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Body language specialist gives her take on Fab Four

A body language expert has shared what she believes was happening for Prince William, Kate, Harry and Meghan during Wednesday’s lying-in-state ceremony for Queen Elizabeth II. Body language and connection specialist Katia Loisel told 7News that William and Kate seemed “highly distressed” and “struggling to hold it together” during the procession at Westminster Hall, pointing to their lowered heads, furrowed brows and tension in the neck and mouth as indicators. “The more pronounced the lip compression, as is the case with Prince William - his lips pressed together, rolling inwards until they have completely disappeared - indicate extreme levels of discomfort and stress,” she said. Meanwhile, Harry and Meghan holding hands - which is a break with formality - was a sign they had a “desire to connect and be close to one another”. One photo where William and Kate looked forlorn and Harry and Meghan were behind them looking at each other offered an “interesting non-verbal perspective” on the difference between the couples according to Loisel. “Prince Harry and Meghan use both contact tie signs, such as holding hands, and non-contact tie signs, such as postural echoing, their bodies orientated inwards towards one another, and mutual gaze in a mutual display of support and reassurance,” she said. “Prince Harry and Meghan use both contact tie signs, such as holding hands, and non-contact tie signs, such as postural echoing, their bodies orientated inwards towards one another, and mutual gaze in a mutual display of support and reassurance.” Loisel added that the couples’ differences were more evident in moments where William and Kate stood apart while Harry and Meghan held hands. She explained that the separation between the newly-appointed Prince and Princess of Wales was “reflective of their roles and the seriousness of the occasion”. The expert noted Kate’s downcast eyes, lack of facial muscle tones, slightly compressed lips, swallowing and rapid blinking, which she said suggested the royal was “on the verge of tears”. William shared a similar expression, reflected in the tightness of his eyebrows, droopy upper lids, compressed lips and lowered corners of his mouth. After Harry and Meghan kept a “more formal distance” during the ceremony, Loisel said their move to join hands showed they were “non-verbally seeking each other out” in an attempt to reduce stress and share “support and reassurance” with each other. Loisel noted that the former prince was more visibly relaxed upon reconnecting with his wife, after exhibiting signs of being visibly in distress, including a heightened blink rate, lowered head, shifting weight, swaying, lip licking, swallowing, and use of pacifying gestures. She also commented on a now-viral clip of the two couples greeting fans outside Windsor Castle, where Kate flashed a stern look at her sister-in-law. <blockquote class="twitter-tweet"> One day satan going to deal with Kate Middleton. This woman hates Meghan and had be pulled into being in the same space <a href="https://t.co/iooEBItfeg">pic.twitter.com/iooEBItfeg</a> — Thando - Ntsikasaunty (@ntsikasaunty) <a href="https://twitter.com/ntsikasaunty/status/1568722440003387394?ref_src=twsrc%5Etfw">September 10, 2022</a></blockquote> Loisel said the interaction would undoubtedly have affected Meghan’s self-confidence, noting that she appeared uneasy during her public appearance with her husband, William and Kate. “Quite unlike the confident Meghan we know, Meghan appeared ill at ease during this encounter, which is not surprising given the recent criticism that she has faced,” she told <a href="https://7news.com.au/entertainment/royal-family/body-language-expert-decodes-kates-icy-stare-moment-c-8239742?fbclid=IwAR2SazRZ293BYA3FNmIKZiVNdaFIBQidZAZNM6RRnYh5OJDph05onMqggH8" target="_blank" rel="noopener">Seven News</a>. She added that Wiliam appeared to make an effort with Meghan, but claimed Kate was acting as though she was trying to “freeze out” Meghan. “On numerous occasions Meghan looked over at Kate, however, the gaze wasn't reciprocated,” Loisel said, going on to say Kate chose to “look through” Meghan instead. “Meghan's hand lifted hesitantly as if to wave, but stopped mid-air, rather pausing to adjust her hair, her head and gaze lowered, before looking up and giving a quick wave, her arm coming back to rest in front of her body in a partial arm barrier,” Katia added, pointing out that Harry seemed to notice, touching her arm gently and coming to her side to protect her. The group outing marked the first time all four have been spotted together in public since Commonwealth Day in 2020, just weeks before COVID-19 lockdowns were first introduced. Once dubbed the “fab four”, the royals were greeted with applause from the public as they walked along the gates of Windsor Castle. During the rest of the walk, believed to have lasted around 30 minutes, the couples appeared to remain separate and barely interact with each other. During certain points of the walk, all four split up to greet and speak with members of the public individually. Images: Getty Images

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Why seeing private specialists often costs more than you bargained for

Around <a href="http://www.apra.gov.au/Pages/phiac-redirect.aspx">half of Australians have</a> private health insurance. Most of us know that if we need to see a private specialist, we may face some out-of-pocket fees between what the doctor charges and the rebate we receive from Medicare and, if we’re having a procedure or operation, our private health fund. But why is it so difficult to find out exactly how much it’s going to cost to have that suspicious mole removed or to be admitted to hospital for that colonoscopy or hip replacement? Outside of public hospitals, most clinical health services are essentially private markets. The Commonwealth government, through Medicare, provides a variety of subsidies to reduce the cost burden on patients but does not regulate prices. Doctors can charge what they like – or what the market will bear. Patients can learn their local GP’s fees relatively quickly and make informed choices about whether to switch practices. Our <a href="https://www.melbourneinstitute.com/downloads/working_paper_series/wp2013n23.pdf">recent research</a> suggests GP practices facing strong local competition were more likely to keep their prices low. But specialist prices are more obscure. Patients often rely on their GP to make the choice of specialist for them through the referral process, with little or no discussion of prices. And patients see specialists less frequently than GPs, so they don’t have the opportunity to learn about prices through repeated use. There is a simple way of increasing price transparency so we all know how much services cost at alternative providers: make this a requirement for all specialists and publish the data on a government website such as the <a href="http://www.myhospitals.gov.au/">My Hospitals</a> portal. Specialist consultations Prices for specialists are high, with only <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/34A89144DB4185EDCA257BF0001AFE29/%24File/MBS%20Statistics%20Financial%20Year%202014-15%20external%2020150714.pdf">around 30%</a> of consultations bulk-billed and an average out-of-pocket cost of A$65.73 (for those not bulk-billed). The size of out-of-pocket costs may be influenced by the <a href="http://www.amawa.com.au/wp-content/uploads/2015/10/AMA-Fees-List-Nov-15.pdf">list of recommended fees</a>published annually by the Australian Medical Association. The AMA-listed fee for initial specialist consultations is A$166, almost twice the Medicare Benefits Schedule (MBS) fee of A$85.55. For initial consultations with consultants, the listed fee is A$315, more than twice the MBS schedule fee of A$150.90. <a href="http://onlinelibrary.wiley.com/doi/10.1002/hec.3317/epdf">Recently published research</a> by health economists at the University of Technology Sydney confirms that many specialists practise “price discrimination” – they charge higher prices to patients who can afford to pay more. This is often seen as an indicator of a lack of competition in an industry. Specialists are less price-competitive because of the high barriers to entry into these professions. This leads to long waiting lists for consultations as well as high prices. <a href="https://www.hwa.gov.au/sites/uploads/HW2025_V3_FinalReport20121109.pdf">Health Workforce Australia</a> has identified psychiatry, obstetrics and gynaecology among important specialities with a current shortage that are likely to be under-supplied in the future. Causes include a lack of specialist training places, long training programs and falling working hours. Procedures and surgery Most patients who have private in-hospital elective procedures have health insurance that pays their hospital costs, subject to an excess on the insurance policy. But doctors’ fees are more complicated. Doctors’ fees for such procedures are funded by Medicare with a “gap” payment, often reimbursed by private health insurance. Medicare will fund 75% of the “schedule fee”, with private health insurance usually funding the other 25%. But Medicare <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/34A89144DB4185EDCA257BF0001AFE29/%24File/MBS%20Statistics%20Financial%20Year%202014-15%20external%2020150714.pdf">data shows</a> only 13% of anaesthetics services and 47% of operations services (mainly the surgeons’ fees) are charged at the schedule fee. This leads to an average patient contribution of A$76 for operations and A$126 for anaesthetics. This may be funded by private health in some cases, but not all. Often this will depend on the agreements reached between private health insurance companies, doctors and private hospitals. Patients may be left in the dark about their final out-of-pocket costs until months after any private hospital procedure. These delays are caused by the fragmentation of the billing process: an operation or procedure often involves several doctors, such as a surgeon, anaesthetist, pathologists and radiologists. So what’s the solution? Health insurer Bupa has introduced <a href="http://www.independent.co.uk/news/business/news/bupa-offers-fixed-fee-surgery-as-uk-profits-take-turn-for-the-worse-8531854.html">fixed-price surgery</a> in the United Kingdom to reduce the “bill shock” associated with private elective procedures. Such a development would be welcome in Australia. But the motivation is lower here due to the high take-up of private health insurance. We rely on insurance companies to do the bargaining with hospitals and doctors for us. Price-transparency regulation has a lot of potential to reduce the hip-pocket impact on Australian patients. Specialists should be forced to publish a list of their fees online, which GPs can use, together with patients, when making referral decisions. This should put pressure on specialists to think twice about increasing their fees. Liberal MP Angus Taylor, now assistant minister for cities and digital transformation, <a href="http://www.smh.com.au/federal-politics/political-opinion/angus-taylor-time-to-empower-patients-in-healthcare-20151029-gkmiwg.html">has called for</a> a “My Doctor” website to provide comparative quality information about doctors. This is a good idea and a natural extension of existing policies. If it does eventuate, publishing prices should be a key component of the comparative information. Price transparency is no panacea but should be an important component of ensuring taxpayers and patients get good value for money out of the health system. In the meantime, if you’re seeing a specialist or undergoing a procedure, ask questions about the cost of your care, especially referrals to specialists and private hospitals. You’re paying for a service from a private company and should be able to weigh the perceived benefits against the price before making an informed purchase. Written by Peter Sivey. Republished with permission of <a href="https://theconversation.com/how-much-seeing-private-specialists-often-costs-more-than-you-bargained-for-53445">The Conversation</a>.

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Why hospitals need more generalist doctors and specialist nurses

Don Campbell, Professor of Medicine, Monash University, explains why hospitals need more generalist doctors and specialist nurses. New medical technologies and treatments over the past few decades have led to remarkable improvements in treating older patients. The <a href="http://www.pc.gov.au/__data/assets/pdf_file/0005/129749/ageing-australia.pdf" target="_blank">annual death rate</a> for an 80-year-old male in 2011 was just 5.6%, compared with 10% thirty years earlier. But health-care costs are rising inexorably due to our ageing population. The elderly use hospitals at <a href="http://www.aihw.gov.au/publication-detail/?id=6442468045" target="_blank">three times the rate</a> of middle-aged Australians. Costs of hospitalisation rise steeply with age as sicker patients need to stay longer in hospital. Hospital resources can only be stretched so far. As more and more patients arrive in emergency departments and need admission, the capacity to perform elective surgery is reduced, and waiting times increase. So, how will our hospitals cope with the inevitable influx of large numbers of elderly patients and their increasingly complex needs? Hospital reforms have focused on efficiency gains and “doing more with less”. But this alone won’t enable hospitals to respond to these new challenges. We need to redesign the workforce so hospitals are staffed by general physicians and nurses who take on more complex roles. Medical generalists As we age, our risk of developing chronic diseases – such as heart disease, cancer, diabetes, osteoporosis, depression and dementia – increases. And because we’re living longer, we’re more likely to have multiple chronic diseases; in fact, this is becoming the norm, rather than the exception. Hospitals traditionally treated patients with one disease who were seen by doctors who specialised in a particular part of the body or type of treatment. But patients with multiple illnesses need a generalist to manage their care. This is also the case in the United Kingdom, where the Royal College of Physicians recently <a href="http://www.rcplondon.ac.uk/projects/future-hospital-commission" target="_blank">recommended</a> a radical overhaul of the purpose and role of hospitals. The college argues that in future, hospital will need more generalists and fewer specialists. The same is true for Australia. While general physicians are assuming a more prominent role in acute inpatient care, there is a shortage of experienced generalists and training positions. Luckily, with an anticipated oversupply of medical graduates in Australia over the next few years, there is <a href="https://www.mja.com.au/journal/2014/201/2/future-medical-careers" target="_blank">an opportunity</a> to alter the structure of medical training to promote flexibility and generalism for medical careers. State governments, however, need to actively support training programs for general physicians and include rotations through specialties. This will create the cadre of outstanding clinicians who can reduce the need for over-investigation and promote timely, holistic hospital care. Specialist nurses The increasing pressure of chronic diseases on hospitals and increased demand for beds will require nurses and doctors to work <a href="http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf407990" target="_blank">very differently</a> to the way they have in the past. Nurses will need to be better utilised, in more specialist roles. With the right support and development pathways, for instance, nurses can <a href="http://docs.health.vic.gov.au/docs/doc/A6FC107F7A0E2FA4CA257C040071C945/%24FILE/Final%20FAQ.pdf" target="_blank">safely perform</a> medial procedures such as endoscopies and colonoscopies, which use a long tube with a video camera and light on one end to examine the inside of the body. Nurses can also oversee patients’ <a href="http://www.publish.csiro.au/paper/PY11164.htm" target="_blank">chronic disease management programs</a> for illnesses such as diabetes and heart disease. Grattan Institute health economist Stephen Duckett has <a href="https://theconversation.com/hospital-workforce-reform-better-jobs-and-more-care-25488" target="_blank">previously proposed</a> up-skilling hospital-based nurses to ease the pressure on hospitals. By employing nursing assistants to undertake more administrative tasks, nurses would be free to take on more complex roles. This could help create more rewarding jobs and a more sustainable health-care system. Nursing researcher Stacey Leidel agrees. She <a href="https://www.mja.com.au/journal/2014/201/2/nurse-practitioners-australia-strategic-errors-and-missed-opportunities">argues</a> that the way forward is to reinvigorate the role of the clinical nurse consultant, rather than up-skill specialist nurses (nurse practitioners, who focus on a specific area of clinical care). These clinical nurse consultants would be educated according to a generalist framework, based on national priorities. However, the cultural barriers to nurses increasing their scope of practice span legislative, administrative, professional and societal domains. The argument for change will require attention to fear as much as logic and evidence. What progress is being made? Disruptive innovation will need to challenge professional silos built around specialisation, as well as stereotypes. This fresh approach is starting to appear in a diverse range of settings, such as the Mayo Clinic, where the <a href="http://www.mayo.edu/center-for-innovation/" target="_blank">Center for Innovation’s</a> mission is to transform the experience and delivery of health care through the application of design thinking. In New Zealand, the <a href="http://koawatea.co.nz/" target="_blank">Ko Awatea Centre at Counties Manukau DHB</a> in Auckland is changing the stance and perspective taken by health-care workers as a first step to co-design of services. Locally, <a href="http://www.monashhealth.org/" target="_blank">Monash Health</a> in Melbourne has reorganised its general medicine model of care across three acute hospital sites. Senior nurse nurses and allied health practitioners now work in specified roles to coordinate integrated care. And general physicians focus on providing timely appropriate care across the hospital. The increase in patient admissions under general medicine over the last five years has been accompanied by a reduction in length of stay which would otherwise have required an additional 120 beds to be opened. In other words, the operating efficiency gain is equivalent to 120 beds. Towards more integrated care In order to create the radically different hospital to meet the needs of the rapidly ageing population over the next 20 years, we need to create new roles for health-care workers and challenge traditional siloed professional practice. Health services must bring design thinking and systems thinking together to create truly innovative health care services that make patient and front-line team experience the priority. In doing so, we must see the patient journey as an integrated whole and focus on providing effective care for our patients. This, of course, will require effective care teams and <a href="http://www.nejm.org/doi/pdf/10.1056/NEJMp1301814" target="_blank">clinical leadership</a>. To achieve this vision, enlightened hospital decision-making boards will need to challenge service providers to take this radical design approach. And governments will need to support a more strategic approach to workforce training for doctors, nurses and other health providers. Do you agree with this advice? Written by Don Campbell. Republished with permission of <a href="http://theconversation.com/" target="_blank">The Conversation</a>.

Caring

Specialist police unit introduced to combat elder abuse in NSW

Elder abuse is sadly on the rise, with a 50 per cent increase in reports of cases to a New South Wales Police Force hotline over a 12 month period. As a result, Vulnerable Community Support Officers have been introduced and are working in Local Area Commands (LAC) to check on the welfare of older people. Deniliquin LAC support officer, Inspector Steve Worthington, says that many older Australians feel as though they are being taken advantage of, even by their own families. This is where the support officers can step in to help. "We're happy to take the initial call, see what sort of assistance these people need and if needed, we can refer those people on," he said. "Apparently there have been around 3,000 calls since the hotline was established in 2013, which is a 50 per cent increase on the previous year." For those living alone, Inspector Worthington says advice on improving home security can also be given. "Increasing the security on their doors or window locks," he said. "If there are deadlocks installed, make sure you leave the keys inside the door, not the outside of the door. Installing proper lighting, so there's sensor lighting that comes on. Visibility around the house, keep your trees and shrubs trimmed. There are a number of things we are able to provide in relation to information." The Elder Abuse Hotline number is 1800 628 221. They offers information, advice and referrals for people who experience, witness or suspect the abuse of older people living in their homes in NSW. Related links: <a href="/news/news/2015/07/71-year-old-woman-finishes-161km-race/">71-year-old woman completes 161 kilometre marathon with 6 seconds to spare</a> <a href="/news/news/2015/06/older-women-most-at-risk-of-internet-scams/">Older women most at risk of falling victim to internet scams, study finds</a> <a href="/news/news/2015/07/older-australians-sex-life/">Do older Australians have the best sex life? According to this study, they do</a>

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World-record moment a basketball trick-shot specialist drops a ball from 130 metres – and gets it in the hoop

A team of basketball trick shot experts have set a new world record by making a shot from 126.5 metres above the ring, smashing their previous record of 91 metres. The Australian group of friends, called “How Ridiculous”, attempted their crazy goal atop Tasmania's Gordon Dam. Footage, captured by Channel 7's Sunday Night, shows the ball curve in the air before the satisfying swishing through the net. “There was definitely some luck involved but really a shot like this is more likely when you can consistently put the same spin on the ball every time,” the group wrote online. “There are some good things that happen in life with some luck, some skill and lots of hard work.” Related links: <a href="/news/news/2015/06/james-harrison-blood-donation/">Meet the man who has saved the lives of over 2 million babies</a> <a href="/news/news/2015/06/abs-results-aussies-veggies/">A survey found that Aussies aren't eating enough veggies</a> <a href="/news/news/2015/06/man-donates-wedding-dress/">A man donated his late wife's beautiful wedding dress to charity along with a touching note</a>

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Body language specialist gives her take on Fab Four

Why seeing private specialists often costs more than you bargained for

Why hospitals need more generalist doctors and specialist nurses

Specialist police unit introduced to combat elder abuse in NSW

World-record moment a basketball trick-shot specialist drops a ball from 130 metres – and gets it in the hoop

Our Partners

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Entertainment

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Body language specialist gives her take on Fab Four

Why seeing private specialists often costs more than you bargained for

Why hospitals need more generalist doctors and specialist nurses

Specialist police unit introduced to combat elder abuse in NSW

World-record moment a basketball trick-shot specialist drops a ball from 130 metres – and gets it in the hoop

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