness-and-research-centre-with-family-and-staff/340a9404-e7ef-46f4-8e49-3d0f2e0fd654" target="_blank" rel="noopener">A Current Affair</a>'s Ally Langdon to visit patients in the centre to hear their stories. Chloe Lattanzi dropped into the centre with her cousin Tottie Goldsmith, where she was greeted by patients who were over the moon to meet her. "Oh my god, you are so like your mum," one patient told Lattanzi as she squeezed her tight in a warm hug. "You're just beautiful like her … she's an Aussie treasure." "She's done so much and I'm so grateful for what she's done here because they (staff) are just amazing." Lattanzi said she first visited the ONJ Wellness Centre with her mum in 2019 and now she's "very passionate" about continuing her legacy. "I am very much looking forward to meeting the people who are here and connecting with them," Lattanzi said. "I hope to bring some kind of comfort and joy … because I know what they're going through." Patients in the centre were quick to praise the work Olivia Newton-John had done in creating the centre, sharing how much of a difference such an environment had while undergoing treatment. "Everything's serene and calm because it's a traumatic time and to have that sort of thing is really marvellous," another patient said. "It's a home away from home," Sergio, who is also a patient at the centre, added. Chloe said that it was an honour to be invited into the centre and felt her mother with her "in spirit". "I feel like she's inside of me and this is my purpose," Lattanzi said. Director of Austin Health Foundation Debbie Shiell was also at the centre when Lattanzi paid the patients a visit and said "Chloe gave them the gift that Olivia gave them". "Olivia gave them a break from here and love and healing energy and that was really special to witness and I have no doubt that those people you saw today will be beaming tomorrow," Shiell told Lattanzi. "This (wellness centre) is her vision, her legacy." Image credits: A Current Affair

Caring

Lucid dying - what some patients experience as they’re going through CPR

A study of people who received cardiopulmonary resuscitation (CPR) in hospital has found that some of them had what’s being dubbed “lucid experiences of death,” accompanied by spikes in brain activity. The research found that roughly one in five CPR survivors described unique experiences, including feeling separated from their bodies, observing the events without pain or distress, and a meaningful evaluation of life. These experiences were different to hallucinations, dreams, or CPR-induced consciousness, according to the researchers, who presented their findings at the American Heart Association’s Scientific Sessions 2022 conference. The international team of researchers collected data on 567 patients whose hearts stopped beating, in UK and US hospitals, between May 2017 and March 2020. While they were all treated immediately, fewer than 10% of these people were ultimately discharged from hospital. In addition to hearing the patients’ experiences, the researchers observed spikes in brain activity – specifically, in so-called gamma, delta, theta, alpha and beta waves. In some cases, these activity spikes were observed when CPR had been going on for up to an hour. “These recalled experiences and brain wave changes may be the first signs of the so-called near-death experience, and we have captured them for the first time in a large study,” says lead investigator Dr Sam Parnia, an intensive care physician and associate professor in the Department of Medicine at New York University Langone Health, US. “Our results offer evidence that while on the brink of death and in a coma, people undergo a unique inner conscious experience, including awareness without distress.” While plenty of people have personal accounts of near-death experiences before, they’re difficult to judge empirically. “These lucid experiences cannot be considered a trick of a disordered or dying brain, but rather a unique human experience that emerges on the brink of death,” says Parnia. It may be linked to disinhibition – the release of barriers in the brain as it shuts down. The researchers are keen to investigate the lucid dying experiences further. This article originally appeared on <a href="https://cosmosmagazine.com/health/lucid-dying-cpr/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Image: Shutterstock

Mind

Iron key to heart failure patients’ wellbeing

Patients with chronic heart failure should be made aware of the importance of having their iron levels checked regularly, with research showing half of all heart failure patients have low iron, increasing their risk of hospitalisation, which is often associated with premature death. More than half a million Australians have chronic heart failure, and it is estimated that around 158,000 will require hospitalisation each year. Hospitalisation for heart failure is associated with high rates of readmission, and death, with Australia recording an estimated 61,000 heart failure-related deaths each year. New Australian treatment guidelines recommend intravenous iron treatments rather than oral supplementation for patients with heart failure with reduced heart function who have low iron. This is in a bid to reduce the risk of hospitalisation, as oral iron has been shown to be ineffective in increasing iron levels in these patients. The updated guidelines reflect new research, including a 2020 study that found heart failure patients that received an intravenous iron treatment had a 26 per cent risk reduction in total heart failure hospitalisation, and were 21 per cent less likely to experience cardiovascular death and total heart failure hospitalisation. University Hospital Geelong cardiologist John Amerena, who co-authored the new treatment guidelines, said iron deficiency was easily diagnosed by a blood test, and should be screened for as part of routine management for heart failure patients. “Patients with heart failure with reduced heart function can experience symptoms of tiredness, restlessness, bloating and poor quality of life. These can occur regardless of whether the patient is anaemic or has experienced iron deficiency in the past,” Associate Professor Amerena said. Heart failure prevents the heart from pumping enough blood to organs and tissues and can occur as the result of conditions such as coronary artery disease, high blood pressure, heart valve defects, viral infection, or alcohol misuse. Associate Professor Amerena said heart failure patients’ chances of survival decreased with each subsequent hospitalisation, with research showing a 25 percent chance of death within one year of first hospital admission. He said evidence showed intravenous iron could improve symptoms and patient quality of life, helping to prevent rehospitalisation. Women were more typically at risk of low iron, particularly before menopause, and should have their iron levels measured regularly, particularly if they had a history of heart problems or their family members had experienced heart issues, he said. “Women should be aware that low iron is common in heart failure. Measuring iron levels should be a part of routine blood testing. If their iron stores are low, there is good evidence that the administration of intravenous iron can improve their wellbeing and functional status, as well as reducing the risk for re-hospitalisation” he said. Image: Shutterstock

Body

"Let him do this job": Mother of Charlie Teo's "miracle girl" blasts surgery restrictions

The mother of Dr Charlie Teo's "miracle girl" has spoken out against the restrictions placed on the surgeon and how they will impact the lives of many families with sick kids. In 2019, Milli became one of Dr Teo's most well-known patients after he successfully removed 98 per cent of a brain tumour that had been dubbed inoperable and incurable by other surgeons. Although Milli tragically died in January 2021, her mother Monica said she feels “devastated” and “disappointed” over the restrictions placed on Dr Teo, saying it will greatly impact patients and their families who no longer have access to potentially lifesaving surgery. Since August 2021, Dr Teo has been barred from operating in Australia under rules imposed by the Medical Council of NSW. In order to operate, Dr Teo must have written approval from a second independent neurosurgeon with more than 20 years of specialist experience. These conditions will remain in place until September 30, when they will be subject to review. “Why? Just why? I wish they’d leave him alone and let him do this job. He helps people – that’s all he does,” Monica told <a href="https://www.news.com.au/lifestyle/health/health-problems/mum-of-dr-charlie-teos-miracle-girl-amelia-milli-lucas-says-operating-restrictions-have-robbed-australians/news-story/9fb19e4d6ab9b644e30ff03817d813b1" target="_blank" rel="noopener">news.com.au</a>. “I know the neurosurgeons in Australia think he’s a cowboy and think he takes things just that little bit extra … but that should be left to the patient to choose.” Dr Teo has has had daily requests from desperate patients to operate, as Monica said it should be up the patients to have final say over their treatment, and it’s an opportunity she’s grateful that her daughter had. “A neurosurgeon could go: ‘No, I’m not going to do it because in three months time it’s going to be back in and you’re going to be dead anyway’ but if someone wants to do it and live that three months, why aren’t they given that choice? Charlie gives you that choice,” she added. “He doesn’t mince his words and he doesn’t give anyone false hope, he just gives them real hope.” She also said the rules which have limited Dr Teo’s operating ability also “robbed” the “medical industry” and future research as well. Since the neurosurgeon has been barred from operating in Australia, Dr Teo has continued teaching, lecturing and performing pro bono surgery internationally. “I feel sorry for the people in Australia who want to be a neurosurgeon and aren’t able to learn from the best in the world.” Image credits: Facebook

Caring

Not “your average beanie”: Smart Aussie invention to help stroke and trauma patients

A new ‘smart helmet’ packed with tech is being developed to monitor brains of patients who have suffered a stroke, injury or trauma by a team of Australian scientists and developers thanks to funding from the Victorian government. Patients with these kinds of injuries often experience brain swelling and have parts of their skull removed to prevent the brain from pushing on structures such as the brainstem, the part of the brain that regulates the cardiovascular and respiratory systems, <a href="https://www.urmc.rochester.edu/news/story/brain-drowns-in-its-own-fluid-after-a-stroke" target="_blank" rel="noopener">which can be fatal</a>. The SkullPro, developed by Anatomics Pty Ltd and the CSIRO, is a customised protective helmet that includes sensors that relay data back to the patient’s neurosurgeon to help them determine the best time to repair the skull. With the helmet, the conditions of patients’ brains can be monitored while they recover at home. Neurosurgeons can monitor their brain function in real time thanks to a ‘brain machine interface’ developed using machine learning, advanced sensors and microelectronics. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CDApuNgj68s/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CDApuNgj68s/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Anatomics (@anatomicsrx)</a> </div> </blockquote> Victorian Premier Daniel Andrews announced that Anatomics’ development of the helmet would be among 11 Victorian medical technology products funded through the latest round of MedTech grants. “This isn’t your average beanie. This is a Smart Helmet,” Mr Andrews <a href="https://www.facebook.com/DanielAndrewsMP/posts/pfbid02SJfjW1BcypXz8ubJHtQUTPvG349spbWAch4Eib1nguHedjAH1fFhWg4DaPJ9V5kNl" target="_blank" rel="noopener">wrote</a> on social media. “It helps monitor the brains of patients who've had a stroke or suffered traumatic brain injury. It lets doctors know how the brain is healing and helps surgeons decide on the ideal time to perform operations on the skull to give patients the best possible chance of a full recovery. It's been researched, designed and manufactured right here in Bentleigh East by Anatomics. “It's the kind of technology that doesn't just save lives – it changes lives too.” Mr Andrews added that the series of grants would help support “Victorian innovation” and create jobs. “We're backing Anatomics and 11 other Victorian medical technology manufacturers with a new round of MedTech grants. Creating jobs and supporting Victorian innovation,” the post continued. “That's something we can all get behind.” <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/B8xqoDDnORs/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/B8xqoDDnORs/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Anatomics (@anatomicsrx)</a> </div> </blockquote> The team developing the SkullPro hope it will lay the foundation for research relating to brain injuries, diagnostics, and treatments in Australia. In a <a href="https://www.anatomics.com/au/news/2020/07/24/smart-skullpro.html" target="_blank" rel="noopener">statement</a>, Professor Paul D’Urso, a neurosurgeon and the founder of Anatomics, said the grant would “greatly benefit brain injured patients throughout the world”. "The recently announced funding through MTPConnect’s BioMedTech Horizons program will allow Anatomics and CSIRO to lay the foundations for advanced diagnostics and therapies for decades to come that will greatly benefit brain injured patients through-out the world,” he said. "We should all be proud of the pioneering R&D (Research & Development) that has already occurred in Australia and the opportunities that this grant will deliver to our future." Image: @anatomicsrx (Instagram)

Mind

Moral injury: what happens when exhausted health workers can no longer provide the care they want for their patients

Healthcare workers in New Zealand already face life-and-death decisions daily. But as multiple winter illnesses add pressure to a system already stretched by COVID, staff now also have to deal with <a href="https://www.stuff.co.nz/national/politics/local-democracy-reporting/300534812/covid19-union-and-frontline-worker-say-staff-at-middlemore-hospital-facing-increasing-abuse" target="_blank" rel="noopener">daily abuse</a>, acute <a href="https://www.newshub.co.nz/home/new-zealand/2022/05/christchurch-hospital-cancels-surgeries-as-it-hits-112-pct-capacity.html" target="_blank" rel="noopener">staff shortages</a> and <a href="https://www.1news.co.nz/2022/06/17/dhb-clashes-with-union-over-stretched-palmerston-north-ed/" target="_blank" rel="noopener">unsafe working conditions</a>. At times, they cannot provide the care they would like for their patients. The impact on health workers is often described as <a href="https://www.nzherald.co.nz/rotorua-daily-post/news/great-minds-health-workers-on-covid-19-frontlines-burnt-and-bled-by-two-years-of-virus/T7JXOXGXEKKCICUNOMUJYT4QWM/" target="_blank" rel="noopener">stress and burnout</a>. The consequences of this prolonged pressure can be seen in the number of <a href="https://www.nzdoctor.co.nz/article/undoctored/acem-welcomes-111b-health-nz-budget-urges-fixes-health-workforce-crisis" target="_blank" rel="noopener">doctors</a>, <a href="https://www.nzherald.co.nz/nz/nursing-shortage-nurses-broken-while-sector-faces-thousands-of-vacancies/L7NUXOPG4AB472OKXOH5QJSUMU/" target="_blank" rel="noopener">nurses</a> and other <a href="https://capsulenz.com/be/therapist-shortage-nz/" target="_blank" rel="noopener">health professionals</a> leaving their jobs for overseas positions and the private sector, or being lost to their professions completely. Many of these healthcare workers may well be suffering from a more serious form of psychological distress than burnout: moral injury. <a href="https://www.phoenixaustralia.org/wp-content/uploads/2020/07/Moral-Stress-Healthcare-Workers-COVID-19-Guide-to-Moral-Injury.pdf" target="_blank" rel="noopener">Moral injury</a> refers to the psychological, social and spiritual impact of events on a person who holds strong values (such as caring for patients) and operates in high-stakes situations (hospital emergency care), but has to act in a way inconsistent with those values. Examples include having to turn patients away despite them being in pain or discomfort; being unable to provide adequate care due to staff shortages; having to care for a dying patient isolated from their loved ones while wearing full protective gear. Symptoms of moral injury can include strong feelings of guilt and shame (about not being able to uphold healthcare values, for example) as well as high levels of anger and contempt towards the system that prevents proper care. High levels of self-criticism, loss of trust in people and organisations and a weakening of personal relationships are further <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00113-9/fulltext" target="_blank" rel="noopener">symptoms</a> of moral injury. It can be viewed as a <a href="https://www.afta.org/wp-content/uploads/2019/07/Physicians-aren%E2%80%99t-%E2%80%98burning-out.%E2%80%99-They%E2%80%99re-suffering-from-moral-injury..pdf" target="_blank" rel="noopener">more severe form of burnout</a>. But while burnout can happen in most workplaces, moral injury requires the three core components listed above. From war to the operating table The term moral injury arose in <a href="https://www.ptsd.va.gov/professional/treat/cooccurring/moral_injury.asp" target="_blank" rel="noopener">military psychology</a> to refer to situations where, for example, soldiers were unable to intervene to save lives in case they risked breaching the rules of engagement. More recently, the term has been adapted to apply to healthcare. Viewing the experiences of health workers through this lens can help us understand why they may experience a seesawing emotional state and the confusing conflict of simultaneously wanting to be at work while wishing they were anywhere but. For healthcare workers, understanding the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752815/#:%7E:text=Over%20time%2C%20these%20repetitive%20insults,is%20in%20some%20way%20deficient" target="_blank" rel="noopener">concept of moral injury</a> may help reframe it as something that is happening to them rather than because they don’t have the skills to cope. The latter can sometimes be a mistaken implication of the term burnout. <figure class="align-center "><img src="https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Exhausted nurse" /><figcaption>Staff shortages can take health workers beyond exhaustion and burnout. Getty Images</figcaption></figure> While healthcare workers are largely at the mercy of the organisations they work for, there are some steps individuals can take to alleviate moral injury. Firstly, simply recognising they may be suffering from this condition can reduce confusion and validate their experiences. Secondly, reconnecting back to an individual’s values and beliefs can help refocus and re-energise, at least temporarily. Reminding themselves why they got into this job in the first place is a useful place to start. Organisational responses Organisations and businesses must play a lead role in preventing and treating moral injury. Many of the factors leading to it (lack of resources or staff, a pandemic or peak flu season) are outside the control of individuals. Most modern businesses will be aware they have a legal responsibility under the 2015 <a href="https://www.legislation.govt.nz/act/public/2015/0070/latest/DLM5976660.html" target="_blank" rel="noopener">Health and Safety at Work Act</a> to look after their employees’ mental and physical well-being. At a high level, organisations can advocate for systemic change and increases in funding and resourcing, where needed. But these higher-level changes take time to achieve. In the meantime, it is important healthcare workers are protected and supported. Broad steps an organisation can take to prevent or reduce moral injury include removing the burden of difficult ethical decisions from frontline workers and instead adopting evidence-based policies to guide an organisation-wide response. Where possible, rotating staff between high and low-stress environments may help. Providing funding for workers to access professional psychological supervision is another practical step businesses can consider. At a team level, it can be helpful to have leaders who are visible, validating and can help make sense of the moral conflict. Leaders can also play a role in keeping alive professional values and modelling their own struggles with the situation. The general public also has a role to play in supporting healthcare workers. Any steps we can take to protect our own health and thereby reduce pressure on the system can have a cumulative effect on the well-being of doctors, nurses and allied health clinicians. The health of our nation rests with those who work in this field and it is in all our interest that their health is protected and prioritised.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/185485/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dougal-sutherland-747623" target="_blank" rel="noopener">Dougal Sutherland</a>, Clinical Psychologist, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200" target="_blank" rel="noopener">Te Herenga Waka — Victoria University of Wellington</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/moral-injury-what-happens-when-exhausted-health-workers-can-no-longer-provide-the-care-they-want-for-their-patients-185485" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Caring

Dr Charlie Teo breaks his silence with post about his "miracle girl"

Controversial brain surgeon Dr Charlie Teo has broken his silence in a touching tribute to a teenage patient he called his "miracle girl". The former Australian of the Year has been quiet online since a series of <a href="https://www.oversixty.com.au/news/news/charlie-teo-s-future-in-jeopardy" target="_blank" rel="noopener">conditions were imposed</a> on his medical registration following complaints from fellow colleagues last year. Before the in-depth review of his medical practices, Dr Teo was a decorated surgeon loved by many, who made a name for himself by operating on those with incurable or inoperable brain cancers. One of his most well-known patients was Amelia "Milli" Lucas, a 14-year-old from Perth who crowdfunded $170,000 to afford Dr Teo's services and flew across the country to Sydney for the operation. After successfully removing 98 percent of Amelia's life-threatening brain tumor with the experimental surgery, she was hailed Dr Teo's "miracle girl". In a lengthy social media post, Dr Teo discussed Milli’s “simple but enlightening” legacy in a bid to attract funding for his eponymous brain cancer charity. “There is nothing worse than the death of a child,” he wrote. He said the teen was “an exceptional example of how to make the most of one’s life” throughout her ongoing battle with cancer, which claimed her life in January 2021. “When faced with adversity, you can be angry, resentful, bitter and consumed or you can accept the hand that you’ve been dealt and make the most of what you have,” he said. <div id="ad-block-4x4-1" data-type="unruly" data-ad-size="4x4" data-device-type="web" data-ad-tar="pos=1" data-ad-pos="1" data-google-query-id="CMj4p8i40fgCFQm6aAodGJsCfQ"></div> “(Milli) was an engaging and beautiful soul. When I think about each time I saw her, she was always smiling. I loved her dearly.” According to Dr Teo, brain cancer is the most deadly disease for children in Australia, but research is woefully underfunded. <div id="indie-campaign-EAbKwvW1L2TJ5OnFRiOT-0" data-campaign-name="NCA LIFESTYLE Newsletter OneClick SignUp" data-campaign-indie="newsletter-signup" data-jira="" data-from="1650290400000" data-to="1681826400000"></div> “It has a significant socio-economic impact on our society as a killer of children and young people, yet governments aren’t pouring in the research funding,” he wrote. “Brain cancer isn’t a common cancer, so put simply: it doesn’t win votes.” The high-profile brain surgeon asked for donations to his charity, The Charlie Teo Foundation, which he said was dedicated to funding the “desperately needed” research into brain cancer. “It’s not fair that children like Milli are dying and there are no treatments for them,” he said. “I don’t want to have to tell another parent, ‘I can’t save your child’.” He went on to detail the challenges that come with being a brain surgeon, as he compared himself to an "elite athlete" as he tries to achieve the same focus and success in a much higher-stakes environment. The brain surgeon made nationwide headlines last year as he was slapped with a series of restrictions on his medical license. Following complaints from colleagues, a <a href="https://www.oversixty.com.au/finance/legal/ruling-made-against-dr-charlie-teo" target="_blank" rel="noopener">ruling </a>was made which including<span style="background-color: #ffffff; color: #212529; font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px;"> a rule which requires Dr Teo to obtain written support from an approved neurosurgeon before performing certain types of surgery. <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;">“If the written statement does not support the practitioner performing the procedure(s) the practitioner cannot recommend or perform the surgery,” the statement on his registration states. <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;">In a statement to the Sydney Morning Herald, Dr Teo said he accepted the direction from the Medical Council to consult with another neurosurgeon on two types of brain surgery, and that he will also have retrospective discussions with a colleague to review outcomes of surgeries. <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;">The council is also allowed to randomly audit Dr Teo’s records. <span style="background-color: #ffffff; color: #212529; font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px;">Image credits: Instagram

Caring

Cancer patients go untreated due to hospital debts

A cancer centre in Palestine is turning away patients for the first time in its history, with some 500 patients turned away since September last year for one reason - it’s owed $96 million ($NZ 105 million). The cancer unit in the Augusta Victoria Hospital in eastern Jerusalem is owed the funds from the Palestinian Authority (PA) and is unable to buy the chemotherapy drugs needed to treat patients, according to the <a href="https://www.bbc.com/news/world-middle-east-60829319" target="_blank" rel="noopener">BBC</a>. “It’s the first time in our history that we’ve been forced to take the decision not to accept new patients,” Dr Fadi al-Atrash, the hospital’s deputy CEO, told the BBC. “We’re facing a very critical situation where we might be forced to close some departments in future. We might have to stop the treatment of patients already in our care. “It means that more people might die of cancer because they’re not receiving their treatment on time, or according to the right schedule.” A lack of funds for healthcare isn’t the only problem for the PA, which says it’s facing the worst financial crisis since it began 30 years ago, due to a combination of the pandemic, inflation and the Palestinian conflict with Israel. Salem al-Nawati, a 16-year-old with leukaemia from Gaza, collapsed outside the PA Health Ministry in Ramallah earlier in the year and was declared dead soon after. His uncle, Jamal al-Nawati, was fighting to secure a hospital bed for Salem, and detailed the barriers his nephew faced in accessing treatment. Since hospitals in Gaza are ill-equipped to treat many serious cases of cancer, Salem was given a medical referral and PA financial guarantee for treatment in a private hospital in Nablus. However, after being initially refused a travel permit by Israel, Salem arrived for treatment a month later and was turned away from the Nablus hospital because its bills hadn’t been paid by the PA. “I was wondering what we’d done wrong, what had this poor patient ever done?” Mr al-Nawati said. “Salem’s condition was deteriorating hour-by-hour, day-by-day. He was so sad, asking me why he was being refused treatment, and I was doing my best to reassure him.” Though an influential family friend intervened, resulting in the PA offering to send Salem to an Israeli hospital, his permit didn’t allow him to travel there. Image: Getty Images

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Some Covid patients develop resistance to Sotrovimab treatment

As treatments continue to be developed for patients with COVID-19, some scientists have found that one in particular may cause the virus to mutate so that it becomes harder to treat. A team of Australian researchers analysed samples from the first 100 people to be treated with Sotrovimab - an increasingly popular treatment that targets the Omicron variant and prevents severe COVID-19 symptoms - only to make some interesting findings. They took samples from the patients before and after they were treated with Sotrovimab and sequenced the genome of the virus in each sample. In four of the patients, the team found that the virus had mutated in ways that made it more resistant to treatment within 13 days of treatment. “We discovered that the virus that causes COVID-19 can develop mutations within the patient several days after Sotrovimab treatment, which reduces the effectiveness of this treatment by greater than 100-fold,” Dr Rebecca Rockett, a Sydney researcher in infectious disease and co-author of the study, <a href="https://www.scimex.org/newsfeed/covid-19-patients-can-develop-resistance-to-treatment-with-sotrovimab" target="_blank" rel="noopener">said</a>. This research, published in the <a href="https://www.nejm.org/doi/10.1056/NEJMc2120219" target="_blank" rel="noopener">New England Journal of Medicine</a>, is the first to show the mutations in clinical models, with previous research finding the mutations developed in animal models and when growing the virus in a lab setting. With this finding, the researchers are calling for the use of Sotrovimab to be monitored to prevent treatment-resistant versions of the virus from spreading in the community. “Resistant virus samples could be readily grown in the laboratory, a marker that individuals who develop resistance may transmit the resistance virus to others,” said Professor Vitali Sintchenko, the study’s senior author and a fellow researcher in infectious disease. “(Sotrovimab) is the only one (treatment) we have evidence against so far, but we need to be more on the front foot in terms of efficacy,” Dr Rockett told <a href="https://7news.com.au/news/coronavirus/australian-covid-19-patients-developed-resistance-to-antiviral-drug-as-virus-mutates-within-days-of-first-treatment-study-finds--c-6001171" target="_blank" rel="noopener">7News</a>. “I don’t think the infrastructure is in place to capture the resistance. We need better surveillance.” Since the research was published, GSK, the manufacturer of Sotrovimab, has confirmed that the study’s findings were consistent with the company’s large clinical studies. “Resistance is also seen in studies for other COVID-19 monoclonal antibodies and oral treatments, and relates to how the immune system interacts with the virus,” a spokesperson said, per 7News.com.au. “This report does not change the positive benefit-risk of sotrovimab for use in the treatment of mild to moderate COVID-19 in patients at high risk of progression.” Image: Getty Images

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