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Autism and ADHD assessment waits are up to 2 years’ long. What can families do in the meantime?

<p>Reports have emerged from around Australia of waitlists of <a href="https://www.smh.com.au/national/nsw/unacceptable-wait-to-screen-children-for-developmental-delays-autism-20220125-p59r1d.html">up to two years</a> to receive a diagnostic assessment for neurodevelopmental conditions, such as autism and attention deficit hyperactivity disorder (ADHD).</p> <p>Assessment delays can create additional stress for families who are already worrying their child may be developing differently.</p> <p>These waiting times are a symptom of the significant strain our health systems are under. System reform will take time, and in the meantime, there are many children who require urgent support.</p> <p>But supporting your child doesn’t need to be put on hold while you wait for assessment.</p> <p><strong>Why are waitlists so long?</strong></p> <p><a href="https://theconversation.com/wondering-about-adhd-autism-and-your-childs-development-what-to-know-about-getting-a-neurodevelopmental-assessment-197528">Diagnostic assessments</a> are an important part of the <a href="https://www.autismcrc.com.au/access/national-guideline">clinical pathway</a> for children developing differently.</p> <p>Diagnoses can provide parents and carers with a deeper understanding of their child. A diagnosis allows the child, their family and the supporting health professionals to benefit from all the information we have about that diagnosis, to understand how best to <a href="https://www.autismcrc.com.au/access/supporting-children">support the child going forward</a>.</p> <p>One reason why our diagnostic systems are currently under so much strain is because of expanding diagnostic boundaries. The criteria for autism and ADHD have <a href="https://theconversation.com/from-deficits-to-a-spectrum-thinking-around-autism-has-changed-now-there-are-calls-for-a-profound-autism-diagnosis-194049">changed over time</a>, meaning more children meet criteria for these conditions than before.</p> <p>Another reason is that our health, disability and education systems often require a formal diagnosis for a child to receive support. This further increases demand for diagnostic assessments.</p> <p>Often, long waitlists result in children and families not getting timely access to crucial early therapy services. Delays can mean that many of the best opportunities to support children’s development early in life are missed, which can further <a href="https://www.sciencedirect.com/science/article/abs/pii/S1750946719301849">entrench developmental disability and disadvantage</a>.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Parents turn to equine therapy for children with autism, ADHD as disability services wait times blow out <a href="https://t.co/JezFJ2TmuV">https://t.co/JezFJ2TmuV</a> via <a href="https://twitter.com/ABCaustralia?ref_src=twsrc%5Etfw">@ABCaustralia</a></p> <p>— Robert Koenig-Luck (@koenig_luck) <a href="https://twitter.com/koenig_luck/status/1645227611193475077?ref_src=twsrc%5Etfw">April 10, 2023</a></p></blockquote> <p>However, importantly, there are many beneficial things that families can do in the meantime to pave the way for the future.</p> <p><strong>3 things families can do</strong></p> <p>While a diagnosis may help a child access support services, they are still able to access services without a diagnosis.</p> <p>If a parent is worried about their child’s development, then it is important they continue to seek out support services while the child is on a diagnostic waitlist.</p> <p>A GP is typically the best person to consult in the first instance. They can then refer the child and family to public or private therapy services. However, private service options may involve out-of-pocket expenses, which can create inequity in access to services.</p> <p>Parents can also take steps to:</p> <p><strong>1. Build connections with their child</strong></p> <p>A key part of all early supports is nurturing the connection parents have with their child. All children benefit from having frequent, meaningful time set aside to <a href="https://clinikids.telethonkids.org.au/information-hub/blog/serve-and-return-interactions/">connect</a> with their primary caregivers.</p> <p>During this special connection time, parents might focus on slowing down, approaching their child with curiosity, being open to following their child’s special interests, and trying a variety of communication strategies (including words, gestures or using pictures) to <a href="https://clinikids.telethonkids.org.au/information-hub/blog/shared-attention/">support communication</a>.</p> <p>Parents needn’t feel pressure to spend all their time engaging with their child – but any time that can be dedicated to this will be time well spent.</p> <p><strong>2. Gather information to support diagnosis</strong></p> <p>Diagnoses of <a href="https://www.cdc.gov/ncbddd/adhd/diagnosis.html">ADHD</a> and <a href="https://www.cdc.gov/ncbddd/autism/hcp-dsm.html">autism</a> are based on the observation of certain behaviours. A clinician will be able to observe some of these behaviours in their assessment, but they will also rely on information from parents about how their child usually behaves or interacts in different situations.</p> <p>Parents can support this process by noting examples of the patterns of behaviours they’ve observed. These might include special interests, repetitive activities, social interactions, emotional regulation, sensory preferences or how their child communicates.</p> <p>It is important parents don’t only note what a child finds difficult, but also their strengths and interests. Sometimes, the things a child is particularly good at can tell us just as much as their challenges.</p> <p><strong>3. Prioritise family wellbeing</strong></p> <p>While parents are often proactive in seeking support for their child, they can sometimes neglect their own need for support. Parents are the most important person in a child’s life, and parental capacity and wellbeing can have a significant influence on their child’s outcomes.</p> <p>While waiting for a diagnosis, parents should start to plan how they are also going to get the support they need. This can include staying connected within the community and making time for activities that bring them and their family joy.</p> <p><strong>Looking beyond diagnosis</strong></p> <p>When parents seek out a diagnosis for their child, they want help to support their child’s development. But long waits for assessment and diagnosis can present barriers between Australia’s health, education and disability systems and the help families need. The long waiting lists to receive a diagnostic assessment are at odds with what we know about the importance of early intervention.</p> <p>Recent <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2784066">clinical trials</a> have shown how providing support to babies and parents at the first sign of developmental concern can lead to <a href="https://theconversation.com/therapy-for-babies-showing-early-signs-of-autism-reduces-the-chance-of-clinical-diagnosis-at-age-3-167146">positive developmental outcomes</a> for children.</p> <p>This approach prioritises acting quickly over diagnostic clarity, and makes it more likely children and families receive support during critical times in brain development.</p> <p>As Australia seeks to reform our early childhood development system, the need of families to receive prompt support should be front of mind.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Can we have a twitter thread where we list all of the therapies and supports that parents -can- use to help their autistic kid? <a href="https://twitter.com/hashtag/OtherWaysThanABA?src=hash&amp;ref_src=twsrc%5Etfw">#OtherWaysThanABA</a> <a href="https://twitter.com/hashtag/SayNotoABA?src=hash&amp;ref_src=twsrc%5Etfw">#SayNotoABA</a> <a href="https://twitter.com/hashtag/AskingAutistics?src=hash&amp;ref_src=twsrc%5Etfw">#AskingAutistics</a> <a href="https://twitter.com/hashtag/ActaullyAutistic?src=hash&amp;ref_src=twsrc%5Etfw">#ActaullyAutistic</a></p> <p>My go-to is ear defenders/earplugs/sunglasses/hoodies/fidget toys/punching bag</p> <p>— AutisticSciencePerson, MSc (@AutSciPerson) <a href="https://twitter.com/AutSciPerson/status/1116527158564986880?ref_src=twsrc%5Etfw">April 12, 2019</a></p></blockquote> <p><em>Image credit: Shutterstock</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/autism-and-adhd-assessment-waits-are-up-to-2-years-long-what-can-families-do-in-the-meantime-203232" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Family & Pets

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A failure at 6? Data-driven assessment isn’t helping young children’s learning

<p>Children’s <a href="https://www.education.vic.gov.au/Documents/childhood/providers/edcare/veyldframework.pdf">early years</a> from birth to the age of eight are crucial for their social, emotional and intellectual development. However, early years education in Australia is fragmented. It operates across two spaces, the pre-compulsory period, often called early childhood education, and the first three years of compulsory schooling.</p> <p>In recent times the focus in these three years has been on assessment that produces numerical data. Teachers need to demonstrate children are meeting standards.</p> <p>In contrast, in the pre-compulsory years the focus is on observing and interacting with the child. Practices are based on the belief that all children have agency and are capable learners.</p> <p>A chasm has opened up between these <a href="https://www.routledge.com/Early-Childhood-and-Compulsory-Education-Reconceptualising-the-relationship/Moss/p/book/9780415687744">separate education systems</a>. Children go from playing to being tested in the blink of an eye. This abrupt change in young children’s education is problematic.</p> <h2>What does research tell us about the early years?</h2> <p>A <a href="https://research-repository.griffith.edu.au/bitstream/handle/10072/391647/Dunn356707Accepted.pdf?sequence=2&amp;isAllowed=y">2015 review</a> of research on best practices in the early years identified key factors in successful teaching and learning. The review noted the importance of:</p> <ul> <li> <p>a smooth transition between pre-school education and compulsory school education</p> </li> <li> <p>play-based learning</p> </li> <li> <p>seeing children as capable and having agency in their learning</p> </li> <li> <p><a href="https://www.education.vic.gov.au/school/teachers/teachingresources/discipline/english/literacy/speakinglistening/Pages/teachingpracdialogic.aspx">dialogic interactions</a> involving <a href="https://earlychildhood.qld.gov.au/earlyYears/Documents/language-dialogic-in-action.pdf">rich discussions</a> between children and between children and teachers.</p> </li> </ul> <p>Australia has introduced a mandated curriculum and a national assessment program in primary schools. The review noted this meant many early years teachers have adopted a more formalised and narrow approach to learning in schools. It isn’t appropriate for young children.</p> <p>We can see the resulting <a href="https://researchnow.flinders.edu.au/en/publications/where-are-the-early-years-of-school-in-contemporary-early-childho">divide between non-compulsory and compulsory</a> early years education in Victoria. On the one hand, teachers need to acknowledge the needs of children from birth to eight years. On the other hand, for those between the ages of five and 12, the <a href="https://victoriancurriculum.vcaa.vic.edu.au/">Victorian Curriculum</a> requires teachers to assess and report against curriculum standards.</p> <p>The focus on formal assessment and numerical data in the early years of schooling means children as young as six can be labelled as failing. In countries like Finland and Singapore, which have been <a href="https://www.oecd.org/pisa/pisaproducts/strongperformers/">identified</a> as <a href="http://timssandpirls.bc.edu/pirls2016/international-results/pirls/student-achievement/pirls-achievement-results/">high-performing</a>, children do not even <a href="https://expatchild.com/school-starting-ages-around-world/">begin formal schooling</a> before the age of six or seven.</p> <p><iframe src="https://data.worldbank.org/share/widget?indicators=SE.PRM.AGES&amp;type=shaded&amp;view=map" width="100%" height="380" frameborder="0" scrolling="no"></iframe></p> <p><a href="https://journals.sagepub.com/doi/pdf/10.2304/ciec.2014.15.2.185">One study</a> has described the early years in countries like the United Kingdom, America and Australia as being at the mercy of top-down policy development, leading to “a highly prescriptive and assessment-driven early years climate”. <a href="https://www.routledge.com/The-Datafication-of-Primary-and-Early-Years-Education-Playing-with-Numbers/Bradbury-Roberts-Holmes/p/book/9781138242173">UK researchers</a> have identified the “datafication” of early years education and its impacts on children and teachers. And <a href="https://researchoutput.csu.edu.au/en/publications/a-sociological-analysis-of-australias-naplan-and-my-school-senate">Australian researchers</a> used the term “adultification” to describe the unrealistic expectations placed on young children.</p> <h2>So what happens in our schools?</h2> <p>My doctoral <a href="https://minerva-access.unimelb.edu.au/handle/11343/268186">research</a> found “datafication” and “adultification” defined the early years of schooling in Victoria. I engaged with more than 100 early-years teachers to explore their literacy teaching and assessment practices. The recurring theme was these teachers were expected to frequently assess young children in formal ways that provided numerical data.</p> <p>Teachers voiced frustration. One described the early years as “death by assessment”. Another lamented that community expectations were unreasonable, saying “people are hung up on data, numbers”.</p> <p>There was an overwhelming sense that the teachers knew their children best and should be given the agency to assess and plan for literacy teaching rather than being required to use a suite of commercially produced assessment tools.</p> <p>The Victorian Early Years Learning and Development Framework (<a href="https://www.education.vic.gov.au/Documents/childhood/providers/edcare/veyldframework.pdf">VEYLDF</a>) is designed to support early years teachers working with children and families. Its premise is that children have the greatest opportunities to develop neural pathways for learning and are also most vulnerable to negative experiences from birth to eight years.</p> <p>The framework is based on research into best practice for children in these years. Rather than formal assessment based on numbers, the VEYLDF advocates for assessment that is authentic and responsive to how all children can best demonstrate their learning and development.</p> <p>The Victorian Education Department <a href="https://www.education.vic.gov.au/childhood/professionals/learning/Pages/veyldf.aspx">encourages</a> teachers in schools to use the framework. However, little is known about how many actually use the framework to inform teaching and learning.</p> <p>Making it mandatory to report against curriculum standards from the time children begin compulsory schooling sets the boundaries for how many teachers operate. It is hard to have a foot in both camps when reporting against these standards is mandatory and you feel compelled to prepare children for what comes next – which includes <a href="https://www.nap.edu.au/">NAPLAN</a>, the national assessment program.</p> <p><img src="https://images.theconversation.com/files/432555/original/file-20211118-18-1xgrfo5.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="Group of laughing and smiling children together among trees" /> <span class="caption">‘Death by assessment’ threatens the joy young children find in learning.</span> <span class="attribution"><span class="source">Shutterstock</span></span></p> <h2>Schools can still let children be children</h2> <p>However, some schools are turning their backs on the relentless measuring of young children’s attainments. <a href="https://www.sjfootscray.catholic.edu.au/">St John’s</a>, a multicultural primary school in Melbourne’s inner west, is one example. You only need to look at the school <a href="https://www.sjfootscray.catholic.edu.au/learning/">website</a> to see its philosophy differs from many others.</p> <blockquote> <p>“St John’s Horizon [a school community-developed vision] clearly states ‘KIDS AT THE HEART’ which encapsulates our focus and belief in the image of the child – the child who is capable, curious, full of wonder, rich in knowledge, able to construct and co-construct his or her own learning. We believe in JOY – Joy in learning.”</p> </blockquote> <p>A conversation with the then principal, Gemma Goodyear, gave me an insight into these beliefs, which are inspired by teaching and learning in schools in <a href="https://www.reggiochildren.it/en/reggio-emilia-approach/">Reggio Emilia</a>, Italy. Goodyear said children do not come to school to be “fixed”, and the teachers engage them by providing meaningful, contextualised learning experiences. And, yes, through their focus on rich learning they still get great results without relentless testing.</p> <p>It is time to revisit the early years of schooling and ensure teachers have the skills and understandings they need to support learners in this phase. These years should be a time when children become engaged and excited about learning, a time of great joy, and a time when children are allowed to be children.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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; text-shadow: none !important;" src="https://counter.theconversation.com/content/169463/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/martina-tassone-1270226">Martina Tassone</a>, Early Childhood and Primary Course Coordinator and Language and Literacy Lecturer, <em><a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></span></p> <p>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/a-failure-at-6-data-driven-assessment-isnt-helping-young-childrens-learning-169463">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

Family & Pets

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Can an algorithm assess Trump’s control over discourse?

<div> <div class="copy"> <p>Controversial former US president Donald Trump will always be remembered for his prolific and volatile <a rel="noreferrer noopener" href="https://cosmosmagazine.com/people/society/in-disasters-twitter-influencers-are-out-tweeted/" target="_blank">twitter </a>presence, but it’s difficult to assess, on the basis of a social media site with billions of tweets and users, how much influence these messages have actually had on public opinion.</p> <p>To find out, researchers have conducted a computational analysis of the many phrases found in Trump’s tweets between 2016 and 2021, looking for answers about how powerful the former president’s influence was over public narratives at that time.</p> <p>The study, led by Peter Dodds of the University of Vermont, Burlington, US, is published today in <em>PLOS ONE.</em></p> <p>The researchers developed a novel computational method for analysing tweets in order to build timelines of stories on a given subject. They analysed all tweets related to Trump spanning the five-year study period, applying their algorithms to measure the temporal dynamics – the fluctuating relevance over time – of stories, as represented by words or short phrases, like “Hillary” and “travel ban”.</p> <p>They noted that the turbulence of a story – how quickly it declined in dominance as new stories arose – varied over time and by topic. Trump’s first year in office, 2017, was the most turbulent, with a myriad of dominant stories like “Russia” and “Comey”.</p> <p>Turbulence declined in 2018 onwards, with stories enduring for longer periods, including 2018’s “Mueller” and 2020’s “Covid-19”. Turbulence spiked with 2020’s Black Lives Matter protests, the 2020 election and 2021’s Capitol riot.</p> <p>“In 2020, story turbulence around Trump exploded with the start of the COVID-19 pandemic, the murder of George Floyd, and the presidential election,” the authors write, “but also ground to a halt as these stories dominated for long stretches.”</p> <p>So, what does this all mean? The persistence of some stories over others could suggest higher social relevance, and, crucially, the authors note their technique as a way of measuring the zeitgeist and its attitudes over time in a large-scale, systematic way, with implications for recorded history, journalism, economics and more.</p> <p>The researchers say their analysis was also able to measure how much Trump controlled the narrative of each story, based on how much his tweets were retweeted, with his tweets about “Fake news” and “Minneapolis” retweeted far more than those about “coronavirus” and “Jeffrey Epstein”, for example. However, retweets may not be a measure of influence so much as a measure of social relevance; people tend to share posts about issues they care about the most, and may still implicitly agree with Trump’s many other narratives.</p> <p>It’s also worth noting that <a rel="noreferrer noopener" href="https://www.pewresearch.org/internet/2019/04/24/sizing-up-twitter-users/" target="_blank">twitter is not a microcosm of real life</a>; the site’s most vocal users are often particularly political and engaged either in very left-wing or right-wing narratives, and users are also of a narrower age bracket than the general public. </p> <em>Image credits: Getty Images</em></div> <div id="contributors"> <p><em>This article was originally published on <a rel="noopener" href="https://cosmosmagazine.com/technology/computing/can-an-algorithm-assess-trumps-control-over-discourse/" target="_blank">cosmosmagazine.com</a> and was written by Cosmos. </em></p> </div> </div>

Technology

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How the pandemic forced Australians to assess their finances

<p><span style="font-weight: 400;">Australians are making the most of extended lockdown procedures, as a recent survey claims most of us are forming healthier spending habits. </span></p> <p><span style="font-weight: 400;">The pandemic has forced us all inside and away from shopping in-person, impulse buying coffees, and daily public transport costs, leaving many with more money to save. </span></p> <p><span style="font-weight: 400;">A survey conducted by ME Bank revealed that 40% of adults are taking this time to create new habits to achieve their financial goals. </span></p> <p><span style="font-weight: 400;">The majority of those who took the survey said that time spent at home over the last year has been a prime opportunity to assess their future financial objectives.</span></p> <p><span style="font-weight: 400;">New financial habits for many include creating an emergency fund, saving for a significant expense, and even starting a side hustle business. </span></p> <p><span style="font-weight: 400;">People have also noticed that their savings have increased through less everyday spending, creating budgets, tracking expenses more closely, and planning more extravagant purchases. </span></p> <p><span style="font-weight: 400;">ME's money expert, Matthew Read, says many people re-evaluating their finances is due to the extra time on their hands during lockdowns.</span></p> <p><span style="font-weight: 400;">"It might be fair to say COVID lockdowns have, and may continue to, make many Australians more financially savvy."</span></p> <p><span style="font-weight: 400;">Despite many Aussies claiming the lockdowns have positively impacted their spending, the pandemic has also seen a sharp increase in online shopping, as well as other negative habits. </span></p> <p><span style="font-weight: 400;">Others have admitted to using their abundance of free time online browsing when they’re bored, or spending more free cash on alcohol and takeaway food deliveries. </span></p> <p><span style="font-weight: 400;">Mr Read said, </span><span style="font-weight: 400;">"We all know the lockdowns aren’t easy, and we’re once again being tested, but it’s great to see so many Australians working towards a healthy financial future."</span></p> <p><em><span style="font-weight: 400;">Image credit: Shutterstock</span></em></p>

Retirement Income

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Body language expert assesses Christian Porter

<p><span>A body language expert has claimed that the historical rape allegations made against Attorney-General Christian Porter has taken a “heavy toll” on him.</span><br /><br /><span>Mr Porter ousted himself as the federal minister accused of raping a 16-year-old girl in 1988, and insists it never happened and he will not stand down from his position.</span><br /><br /><span>In a live press conference on Wednesday afternoon, Mr Porter was grilled over the allegations which were investigated by police who closed the case on Tuesday and concluded there was not enough evidence to proceed.</span><br /><br /><span>The 50-year-old former public prosecutor said he attended a debating competition at Sydney University with his accuser when he was 17 and she was 16.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7840115/christian-porter-5.jpg" alt="" data-udi="umb://media/839e354496424b089e7392265861c2c4" /><br /><br /><span>He denied however, sleeping with the woman, who has since taken her own life.</span><br /><br /><span>Body language and speech expert Michael Kelly said the man came across as “aggrieved” and righteous, but also dejected.</span><br /><br /><span>“He gave a genuine presentation of himself and his ideas. He was very measured,” Mr Kelly told <em>Daily Mail Australia.</em></span><br /><br /><span>“But you can tell it has taken a heavy toll on him.”</span><br /><br /><span>He went on to say: “His eyes were watery and red, his voice was trembling and he had trouble taking intakes of breath about five minutes in.”</span><br /><br /><span>He said Mr Porter showed a wide range of emotions during the 30-minute press conference.</span><br /><br /><span>The Attorney-General’s red eyes showed a man harrowed and pained while his grieved facial expression signaled remorse, regret, and resignation, Mr Kelly claimed.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7840116/christian-porter-2.jpg" alt="" data-udi="umb://media/dc7c1520f0aa484baac1d378daf3877f" /><br /><br /><span>“He’s a public figure accused of some serious allegations and that stress showed through his words, body language and gestures,” Mr Kelly said.</span><br /><br /><span>“He showed to be not hiding or covering anything up.”</span><br /><br /><span>Mr Kelly also addressed Mr Porter's message to the family of his deceased accuser.</span><br /><br /><span>He told them they didn't deserve the frenzied politicisation in the past week of the circumstances of her death.</span><br /><br /><span>Mr Porter pleaded with the family to understand why he was deny their loved one's claims of historic sexual assault however didn't want to impose anymore on their grief.</span><br /><br /><span>“His pained, facial expression and flushed facial skin (lack of blood to the face) signal that his vitality; some of his life force has been ‘drained’ due to the accusation,” Mr Kelly said.</span><br /><br /><span>“Throughout the delivery, there was a thin, tremulous voice signalling remorse, resignation, sorrow and empathy (for the family) about the incident.”</span><br /><br /><span>In reference to Mr Porter’s sharp intakes of breath while being grilled by reporters, Mr Kelly said: “He appears frustrated about the position he's in but he doesn't shut them down.”</span><br /><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7840117/christian-porter-4.jpg" alt="" data-udi="umb://media/62f8c1f08a144938874b3acba4b3e75a" /><br /><span>“His face showed no inconsistencies. If you look at the whole piece, it all fits, there was nothing out of place.</span><br /><br /><span>“He’s earnest in trying to do his job.”</span><br /><br /><span>Mr Porter has refused to stand down from his position.</span><br /><br /><span>“If I stand down from my position as Attorney-General because of an allegation about something that simply did not happen, then any person in Australia can lose their career, their job, their life's work based on nothing more than an accusation that appears in print,” he said.</span><br /><br /><span>“My guess is if I were to resign and that set a new standard there wouldn't be much need for an attorney-general anyway because there would be no rule of law left to protect in this country.</span><br /><br /><span>“So I will not be part of letting that happen while I am attorney-general and I am sure you will ask and I will state to you, I am not standing down or aside.”</span></p> <p><em>Images: Getty </em></p>

Legal

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Why it might be time to re-assess your alcohol intake

<p>Drinking patterns tend to change as we age. The older we get, the <a href="http://www.nceta.flinders.edu.au/files/4614/4892/9660/EN605.pdf">more likely we are to drink on a daily basis</a>. But older adults often perceive that drinking is only a problem if a person appears drunk.</p> <p>Australia’s <a href="https://www.nhmrc.gov.au/health-advice/alcohol">draft alcohol guidelines</a> recommend healthy adults drink no more than ten standard drinks per week and no more than four in a day. This is down from 14 standard drinks per week in the <a href="https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol">previous guidelines</a> and no more than two standard drinks in any one day.</p> <p>Anything above this is considered risky drinking because it <a href="https://www.nhmrc.gov.au/health-advice/alcohol">increases the risk of alcohol-related diseases</a>, such as cancer, and injuries.</p> <p>Between 2007 and 2016, there was a <a href="https://ro.ecu.edu.au/ecuworkspost2013/5672/">17% increase</a> in risky drinking among Australians aged 60-69. In 2016, <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/data">18.2% of 60-69 year olds</a> drank at risky levels.</p> <p>Among women, <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-key-findings/contents/alcohol-use">those aged 50-59 years</a> are now more likely to drink at risky levels (13%) than any other age group, including women aged 18 to 24 years (12.8%).</p> <p>Older adults are more vulnerable to alcohol’s interactions with medicines, medical conditions that can be made worse by alcohol, and age-related changes in the metabolism of alcohol that mean we become more intoxicated from drinking the same amount of alcohol. Alcohol can also increase the risk of falls.</p> <p>For some older people, this means that maintaining their current levels of alcohol consumption as they age inadvertently places them at risk.</p> <p><strong>Alcohol and many medications don’t mix</strong></p> <p>Older adults are <a href="https://onlinelibrary.wiley.com/doi/pdf/10.5694/mja2.50244">more likely</a> to be taking a number of medications; about two-thirds take <a href="https://www.ncbi.nlm.nih.gov/pubmed/20073039">four or more</a>.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331237/">Many of these medications</a> can interact with alcohol.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/31769178">Our research</a> among risky drinkers aged 58 to 87 found 92% were taking medications that when combined with large amounts of alcohol could lead to serious adverse effects. This included common medications prescribed for high blood pressure.</p> <p>For 97% of the people we studied, drinking alcohol reduced the effectiveness of the medication. This included Nexium, a medication commonly prescribed to treat gastric reflux.</p> <p><strong>Why are older Australians drinking more?</strong></p> <p>While age-related factors such as <a href="http://www.nceta.flinders.edu.au/files/4614/4892/9660/EN605.pdf">bereavement</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/28382628">retirement</a> can increase the likelihood of drinking at risky levels, most often alcohol is part of an enjoyable social life as people age.</p> <p>In <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/hsc.12110">our research</a>, alcohol use was closely linked to social engagement: more frequent opportunities to socialise were associated with more frequent drinking.</p> <p>Among retirement village residents, having access to a social group “on tap” also encouraged more frequent drinking.</p> <p>In a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12991">recent study of Australian and Danish women drinkers</a> aged 50 to 70, those who were drinking at risky levels said overwhelmingly their drinking was a normal, acceptable and enjoyable part of their lives, so long as they appeared to be in control.</p> <p>In doing so, they were able to mentally distance their drinking from current and future health problems.</p> <p><strong>Recognising heavy drinking as a health issue</strong></p> <p>Australia’s <a href="https://www.nhmrc.gov.au/health-advice/alcohol">draft alcohol guidelines</a> don’t provide any specific recommendations for older adults, beyond those recommended for adults in general.</p> <p>Rather, they recommend older adults speak with their GP to determine an appropriate level of drinking based on their medical history and medications they are taking.</p> <p>But <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/ijpp.12255">our research</a> found only 30% of older men and 20% of older women could recall their GP asking about their alcohol use over the past 12 months, regardless of what medication they were taking.</p> <p>Even fewer could recall their community pharmacist asking about their alcohol use.</p> <p>Promisingly, almost all participants were open to their GP asking about their alcohol use, particularly in relation to medication.</p> <p>And more than half believed it was OK for their community pharmacist to raise this issue with them when being dispensed medication.</p> <p><strong>So what can we do about it?</strong></p> <p>Recognising the social context to older adults’ drinking and other drug use, and understanding how they make sense of these behaviours, is an important first step in preventing and minimising harm.</p> <p>At a population level, public health messages must resonate with older people by reflecting the context in which they drink.</p> <p>At a community level, GPs and community pharmacists are well placed to help older adults minimise the risk of harm, but may require further training to develop their skills and confidence in broaching this topic with patients.</p> <p>For older adults experiencing alcohol-related issues, Australia’s first older adult-specific service, called Older Wiser Lifestyles (OWL), has effectively identified and engaged with <a href="https://www.publish.csiro.au/ah/ah17013">more than 140 people</a> who didn’t realise their drinking could be placing their health at risk.</p> <p>This Victorian initiative asks patients at GP clinics to complete a screening test on a iPad and notifies the GP if risks are identified. The person can then participate in an OWL early intervention program of education, brief counselling and harm-reduction advice.</p> <p>So far the program has led to participants reducing their alcohol consumption and having fewer problems with medicines that interact with alcohol.</p> <p>Such a scheme could be replicated across the country, and has the potential to improve lives, reduce preventable disease and premature deaths, and save the health system money.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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; text-shadow: none !important;" src="https://counter.theconversation.com/content/131651/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/stephen-bright-15258">Stephen Bright</a>, Senior Lecturer of Addiction, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/julie-dare-385086">Julie Dare</a>, Senior Lecturer, Health Promotion, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-youre-ageing-and-on-medication-it-might-be-time-to-re-assess-your-alcohol-intake-131651">original article</a>.</em></p>

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Everything you need to know about the ACAT assessment process

<p><em><strong>Marissa Sandler is the CEO and co-founder of <span style="text-decoration: underline;"><a href="http://www.careseekers.com.au/" target="_blank">Careseekers</a></span>. Previously a social justice lawyer and researcher for over 15 years, Marissa is passionate about helping people live with dignity and finding innovative solutions to problems.</strong></em></p> <p>If you have a loved one who is needing aged care support, you have probably heard the term ACAT being thrown around.  You may be feeling nervous or confused as to what an ACAT assessment is and what you should expect in the assessment. Our in-home aged care specialist Deb Burman is very familiar with the process. Below she outlines exactly how the process works so you are well prepared and know what to expect.</p> <p><strong>What is an ACAT assessment?</strong></p> <p>In order to access government subsidised services, you will need to have a comprehensive ACAT assessment. The assessment looks at your overall needs, including your health and medical, physical, psychological and social needs, and any other needs specific to you. The assessment will determine how much of and what type of support you will benefit from at home.</p> <p><strong>What happens at an ACAT assessment?</strong></p> <p>An ACAT assessor will make a time to visit you, to talk to you about how you’re managing at home. They will bring with some paperwork which they will fill out whilst chatting to you.  You are welcome to have a relative or a friend present during the assessment, if you’d like some extra support.  You can also ask for an interpreter if you would like one. The ACAT assessment will generally take between 45 and 75 minutes.</p> <p>Your assessment will start with some questions to obtain your approval to apply for Aged Care Services, as well as your permission for the assessment to take place. The ACAT assessor will explain the different services available and request that you sign application form.</p> <p>Next, the ACAT assessor will talk to you about how you’re managing all your activities of daily living, such as personal care, cooking, cleaning, shopping, transport to appointments and getting out and about. They will ask you about any support you already have from family, friends or others. Further questions will be asked about your general health and any medications that you are taking. They may ask your permission to have a look around your home, to see if there are any concerns with safety or access.</p> <p>Throughout the assessment, you will be able to speak freely, express your opinions and preferences.  The ACAT assessor will also provide you with information about local services and answer any questions you may have.</p> <p><strong>How long does it take to hear back from the ACAT team after I have been assessed?</strong></p> <p>After the assessment, has been completed, the assessor will take the information back to the Aged Care Assessment Team. A decision will then be made about which services you are eligible for. This process can take a couple of weeks, after which time you will receive written notification from ACAT regarding the outcome of your assessment.  Once you have been assessed as eligible for government funded services, you will be placed on a waiting list until the services become available. The ACAT team will be able to give you an idea of how long it will be until your services will be put in place.</p>

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12 questions to assess the health of your relationship

<p><em><strong>Susan Krauss Whitbourne is a professor of Psychology and Brain Sciences at the University of Massachusetts Amherst. She writes the <span style="text-decoration: underline;"><a href="https://www.psychologytoday.com/experts/susan-krauss-whitbourne-phd" target="_blank">Fulfilment at Any Age</a></span> blog for Psychology Today.</strong></em></p> <p>If you’re lucky enough to make it into midlife with your closest relationship intact, you know that over the course of the decades, that relationship has changed. The factors that spelled success in your earlier years no longer seem to apply once you’ve made it through your 40s, 50s, and beyond. Acknowledging that the rules for relationship success in midlife and beyond are not the same as those of youth, University of Miami family psychologist Blaine Fowers and colleagues (2016) developed a measure of relationship health especially designed for mature couples. With their measure of relationship “flourishing,” or the Relationship Flourishing Scale (RFS), the Fowers team hope to capture the key qualities, in a good long-term partnership, of being able to grow and change as a couple as well as individuals.</p> <p>The University of Miami researchers propose that a positive relationship science needs to become established in which it’s recognised that over time, couples experience fulfillment in ways that may not appear synonymous with “satisfaction” or “happiness.” Instead, they propose that consistent with the Aristotlean notion of “eudaimonia,” the quality of long-term relationships should be measured in terms of such qualities as meaning and purpose, personal growth, goal sharing, and relational giving (prioritising the partner more than oneself).  It doesn’t necessarily take decades, but it’s more likely that long-term couples will develop a shared identity in which they find it impossible to imagine themselves without their partner, regard their partner as essential to their daily existence, and regard their goals as mutually compatible. They also share a history and, just as our memory is a part of our identity, that shared history becomes part of their identity as a couple. Imagine returning to your favorited family vacation spot without your partner. It just wouldn’t seem the same.</p> <p>Relationships that are floundering, by contrast, don’t have that quality of mutual growth and connectedness. They feel stale, empty, and confining. You and your partner share hardly anything of importance to each other anymore, and you could be just as happy alone as you are when you’re together, if not happier.</p> <p>The RFS provides 12 simple behaviorally-based items that will allow you to judge your own relationship’s health with this new, made-for-midlife, measure. Rate each item from 1 (never or strongly disagree) to 5 (always or strongly agree):</p> <p>1. I have more success in my important goals because of my partner’s help.</p> <p>2. We look for activities that help us to grow as a couple.</p> <p>3. My partner has helped me to grow in ways that I could not have done on my own.</p> <p>4. It is worth it to share my most personal thoughts with my partner.</p> <p>5. When making important decisions, I think about whether it will be good for our relationship.</p> <p>6. It is natural and easy for me to do things that keep our relationship strong.</p> <p>7. Talking with my partner helps me to see things in new ways.</p> <p>8. I make it a point to celebrate my partner’s successes.</p> <p>9. I really work to improve our relationship.</p> <p>10. My partner shows interest in things that are important to me.</p> <p>11. We do things that are deeply meaningful to us as a couple.</p> <p>12. I make time when my partner needs to talk.</p> <p>This scale pretty much scores itself, as you can see, but it does divide up into these 4 areas of relationship flourishing, as determined by the statistical analyses of the over 400 married individuals in the Fowers et al. sample:</p> <p>Goal sharing= 1, 6, 10</p> <p>Personal growth= 2, 3, 7</p> <p>Meaning= 5, 9, 11</p> <p>Relational giving= 4, 8, 12</p> <p>Once you’ve given yourself this scale, try this next step in the process. Ask your partner to complete it as well but on his or her own time (i.e. not with you present). If you want to add a layer of complexity to the process, see if you can guess how he or she would respond. Then sit down and compare notes. You may find that despite what you perceive of as celebrating your partner’s success is seen, instead, as apathy —or worse, as jealousy or competitiveness. If you and your partner can go through the items of greatest discrepancy in a constructive and non-confrontational manner, you should be able to identify two or three key areas in which both of you could work harder to achieve greater alignment.</p> <p>Midlife can be a time of relationship stress, given the many pressures operating on all of us to keep up with our obligations, routines, and demands. However, by taking advantage of your shared lives, identities, and histories, it can also be a time of your greatest relationship fulfillment, a fulfillment that will continue to flourish.</p>

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