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Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

<p><a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>Rumours and conspiracies have been <a href="https://www.nytimes.com/2024/02/28/style/princess-kate-middleton-health.html">swirling</a> following the abdominal surgery and long recovery period of Catherine, Princess of Wales, earlier this year. They intensified on Monday when Kensington Palace released a photo of the princess with her three children.</p> <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/C4U_IqTNaqU/?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/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>The photo had clear signs of tampering, and international wire services <a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">withdrew the image</a> amid concerns around manipulation. The princess later <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised for any confusion</a> and said she had “experimented with editing” as many amateur photographers do.</p> <p>Image editing is extremely common these days, and not all of it is for nefarious purposes. However, in an age of rampant misinformation, how can we stay vigilant around suspicious images?</p> <h2>What happened with the royal photo?</h2> <p>A close look reveals at least eight inconsistencies with the image.</p> <p>Two of these relate to unnatural blur. Catherine’s right hand is unnaturally blurred, even though her left hand is sharp and at the same distance from the camera. The left side of Catherine’s hair is also unnaturally blurred, while the right side of her hair is sharp.</p> <p>These types of edits are usually made with a blur tool that softens pixels. It is often used to make the background of an image less distracting or to smooth rough patches of texture.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.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/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=358&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=358&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=358&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=450&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=450&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=450&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><span class="caption">At least eight logical inconsistencies exist in the doctored image the Prince and Princess of Wales posted on social media.</span> <span class="attribution"><a class="source" href="https://www.instagram.com/p/C4U_IqTNaqU/">Photo by the Prince of Wales/Chart by T.J. Thomson</a></span></figcaption></figure> <p>Five of the edits appear to use the “clone stamp” tool. This is a Photoshop tool that takes part of the same or a different image and “stamps” it onto another part.</p> <p>You can see this with the repeated pattern on Louis’s (on the left) sweater and the tile on the ground. You can also see it with the step behind Louis’s legs and on Charlotte’s hair and sleeve. The zipper on Catherine’s jacket also doesn’t line up.</p> <p>The most charitable interpretation is that the princess was trying to remove distracting or unflattering elements. But the artefacts could also point to multiple images being blended together. This could either be to try to show the best version of each person (for example, with a smiling face and open eyes), or for another purpose.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Like many amateur photographers, I do occasionally experiment with editing. I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother’s Day. C</p> <p>— The Prince and Princess of Wales (@KensingtonRoyal) <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616?ref_src=twsrc%5Etfw">March 11, 2024</a></p></blockquote> <h2>How common are image edits?</h2> <p>Image editing is increasingly common as both photography and editing are increasingly becoming more automated.</p> <p>This sometimes happens without you even knowing.</p> <p>Take HDR (high dynamic range) images, for example. Point your iPhone or equivalent at a beautiful sunset and watch it capture the scene from the brightest highlights to the darkest shadows. What happens here is your camera makes multiple images and automatically stitches them together to make an image <a href="https://www.adobe.com/creativecloud/photography/hub/guides/what-is-hdr-photography.html">with a wider range of contrast</a>.</p> <p>While face-smoothing or teeth-whitening filters are nothing new, some smartphone camera apps apply them without being prompted. Newer technology like Google’s “Best Take” <a href="https://blog.google/products/photos/how-google-photos-best-take-works/">feature</a> can even combine the best attributes of multiple images to ensure everyone’s eyes are open and faces are smiling in group shots.</p> <p>On social media, it seems everyone tries to show themselves in their best light, which is partially why so few of the photos on our <a href="https://www.tandfonline.com/doi/abs/10.1080/15551393.2020.1862663">camera rolls</a> make it onto our social media feeds. It is also why we often edit our photos to show our best sides.</p> <p>But in other contexts, such as press photography, the <a href="https://www.ap.org/about/news-values-and-principles/telling-the-story/visuals">rules are much stricter</a>. The Associated Press, for example, bans all edits beyond simple crops, colour adjustments, and “minor adjustments” that “restore the authentic nature of the photograph”.</p> <p>Professional photojournalists haven’t always gotten it right, though. While the majority of lens-based news workers adhere to ethical guidelines like those published by the <a href="https://nppa.org/resources/code-ethics">National Press Photographers Association</a>, others have let deadline pressures, competition and the desire for exceptional imagery cloud their judgement.</p> <p>One such example was in 2017, when British photojournalist Souvid Datta admitted to <a href="https://time.com/4766312/souvid-datta/">visually plagiarising</a> another photographer’s work within his own composition.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Photographer Souvid Datta appears to have plagiarized Mary Ellen Mark: <a href="https://t.co/iO1Lm8CowU">https://t.co/iO1Lm8CowU</a> <a href="https://t.co/jswHyApGNj">pic.twitter.com/jswHyApGNj</a></p> <p>— PetaPixel (@petapixel) <a href="https://twitter.com/petapixel/status/859824132258537472?ref_src=twsrc%5Etfw">May 3, 2017</a></p></blockquote> <p>Concerns around false or misleading visual information are at an all-time high, given advances in <a href="https://theconversation.com/nine-was-slammed-for-ai-editing-a-victorian-mps-dress-how-can-news-media-use-ai-responsibly-222382">generative artificial intelligence (AI)</a>. In fact, this year the World Economic Forum named the risk of misinformation and disinformation as the world’s greatest <a href="https://www.weforum.org/agenda/2024/01/ai-disinformation-global-risks/">short-term threat</a>. It placed this above armed conflict and natural disasters.</p> <h2>What to do if you’re unsure about an image you’ve found online</h2> <p>It can be hard to keep up with the more than <a href="https://theconversation.com/3-2-billion-images-and-720-000-hours-of-video-are-shared-online-daily-can-you-sort-real-from-fake-148630">3 billion photos</a> that are shared each day.</p> <p>But, for the ones that matter, we owe it to ourselves to slow down, zoom in and ask ourselves a few simple <a href="https://www.aap.com.au/factcheck-resources/how-we-check-the-facts/">questions</a>:</p> <p>1. Who made or shared the image? This can give clues about reliability and the purpose of making or sharing the image.</p> <p>2. What’s the evidence? Can you find another version of the image, for example, using a <a href="https://tineye.com/">reverse-image search engine</a>?</p> <p>3. What do trusted sources say? Consult resources like <a href="https://www.aap.com.au/factcheck/">AAP FactCheck</a> or <a href="https://factcheck.afp.com/">AFP Fact Check</a> to see if authoritative sources have already weighed in.<!-- 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;" src="https://counter.theconversation.com/content/225553/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><a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, Senior Lecturer in Visual Communication & Digital Media, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></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/yes-kate-middletons-photo-was-doctored-but-so-are-a-lot-of-images-we-see-today-225553">original article</a>.</p> <p><em>Hero image: The Conversation / X / Instagram</em></p>

Technology

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"I thought I was gone": Doctors reveal how close Jimmy Barnes came to dying

<p>Jimmy Barnes has shared how he fought to stay alive after being forced to undergo major surgery, admitting he didn't think we would survive. </p> <p>The rock legend underwent emergency heart surgery in December 2023, after being struck down with a dangerous infection that threatened his life. </p> <p>Speaking candidly to <a href="https://9now.nine.com.au/60-minutes/jimmy-barnes-cold-chisel-illness-how-rock-icon-fought-to-stay-alive/3717a0d8-25ff-4400-bab3-f556e0b417c2" target="_blank" rel="noopener"><em>60 Minutes</em></a>, the 67-year-old said he didn't have much hope in his survival. </p> <p>"I just said to Jane, 'I don't think I'm gonna make it'. I just had this horrible morbid feeling because I've never felt this sick before. I thought I was gone," he said. </p> <p>Barnes was first admitted to hospital the day after pushing through excruciating pain in November to perform at a tribute concert for his late friend Michael Gudinski. </p> <p>After being admitted to St Vincent's Hospital in Sydney with pneumonia, a team of specialists including cardiothoracic surgeon Dr Paul Jansz, soon discovered a much more sinister health issue was at play, as an infection quickly led to endocarditis: a life-threatening inflammation of the heart.</p> <p>"[The infection] was just eating at his heart. You see an abscess cavity forming around the valve, and that would've just grown and grown and grown," Jansz said.</p> <p>"It's fatal. If he didn't die of the infection, he would've died from heart failure, from the whole valve falling apart."</p> <p>By the time he was wheeled into theatre, his doctors say he had hours to live.</p> <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-permalink="https://www.instagram.com/reel/C3e_KPSPsC-/?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/reel/C3e_KPSPsC-/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by 60 Minutes Australia (@60minutes9)</a></p> </div> </blockquote> <p>"When I contemplated dying before surgery, I just thought, 'you have to savour those moments; have I told my children that I love 'em enough? Have I told Jane? The people you love, make sure you tell 'em'," Barnes said.</p> <p>Surgeons managed to fix Barnes' heart in a marathon seven-hour surgery, as the musician then faced a lengthy recovery process. </p> <p>"It's like you've been ripped in half," he said.</p> <p>"Your best friend is a pillow. If you cough, it's just agony. If you breathe too deep, it's agony. And sneezing would be the end of you."</p> <p>"But I think it's made me stronger. I want to be better than I was. I've got all this new life from this and I want to make the best of it. I want every minute to count."</p> <p>Now two months into his recovery, Jimmy is getting stronger everyday, and has nothing but thanks for his loved ones that stayed by his side during the difficult journey. </p> <p>"Without a doubt, the fact that my family were there and Jane was there, I wasn't going anywhere. I wanted to spend every breath I could spend with Jane. And if that meant fighting to live longer, I was going to do it."</p> <p>When asked about his highly-anticipated <a href="https://oversixty.com.au/entertainment/music/huge-news-for-jimmy-barnes-fans" target="_blank" rel="noopener">return to the stage</a> in April, he joked it would be his version of resurrection. </p> <p>He said, "I miss being on stage, I have to do it, I don't have a choice. I need to get out there and scream, it just clears the emotions out of you."</p> <p><em>Image credits: 60 Minutes </em></p>

Caring

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Heartbroken parents of slain Melbourne doctor break silence

<p>Dr Ash Gordon's heartbroken parents have spoken out about the moment they found out their son had died. </p> <p>The Melbourne GP was allegedly killed after <a href="https://www.oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor" target="_blank" rel="noopener">confronting two teenage</a> boys who had allegedly broken into his home in Doncaster in the early hours on Saturday, January 13.</p> <p>Dr Gordon’s grieving mother Catherine, recalled the moment she was woken by the phone call no parent wants to receive. </p> <p>“He said that Ashley had gone. And I said gone where? He’s gone. He’s no longer with us,” Mrs Gordon told <em>A Current Affair </em>about the moment her son's housemate delivered the devastating news. </p> <p>“I said, ‘Don’t lie, you’re joking.‘ And I hung up on him."</p> <p>Holding back tears, Mrs Gordon also shared the denial she went through as she received the call from a detective. </p> <p>"Then the detective rang and I told him that I didn’t believe him, and he said 'how can I get you to believe?', I said 'until there is a police person in uniform in front of me, it's not happening'"</p> <p>"Well you don't want to believe do you?" <em>A Current Affair </em>host Ally Langdon replied, and both parents shook their heads. </p> <p>“We saw the police car coming up, and I just prayed to God they’d just keep going. I didn’t want them to turn into the driveway, but unfortunately, it happened.”</p> <p>Ally Langdon who was brought to tears during the interview added: “It’s a cruel contrast isn’t it? That Ash has dedicated his life to saving lives, yet his was taken in this horrible way." </p> <p>The 33-year-old doctor was found by police less than a kilometre from his home, but unfortunately he died at the scene. </p> <p>In the days following the incident, two 16-year-old boys with Dr Gordon’s murder as well as aggravated burglary and theft.</p> <p>Dr Gordon's family have since held a <a href="https://www.oversixty.com.au/health/caring/i-ll-see-you-again-one-day-sister-of-slain-doctor-s-emotional-tribute" target="_blank" rel="noopener">memorial service</a> for him to honour the slain doctor. </p> <p><em>Image: A Current Affair</em></p>

Family & Pets

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“I’ll see you again one day”: Sister of slain doctor’s emotional tribute

<p dir="ltr">Dr Ash Gordon has been farewelled in an emotional memorial service, with his family and friends joining together to honour the slain doctor. </p> <p dir="ltr">The 33-year-old died after a violent altercation following a home invasion on January 13th in the Melbourne suburb of Doncaster. </p> <p dir="ltr">Loved ones gathered at Kernot Hall, in Morwell, south-east Victoria, to honour his life and share in their grief.</p> <p dir="ltr">Funeral celebrant Elisha Dowsett opened the funeral by encouraging the mourners to “leave the anger” and focus on remembering Dr Gordon’s celebrated life. </p> <p dir="ltr">“He warmed the hearts of anyone lucky enough to cross paths with him,” she said.</p> <p dir="ltr">“He was a strong, compassionate, funny, driven, determined and cheeky man. He filled this dark and unpredictable world with genuine goodness.”</p> <p dir="ltr">Dr Gordon’s sister Natalie spoke to the congregation, sharing how she will “never get over his death”.</p> <p dir="ltr">“He was a huge part of our lives. He always encouraged me to take risks because he would say, ‘if you don’t, you’ll wonder what if’,” she said.</p> <p dir="ltr">Breaking down in tears, Ms Gordon told mourners she had promised to “take the risk and live the life I dreamt of just as he did”.</p> <p dir="ltr">“This isn’t goodbye little brother, this is see you soon. I’ll see you again one day,” Ms Gordon said.</p> <p dir="ltr">“And, when I do, I can't wait for you to tell me how bad my wrinkles are and for you to give me a big hug. Until we meet again Brother Bear.”</p> <p dir="ltr">Ash’s other sister Tammy Gordon said she “cannot express” how proud she is to call Dr Gordon her brother.</p> <p dir="ltr">“Losing a sibling is losing the person you can truly be yourself with,” she said.</p> <p dir="ltr">Following the passing of Dr Gordon, two 16-year-olds were <a href="https://oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor">charged</a> with murder, aggravated burglary and theft over his death. </p> <p dir="ltr">The teenagers allegedly broke into the home of 33-year-old Dr Ash Gordon, when the doctor then pursued the intruders after they fled the house. </p> <p dir="ltr">The teens then became violent, allegedly stabbing Dr Gordon several times and leaving him to die a kilometre from his home. </p> <p dir="ltr"><em>Image credits: YouTube</em></p> <p><span id="docs-internal-guid-aab57aa9-7fff-de2f-7f15-6813b34ca13d"></span></p>

Caring

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Major update in fatal stabbing of young Melbourne doctor

<p dir="ltr">The 16-year-old accused of stabbing a young Melbourne doctor to death had allegedly committed a similar crime just months prior. </p> <p dir="ltr">The teenager was allegedly involved in the home invasion of Dr Ash Gordon, which turned fatal after the doctor chased the intruders from his home, ending when Dr Gordon was stabbed and left for dead. </p> <p dir="ltr">As the teens now <a href="https://oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor" target="_blank" rel="noopener">face charges</a> for his death, an alleged previous victim of the same teenager has come forward, claiming the young man left him with serious head injuries after robbing his house in October. </p> <p dir="ltr">His alleged previous victims claim that the Victorian government has “blood on its hands” and that the boy should not have been released on bail.</p> <p dir="ltr">The victims told<a href="https://www.heraldsun.com.au/truecrimeaustralia/police-courts-victoria/we-feel-anxious-helpless-and-frustrated-with-the-broken-system-alleged-victims-speak-out/news-story/c05575a0908bf85f014217bb4fda7fa4"> <em>the Herald Sun</em></a> that Dr Gordon's death has left them traumatised and struggling to move on from their own terrifying encounter.</p> <p dir="ltr">In an emotional statement, the alleged previous victims pleaded with Victorian premier Jacinta Allan to reconsider the state's planned youth justice reform. </p> <p dir="ltr">“We are trying to move on with our lives, however, when a case on (alleged) teen crime is reported, we feel anxious, helpless and frustrated with the broken system," they told the publication.</p> <p dir="ltr">“The Allan government and the justice system have blood on their hands, and ultimately should be held accountable.”</p> <p dir="ltr">Under the terms of the 16-year-old’s bail, he was to adhere to a strict nightly curfew, but still managed to allegedly break into Dr Gordon's home shortly before 5:30am on January 13th. </p> <p dir="ltr">Ms Allan has faced increasing pressure to abandon Victoria's overhaul of the youth justice system which would see the age of criminal responsibility raised.</p> <p dir="ltr">The government has committed to raising the age that a child can be arrested, jailed or charged from 10 to 12 by the end of 2024, and again to 14 by 2027, with serious crimes such as homicide being exempt from these changes. </p> <p dir="ltr">Ms Allen however has insisted that the reforms are a key priority of her government and that they will help prevent future criminal ­activity.</p> <p dir="ltr">“There’s a huge amount of work that’s being undertaken by Victoria Police to work with those young people ... [and] that sort of prevention-based activity is the best way to address future youth crime,” she said.</p> <p dir="ltr">“At the same time, when offences are made, Victoria Police have the tools and resources to deal with those.”</p> <p dir="ltr" style="line-height: 1.38; margin-top: 0pt; margin-bottom: 12pt;"><em>Image credits: Facebook</em><span id="docs-internal-guid-deb8779e-7fff-f1a9-74f6-d47cadad48af"></span></p>

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“We will hurt forever”: Sister of slain doctor speaks out

<p>Dr Ash Gordon’s sister Natalie, has broken her silence after her brother's tragic <a href="https://www.oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor" target="_blank" rel="noopener">passing</a>.</p> <p>Ash was found allegedly stabbed to death less than a kilometre from his home, following an  aggravated burglary in Doncaster, Melbourne on Saturday night. </p> <p>Two 16-year-old boys have since been arrested and have been charged with murder, aggravated burglary and theft. </p> <p>Recalling the moment she found out the two boys were arrested, Natalie said she felt slightly relieved. </p> <p>“We thought we’d be going through this a lot longer,” she said. </p> <p>“Then I felt anger (and) a whole new wave of sadness.”</p> <p>She added that her family is grieving and having a hard time processing that their beloved son and brother is gone. </p> <p>"We will hurt forever," she said. “Ash’s patients, colleagues ... Ash’s friends, will all hurt. He was an amazing person, with the best smile, the biggest heart. Our family will never, ever repair itself.”</p> <p>She said that the hardest part for her was watching her parents breakdown. </p> <p>“We all held him on the biggest pedestal, and it’s gone. It’s just gone.”</p> <p>Ash's funeral will be held next Thursday and the family wants to send him off “with a bang”, just like what he would want, according to his sister. </p> <p>“I can’t begin to explain how hard it is now to go through photos ... to go through photos and try to pick photos to show everyone how amazing he was.”</p> <p>Natalie, who has three daughters herself, said that she hopes no other family will ever have to go through the heartache she's experiencing. </p> <p>“I would never want any other family to have to go through what we’re going through,” she said.</p> <p>The two teenagers will appear at a children’s court on February 8, and the prosecution has asked for 12 weeks to prepare a brief of evidence.</p> <p><em>Images: 7NEWS</em></p>

Family & Pets

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“They have stolen everything”: Slain doctor’s partner speaks out

<p dir="ltr">Dr Ash Gordon’s long-term girlfriend has broken her silence after her partner’s untimely death, saying she expects her boyfriend’s killers to be dealt “the maximum punishment”.</p> <p dir="ltr">The 33-year-old doctor was left for dead after a home invasion went wrong, with two teenagers now facing <a href="https://oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor">murder charges</a>. </p> <p dir="ltr">Two 16-year-olds have been charged with murder, aggravated burglary and theft after breaking into the young physician’s home, before allegedly stabbing him. </p> <p dir="ltr">Now, Dr Gordon’s grieving girlfriend Dakota Nagel has spoken out for the first time, telling <em><a href="https://www.news.com.au/national/victoria/ash-gordons-partner-dakota-nagel-speaks-after-teens-charged-over-alleged-murder/news-story/c5bf92f8f14ba87b0c3efd0cd8d1f1e7">news.com.au</a></em> she was grateful for the work of police in the days since the alleged murder.</p> <p dir="ltr">Ms Nagel said those allegedly responsible “deserve the maximum punishment and I will accept nothing less”.</p> <p dir="ltr">“They are heartless enough to take a life that meant so much to all of us,” she said.</p> <p dir="ltr">Ms Nagel said her partner of almost six years was the “light of my life” and “irreplaceable”.</p> <p dir="ltr">“They’ve stolen more than just belongings, they have stolen everything from myself and his family and friends, he was our world,” she said.</p> <p dir="ltr">“He was the most beautiful, kind, patient and understanding person I’ve ever met and I’m just lucky to have spent my life with him.”</p> <p dir="ltr">Miss Nagel told the <em>Herald Sun</em> that her boyfriend should be remembered for the positive impact he had on everyone he knew, including his patients.</p> <p dir="ltr">“We wish for Ash to be remembered for the loving kind person he was and the impact of good he made on the world,” she said.</p> <p dir="ltr">“He died a hero and the people responsible will be held accountable, and justice will be served for Ash and his loved ones.”</p> <p dir="ltr">Superintendent Janet Stevenson said police worked “tirelessly” to “apprehend those responsible for his tragedy”. </p> <p dir="ltr">“We know that Ash’s family and loved ones are grieving. This arrest will not take away the tragedy of this dreadful situation, but we hope that it will alleviate some of their distress,” she said.</p> <p dir="ltr">“We will continue to provide all the support they require during this difficult time.”</p> <p dir="ltr">The alleged attackers will face children’s court at a later date. </p> <p dir="ltr"><em>Image credits: Instagram / Nine</em></p> <p> </p>

Relationships

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Major update in tragic death of young Melbourne doctor

<p dir="ltr">Two teenage boys have been charged with murder just days after the <a href="https://oversixty.com.au/health/caring/sister-of-slain-doctor-calls-for-killers-to-turn-themselves-in">death</a> of a Melbourne doctor. </p> <p dir="ltr">The 16-year-old boys allegedly broke into the home of 33-year-old Dr Ash Gordon on Saturday, when the doctor then pursued the intruders after they fled the house. </p> <p dir="ltr">The teens then became violent, allegedly stabbing Dr Gordon several times and leaving him to die a kilometre from his home. </p> <p dir="ltr">As his heartbroken family continue to grieve their loss, homicide detectives confirmed that the two 16-year-olds have been charged with murder, aggravated burglary and theft and will face a children’s court at a later date. </p> <p dir="ltr">Superintendent Janet Stevenson said police worked “tirelessly” to “apprehend those responsible for his tragedy”. </p> <p dir="ltr">“We know that Ash’s family and loved ones are grieving. This arrest will not take away the tragedy of this dreadful situation, but we hope that it will alleviate some of their distress,” she said.</p> <p dir="ltr">“We will continue to provide all the support they require during this difficult time.”</p> <p dir="ltr">Tributes have poured in for the young doctor, with his sister Natalie describing the 33-year-old as her “world”.</p> <p dir="ltr">“I’m his older sister, but I looked up to him for so much, as did our other siblings. He’s the youngest, but we all looked up to him. Mum and dad would ring him for advice,” she said.</p> <p dir="ltr">“He was just so sure of himself. Such a confident person and so willing to help anyone and everyone.”</p> <p dir="ltr">Friends have also flooded social media with their grief, sharing words of condolences for his loved ones while posting kind words about their fallen friend. </p> <p dir="ltr">“Thank you for the many unforgettable memories, you were one of a kind,” one friend wrote on Facebook.</p> <p dir="ltr">“You were definitely such an inspiration to others, you worked so hard to get where you are! Life’s just not fair.”</p> <p dir="ltr"><em>Image credits: Nine / Instagram </em></p>

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Sister of slain doctor calls for killers to turn themselves in

<p dir="ltr">The distraught sister of Dr Ash Gordon has made an emotional appeal for those responsible for the death of her brother to turn themselves in. </p> <p dir="ltr">In the early hours of Saturday morning, the 33-year-old doctor was killed after a group of criminals broke into his home in Doncaster in Melbourne’s east. </p> <p dir="ltr">After they stole several items from his home, he managed to chase them out of the house and pursued them in his car, until both he and the intruders exited their vehicles and a fight erupted just 500 metres away. </p> <p dir="ltr">Dr Gordon was stabbed fatally several times in the altercation and was left for dead. </p> <p dir="ltr">As his family grieve his premature death, his devastated sister Natalie has called for justice. </p> <p dir="ltr">Appearing on <em>Sunrise</em>, she shared how angry the situation has made her. </p> <p dir="ltr">“I think for me it's been anger the entire time. I'm just obviously devastated, but so angry that anyone could do this to not only my brother but any person, any human being,” she said.</p> <p dir="ltr">"His girlfriend is heartbroken, mum is completely broken and I've never seen my dad like this. You never want to have to bury your own children."</p> <p dir="ltr">Ms Gordon said her little brother had “a big personality with a large heart”, sharing how “his presence was known everywhere.”</p> <p dir="ltr">“He had a cheeky grin, a charm and charisma about him that had everyone wrapped around his little finger.”</p> <p dir="ltr">“He was the absolute apple of all of our eyes. He was the centre of our family and he was the youngest of five but we all looked up to him.”</p> <p dir="ltr">While Dr Gordon's attackers remain on the run and no arrests have been made, Natalie has pleaded for the killers to turn themselves in to police. </p> <p dir="ltr">“Wear the consequences, because you'll never imagine what we're feeling, what we're going through,” she said.  </p> <p dir="ltr">“You have taken away a wonderful doctor, a caring man and the best little brother. Don't be a coward now.”</p> <p dir="ltr"><em>Image credits: Nine / Sunrise</em></p>

Caring

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Devastating update after doctor attacked at home

<p>Prominent Adelaide doctor and former head of the intensive care unit at Adelaide Women’s and Children’s Hospital <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Dr Michael Yung, who fell victim to a brutal assault during a home invasion, has tragically succumbing to life-threatening injuries at the age of 61.</span></p> <p>The news of Dr Yung's death sent shockwaves through the medical community, with the state's Health Minister, Chris Picton, expressing profound sorrow. In a statement, he spoke of Dr Yung's unwavering dedication to healing others, particularly the most vulnerable children in South Australia. The abrupt loss has left the entire SA Health family grappling with grief, as they remember a man who dedicated his life to serving those in their darkest times.</p> <p>As the investigation into the incident unfolds, Detective Superintendent Des Bray revealed a <a href="https://www.oversixty.com.au/finance/legal/prominent-aussie-doctor-fighting-for-life-after-violent-home-invasion" target="_blank" rel="noopener">chilling sequence of events</a> leading up to the fatal assault. In the days preceding Dr Yung's attack, a wave of home break-ins and car thefts plagued the affluent suburbs. The community of Medindie, adjacent to Dr Yung's residence, witnessed a series of intrusions, with surveillance capturing the haunting image of five youths attempting to break into a home.</p> <p><strong>IMPORTANT EDITOR'S UPDATE:</strong></p> <p>South Australian Police have swiftly taken action, announcing the arrest of a 22-year-old man and a 27-year-old woman from Thebarton in connection with the crime. The arrests took place in Torrensville, where the suspects were apprehended on Tuesday evenin. The charges laid against the pair include not only murder but also aggravated serious criminal trespass and committing theft using force.</p> <p>Police have indicated that the investigation is progressing, with detectives diligently working on the case. Authorities have reassured the public that no additional suspects are being sought in connection with Dr Yung's alleged murder. Furthermore, there appears to be no discernible link between the arrested individuals and those sought in connection with a recent crime spree across Adelaide, providing a measure of relief to residents.</p> <p>While the Adelaide Major Crime Unit continues to work on the case, authorities are urging anyone with further information or dashcam footage from the vicinity to come forward.</p> <p><em>Images: SA Police / Adelaide Women’s and Children’s Hospital</em></p>

Caring

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Prominent Aussie doctor fighting for life after violent home invasion

<p>Dr. Michael Yung, a distinguished 61-year-old Adelaide doctor and former head of the intensive care unit at Adelaide Women’s and Children’s Hospital, is fighting for his life following a brutal home invasion early on Monday morning.</p> <p>The assault, deemed "life-threatening" by South Australia Police, unfolded within the confines of Dr Yung's opulent $2 million residence on James Street, Gilberton, at approximately 4:20am. Transpiring in one of the city's most affluent suburbs, the incident has been elevated to the status of a "major crime", prompting an expansive manhunt.</p> <p>Upon the arrival of emergency services, Dr Yung, suffering from severe injuries, was promptly transported to the Royal Adelaide Hospital, where he currently remains in critical condition.</p> <p>A comprehensive investigative effort is underway, involving Major Crime Detectives, Eastern District Detectives and patrol officers. Specialised forensic officers have diligently combed through the crime scene, with their efforts extending well into the night.</p> <p>Despite the intensive search, no suspects have been apprehended. Authorities suspect the involvement of multiple offenders, though the investigation is still in its early stages. Officers are actively pursuing leads and appealing to the public for assistance, requesting dashcam footage recorded between 3:30am and 5am on Monday in the vicinity of James Street and Nottage Terrace at Gilberton.</p> <p>CCTV footage has been secured, revealing a group of youths attempting a break-in at a nearby residence in Medindie hours before the assault on Dr Yung. Residents in the area have recently experienced a series of break-ins, although it remains uncertain if this incident is linked to other offences.</p> <p>Dr Yung's 30-year-old son emerged unscathed from the ordeal and is being treated as a witness, not a suspect, by detectives. Additional family members, including his second son, are reportedly en route from interstate to stand vigil by Dr Yung's bedside.</p> <p>This tragedy compounds the family's grief, as it follows the sudden death of Dr Yung's wife, Kathryn Browne-Yung, in March 2020. The wider medical community, as well as the Women’s and Children’s Hospital and SA Health family, are extremely distressed by the attack.</p> <p>SA Health Minister Chris Picton expressed the gravity of the situation, stating, "Dr Michael Yung has been there for so many South Australian children and families at their darkest times – now it is time for all of us to be there for him and his family."</p> <p><em>Images: SA Police / Adelaide Women’s and Children’s Hospital</em></p>

Legal

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No, antibiotics aren’t always needed. Here’s how GPs can avoid overprescribing

<p><em><a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>The growth in antibiotic resistance threatens to return the world to the pre-antibiotic era – with deaths from now-treatable infections, and some elective surgery being restricted because of the risks of infection.</p> <p>Antibiotic resistance is a major problem worldwide and should be the concern of everyone, including you.</p> <p>We need to develop new antibiotics that can fight the resistant bacteria or antibiotics that bacteria would not be quickly resistant to. This is like finding new weapons to help the immune system fight the bacteria.</p> <p>More importantly, we need to use our current antibiotics – our existing weapons against the bacteria – more wisely.</p> <h2>Giving GPs the tools to say no</h2> <p>In 2022, more than <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one-third of Australians</a> had least one antibiotic prescription, with <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/analysis-2015-2022-pbs-and-rpbs-antimicrobial-dispensing-data">88%</a> of antibiotics prescribed by GPs.</p> <p>Many people <a href="https://pubmed.ncbi.nlm.nih.gov/28289114/">mistakenly think</a> antibiotics are necessary for treating any infection and that infections won’t improve unless treated with antibiotics. This misconception is found in studies involving patients with various conditions, including respiratory infections and conjunctivitis.</p> <p>In reality, not all infections require antibiotics, and this belief drives patients requesting antibiotics from GPs.</p> <p>Other times, GPs give antibiotics because they think patients want them, even when they might not be necessary. Although, in reality they are <a href="https://pubmed.ncbi.nlm.nih.gov/17148626/">after symptom relief</a>.</p> <p>For GPs, there are ways to target antibiotics for only when they are clearly needed, even with short appointments with patients perceived to want antibiotics. This includes:</p> <ul> <li> <p>using <a href="https://pubmed.ncbi.nlm.nih.gov/32357226/">decision guides</a> or tests to decide if antibiotics are really necessary</p> </li> <li> <p>giving <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">patients information sheets</a> when antibiotics aren’t needed</p> </li> <li> <p>giving a “<a href="https://pubmed.ncbi.nlm.nih.gov/33910882/">delayed prescription</a>” – only to be used after the patient waits to see if they get better on their own.</p> </li> </ul> <p>All these strategies need some <a href="https://www.nps.org.au/assets/NPS/pdf/NPS-MedicineWise-Economic-evaluation-report-Reducing-Antibiotic-Resistance-2012-17.pdf">training</a> and practice, but they can help GPs prescribe antibiotics more responsibly. GPs can also learn from each other and use tools like <a href="https://pubmed.ncbi.nlm.nih.gov/24474434/">posters</a> as reminders.</p> <p>To help with patients’ expectations, public campaigns have been run periodically to educate people about antibiotics. These campaigns <a href="https://pubmed.ncbi.nlm.nih.gov/35098267/">explain why</a> using antibiotics too much can be harmful and when it’s essential to take them.</p> <h2>Giving doctors feedback on their prescribing</h2> <p>National programs and interventions can help GPs use antibiotics more wisely</p> <p>One successful way they do this is by <a href="https://pubmed.ncbi.nlm.nih.gov/34356788/">giving GPs feedback</a> about how they prescribe antibiotics. This works better when it’s provided by organisations that GPs trust, it happens more than once and clear goals are set for improvement.</p> <p>The NPS (formerly National Prescribing Service) MedicineWise program, for example, had been giving feedback to GPs on how their antibiotic prescriptions compared to others. This reduced the number of antibiotics prescribed.</p> <p>However, <a href="https://australianprescriber.tg.org.au/articles/the-end-of-nps-medicinewise.html">NPS no longer exists</a>.</p> <p>In 2017, the Australian health department did something similar by sending <a href="https://behaviouraleconomics.pmc.gov.au/projects/nudge-vs-superbugs-behavioural-economics-trial-reduce-overprescribing-antibiotics">feedback letters</a>, randomly using different formats, to the GPs who prescribed the most antibiotics, showing them how they were prescribing compared to others.</p> <p>The most effective letter, which used pictures to show this comparison, reduced the number of antibiotics GPs prescribed by <a href="https://behaviouraleconomics.pmc.gov.au/sites/default/files/projects/nudge-vs-superbugs-12-months-on-report.pdf">9% in a year</a>.</p> <h2>Clearer rules and regulations</h2> <p>Rules and regulations are crucial in the fight against antibiotic resistance.</p> <p>Before April 2020, many GPs’ computer systems made it easy to get multiple repeat prescriptions for the same condition, which could encourage their overuse.</p> <p>However, in April 2020, the Pharmaceutical Benefits Scheme (PBS) <a href="https://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/psd/2019-08/antibiotic-repeats-on-the-pharmaceutical-benefits-scheme">changed the rules</a> to ensure GPs had to think more carefully about whether patients actually needed repeat antibiotics. This meant the amount of medicine prescribed better matched the days it was needed for.</p> <p>Other regulations or policy targets could include:</p> <ul> <li> <p>ensuring all GPs have access to antibiotic prescribing guidelines, such as <a href="https://www.tg.org.au/">Therapeutic Guidelines</a>, which is well accepted and widely available in Australia</p> </li> <li> <p>ensuring GPs are only prescribing antibiotics when needed. Many of the conditions antibiotics are currently prescribed for (such as sore throat, cough and middle ear infections) are self-limiting, meaning they will get better without antibiotics</p> </li> <li> <p>encouraging GP working with antibiotics manufacturers to align pack sizes to the recommended treatment duration. The recommended first-line treatments for uncomplicated urinary tract infections in non-pregnant women, for example, are either three days of trimethoprim 300 mg per night or five days of nitrofurantoin 100 mg every six hours. However, the packs contain enough for seven days. This can mean patients take it for longer or use leftovers later.</p> </li> </ul> <h2>Australia lags behind Sweden</h2> <p>Australia has some good strategies for antibiotic prescribing, but we have not had a sustained long-term plan to ensure wise use.</p> <p>Although Australian GPs have been doing well in <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/aura-2021">reducing antibiotic prescribing</a> since 2015, <a href="https://pubmed.ncbi.nlm.nih.gov/35098269/">more</a> could be done.</p> <p>In the 1990s, Sweden’s antibiotic use was similar to Australia’s, but is now less than half. For more than two decades, Sweden has had a national strategy that reduces antibiotic use by about <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677604/">7% annually</a>.</p> <p>It is vital Australia invests in a similar long-term national strategy – to have a centrally funded program, but with regional groups working on the implementation. This could be funded directly by the Commonwealth Department of Health and Ageing, or with earmarked funds via another body such as the Australian Centre for Disease Control.</p> <p>In the meantime, individual GPs can do their part to prescribe antibiotics better, and patients can join the national effort to combat antibiotic resistance by asking their GP: “what would happen if I don’t take an antibiotic?”.<!-- 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><em><a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, Assistant Professor of Public Health, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/no-antibiotics-arent-always-needed-heres-how-gps-can-avoid-overprescribing-213981">original article</a>.</em></p>

Caring

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Why a familiar face made Adele break down on stage

<p dir="ltr">Adele has broken down during an emotional show in Las Vegas, after she locked eyes with a special audience member. </p> <p dir="ltr">The British songstress was performing at her residency show with a special Halloween show when she spotted a familiar face in the crowd.</p> <p dir="ltr">While dressed as Morticia from the Addams Family for the spooky-themed concert, Adele began to perform her hit song <em>When We Were Young</em> from her award-winning album <em>25</em>. </p> <p dir="ltr">She suddenly burst into tears and ran into the audience, as she spotted the doctor who delivered her son Angelo ten years ago. </p> <p dir="ltr">Adele could be seen mouthing “Shut up!” in between lines of the heartbreaking ballad, as she couldn't believe what she was seeing.</p> <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-permalink="https://www.instagram.com/reel/Cy_HGsFrr7Q/?utm_source=ig_embed&amp;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/reel/Cy_HGsFrr7Q/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by 𝒜𝒹𝑒𝓁𝑒 𝐿𝒶𝓊𝓇𝒾𝑒 𝐵𝓁𝓊𝑒 𝒜𝒹𝓀𝒾𝓃𝓈 (@thirtyfreeadele)</a></p> </div> </blockquote> <p dir="ltr">“Oh my god, Colin! Oh my god! This is my doctor that gave birth to my baby!”</p> <p dir="ltr">“I haven't seen you for years!” she exclaimed, as she paused the song and ran up into the audience.</p> <p dir="ltr">As Adele caught up with her long-lost friend, the tune continued playing in the background. </p> <p dir="ltr">The singer apologised to her fans as she was caught up in the emotional moment.</p> <p dir="ltr">“Sorry!” she said to the crowd. “Will you sing it for me? That man delivered my baby!”</p> <p dir="ltr">Fans on Twitter rushed to praise the touching moment and Adele's sweet gesture to the doctor. </p> <p dir="ltr">One said, “This is so heartwarming,” while another added, “That's just the coolest thing ever!”</p> <p dir="ltr"><em>Image credits: Instagram</em></p>

Music

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All the reasons you might be having night sweats – and when to see a doctor

<p><em><a href="https://theconversation.com/profiles/siobhan-banks-18473">Siobhan Banks</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/linda-grosser-1461631">Linda Grosser</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>You’ve finished a workout, so you’re hot and drenched with perspiration – but soon you begin to feel cool again. Later, it’s a sweltering summer evening and you’re finding it hard to sleep, so you kick off the covers.</p> <p>Sweating is a normal part of the body’s cooling system, helping to release heat and maintain optimal body temperature. But regularly waking up during the night, soaked through from excessive sweating is not.</p> <p>Night sweats are <a href="https://www.mayoclinic.org/symptoms/night-sweats/basics/definition/sym-20050768">repeated episodes</a> of excessive or intense sweating at night. They are an unpleasant part of life for many people.</p> <p>Many conditions and factors can trigger night sweats by changing the body’s tightly regulated temperature set point, at which the body attempts to maintain its <a href="https://www.tandfonline.com/doi/full/10.4161/temp.29702">core temperature</a>. Some triggers are harmless (a hot bedroom) or even related to positive lifestyle changes (exercise). Others have an underlying cause like menopause, infection, disease or medication.</p> <h2>Temperature control and sweating</h2> <p>The hypothalamus, located in the brain, is part of the <a href="https://www.hormones-australia.org.au/the-endocrine-system/">endocrine system</a> and the temperature control centre for the body. It contains <a href="https://www.statpearls.com/point-of-care/29920#ref_19631766">temperature sensors</a> that receive information from nerve cells (thermoreceptors) located centrally (in the organs) and peripherally in the skin.</p> <p>Thermoreceptors detect changes in body temperature, sending signals back to the hypothalamus. These <a href="https://www.sciencedirect.com/science/article/pii/S1876034111000256">signals</a> will either activate sweating to cool the body or shivering to warm the body.</p> <h2>Hormones and night sweats</h2> <p>Anyone, regardless of age or gender, can experience night sweats. But women experience night sweats more often than men, largely because menopause and associated changing hormone levels are <a href="https://www.tandfonline.com/doi/abs/10.3109/13697137.2011.608596">a leading cause</a>.</p> <p>Approximately 80% of women experience <a href="https://link.springer.com/article/10.1007/s00737-007-0209-5">hot flashes</a> (also called hot flushes) or night sweats after <a href="https://www.menopause.org.au/hp/information-sheets/what-is-menopause">menopause</a> (when periods have ceased for 12 months) and during <a href="https://www.healthdirect.gov.au/perimenopause">perimenopause</a> (the time leading up to it).</p> <p>While both hot flashes and night sweats produce a feeling of overheating, they are different experiences associated with menopause. Hot flashes occur during the day, are transient episodes of flushing and may involve sweating. Night sweats occur at night and involve an intense period of <a href="https://www.proquest.com/docview/2821423865?accountid=14649">sweating</a>. Changing oestrogen levels are thought to impact norepinephrine and serotonin levels, two neurotransmitters that influence <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/#:%7E:text=%5B21%5D%20Estrogens%20stimulate%20the%20production,norepinephrine%20which%20disturbs%20hypothalamic%20thermostat">temperature regulation</a> in the hypothalamus.</p> <p>Hormones also influence night sweats in men, particularly those with low <a href="https://www.healthdirect.gov.au/testosterone">testosterone</a> levels, known as <a href="https://www.hormones-australia.org.au/endocrine-diseases/hypogonadism/">hypogonadism</a>. Around 38% of men aged 45 years or older have low testosterone <a href="https://www.scielo.br/j/ibju/a/RZqqfTn5tY6BFpV6rp3GMxJ/">levels</a> but it can affect men at any age.</p> <h2>Infections, disease and medications</h2> <p>When fighting infection, our body temperature often <a href="https://europepmc.org/article/nbk/nbk562334">rises</a>. This can stimulate sweating to cool and decrease body <a href="https://www.sciencedirect.com/science/article/pii/S1876034111000256">temperature</a>.</p> <p>Minor infections like the common cold can cause night sweats. They are also a symptom of serious infections such as human immunodeficiency virus (HIV) and diseases such as <a href="https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html">Hodgkin’s</a> and <a href="https://link.springer.com/article/10.2165/00002018-200831020-00002">non-Hodgkin’s lymphoma</a>. However, night sweats are rarely the only symptom present.</p> <p>Medications such as selective serotonin reuptake inhibitors (SSRIs), corticosteroids, thyroid hormone replacement and methadone can cause night sweats. These medications affect parts of the <a href="https://link.springer.com/article/10.2165/00002018-200831020-00002">brain</a> and neurotransmitters that control and stimulate sweating.</p> <p>Regular alcohol (particularly alcohol dependence) and recreational drug use can also <a href="https://link.springer.com/article/10.2165/00002018-200831020-00002">increase the risk</a> of night sweats.</p> <h2>Stress, snoring and strenuous exercise</h2> <p>Night sweats are commonly reported by people with <a href="https://karger.com/spp/article-abstract/26/2/92/295722/Psychological-Sweating-A-Systematic-Review-Focused?redirectedFrom=fulltext">anxiety</a>.</p> <p>Psychological stress activates the body’s fight or flight system releasing neurotransmitters that increase heart rate, respiration, and blood pressure. This causes the body to heat up, at which point it starts sweating to cool the body back down. Night sweats may also increase anxiety, causing more sweating which in turn leads to less sleep and more anxiety.</p> <p>If anxiety causes night sweats and this causes distress, it’s best to get up, move around and engage in a <a href="https://www.calmclinic.com/anxiety/symptoms/night-sweats">calming routine</a>, preferably in a dark or dimly lit room.</p> <p>Night sweats have similarly been connected with sleep disorders like <a href="https://www.healthdirect.gov.au/obstructive-sleep-apnoea">obstructive sleep apnoea</a>, where the airway is repeatedly blocked during sleep and there is loud snoring. About one third of people with obstructive sleep apnoea regularly <a href="https://link.springer.com/article/10.1007/s11325-011-0502-4">experience night sweats</a>. The exact cause is undetermined but research shows it is linked with low blood oxygen levels (<a href="https://link.springer.com/article/10.1007/s11325-022-02701-3">hypoxemia</a>) and/or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2869.2009.00743.x">high blood pressure</a>.</p> <p>People can experience night sweats after high-intensity workouts. Vigorous exercise can stimulate the thyroid, <a href="https://www.ncbi.nlm.nih.gov/books/NBK500006/#:%7E:text=Thyroid%20hormone%20increases%20the%20basal,respiration%20rate%2C%20and%20body%20temperature">increasing basal metabolic rate</a> and body temperature for up to <a href="https://journals.lww.com/acsm-msse/Fulltext/2011/09000/A_45_Minute_Vigorous_Exercise_Bout_Increases.6.aspx">14 hours post exercise</a>. So night sweats can occur even after a vigorous morning workout.</p> <p>Night sweats can indicate overtraining and/or under-fuelling. If not enough calories are consumed to support the increase in training, blood sugar could drop and you could experience <a href="https://www.aafp.org/pubs/afp/issues/2003/0301/p1019.pdf">hypoglycaemia</a>, which can cause night sweats.</p> <h2>When to seek help and 5 things to try</h2> <p>There are <a href="https://www.aafp.org/pubs/afp/issues/2020/1001/p427.html">numerous</a> health conditions and medications that can cause night sweats and interfere with sleep.</p> <p>If night sweats are regular, distressing, interfere with sleep or are accompanied by symptoms such as fatigue or weight loss (not related to lifestyle or diet changes) talk to a doctor to help determine the cause. They might suggest alternative medications to any you’re taking or recommend tests or investigations.</p> <p>In the meantime, you can try the following ideas:</p> <p><strong>1.</strong> sleep in a cool room and use a fan if needed</p> <p><strong>2.</strong> don’t overdress for bed. Wear breathable cotton or linen pyjamas</p> <p><strong>3.</strong> choose lightweight bedding you can kick off. Avoid synthetic fibres and flannel bedding</p> <p><strong>4.</strong> consider a cooling mattress or pillow and avoid those (such as foam ones) that can limit airflow</p> <p><strong>5.</strong> avoid spicy foods, caffeine or alcohol before bed.<!-- 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;" src="https://counter.theconversation.com/content/211436/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><a href="https://theconversation.com/profiles/siobhan-banks-18473"><em>Siobhan Banks</em></a><em>, Research professor, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/linda-grosser-1461631">Linda Grosser</a>, , <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/all-the-reasons-you-might-be-having-night-sweats-and-when-to-see-a-doctor-211436">original article</a>.</em></p>

Body

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Woman dies after being accused by doctors of faking symptoms

<p>A woman from New Zealand has passed away from a debilitating illness after being told by a doctor that her illness was “all in her head”.</p> <p>Stephanie Aston, 33, died after a long and public battle with Ehlers-Danlos Syndrome (EDS), a rare  genetic disorder affecting the body’s connective tissue, on September 1st. </p> <p>EDS, of which there are 13 different variants, is often referred to as an "invisible illness", as sufferers can often appear healthy despite experiencing excruciating symptoms, such as severe migraines, dislocating joints, easy bruising, abdominal pain, iron deficiency, fainting and an abnormally fast heart-rate.</p> <p>Aston said she was dismissed by a doctor in 2016, who dismissed her symptoms and told her that she was faking her disease. </p> <p>Despite being diagnosed with EDS by three different specialists, one doctor in Auckland, who Aston referred to as 'Doctor A', suggested she was not seriously unwell and indicated she was causing her illnesses, <em><a href="https://www.nzherald.co.nz/nz/stephanie-aston-death-eds-sufferers-call-for-change-after-doctors-accused-woman-of-faking-illness/VX4Q6CAWRVH25I6OCKGQ4KTW4M/">The NZ Herald</a></em> reports.</p> <p>Ehlers-Danlos Syndromes New Zealand founder Kelly McQuinlan said Stephanie's death has shocked the community, and said more needs to be done for those suffering with the debilitating condition. </p> <p>“A lot of people are feeling very lost,” she said.</p> <p>“I think most people in these rare positions or invisible illnesses, definitely experience setbacks and disbelieving because things can’t be seen but really the clinical symptoms are there that are being ignored.”</p> <p>Ms McQuinlan described Ms Aston as a “beacon” for those with the illness in a tribute to her on Facebook.</p> <p>“Most people in our community have experienced some form of sort of doctors not believing them or questioning their diagnosis which is extremely hard,” she wrote.</p> <p>“When they see someone in their community pass away, the first thing they think is ‘What if my care is not looked after? What’s going to happen to me?’.”</p> <p>“At the end of the day, if symptoms aren’t managed correctly, anyone can get sick enough that they will pass away.”</p> <p><em>Image credits: Facebook</em></p>

Caring

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

<p><em><a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, <a href="http://www.theconversation.com/">The Conversation</a></em></p> <p>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.</p> <p>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.</p> <p>“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>.</p> <p>By raising the issue of weight, Brumfitt says, GPs also risk turning patients off seeking care for other health concerns.</p> <p>So should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts.</p> <p><strong>Brett Montgomery - GP academic</strong></p> <p>Yes, sometimes – but with great care.</p> <p>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.</p> <p>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>.</p> <p>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.</p> <p>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&amp;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.</p> <p>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.</p> <p><strong>Emma Beckett - Nutrition scientist</strong></p> <p>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>).</p> <p>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.</p> <p>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.</p> <p>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>.</p> <p>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?</p> <p><strong>Liz Sturgiss - GP/researcher </strong></p> <p>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.</p> <p><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. </p> <p>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.</p> <p><strong>Nick Fuller - Obesity researcher </strong></p> <p>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.</p> <p>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>.</p> <p>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>.</p> <p>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.</p> <p><strong>Helen Truby - Nutrition scientist </strong></p> <p>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.</p> <p>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>.</p> <p>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.</p> <p>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></p> <p><em><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></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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>.</em></p>

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What happens when doctors don’t act as they should? And what’s the ruling against neurosurgeon Charlie Teo?

<p><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>After several years of controversy, and both praise and blame for his willingness to perform high-risk surgeries, neurosurgeon Charlie Teo has been subject to <a href="http://www.austlii.edu.au/cgi-bin/viewdoc/au/cases/nsw/NSWMPSC//2023/2.html">practice restrictions</a> by a special committee of the Medical Council of New South Wales.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Charlie Teo was fighting two complaints of unprofessional conduct from the families of two different women, who say they were not properly warned about the risk of death before consenting to surgery. <a href="https://t.co/gvhiQdWnRF">https://t.co/gvhiQdWnRF</a></p> <p>— ABC News (@abcnews) <a href="https://twitter.com/abcnews/status/1678952850238349312?ref_src=twsrc%5Etfw">July 12, 2023</a></p></blockquote> <p>So how does the process of restricting doctors’ medical practice work? And what did this mean for Teo?</p> <h2>How are health practitioners regulated in Australia?</h2> <p>Health practitioner regulators in Australia aren’t generally empowered to make <em>punitive</em> decisions about health professionals’ conduct.</p> <p>Instead, Australia’s health practitioner regulations (the so-called “national law”) require decision-makers to exercise their powers to <em>protect</em> patients. They operate in what is often called a “<a href="https://www.mcnsw.org.au/sites/default/files/case_note_-_legal_case_note_-_medical_council_v_lee_-_concerning_stay_applications.pdf">protective jurisdiction</a>”.</p> <p>And though the regulator may sometimes impose fines, it is rare. That’s because it may do so only <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2009-86a#sec.146C">when</a> it is “satisfied there is no other order, or combination of orders, that is appropriate in the public interest”.</p> <p>In all state <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2009-86a#sec.3A">versions</a> of the national law, regulators may <a href="https://www.legislation.qld.gov.au/view/html/inforce/current/act-2009-hprnlq#sec.3A">restrict doctors’ medical practices</a> only if it’s “necessary to ensure health services are provided safely and of an appropriate quality”.</p> <p>But the NSW national law includes additional wording. In all its decisions, the regulator <a href="https://legislation.nsw.gov.au/view/whole/html/inforce/current/act-2009-86a#sec.3A">must regard</a> the “health and safety of the public” as the “paramount consideration.”</p> <p>This can have unusual effects. As the <a href="https://www.ama.com.au/sites/default/files/2022-03/Ahpra---Regulatory-guide---a-full-guide.PDF">Australian Health Practitioners Regulation Agency (AHPRA)</a> acknowledges, requirements to protect the public may sometimes result in “a determination that is harsher on the practitioner than if punishment were the sole purpose”.</p> <h2>What happened in the Teo case?</h2> <p>In late 2022, proceedings commenced against Teo via two complaints by the New South Wales <a href="https://www.hccc.nsw.gov.au/">Health Care Complaints Commission</a> (HCCC).</p> <p>The complaints concerned two brain surgeries on two patients. Both involved “radical resections” (“en bloc” removals) of these patients’ brain tumours. Tragically, neither patient regained consciousness after the operations and both patients died – one just ten days after.</p> <p>In legal terms, the complaints were based on a provision of the national law that defines certain categories of wrongdoing as <a href="https://legislation.nsw.gov.au/view/whole/html/inforce/current/act-2009-86a#sec.139B">unsatisfactory professional conduct</a>.</p> <p>The HCCC alleged Teo had engaged in two categories of this wrongdoing: conduct below the standard reasonably expected of a doctor of his training and experience, and unethical conduct.</p> <p>The HCCC alleged Teo’s decisions to operate were inappropriate and substandard because the risks of “neurological morbidity” (so-called brain death) outweighed the (potential) benefits of the interventions. There was no allegation that Teo’s surgical skills were substandard.</p> <p>The surgeries were also unethical, it was alleged, as informed consent had not been obtained from the patients and one patient was required to pay an expensive upfront fee in circumstances of clear vulnerability.</p> <h2>What were the findings and consequences for Teo?</h2> <p>The HCCC Professional Standards Committee, made up of an experienced judge, two expert neurosurgeons and a lay member, applied the civil standard of proof – the balance of probabilities – to the evidence. Though the committee is not legally bound to <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2009-86a#sch.5D-sec.2">apply the rules of evidence</a> applied in criminal courts, it decided, broadly for procedural fairness reasons, to receive and consider all of Teo’s unchallenged evidence.</p> <p>In a decision of more than 100 pages, the committee found Teo guilty of unsatisfactory professional conduct. It determined to “reprimand” Teo (this means a <a href="https://www.medicalboard.gov.au/sitecore/content/Home/Registration/Monitoring-and-compliance/Removal-of-reprimands.aspx">record of “reprimand” is</a> noted on the public copy of his practitioner licence) and to impose four conditions on his practice.</p> <p>Three conditions involve increased oversight of his practice records. But a more restrictive condition will require Teo to obtain written support from a neurosurgeon approved by the Medical Council of New South Wales for any neurosurgery involving “recurring malignant tumours in the brain or brain stem”.</p> <p>While this order was hotly contested in the proceedings, the committee determined that, for reasons including Teo’s evidenced “isolation from his peers”, the condition was “necessary to protect the health and safety of the public”.</p> <h2>What about patient autonomy or clinical freedom?</h2> <p>Difficult ethical questions arise in medical regulation. Here, the committee had to balance the practitioner’s right to practise medicine against the paramount consideration of patient health and safety and against the patient’s right to exercise autonomy.</p> <p>This last right is sometimes seen as a patient’s <a href="https://jme.bmj.com/content/40/5/293">moral right to be wrong</a>. On these considerations, the committee relied on accepted evidence from ethical experts that proposed that, as a matter of ethics, "a surgeon does not have a licence to undertake any conceivable procedure even with the agreement or acquiescence of the patient."</p> <h2>Is medical regulation strict in Australia and NSW?</h2> <p>Many <a href="https://www.ahpra.gov.au/News/2016-08-10-Independent-review-on-chaperoning.aspx">reviews</a> and <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3668054">academic</a> <a href="https://pubmed.ncbi.nlm.nih.gov/34907681/">studies</a> find the national law to be fair and appropriate, or not strict enough.</p> <p>However, some scholars and representative groups including the Australian Medical Association (AMA) find some aspects <a href="https://www.ama.com.au/ama-rounds/16-july-2021/articles/upholding-natural-justice-doctors">are</a> too <a href="https://www.ama.com.au/media/law-change-threatens-doctors-hard-earned-reputations-and-risks-their-mental-health">strict</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/36763016/">unsympathetic</a> to practitioners.</p> <p>But a potted history of NSW medical history showcases how successive medical scandals have tended to drive strong regulatory reform. In 1984, when the tragic impacts of the shocking and unethical treatment at <a href="https://piac.asn.au/legal-help/public-interest-cases/deep-sleep-tragedy/">Chelmsford psychiatric hospital</a> were <a href="http://www5.austlii.edu.au/au/journals/ALRCRefJl/1988/77.pdf">coming to light</a>, NSW was the first jurisdiction globally to establish a complaints body for health consumers. Known as the Complaints Unit, this body is now the HCCC.</p> <p>Another milestone occurred in the early 2000s following several scandals, including the so-called “Butcher of Bega” episode. An <a href="https://www.parliament.nsw.gov.au/ladocs/inquiries/2112/Final%20Report%20on%20Graeme%20Reeves.pdf">inquiry</a> into these events prompted the NSW government to introduce laws permitting medical practitioners to be immediately suspended if the regulator considered it was in the “public interest”.</p> <p>This was the first power of its kind in Australia and was only adopted into the broader national law of other states in <a href="https://doi.org/10.1071/AH19293">2018</a>.</p> <h2>What next for Teo?</h2> <p>Teo may appeal the orders of the committee to the NSW Civil and Administrative Tribunal or seek a review of the conditions. But as the conditions are not subject to an end date, it appears they will otherwise continue indefinitely.<!-- 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;" src="https://counter.theconversation.com/content/209612/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><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Instagram</em></p> <p><em>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-happens-when-doctors-dont-act-as-they-should-and-whats-the-ruling-against-neurosurgeon-charlie-teo-209612">original article</a>.</em></p>

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Doctor debunks air fryer myth

<p>Air fryers have become somewhat of a commodity in many kitchens worldwide, with them rising in popularity over the past few years, so news that they could be damaging to our health may cause quite a stir.</p> <p>However, similar to how uncredited information seems to circle the internet, a doctor has told viewers not to take the latest warnings over “toxic” air fryers too seriously.</p> <p>One online user posted a TikTok claiming they had found out "air fryers were toxic because of the material used”, so UK doctor Karan Raj decided to weigh in on the matter.</p> <p>"The biggest worry from fear mongers centres around the non-stick materials used, also known as forever chemicals,” he said in a clip that’s since raked in over a million views.</p> <p>"Forever chemicals” earned the name because they don’t break down in the environment or in our bodies. Also known as PFAS, they are resistant to water, grease, and heat and are found in a number of everyday products such as food packaging, cosmetics, clothing and toilet paper.</p> <p>"Fun fact, every time you sit down to eat microplastics fall from the air and land in your food, or are already part of your food," he explained.</p> <p>The issue of “toxic” chemicals leeching into your food from cooking in an air fryer "is only really an issue if the air fryer is damaged,” Dr Raj added.</p> <p>It is recommended to minimise how much damage and scratching there is to the non-stick coating of the fryer so the chemicals don’t get into your food.</p> <p>"Clean it safely, avoid using abrasive scrubbing tools, use wood or silicone utensils and use liners," he said.</p> <p>"And if you're really worried about the non-stick coating, you can use a ceramic or stainless steel air fryer.”</p> <p>People in the comments thanked him for the explanation. " Some people will trust anyone EXCEPT actual Doctors,” one user teased.</p> <p>Dr Raj went on to ask his followers what their favourite meal to cook in an air fryer was, adding, "Air fried chips just taste special".</p> <p><em>Image credit: TikTok</em></p>

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5 ways alcohol can sabotage your weight loss goals, according to an obesity doctor

<p><strong>Alcohol and weight loss </strong></p> <p>“Hey Siri, can I still lose weight if I drink alcohol?” Goodness, we only wish the answer was that simple. Research is mixed (no pun intended) on whether alcohol can lead to weight gain. That’s because weight is complex – and some people notice a shift on the scale when they consume alcohol, while others don’t.</p> <p>As a doctor who specialises in the science of weight, I can say what we do know is that many of these alcoholic drinks are energy-dense (meaning high in kilojoules) and provide little to no nutrition, which may put a damper on your weight loss efforts. Here are five major reasons alcohol can impede you weight loss efforts.</p> <p><strong>Your body views alcohol as a toxin</strong></p> <p>Your body metabolises and eliminates alcohol from the body with the help of two enzymes: Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). When you imbibe, these two work together to break apart the alcohol molecules, producing a toxic substance, acetaldehyde, then acetate, so that your body can get rid of it – and fast.</p> <p>Here’s why that matters when you’re trying to lose weight. Since your body prioritises alcohol digestion, it puts digestion of other nutrients (like fat, carbs, and protein) on the back burner. In other words, your body might put off metabolising fat and carbs when it’s busy breaking down alcohol. Over time and repeated patterns, this could lead to increased fat storage and weight gain.</p> <p><strong>Alcohol can cause inflammation</strong></p> <p>Alcohol can impair the functions of the gut, liver, and other organs – interfering with the immune system and causing systemic inflammation. Alcohol consumption stimulates a cascade of inflammatory responses, one of which is the release of cortisol, the stress hormone. And research has shown that persistently high levels of cortisol are associated with obesity. That’s why it’s best for people with obesity, who are already at an increased risk of inflammation, to limit or avoid alcohol.</p> <p><strong>Alcohol affects sleep - and sleep impacts weight </strong></p> <p>It may seem like that nightcap helps you fall asleep, but alcohol can actually disrupt how well you snooze. One study, which looked at participants’ heart rates and ability to relax during sleep, showed that even small amounts (0.25 grams per kilogram or less) of alcohol decreased those markers of quality of sleep by 9.3%.</p> <p>And the more you drink, the worse you sleep – the same study linked moderate drinking to a 24% decrease in sleep quality, and heavy drinking to a 39.2% decrease in sleep quality.</p> <p>You may think a few nights of low-quality shut-eye is harmless, but research has shown that just one to three nights of poor sleep can lead to insulin resistance. Over time, that could put you at risk of obesity.</p> <p><strong>Alcohol is often full of sneaky of sneaky kilojoules and sugar</strong></p> <p>Many mixed drinks, tasty as they might be, contain added kilojoules and sugar on top of the naturally occurring sugars and kilojoules in alcohol.</p> <p>Even a so-called “lower-kilojoule” option, like a vodka tonic, can have as many kilojoules and grams of sugar as a serving of ice cream. Before you know it, your 30ml serving of vodka just jumped from 280 kilojoules to 700 kilojoules when you add 200ml of tonic. Have a few of those, and you’re looking at upwards of 2000 or more kilojoules on liquid alone – kilojoules that don’t provide your body with the best nutrition.</p> <p>Let’s compare these 2000 kilojoules in a few vodka tonics to a 2000-kilojoule meal of salmon, brown rice, and steamed veggies. The drinks are empty kilojoules, whereas the meal has fat, fibre and protein to keep you fuller and satisfied for longer – a win-win while trying to lose weight – while also providing high-quality nourishment.</p> <p><strong>Drinking impacts food choices</strong></p> <p>Have you ever noticed after drinking alcohol, you get a sudden hankering for a fast food run or pizza delivery? That’s because alcohol can impair decision-making and lead to impulse decisions when it comes to food – and research suggests it may even stimulate the appetite. Those who drink alcohol with a meal also tend to eat more – 30% more, according to one study.</p> <p>While alcohol won’t impact everyone’s weight the same way, it’s best to be mindful of how much you drink when trying to lose weight. Consider skipping it altogether or aim for moderation. Just know that even if you follow the limit for moderate drinking as recommended in the Australian Alcohol Guidelines by the National Health and Medical Research Council (NHMRC) —no more than 10 standard drinks a week and no more than 4 standard drinks on any one day – it still adds up over time. Several studies have shown that the risk of obesity is roughly two times higher in adults who consume alcohol than in those who don’t.</p> <p>Considering mocktails (non-alcoholic beverages) are popping up on more and more bar menus these days, rest assured your after-work social hour will still be filled with cheers. Just be sure to opt for a lower-kilojoule option, such as soda water with a squeeze of fresh lime or a craft mocktail with half the amount of simple syrup.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/diet/5-ways-alcohol-can-sabotage-your-weight-loss-goals-according-to-an-obesity-doctor" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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Longevity doctor shares secret to a long life

<p dir="ltr">A doctor who specialises in the science of longevity has shared his secret for living longer, and it's much more simple than you would think. </p> <p dir="ltr">Dr Peter Attia, a U.S.-Canadian physician, says exercising for just three hours a week is not only essential for a healthy lifestyle, but can reduce your chances of an early death by 50 per cent.</p> <p dir="ltr">“Exercising is the most underutilised change we can make to affect the length and quality of our life,” Dr Attia said.</p> <p dir="ltr">He encouraged everyone to include both strength training and cardiovascular fitness into regular exercise routines, and to eat enough protein in a balanced diet. </p> <p dir="ltr">“You want to make sure you're covering all your bases and that means both lifting weights, because strength is one of the most highly associated features with longevity, but also doing cardiorespiratory fitness,” he told the Sunrise breakfast show. </p> <p dir="ltr">Dr Attia believes that, in simple terms, if you're starting from zero, exercising for just 30 minutes a day, six days a week, can half your death rate.</p> <p dir="ltr">However, he said the “right” amount of exercise a person should be doing per week is dependent on an individuals’ level of fitness.</p> <p dir="ltr">While Dr Attia shared the physical benefits of regular exercise, he also reiterated how important daily movement is for mental health. </p> <p dir="ltr">“What we know is exercise is the single biggest elixir for brain health. And it's amazing how much more powerful it appears to be than nutrition, even sleep. And those things are very important, but exercise is on a league of its own,” he said.</p> <p dir="ltr">“I thought there had to be something more powerful. But as important as sleep [and] nutrition are, exercise kind of takes the cake.”</p> <p dir="ltr"><em>Image credits: Instagram</em></p>

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