James Frizelle’s
AUTOMOTIVE GROUP
James Frizelle’s Automotive Group is proud to offer a diverse range of premium, quality brands.
Located in Southport, one of South East Queensland’s fastest growing regions, along with Robina, Tweed, Nerang and Springwood, James Frizelle’s commitment to providing quality, old fashioned service has underpinned our position as a dealer of choice since 1985. Our experienced and friendly sales and service staff are always ready to provide great advice and information on Audi, Jaguar, Land Rover, Volkswagen, Mazda, Hyundai, Chrysler, Jeep, Dodge, Skoda, Isuzu UTE, Isuzu Trucks and Used Cars.
At James Frizelle’s, we look after everyone.
” I have to be completely honest, I really dislike buying cars. I think I’d rather see a Dentist (no offence to any Dentists who might be reading this), but commuting from my home in Byron to Pindara in my 1972 VW Kombi Van was becoming tedious to say the least. I have a long standing affinity for German cars, stemming back to my UK roots, so when I needed a new car I naturally went looking for another VW to add to my collection. I was carefully steered towards the Frizelle Group, given their affiliation with Pindara. Obviously the Frizelle Group has VW and Audi, as well as many others, making them a prime target for my shopping trip! I must admit I’d already met a few of the sales team before Rebecca Frizelle became involved and had a very positive experience with all of them I was even starting to enjoy the process! I love my car, I had a great experience buying it and I am very grateful to all of the staff that contributed. I’m even considering buying another car because my wife is enjoying the Audi so much that I’m starting to struggle to get a go in it! Thank you to everyone at James Frizelle’s Automotive Group, and to Rebecca for her help.”
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Corner Nind & High St, Southport
44 Brabham Circuit, Robina Automall
117-123 Minjungbal Dr, Tweed Heads South
107-113 Spencer Road & 9A Indy Court, Nerang
2/3361 Pacific Highway, Springwood
07 5583 8888 | frizelles.com.au facebook.com/jamesfrizelles @jamesfrizellesautomotive
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CONTENTS
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Contents
REGULARS From the CEO Editor’s Desk Pindara News
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MEN’S HEALTH 4 6 8
GENERAL HEALTH The Start of Something New 10 New Year's resolutions designed to succeed The Low Down on IBS Symptoms and management
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On the Up People with Down syndrome are breaking through barriers
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WOMEN’S HEALTH
Goodbye for Good Male Pattern Baldness
32
A Glass a Day Moderate drinking versus binge drinking
37
Replace, or Not Replace The risks and results of HRT
40
CHILDREN’S HEALTH Play it Safe 42 Keeping little heads above water this summer Summer of Fun! Family activities for the school holidays
46
On Thin Ice 26 Australia’s most frightening drug epidemic yet
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2015/2016
CONTENTS
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56
88
82
TRAVEL
BEAUTY
ENTERTAINMENT
Feeling Hot This season’s beauty buys
52
Travel by Tasting The foodie’s guide to Vietnam
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At the Movies Latest movie reviews
Dress Code: Decoded Men
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76
Top Reads Book reviews
Dress Code: Decoded Women
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Slipping Away The luxury and grace of Palazzo Versace
NUTRITION & FITNESS The FODMAP Diet TM 16 An effective treatment for IBS
LIFESTYLE Drive 82 Exploring the speed of the McLaren S650 Boating 88 The homegrown luxury of Riviera Get Techy This season’s tech buys
98 100
DINING Los Villanos 102 Brisbane’s cheekiest Mexican kitchen The Gleneg Public House Not your ordinary steak house
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Finance 110 Five essentials for starting out in business pindaramagazine.com.au
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FROM THE CEO
2015\2016
Pindara Private Hospital Trish Hogan CEO Pindara Private Hospital Katriya De Vincentiis Executive Group Editor Nude Creative Robbie Falconer Assistant Editor Pindara Magazine Business Development & Marketing Manager Pindara Private Hospital Published by Nude Publishing a division of Nude Creative Pty Ltd www.nudepublishing.com.au Art Direction, Editorial & Production Nude Creative hello@nudecreative.com.au www.nudecreative.com.au National Advertising Manager Peter Wastie peter@nudepublishing.com.au MEDICAL CONTRIBUTORS Dr Marco Matos Oncologist Dr Mark Doudle Colorectal Surgeon Drs Leigh Dotchin & Anthony Espinet Pain Specialists
From the CEO
Dr Dilip Gahankari Plastic & Reconstruction Surgeon
Trish Hogan CEO Pindara Private Hospital My how this year has flown! Hospitals are always busy places, but as the largest and most comprehensive private hospital on the Gold Coast, Pindara is particularly busy. This year has seen us add valuable new services to our already extensive mix – our new rehabilitation unit is fully utilised, our renal dialysis service is operating Monday – Saturday, and our chronic pain unit has provided welcome relief for those living with chronic pain. Our operating theatres have seen some amazing surgery performed and our dedicated medical and clinical teams continue to strive to deliver the highest quality of care possible. In 2016, Pindara celebrates 45 years of caring for this community and oh how we have grown! From a small family-operated 50-bed facility with three operating theatres in 1971 to a comprehensive, 348-bed acute care hospital with 18 operating theatres in 2015, the expansion is set to continue. Work is due to commence soon to triple the size of the Pindara emergency service and the Allchurch Avenue entrance to the hospital is due to be refreshed with work commencing to render and paint the full front façade. With the storm and fire season upon us, I take this opportunity to remind you all to prepare and stay safe. If you are travelling, beware of driver
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Dr Craig Layt Plastic & Reconstruction Surgeon
fatigue and if you are holidaying here on the beautiful Gold Coast remember your sunscreen and please swim between the flags. I wish you the very best for 2016.
Season’s Greetings! Trish Hogan
Dr Dan Robinson Ear Nose & Throat Surgeon Dr Nicolas Hall South Coast Radiology
LIFESTYLE CONTRIBUTORS Larna Howard Lizzy Keen
Disclaimer. No part of this publication may be reproduced or copied in any form by any means without prior written permission from the Publisher. Opinions expressed in this magazine are those of the authors and not necessarily those of Pindara Private Hospital or Nude Publishing. Every issue of Pindara Magazine is prepared with careful attention to accuracy. Please use this magazine as a general guide. Pindara Magazine expresses the views of the authors and is based on the information available at the time of publication and it is not to be taken as advice. All prices quoted in this publication are correct at time of printing. All editorial material is accepted in good faith. We welcome editorial and photographic contributions.
2015/2016
UPPER GASTROINTESTINAL & ENDOCRINE SURGERY, WEIGHT LOSS SURGERY WITH MORE THAN 25 YEARS OF SURGICAL EXPERIENCE, DR JORDAAN PRIDES HIMSELF ON PROVIDING HIS PATIENTS WITH THE HIGHEST LEVEL OF SURGICAL CARE. Dr Jordaan performs minimally invasive surgery in: Gastrointestinal Surgery
specialising in anti-reux and gallbladder surgery, plus hernia repairs
Endocrine Surgery
focusing on thyroid and parathyroid surgery
Weight Loss Surgery
performing gastric sleeve, bypasss, band and revisional surgery
T: 07 5556 8888 E: info@surgicalweightlosscentre.com.au
E: info@jordaansurgical.com.au
Suite 2.05 (Level 2) Pindara Specialists Suites 29 Carrara Street Benowa, Qld, 4217 www.surgicalweightlosscentre.com.au www.jordaansurgical.com.au
2015\2016
Hello and welcome to another issue of Pindara Magazine. Can you believe we are at another year’s end already? The time really has flown this year and in a matter of days it will be a brand new year. If you’re looking to make a New Year’s resolution, read our article on page 14 to get some tips on making resolutions you can actually stick to. If one of your resolutions is to travel more, get inspired by our story on Vietnam – a food lover’s paradise – on page 70. If an overseas trip is not on the cards, then why not consider a ‘staycation’? After all, the Gold Coast is home to some of the most luxurious lodgings in the world, including the famed Palazzo Versace. Turn to page 82 and you’ll see that a change is as good as a holiday! Summer down under means lots of fun in the sun but it is important to stay vigilant when the children are playing in, and around, water. Read our story on page 49 to help prevent accidental drowning, and to recognise the symptoms of secondary drowning. From the team at Nude Creative, we wish you a very merry holiday and a happy New Year! Until next time …
Ask any question ask@pindaramagazine.com.au
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Send your letters to letters@pindaramagazine.com.au
2015/2016
THE IDEAS OF TOMORROW, REALISED TODAY.
Bruce Lynton
Sales Finance Service Parts Lifestyle
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NEWS
Experience Counts at Pindara Private Hospital
First established in 1971, Pindara Private has been servicing the local community for more than 40 years. Originally a small family-operated 50-bed facility serviced by three operating theatres, today Pindara is a comprehensive, acute care hospital with 348 beds and 18 operating theatres, including a world-class hybrid theatre and day surgeries at Pindara Day Procedure Centre and Short Street Day Surgery Centre. Pindara offers a full array of surgical services including neurosurgery, neuro-interventional radiology, ENT, GI, urology, plastics, orthopedics, breast, bariatric, vascular and gynaecology. The hospital is also supported by a nine-bed intensive care unit, capable of providing complex ventilation and renal replacement therapy. Extensive medical services, available on campus, include after hours cardiac and emergency, obstetrics, general medicine, respiratory (including endobronchial ultrasound services and a lung function laboratory), gastroenterology (with a dedicated endoscopy suite) and renal medicine. Outpatient renal dialysis and day haematology/ oncology services are also available, and in 2014, the hospital opened a 30-bed inpatient rehabilitation unit complemented by an outpatient rehabilitation program and, most recently, an inpatient chronic pain service was launched. Pindara’s cardiac service offers an emergency interventional cardiology, 24 hours a day, seven days a week, with referral (if required) to cardiothoracic
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surgeons 24 hours a day, seven days a week. The unit manages acute care patients and the average 'door to needle’ time is 20 minutes. A comprehensive range of diagnostic and interventional treatments for coronary artery disease and abnormal heart rhythms are offered, including: emergency management of heart attack; angiogram; angioplasty and stenting; pacemaker insertion; implantable cardioverter defibrillator (ICD); closure of patent foramen ovale (PFO); electrophysiological studies (EPS) which includes diagnostic studies of cardiac arrhythmias and cardiac ablations. Both inpatients and outpatients can access accelerated work-ups for cardiac presentations.
Pindara Maternity Unit
After more than 40 years of operation, the Pindara maternity unit is the busiest private maternity unit on the Gold Coast with its premium, Baby Friendly accredited service, centered on the needs of the woman, a proven popular choice with new Gold Coast mothers-to-be. The Pindara maternity team includes experienced nurses, midwives and lactation consultants, and specialist trained nurses care for the babies in the special care nursery. The unit is serviced by leading private Gold Coast obstetric and gynaecology specialists. Combined, these nursing and medical staff have more than 1,000 years’ experience, caring for mothers-to-be through pregnancy and birth. The Pindara maternity unit is also serviced by
24-hour specialist paediatrician cover, and the only private paediatric hospital unit on the Gold Coast. Sick or premature babies (from 32 weeks gestation) are cared for in a special care nursery (SCN), equipped with the latest technology and equipment. These highly-skilled health professionals are on hand to support the mother-to-be through her birthing process, and as she and her partner transition into their new or extended parenting roles. Experience goes hand in hand with quality care and comfort at Pindara maternity. The unit’s freshly refurbished facilities are comfortable and contemporary. Birth suites are bright and airy and the private patient rooms feature an ensuite bathroom. For those wanting a touch of luxury, there is plenty of choice. At an additional cost, the hospital offers spacious Regal Suite accommodation onsite, and luxurious packages are available offsite, under the care of a Pindara maternity nurse, at the Palazzo Versace Hotel. To help parents-to-be prepare for their journey ahead, special childbirth classes are offered and a postnatal clinic is available to help develop valuable parenting and feeding skills in the early weeks after the birth of the baby. As an additional level of support, the Pindara paediatric unit has recently launched a baby assessment unit. This friendly, caring service will assist mothers with babies aged from one month to 12 months, to manage issues such as irritability, reflux, feeding difficulties or the unsettled baby. 2015/2016
2015/2016
NEWS
Pindara Emergency
Pindara Private Hospital has been undergoing a progressive multiphase redevelopment since 2008. The next stage in this redevelopment will involve the complete refurbishment and expansion of the Pindara Emergency Department. This project will almost triple the size of the emergency department and create a new undercover ambulance bay so that patients arriving via ambulance no longer need to enter emergency through the main foyer. This phase will also expand purpose-built and equipped paediatric areas, add spacious and well-equipped adult treatment bays and update the patient waiting lounge. New and enhanced back-of-house, clinical support areas, as well as educational, administrative, staff and consulting office space will also be created. This exciting project is expected to commence before Christmas 2015. When the Pindara Emergency Department opened in 1987, it was the first private emergency department in Australia. Today, the emergency team treats approximately 22,000 patients a year, of which four to five thousand are paediatric presentations. The unit accepts all emergency presentations, with the exclusion of multisystem trauma and acute psychiatric presentations. The Pindara medical team aim to assess, treat and admit, or arrange appropriate follow up care for their patients. They communicate with other health care providers at every step of the patient’s care, and as a result, many have developed strong relationships with the patient as well as their GP or treating specialist. The Pindara Emergency team has a very stable medical work force (with very little staff turnover) that includes vocationally trained emergency practitioners (with an average of 20 years emergency experience each), specialist emergency physicians (FACEMs) and an advanced emergency medicine registrar seconded from GCUH.
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GENERAL HEALTH
The Start of Something New New Year’s resolutions that are bound to succeed
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GENERAL HEALTH
If you Google New Year’s quotes, the search results are unfailingly optimistic. Advice from the world’s best-known philosophers, authors, saints and scientists – from Oprah to Einstein – always alludes to the opportunity and change that lies ahead. Roman Catholic missionary Mother Teresa had a different idea when she said, “Yesterday is gone. Tomorrow has not come yet. We have only today. Let us begin”. Instead of planning for months down the track, and burdening ourselves with the ‘lose-thisachieve-that’ New Year’s resolutions, let’s take 2016 each day as it comes and commit to small yet powerful lifestyle changes that we can make throughout the year.
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GENERAL HEALTH
2016 is approaching fast. Let us begin. 1. Send yourself a letter Strange, yes. Corny, definitely. But writing a letter to yourself is a sentimental way to watch how you’ve evolved over time – how your dreams, relationships and perspectives have changed. Selfaddressed letters also help us to recall memories and moments that we didn’t capture on film. If you’re a digital reader, instead of handwriting a letter you can head to websites like futureme.org, write an email and then choose a future delivery date. The question is: six months, one year or five years later?
2. Turn your phone off Don’t let the buzz-buzz of your smartphone interrupt your meetings, social events or your attention span. Turning your phone off for at least one hour of the day can improve your concentration, engagement in conversations and sleeping patterns. When you’re working or studying, switch your phone off (or to Flight Mode) and only check for messages or notifications every two to three hours. In turn, you’ll also learn to distinguish between urgent and ‘urgent’ communication.
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3. Learn something new Haven’t you always wanted to learn salsa, speak French or grow your own vegetables? There are hundreds of online, community and tertiary courses available to help you gain a new skill. Check out your local information centre, community garden or TAFE for new courses in the area and choose one to embark on. Refreshing our skills and education improves our memory and brain function for later in life while also providing an opportunity to connect with people in a new environment.
4. Buy local Eating locally grown vegetables and choosing locally owned businesses benefits both you and the community. As economists have shown, money spent in the area stays in the area, and goes directly to the people behind the counter and the farm gate. Plus, food grown closer to home tastes better! Next time you have a free Saturday or Sunday morning, head down to the farmers’ markets for a taste of just-picked farm-fresh produce, and learn about how they’re grown. Visit goldcoast.qld.gov.au for a list of Gold Coast farmers’ markets.
5. Enjoy the simple things When was the last time you really appreciated a hug, or admired the intricate pattern of a fallen leaf? Noticing the beauty in simple things everyday can revolutionise your outlook on life. Whether you wake up for the sunrise, eat lunch outdoors or do five minutes of slow breathing – it all helps you to lead a happier and more fulfilled life. In fact, look around you right now and identify three things that you’re grateful for. Feels good, right?
6. Change your route What might you encounter on the alternate route to work? You may discover a new café passing through a different neighbourhood or it may just be a pleasant change of scenery. Whether you’re walking, cycling or driving, you never know what a chance meeting might bring you. Where are you reading this magazine? Is there an alternative way for you to reach home? Today your adventure begins.
2015\2016
You’re in safe hands at Short Street Day Surgery Ophthalmologists Dr Robert Bourke Dr Frank Howes Dr Darryl Gregor Dr Jon Farrah Dr Alan Hilton Dr Matthew Russell
Plastic Surgeons Dr Peter Widdowson Dr Paul Downie Dr Michael Lanigan Dr Dilip Gahankari Dr Sheree Moko
T: (07) 5528 4011 F: (07) 5528 4033 www.shortstreetdaysurgery.com.au Lvl 1, 2 Short St, SOUTHPORT QLD 4215
7. Swap it If you’re trying to shape up, cutting out sugar and fat is never easy, or fun. Instead, swap highcalorie food for a healthy alternative. Begin in the morning by sweetening your tea or coffee with honey instead of sugar. When snacking, oven-bake some fresh kale (with olive oil and sea salt) until crispy, a much more nutritious option than potato chips. When seasoning your food, push the salt aside for cracked pepper, dried herbs and a squeeze of lemon for extra zest. Check out healthdirect.gov.au for more suggestions.
8. Reward yourself Sometimes you really do deserve those new shoes. But instead of splurging on products at a whim, shop consciously and reward yourself every now and then with a sentimental, highquality gift or experience, such as concert tickets, a fancy dinner or those shoes that keep catching your eye. But also, you don’t have to wait months to reward yourself. Even when you finish the housework, a project or a busy week at the office, treat yourself to something delicious or some simple downtime. You deserve it.
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9. Save energy Has ‘save the planet’ ever been one of your New Year’s resolutions? Saving energy is a two-way win: we save money on our electricity bill and we reduce our carbon footprint, in turn helping the health of our environment. You can save energy by purchasing appliances with high energyefficient ratings, opening the windows instead of using the air-conditioner, switching appliances off at the wall and drying clothes on the line instead of using the dryer. For more tips, head to energyaustralia.com.au.
10. Choose quality Which is more important: the cost to you or the Earth? Although low prices are tempting, when we purchase cheap clothing, electronics and homewares, we often are stung later by faulty parts or a low product lifespan. Also, cheap products that don’t last inevitably end up in landfill to join the 2.5 million appliances that are discarded each year. Shopping for quality over price helps us to reduce landfill and advocate sustainable brands.
11. Go second-hand If you’ve never shopped in an op-shop before, you’ll be surprised by the amount of treasures to be found. Buying high quality, second-hand clothing, homewares, furniture and books will save you money, reduce landfill and assist funding for social organisations such as Lifeline, St Vincent de Paul and the RSPCA. Additionally, clothing from op-shops is original! There are dozens of op-shops around the Gold Coast, as well as regular car boot sales.
12. Save small From little things, big things grow. At the end of each day, try to put at least one coin into a piggy bank. What could you buy at the end of the year with all those 20-cent coins you saved each day? Some new books, a fancy meal for two? It may just be enough for a one-way flight from the Gold Coast to Sydney! On the other hand, you could turn this money into a donation or a gift for someone you love.
2015\2016
PHONE 07 5564 6501 Suite 2, Pindara Professional Centre 8 - 10 Carrara Street, Benowa QLD info@surgerygoldcoast.com.au www.surgerygoldcoast.com.au
It starts today... MAKE ONE PHONE CALL TO CHANGE YOUR LIFE FOREVER
The Obesity Surgery Gold Coast Clinic is here to help. Are you one of the 60 percent of Australians who are overweight or obese? Has your self-esteem suffered as a result of your body-image? Are you avoiding living a rich and full life because you are overweight? Do you suffer from depression or anxiety as a result of weight gain? Has your health been compromised because of your weight? You are not alone. The Obesity Surgery Gold Coast Clinic is here to help. Through surgery we have transformed the lives of many people just like you, who are now living the life they could only dream of before. The Obesity Surgery Gold Coast Clinic’s surgeon Dr Jason Free is one of Australia’s most highly-regarded experts in weight-loss surgery, with extensive specialist bariatric training, and is known as a foremost surgeon in the field.
Call The Obesity Surgery Gold Coast Clinic for an obligation free consultation. All you have to lose is the weight.
Weight-Loss Surgery Sleeve Gastrectomy This procedure involves resection of about 85-90 percent of the stomach, converting the stomach from a large bag into a narrow tube, thus decreasing the amount of food that can be eaten. A sleeve gastrectomy provides extremely good rapid weight-loss, about 70-75 percent excess weight-loss.
We also offer: Adjustable Gastric Banding / Gastric Bypass / Revisional Bariatric Surgery
Also at Hope Island: Suite 1, The Broadwalk, Rialto Quay Drive, Hope Island QLD 4712
www.surgerygoldcoast.com.au
GENERAL HEALTH
The Low Down on IBS Irritable bowel syndrome (IBS) is a chronic relapsing syndrome characterised by pain and altered bowel habit in the absence of any organic cause. IBS is an important condition for many reasons, not least because of its prevalence. In Australia the overall prevalence is 12% but this decreases with age. It is the second highest cause of work absenteeism after the common cold. In other parts of the world the prevalence has been quoted to be as high as 20-25%.
WHAT ARE THE CLINICAL FEATURES OF IBS? Abdominal cramping, discomfort or pain is a central feature of IBS but its location, character and severity can vary widely. Altered bowel habits are also a key feature and IBS is often classified according to the nature of the bowel d isturbance: constipation-predominant (C-IBS), diarrhoea-predominant (D-IBS) and alternating (A-IBS). There are other symptoms that are commonly reported by people with IBS. Abdominal bloating is particularly common, but when it is present as a lone symptom (not associated with pain and altered bowel habits) it is also a feature of normal populations. The relationship of symptoms to food intake or specific food sensitivities is also a common feature and one that can be useful in tailoring therapy. People with IBS also commonly describe their symptoms as being dynamic over time, including such things as a change in location of the pain and even a change in stool pattern. 16
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An important issue in the assessment of people with IBS is the exclusion of so-called ‘red flag features’. These ‘alarm symptoms’ may indicate underlying organic disease and include:
• Symptom onset above age 50 years • Nocturnal symptoms, especially nocturnal diarrhoea • Unexplained weight loss • Gastrointestinal bleeding • Unexplained anaemia, especially iron-deficiency anaemia • Severe or worsening symptoms •
Family history of organic gastrointestinal disease, including cancer and inflammatory bowel \disease (IBD)
2015\2016
GENERAL HEALTH
WHAT IS THE NATURAL HISTORY OF IBS?
SYMPTOMATIC THERAPY FOR IBS
People with IBS do report a change in their symptoms over time. In about 40% the symptoms improve over time but this can take some years. About 20% of patients have persisting symptoms. Interestingly, about 20% of patients report a change in their symptoms over time. For instance, some people with D-IBS develop A-IBS or vice-versa. Some of those with C-IBS will go on to develop functional constipation (i.e. the pain component of their symptoms improves but the bowel disturbance does not) or functional abdominal pain (i.e. the bowel disturbance improves but the pain does not). This is likely explained by the fact that IBS is only one member of a ‘family’of functional gastrointestinal disorders and the nature of a person’s functional disturbance can change over time.
It is a truism to say that the therapeutic relationship between doctor and patient is the cornerstone of effective therapy. This is of particular importance in the management of functional disorders such as IBS, which tend to be recurrent and where symptom management (rather than cure) is the primary goal of therapy. Often the severity of symptoms will guide the therapeutic approach. For those with mild or intermittent symptoms, education about the nature of IBS can have a powerful therapeutic effect by providing reassurance about the benign nature of the disorder. Diet based therapies (especially FODMAP TM restriction) can help up to 75% of patients improve their symptoms. Due to the restrictive nature of the low FODMAP TM diet liberalisation of the diet after a few weeks is also useful in mitigating against nutritional restriction as well as making the therapy more practicable. For moderate symptoms that fail to respond to dietary therapy alone there is significant data to support the use of pharmacological adjuncts such as tricyclic anti-depressants and selective serotonin re-uptake inhibitors (SSRIs). Indeed, very few other treatments have as much evidence to support their use in this patient population. This may be further evidence for the emerging concept of a ‘gut-brain axis’ whereby treatment of disorders of the central nervous system (CNS) and the gastrointestinal tract (GIT) can be improved by utilising treatments targeted to the other system in the axis. Psyllium based treatments can be useful in patients with C-IBS. Simple laxatives can also be effective as second line therapy in this patient group. Loperamide is often used in D-IBS and can provide symptomatic relief. There is not much evidence to support the use of currently available probiotics in patients with IBS but it is hoped that an improved understanding of the role of the microbiome in pathophysiology will lead to improved therapies.
WHAT IS THE PATHOPHYSIOLOGY OF IBS? IBS results from the interaction of a number of factors and no particular abnormality is specific for this disorder. Whilst our understanding of the pathophysiology of IBS continues to evolve, it is clear that motility and visceral hypersensitivity are important in many people with IBS. Motility refers to the motor activity of the gastrointestinal tract. In C-IBS a prolonged transit time can be observed in the gut. In D-IBS an exaggerated transit time can be seen following meals, for instance. Visceral hypersensitivity refers to subjective awareness of sensation and pain related to gut function. Often these factors overlap and lead to the commonly observed symptoms of IBS, where altered motility and an increased sensitivity to pain leads to people requiring assistance in managing the resultant symptoms. There is also emerging evidence that other factors may be important, including inflammation and alterations in the gut microflora (aka microbiome).
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GENERAL HEALTH
FODMAPS TM DIET How sufferers are finding relief from IBS Around one in five Australians experiences the unpleasant symptoms of irritable bowel syndrome (IBS) at some time. These include abdominal pain, mucus in the stools, and alternating diarrhoea and constipation. Also referred to as ‘spastic colon’ or ‘irritable colon’, sufferers have sensitive bowels that are easily irritated. It tends to affect more women than men, with symptoms commonly first appearing in early childhood. Whilst the cause remains unknown, it is accepted that environmental factors such as changes of routine, emotional stress, infection and diet can trigger an attack. A large number of dietary triggers have been associated with Irritable Bowel Syndrome (IBS) and aggravating bowel symptoms, common ones being fatty foods, fibrous foods, alcohol and caffeine. More recently, research has identified four groups of carbohydrate based food molecules termed FODMAPs™ that are difficult to digest and absorb by the digestive system. FODMAPs™ stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. The ability to digest FODMAPs™ varies from person to person as does the severity of physical symptoms experienced. It has been identified the natural intestinal bacteria that live in the bowel feed on FODMAPs™ as a food source and as a result produce gas and by-products. The millions of nerve endings lining the gut can be sensitive to the excess gas production triggering undesirable symptoms and/or change in bowel pattern. While it is natural to produce gas from intestinal bacteria and common for many FODMAPs™ to be poorly absorbed, not
everybody experiences undesirable symptoms. It is thought some people have: 1)
Greater gas production in the large intestine and/or existence of more highly sensitive nerve endings in the gut.
2)
Bowel muscles that are more sensitive to distension and respond by increasing or decreasing gut motility.
3)
Overgrowth of bacteria in the small intestine (small bowel bacterial overgrowth), which have migrated from the large intestine where they normally inhabit.
Dietary restriction of FODMAPS™ in people who suffer from Irritable Bowel Syndrome and aggravating bowel symptoms such as bloating, wind, pain, discomfort, diarrhoea and/ or constipation may be beneficial. Trialling a Low FODMAPS™ Diet for a six to eight week period under the guidance of an Accredited Practising Dietitian (APD) can help determine if FODMAPS™ are being poorly digested. If symptom improvement is achieved, foods can then be re-introduced to test for main dietary culprits and tolerance level. FODMAPS™ exist in our diet as Fructans, Galactans, Lactose, Fructose and Sugar Polyols. For a list of common high FODMAPS™ foods and more information search at: http://www.med. monash.edu/cecs/gastro/fodmap/. To find a local Accredited Practising Dietitian search at: http://daa.asn.au/for-the-public/findan-apd/ Produced by Amanda Cini Pindara Private Hospital Dietetic Team October 2015.
Ingested FODMAPs™
SMALL INTESTINE
Diarrhoea can result from the osmotic effect of FODMAPs™ and increased delivery of water into the small bowel
LARGE INTESTINE
GAS GAS GAS
GAS
GAS GAS GAS
Resources: The Monash University Low FODMAP Diet Department of Gastroenterology, Monash University “Dietary Triggers for IBS Symptoms: The Low FODMAP Diet Approach” International Foundation for Functional Gastrointestinal Disorders 2010-2014. “Extending Our Knowledge of Fermentable, Short Chain Carbohydrates for Managing Gastrointestinal Symptoms” Nutrition in Clinical Practice June 2013. "A FODMAP Diet Update: Craze or Credible?" Nutrition Issues in Gastroenterology December 2012. "Evidence Based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP Approach” Journal of Gastroenterology and Hepatology February 2010.
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GAS
Bloating, wind, pain, discomfort, and/ or constipation can result from excess gas production and luminal distension in the large bowel
2015\2016
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LIST OF COMMON HIGH FODMAPS™ FOODS: FODMAP
Food Type
Fructans
Wheat and wheat products (e.g. white bread, pasta, pastries, cookies, flour), rye and rye products (e.g. rye bread, rye crackers), onions, garlic, artichokes, leek, peaches, watermelon, inulin (often called ‘fibre’ in products).
Galactans
Lentils, chickpeas, legumes (baked beans, kidney beans)
Oligosaccharides
Disaccharides
Monosaccharides
Polyols
Food Source
Lactose (milk sugar)
Cow’s milk and milk products like ice cream, custard, dairy desserts, condensed milk, evaporated milk, milk powder, yoghurt, custard, margarine, soft unripened cheese (e.g. cottage, ricotta or cream cheese).
Fructose (fruit sugar)
Apples, cherries, mangoes, pear, watermelon, peaches, dried fruits, tinned fruit in natural juice, asparagus, sugar snap peas, sweeteners like honey and high fructose corn syrup.
Sugar Polyols
Apples, pears, blackberries, apricots, avocado, cherries, lychee, nectarines, pears, plums, prunes, watermelon, mushrooms, snow peas, cauliflower, diet products and sugar free gum/chocolate & lollies with sorbitol (420), mannitol (421), xylitol (967), maltitol (965), and/or isomalt (953).
EXAMPLE MEAL IDEAS FOR A LOW FODMAPS™ DIET WF = WHEAT FREE, GF = GLUTEN FREE, LF = LACTOSE FREE BREAKFAST IDEAS
LUNCH IDEAS
DINNER IDEAS
SNACKS & SWEETS
• Porridge or WF/GF Cereal e.g. Cornflakes, Rice Bubbles, Rice Flakes, WF muesli) + LF milk/soy or rice milk + banana & golden syrup.
• WF/GF/spelt bread sandwich or crispbread with LF margarine, plain tuna/sardines/ salmon/egg/hard cheese/cold deli meats and lettuce/spinach, carrot, tomato, cucumber.
• Meat & veg — lean grilled meat, fish or chicken or eggs + GF/ WF pasta/noodles or baked potato or polenta and steamed allowed mixed vegetables e.g. pumpkin, potato, zucchini, carrot, corn, spinach, eggplant, squash.
• 1 piece allowed fruit e.g. banana, berries, kiwi, oranges, mandarin.
• WF/GF/spelt toast with LF margarine, poached eggs & spinach. • Smoothie e.g. cup of berries + LF milk/soy or rice milk + LF yoghurt + 2tsp golden syrup + -1tbsp oat/rice bran + ice.
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• Frittata or omelette with tasty cheese, spinach, capsicum, tomato, corn, zucchini and pumpkin.
• Plain rice/corn cakes with LF margarine, vegemite, peanut butter, golden syrup, or tomato & tasty cheese. • Low fat LF yoghurt (not with inulin or apricots) • Small handful of almonds (<10) and pumpkin seeds
2015\2016
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How social acceptance and physical activity has changed the lives of people with Down syndrome
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Pindara Magazine
Photo credit: gaines addiction photography
ON THE UP
2015\2016
Madeline Stuart has just walked the runway of New York Fashion Week. Ellen DeGeneres has been in contact. She’s been nominated for the Young Australian of the Year award. Her eco-luxe handbag line is flying off shelves. She’s booked up for shoots. And despite three holes in her heart and a leaky valve, Madeline is feeling stronger than ever.
At 18 years old, Brisbane’s Madeline Stuart is the world’s first professional model with Down syndrome. With help from her mum Rosanne, she’s converted her global social media following into a modelling career – and turning the notion of beauty on its head. Madeline’s Down syndrome (DS) was diagnosed at birth. Soon after, single parent Rosanne was told she had an 11 % chance of survival. But despite this, Madeline has gone on to become a sensitive and inspirational young woman who values her health and career. Her story begins with initiative. A passionate dancer, Madeline decided in March last year to lose weight and get fit for her dance performances. Then, the following August at Brisbane’s EKKA show, Madeline attempted to join a group of models on one of the stages, but was frustrated when Rosanne said she wasn’t allowed. To give her the experience, and as a reward for her fitness training, Rosanne paid for a professional model shoot of Madeline, which she posted into a closed-group website for parents of children with disabilities. The photos went viral, the job offers rolled in and the rest is history. Another person who has inspired a dramatic lifestyle change for people with DS is dance teacher Alison Cotterell from Street Jam Dance Studio in Bundall, Gold Coast. While Madeline is breaking DS stereotypes on a global level, Alison’s weekly dance classes for local people with DS are proving that these guys can, and will, overcome obstacles of their condition when given the opportunity. Alison, who was requested by the Gold Coast Down Syndrome Organisation coordinator to set up the children’s class four years ago, runs two classes of hip-hop and contemporary jazz: one for children and one for young adults. Since the beginning, Alison has noticed huge changes in her students – and herself. “We can tailor the specific classes to allow the students to flourish in their element. I give my students with DS the same boundaries as any other student, and their progress and growing confidence is incredible,” Alison says. “My perception of DS has completely changed. They’re capable of so much more than we think. Dance is a brain thing – rhythm, steps, memory – and not always easy. But they’re constantly exceeding expectations.” One of Alison’s 14-year-old students has pindaramagazine.com.au
recently transitioned from the DS class to the mainstream class to join the strongest of the studio’s dancers, which she sees happening for a number of other students in coming years. Similarly, Madeline Stuart’s story and love for dance prompted Brisbane’s InsideOutside Theatre Company to launch a new dance ensemble for young people with a disability who are working towards a career in the arts. Today, people with DS are enjoying the participation, goals and triumphs of ordinary people – but this hasn’t always been the case.
What is Down syndrome?
DS is the most common form of intellectual disorder that we know, with one in every 700-900 babies worldwide born with the condition. This number is lower in Australia, where there are approximately 13,000 people currently living with DS; a figure linked to our higher birth termination rates. While human DNA is made up of 46 chromosomes, DS results from the formation of 47 chromosomes. Diagnosed at conception, DS produces similar effects across all social and ethnic classes and presents no cure. People with DS have some characteristic physical features, development challenges, some level of intellectual disability and usually experience other health issues. These include: • • • • • • • • •
Heart defects Vision problems Hearing loss Blood disorders Sleeping problems Gum disease and dental problems Hypothyroidism (underactive thyroid) Spinal problems Hypotonia (low muscle tone)
Every person is unique, therefore the level of developmental delay is different and unpredictable in each person. While some people with DS go on to lead ordinary, fulfilling lives, others require life-long care and support. Nowadays parents, organisations, educators and researchers argue that DS is not the most important influence on the individual’s life; rather the social, cultural, environmental and family factors that shape who they become. Alison says that one of the few challenges for her dance students with DS is their level of health
and accompanying health conditions. “Most of our students have had heart operations as babies. And in the early weeks, the adults grow tired faster or aren’t as fit because they’ve been excluded from physical activity and sport in the past,” she explains. “But they mature and grow stronger each lesson, and their memory is phenomenal. I am often asking them about last week’s dance steps that I’ve forgotten, because they remember so well!”
Past health rates and experiences
Observing Madeline’s sophisticated fashion sense and photographs, and the enthusiasm of Street Jam’s dancers, it’s hard to believe that some 60 years ago these bright, resolute individuals were considered much less capable than ordinary people. According to the Royal Australian College of General Practitioners (RACGP), the 1950s presented poor attitudes, low expectations and limited opportunities for people with DS.But while their health outcomes still rate much lower, the increase of life expectancy for people with DS from 15 to 60 years reflects the impact of research and shifting perceptions of the condition. Families, clinicians and associations have also, for the last 30 years, campaigned against institutionalisation and improved the access to health care, inclusion and education for people with DS. They now grow up in family environments and enjoy similar, if not equal, opportunity to education and employment. While they usually attend mainstream schools, children with DS have often been separated from their peers, which can further delay their social development. Exclusion from physical activity and sport has also led to inertia, and weakened muscles and bones among children with DS. Socialising and participating with their peers is now widely encouraged for children with DS, which assists a smooth transition into adulthood and encourages their self-expression. Socialising is the basis of Alison’s only rule for her classes at Street Jam. “We have one rule: students can hug each other before and after class, but not in between. Otherwise we don’t get any dancing done,” Alison laughs. “These students really love each other.” Pindara Magazine
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GENERAL HEALTH
Prenatal decisions
University of Sydney’s Senior Lecturer of Inclusion Education, Dr Spandagou, points out that a decline in fertility rates in Western countries has led to a delay in women having children, increasing birth rates for women over 35 – when the risk of a child with DS is greatest. Since 2003, the fertility rate (births per woman) for women aged 35-39 has been higher than those between 20-24, an accurate reflection of social change around women’s work and family roles. As a result, there are now more women with a higher risk of having a child with DS. On the other hand, due to advances in screening, diagnostics and prenatal technology, there are now more women facing the decision of whether to continue the pregnancy of a child with DS. Prenatal testing to determine whether the foetus has DS has raised a number of ethical issues. RACGP highlights that the decision of whether or not to terminate is based on a complex interplay of factors relating to the parents, family circumstances, socio-cultural environment and professional advice. Relatedly, as the author of Greater Expectations: Living with Down Syndrome in the 21st Century Jan Gothard shows, the live birth rate of children with DS is inversely related to the rate of terminations – a higher rate of abortions leads to lower rates of DS. But despite this correlation, there are over 270 women giving birth to children with DS in Australia annually, many of whom are proving that with a safe environment and loving family, children with DS will reach their potential.
Looking ahead
With recent improvements in inclusiveness, education and care techniques, as well as a major positive shift in attitudes towards people with DS, the future will only continue to produce superstars like Madeline Stuart and the students at Street Jam. Alison says dancing, as well as all types of physical activity, is pivotal in propelling children and adults with DS forward with confidence and strength. “Dancing has an impact on their general health, muscle tone, learning capacity, but especially their confidence. Here they realise they really can do what they didn’t think they could,” she says. “They learn just as well as other people, just a little slower. But the more dancing and activity they do, the stronger and more incredible they become.”
Check out Madeline Stuart’s work facebook.com/madelinesmodelling twitter.com/Madelinesmodel1 Support Madeline’s Go Fund Me campaign gofundme.com/danceensemble
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2015\2016
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A RC A R E R EGENC Y â&#x20AC;˘ C ASE YS ROA D, HOPE ISL A ND
GENERAL HEALTH
ON THIN ICE AUSTRALIA’S MOST FRIGHTENING DRUG EPIDEMIC YET
You’ve seen the ads. A sweating employee snaps at his colleague; an agitated son steals cash from his mother’s wallet before knocking her to the ground; a psychotic young man launches a chair through a hospital hallway – these are the images of ice addiction. The series of ‘Ice Destroys Lives’ advertisements is one of many public messages broadcasting around the country. In recent months, government, organisation and media attention has turned to Australia’s use of ice and its damage to users and the community. Given the drug’s increased availability, more frequent use and its purity, some experts and organisations are calling ice’s rampage across Australia an ‘epidemic’, not least in the light of Tasmanian Senator Jacqui Lambie’s revelation
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in August of her 21-year-old son’s ice addiction. Its grip on users, families and community welfare also sparked former Prime Minister Tony Abbott to launch a national taskforce in early April, led by former Victorian Police commissioner Ken Lay. With progress already underway, the National Ice Taskforce is mainly focusing on prevention, intervention, treatment, and community and frontline support. However, unless you’ve experienced or witnessed the direct or indirect effects of ice, it’s difficult to judge the health issue as an epidemic. Ice use and addiction reveals a problematic web of social, health and cultural factors that varies the experience, appropriate treatment and aftercare for each user. But epidemic or not, ice use in Australia demands serious attention.
2015\2016
What is ice?
Ice is the crystalline (crystal) form of methamphetamine (meth), a highly addictive, synthetic stimulant that affects the central nervous system. Meth has three forms: ice is the most potent, followed by the powder (speed), then the paste (base). Like comparing light beer with 96% Polish vodka, ice, speed and base are all methamphetamine but with varying strengths per quantity. Although ice can be cut with other chemicals, including antifreeze and drain cleaner, its purity means the effects and comedown are much more intense and the likelihood of addiction is greater. Another advantage of ice for users is its ability to produce a stronger high with a smaller amount. When ice is used – usually smoked – the receptors in the brain are flooded with monoamines, which produce an adrenaline-like effect characterised by chattiness, optimism and euphoria. It usually takes one to two days to completely exit the system. Continued use destroys these receptors and diminishes the drug’s effects, leading to what people call ‘chasing the high’ – taking more of the drug to try to attain the initial feeling. Prolonged use will lead to a point where the user cannot function or live without using ice. Ice rewires the brain in a way that makes the user extremely susceptible to drastic behavioural and emotional change, turning even the most placid people into aggressive psychotics with super-human strength. All these factors make quitting ice an extremely difficult and lengthy process. In Australia, 70% of users have relapsed at least once.
The signs and side effects
When someone is on ice, most of the signs are observable but not necessarily the same among all people. Some of these include: • Dilated pupils • Chattiness/talkativeness • Agitation • Aggressiveness and abrupt behaviour • Paranoia and psychosis • Increased heart rate • Fast breathing • Jaw clenching, scratching and teeth grinding • Sweating
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Users have explained that ice creates a feeling of intense pleasure and clarity, giving them the ability to plan effectively, make ‘good’ choices and think positively. When on the drug, users will also have excessive amounts of energy. This is because ice dramatically increases the level of dopamine (reward and pleasure transmitter) – up to 1,000 times the regular level. The effects of the comedown – when the drug has worn off – include: • Depression/hopelessness • Exhaustion • Increased need for sleep • Anxiety and paranoia • Irritability • Decreased appetite The health effects of regular use include: • Dehydration • Malnutrition • Exhaustion • Stroke • Heart, lung and kidney problems • Dental issues such as sensitivity, cracked teeth and gum disease The three main areas of harm are psychosis (paranoia, hallucinations), violence (domestic, public) and cardiovascular risk, whereby users experience health problems and organ failure that they wouldn’t have otherwise.
Australia’s ice use
According to the Australian Institute of Health and Welfare (AIHW), around 2.1% of Australians use meth, a figure that hasn’t changed much in the last decade. While the most commonly used illicit drug is cannabis, used by 10.2% of Australians, the proportion of people using ice has increased in recent years. As recorded by the AIHW, the number of users who prefer ice to other forms of meth increased by 27% in 2007, 22% in 2010 and 50% in 2013. Additionally, weekly usage increased from 9.3% in 2010 to 15.5% in 2013. Based on the latter, it has been estimated that around 160,000 Australians are addicted to some form of meth. As research by Scott et al. explains, the purity of ice has also increased from 21% in 2009 to
Pindara Magazine
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GENERAL HEALTH
64% in 2013, while that of lower-grade speed has also increased to 37% in the same period. Therefore, the ice ‘epidemic’ isn’t based on the amount of users but rather the increased frequency of use and purity of the drug. A large proportion of ice is imported into Australia, but there are still hundreds of hidden meth and ecstasy ‘labs’ around the country. According to the United Nations Office on Drugs and Crime (UNODC), 602 laboratories were seized in 2009-2010, most of which were found in Queensland. The Australian Crime Commission has also found that there is also a greater tendency in Australia towards poly-drug use, the combination of two or more psychoactive drugs to achieve a particular effect. Organised crime groups respond to this by dealing various illicit drugs and/or mixing them to increase addiction levels, which has effectively increased their access.
Impacts on the community
Ice use and addiction can create long-lasting social issues like family and relationship breakdown, domestic violence, loss of employment, encounters with police and the law, and homelessness. This is often compounded by poverty and a dysfunctional lifestyle – which are often reasons people turn to ice – as well as alcohol abuse, smoking and other drug use. According to the AIHW, there has been an increase in people seeking treatment at drug and alcohol clinics, while treatment where meth was the major drug of concern doubled between 2009-2010 and 2012-2013 to 14%. Research by the Turning Point Alcohol & Drug Centre Victoria shows an 88% increase in ambulance call-outs in metropolitan Victoria and a 198% increase for meth-related incidents in some regional areas. The Australian Institute of Criminology (AIC) showed a 30% increase of meth-related crimes between 2010-2011 and 2011-2012, while Queensland results from the 2007-2012 roadside drug-testing program found 41% of those surveyed tested positive for meth. The manufacturing of meth has devastating environmental consequences, as it produces a range of toxic fumes that permeate walls, furniture and carpets, and pollutes the air surrounding a lab. Houses used as meth labs are extremely dangerous for unsuspecting future tenants. Lab operators have often been found dumping toxic waste into nearby streams, rivers, fields, backyards and sewage systems, which contaminates human water resources. Ice breeds violence and crime, which are usually linked with the user’s desperation to attain the drug or seek the means to pay their dealer. Additionally, children who are exposed to the chemicals are in severe risk of health problems or death, or can be neglected by addicted parents.
Is this an epidemic?
Despite the increased frequency, potency and availability of ice in Australia, many organisations and drug use researchers have dismissed the ‘epidemic’ label. As well as this, a number of experts have argued that Senator Lambie’s proposal for a private member’s bill, which would allow parents of iceaddicted offspring to force them into detox, will not work. Contrarily to the short-term detox approach administered by many health and rehabilitation institutions, experts are pushing for a less simple solution for a complex problem. Criticism of mandatory short-term treatment points to research that shows relatively few benefits in detox programs. 28
Pindara Magazine
In particular, research by Australian National University Associate Professor Rebecca McKetin explored the differences in recovery between long-term ice users: the first group undertook a residential rehab program; the second undertook a weeklong detox program; the third undertook no treatment. After three months, interviews showed that those who undertook the weeklong detox were just as likely to still be using meth as those who had undertaken no treatment. Senator Lambie’s proposal faces disapproval on the basis that ice addiction is a chronic condition that impacts decision making and thought processes; many ice addicts are not in the position where they want to get better. In one Sky News article, Flinders University’s National Centre for Education and Training on Addiction Associate Professor Nicole Lee said, “Just having more beds, and forcing people into rehab, does not mean they’re going to get better, or stay better." Neuroscience supports the argument that ice addicts are not acting entirely on their own. Such research demonstrates the drug’s ability to change or rewire brain function and structure that makes sensible decision making more difficult. Not all ice users need intense treatment because not all are addicted. Research by Boston College Senior Lecturer Gene Heyman PhD proves that many addicts do quit without professional help for legal concerns, economic pressures and the desire for acceptance in the community. Additionally, Australia already has a number of mandated treatment pathways for drug use and possession offenders, which operate through the police and justice systems. In all states, police can refer people to treatment as an alternative to the justice system, which has proven to be effective. Drug courts – special courts for users that haven’t committed a violent crime – can send offenders to treatment if they plead guilty to divert the justice system, which has also had positive effects. However, in order to best understand ice addiction and combat its impact as a community, it should not be viewed as something over which users have absolute control or lack of control. As mentioned above, there is a range of personal and environmental factors contributing to the user’s experience. So far, the most effective treatment for meth dependency is residential rehabilitation and cognitive behaviour therapy (counselling). Verifying the best way to develop and implement treatment and aftercare strategies will constitute one of the challenges for the National Ice Taskforce in the coming months.
Education is power
Education, starting in primary schools, has been highlighted as a major approach to addressing Australia’s ice problem. In one ABC report from February, both Hunter Valley magistrate Col Elliot and the Health Services Union called for education to be implemented in schools to warn children and young adults about the effects and dangers of ice use. Also this year, Liberal MP Fiona Scott produced the ‘Ice Meltdown Report’ with the cooperation of community members, health professionals and police in the Lindsay Electorate of Western Sydney, which suggested ice education be initiated in primary schools. Equipping children with the tools to say ‘no’ to ice and other illicit drugs is education’s primary objective. Understanding the effects of and refusing drugs from an early age manifests years later in reduced health care costs, social cohesion and loving families. 2015\2016
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GENERAL HEALTH
Young adults are currently being targeted by organised crime groups who position ice as a party drug and tempt young users with free ‘hook ups’. After a taste, young people are finding that the next supply is more expensive and that their self-control is now compromised – and so the cycle begins. With children as young as 10 seeking withdrawal treatment and help for ice-related mental illnesses in Ballarat, New South Wales, as reported in June 2014, it appears that primary school is not too early for prevention strategies. Prominent youth outreach worker and community activist Les Twentyman AO urged in June 2014 for principals to hold off suspending and expelling students who are found to be using ice, saying this will only isolate young users and perpetuate anti-social behaviour. Some desperate schools in Victoria have even considered drug-testing students as a way to identify those at risk, but the idea was knocked back by State Government and the Youth Support Advocacy Service. Since ice has already seeped into schools and young communities, particularly in disadvantaged rural areas, education and real case studies could help deter primary and secondary school children from trying or using the drug.
Where to from here?
Ice and all forms of methamphetamine are inarguably dangerous for an individual’s health, family, community and their potential. While the experience differs for each user, it does not discriminate in the destruction of lives. If you are experiencing or witnessing the effects of ice, or have any suspicion of ice-related activity in your area, visit www.drugs.health.gov.au, www.dfds.org.au or call your local police station.
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2015\2016
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MENâ&#x20AC;&#x2122;S HEALTH
Goodbye for Good MALE PATTERN BALDNESS
AD Dr Michael Freeman, Dermatologist
While there are a number of treatments available for male pattern baldness, there is no cure. The cause of male pattern baldness is well established, with up to five genes that are involved. Identical twins go bald at the same age, rate and pattern irrespective of diet, lifestyle or stress levels. Hippocrates noted that castration saved the eunuchs in the Persian army from baldness. Effective treatments include Minoxidil lotion and tablets, Finasteride and Duasteride tablets. Unproven treatments include lasers, LED light sources and plasma-rich proteins. Cosmetic options include camouflage sprays, wigs and hair transplant surgery. Investigation of the genetics of baldness may lead to new treatments, but there are none available yet. Hair transplantation still offers the best hope for men with hair loss restricted to a small region of the scalp. If the ultimate size of the baldness is too great, then the available hair density for transplantation is not enough, leading to a very thin cover of the recipient region.
Treatment Options 5-alpha reductase inhibiters The benefits are clear: men who start taking one milligram of Finasteride daily at the first signs of hair loss will not go bald. If erectile dysfunction, ejaculatory problems and reduced libido develop then cessation of the drug is recommended.
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There is only a reduction in risk for low-risk prostate cancer and a suggestion of a slight increase risk in the high-risk cancers, although this might be explained by the increased recognition of prostatic cancer due to the smaller prostate size. The addition of Duasteride 500 micrograms once a week gives further benefits.
Minoxidil The effect on hair growth of Minoxidil having a viagra-like effect was discovered by accident. Hair removal laser has led to a renaissance in the use of Minoxidil tablets, as now effective management of the unwanted hair elsewhere is possible. Low doses of Minoxidil, (as low as one milligram a day) can still grow hair with minimal effect on blood pressure. About 75% of topical 5% Minoxidil users get some benefit and 1% get fantastic results. The combination of Minoxidil and Finasteride maximises hair regrowth.
Alternative therapies Vitamins and dietary supplements do little in this kind of baldness. We at The Skin Centre (www.skincentre.com.au) are currently trialling platelet rich plasma injected into the scalp. Multiple treatments are required. There is no data to suggest a lasting response yet. So, while there is no cure, it's important to remember the earlier the balding scalp is treated the more effective the treatment will be.
2015\2016
MENâ&#x20AC;&#x2122;S HEALTH
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HOW WEIGHT LOSS SURGERY CAN HELP TYPE 2 DIABETES Dr Jacobus Frederick Jordaan
Weight loss surgery can make a big difference for people with obesity and Type 2 diabetes. For instance, evidence shows that weight loss surgery can slow down or even stop the progression of Type 2 diabetes. For some people blood sugar levels return to normal within days or weeks after surgery, meaning they need less medication or none at all. There is general agreement that gastric sleeve and gastric bypass surgery should be offered as an option for people with Type 2 diabetes and obesity (with body mass index above 35). Dr Jordaan says, “In my experience, after gastric bypass surgery I can typically halve my patient’s dose of insulin and/or tablets by the time they leave the hospital three days later”.
What do studies show? The data has been overwhelmingly positive. One long-term study tracked 400 people with Type 2 diabetes for six years after they had weight loss surgery. More than 60 out of every 100 people in the study had their diabetes put into remission by the surgery. Their symptoms disappeared completely and they no longer required medication. They also had better blood pressure, cholesterol and triglyceride levels. 34
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Other studies have tracked people who took medicine and made lifestyle changes, such as improved diet and increased physical activity. Typically, only six to eight people out of every 100 achieved a similar improvement in their Type 2 diabetes.
Which operation is the best? In terms of diabetes management, not all weight loss surgery is equally effective. A recent analysis of 26 studies involving almost 8,000 patients showed that gastric bypass surgery was more effective for diabetes than gastric sleeve surgery. Out of every 100 people who had gastric bypass surgery, 75 had their diabetes put into remission. Only 60 people out of every hundred achieved the same result after a sleeve gastrectomy.
Recent short to medium term studies suggest that it may be a more effective treatment for Type 2 diabetes than the Roux-en-Y gastric bypass, with remission rates of up to around 88%. Long-term data is pending.
When is surgery indicated to treat diabetes? Those who have Type 2 diabetes and a body mass index (BMI) above 35 may want to consider bariatric surgery. This is almost a third of our Type 2 diabetics in Australia. Another factor that influences the success rate of surgery is how long a person has had Type 2 diabetes when they have surgery. Those who have had diabetes for less than three years before undergoing weight loss surgery remained in diabetes remission the longest.
An additional benefit is that people who take less diabetes medication also achieve better weight loss. This is because medication to control diabetes causes weight gain, so reducing the dose improves weight loss following weight loss surgery.
Controversial research has suggested that even people with Type 2 diabetes who aren't obese may benefit from surgery.
Gastric bypass surgery usually refers to the Roux-en-Y gastric bypass, which is considered worldwide as the gold standard for gastric bypass surgery. Another form that is gaining in popularity is known as the Omega-Loop or Mini Gastric bypass.
The rapid remission of Type 2 diabetes after gastric bypass surgery — independent of weight loss — is one of the most enticing discoveries about weight loss surgery. Why this occurs is a subject of current research.
This is because weight loss surgery often improves Type 2 diabetes, even before patients start to lose weight.
2015\2016
Some researchers believe it is due to GLP-1, a hormone made in the lower small intestine that helps with blood glucose control and weight loss. The diabetes medication exenatide (Byetta) works by behaving like GLP-1. Studies have shown that blood GLP-1 levels increase after weight loss surgery. Solving the mystery of how weight loss surgery puts Type 2 diabetes into remission could provide the basis for powerful new diabetes medications. In the absence of such a breakthrough, the question at the heart of the debate is: who stands to benefit the most from surgery, and who should stick with a more traditional treatment of diet, exercise, and medication? Weight loss surgery has to work in tandem with lifestyle changes. It reduces portion size, causes some malabsorption of calories and alters some of the hormones. However, it is not a ‘magic bullet’. The 60-80% of excess weight loss that occurs over a 12-18 month period allows someone who has been struggling with obesity the time to modify their diet and exercise to achieve a healthy lifestyle.
What are the downsides? Weight loss surgery has a much higher upfront cost compared to medication and lifestyle modification. However, those costs can be recouped in as little as four years in patients with Type 2 diabetes. Long-term follow-up is necessary. Patients are advised to take regular vitamin and mineral supplements to prevent micronutrient deficiencies and bone disease. To avoid this, Dr Jordaan typically reviews patients at least yearly. As with any surgery, there is the risk of a surgical complication: bleeding, infection, leak, cardiac event, blood clot or damage to other organs. However for comparison, the overall level of risk for a gastric sleeve (the most commonly performed weight loss procedure) is similar to having a gallbladder removed and less than having a joint replacement. This has to be weighed against the risk of medical complications from the continued combination of obesity and Type 2 diabetes.
What’s the bottom line? Weight loss surgery offers an opportunity for those with Type 2 diabetes to put their disease into remission. That is, living their day-to-day life with no medication, no insulin. With wellcontrolled blood sugars patients reduce the damage being done to their eyes, kidneys, heart, blood vessels, teeth and nerves. Dr Jordaan states that patients now have an opportunity to decide if they want a lifetime of medical management or a surgical procedure. “I think people are entitled to be given a choice, to be educated about the possibilities that exist today,” he says.
pindaramagazine.com.au
Dr Jacobus (Jorrie) Jordaan MB ChB MMed Surg (Pret) (Hons) FCS (SA) FRACS is a Specialist Upper Gastrointestinal and Endocrine surgeon with 25 years experience. Having performed thousands of advanced and complicated surgical operations, he is among Australia’s most experienced specialists in minimally invasive weight loss (bariatric) surgery. Dr Jordaan and his team of dietitians, psychologists, nurses, anesthetists and medical specialists combine their years’ worth of expertise, innovation and people skills to ensure excellent patient experiences and long-term results.
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MEN’S HEALTH
A GLASS A DAY
Is regular moderate drinking really better than binge drinking? Alcohol plays a significant cultural role in Australia. Whether it’s at a lively AFL game, an intimate barbecue or bass-pumping nightclub, alcohol features in myriad social settings and is consumed in many different contexts. For years, there has been substantial research undertaken into the effects of alcohol on our health and community, much of this focusing on how the effects differ with frequency and quantity of consumption. In Australia, because alcohol is so widely accepted, we often forget that as a drug it comes with a risk to our health and safety. Additionally, people interested in reducing the risks are tempted to believe that regular moderate drinking – defined as two standard drinks per day – is less dangerous than binge drinking.
BUT HOW TRUE IS THIS, REALLY? With summer around the corner – a season of festivity, parties and sporting events that make up what we call the ‘silly season’ – this may be the opportunity for you to learn how your drinking patterns, or those of your partner, brother, father or friend, are affecting your health.
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MEN’S HEALTH
amount consumed and that for men and women, drinking only two standard drinks per day will reduce the risk of ARD or alcohol-related injury (ARI). Drinking less frequently over a lifetime – two standard drinks per week instead of day, for instance – also reduces this risk. For low-level, moderate drinkers, the level of risk of ARH is similar for men and women. However, as the level of drinking increases, the lifetime risk of ARD increases more quickly for women, and the lifetime risk of ARI increase more quickly for men. The Australian Bureau of Statistics identifies different attitudes between men and women towards health and health services, due to both biological and gender factors. This is associated with the fact that men are more likely to engage in risk-taking behaviour such as substance abuse and drink driving than women, which may partly explain why the risk of ARI is higher in men.
ONE SIZE DOES NOT FIT ALL
DRINKING IN AUSTRALIA
‘Bundy, champers, stubbies, grog’ – most, if not all, Australians are familiar with alcohol culture. According to the Australian Institute of Health and Welfare’s (AIHW) ‘2007 National Drug Strategy Household Survey’, 90% of Australians have tried alcohol in their lifetime, and 83% would have consumed it in the past 12 months. As noted by the Australian Drug Foundation, alcohol is the most commonly used drug in the country. The AIHW’s survey also identified that 50% of Australians drink at levels that put them at higher risk of alcohol-related harm (AHR) in the short-term and about one quarter of Australians at levels that put them in higher risk of ARH in the long-term. Forty-one% of Australians drink weekly and 8% daily, which contributes to alcohol’s huge burden of death, disease and injury across the country. As reported by Victoria’s Turning Point Alcohol and Drug Centre, there were 5,554 deaths attributable to alcohol in 2010 - 3,467 of those were men. In the same year, 101,425 of male hospitalisations were alcohol-related, while injuries were responsible for the largest proportion of alcohol-related deaths (ARD) in men. ARDs were also responsible for 84,945 years of life lost in men that year. Alcohol is a major factor in thousands of road and other accidents annually, and is at the core of many social problems such as public and domestic violence, family breakdown, child abuse and child neglect.
DRINKING GUIDELINES
Established by the National Health and Medical Research Council (NHMRC), the Australian Guidelines to Reduce Health Risks from Drinking Alcohol aim to form the evidence base for future policies and provide community resources on reducing the health issues associated with alcohol. The NHMRC conveys that the lifetime risk of ARH increases with the 38
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An individual’s ability to ‘handle’ their booze often distorts their perception of the damage. For instance, a man who doesn’t feel inebriated until his seventh drink, while his friend feels tipsy after two, may think that his health isn’t as vulnerable to alcohol. In fact, any consumption of alcohol has some level of impact on health, with certain quantities presenting more danger than others. There is a range of factors that also contribute to the variability in our biological responses to alcohol, determined by sex, body size and composition, age, experience in drinking, genetics, nutrition and individual metabolism. The NHMRC also identifies some social determinants that contribute to increased risk of ARH, including the clustering of risk-taking behaviour (smoking and binge drinking), particularly in men, and level of risk posed by the setting (driving from location after drinking). Although men experience lower blood alcohol concentration (BAC) than women because of their size, leaner tissue and larger livers, men’s higher rate of risk-taking behaviour means their risk of ARH exceeds that of women over a lifetime, within any drinking pattern. Mental health, existing health conditions, medication and family history of alcohol dependence also impacts an individual’s drinking experience and their level of risk of ARH.
REGULAR DRINKING VERSUS BINGE DRINKING
Over the years, research has been dedicated to debunking the myth around whether regular moderate drinking (two standard drinks per day) is healthier than binge drinking (for example, 10 standard drinks on a Saturday night). More recently, there have been a number pointing to regular low-moderate consumption as beneficial to health. Research by the University of Rochester in the United States tested the theory over a month by feeding one group of mice the human equivalent of two drinks every day, and another group seven drinks two days in a row, in an attempt to simulate regular moderate drinking and weekend binge drinking. A third group was given no alcohol. Unsurprisingly, the ‘binging’ mice had 19% higher levels of LDL cholesterol – the bad kind – than the ‘sober’ mice. However, quite surprisingly, the ‘moderate’ mice had lower levels of LDL 2015\2016
MEN’S HEALTH
cholesterol than the ‘sober’ mice, confirming the belief that regular modern drinking is beneficial. Post-binge levels of acetaldehyde, the by-product of alcohol metabolism responsible for hangovers, could be the reason for this. The body can process acetaldehyde well after one or two drinks, but struggles with any more. This is further explained in a separate study by the University’s Research Associate Professor John Cullen PhD, who explored how acetaldehyde makes white blood cells stick to the inside of blood vessels, which can lead to an artery blockage. Conversely, small amounts of alcohol were shown to actually prevent white blood cells from sticking to the arteries. In an experiment for a BBC Horizon documentary made earlier this year, identical twin doctors Chris and Xander van Tulleken from the United Kingdom set about testing the same theory. They both drank 21 units of alcohol per week over a month, but while Xander consumed the amount in one day, Chris spread the 21 units over seven days. After one month, the results showed that the men’s levels of cytokines and interleukins (markers of inflammation) were almost the same, which questions the notion that regular moderate drinking doesn’t produce as much damage as binge drinking. However, Xander’s blood test revealed three times the amount of bacterial endotoxin in his blood compared to Chris, caused by the irritation of his stomach lining and intestines during binging, which had leaked bacteria into his bloodstream. Additionally, they proved the UK’s national guideline of ‘two alcohol-free days’ between heavy drinking was not enough time for the liver to recuperate, as Xander’s inflammation levels remained high even six days after each binge. Not the first of its kind, Oregon State University published a study in February suggesting that red wine in moderation could help overweight people burn fat. However, similar claims have been knocked back by Australia’s Alcohol Policy Coalition, who highlight alcohol’s contribution to 5% of all Australian cancers, including one in five breast cancers. One 2009 study of 234 subjects with liver disease by the UK’s University of Southampton demonstrated that 106 of those with alcohol-related liver disease (ALD) drank on a daily basis, 70% of which had signs of cirrhosis. Over the long-term, this study suggests that daily drinking produces a greater risk of ALD than weekly binge drinking.
TO DRINK, OR NOT TO DRINK
Despite the research, social perceptions and personal experiences, there still remains no concrete answer as to which pattern of drinking produces the most damage. At this stage, the best advice to all people who drink alcohol – whether an ice-cold lager on the back deck or a couple of wines with the girls – is to reduce the quantity and frequency as much as possible. Though two standard drinks per day is the national guideline, every time you reduce this amount, your body has more chance to recuperate, detoxify and reduce ARH. Lastly, always drink to your body type, composition, sex and experience with alcohol. There is nothing safe about trying to ‘keep up’with mates. And always enjoy responsibly. Cheers!
For more information about alcohol, its effects and dependency services in Australia, please visit:
DEPARTMENT OF HEALTH WWW.ALCOHOL.GOV.AU DRINKWISE AUSTRALIA WWW.DRINKWISE.ORG.AU ALCOHOLICS ANONYMOUS AUSTRALIA WWW.AA.ORG.AU
artHroplaSty Hip & Knee SportS & trauma Dr. Andrew Letchford is a specialist in hip and knee orthopaedic surgery, with a particular interest in arthroplasty (joint replacement), knee reconstructions, sports injuries and acute orthopaedic trauma.
Fellow A.Ortho.A. FRACS Ortho MBBS ( Hons 1st Syd) B.Science ( Hons 1st Qld) Dip.Ed Orthopaedic Surgeon
Pacific Orthopaedics Pty Ltd Suite 3c level 4 pacific private Clinic | 123 nerang Street Southport
T 07 5527 1818
F 07 5526 4788 E reception@pacificorthopaedic.com.au
www.dr-andrew-letchford.com.au
WOMENâ&#x20AC;&#x2122;S HEALTH
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WOMEN’S HEALTH
Hormone Replacement Therapy Dr Michael Flynn
Some may say it is a time of anxiety. That biological clock alarm is about to go off. You have been warned about the hot flushes, and all the things happening at that time of life. You have been told that every little symptom you feel is just a matter of age and that’s just what you have to accept. But do you accept it or question it? For many women, menopause is surrounded by confusion and the medical profession has been one of the main perpetrators of women’s anxiety with their message changing constantly. On top of this, there are regular media reports about cancer risks and risks associated with hormone replacement therapy. So what is the real story and what is considered best practice today? Hormone replacement therapy (HRT) was the mainstay treatment 20 years ago. Every woman reaching menopause would commence HRT and no one battled hot flushes or had concerns about osteoporosis. The bigger question was when to cease HRT and which women should be restricted from it. Then along came The Women’s Health Initiative, which was a worldwide study giving outcomes suggesting an increased risk of heart attack and stroke if HRT was undertaken for more than five years. Immediately, all prescriptions ceased and women looked at alternative options, many of which had been less studied than HRT. Hot flushes, osteoporosis, mild urinary incontinence symptoms and painful intercourse became reasons women sought help, now that HRT was not being used. More subtle, but equally important, concerns of cognition, thought processing and longerterm dementia due to hormone deficiency came to light, Further investigation into the findings of The Women’s Health Initiative has indicated that their findings are not black and white. The complications of HRT seemed to focus on women who started HRT in their mid 60s. New research is now suggesting a possible ‘window of opportunity’ with many symptoms including dementia and cardiovascular risks decreasing if oestrogen is given prior to commencement of menopause, but possibly increasing if commenced more than 10 years post menopause. Best medicine today is the individualisation of care. Hitting 50 should be the exciting commencement of the next phase, rather than the anxiety of winding down.
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My best advice to make 50 the new 40 is:
1.
2.
3.
4.
5.
6.
Have a yearly check up with your GP. Minor medical problems are best dealt with early. Increase the focus on healthy living. Diet and exercise become more important. A diet rich in Vitamin E, Folate, B12 and mega-3 fatty acids may be protective against cognitive decline. Age is not an excuse not to attain that exercise goal. Do not be afraid of exploring oestrogen replacement. There are only a few absolute contraindications and the long-term benefits may be significant. Natural oestrogens and progestagens seem to have the lowest risk and you do not require blood testing to confirm benefits. Make a pledge to start brain exercises. There is strong evidence that daily mental stimulation decreases dementia risks. Do not accept that normal activities like sex and intimacy have to change. While thinning of the vaginal skin after menopause with subsequent painful intercourse is a very common complaint, reparative treatment like vaginal laser, which requires minimal downtime will restore moisture and stop the pain and dryness that make many women shy away from intimacy. Relations mature and evolve but should not stop.
Have osteoporosis assessment. Bone thinning is a significant medical problem in later life, which can be avoided.
7.
Do not neglect breast cancer screening.
Following these simple steps can help you to embrace one of the most exciting times in your life with a positive outlook!
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PLAY IT SAFE How to keep those little heads above water this summer
What is summer without water? As December ticks over, we take beach days to the next level, spending most of our time by the water with friends, family, and inevitably, children learning to swim. But whether a child is the swimming star of the local pool or the next Kelly Slater in the surf, parents spending summer by the water will start keeping an extra eye on young swimmers, as water presents one of the greatest dangers to children around the country. According to community service program Kids Alive, drowning is the greatest cause of accidental death in children under five in Australia, with an average of one child drowning each week. Though devastating, drowning is one of the most preventable causes of death for children. By learning how to prevent drowning and detect the signs of drowning – because it doesn’t always happen in deep water – parents can ensure their children’s safety and encourage their confidence in the water. 42
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Prevention of drowning As reported by Royal Life Saving Australia’s ‘National Drowning Report 2014’, 8% of children aged 0-4 and 10% of children aged 5-14 drowned between July 2013 and June 2014. These occurred in a range of environments, including inland waterways, pools and beaches. Although the national rate of all-aged drowning deaths has decreased to the lowest number it has been in 12 years, this figure, through water education and strict safety guidelines, could still be reduced. Moreover, 2012-2013 saw a shocking increase in children drowning deaths, whereby 31 children under the age of five drowned in waterways, pools and bathtubs during that period – a 50% increase on the previous report. Even more startling is that half of the 31 deaths occurred in an unfenced or inadequately secured pool, while 81% of all deaths were from falls into the water, indicating a lack of adult supervision.
Parents often think supervision entails being close-by to where children are swimming, but as the figures demonstrate, continuous active supervision is paramount to keeping children safe in the water. Drowning can occur in many other environments apart from the pool or the ocean. Ponds, septic tanks, wells, puddles, animal troughs, dams, spas and rainwater tanks are all very hazardous places for unsupervised children. Backyard pools, however, are the most dangerous. A common misconception is that children will only drown in deep water. In fact, a small child can drown in as little as five centimetres of water, in less than two minutes. Child Accident Prevention Foundation of Australia, Kidsafe, suggests four ways to prevent a young child from drowning. 2015\2016
CHILDREN’S HEALTH
1.Supervision At no point in time should a child be left alone in water, despite how ‘safe’ it seems. Inadequate supervision is the primary factor that contributes to children drowning. When supervising at the pool, bath or beach, even reading a text message or checking your phone momentarily allows enough time for a child to slip underwater. Supervision requires 100% attention and proximity to the water source – there is no safety in watching children in the ground level pool from the second storey balcony. Supervisors must be close enough to enter the water immediately. As reported by Kidsafe, most children are last seen by both parents in the home in the five minutes before drowning. Supervision must be throughout all rooms of the home and/or public area. Even social gatherings with multiple adults provide an opportunity for drowning if no one is allocated to watch the children. At social events, such as a barbeque, take turns with other parents/ adults to watch the pool, and be ready to jump in at any time. Supervising parents should not drink at this occasion. pindaramagazine.com.au
2. Eliminate hazards The simplest way to prevent drowning is to remove any hazards or objects that a child could climb to access a water source. In the pool area, remove any toys not being used from the water and pathway, as children can trip on these into the water or may attempt to grab one before falling in. Removing toys and objects from the area also prevents nasty falls. In the bathroom, remove any unused bath toys and objects and store in a safe place, as well as installing grip mats around the shower and bathtub. Close and secure the bathroom door when not in use. Toilets should also be secured closed. Around the home, anything that can hold water, such as buckets and wading tubs, should be emptied straight after use. Aquariums should be out of reach of children. When swimming, children should be wearing appropriate, lightweight swimwear without loose edges or tassels that may catch on something underwater. At the beach, always swim with children between the flags.
3. Environmental measures The first and most important environmental measure for pools is secure fencing of minimum 1200mm height, and no more than 100mm between slats so that children cannot slide through. The Queensland Government’s ‘Swimming Pool Barriers’ legislation requires that a fence be continuous for the full extent of the pool yard, strong enough to withstand human impact, and that it effectively restricts children from the pool yard with a childproof, self-closing gate and latch. Under changes from the Building Code of Australia (effective 1 May, 2010), child resistant door and window structures are no longer considered barriers to access swimming pools. For additional protection in the pool yard, rigid, motorised safety covers are recommended for preventing falls into the pool. All pool areas should display clear CPR instructions on the fence, and have a first aid kit within reach. Pindara Magazine
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What drowning looks like
4. Education TEACH CHILDREN TO SWIM Children should be familiarised with water from the newborn stage, and introduced to swimming lessons as early as possible. Don’t rely on floaties and floating devices for safety.
LEARN RESUSCITATION Learning CPR (cardio-pulmonary resuscitation) could be the difference between life and death. Once you have learnt it, update your knowledge every few months. Always keep a mobile phone in the pool area to call 000 as quickly as possible.
DEVELOP THEIR WATER SKILLS The most effective way to build children’s confidence in the water is to maintain their swimming lessons and contact with the water. Teach children about the importance of water safety and how to alert parents if another child is in danger. Kids Alive provides a comprehensive water safety video that covers children of all ages from newborn to pre-school. It also provides a CPR demonstration, tips on choosing a swimming school and features the famous ‘Kids Alive – Do the Five!’ water safety song for kids. Visit www.kidsalive.com.au.
This happens when a child has inhaled water, and although it’s less common than regular drowning, just six tablespoons of inhaled water is enough to kill a child. The two types are slightly different. With ‘dry’ drowning, which presents symptoms almost immediately after water inhalation, water doesn’t actually reach the lungs. Instead, the inhaled water causes the child’s vocal cords to spasm and shut down, making breathing difficult. Secondary drowning occurs when the child’s airways open up and allow water into the lungs, where it builds up and causes pulmonary edema; an abnormal build up of fluid in the lungs. Symptoms of secondary drowning usually show hours or days later.
Signs of ‘dry’ or secondary drowning • Lethargy or extreme fatigue • Difficulty breathing • Irritability or mood swings • Chest pain • Shortness of breath • Persistent coughing • Fever
Secondary drowning Most parents would assume that once swimming time is over, so too is the risk of drowning. However, secondary drowning and ‘dry’ drowning occur when a child drowns on land but after submersion into water, sometimes even 48-72 hours later. 44
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Drowning doesn’t always look like hands in the air and lots of splashing; most of the time, children who are drowning are already underwater. Sometimes drowning is silent.
The following are all quiet signs of drowning: • • • • •
The child is still, not waving and not making any noise, which is a sign of exhaustion The child’s eyes are glassy and unable to focus The child’s face is hard to see, as it may be covered in hair or clothing, which restricts breathing The child appears peaceful or not in distress, meaning they have lost their ability to communicate that they’re in trouble Total silence when the child is completely underwater
For more information about child water safety, drowning prevention and tips on choosing a swimming school, please visit the following: Kids Alive www.kidsalive.com.au
If you suspect that your child has swallowed a dangerous amount of water, take them to the hospital, where doctors can monitor their condition and/or remove fluids through diuretics. Do not ignore the signs.
Kidspot www.kidspot.com.au Australian Water Safety Council www.watersafety.com.au 2015
CHILDREN’S HEALTH
Excellence in women’s health care
For more than 22 years Dr Andrew Cary has been providing care to women of the Gold Coast. As a specialist gynaecologist and obstetrician, Dr Cary is able to assist with all women’s health concerns from heavy periods, endometriosis and hysterectomy to contraception, antenatal care and delivery. He has a particular interest in high-risk obstetric and antenatal care.
partner’s journey into conception, pregnancy and delivery.’ Dr Cary specialises in the following types of surgery, among others:
Dr Cary is a respected IVF specialist, having assisted many women and couples to achieve their dream of parenthood. He is a co-founder of Queensland Fertility Group Gold Coast.
• IVF egg collection • Complex embryo transfer • Hysteroscopy and surgery of the endometrium (womb-lining) • Laparoscopy • Tubal Sterilisation • Endometrial ablation.
‘As a father of three children, I understand both the trials and rewards of parenthood, and I am committed to every
‘I hope to be able to assist and guide you through your obstetric, gynaecology and reproductive care.’
Suite 10, Pindara Place, Carrara St, Benowa, Qld, 4217
Email: reception@drcary.com.au | Phone: 07 5597 3770 | Web: www.drcary.com.au
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CALL TODAY – (07) 5598 0098 Pindara: Suite 11, Lvl 2, Pindara Pl 13 Carrara St Benowa QLD, 4217
CHILDREN’S HEALTH
Summer of Fun! KEEPING THE KIDS ENTERTAINED THESE SCHOOL HOLIDAYS
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CHILDREN’S HEALTH
Movies Under the Stars Ages: 5 – 12
December hits, the heat rises, the waves crash and the days grow longer. Summer is a beautiful time for us lucky Australians, especially those living on the Gold Coast, where the holiday rhythm quickly attunes to the tide and coastal breeze. But for many families, the holidays also mean a house full of excitable kids who, without liability to homework or uniforms, feel the need to unload their energy on Mum and Dad. This summer, plan your family holidays with a loose agenda of activities, games and local events that will keep kids entertained and parents, sane.
Out and about The Broadwater Parklands Ages: All Stretching alongside the Gold Coast’s sparkling Broadwater lays the Broadwater Parklands with multiple barbecue areas, cycling and scooter tracks, shaded grass areas, a fenced playground and a boardwalk along the water’s edge. A narrow beach fades into an enclosed lido for young swimmers, while just off the shore, a series of mini pools and fountains - The Rockpools Water Playground - holds adventure for toddlers. On New Year’s Eve (Thursday 31 December 2015) the Broadwater Parklands will host its Food Truck Feast, featuring the Gold Coast and Brisbane’s best food trucks, live music and entertainment, and a spectacular fireworks show from 5.00pm to 9.00pm. Visit goldcoast.qld.gov.au for more information.
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Summer isn’t about being cooped up indoors with a couple of DVDs – it’s about watching great family films beneath the cover of twilight. Throughout summer, City of Gold Coast is playing family films, such as Shaun the Sheep and Inside Out, in pop-up outdoor theatres across various Gold Coast parks for its Movies Under the Stars program. From late December until early March, movies will be played at Palm Beach, Elanora, Broadbeach, Burleigh Heads, Reedy Creek, Mudgeeraba, Southport, Nerang, Ashmore, Pacific Pines, Coomera, Pimpama, Worongary and Maudsland. Grab a picnic blanket and enjoy some relaxed family time under the stars. Visit goldcoast.qld.gov.au for the timetable and list of movies.
Surfing lessons Ages: 5 – 16 The Gold Coast is an international surfing mecca that draws thousands of world-class surfers every year. Now it’s time for the kids to join them. Many local surf schools offer school holiday programs, including Currumbin Alley Surf School (CASS) and Go Ride A Wave (GRAW) in Surfers Paradise. Throughout the summer holidays, CASS offers a five-day Frothing Grommet Program for kids aged five to 16, which teaches surf safety and awareness, standing up, surf specific stretches, board control, and surfboard design and technology, with the option of duck diving and turning for more advanced students. GRAW is part of Surfing Queensland Surf School, whose programs are designed to teach 5-16-year-olds basic water safety and confidence, body surfing and standing up, with beach games included. GRAW offers a four-day school holiday program, as well as six-week school term programs for continued lessons. Visit currumbinalleysurfschool.com. au and gorideawave.com.au for more information.
Sparky Do Dah’s Natural Adventures Ages: 5 – 10 Playground adventurist Sparky Do Dah is one of the Gold Coast’s best entertainers who loves connecting kids with the natural environment. From late December through to late January, Spark Do Dah is hosting six ‘Sparky’s Natural Adventures’ in Burleigh, Mudgeeraba, Benowa, Bonogin and Varsity Lakes. Each Natural Adventure consists of two hours of nature-based games and activities designed to educate and familiarise kids with Australian flora and fauna. Parents are required to stay and watch their children participate, but are also welcome to join in the fun! Visit sparkydodah.com.au for the timetable and locations.
Mrs Red’s Art Room Ages: 2 – 9 Tucked away on West Burleigh Road, Mrs Red’s Art Room is bursting with paint, glitter and glue! Owned and operated by local art teacher Mrs Whittred (Mrs Red), this cosy and colourful art studio runs several art classes throughout the summer holidays for different ages. Let the kids’ creativity flourish in the Kombi Canvas class where they’ll use sand, fabric and paint to create their own vintage Kombi picture. The Skate Deck workshop supplies kids aged 9+ a high quality deck and materials to customise it, while children aged 5-8 in the Recycled Owls class will get arty with egg cartons, sticks and feathers. Visit mrsredsartroom.com for the Summer Madness timetable.
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At Home
Homemade Terrariums Ages: 12+ Equipment: • Coloured sand • Beach sand • River pebbles • Organic soil • Various small succulents and cacti • 1 spray bottle of water • 1 glass jar per child (you can pick up cheap glass jars from a dollar shop, or just use recycled jam jars) Instructions: 1. Pour a layer of coloured sand into jar and tap to even out. Pour a layer of beach sand and repeat. 2. Arrange one or two plants on top of the beach sand and surround with enough organic soil to cover the roots. 3. Arrange river pebbles around the plants to create a ‘miniature garden’ effect. 4. Spray with water regularly to hydrate.
Toilet Roll Characters Ages: 3 – 6 Balloon Painting Ages: 4 – 6 Equipment: • 4-6 inflated balloons • 4-6 different coloured oil paints • Easel • Mural (100 x 80cm) sheet of paper Instructions: 1. Set paper on easel and allocate one balloon per paint. 2. Show the kids how to press balloon into paint and onto paper. 3. Let them go nuts! Watch as they learn how different colours combine to create new colours.
Equipment: • Several empty toilet paper rolls • Paint and paintbrushes • Black permanent marker • Glue • Glitter • Googly eyes Instructions: 1. Paint each toilet roll with the colours that represent personalities – blue for sea monsters, green for forest creatures and purple for magical friends. 2. Using the permanent marker, draw each character’s facial features. 3. Glue on the googly eyes – as many as they wish! 4. Add glitter for special effect.
Great app alert! THE CLEAN & GREEN KIDS APP They want to help you cook, and you want them to eat healthy – parents, say ‘hello’ to the app that combines the two! Created by a creative Gold Coast couple who are passionate about holistic health, the Clean & Green Kids App is filled with easy and nutritious recipes for the young ones.
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From coconut and vanilla pops, to healthy chocolate crackles, to chicken teriyaki bowls, these recipes are designed to inspire kids to discover the beauty of real food.
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The Blueprint for Breasts An architectural science by Dr Layt
The finest things are tailor-made, so why should your breasts be an exception? At the Layt Clinic, Dr Craig Layt has developed a perfect model that balances his expertise with his patient’s desires. In the same way that a blueprint is necessary to build the perfect house, Dr Layt’s unique six-step strategy to breast augmentation allows patients to plan, envisage and experience a customised procedure. It’s our busiest time of year for breast augmentations at The Layt Clinic, and below we answer some of the most frequently asked questions. What is a breast augmentation? Am I suitable?
A breast augmentation is a procedure designed to produce larger and more shapely breasts. It involves the placement of breast implants behind the breast or chest wall muscles in order to achieve the desired result. Breast augmentation surgery is performed under a general anaesthetic and normally as a day procedure. Candidates for breast augmentations include women who desire larger breasts and women with smaller breasts who have a moderate degree of breast sagging. We can also assist women with asymmetry (where one breast is noticeably smaller than the other).
What should I expect during the consultation process and lead up to surgery? The most important part of the surgery experience is often the consultation process. This process enables a decision to be made regarding the appropriateness of the operation and the type of procedure which best suits the individual. At the initial consultation, Dr Layt takes each patient through six decisions needed to “build the house”:
1. Size of the implant
The final size after breast augmentation is a result of the existing breast tissue plus the implant. This means that placing the same implant size in two different people will give two different results. Dr Layt will discuss 50
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the desired size, and direct the decision making process based on what may suit the individual’s particular body shape. Dr Layt states, “It’s a bit like building a house. The footprint of the house needs to be the correct size and shape, and then the volume is determined by how many floors are put on it. This process is assisted by the use of our Vectra 3D imaging system". The Vectra 3D Imaging System at our Southport Clinic allows the patient to see a surgical prediction in 3D and with high definition. This is a valuable tool for Breast Augmentation in particular, allowing patients to become familiar with a very realistic simulation of their surgical forecast. Highquality before photos will be taken in both 2D and 3D forms for accurate reflection and comparison post surgery.
2. Shape of the implant
The final breast shape is largely determined by the current shape. The use of shaped implants can sometimes be an advantage. This will be discussed at the consultation.
3. Surface
The implant shell can be either smooth or textured, reflecting the different approaches taken to limit the risk of capsular contracture - also known as implant hardening. Generally, textured implants are preferred as they have a lower risk of long term issues.
4. Incision site
Implants can be placed with an axillary
(armpit) incision or peri-areola incision but most commonly an incision in the breast crease is used as it has the most predictable long term result. A scar in the crease under the breast is usually hidden while standing and is not seen whilst dressed in standard clothing. The choice of approach will be discussed at length during the consultation process.
5. Placement of the implant
Breast implants can be placed in front of or behind the chest wall muscle. Placing the breast implant behind the muscle tends to give a smoother line and less chance of feeling the edge of the implant. There is also evidence that it reduces the incidence of hardening of the implant. It is particularly useful in women who have very little breast tissue. Positioning the breast implant in front of the muscle is advantageous in women who have slightly droopy breasts or who do a lot of chest exercises.
6. Implant filling
The breast implant can be filled with either saline or silicone. A cohesive medical grade silicone gel, in general, feels more natural than saline, and produces long term good results. The selection of the implant is a joint decision between the patient and Dr Layt. The pros and cons of the various implants will be discussed, including the appropriateness of size, shape, placement, implant filling and implant shell in relation to the individual patient.
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A selection of pre and post-operative photographs of our patients are available on our website, however a larger range are available for viewing at the initial consultation. At The Layt Clinic, we are committed to helping patients through this important decision-making process, and patients can see Dr Layt after their initial consultation for a further discussion appointment prior to surgery. Patients can also choose to see one of our Patient Co-ordinators for a complimentary information session prior to seeing Dr Layt to discuss the procedure and recovery, quotations for the procedure, Vectra 3D simulation, booking a consultation with Dr Layt and available surgery dates. Most patients find this to be a valuable step in their journey and experience. Once the consultation is complete, a Patient Co-ordinator will manage any paperwork, including hospital bookings and quotations for surgery.
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Dr Layt uses a precise surgical technique which allows for a rapid recovery process. Patients go home after the procedure wearing a comfortable soft cup bra. Dr Layt rarely uses drains for routine Breast Augmentation. Most patients find they can return to work within one to three weeks depending on their role. Normal activity such as exercise can usually be resumed within 6-12 weeks. Please note this may differ for each patient and their circumstances.
Why choose Dr Layt?
Dr Layt is a Specialist Plastic, Reconstructive and Cosmetic Surgeon with over 20 years experience in his field. The focus of Dr Laytâ&#x20AC;&#x2122;s practice is Plastic and Reconstructive surgery, with a subspecialty in Cosmetic surgery â&#x20AC;&#x201C; Breast Augmentation in particular. Dr Layt is dedicated to a high standard of patient care and the achievement of excellent results, while his commitment to quality and safety are a testament to his passion for his work.
For more information, or to make an appointment to see Dr Layt or one of our Patient Co-ordinators, contact us on (07) 5597 4100 or through our website at www.drlayt.com.
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2015\2016
Feeling Hot This season's best beauty buys
Trilogy Daily Defence Moisturiser SPF15 $45.95 RRP Go Vita stores Trilogy’s philosophy is built on uncomplicated skincare. Using a unique blend of pure natural plant oils and botanical extracts, including Jojoba and rose hip seed oil, Trilogy’s non-greasy, non-whitening Daily Defence Moisturiser SPF15 gives you healthier, younger looking skin with no nasty ingredients.
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Miód Everyday Gift Pack for Men $68.00 RRP
miod.com.au Ladies, why should we get all the beauty pack fun? For Christmas, gift your male loved ones with a nourishing skin pack from the 100% natural Australian skincare brand, Miód. The Daily Face Cream, Cleansing Shaving Oil and Soothing Aftershave Gel are made from rich combinations of minerals and oils, which leave faces smelling fresh with woody, citrus and fruity fragrances.
The Little Alchemist Cacao & Banana Face Glow $65.00 RRP
thelittlealchemist.com.au Sounds like a smoothie, works like a dream. The Little Alchemist’s Cacao & Banana Face Glow combines raw cacao, banana, acai berry, green papaya, turmeric root and loads of vitamins, minerals and antioxidants to exfoliate, smoothen and draw toxins from the skin. Enjoy the feeling – and fragrance – of naturally beautiful skin.
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Edible Beauty No.2 Fountain of Youth tea $24.00 RRP
ediblebeautyaustralia.com
Sip to beautiful health with Edible Beauty’s aromatic, anti-ageing and hydrating tisane. Let rosehip and hibiscus soothe your senses and promote circulation, while pineapple and papaya, abundant with Alpha-Hydroxy Acids, promote skin renewal, assist your digestion and turn back the clock.
Sukin Super Greens Detoxifying Clay Masque $15.99 RRP Priceline
Invisible Zinc 4HR Water Resistant SPF50+ $21.99
Kiehl’s Powerful-Strength Line-Reducing Concentrate $91.00 RRP
Priceline
Myer
This maximum-protection, non-greasy sunscreen from Invisible Zinc is the first of its kind in Australia, with Zinc Oxide as the only active ingredient. It’s silky to touch, easy to apply, four hours water resistant and is free of parabens and mineral oils. Healthy skin starts with excellent sun care.
You can kiss your crow’s feet and frown lines goodbye with this active soothing concentrate from Kiehl’s. Formulated with 10.5% Vitamin C and antioxidant and collagen boosting ingredients, daily use has shown to improve skin texture and reduce the appearance of lines and wrinkles.
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We eat them, we drink them, and now they’re in our beauty regime! Kale, spirulina, avocado, parsley and chlorella combine with a luxurious blend of antioxidants and vitamins in Sukin’s Detoxifying Clay Masque. Along with rosehip oil, baobab and bentonite clay, your fresh, youthful complexion will have onlookers green with envy.
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BEAUTY
Dress Code: Decoded MEN
With the silly season well and truly upon us now, there is no doubt your social calendar is quickly filling up with festive invites. From cocktail parties to more formal affairs, the confusion surrounding what to wear can be overwhelming. Here we decode the dress code for you.
WHITE TIE
Also referred to as full evening dress, full dress, or evening dress, this is the most formal of all the dress codes. For men, white tie calls for full coat and tails: black tailcoat worn over a white starched shirt, marcella waistcoat and a white bow tie worn around a detachable collar. Accessorise with cufflinks and shirt studs. Traditionally, white tie called for a top hat, however this is no longer the case.
BLACK TIE
Slightly less dressy than the white tie code, black tie generally requires a tuxedo and white dinner shirt with black bow tie. Accesorise with freshly polished patent leather shoes and a white handkerchief or pocket square tucked into the left breast pocket of the jacket. Don’t ruin the look with white or coloured socks! Make sure you wear long, black socks so that you don’t accidentally flash any bare flesh whilst seated.
COCKTAIL
Although the cocktail dress code used to stipulate a black suit with white shirt, these days it’s perfectly acceptable to stray from black, as long as you stick with a darker colour in an appropriate fabric. A tailored, slim cut charcoal or black suit with a white shirt and patterned tie will ensure you stand out from the crowd, without drawing too much attention to yourself. As with the other codes, ensure your shoes are freshly polished, your suit is wrinkle-free, and your shirt is crisply ironed.
LOUNGE SUIT
Whilst ‘lounge suit’ may sound a bit daunting, it actually just means your regular old every day business suit. This is where you can get a bit more creative with colour, wearing a navy, blue, grey or taupe suit paired with a patterned or coloured shirt. It is customary to wear a tie, and you may accessorise with a pocket square if desired.
SMART CASUAL
This is where you get to ditch the suit and tie! Pair a blazer or sports coat with slacks or chinos, and a collared shirt, preferably in a lighter colour. You can leave the tie at home, and if it’s too hot, it’s perfectly acceptable to ditch the jacket. Just make sure your shirt is freshly pressed and tucked neatly into your pants. Denim is to be avoided, and shorts are also a no-no. 54
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BEAUTY
Dress Code: Decoded WOMEN
With the silly season well and truly upon us now, there is no doubt your social calendar is quickly filling up with festive invites. From cocktail parties to more formal affairs, the confusion surrounding what to wear can be overwhelming. Here we decode the dress code for you.
WHITE TIE
Also referred to as full evening dress, full dress, or evening dress, this is the most formal of all the dress codes. White tie calls for a full-length, formal evening dress. Shorter dresses or trousers for women are considered unacceptable. Being the dressiest and most formal code, extravagant jewellery may be worn to complement your gown, and evening bags should be small and elegant. Shoes should have a high heel. Traditionally, white tie called for long evening gloves, however this is no longer the case.
BLACK TIE
Slightly less dressy than the white tie code, black tie for women generally requires a floor-length gown, although perhaps in a slimmer silhouette than a white tie gown, in any colour. Dressy trousers, preferably in a wider cut, are acceptable, so long as the whole look is appropriately styled. Your dress can be accessorised with fine jewellery and an elegant evening bag. Hair may be styled in an up-do or may be worn out, as long as it is perfectly coiffed. Shoes should have a medium to high heel.
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COCKTAIL
Although the cocktail and lounge suit dress codes are quite similar, there are subtle nuances that lend a difference. The cocktail dress code is slightly dressier than lounge suit, and whilst both codes call for knee-length or midi length dresses, cocktail dresses are generally darker or richer in colour and fabric, and may feature embellishments such as sequins or beading. Complement your cocktail dress with high heels, dressy jewellery and a small evening bag.
LOUNGE SUIT
For an event with a lounge suit dress code, choose a knee-length dress in a lighter colour and fabric, leaning more towards a day dress. Accesorise with a mid to high heel and some understated jewellery. You may carry a more casual bag such as a plain oversized clutch.
SMART CASUAL
Smart casual is probably the most confusing of all the dress codes, but the general rule is to dress appropriately for the event you have been invited to. For example, Christmas drinks with a smart casual dress code would call for a blouse and skirt, jumpsuit, or well-cut trousers or tailored shorts with silk camisole top and heels. Accessorise with simple jewellery and an understated shoulder bag. Denim jeans or shorts should be avoided â&#x20AC;&#x201C; save these for a casual barbecue or informal gathering.
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INCREASE IN MEN SEEKING COSMETIC PROCEDURES It used to be an almost exclusively female dominated market, but in recent years industry experts are reporting an increase in men undergoing non-surgical and surgical cosmetic procedures. Whether it is to maintain a competitive edge in a business world full of younger men, to keep up with a younger looking (or just younger) partner, or simply to feel better about themselves, more and more Gold Coast men are embracing surgical and nonsurgical procedures. Susan Walsh, registered nurse and injectables specialist with leading Gold Coast cosmetic practice Advanced Aesthetics says while the ratio of men to women utilising cosmetic procedures is still about 1:30, she has seen a significant increase in male procedures over the past decade. “Those numbers have certainly been increasing over time,” Susan says. “Men of all ages are becoming increasingly aware of their appearance, and recognising that there is a huge variety of treatments suitable for men.”
While Australian figures are unavailable, in the US the increase in male surgical procedures has been significant, with the American Society of Aesthetic Plastic Surgery (ASAPS) reporting the number of cosmetic procedures for men has increased by more than 106% between 1997 and 2012. Leading Gold Coast plastic, reconstructive and cosmetic surgeon Dr Dilip Gahankari says he had also seen an increase in male surgical cosmetic procedures, most commonly rhinoplasty (nose job) and gynecomastia surgery (male breast reduction). Dr Dilip says there has also been an increase in tummy tucks for men, body lifts (after massive weight loss), liposuction and eyelid surgery to address drooping or heavy eyelids.
Susan, who is also the Queensland Clinical Trainer for Galderma Q Med, the global dermatology company that produces many of the injectable products used widely in the industry, reports an increase in men between the ages of 30 and 50 accessing treatments, most commonly those used to address wrinkles and frown lines. “Some men have professional reasons for wanting to address excessive wrinkles and sun-damage,” she says.
“As patients become more aware of their options, and the relative ease with which these procedures can be undertaken, we are seeing an increase in men taking up surgical solutions,” Dr Gahankari says.
“They are doing business or competing with much younger men, and often believe a prematurely aged face is holding them back professionally. So they may undertake a series of injectables to address that; allowing them to make very subtle changes that have a big impact on their appearance and confidence.
“It is rarely talked about, but Gynecomastia is a condition that affects an estimated 4060% of men. In some cases the condition is so noticeable that it may have a severe impact of a man’s self-esteem, his personal relationships, sex life and in some cases his career.”
“On a personal level there are many men who – like our female patients – don’t feel their appearance accurately reflects who they are. In Australia, sun damage to the 58
skin results in premature aging of the face in both men and women, and more and more men are seeking measures to undo this, and turn back the clock somewhat. “We are also seeing men undertake laser tattoo removal as well as laser skin treatments.”
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“With something like the male breast reduction or Gynecomastia, this can be a life-changing surgery for men who have spent much of their adult life self-conscious about this area of their body.
Both Susan and Dr Gahankari say that male patients, while open to undergoing the procedure, are less open to discussing it with friends and family.
“Certainly men are concerned about the procedures remaining private,” Susan says. “And they are looking for subtle results that will make a difference without being overtly noticeable. “With the type of procedures we offer we are able to tailor the results so a male patient looks refreshed and rejuvenated without looking ‘done’, which is very important to them.”
Top three procedures for men 1. Anti-ageing injectables 2. Nose reshaping surgery 3. Male breast reduction surgery
About Advanced Aesthetics: Advanced Aesthetics Plastic Cosmetic Surgery and Laser Centre is based on the Gold Coast. The specialist team at Advanced Aesthetics is headed by Dr. Dilip Gahankari, an Australian qualified plastic, reconstructive and cosmetic surgeon, with more than 21 years of experience. Dr. Dilip specialises in minimal scar plastic surgery of the face, breasts and body, and is keenly aware of the importance of short scars in modern plastic surgery and is dedicated to delivering a natural look. Advanced Aesthetics also specialise in laser therapies, including the latest in tattoo removal technology, along with a full suite of skin health and beauty treatments including waxing, manicures, facials and more. For more information visit www.iplasticsurgeon.com.au or phone Advanced Aesthetics on (07) 55 39 4611.
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SKIN HEALTH ○ New York Facial ○ Microdermabrasion ○ Transdermabrasion ○ Acne Peel ○ Hydration Peel ○ Pigmentation Peel ○ Anti-Ageing Peel ○ Dermapen Skin Needling
ANTI-WRINKLE CENTRE ○ Injectable Fillers ○ Wrinkle Treatments ○ Platelet Rich Plasma (PRP) ○ Lip Lines ○ Lip Enhancement ○ Fine Lines ○ Frown Lines ○ Smile Lines ○ Bunny Scrunch ○ Marionettes ○ Brow Lift ○ Brow Flare ○ Gummy Smile ○ Temples ○ Chin Dimples
LASER CENTRE ○ Laser Hair Removal ○ Veins ○ Pigmentation ○ Rosacea ○ Acne • Birthmarks • Tattoo Removal • Large Pores • Scarring • Photorevelation ○ Skintyte • ProFractional Resurfacing • Emerge • Vasculyse • Focus Array
BODY HEALTH ○ Hyperbaric Oxygen Chamber • Aromatherapy Massage • Healing Hot Stone Massage • Mummy-To-Be Massage • Exfoliation & Salt Glow
BEAUTY SERVICES
Anti-Wrinkle Treatments FROM
$4.75 p/u Plus skin peel
for a limited time only!
○ Waxing • Tinting • Deluxe Manicure • Deluxe Pedicure • Spray Tan • Exfoliate & Tan • SkinCeuticals • PrioriMD
DR DILIP GAHANKARI M.Ch., F.R.C.S (Edin), F.R.A.C.S (Plast)
Dr. Dilip’s commitment is to provide outstanding care to his patients with assurance of safety and quality in all aspects of their Plastic Surgery management. It is with this sincere philosophy that he performs every procedure.
Pindara Specialist Suites, Level 3, Suite 305, 29 Carrara St, Benowa | P: 55 39 46 11 | www.iplasticsurgeon.com.au
A local,natural sunscreen manufacturer shares their tips on sunscreen usage MooGoo Skin Care recently released their Natural SPF 40 Sunscreen.
Many regard sunscreen as an inconvenient necessity. Sometimes it’s too greasy, sometimes it contains seemingly harmful ingredients – and then there’s the confusion about how they should be used.
We want to clarify some that confusion with these basic tips: There are two categories of sunscreen. Most commercial sunscreens use UV filters to absorb UV radiation, causing the sunscreen to gradually break down on the skin. Therefore, they generally need to be reapplied every one to two hours, as per the directions, to maintain adequate sun protection. These sunscreens are often lighter and easy to apply, and a little cheaper to purchase. The other type of sunscreen uses Zinc Oxide to reflect UV radiation away from the skin, acting like a reflective barrier. Clear Zinc Oxide sunscreen rubs in clear, but because it needs to warm to body temperature it demands a little extra effort to apply. It’s usually thicker in consistency. A high SPF number does not mean a sunscreen will provide sun protection for a longer period of time. SPF measures sun protection at a given time, which is tested about 20 minutes after application, not hours after application. Some sunscreens need to be reapplied often in sunlight to maintain their SPF level. A high SPF will give many hours of protection, provided it is used as directed. Sunscreens do not need to list all of the ingredients they contain, only the active ones and the preservatives used. This can make it difficult for people with allergies to certain ingredients, people who prefer natural ingredients and vegans. The best sun protection – and first line of defence – is adequate clothing, a hat and avoiding the sun during peak hours. The next step is to choose the type of sunscreen you are most comfortable with and applying it as directed. If your sunscreen requires frequent reapplication, make sure not to forget!
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THE LOTUS INSTITUTE
M.I.F.A.C.E.
Before
After
PROSHOCK ICE THERAPY
(PSI)
The team at the Lotus Institute are excited to introduce the next generation in fat reduction technology the Proshock Ice (PSI), a ground breaking new treatment for stubborn pockets of fat and cellulite. The Lotus Institute on the Gold Coast is the first plastic/cosmetic clinic in Australia to utilise this form of therapy.
PSI works in the following steps: 1. Freeze the fat cells in the area being treated 2. Shock the frozen fat cells that contain ice crystals 3. Fragment the fat cells, which release stored fats into the lymphatic system and circulation
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CELLULITE: The treatment is performed every seven to ten days for six sessions. The treatment lasts 30-60 minutes in which time the two technologies, ice lipolysis and shock therapy, are rhythmically alternated.
Meanwhile, PSI freezing only takes 1020 minutes per area, with the operator moving the cup every one to two minutes. This is immediately followed by the shock treatment, administered with the Proshock gun, which produces up to 1,000 rapid shocks to the area over five to ten minutes. The PSI procedure is painless, non-bruising and with no risk of cold burns. Data from overseas users suggests good results after four to six treatments to each area of concern, with seven to ten days between each treatment. Excess fat in the areas of concern can be treated, as well as areas of dimpling or cellulite, utilising three different protocols. Assessment of the areas of concern will be completed by a consultant/nurse/doctor to ascertain whether PSI is the appropriate treatment for you. A simple questionnaire requesting your history of lifestyle (diet and exercise), genetic background, medical history, previous treatments in the area are all important questions to determine the best treatment for you.
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The freezing probe reaches a higher temperature compared to that of the fat treatment. As a result of vascular gymnastics and shockwave treatment, excellent results are obtained.
Proshock Ice FAQ ProShock Ice is a non-invasive device used for the reduction of localised fat and cellulite. It uses an innovative, patented technology called ‘Ice-Shock-Lipolysis’ which is a controlled cooling system that is able to eliminate excess fat cells without damaging the surrounding tissue and a shock wave which effectively eliminates cellulite.
What does ProShock Ice target? • • •
Localized fat bulges that have not responded to diet and exercise Fibrous Cellulite Edematous Cellulite
What happens during the procedure?
The examination includes an assessment of the skin, fat and cellulite, hydration of the area, measurements of the area at each treatment and standardised photographs.
FAT TREATMENT: The treatment is performed every seven to ten days for six sessions. Each session begins with the ice lipolysis treatment first, followed by the shock therapy treatment.
While PSI is not a treatment for general obesity, it is an effective and affordable way to treat several areas over a period of time, treating up to two areas at one time.
The freezing probe reaches very low temperatures to allow freezing of the fat cells and as a result the cells undergo “apoptosis” (programmed cell death).
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Can I return to normal activities after my procedure? Yes! The PSI procedure is completely non-invasive and does not require any anaesthesia, so you can resume daily activities and physical exercise immediately. We even recommend partaking in exercise such as walking to help flush your system and aid in detoxification.
How long do the results last? The results for fat reduction are permanent. Once a fat cell is destroyed it is gone for good and cannot re-grow. Cellulite results will last for approximately 1-1½ years and all that is required is one to two treatments per year for maintenance.
Dr Peter Widdowson M.B., ChB, F.R.A.C.S.) Plastics. Dr Paul Downie M.B.,B.S., F.R.C.S.(ED),F.R.A.C.S Head Office: Level Two, 2 Short St Southport 4215 Tel: (07) 5509 4488 Fax: (07) 5528 4166
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Darina’s passion for pathology was ignited by her U EbasisEof disease N Sduring L A fascination by theQ pathologic medical school.
N D U L T R A S O U N D “I find it stimulating, challenging and F O R W O M E N
satisfying making tissue diagnoses on all the women the Gold Coast & surrounding areas. specimens,Caring rangingforfrom smallonbiopsies to the complex surgical resections. It is about getting the right diagnosis for the NON INVASIVE PRENATAL TESTING right- FROM treatment.” (NIPT) 10 WEEKS ROUTINE DATING SCANSHistopathologist Dr Darina Vuong, Consultant FIRST TRIMESTER SCREENING and Cytopathologist MORPHOLOGY
QML Pathology upholds a strong commitment to GROWTH SCANS delivering world-class GYNAECOLOGY SCANSdiagnostics services to support medical practitioners in patient care. Our testing HIGH RISK COUNSELLING INVASIVE PROCEDURES capabilities assist in the treatment of patients through - CVS/AMNIOCENTESIS improved prevention, early detection and diagnosis of SALINE INFUSION SONOGRAPHY diseases. As 70 per cent of all healthcare decisions are TUBAL PATENCY ASSESSMENTS reliant on diagnostic services, we are proud to offer such MULTIPLE PREGNANCIES extensive and diverse pathology testing. QML Pathology is dedicated to providing medical practitioners premier pathology services, Contact our friendly staff combining advanced technology with for an appointment. highly skilled staff to ensure the best service possible.
Specialist doctors who are obstetricians & gynaecologists working with highly trained specialised obstetric & gynaecology sonographers. QUFW doctors & sonographers are also skilled in the management of routine & high risk obstetrics & tertiary gynaecology ultrasound.
WE NOW OFFER NON INVASIVE PRENATAL TESTING - NIPT.
Q U E E N S L A N U L T R A S D O U N F O R D W O M E N
PHONE 07 5528 2934 FAX 07 5528 3849
ALL REFERRALS ACCEPTED.
www.qufw.com.au
Suite 2401, Southport Central, Tower 2 Level 4, 5 Lawson Street, Southport
OPENING MID JAN 2016 John Flynn Medical Centre Suite 3D, 42 Inland Drive, Tugun
T H R E E H O UR S FRE E PARKI NG I N T HE UNDE RC OVE R C AR PARK
Your Local Gold Coast Pathologists Our specialist pathologists have access to the latest diagnostic technology, ensuring results and specimens are processed accurately and efficiently. They are experts in their field, who are supported by a network of five laboratories and over 100 accredited collection centres. Our Pathologists and scientific team are available for consultation and invite you to contact them with any queries on (07) 5668 4444 or visit www.qml.com.au
Dr Darina Vuong
Dr Tony Dare
Consultant Histopathologist and Cytopathologist darina.vuong@qml.com.au
Pathologist in Charge: Gold Coast and Northern Rivers anthony.dare@qml.com.au
MBBS (Hons), BSc, FRCPA
FRCPA MIAC
TRAVEL
THE FOODIEâ&#x20AC;&#x2122;S GUIDE TO
Vietnam Whilst Thailand has long held the culinary crown of Southeast Asia, Vietnam is shaping up to steal the title of gourmet paradise. A feast for all the senses, Vietnam deserves a place on your bucket list, as avid foodie, traveller and photographer Larna Howard recently discovered â&#x20AC;Ś
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HANOI
Affectionately known as ‘Hanoisy’ for its constant symphony of motorbike horns, Hanoi immediately gets under your skin. We stayed in the Old Quarter, with its narrow streets, delicious pho (the quintessential Vietnamese noodle dish) on every corner and fellow tourists anxiously learning to dodge the traffic. We spent the day wandering the streets and enjoying the local beer while people-watching from six stories up, at the City View Café near the Ho Hoan Kiem Lake. We explored the French Quarter, with its majestic buildings including the Sofitel Metropole, famous for being the home of both foreign reporters and visiting celebrities protesting the war. Our first night was spent on a street food tour with local student ‘Gary’, who took all the worry out of finding the best places to eat, introducing us to Bun Cha, (skewers of marinated pork with vermicelli noodles and fresh herbs) and Nem Ran (mushroom spring rolls). Papaya salad with air dried beef was another new favourite, and amazingly after sampling all of this, we still had room for mushroom and pork pancakes (Banh Cuon) and dragon and jackfruit salad with coconut water jelly and condensed milk – another French influence. The final stop of our tour was a tiny rooftop bar overlooking the serene lake, hidden down a narrow alleyway and up five stories of wobbly spiral staircases. This is where the locals enjoy yet another Vietnamese institution, sweet iced coffee. The next day, an escape to the countryside took us to nearby Ninh Binh and Tam Coc where we were paddled by locals through the paddy fields framed by tall limestone mountains. This area was once the ancient capital of Vietnam and, as such, has seen its fair share of conflict, but is now peaceful but for the sound of locals beeping their horns at tourists riding bicycles for probably the first time since childhood. Dinner back in the city was once again happily spent on a busy sidewalk, our gangly knees struggling to fit on the tiny plastic chairs obviously not designed for tall westerners. We had Bun Cha again, too full to fit more in before calling it an early night with the rest of the city. I was surprised to find myself almost emotional that we were leaving Hanoi – the city really grows on you. We headed to Halong Bay, a slow four-hour drive north towards the Chinese border. We were met with rain and fog but the sheltered waters were a calm change from the city. The bay is littered with identical cruise boats, with all their passengers taking identical photos – but the natural beauty of the area surpassed the conveyer-belt feeling. We kayaked through caves and towering castes, learnt how to make Nem Ran (fried spring rolls) and made new friends. Our tour guide Huiu, or Mike as he introduced himself to foreigners, really made the trip, memorising every guest’s name and nationality even before we’d left the coach on the first day. He epitomised the Vietnamese people, with his enormous smile and neverwavering enthusiasm.
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Eat • ‘For Tomorrow Travel’ Food Tour • Banh Mi 25 • City View Cafe Stay • Golden Sun Moment Hotel (15 Hang Can, Hanoi) Play • Galaxy Premium Cruises
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HOI AN
This small ancient fishing town had a lot to live up to. We arrived wary that we held too-high expectations after everyone we’d spoken to declared it their favourite part of Vietnam. Safe to say, it did not disappoint. A foodie’s paradise, and as pretty as a picture, it’s easy to see why it rates so highly with visitors. Hoi An was where we saw the first blue skies of our trip, where we ate some of the best food of our lives and where I could easily spend another week. It exudes a laid back calmness where time seems to slow down. Among other things, we made sure we sampled at least three of the local delicacies, being Hoann Thanh Chien (crispy fried crab wontons with tomato salsa) Mi Cao Lau (delicious thick smoked noodles with pork, only found in Hoi An) and of course the famed Banh Mi, which was first on our list. Celebrity chef, author and television host, Anthony Bourdain, was right to claim these are the best sandwiches in the world. There is no shortage of amazing street food in Hoi An, as well as a huge array of elegant yet affordable dine-in restaurants, and you’d struggle to spend $20 on a single meal. Our first full day was spent scouting the hundreds of tailors lining the streets. We settled on two different stores – a bit of an experiment in case we weren’t impressed with the quality of one, a fear that proved to be unfounded. After measurements were taken and fabric choices were made, we took a short stroll back to the calm oasis of our hotel – my favourite of the trip – Ha An. This boutique-style hotel of only 24 rooms featured large airy rooms and architecture that was a mixture of French Colonial and Portuguese influence. The next day we awoke to welcome sunshine, so after relaxing by the newly constructed pool, we took our complimentary pushbikes into the centre of old town again, for more street food and the obligatory suit fittings. We met up with an old friend of my husband’s, who has called Hoi An home for three years now, and received some great local tips (all about food of course!) and even bumped into people from our Halong Bay cruise in the pretty streets. Hoi An by day is simply beautiful - blue skies offset by ochre and sunset-coloured buildings hundreds of years old, with vibrant pink bouganvilleas on every corner, but Hoi An by night is pure postcard material. 70
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The population seems to quadruple by evening, as drums are played by the river, puppet and dance shows are performed and locals peddle their wares, offering lanterns to float down the river. It superseded all expectations, especially the buzz of dusk with brightly coloured lanterns suspended above each street. We finally felt we needed something other than street food, and consulted Trip Advisor for the best dine-in restaurants – we chose Cargo Club one night, and Morning Glory the next – both run by the same Vietnamese woman who also holds cooking classes, one of the many things we want to return one day to attend. I sat by the pool the next day already dreading having to leave the warm colourful village. More Banh Mi (from the stand Anthony Bourdain made famous) was well earned that day, after a very sweaty half-hour bike ride to nearby Ao Nang beach. We collected our tailored clothes and reluctantly farewelled Hoi An. Another week could easily be spent here – and even if you did bore of the town itself, it’s less than half-an-hour to the clean, modern city of Danang with its pristine palmlined beaches, and the nearby mountain ranges are easily accessible for a bit of exploring.
Eat • Cargo Club • Morning Glory Restaurant • Phi Banh Mi • Madam Khanh Banh Mi • Banh Mi Phuong • Café Ti Muoi Stay • Ha An Hotel (6 Phan Boi Chau Street, Hoi An City) Play • Ao Nang beach
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NHA TRANG
A spectacular sunset welcomed us to the seaside city of Nha Trang, an hour-long flight south of Hoi An. With each stop we made on our tour of Vietnam, the weather got warmer and more humid, as we neared the equator. Luckily, we welcomed the heat, as Nha Trang was our chance to relax poolside, and do as little as possible! Our first evening was spent atop our hotel, at the Sheraton’s rooftop bar ‘Altitude’ where happy hour happily lasted not one, but two hours. After enjoying the sweeping views of the bay dotted with the lights of squid fishing boats, we walked south to the Sailing Club and enjoyed a delicious meal before catching a local band covering a mix of Red Hot Chili Peppers and Vietnamese rock. This town has a reputation as a party destination and has no shortage of bars, ranging from backpacker-friendly holes in the wall selling 30 cent beer, to
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stunning rooftop clubs such as the newly-opened ‘Skylight’, perched atop the Best Western Havana Hotel – complete with working lighthouse 43 stories up! No matter the budget, it was obvious in each venue we went to that they pride themselves on a high level of service. The next day we told ourselves we should probably do more than just lie by the pool, so we walked the local streets in search of a BBQ restaurant recommended to us by a Vietnamese friend back home. Like many of the restaurants we enjoyed most, it didn’t exude much street appeal, but the food definitely lived up to the hype. We enjoyed barbecued pork ribs and marinated beef strips with the locals, washed down with Bia Saigon and garlic fried rice. For dinner we again consulted our lifeline, Trip Advisor, and settled on ‘Lanterns’, a wonderfully colourful restaurant that runs not only cooking classes, but tours of local schools and orphanages. One day every week their volunteer staff provide lunches to anyone in need, and also provide scholarships to over 200 local school children. Again, the generosity and kindness of the Vietnamese people was evident. For a country that’s seen more than its share of conflict and loss, it’s a testament to their spirit that they want to always improve, and look forward, rather than back. Nha Trang was slightly different to our previous stops in that another culture is firmly engrained in the cultural fabric, with the huge number of Russians that fly in direct from Moscow. Almost every menu and store name was written in both English and Russian – yet another language for the poor locals to get their heads around! On our final day in Nha Trang, we decided we could no longer ignore the main attraction, and travelled over three kilometres on the world’s longest over-water cable car to Hon Tre Island, better known as the home of VinPearl Land (a Disney-like family theme park) and various luxury island resorts, opened by the country’s first billionaire, Pham Nhat Vuong. We didn’t stay long, as the park is more suited to families and was also under construction in the quiet season – but the view it offered across the bay back to the city was worth the ride.
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Eat • Sailing Club • Lac Canh BBQ Restaurant • Lanterns • Skylight 360 Sky Deck & Rooftop Beach Club Stay • Sheraton Nha Trang (26 Tran Phu Street, Nha Trang City) Play • Hon Tre Island
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HO CHI MINH CITY
Another midnight landing, and we were in Ho Chi Minh City. A cosmopolitan, modern city absolutely bustling with life – a far cry from its northern counterpart of Hanoi, where the streets were all but deserted by 11pm. We chose to stay near the centre of District 1, not far from the river in the Japanese-themed hotel Silverland Sakyo. The staff here were amazingly attentive and professional – even sending up a bottle of sparkling wine and canapés at midnight when they discovered we were celebrating our wedding anniversary the next day. The street our hotel was on was the most eclectic mix of cultures, with Vietnamese street vendors, Japanese Sushi bars, French restaurants and Canadian bespoke boot stores lining the streets. Saigon (as we affectionately referred to it like many others still do) is infectious, possessing the same wonderfully manic motorbike traffic as Hanoi, but with a bit of added glamour from both its French past and its modern new generation. We travelled by car to the Cu Chi tunnel system, only a short drive from the centre of the city. Now preserved as a War Memorial Park and one of the country’s most popular tourist attractions, it offered a powerful insight into the trauma experienced by the Vietnamese in various conflicts – not just the ‘American’ war. The network of tunnels expands more than 120 kilometres, and a small portion has been widened to allow the larger western tourists to crawl through. Local guides lead the way, pointing out the scars carved by B52 bombs, and purely evil yet ingenious booby traps used by the Viet Kong to eventually defeat their enemy. Intriguing and awe-inspiring, we’re glad we caught a glimpse of the area’s history. The remainder of the day was spent wandering the wide boulevards of District 1, passing the glamorous (yet evidently empty) Chanel and Versace stores housed in the proud and elegant French buildings such as the Continental and Majestic Hotels. We spoke at length with local university students who were keen to practice their English skills with us, and were amazed at how humble they were, questioning why of all the places we could travel to, did we choose Vietnam? We continued our history lesson at the War Remnants Museum where we posed in front of captured and deserted American helicopters, tanks and planes and were moved by the stories and photos of the war’s many victims, from local civilians to war journalists and photographers, and most disturbingly the innocent victims of Agent Orange, which will continue to affect and haunt the Vietnamese people for generations to come. After sheltering in the museum from a tropical afternoon downpour, we returned to the cleansed streets, passing the gothic Notre-
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Dame Basilica, the beautiful Central Post Office and the understated but imposing Communist Architecture of the Palace of Independence, before finishing at the pulsing Ben Thanh Markets. By night, the city is even more stunning, with famous landmarks such as the historic Rex Hotel lit up, competing for skyline with the imposing modern office towers, complete with laser light shows dancing on their facades. Just like all the other cities we visited, we always felt welcome and safe (as long as you quickly learnt to negotiate the motorbike traffic like a local - there’s quite an art to crossing a street in Vietnam)! We wanted to try something different for dinner, so booked ourselves a table at Noir – a concept restaurant where you dine in complete darkness. Housed in a beautifully-preserved French Colonial building with décor that wouldn’t be out of place in Paris, Noir was intriguing from the outset. We were greeted by the friendly owner, who explained to us that we would be led to the dining room and served by a completely blind waitress (a wonderful example of supporting locals who would otherwise struggle to find employment). We were given a surprise mystery cocktail to start our three-course meal, which was served in parts like a degustation. The food was delicious - I won’t spoil the mystery by telling you what any of it was - each dish was later explained to us complete with photos. Finding out just how wrong we were about some of the dishes really opens your mind and makes you realise just how much food preferences are sometimes mind over matter! After our eyes had re-adjusted, we headed to one of the city’s most popular rooftop bars, Chill Skybar on the 26th floor of the AB Tower. The panoramic views it offered of the twinkling city below were worth the hefty cocktail price tag, but we soon left as we missed the most exciting part of Vietnam - life down on the streets. It seemed everywhere we visited, the thing we noticed the most was how life really did happen here on the sidewalks. Eating, drinking, chatting, kids working on their homework after school – it was wonderful to see the typical Vietnamese life out in the open rather than hidden behind closed doors. We left the manic yet controlledchaos behind, vowing to definitely return sometime soon. Vietnam, its food and its warm people really grabbed a part of our hearts and we’re happy it exceeded all expectations. It will be interesting to see how much it will have changed next time we visit, as it seems an exciting time of growth and recovery for the country – although we really hope it doesn’t change too much – we love you as you are, Vietnam.
Eat • Noir Dining in the Dark • La Mint by Danh French Restaurant • 5KU station • Ben Thanh Markets Stay • Silverland Sakyo (10 Le Thanh Ton Street, District 1, Ho Chi Minh City) Play • District 1
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SLIPPING AWAY AT PALAZZO VERSACE Words by Lizzy Keen
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As the aureate sun crawls behind the palm leaves, the sense of opulence sets in. The daybed softens under my high thread-count pool towel. Hundreds of mosaic tiles sparkle around the water’s edge. Surrounded by birdsong and breeze, I’m seduced into a daydream. “Your cocktail, miss,” the voice of a poolside waiter pulls me back. Having assumed a new posture on the daybed, sunlight now pours through the frosted glass of Limoncello and kaleidoscopes across my legs. My head dips back, warmth floods my skin and a revised agenda ensues: drink, swim and slip away. It’s hard not to be swept up in the hedonism at Palazzo Versace, the world’s first fashioned-branded hotel on the Gold Coast. This 200-room palace of European design and local character enjoys a reputation of blending unmatched luxury with comfort. But even at the entrance, the odds are against you. Plaids of vine leaf sweep across the Italian style structure and wrought iron ‘Juliet’ balconies, while white-gloved doormen and a fleet of Rolls Royces punctuate the terrace, gatekeepers to a modern kingdom. As a limousine glides towards the lobby, a group of guests dripping in jewellery emerge from its interior and make for the front door. Beneath them, multi-coloured pebbles form another timeless Versace mosaic that stretches back to the main road. When the doorman welcomes you into the luminous marbled lobby, where soaring floor-to-ceiling windows expose the lagoon pool and eruption of date palms outside, you finally give in, spellbound by luxury. Palazzo Versace is the masterwork of Australian development firm Sunland Group, designed with the ingenuity and style of the late Italian fashion designer, Giovanni Versace. Versace, a lover of architecture, shines through every feature of the hotel – from the plush fabrics to the vivid colour palettes. Versace’s love of extravagance, however, is perhaps most apparent in the lobby’s antique chandelier, once belonging to the grand State Library of Milan. Resplendent in sunlight, it suspends from a goldtrimmed ceiling, while beneath it, Medusa – the hotel’s emblem – unfolds in stone and marble. Concierge and restaurant staff hover across the floor between international guests who are taking a break between activities, many swathed in Camilla kaftans. Droplets of light dance across the windows from the 65-metre ‘lagoon’ outside, where guests are making big decisions: drink, swim or slip away. On my way to the fourth floor, Versace’s eccentric yet hypnotic vision for fashion comes alive in the large framed photographs of his 1991/1992 Dresses For Thought collection, which hang throughout the hallways. But it is in my Lagoon Room that his vision soars. Offering views of the lagoon and distant Broadwater, glass doors glide open at the edge of the timber-floored living space, which contains a queensized bed cloaked in golden, textured linen, neoclassical furnishings and a spacious marbled bathroom. Ignore your instincts – devoting an entire night to your bathroom is both rational and rewarding. Here, you can slowly soak into a signature ‘bath ritual’, a palatial pastime of Ancient Rome, created by a judicious room attendant. Your only job is to manage the chilled Veuve Clicquot bubbles in your glass. Each of Palazzo Versace’s rooms is crafted for down time and convenience, all offering prompt, personable room service, easy access to the hotel’s amenities, and plenty of natural light. pindaramagazine.com.au
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A series of suites and condominiums are also available for A-list guests, families or couples seeking extra space. Let’s step outside to the lagoon while the sun is at its zenith. Here, we can get personal with the wait staff, who never miss a beat among the rhythm of rest. If you’re looking to splash out, food and beverages are available all day, delivered promptly to your daybed and charged to your room. Another cocktail, please. Between you and me, I can’t help but want to peer inside one of the private cabanas. The only of its kind in Australia, the Water Salon offers two full-day cabana packages with body products, food and sparkling wine. When the relaxation gets too much, guests can cacoon themselves in a world of white cloth. Reclining in the shade, I watch the splashand-dive of some children whose parents sip drinks upon black wicker deckchairs. On days like today, leisure time caters as much to the most affluent sunbathers as it does for toddlers wrapped in Disney towels – a down-to-earth Gold Coast mix. Palazzo Versace is a place of big decisions. While I’m tossing up whether to face north or south for the next hour, I can only imagine the difficulty for guests of the waterfront condominiums. Should they swim in the lagoon or the private plunge pool just metres away? It’s almost too much. Meanwhile, in the Imperial Suite above the lagoon, where rock bands U2 and the Rolling Stones have stayed, guests are deciding whether to dine in one of the hotel’s three restaurants or to stay in their robes and have their butler prepare dinner in-suite. As the tangerine and steel blue sky melts over the mountains, swirling a glass of French Rosé, I applaud my decision to dine at Vie Restaurant & Bar. Bearing one Wine Glass from the Wine List of the Year Awards and led by acclaimed Chef de Cuisine, David Pommier, Vie is one of the most refined restaurants in the city. In its open-air design, white linen settings and salt swept position on the exclusive Marina Mirage, Vie rejuvenates classical dining with a relaxed local edge, spotlighting Australian produce with worldly flavours honed by the French-trained Pommier. It all begins with the Tasmanian salmon and horseradish terrine, a sort of gravlax 2.0, served with green tea noodles. Beautified with seaweed and microherbs, the salmon falls apart into fine, oily segments, which sing in salted harmony with the piquant horseradish crème. Simple, yet divine. 80
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To be served the chef’s homemade sand crab lasagne is to meet the subject of local legend. Made with layers of pasta, crab and aromatic sauce, it rests under a handful of delicately deep fried crab legs, which add a moreish textural quality. Its savour lies in the way Pommier treats – or doesn’t treat – the crab, which retains a natural saltiness throughout. If its location was any reason for Vie to be a little haughty, there is no such indication in the wait staff, who are sharp, proficient and willing to stop and connect with diners. This attitude extends from the kitchen, too, as a chef begins personally explaining the dishes to a nearby table of diners. After resurfacing from the dream that was a spiced raspberry soufflé, served with warm dolce chocolate ganache, blueberries and mint, and a glass of pinot noir recommended by the sommelier, I’m left contemplating the veneer of pearl black water, flecked with the final glints of the sleepy sun. Content doesn’t begin to describe it. For guests seeking to dine inside the hotel, Il Barocco Restaurant is open for breakfast through to dinner for classic, informal buffet dining. Vanitas, which was named the world’s most fashionable restaurant by Harper’s Bazaar, serves high-end contemporary cuisine and degustation dining. If you’re looking to raise your pinkie, head straight to high tea at Le Jardin in the hotel’s lobby. Among four Couture High Tea packages, three of which come with a glass of sparkling wine or champagne, guests can wander through a culinary garden of opera cakes, finger sandwiches, tarts, scones and exotic hot and iced teas. The clinking of teaspoons and the whirr of the coffee machine are the only sounds entwining with the aural cascade of Gold Coast classical pianist, Cassidy Wilson. His music cartwheels through the lobby and as I melt into my chair, I’m seduced into a daydream once more. Palazzo Versace is renowned for its executive style, its award-winning cuisine, and its ability to turn every detail into fragments of an unforgettable memory. But it is perhaps the hotel’s ability to delight every guest – from celebrities to rock stars to children – that best justifies its praise. In a city that thrives on both ball gowns and beach towels, Palazzo Versace creates an experience that is luxurious, comfortable and ideal for the making big decisions: drink, swim or slip away. 2015
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N E R A L Mc 650S
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DIALS UP PERFORMANCE AND EXCITEMENT The McLaren 650S joins the range as an additional model alongside the sold-out McLaren P1â&#x201E;˘, learning from both models as well as 50 years of competing in the highest levels of motorsport.
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Available as a fixed-head Coupé or Spider, with a retractable folding hard top, the McLaren 650S promises to redefine the high performance supercar segment, and has been designed to provide the ultimate in-driver engagement onroad and on the race track. The 650S badge designation refers to the power output – 650PS (641 bhp) – of the unique Britishbuilt McLaren M838T twin turbo V8 engine. ‘S’ stands for ‘Sport’, underlining the focus and developments made to handling, transmission, drivability and engagement. The maximum power figure ensures the best power-to-weight ratio in its class, at 500PS (493 bhp) per tonne. The design is inspired by the McLaren P1™, showcasing a new family design language for the brand. More importantly, the new look follows the McLaren design ethos of ‘form follows function’, with the front bumper providing a dramatic yet clean appearance, while the integrated front splitter contributes to increased levels of downforce. This produces a greater level of steering ‘feel’ and confidence on turn-in, while also adding to the agility and handling balance. Distinctive sculpted side intakes direct air into the efficiently packaged radiators to cool the unique 3.8-litre twin turbo M838T V8 engine, with a maximum torque of 678Nm (500 lb ft). “McLaren is an engineering led company, and we’re proud of that,” McLaren Automotive CEO Mike Flewitt says. “The new design gives important engineering and driver benefits. Yet it’s not just about improving the numbers – the McLaren 650S also dials up the design drama and driving excitement.” Key to the McLaren 650S is that the signature McLaren capabilities are not compromised. Despite the power and performance focus, the McLaren 650S boasts an extensive specification list, with an optimised powertrain, braking and suspension systems, as well as a refined and luxuriously equipped cabin. Despite these extra features, the McLaren 650S weighs just 1330 kilograms (dry). Performance is class leading for both the Coupé and Spider models. Acceleration from 0 to 100 km/h (62 mph) takes only three seconds, while 0-200 km/h (124 mph) takes just 8.4 seconds for the Coupé [Spider 8.6 seconds]. Maximum speed is 333 km/h (207mph) [329 km/h (204 mph) for Spider]. “The McLaren 650S is a multi-purpose, high performance sports car, and is thrilling to drive,” Flewitt says. “No other series-production sports car on sale today offers such a breadth of capabilities. Maximum driver appeal, and driver engagement, is at the heart of this car, as it is with all McLarens. Yet unlike some rivals, the McLaren 650S is not a stripped-out racer. It is faster than many other ultra-sports car rivals, yet there is no compromise in luxury. It has all the refinement and comfort you would expect from McLaren, and all the power and excitement as well.”
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The ‘no compromise’ McLaren 650S is also one of the most efficient models in class, returning 24.2 mpg (11.7 l/100km) on the EU combined cycle, and a CO2 figure of 275g/km. This is testament to the drive by McLaren for continued improvement and class-leading efficiency. As with the limited edition McLaren P1™, the McLaren 650S models use a Formula 1™-inspired carbon fibre chassis. Weighing just 75 kilograms, the innovative MonoCell forms the centre of the McLaren 650S and offers advantages in weight, torsional rigidity, durability, safety and quality. Other technologies that link to the company’s Formula 1 heritage include full wishbone suspension, mid-engine architecture, Brake Steer for enhanced agility and carbon ceramic disc brakes (standard on the McLaren 650S). The McLaren 650S also benefits from the groundbreaking technologies fitted to other McLaren models. Active aerodynamics, which feature on the McLaren P1™, have been further honed to ensure the ultimate performance and ability for the McLaren 650S. The McLaren Airbrake, designed to offer optimised levels of downforce on the rear of the car, now works with greater levels of functionality, and offers a greater degree of stability in a wider range of conditions. “Everything we’ve learnt from the McLaren P1™ has gone into the McLaren 650S,” Flewitt says. “The result is a car that’s faster, more fun and thrilling to drive, yet also more comfortable, luxurious and even easier to enjoy, day-to-day.” “At McLaren, we are a fast moving company, continually striving for improvements and technical advantages. That’s our Formula 1 heritage and mentality shining through; always seeking to innovate, to be the class-leaders, to bring new technologies to market as fast as possible.” The McLaren 650S uses a unique version of the award-winning 3.8-litre twin turbo V8 M838T engine. New pistons and cylinder heads provide a boost in engine power and torque, and these are combined with new exhaust valves and revised cam timing. Further advances have been made to the transmission software to allow faster and crisper gearshifts. Adding to the aural drama in ‘Sport’ mode is the ‘cylinder cut’ technology, which produces an exhaust flare on upshifts. This is achieved by momentarily interrupting the spark and ‘popping’ the fuel on re-ignition, creating a distinctive engine note as exhaust sound is amplified without any loss in performance. Under hard acceleration in ‘Track’ mode, when full performance is required, the McLaren 650S features ‘inertia push’, which harnesses the built up kinetic energy to deliver an impulse of torque as the next gear is engaged. This approach delivers the next gear before the engine speed has dropped, resulting in continual strong acceleration. Further optimisation has been made to the McLaren-developed clutch control software, which improves smoothness, predictability and 2015\2016
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refinement, particularly at low speed, through the seven-speed dual clutch gearbox. The pioneering ProActive Chassis Control (PCC) suspension system, developed by McLaren, has been further enhanced for the McLaren 650S. A feature of the system is the ability to adjust the ride and handling modes – Normal / Sport / Track – in isolation from the drivetrain, which gives complete freedom in ride and handling. These settings, for both powertrain and suspension, have been recalibrated to improve driver engagement. New damper mounts offer improved levels of ride comfort and minimise any noise, vibration and harshness carried through into the cabin, while redesigned dampers and springs are coupled with sharper steering. A new lightweight forged ‘650S’ alloy wheel design is fitted as standard on the McLaren 650S. Finished in silver, and available with an optional stealth or diamond cut finish, the unique design is shod with Pirelli P Zero™ Corsa tyres to offer optimised roadholding, handling and driver feedback. The bespoke ‘MC1’ branded tyres have been developed alongside the McLaren 650S by McLaren technology partner Pirelli, and offer strong performance in normal road conditions and on track. The dramatic exterior styling includes full LED headlamps derived from the McLaren P1™. These provide a distinctive illumination of the pindaramagazine.com.au
road ahead, and echo the signature McLaren ‘speed marque’ logo in the design. The bonnet is finished with a new McLaren badge, inspired by the badge fitted to the iconic McLaren F1. The rear of the McLaren 650S has been designed to optimise aerodynamics, with a GT3-inspired three-piece bumper. As standard, the interior is trimmed in lightweight Alcantara, with full leather also available. These materials extend to include the full headlining, while contrast colour stitching is also available. Fixed-back carbon racing seats, based on the lightweight design found in the McLaren P1™, offer superb levels of upper and lower body support, improve driver engagement and save 15 kilograms. The McLaren 650S models are equipped with IRIS satellite navigation with Bluetooth telephony, DAB digital radio in European markets (SIRIUS satellite radio in North America), wireless tethering, audio streaming and voice control as standard, while also offering enhanced levels of optional specification than previously offered. Options include fixed-back carbon racing seats, based on the lightweight design found in the McLaren P1™, an electric steering column adjustment assisting ingress and egress, a rear parking camera and extended carbon fibre throughout the interior.
For more information on McLaren vehicles, please contact Craig Padfield at McLaren Gold Coast on 0411 266 118. McLaren Gold Coast is located on 179 Nerang Road, Southport, 4215. Pindara Magazine
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HOMEGROWN LUXURY:
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Gold Coast luxury yacht builder Riviera is an iconic Australian company that today stands synonymous on an international scale with hallmark luxury, easy-to-use technology, bluewater sea-keeping capability and unrivaled owner support. This has not come about by chance – underpinning the growing success of 2015’s Australian Marine Industry Exporter of the Year is an deeply embedded ethos of excellence that is reflected through a rich 35-year heritage and the launch of almost 5200 motor yachts that can today be seen cruising the lakes, rivers, seas and oceans of the world. Riviera owner and chairman Rodney Longhurst – who returned the company to private ownership in 2012 – said that whilst humbled by the growing global affection for the luxury marque, the 480-strong team of dedicated designers, engineers and master craftsmen at Riviera’s world-class facility at Coomera remains absolutely focused on building the best Rivieras ever. “I was recently asked to describe Riviera in one word and it immediately struck me that ‘proud’ truly represents all the key attributes that have helped Riviera to be considered as amongst the best builders of luxury yachts in the world,” he said. “In fact over 55% of our production is exported to international ports.” 90
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The current Riviera range – spanning 17 different models across five distinctive model collections – caters to an extremely wide range of boating pursuits and individual styles. “We are continually refining our existing models and creating new models to suit the changing needs and desires of discerning yacht owners,” said Mr Longhurst. “A luxury yacht must be able these days to be the consummate entertaining vessel, the ultimate passage-maker, the total family getaway, even the perfect home away from home where owners can enjoy extended living aboard without pining for any shore-side comforts.” In the past 12 months, Riviera has staged the World Premieres of a range of new models designed for family, fun and fishing. These models include the new 77 Enclosed, 57 Enclosed and 52 Enclosed models from the true blue-water classic Flybridge collection, a new presidential master stateroom design for the stylish and sophisticated 6000 Sport Yacht, and a new 525 design from the sporty and adventurous Riviera SUV series. The marque has also this year announced a new 5400 Sport Yacht will make its World Premiere at Miami International Boat Show (11-15 February 2016) and a new 575 SUV design will make its World Premiere at the Riviera Festival of Boating (19-22 May 2016). 2015\2016
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ULTIMATE EVOLUTION THE NEW 2015 VANQUISH New Vanquish is the culmination of an extraordinary determination to create the ultimate Grand Tourer. â&#x20AC;&#x201C; boasting a new 8 speed Touchtronic III gearbox, more power, faster top speed, improved acceleration and leaner fue and poise are elevated to unprecedented heights. Vanquish knows no limits.
PLEASE CONTACT GENERAL MANAGER PAUL HEWITT TO ARRANGE A TEST DRIVE. Aston Martin Queensland, 179 Nerang Road Southport QLD 4215 07 5582 7888 www.queensland.astonmartindealers.com DL1303030
urban 31.0 (9.1); combined 22.1 (12.8). CO2 emissions 298 g/km. real driving experience, which may vary depending on factors including road conditions, weather, vehicle load, and driving style.
Additionally, Riviera has also trumpeted an entirely new model collection, the Sports Motor Yacht, from which the first 67 model is scheduled for a 2017 release. Mr Longhurst says existing and new Riviera owners have eagerly embraced all these new models at major boat shows around the world, and this is in no small part due to Riviera’s renowned commitment to customer care which also extends to the timelessly classic Belize collection. “The unrivaled Riviera Experience runs much deeper than owning a striking and stylish motor yacht – it also means you are part of a global family of like-minded luxury motor yacht owners,” he said. “Our family members enjoy a vast array special Experience voyages cruising in company of fellow Riviera or Belize owners to idyllic destinations around Australia and New Zealand, and indeed right around the world.” The fantastic Riviera Experience cruising and fishing destinations in Australia include the turquoise waters of the Whitsunday, Lady Musgrave Island and Moreton Bay in Queensland, picturesque Sydney Harbour, Pittwater and the Myall Lakes in New South Wales, Refuge Bay and Port Phillip Bay in Victoria, Kangaroos Island and Port Lincoln in South Australia, Geographe Bay and Rottnest Island in Western Australia as well as bluewater passages from Auckland in New Zealand, including beautiful Motuihe Island. Mr Longhurst said these special events were staged in conjunction with Riviera’s worldwide dealer network that spans some 60 countries and every continent of the world, and specifically in Australia and New Zealand through the R Marine network – the largest luxury motor yacht dealer network in the Southern Hemisphere. “Riviera and our dealers also conduct regular educational workshops and seminars to give our owners the skills and confidence to experience everything from weekend harbour and coastal cruising to extended coastal passages,” he said. “One great event is the Riviera Festival of Boating each May at our 14-hectare Coomera facility where we stage over 70 free educational and fun social events across four days right in the heart of the Gold Coast International Marine Expo (19-22 May 2016). “Now in its fifth year, Riviera’s festival of fun and learning is every bit as much about honing the skills of experienced boaters, as it is introducing new people to the joys and rewards of the boating life.” “The seminars span understanding the weather, emergency essentials, offshore navigation and provisioning to motor yacht engine and equipment maintenance and tricks of the trade, to name just a few.” “We also conduct fully narrated factory tours by train of Riviera – the largest luxury motor yacht manufacturing facility in the Southern Hemisphere.”
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“Importantly, all Festival events are open to everyone, even if they simply aspire to one day own a luxury motor yacht.” Mr Longhurst says Riviera is committed to ensuring members of its family of owners are able to get the most of out the advanced yet easy-to-use technology that is continuing to make recreational luxury boating vastly easier and much more enjoyable. “Through clever innovations such as gyroscopic stabilisers that significantly reduce boat roll, clever touch-screen navigation systems that centralise monitoring and control of all onboard systems all in one place, and also amazing joystick maneuverability, we are inspiring a new generation of people to take the helm and 94
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experience the relaxing and rewarding boating lifestyle,” he said. “Joysticks, for instance, enable a skipper, either solo or with a novice crew, to simply push and twist the joystick and the yacht will respond immediately, pivoting in place or tracking sideways into a tight berth. “The advanced marine technology of today really does enhance time aboard for every owner and every guest, and that’s why we have been so enthusiastic to embrace it. “We’re making boating easier, safer and even more fun and this a key part of our philosophy of helping Riviera and Belize owners to achieve the ultimate boating experience.” 2015\2016
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WRAITH And the world stood still
Introducing Wraith â&#x20AC;&#x201C; the most dynamic Rolls-Royce in history. Experience the power, style and drama for yourself. Contact: General Manager Paul Hewitt on 0425 001 964 Brand Manager James Staniforth on 0450 638 046
Rolls-Royce Motor Cars Queensland 179 Nerang Road, Southport Queensland 4215 Tel: 07 5509 7197 www. rolls-roycemotorcars-queensland.com.au DL 1303030 Š Copyright Rolls-Royce Motor Cars Limited 2013 . The Rolls-Royce name and logo are registered trademarks.
GIZMO GUIDE
2015\2016
Sol Republic Tracks HD On-Ear Headphones $159.00 RRP Listen loud and clearly again with the Tracks HD, whose high-tech sound engines are loaded with a punchier bass and crisper highs so you can lose yourself in the beat. Noise-isolating ear cushions, extra wide pads and a uniquely sleek design make these headphones the hottest way to listen.
GoPro Chest Mount Harness for HD Hero $59.00 Just when you thought adventure photography was all hands-on! The ‘Chesty’ is fully adjustable to fit all adventurists, and delivers the perfectly centred shot for snowboarding, hiking, mountain biking, motocross or any extreme action worth shooting. Perfect for activities that demand arm movement, such as paddling or skiing. Includes one-year warranty.
Dick Smith
JB Hi-Fi
GET Breville Pro 800 Citrus Press $239.00 RRP Top off a morning surf or yoga session with an ice-cold glass – or jug – of freshly pressed citrus juice straight from your kitchen. Breville’s Citrus Press juices limes, oranges and grapefruits with the one multi-size cone, and made with die-cast stainless steel, it also refreshes your kitchen top. David Jones
Cuisinart Frozen Yoghurt, Ice Cream & Sorbet Maker Key Lime Pie $119.00 RRP Summer calls for deliciously cold treats, but it shouldn’t stop at ice cream. This tropically coloured, stylish kitchen appliance from Cuisinart makes frozen yoghurt, sorbet and ice cream with its fully automated, double-insulated freezing bowl. Extra smooth, extra creamy and ready for your flavour inventions! Myer 96
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GIZMO GUIDE
The Pocket Spotlight $30.00 RRP Photographers can’t control sunlight, but they can create their own light with the Pocket Spotlight for smartphone and camera devices from Photojojo! While iPhone lights are often harsh or illuminate the wrong details, the Pocket Spotlight is a dramatic, diffused light source for emphasising subjects or creating artistic shadows. Lightweight and chargeable via USB. photojojo.com
Panasonic Lumix GF7 Digital Camera with 12-32mm Lens $699.00 RRP Compact, lightweight and so good looking, you’ll want to photograph it. Beginners and professionals alike will enjoy the modern features, innovative technology and modern-vintage styling of the Lumix GF7, which offers assisted shooting functions and precise autofocus. With left and right-hand trigger release, it’s also the ultimate selfie camera! Domayne
Techy Balloon Dog Light $44.95
Fitbit Aria WiFi Smart Scale How smart are your scales? These Aria WiFi scales track your weight, body fat percentage and BMI in order to analyse your progress, help you set goals and motivate your workout. It wirelessly syncs all this information into online graphs for easy viewing, and will monitor data for up to eight users.
Kids love nightlights, and they can’t get enough of balloon animals. Combine the two and you get this awesome, battery-powered nightlight, which emits a soft red glow into the dark. Turn the light off and on by squeezing its paw, which is made from flexible silicone and feels like a real balloon!
Harvey Norman
coolthings.com.au
$168.00 RRP
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AT THE MOVIES
2015\2016
At the movies
STAR WARS: THE FORCE AWAKENS (CTC) IN CINEMAS DECEMBER 2015 Set thirty years after Star Wars: Episode VI – Return of the Jedi (1983), the Star Wars saga, created by George Lucas, continues. Star Wars: The Force Awakens, which features new lead characters Finn, Rey and Poe Dameron alongside characters returning from previous Star Wars movies, is the first film of the third trilogy by The Walt Disney Company, who purchased the films from Lucasfilm in 2012. One Variety poll reports that 63 per cent of Star Wars fans expect the seventh ‘episode’ to be the best. May the force be with us.
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THE GOOD DINOSAUR (CTC)
THE DANISH GIRL (CTC)
IN CINEMAS BOXING DAY 2015
IN CINEMAS BOXING DAY 2015
The Good Dinosaur asks the question: what if an asteroid that forever changed life on Earth missed the planet completely and giant dinosaurs never became extinct? Pixar Animation Studios takes you on an epic journey into the world of dinosaurs where an Apatosaurus named Arlo makes an unlikely human friend. While travelling through a harsh and mysterious landscape, Arlo learns the power of confronting his fears and discovers what he is truly capable of.
Based on the book by David Ebershoff, The Danish Girl is the remarkable love story inspired by the lives of Lili Elbe and Gerda Wegener, portrayed by Academy Award winner Eddie Redmayne (The Theory of Everything) and Alicia Vikander (Ex Machina), and directed by Academy Award winner Tom Hooper (The King’s Speech, Les Misérables). Lili and Gerda’s marriage and work evolve as they navigate Lili’s groundbreaking journey as a transgender pioneer.
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AT THE MOVIES
J A C K
B L A C K
THE STORIES ARE ALIVE
Mild scary scenes
IN CINEMAS SOON SEE IT IN 3D, ALSO IN 2D
RoadshowFilms www.goosebumpsmovie.com.au
SNOOPY AND CHARLIE BROWN: THE PEANUTS MOVIE (CTC) IN CINEMAS JANUARY 2016 Charlie Brown, Snoopy, Lucy, Linus and the rest of the beloved Peanuts gang make their big screen debut, like they have never been seen before, in this state-of-the-art 3D animation. Snoopy, the world’s most beloved beagle and flying ace, embarks upon his greatest mission as he takes to the skies to pursue his arch-nemesis The Red Baron, while his best pal, Charlie Brown, begins his own epic quest. From the imagination of Charles M. Shultz and the creators the Ice Age films, The Peanuts Movie will prove that every underdog has his day.
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GOOSEBUMPS
(PG)
THE LADY IN THE VAN (CTC)
IN CINEMAS JANUARY 2016
IN CINEMAS JANUARY 2016
Upset about moving from a big city to a small town, teenager Zach finds a silver lining when he meets the beautiful girl living next door. But every silver lining has a cloud, and Zach soon learns that Hannah’s mysterious father is R. L. Stine, author of the bestselling Goosebumps series. But there’s a reason behind Stine’s strangeness: he’s a prisoner of his own imagination, haunted by the monsters of his books.
Two-time Oscar winner Dame Maggie Smith recreates one of her most celebrated roles – the remarkable Miss Shepherd – in TriStar’s The Lady in the Van. In Alan Bennett’s big-screen adaptation of his own memoir and famous stage play, the film tells the true story of Miss Shepherd, a woman of uncertain origins who ‘temporarily’ parked her can in Bennett’s London driveway and lived there for 15 years. What begins as a begrudged favour becomes a relationship that changes both their lives.
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TOP READS
2015
Top reads
Everyday Super Food
Suri’s Wall
Deep South
JAMIE OLIVER $55.00 RRP
LUCY ESTELA $24.99 RRP
PAUL THEROUX $19.99 RRP
Forget spirulina; your everyday pantry is already full of superfoods! World famous chef and health advocate Jamie Oliver has introduced his latest good eating guide in Everyday Super Food, which is divided into breakfast, lunch and dinner recipes all under 600 calories. Inspired by fresh, affordable ingredients with realistic creativity – from fish tacos with kiwi-lime salsa to nutty smoothies and pancakes – this cookbook makes reaching your health potential all too easy.
Have you ever wondered what’s on the other side of the wall? Suri, who is is different to other children, makes friends with the wall that encircles her life. But suddenly, after a long time of sharing secrets and thoughts with the wall, her view of it and what lies beyond changes with the sound of one child’s voice. In collaboration with multi-awarding winning illustrator Matt Ottley, Suri’s Wall is a moving tale for children and young adults about the power of the human spirit.
Unparalleled hospitality, a lively community and the world’s best fried chicken – but still the Deep South suffers the nation’s worst schools and unemployment rates. Globally acclaimed travel writer Paul Theroux takes us through the paradoxical world of America’s southern states on a four seasons-long road trip, talking to mayors, social workers, reverends and various unsung heroes about life down South. From gun shows to churches to old ‘plantations’, Theroux’s ode to the region is vivid, insightful and impossible to put down.
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The Edible City INDIRA NAIDOO $45.00 RRP From the woman who turned her thirteenthfloor apartment balcony into a flourishing vegetable garden, Australia news presenter Indira Naidoo bring us The Edible City, an exploration of five unusual and inspirational urban gardens around the country. Discover an organic, honey-producing rooftop garden tended by Sydney’s homeless, a school bushtucker garden for indigenous reconnection as well as plenty of gardening tips and recipes inspired by the urban garden revolution.
TOP READS
Kupapa: The Butter Legacy of Maori Alliances with the Crown RON CROSBY $55.00 RRP The details of New Zealand’s historical Treaty of Waitangi, the agreement between the British Monarch and Maori people, may shock you. Due to varying translations, interpretations and motifs among the Maori, the Treaty led to the formation of three groups of kupapa (loyalists) and a series of volatile conflicts between the New Zealand government and resistant Maori, known as the New Zealand Wars. Kupapa is a captivating critique of Britain’s use of the Maori, Maori segmentation and history from across the ditch.
Peppa Pig: Goodnight Peppa LADYBIRD $16.99 RRP Night has fallen and it’s time for bed, but Peppa and her little brother George are not even a tiny, little bit tired – until the Pig family steps in. A story from Granny Pig, Grandpa Pig, Daddy Pig and Mummy Pig should send Peppa and George to sleep, right? This is another Peppa Pig classic with vivid colours and playful storytelling perfect for bedtime, play time or anytime!
Finding the right Hotel just got a whole lot easier. Compare and Book 100’s of travel sites at once.
www.CompareandBook.com.au
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NOW OPEN Baby Giftware & Clothing Bespoke Gifts Candles & Home Fragrance Handbags & Accessories Fashion Jewellery Books Wall Art & DĂŠcor Gifts for special events Complimentary Gift-wrapping Lay-By available
Shop 24- Benowa Gardens Shopping Centre Ph. 07 5539 2955 info@finethings.com.au
DINING
KEEP THEM CLOSER LOS VILLANOS Words by Lizzy Keen
It’s 2.15pm and lunchtime in Brisbane. Snippets of laughter rebound off the surrounding pavement and brick. Little plastic flags ripple in a patchwork of colour overhead, matching the yellow vinyl tablecloths. Posters of brightly masked men leap out from various surfaces. Sharp and bubbly, our waiter Charlie greets our table and prompts an appetiser. “So, it’s lunch. Shall we start with some margaritas?” This is the pace at Los Villanos Mexican Kitchen, a cheeky fast-paced bar and restaurant inside The Barracks, a hip entertainment precinct integrated into Brisbane’s old heritage-listed police barracks. Blending Lucha Libre (Mexican wrestling), Frida Kahlo-esque details and Day of the Dead paraphernalia, it’s one of the most eclectic eateries this side of the river. As The Cat Empire climbs a decibel in the speakers, Charlie reveals which dishes we’ll be eating and lands two frosted cloudy lime green glasses on our table. It’s 2.21pm and I’m toasting a margarita. Situated at street level, Los Villanos enjoys the energy of nearby Caxton Street with the intimacy of a hidden cantina. While the heritage police barracks building stands as rigid as it did some 130 years ago, today it stirs with the energy and noise of 12 restaurants and cafés, Los Villanos among them. Los Villanos – ‘the villains’ in Spanish – is owned together with the trendy Spanish restaurant, Peasant, next door. Whereas Peasant, in stark contrast to its name, is all sophisticated tapas and wine, its North American counterpart is bold, sassy and armed with lime and salt. Here, the dining ends late and the boozing even later, hence the number of upholstered stools, bar-top tables and two-three pax settings, designed for small after-work wind downs, pre-drink nibbles and date nights. pindaramagazine.com.au
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Note that, besides its appearance on many local food blogs under ‘Brisbane’s Best Mexican’ and ‘Best Margaritas’, Los Villanos is known as the city’s number one date spot, according to The Urban List. Apparently, their Tinder Tuesdays go off. It’s not hard to see why. At all hours, the lighting is delicious, thanks to either the outdoor fairy lights or the hushed tea candles winking along the back bar inside. Awkward dates can refer to the dancing skulls, sequined sombreros or the illuminated La Virgen Maria shrine on the mirrored wall for subject matter. Eclectic charm exists in every inch of vintage wrestling poster, polished timber and sultry lamplight. It’s schmoozy, smouldering. All we need to perfect the occasion is the velvety vocals of Chavela Vargas or a space for some salsa steps. But this is Brisbane, so we turn to corn chips. And so arrives a rippled ceramic bowl-full of salted tortilla (pronounced tor-ti-ya, actually) chips served with an utterly fresh, lime-kissed guacamole and tangy tomato salsa. The chips are toasted, brittle, savoury; nothing like the packaged kind. With the creamy avocado we enter beer food heaven. Speaking of which, choice abounds in the bar menu. There are, unsurprisingly, 36 kinds of international tequilas, from the premium Gran Corralejo Añejo, made by the 260-year old artisan distillery Tequila Corralejo, to the sweeter, spicier Kah Skull Blanco. If you haven’t tried mezcal, consider yourself somewhat lucky. Though imbedded in the culture of southwest Mexico, especially Oaxaca, this plant-based spirit might come across abrasive and almost ‘dirty’ tasting if you’re a card-carrying craft beer or wine drinker. But served at room temperature, in an open glass to release the smoky layers of cinnamon and 104
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marzipan, it’s an exciting, chair-gripping spirit, and certainly capable of turning the heat up for your evening. Los Villanos has 11 types for your induction. Does Charlie, approaching now with a plate of elote, know of an equally racy drink? “Well, my friend combines a shot of tequila with a shot of Yucateco (hot sauce) and calls it breakfast,” he says before departing. The elote, four half-cobs of ‘street’ corn snuggled under a shaving of manchego, leave McCain’s in the dust. Each silky kernel explodes with juice, sweetened more by the gush of warm chipotle mayo, spliced with fresh coriander. They taste of Mexican summer, from where you’d rather be. At the same time arrives a duo of tacos, or tacquitos; palm-sized soft maize tortillas topped with a tumble of crushed avocado, pico de gallo (fresh tomato and lime salsa), corn kernels, shaved queso fresco and plump black beans, which gleam like river stones. Fresh, moreish, textured and filling, they make for a brilliant light lunch or fuel for a night out. The tortillas, sourced from a local boutique supplier (who they won’t name), have that mouthfilling maizey-ness I haven’t had since stepping off the streets of Mexico D.F. The chef Karl, who works between Los Villanos and Peasant, explains that the team had recently cut down the menu options to hone in on the favourites and further spotlight the freshness of local ingredients. The starters are proof. By 2.50pm, it’s so far so bueno. The drinks are cold, the music is loud and diners are coming and going, lending the place a transient, relaxed energy. But although it’s a hotspot for quick bites, there is ample opportunity to extend your stay. Especially if ordering Pedro’s Grandmother’s slow-cooked pork ribs, a sizeable structure of
meat laid on a wooden board with vivid green jalapeño sauce, pickled chilli and coriander. The hours have done their job, softening the meat into buttery segments, steeped in smoky nuances. Los Villanos welcome vegetarians, offering multiple meat-free options throughout the snacks, mains and sides. Mushrooms are the heroes here, and hold enough robust flavour and hearty texture to tempt carnivores to the dark side. The quesadilla de hongos (mushrooms) with jalapeño crema and guacamole will practically turn them for life, I kid not. Presented flat, toasted and cut into thirds, it’s made for sharing, and for totally classy ambidextrous dining: right hand quesadilla, left hand Corona. The mushroom packs punches of umami, and is succulent with oil and salt. Each mouthful moves through crunch, sauce and spice with the welcome cool respite of coriander and tomato, bringing body slams of flavour when dipped in the side of guacamole. If you can resist scoffing the lot yourself, share this generous plate with amigos. Such is the vibe at Los Villanos that you can’t help but wish the staff could sit down for a bite and a brew. Smiles out, drinks down, orders taken; the service is a sound medley of professionalism and matey-ness, and they don’t miss a beat among the commotion. And as for the experience, as well as being a solid date venue, it’s Mexican that nails authenticity without trying too hard, and that still throws a shade of Brisbane into the proceedings. Viva la local touches. Atmosphere, tequila and enough Hispanic flavour to bring a wrestler to his knees, everything at Los Villanos suggests we should keep our friends close, and our villains closer. 2015\2016
DINING
LOS VILLANOS MEXICAN KITCHEN 6/61 Petrie Terrace, Brisbane 4000 07 3368 2666
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ALL SIZZLE The Glenelg Public House
Words by Lizzy Keen
Just this once, let’s judge the Glenelg Public House, a handsome new eatery in Mermaid Beach, by its cover. Perched at the front of a slowly gentrifying shopping complex on the Gold Coast Highway, next to Glenelg Avenue, it enjoys loads of exposure. Its smoky blue paint and pale timber signage imparts a coastal-urban look that minimalists really dig around here. The ‘public house’ name is trending. Nevertheless, nothing of this venue’s vogue exterior and title alludes to the type of cuisine it serves. French, tapas, a shot at Nordic, perhaps? But soon after entering, the menu guessing game is cut short by a set of large plastic chops propped up on the bar as decoration. Painted on the far wall, a minotaur stands staunchly besides four diners who all hold serrated knives. So, it’s a steak house. Yet there’s something dapper about it. The former laundromat space was transformed into a 50-person restaurant in what felt like merely days, with the odd delicate touch thrown into the mix of exposed brick, concrete floor and rustic wooden beams. Heavy, subtly curved cutlery rests on beige ‘GPH’ monogrammed cotton napkins, while an elegant pair of vintage lounges invites drinkers to the corner. Some days, tiny purple flowers spiral out from miniature bottles on top of the tables.
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A small galaxy of Edison bulbs throws light onto the fine wine glasses and studded glass candleholders. On the left, a splendid timber bar backed by gently lit shelving offers a selection of mysterious craft beers on tap, forging a magnetic force between you and the stool. Don’t fight it. Tossing back a frosted glass of, say, Brookvale Union Ginger Beer or the locally made Black Hops Pale Ale, you might notice the few awkward moments in the décor. The money put towards napkin embroidery might have been better spent on actually filling the shelf space with bottles, or more plastic chops. Behind the vintage lounges, too, the brick wall takes bareness to another level. Where’s the painting, the street art? But despite this, the rest of the restaurant is hushed and sophisticated. We might even consider the blank space as room to get creative in the coming months. On first glance – and second and third – the menu comes across monomaniacal. It centres heavily on meat. If the sizzle-smoke curling over the pass wasn’t enough of a clue, perhaps the unambiguous ‘Steak’ and ‘Not Steak’ main menu will be. Repeat, steak house. The Glenelg Public House feels somewhere
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between a big risk and a real what-the-hell moment. In the epicentre of Lorna Jane territory, where nearby cafés are serving organic, hyperwholesome smoothie bowls and coco-whips, it’s chancy to focus on wagyu, beef and breast. But the impression rests heavily on the quality of the food and the comfort of the setting. Whether you don a white shirt and jeans, or a cocktail dress and heels, the Glenelg Public House is a polestar of the Gold Coast’s smart casual style. The starter menu explores land and sea with a subtle lean to Europe. The cured ocean trout – the freshest entrée – arrives as four steaks of lightly marbled trout, scattered with dill, lemon, juniper and gin. The beetroot and horseradish cream on top mix the fish’s oily flavour with crunch to cream in each mouthful. Things head south to France with the rabbit terrine, a neat patchwork of chunky game and pickled chilli, onion and gherkin, which also double on the plate as garnish. Served with two slices of toast, it’s a punchy yet approachable dish. What’s a steak house without the undeniable pleasure of ten-at-a-time French fries? Or
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shoestring fries as they are known here, scattered with Parmesan cheese. To ramp things up, order a side of the smoky hot tomato sauce to lift the fries straight to indulgent food nirvana. Thankfully, all the sides are vegetarian – most of which are so tasty and generous they constitute meals in combination. Seriously, the honey baked pumpkin wedges with pistachios are so sweet and buttery they cover savoury and dessert terrain at once. The sharp and responsive service adds to the enjoyment of choosing one of the five steaks. They’re all smiles and button ups, while the guys’ beards are benchmarks for the lumberjack look. But brains over beauty is important here. Tom, the bar manager, describes which part of the cow cuts like the Black Onyx petite tender and Rangers Valley chuck tail are from. The funny sounding Brunette Downs oyster blade is, for instance, “the meat connected to the shoulder blade,” Tom says, making a chart of himself. “It’s succulent without too much marbling.” The decision to go with the petite tender pays off. Popular among blood lusty beefeaters, it’s served on a stark white ceramic plate with a sunny cheek of lemon and pot of chosen sauce.
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About the size of a hand and three centimetres thick, it’s certainly work to finish. But its lean, peppery savour, rich with sauce and spliced with citrus, hooks you the whole way through. I’ve not known a gnocchi with as much liability as the one at the Glenelg Public House. The entire (scarce) vegetarian crowd depends on it. But this artful tumble of cubed pumpkin and gnocchi pulls through with buttered pillows of smooth potato and truffled pecorino. The sunflower seeds also add texture and tie in the dish’s ‘from the farm’ vibe. The wine list offers a lot of room to grab the cork and frolic around with. Apart from the obvious varietals, it follows a modest but worldly motif, with some smart sauvignon blanc blends and perfumed tempranillos peppered throughout. If not just for the exquisite pinot noir glass in which it’s served, order the 2013 Wild Rock ‘Cupids Arrow’ pinot noir from Central Otago, a sustainably grown, softly tannic wine that might battle with the steak but sings with buttered vegetables. And now we reach the part diners in this kind of place seldom remember: the dessert menu, which only covers lemon, cheese and chocolate in three
succinct dishes, all reasonably priced. Sure, there’s lemon tart with vanilla bean ice cream and a cheese board that would have Will Stud nodding his head, but the ‘oh my’ moments really come from the hot chocolate chip cookie with chocolate ice cream. A rough, soufflé-like ‘cookie’ served in a miniature cast iron pan, its flavour and presentation resembles Sara Lee baking in a campsite. The velvety contents melt as the spoon falls through the surface, and are suddenly chilled with a kiss of decadent ice cream dusted in chocolate. The Glenelg Public House didn’t join the game to please all parties. In its niche, it appeals to locals looking for a personable service team, a round of diverse beers and a table of honest, hearty food – a place where the button ups are partly undone. Sometimes we can judge a book by its cover.
THE GLENELG PUBLIC HOUSE 2454-2460 Gold Coast Highway, Mermaid Beach 4218 07 5575 2284
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Building the Dream Darren Hagarty's top five financial tips for launching your own business
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FINANCE
Going into business for the first time can be an incredibly exciting time, but it also not without its perils. Good judgement, strong planning and key decisions on the big issues are absolutely crucial. In this article, we explore 5 of the key things to get right in order to give your new business the best possible chance of success.
1. Funding and Equity Decisions There are a number of ways to fund a new business: • Bootstrap (essentially, building a business from personal finances or from the operating revenues of the new business) • Family and friends • Personal loans • Business loans • Asset loans • Debtor financing • Angel capital • Venture capital • Crowdfunding Your personal circumstances will typically dictate what’s possible, but be sure to do your homework and take professional advice. pindaramagazine.com.au
Another way of gaining funding is to take on a business partner. This leads us to a discussion of the very slippery issue of equity. Taking on a partner or granting equity to another person in your business is not a decision to be taken lightly. Equity can be forever. Once a person has equity, you will be forever sharing profits and/or ownership with them and forever reporting and being accountable to them. You should think long and hard about who can offer genuine, long-term strategic value to your business and who is merely providing a task or filling a role. If it’s the latter, they should not really be a candidate for equity. The key here is to reward value not time. There are no “hard and fasts”, but here are some questions I like to ask when considering whether someone is deserving of equity in a business: • • • •
Will they deliver long-term value and be instrumental to the business’ success? Will they take the business to heights it couldn’t otherwise get to? Will they solve a crisis that threatens the business’ livelihood? Will they cause greater damage by doing their own thing?
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4. Embrace Cloud Accounting Having decided that someone is deserving of equity, the style of equity they should receive is then a separate consideration again. There are again a number of options, which include: • Full equity • Dividend (profit) participation but not capital participation • Phantom equity (in other words, a bonus scheme of sorts) • Vesting equity (i.e. equity that vests gradually over time based on targets being met).
2. Choice of Trading Structure
When you’re starting out in business, the excitement and frenetic pace can sometimes mean that the more mundane tasks can be neglected. It is important to understand which government identifiers you will need, including
When we talk about ‘trading structures’, we are referring to a decision between sole trader, partnership, trust or company. Every circumstance is different and the right answer will sometimes be a combination of more than one entity. Utilising the wrong structure and needing to rectify it later on can lead to significant disruption and transaction costs, including capital gains tax and stamp duty. It pays to seek professional advice to come up with a structure that suits your circumstances, and is scalable and effective. Among the considerations when choosing a trading structure are:
• • • •
• Income Tax effectiveness • Capital Gains Tax friendliness in the event of a future sale • Asset Protection (both personal and for the business) • Liability • Estate and Succession Planning • Cost (establishment and ongoing) • Complexity • Ownership requirements.
And then of course there is arguably the trickiest area of all – employing staff. This spawns a myriad of issues that you should seek expert advice on, including:
It may be cheaper to avoid using a professional, but a simple mistake can mean paying a much higher price. 112
3. Understand Your Statutory Obligations
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Tax File Number (TFN) Australian Business Number (ABN) GST & PAYG-W Registrations Business Name Registrations
Similarly, try to develop an awareness of your reporting obligations and their timings. This refers to the likes of: • • • •
• • • • • • •
Financial Statements Monthly or Quarterly Activity Statements Annual Income Tax Returns ASIC Filings (companies only)
Distinguishing Employees from Contractors Determining the status of employees, i.e. Casual vs Part-time vs Full-time Ascertaining Rates of Pay (including Awards) Understanding Leave Entitlements Obtaining TFN Declarations and Choice of Super forms Making Quarterly Superannuation Payments Preparing Payment Summaries
Cloud accounting, sometimes referred to as ‘online accounting’, serves the same function as accounting software that you would install on your computer, except it runs on hosted servers and you access it using a web browser or app. Your data is thus stored and processed ‘in the cloud’. Cloud accounting can carry with it a host of benefits to business owners, stakeholders and advisors, including: • Real-time • Reduced Data Entry • Intelligent Software • No More Filing • Automatic Back-ups • One Version • Mobility & Flexibility In the Australian market, most of the major software vendors have cloud accounting offerings. My preferred platform is Xero. We have a great summary of the benefits of Xero on our website at www.ptpartners.net.au/xero 5. Surround Yourself with Good Advisors Being new to business is not for the faint-hearted. It can be a lonely and incredibly daunting space. You need to pick a good team and that includes professional advisors who understand your mission and passion, and want to take the journey with you. Regardless of the space that they operate in – whether it be accounting, legal, financial services or any other – the aim should be to choose advisors who are as much your partners in business as they are your supplier of services. Sometimes it will take a while to settle on the right ones, but you’ll know when the time arrives.
Darren Hagarty is a Director of PT Partners.
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