Private Hospital
In your bones How arthritis affects women
Don’t sleep on it Snoring in men
Warm up Slim down
Hot, delicious meals for losing weight
Ghost of elegance Exploring the luxury Rolls-Royce Ghost
No jab – No play
Vaccinations, childcare and welfare payments
Complimentary
Luxe toLess A local’s guide to tropical Port Douglas
Pindara Magazine Issue five 2015
Health
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Living
www.pindaramagazine.com.au
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Motoring
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Boating
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Travel
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 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, 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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Benjamin French Walters – Doctor at Pindara Private Hospital
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St ate of the Audi Cen art tre coming in 2015 Tempora ry si now op te en
Southport
Robina
Tweed Heads South
Nerang
Springwood
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
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Contents
2015
14
34
42
70
Contents
Regulars From the CEO Editor’s Desk Pindara News
4 6 8
General Health Managing Chronic Pain Improving quality of life through pain management
14
Dr Google 16 The pros and cons of online health consultations Another first for Pindara 20 Selective Internal Radiation Therapy
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Cancer Treatment Evolution How far we’ve come in treating Colorectal Cancer
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Colorectal Cancer 26 What we know about this disease
Men’s Health
Women’s Health 3D Mammography makes Time Magazine 38 Why this treatment topped the list In Our Bones How arthritis affects women
40
The Man Flu Do men really feel it worse than women?
30
Children’s Health 42
Don’t Sleep On It Snoring in men
34
Play School The importance of play-based learning No Jab – No Play Vaccinations, childcare and welfare payments
46
Loud Nights for Little Ones Snoring in kids
50
2015
2015
Contents
46
102
80
58
Beauty Keeping it Cool This season’s beauty buys
52
A Journey of Discovery Dr Craig Layt on education in plastic surgery
54
Baby Body 58 The danger of rapid, post-pregnancy weight loss
Nutrition & Fitness Losing it in the Cold Winter weight loss
62
Warm Up, Slim Down 67 Hot, delicious meals for losing weight
pindaramagazine.com.au
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Travel
Entertainment
Port Douglas: Luxe to Less 70 A local’s guide to tropical paradise
At the Movies Latest movie reviews
Lifestyle
Top Reads Book reviews
Drive Exploring the new Rolls-Royce Ghost
78
Boating The Maritimo M61 has the best of both worlds
88
Go Gadget This season's tech buys
96
Finance Misconceptions of the Small Business tax write-off
110
30
98 100
Dining Cucina Vivo The right kind of Italian at Jupiters’ latest restaurant
102
New Shanghai 106 Underground Chinese in Brisbane’s Queens Plaza
Pindara Magazine
3
FROM THE CEO
2015
Pindara Private Hospital Trish Hogan CEO Pindara Private Hospital Katriya De Vincentiis Editor Pindara Magazine 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
From the CEO
Medical Contributors
Trish Hogan CEO Pindara Private Hospital
Dr Mark Doudle Colorectal Surgeon
Pindara has come a long way in the five short years since we opened the stage one redevelopment in 2010! Stage two is now also complete and work is underway on stages three and four. Within the hospital, we have continued our renovation program to update and convert the old tired twin-share rooms, into beautiful spacious single rooms. The addition of renal dialysis facilities, our new Rehabilitation Unit and our Chronic Pain Unit have all been great achievements and testament to the quality of the team we have here at Pindara. These are essential services that enhance the quality of service our hospital provides to the community. Quality is important to us here at Pindara. It is a term we take seriously, as we pride ourselves on the standard of care and the level of service we have provided to the Gold Coast community for more than forty years. Our aim is to continue to improve, to continue delivering the highest quality of care and service for you, and your feedback is vital to helping us achieve these aims. Feedback in the form of compliments or complaints helps us improve our service delivery. If, during your stay, you experience a difficulty or problem, we encourage you to bring it to our attention immediately. Similarly if you wish to commend a staff member or compliment us on our service or make a suggestion to help us improve our service, please let us know. You can provide feedback by completing Patient Satisfaction Survey Cards, which are located on the side table in every room, or you can provide verbal feedback to the nurse looking after you, or
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Dr Marco Matos Oncologist
the Nurse Unit Manager. Alternatively you can send your feedback by email using the ‘contact us’ section of the hospital website. With the flu season now well and truly upon us, it is timely to bring to your attention the importance of good hand hygiene in helping us control the spread of infection in our hospital. Hand hygiene is regarded as one of the most important elements of infection control so please remember to wash or clean your hands with antibacterial gel before, during and after you have visited hospital. Finally, with the commencement of a new financial year, some of you might be considering updating or downgrading your health fund cover. If you are about to be admitted to hospital, I recommend that you check your health fund cover before your admission. You need to confirm if your policy covers you for the particular procedure you are about to undergo and ascertain if you have an excess payment on your insurance policy, or if you are to pay a co-payment for each night you will be in hospital. You also need to check if your policy excludes some treatments, for example cardiac, orthopaedic or rehabilitation, or, if there are any prosthetic or disposable items used in the surgery that will not be covered by your insurance. I wish you all a healthy and safe second half of the year. Warm Regards Trish Hogan
Drs Leigh Dotchin & Anthony Espinet Pain Specialists Dr Dilip Gahankari Plastic & Reconstruction Surgeon Dr Craig Layt Plastic & Reconstruction Surgeon Dr Dan Robinson Ear Nose & Throat Surgeon Dr Nicolas Hall South Coast Radiology
Lifestyle Contributors Jessie Goetze 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
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
Editor's Desk
2015
Hello and welcome to another issue of Pindara Magazine. Whether you are reading this as an inpatient at Pindara Private Hospital, or whether you are enjoying the read elsewhere, we have plenty of entertaining and informative articles for you this issue. If you’re struggling with the dreaded winter weight gain, turn to pages 64 – 68 for some great fitness tips and a sample healthy eating plan that will tantalise the tastebuds. If you’re dreaming of escaping winter for somewhere a little warmer, check out our travel story on Port Douglas, on page 70. To discover the importance of play-based learning for children on page 48, and then find out what the government’s new No Jab, No Play, No Pay policy means for you on page 52. Until next time …
Ask any question ask@pindaramagazine.com.au
Send your letters to letters@pindaramagazine.com.au
ST HILDA’S SCHOOL PRE-PREP INVITATION SWIMMING GYMNASTICS
FRENCH NUMERACY LITERACY ART MUSIC Head of St Hilda’s Junior School Mrs Lisa Cleverly invites you to visit our Approved Kindergarten and learn more about the dynamic Pre-Prep Curriculum.
In 2015, St Hilda’s Pre-Prep was rated as ‘Exceeding’ the National Quality Standard for Approved Kindergarten Programs.
☎ 07 5577 7231
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NEWS
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2015
Pindara Cancer Services
Pindara Cardiac Services
Pindara Private Hospital provides a comprehensive range of cancer diagnostic and treatment services including on-site day oncology and state-of-the-art imaging and pathology services. The hospital also offers new private patient accommodation with the recent opening of a 29-bed oncology ward on level four of the $55milion Dr David Lindsay Wing. These new rooms offer panoramic views across the Gold Coast and feature comfortable, contemporary furnishings and fittings as well as private ensuites. Two rooms are equipped with hepa air filters to accommodate immuno-suppressed patients. Pindara’s 12-chair Day Oncology Clinic treats day patients with chemotherapy or blood, iron, intragam or remicade infusions and treatments. The service is popular with patients, who rate the standard of care provided the team highly. Pindara Private is serviced by the Gold Coast’s leading oncologists and haematologists, and surgeons and clinicians, many of whom have consulting suites located on campus for the convenience of patients and their families. Services available on the Pindara Private Hospital campus include: • Radiology with MRI • Pathology • Medical oncology • Clinical haematology • Surgical Oncology • Chemotherapy • Palliative care and support therapy Free off-street car parking is available in the multilevel car park accessible from Carrara Street.
Pindara Private Hospital offers an extensive range of cardiac services supported by the latest in cardiac technology, and first-class standards of accommodation. The Cardiac Services Unit includes a five-bed Coronary Care Unit, a dedicated Cardiac Catheter Laboratory, and a cardiac step down ward. These areas are run by teams of highly skilled cardiologists, nurses and allied health professionals in accordance with the latest Cardiac Society recommendations. The experienced Pindara Cardiac Services team aims to provide the best care and treatment possible and is committed to supporting the individual needs of the patient as well as their relatives. The Cardiac Services Unit is equipped with advanced monitoring equipment and has the facility to manage any acute care patient, in a comfortable private environment. Pindara Private Hospital offers the latest technologies in cardiovascular diagnostic services, including: • An emergency interventional cardiology service, 24 hours a day, 7 days a week. • Referral if required to cardiothoracic surgeons 24 hours a day, 7 days a week. • A specialised 5-bed Coronary Care Unit with on-site medical staff. • Referral to Post-procedural rehabilitation. • Diagnostic and Interventional Treatments offered at Pindara Private Hospital for coronary artery disease and abnormal heart rhythms include: • Emergency Management of Heart Attack • Angiogram • Angioplasty and Stenting
Pindara Magazine
• Pacemaker insertion • Implantable Cardioverter Defibrillator (ICD) • Closure of Patent Foramen Ovale (PFO) Cardiac Catheter Laboratory Pindara’s Cardiac Catheter Laboratory offers 24-hour emergency cover, seven days a week. State-of-the-art technology enables specialisation in a comprehensive range of procedures. Specialist Cardiologists provide prompt diagnosis of heart disease by angiography. Once diagnosed, certain heart diseases are able to be treated under local anaesthetic using the latest, non-invasive surgical techniques including balloon angioplasty, coronary stenting and insertion of pacemakers. Coronary Care Unit The Coronary Care Unit is a specialised area with care delivered by dedicated and experienced nursing staff. State-of-the-art monitors enable 24-hour monitoring and ensure that cardiac arrhythmias are acted upon instantly. Medical staff are available 24 hours, seven days per week to assist in the event of an emergency. Cardiologists are available at all times. Cardiac Step Down The Pindara Step Down provides ward accommodation for patients with medical conditions that include unstable angina, recovery after a catheter lab procedure and recovery from heart attack when the patient requires full telemetry monitoring. Telemetry monitoring enables the patient to move around the ward freely within hours of their procedure. The monitoring is visible to cardiac nurses in the Coronary Care Unit at all times. Patients waiting to be discharged receive specific education and are referred to a rehabilitation program if applicable.
2015
2015
NEWS
New Fellowships in Place at Pindara Private Hospital
Pindara Private Hospital has offered Dr Anna Chang Li Kuin a Fellowship in Neurosurgery. Dr Chang said she was honoured to be the inaugural recipient of the NuVasive Fellowship in Neurosurgery at Pindara Private, and have the opportunity to work under leading Gold Coast Neurosurgeons Dr Leong Tan, Dr Ellison Stephenson and Dr Chris Schwindack, in a hospital that offers a dedicated Neurosciences Unit serviced by a highly specialised nursing team. “Pindara provides exposure to a wide range of spinal surgeries, including complex cases, plus I have excellent support from my supervising consultants and plenty of opportunity to assist during operations,” Dr Chang said. Pindara is also offering a Fellowship in General Surgery, which is due to be filled later in 2015. Pindara CEO Trish Hogan said the Geneal Surgery Fellowship will provide exposure to general surgery, oesophagogastric surgery, hepatobiliary surgery, endocrine surgery, bariatric surgery and a large volume of laparoscopic surgery. Pindara Private Hospital runs 20 operating theatres including a new state-of-the art hybrid theatre for neuro-radiology and vascular cases. This worldclass facility was opened in 2014 at the same time the hospital opened a state-of-the-art, 29-bed Neurosciences Unit and four-bed close observation unit as part of the Dr David Lindsay Wing.
Pindara Emergency Centre
When the Pindara Emergency Centre opened in December 1987, it was the first private emergency unit in Australia. Twenty-eight years on, the centre services the busiest private healthcare precinct on the Gold Coast and is an accredited emergency medicine advanced training facility*, run by a team of emergency trained doctors and nurses with extensive experience in providing immediate and follow-up care. Around-the-clock emergency services are supported by the Gold Coast’s leading private medical specialists and the comprehensive range of health care services available on the Pindara Private Hospital campus. The emergency centre is also well-equipped with life-saving technology and is serviced by 24-hour radiology and other ancillary services. Pindara emergency doctors maintain close relationships with local general practitioners and specialists to ensure the best medical outcomes for patients. They deliver a prompt personalised service 24 hours a day, 365 days of the year, treating patients in order of medical urgency. Patients can present directly to Pindara Emergency Centre, or can request to be taken there by ambulance. No appointment or referral from your doctor is necessary. *The Pindara Emergency Centre achieved accreditation for advanced training in Emergency Medicine and commenced training trainee specialists in January 2014.
pindaramagazine.com.au
Colourful Koala Attracts Attention
Pindara Performs in the AustralianSuper Corporate Triathlon
Pindara teams fared well in the recent AustralianSuper Corporate Triathlon held on the Gold Coast on May 2, 2015. Pindara Private entered a total of seven teams, including two male, two female and two mixed category teams in the ‘Health Care and Medical’ industry category, under the Ramsay Health Care banner. Each team member competing in the Main Tri, was required to complete a full triathlon in relay format. Members of the teams competing in the Woolworths Fun Tri Relay, were required to complete either a swim, cycling or running leg of the triathlon. Despite the inter-industry rivalry being strong in the Main Tri, the Pindara Men’s Team #1, consisting of Dr Sam Dowthwaite, Michael Moore, and Dr Ben Walters, managed to finish in 6th place overall, 4th in the men’s category and 1st in HealthCare and Medical industry, while the Pindara Female Team #5 - Dr Alison Sprague, Dr Sarah Goetz and Carmel Monaghan - finished 2nd in the overall female category. Pindara’s female team #6, Stacey Dickie, Trish Hogan and Dr Clair Allanach, finished second in the Woolworths Fun Tri. Pindara teams also won the award for the best corporate tri suit and our competing doctors and staff really stood out in their award winning costumes, as they completed the 400m swim, 10 km ride and 4 km run around the spit.
A colourful koala attracted plenty of attention during its brief stay at the front of the Pindara Private Hospital, and justifiably so. He (or she) was part of the annual Animals with Attitude Gold Coast Sculpture Trail put on by the Currumbin Wildlife Hospital Foundation to raise much-needed funds for the Currumbin Wildlife Hospital. Pindara proudly sponsored the major fundraiser. The Currumbin Wildlife Hospital Foundation directly funds Currumbin Wildlife Hospital and their vital work treating, rehabilitating and releasing over 8,000 sick, injured and orphaned wildlife patients from across the City of Gold Coast region each year. The hospital has grown to be one of the busiest wildlife hospitals in the world, making the ongoing costs very high. Currumbin Wildlife Hospital has released over 50,000 native animals back into the wild since the first veterinarian started work in 1989. • Australia has one of the worst rates of extinction of its native animal species with over 27 mammal species becoming extinct in the past 200 years. • Koala populations in South East Queensland are rapidly declining due to devastating diseases such as koala chlamydia, as well as loss of natural habitat, which forces koalas into populated areas, where they are more likely to be hit by a car or attacked by domestic pets • It is estimated there are just 600 bilbies left in the wild in the whole of Australia. • Currumbin Wildlife Hospital needs to raise $1 million annually to continue to save Australia’s wildlife and find cures for devastating diseases threatening our native species such as the koala.
Healthy Snacks Available 24/7 at Pindara Fruitbar
To further the commitment to healthy living, Pindara Private Hospital has installed a new vending machine that sells fresh fruit and healthy snack packs, all day, every day for your convenience. The Fruitbar is refrigerated to ensure all fruit is fresh, and unsold fruit is replaced every few days. The machine takes credit cards, cash and coins, and dispenses change. So if you feel like a healthy snack or simply need a sugar hit, visit Fruitbar, located on level 2 of the David Lindsay Wing.
Pindara Magazine
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Advertorial
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Pindara Magazine
2015
Advertorial
Pain today
gone tomorrow Pain is a very personal and subjective experience. No one can judge how much pain you are in but you. Everyone at some point has experienced the feeling of acute pain such as when you stub your toe or slice your finger. Acute pain is the body’s way of warning you of injury and tends to resolve quickly with little to no treatment. Chronic pain is different. Chronic pain persists. Defined as pain lasting longer than six months despite adequate time to heal, it can occur in any area in the body. One in five Australian adults are reported to be living with chronic pain. For most, it develops from a disease, injury or surgical procedure that has long since healed but for others, it can just appear out of nowhere.
Why does some pain persist?
In order for a person to experience pain, special pain receptors (noiceptors) have to be activated through some type of tissue damage or inflammation. A pain signal is sent via nerves to the brain where it is interpreted as pain. In the case of chronic pain, the pain signal continues to travel to the brain despite no sign of the original injury as a result of damage or dysfunction to nerves carrying the pain signal (also called neuropathic pain). Unlike other types of pain, neuropathic pain can be quite severe, and is often described as a sharp, burning, stabbing, shooting or aching pain with some even comparing it to an electric shock. It is also more likely to be chronic and less responsive to pain medications.
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Pindara Magazine
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Advertorial
This therapy has proven particularly successful in managing pain indications involving anatomical areas.
Patient Story:
Jason Campbell, aged 25 from Gold Coast, Queensland Jason’s story began five years ago when complications during a routine surgical procedure to his patella resulted in him needing several surgeries in short succession. Jason subsequently developed chronic pain in his knee and the impact it had on every aspect of his daily life - from work performance, to family life, to social interactions was profound until management with DRG stimulation drastically improved his condition. I was in the army leading a very physically orientated and active life. During morning training one day I dislocated my patella. It required me to have surgery to correct damage to my cartilage. A post surgical facture lead to a further 12 surgeries in short succession. The pain in my knee was so bad I could no longer perform my duties, and I have been unemployed since. I couldn’t walk or stand for any period of time. All physical activities just came to a sudden halt and all I could do was sit around the house and watch TV and that’s when the depression set in. I was living on medications – Morphine, Targin and antidepressants but they were not managing my pain. When I was selected for Dorsal Root Ganglion stimulation therapy I hoped and expected the pain to decrease a small amount but certainly not to the extent it has. As soon as the neurostimulator was turned on there was an immediate reduction of my pain which has progressed to a 80-90% reduction over the last few months. The stimulation only affects the area of pain in my knee and the light sensation of tingling in the area is fading as time goes on. The device is on all the time and I have been able to stop all my regular painkillers that I was having to live on just to get by. I’ve started to become more active. I’m walking the dogs every day, and I’m walking for over an hour straight twice a day, which is something that I wouldn’t have even dreamed of doing before. I feel like a normal 24 year-old again. My message to others who have chronic pain who have been selected for this new therapy would be don’t be scared about it. Give it a chance. It may change your life.
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Pindara Magazine
Importance of managing chronic pain
For those who live with chronic pain, it can be so unbearable that it can make even the simplest task difficult to perform. For others, the biggest challenge they face is not knowing what sort of day it will be, making it difficult to go to work or make plans with family and friends. If left unmanaged, chronic pain can lead to permanent disability and manifest other health problems, such as chronic fatigue, sleep disturbance, decreased appetite and depression.
Managing chronic pain
Because pain is such a subjective experience, the same treatment does not necessarily work for everybody. The most common method for managing chronic pain is prescription medication. Interventional therapies involving injecting local anesthetics directly into the nerve at the site of pain or the use of heat to alter the nerve or nerves that are sending pain signals to the brain are also popular. Spinal
cord stimulation is another well established therapy that uses a small implantable system (called a neurostimulator) to deliver electrical signals to nerves. Patients experience a comfortable tingling sensation in the area of pain or in some circumstance the absence of pain all together. Clinical data shows that applying an electrical field to the DRG may provide improved pain relief to patients by restoring the firing threshold of the nerves that have become hypersensitized due to chronic pain. This therapy has proven particularly successful in managing pain indications involving anatomical areas including the hands, feet and groin, which have traditionally been more challenging to capture with traditional spinal cord stimulation, as well as more targeted and specific pain areas. Pindara now has trained doctors offering these procedures. If you would like to find out more or feel you may be appropriate for this therapy, please call The Pain Doctors on (07) 5527 8025. pm
2015
BRUCE LYNTON LAND ROVER.
THE NEW DISCOVERY SPORT
- Bluetooth Telephone Connectivity - Cruise Control - Emergency Brake Assist - Stop/Start Technology - Land Rover audio system with 10 speakers - 8-inch colour touch screen - Rear view camera with visual guidance & hitch assist function - Automatic Headlamps & Rain Sensing Wipers
- Lane Departure Warning - Powered tailgate - Terrain Response速 - Hill Descent Control - Dynamic Stability Control - Electronic Traction Control - Roll Stability Control - Electronic Power Assisted Steering
The New Discovery Sport is the first in a new generation of Land Rover SUV design. This is a modern, relevant and compelling vehicle, with its well-proportioned compact body and purposeful stance. Its distinctive silhouette and beautifully sculptured surfaces all combine to create a vehicle that truly connects on an emotional level.
Bruce Lynton Land Rover 96-100 Minnie Street, Southport, Qld, 4215
Tel: 07 5571 1011 www.brucelyntonlandrover.com
General Health
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Pindara Magazine
2015
General Health
Managing
Chronic Pain Did you know that pain is Australia's third most costly health problem?
Today, chronic pain is generally not regarded as a symptom; it is considered as a serious separate disease entity. Chronic pain is broadly defined as pain that lasts longer than six months or pain that persists beyond the time expected for healing following surgery or trauma or other condition. It can be mild to severe pain that does not go away. It may be pain described as shooting, burning, aching, electrical or a feeling of discomfort, soreness, tightness or stiffness. Left untreated, chronic pain can have a devastating impact on all aspects of a sufferer's life. About 65% of people with chronic pain report interference with daily activities including sleep, sex, work, exercise and routine self-care, which can have a negative effect on personal relationships, social interactions and lifestyle. Chronic pain sufferers may also experience fatigue, sleeplessness, withdrawal from activity and increased need to rest; weakened immune system; changes in mood including hopelessness, fear, depression, irritability, anxiety, and stress, as well as disability. The etiology of chronic pain syndrome (CPS) is highly complex. All pain is subjective. The individual’s nervous system transmits ‘pain messages’ to the brain, where they are interpreted via a complex process that is specific and unique to the person experiencing the pain. Multiple psychological, physiological and environmental factors can affect this process. Adding to this complexity is the nervous system and brain’s ability to experience neuroplastic changes (i.e. they can change or rewire, over time, in response to sustained stimulation). This distinct multifactorial pathophysiology can result in the person’s pain actually worsening over time, or continuing long after the original cause or source of pain has passed. While there is evidence to indicate that acute pain can lead to chronic pain, chronic pain can and often does exist without a clear reason. Some forms of chronic pain, can be treated with medication or surgery, however, other types, such as neuropathic pain or migraine, may be far more difficult to diagnose and treat.
To help patients living with chronic pain regain a level of comfort and function in their lives, Pindara Private Hospital has opened a new 11-bed chronic pain unit. The Pindara Chronic Pain Rehabilitation Unit provides a structured, supportive and caring inpatient program tailored to the individual needs of three main groups of chronic pain patients. The program focuses on reconditioning and developing coping strategies in the patient to restore confidence and the individual’s capacity to live and function independently. Treatment targets the multiple needs of chronic pain patients and is provided by a team of pain specialists, pharmacists, nurses, physical therapists, dieticians and occupational therapists. Pain specialists and rehabilitation consultants work closely with all Allied Health services, including physiotherapy, occupational therapy and exercise physiology to ensure a tailored service is provided to each individual. • Where indicated, specialist pain physicians administer nerve stimulator treatments, ketamine infusions and other analgesic programs. • Physiotherapy and occupational therapists work through a structured program to help patients regain mobility, strength, endurance and flexibility. • Experienced nursing staff, who understand the special needs of their patients, provide a calm, caring and quiet service to help patients regulate their stress response. The Pindara program offers group and individual management programs to target the individual’s condition: • Daily Physiotherapy group class and individual sessions as appropriate • Daily Chronic Pain Nurse/Dietician/Occupational Therapist group sessions – eg relaxation, coping skills, nutrition, activities of daily living, overcoming social problems • Medication management/education. Worksafe, TAC, DVA and private individuals are accepted pending a medical referral and approval by the relevant health fund. pm
Referral to the Pindara Chronic Pain Unit can be directed to: Dr Leigh Dotchin & Dr Anthony Espinet (Pain Specialists) (07) 5527 8025 Dr Benedicte Mancel (Rehabilitation Medicine) (07) 5598 0070
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Pindara Magazine
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General Health
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Pindara Magazine
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General Health
“Dear Doctor, I’m sorry to inform you, but I am seeing someone else. He doesn’t have a practice or a name, but he works for free inside my keyboard.” Today, the accessibility and improving accuracy of the internet has begun to revolutionise the way patients assess their own health, and the role of their doctor. Recent reports show that one in 20 of Google’s 100 billion monthly searches are health-related; a trend that has led to the term ‘Dr Google’ the action of Googling your health concerns, symptoms and treatments. It appears that Google now wears a stethoscope as much as our local GP. But while a Google a day may keep the doctor away, we begin to look into the implications of internet-assisted self-diagnosis on our health, our doctor-patient relationship and the risk of “cyberchondria”. Here are the pros and cons of Dr Google.
PROS
CONS
Time
Misdiagnosis
Googling your health symptoms, such as upper neck pain or hot rash under the arms, saves both you and your doctor time. Nowadays, many GPs are accustomed to excessive visitations by patients with minor issues like a runny nose or sore muscles after a jog. The internet will prescribe Lemsip and some stretching, no appointment necessary – a major time-saver for both doctor and patient alike!
While the internet has facilitated more participation in decision-making regarding treatment, there is still a considerable safety risk when people reach incorrect self-diagnosis. Somebody who identifies ‘continuous vomiting’ and ‘dizziness’ as dehydration instead of concussion could face serious injury as a consequence. There are also thousands of unauthorised websites out there providing invalid or outdated health information, that when adhered to, may worsen your health symptoms. Doctors are also concerned that people are turning to medical kits purchased online and smartphone applications to identify and treat their sickness, such as the Skin Scan app, which scans skin moles to determine if they’re cancerous.
Education Researching symptoms can increase our awareness of, and knowledge about, certain diseases and injuries, and can even equip us for some medical emergencies. People without their First Aid Certificate can still learn how to resuscitate an unconscious child, or treat a jellyfish sting or minor burn with the help of Dr Google.
Money Googling your minor health concerns and treatment is free. And when GP consultant costs make up a significant portion of Australia’s $140.2 billion health expenditure (2011-12), Dr Google represents the more economic option.
Embarrassment Despite the mountains of confidentiality legislation GPs have under their belt, divulging the graphic details of an infection or your latest bowel movements is still an embarrassing conversation for some. Google search results can help identify your symptoms without a hands-on consultation.
Alternatives For those who prefer ‘greener’ treatments, the internet presents thousands of alternate and natural home remedies for common health and cosmetic concerns. Parsley improves bad breath, dill can alleviate gas, chamomile tea is a great allergy treatment, and tea tree oil helps treat pimples.
Online community support Patients can communicate with each other through online health forums to discuss their experience and access advice. ‘Peer-to-peer’ health care, as explained by the Pew Research Centre, helps patients and caregivers to connect, support each other, and share treatments and practitioner contact details. The online support element is particularly useful for patients suffering from rare or severe diseases, as they can express their emotions in a supportive environment and meet people in similar circumstances.
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Cyberchondria “Cyberchondria” (see cyber-induced hypochondria) is the heightened and illogical fear of disease and death resulting from excessive Googling. Characterised by mistrusting GPs, unnecessary medical testing and stress, some argue that the internet is responsible for instilling unnecessary anxiety in already disconcerted patients.
Doctor-patient relationship Critics argue that Dr Google is impacting the relationship between doctor and patient in two ways. Researchers argue that in this case, the internet undermines the essence of the GP consultation by substituting the personal, face-to-face encounter with an impersonal exchange with a computer. Dr Google deprives the patient of the therapeutic benefit and professional satisfaction provided by a real doctor. Secondly, showing up to consultations with an encyclopaedia of Google results to contend the GP’s judgement will burden the relationship with distrust, frustration and potentially risk. Steve Jobs’ decision to ignore his doctor’s orders, for example, is said to have hastened his death. Whether you’re a frequent patient of Dr Google or not, it is recommended that all online research used to identify and find treatments for any serious symptoms should always be discussed with your GP. pm
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Advertorial
Over 90 Years of World-Class Diagnostic Services AS QUEENSLAND’S LARGEST PROVIDER OF PRIVATE PATHOLOGY SERVICES, QML PATHOLOGY’S STORY IS ONE OF VISION, HARD WORK, PERSISTENCE AND INNOVATION. In the 1920s, QML Pathology provided metropolitan and parts of regional Queensland with the first service of this kind. Since our conception, we have consistently delivered a first class and reliable service to medical practitioners and patients for over 90 years. Today, QML Pathology has vastly expanded to include 25 laboratories and over 600 collection centres strategically located throughout Queensland and northern New South Wales. Our operations are supported by 35 specialist pathologists and over 2,000 dedicated staff. As one of Australia’s leading providers of diagnostic testing services and specialist diagnostic advice, QML Pathology offers an extensive range of pathology testing. From the relatively routine to the highly complex tests, reliable services are guaranteed that enable the medical community to prevent illness, diagnose disease, monitor disease progression and guide treatment pathways. Our services in the Gold Coast and Northern Rivers area contain a network of five laboratories and over 100 accredited collection centres for your convenience. With access to the latest diagnostic technology, we ensure results and specimens are processed timely, accurately and efficiently by our trusted Gold Coast staff. Pathologist in Charge, Dr Tony Dare, expertly leads the team with a wealth of knowledge, and nearly 20 years of experience with QML Pathology. Tony believes QML Pathology is the preferred service provider due to its emphasis on providing world class service to its patients and the medical community.
“QML Pathology has served the Gold Coast longer than any other pathology practice. We uphold strong ethical practice while maintaining our focus on providing quality services.” Dr Tony Dare, Pathologist in Charge Gold Coast and Northern Rivers
Tony previously worked as a General Practitioner, then as a Consultant Pathologist and Director of Anatomical Pathology at the Prince Charles Hospital before commencing work with QML Pathology. Tony says his interest in pathology was inspired as a medical student whilst studying the work of professionals in the field. “As a medical student, the teaching and research work of Professor John Kerr inspired in me, an interest in pathology. I had worked in general practice for a period but decided to follow my earlier interest to train in pathology.” Tony is a Histopathologist with special interests in skin, cardio-pulmonary pathology, and cytopathology including fine needle aspiration. Dr Dare is supported by Dr Darina Vuong, a Consultant Histopathologist and Cytopathologist. Darina joined QML Pathology in early 2015 following her training in Anatomical Pathology at various respected institutions. “QML Pathology is a trusted company which provides the best care and service to both its patients and referring practitioners,” Darina commented on why she chose to work with QML Pathology.
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Darina’s passion for pathology was ignited by her fascination by the pathologic basis of disease during medical school.
“I find it stimulating, challenging and satisfying making tissue diagnoses on all specimens, ranging from small biopsies to the complex surgical resections. It is about getting the right diagnosis for the right treatment.� Dr Darina Vuong, Consultant Histopathologist and Cytopathologist
QML Pathology upholds a strong commitment to delivering world-class diagnostics services to support medical practitioners in patient care. Our testing capabilities assist in the treatment of patients through improved prevention, early detection and diagnosis of diseases. As 70 per cent of all healthcare decisions are reliant on diagnostic services, we are proud to offer such extensive and diverse pathology testing. QML Pathology is dedicated to providing medical practitioners premier pathology services, combining advanced technology with highly skilled staff to ensure the best service possible.
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
Another first for Pindara Selective Internal Radiation Therapy Interventional Radiologists have recently performed the first Selective Internal Radiation Therapy (SIRT) procedure at Pindara Private Hospital. SIRT uses radiotherapy to treat liver cancer that cannot be removed by surgery or local ablative techniques such as radiofrequency ablation. The life-extending procedure is completed in two stages (generally one or two weeks apart) and involves administering radiation directly into, or close to, the tumour rather than it being directed from outside the body. Recently published research has shown a successful SIRT procedure can extend life with reasonable quality for up to eight months. Stage One of the procedure involved the patient undergoing an angiogram to map the liver and identify specific blood vessels, which were then embolised (blocked) to prevent “seepage” of radiation to other major organs and healthy tissue during the procedure’s second stage. Stage Two, which was performed a week later, involved inserting a small flexible catheter through a small puncture in the groin and then guiding it up into the liver. Radioactive SIRSpheres microspheres, containing yttrium-90 (Y-90), which were small enough to flow through the hepatic arteries but too large to pass through the small blood vessels within the tumour, were then administered directly into the liver via the catheter. The microspheres became permanently lodged in the tumour, thus administering a highly targeted radiation dose of Y-90 directly to the tumour, while other major organs and healthy tissue received minimum exposure to the radiation. Doctors Hal Rice and Laetitia de Villiers performed the procedure in Pindara’s new state-of-the-art hybrid theatre, which is equipped with high quality, CT-like imaging and advanced 3D guidance interventional tools. It also features a Maquet operating table, a unique combination that provides the flexibility and functionality required to perform an SIRT procedure. Dr Rice said he was pleased with the success of the procedure and the opportunity it offered to terminally ill patients. “Patients previously had to travel to Brisbane, interstate or internationally, to receive this type of treatment, but these people can now remain at home on the Gold Coast, close to their friends and family – which is fantastic,” Dr Rice said. “The Gold Coast now offers a world-class service that extends the life of terminally ill patients with a treatment that does not further diminish their quality of life.” “We can now do this because we have world-class facilities at Pindara and the latest technology and expertise locally,” he said. Pindara Private is the only hospital on the Gold Coast to offer Selective Internal Radiation Therapy (SIRT).
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Pindara Magazine
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General Health
The Evolution of Colorectal Cancer Management By Dr Marco Matos, Oncologist
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General Health
Multicellular organisms appeared on earth 700 millions years ago. Since then, organisms and their DNA have continuously evolved and in the process mistakes or mutations have occurred. While the processes of evolution and mutation have led to the development of modern man and indeed all of the natural world in which we live today, it could be argued that mutations have also led to the evolution of cancers. Medical scientists have concluded the presence of cancer is an inevitable consequence of our make-up, as a multicellular sexually reproductive organism and consequently cancer is “a statistical inevitability of nature”. While DNA has evolved over millions of years our understanding of cancers has evolved only over the last two centuries. We have gone from the days of the ancient Greeks, who explained cancers as the result of unbalanced “black bile” that also produced depression (equally lethal in some cases); to the days of the medieval physicians who used magic and prayers to “control the demons” that caused “diseases with no cure”; to the present day, when researchers have unscrambled the genetic code of DNA and the secrets of genes to completely map the human genome and the cancer genome. And with this greater understanding has come improved management and treatments of specific type of cancers. Take, for instance, colorectal cancer - medical specialists are now able to look inside the
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heterogeneity of colon cancers and identify different subtypes of disease categorised according to their gene expression, mutations, pathways alterations, RNA or protein expression. They have found five subtypes. The first subtype affects predominantly the right colon and is more common in older people and females. A significant proportion has hypermutation, microsatellite instability MSI, BRAF mutation and immune activation. The second subtype affects mainly the left colon. These cancers are microsatelite stable MSS, have high chromosomal instability CIN, p53 mutation, overexpression of epithelial markers, MYC and WNT pathway activation. The third subtype also has epithelial markers as well as a heterogeneous CIN and MSI. Many are K ras mutant and more frequently overexpress IGFBP 2. The fourth subtype usually affects young people and presents in advanced states. These have mesenchymal expression, TGFB and VEGF pathway activation and NOTCH 3 overexpression. The fifth group have immune and stromal infiltration and variable epithelial mesenchimal activation. Researchers now have evidence that not all colorectal cancers are equal. Each subtype responds differently to treatment and patients with the different colorectal cancer subtypes have different prognoses.
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General Health
The management of patients with these disease subtypes has also evolved over the years, in line with advances in medical technology and the release of new drugs. The introduction of 5FU, the first chemotherapy drug in the 1960s, extended the median survival rate of patients with metastatic colorectal cancer from six to 12 months. The introduction in the late 1990s of more effective drugs such as oxaliplatin and irinotecan improved the median survival rate to 16 - 18 months; and this century, the use of antibodies, such as cetuximab, panitumumab and bevacizumab to target growth pathways (Epidermal Growth Factor Receptor, Vascular Endothelial Growth Factor) and the Tyrosine Kinase Inhibitor (TKI) regorafenib has further extended the median survival to close to 30 months. As a result, these days patients with incurable bowel cancer live five times longer than they did 30 years ago - longer than many patients with heart or kidney failure. Thanks to the greater understanding of the disease, and improvements in treatments, many colorectal cancers previously considered to be incurable in approximately 30% of patients, are now treated with the intention of long term survival. This success can be attributed to the use of systemic chemotherapeutic agents, as well as
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advances in organ specific treatments. These include Stereotactic Internal Radiation Therapy (SIRT), Intra Hepatic Artery chemotherapy, and radiofrequency ablation, which give the treating specialist improved local control over the diseased areas, while protecting healthy areas, thus reducing morbidity and the risk of earlier mortality. The introduction of immunotherapy drugs to control cancer growth by using the immune system to attack cancer cells is also very exciting. It is anticipated this group of drugs will continue to increase the progression-free survival and overall survival of patients with metastatic colorectal cancer. There is no doubt, we are living in times of rapid growth in the understanding of colorectal cancer at the most intimate level, the logical evolutionary process is the development of more effective and less toxic therapeutic options. By understanding the differences between the disease subtypes, and how they differ in terms of their responsiveness to cancer therapies, medical oncologists hope to be able to develop personalised treatment therapies patients with this common cancer. I feel very excited to be practicing as medical oncologist in these amazing days of great discoveries. pm
2015
Q U E E N S L A N D U L T R A S O U N D F O R W O M E N Caring for the women on the Gold Coast & surrounding areas.
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general health
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Pindara Magazine
2015
General Health
Colorectal Cancer Sadly, Australia has one of the highest incidences of bowel cancer in the world. One in 12 Australians will get bowel cancer. While we’re not sure why – maybe there is something in the food we eat, or we’re simply just living longer – the consensus is that a complex interaction between environmental and genetic factors is at play and more research is needed in order to better understand Australia's second biggest cancer killer.
So what do we know about bowel cancer?
We know that bowel cancer is a malignant growth that develops most commonly in the lining of the large bowel. Most bowel cancers develop, over time, from tiny growths called 'polyps'. Not all polyps become cancerous but all polyps should be removed to reduce the risk of developing into the disease. Almost all polyps can be removed during a colonoscopy. Once removed from the bowel, the polyp can no longer develop into cancer. Even if a polyp develops into cancer, in its early stages it can be cured by surgery. However, in more advanced cases, the cancer can spread beyond the bowel to other organs. Bowel cancer is the second most common type of newly diagnosed cancer in Australia, with lung cancer being the most common. 15,151 Australians are told they have bowel cancer every year. Bowel cancer is claiming the lives of 3,980 people every year. We also know that age is one of the biggest risk factors when it comes to bowel cancer and risk rises sharply and progressively from age 50. A person is also at a greater risk if they have: • Previous history of polyps in the bowel • Previous history of bowel cancer • Chronic inflammatory bowel disease (i.e. Crohn’s disease) • A strong family history of bowel cancer • Familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome) • Increased insulin levels or diabetes.
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Given we know that if polyps in the bowel are left undetected they can lead to bowel cancer, and given we know that the risk of bowel cancer increases dramatically from the age of 50, it stands to reason that if you are aged 50 years and over, you are now in an age group at higher risk of developing bowel cancer and you need to act to try to detect polyps early. In fact, doing nothing is not an option for the 50 and overs when it comes to bowel cancer. You need to talk to your GP about your risk factors and the best and most appropriate bowel cancer screening method given your medical history. Screening for bowel cancer can be done by way of a Faecal Occult Blood Test (FOBT), or by colonoscopy, if you are thought to be at an above average risk of developing the disease.
Symptoms of bowel cancer:
• A change in bowel habits with diarrhoea, constipation or the feeling of incomplete emptying or “thin” bowel movements • Blood in the motion • Abdominal bloating or cramping • Unexplained tiredness • Unusual weight loss • Unexplained anaemia. From age 50, if you have no symptoms and the risk factors listed above do not relate to you, you should be screened for bowel cancer every one to two years. If you are aged 50 years or over and have symptoms, it is very important to talk to your doctor ASAP. Similarly, if you are aged 50 years or over and have a family/personal history of bowel cancer/polyps, it is important to discuss your bowel cancer risk with your doctor - you might require a colonoscopy. Gold Coast Colorectal Surgeon Dr Mark Doudle cites family history as a risk factor for bowel cancer is complex. “Family history, on its own, is not necessarily a major risk factor but family history at a young
age is very important,” Dr Doudle said. “Even young people can get bowel cancer.” “If you are aged 50 or over and have a family member diagnosed at say 70, you are in the risk factor group that needs to have some sort of screening (FOBT) at regular intervals.” “If however, you have a first degree relative, who was diagnosed with bowel cancer before they reached the age of 50, you (even if you are under 50) should think about having a colonoscopy, when you are aged 10 years younger than your relative was when they were diagnosed with bowel cancer. For example, if the relative was diagnosed with bowel cancer at 48 years you should have colonoscopy when you are 38 years of age.” If someone has an abnormality, symptoms or a strong family history, they should look at having colonoscopy; otherwise, from the age of 50, they should have some sort of screening on a regular basis. “Screening can be done by way of a Faecal Occult Blood Test (FOBT) and the objective (of screening) is to detect a cancer early, before symptoms of disease exist,” Dr Doudle said. “The ideal person for FOBT screening is someone who has no symptoms. If they are experiencing symptoms, such as unusual abdominal pain or discomfort, unusual loss of weight, change of bowel habits, fatigue, bleeding then they might require a colonoscopy for further investigation.” Dr Doudle said survival rates for bowel cancer are much better than they were 20 years ago. “Our laparoscopic surgical methods have improved significantly and chemotherapy treatments have also improved, but we want to detect bowel cancer early so that we don’t need to intervene surgically.” “Early detection is the key,” he said, “so if you are aged 50 or over, and you receive a FOBT kit in the post – complete the test – it might save your life!”
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general health
It is a common misconception that bowel cancer is an ‘old person's disease'. Australian and international research is showing a worrying global trend towards a higher incidence of bowel cancer in younger people. Between 1990 and 2010 bowel cancer rates doubled in 20-29 year old Australians and increased by 35% in 30-39 year olds. More than 1,000 'younger' Australians are diagnosed with bowel cancer each year. So bowel cancer risk is certainly something people of all ages need to be aware of. But the good news is that bowel cancer is preventable, and if detected early can be successfully treated in 90% of cases. Being aware of bowel cancer, and the steps to prevent and detect it early, are paramount. Early detection offers the best hope.
FOBT
The National Bowel Cancer Screening Program is a population-based screening program for bowel cancer that began in Australia in 2006. The program uses the immunochemical Faecal Occult Blood Test (FOBT) to detect blood in bowel motions. Currently the program is only offered to those turning 50, 55, 60 and 65 years of age. People turning 70 will be included in 2015. Test kits are mailed to people eligible for the program. The FOBT involves using the test kit to take
samples, collected in the privacy of your home, from two or three bowel motions. These samples are sent to a pathologist for analysis and results are then sent to you and your GP. If blood is detected, further tests may be required.
What does the individual need to be mindful of?
Risk of bowel cancer increases significantly after the age of 50. You are also at a greater risk if you have: • Previous history of polyps in the bowel • Previous history of bowel cancer • Chronic inflammatory bowel disease (i.e. Crohn’s disease) • A strong family history of bowel cancer • Familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome) • Increased insulin levels or diabetes. If you are at increased risk, discuss surveillance options with your doctor. An FOBT is recommended every two years from age 50 even if you have no symptoms or family history of bowel cancer. If you are aged 50 years and over and have symptoms and or family/personal history you might require a colonoscopy. If you are not eligible for a free Faecal Occult Blood Test (FOBT) under the national screening
program, you can still be tested. Contact your GP to discuss options. Your GP can request a FOBT, which is eligible for a Medicare benefit. Most pathology practices bulk bill for this test. Some pharmacies have FOBT kits available for purchase over the counter. Some pathology services or health organisations provide online options for purchasing a kit. You should always discuss the use of FOBT kits with your GP before purchasing a kit. Bleeding can come from haemorrhoids – so don’t panic, speak to your doctor about your concerns. For more information call the National Bowel Cancer Screening Program Information Line on 1800 118 868 or visit www.cancerscreening.gov.au Bowel cancer risk factors, include : • age - people 50 years and over are at higher risk of developing bowel cancer • previous history of polyps in the bowel • previous history of bowel cancer • chronic inflammatory bowel disease (i.e. Crohn’s disease) • a strong family history of bowel cancer • familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome) • increased insulin levels or diabetes. pm
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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The Man Flu
No Laughing Matter Around this time each year, we often poke fun at the ‘Man Flu’ myth: when dads and husbands believe they have been hit harder by influenza than women. But the myth has been debunked, and according to health professionals, there is nothing funny about a shocking flu. Research now shows that men aren’t exaggerating their symptoms and that hormones and behaviour are to blame for the discrepancy. Here’s how you can beat influenza, and the ridicule, this winter.
What is the ‘Man Flu’? This tongue-in-cheek expression has long been used to describe males’ intensified experience of influenza, which is characterised by dry coughing and sniffling, weakness, high temperature, days on the couch and often a full system breakdown. Those living with dad or a husband with the ‘Man Flu’ may be subjected to excessive complaints, and expected to provide unconditional sympathy. Nevertheless, influenza is a serious health issue, and causes dozes of deaths and thousands of hospitalisations each year. It is easily spread through sneezing and coughing, which is another reason the ‘Man Flu’ should be treated promptly. Past research has sought to verify the sardonic ‘Man Flu’ concept, with England’s University of Glasgow showing that out of 1,700 participants, men were more likely to overrate their symptoms than women. However, as the whining and sniffling continues, more research has been conducted to explain men’s experience. The difference between men and women comes down to biology and men’s behaviour around identifying and treating themselves for influenza. Higher temperature Men’s larger preoptic nucleus is partly to blame. This is the area that balances a variety of bodily mechanisms, including temperature. As children, this area is the same size for everyone, but as boys hit puberty, their testosterone levels increase and enlarge the preoptic nucleus.
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As the body attempts to fight off bugs, the preoptic nucleus increases in temperature, and because it is larger than that of women, men subsequently suffer a higher temperature than women. Hormones 2013 research by Stanford University School of Medicine in the United States found that female participants provided with a flu shot generated a stronger antibody response than male participants, which gave them greater protection against the virus. The study, which was published in the Proceedings of the National Academy of Sciences, attributed this to lower testosterone levels. The research has been acknowledged for its potential to explain men’s higher susceptibility to bacterial, viral, fungal and parasitic infection than women, as well as the aggravated symptoms. According to Stanford Medicine, women have higher blood levels of signalling proteins that trigger inflammation, which help to activate the immune system. Similar studies have recognised the anti-inflammatory properties of testosterone, which explains why males’ immune system response is lower. As well as this, research by Harvard University School of Public Health found females’ oestrogen levels made them more resistant to influenza. In the first round of testing, researchers observed that female mice were found to be naturally more resistant to pneumonia due to the release of an enzyme linked with oestrogen. Correlatively, when researchers deleted the gene responsible for the production of this enzyme from both male and female mice, their reactions to pneumonia were the same, proving that oestrogen helps females’ immune defence.
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Men’s health
Behaviour Behaviour also contributes to the ‘Man Flu’. General practitioners have continuously reported a lower rate of male visits than women, indicating that men are more reluctant to identify and treat symptoms or manage their health. Common belief maintains that men are less likely to consider themselves susceptible to sickness, when in fact, they are at higher risk than women. According to the Victorian Government’s Better Health Channel (BHC), more men develop serious health problems and die of non-sexspecific health problems than women. For every two women that die, three men die. BHC also identifies that Australian men visit the doctor less frequently for shorter amounts of time, and typically during the more severe stages of the sickness. The common evasion of health services among men has been attributed to the conventional expectation that men are tougher and should put up with their ailments. According to the NSW organisation, Mengage, the traditional stereotype
of a self-reliant male has led to men’s attitudes and behaviours impacting adversely on their health, as many fear being perceived as ‘weak’. As a result, men often let their influenza worsen before arranging to see the GP, which exacerbates their symptoms and prolongs the recovery period. Whereas women will generally visit the doctor or seek treatment in the early stages, the ‘Man Flu’ is left to deteriorate in reluctant hands. Flu Shot Following a severe flu season in the northern hemisphere earlier this year, the appeal of the flu shot in Australia has been particularly strong. As part of the government’s public immunisation program, at-risk groups have free access to the flu shot, including over 65s, pregnant women, Aboriginal and Torres Strait people and people with serious medical conditions. Call your GP to arrange an appointment for a flu shot and and/or discuss the best health practices to prevent and treat the infamous ‘Man Flu’.
Prevention and control • Cough etiquette – covering the nose and mouth while coughing and washing hands after • Washing hands before and after eating or drinking • Taking rest – if you’ve caught the flu, arrange the necessary time off work, refrain from exercise and take it easy • Flu shot – talk with your family about who needs to get the flu shot • Dress warmly • Maintain a healthy and balanced diet – refrain from high-sugar, high-fat foods and focus on warm and nutritious meals, such as soups • Keep hydrated – drink mainly water • Avoid exposure to cigarette smoke and alcohol • Consider paracetamol and ibuprofen for bad symptoms. pm
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Men’s health
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Men’s health
Don’t Just Sleep On It! Snoring in Men
Fellas, you’re not going to catch much beauty sleep when you’re snoring. And neither is your partner. While it affects thousands of people in Australia, men are the highest risk of snoring. According to the Sleep Health Foundation, about 40% of men have mild snoring on some nights, compared to only 30% of women. This is due to a number of physical and health-related factors. Snoring affects not only the sleeper, but also all members of the family, especially any others in the room. Read about the causes and treatments for snoring so that you can put snoring to rest.
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Men’s health
What is snoring?
We know snoring as the noisy breathing that occurs during sleep, created by the vibrating of soft tissue around the airway. When we sleep, the muscles around our throat and mouth relax, narrowing the airway. When these areas – such as the soft palette (roof of the mouth), the uvula (dangling piece of tissue above the throat) or the base of the tongue – relax too much, they begin to block the person’s airway. As the person continues to breathe normally, it applies extra pressure on the throat and causes vibration of the back of the throat (pharynx). The amount of airway that is blocked determines the severity of the snoring – the smaller the passage for air, the louder the snoring.
Who suffers from snoring?
Anyone can be a snorer, but there are a number of health and lifestyle factors that will increase your risk. Men are most likely to snore (40%), and the group at highest risk is middle aged. While some people only suffer from snoring, the condition is usually linked to other sleep-related breathing disorders like apnoea and hypopnea. Sleep apnoea is when breathing stops momentarily during sleep due to obstruction of the airways. Hypopnea involves periods of very shallow breathing or an abnormally low respiratory rate. Which men are at risk? • Overweight or obese people have more fat around the neck, which further narrows the neck and airways • Drinking alcohol relaxes the muscles in the throat, creating more vibration and sound • Breathing through the mouth during sleep • Sleeping on the back, which allows the tongue to block airflow • Nasal polyps (growths in the sinus or nose), large tongue or thyroid swelling • Enlarged tonsils • Allergies, colds and hay fever • Smoking • Deformity of the nose/deviated septum • Some medications that relax the throat muscles • Being born with a smaller airway than normal. What is the impact on health? Snorers are deprived of adequate restorative sleep, which leads to tiredness and fatigue throughout the day. This not only impacts the person’s mood, appetite and energy levels, but also poses risk for those driving or operating machinery, as concentration is impaired. Lack of adequate rest increases blood pressure and risk of heart attack and stroke. People who suffer from long-term snoring are at risk of arrhythmias, an irregular heartbeat, as well as gastroesophageal reflux disease (GERD). GERD occurs when the disordered breathing pattern manages to suck food from the stomach back into the oesophagus. Snoring and sleep apnoea are also responsible for increased crankiness and even depression. Research by the US Centre for Disease Control and Prevention shows a connection between snorting, snoring and sleep apnoea and a range of depression symptoms, including feelings
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of hopelessness and failure. Also, the risk of depression increases with the frequency of snoring. Other health effects include headaches, nocturia (urinating twice or more during the night) and reduced sex drive.
Treatment
The appropriate type of treatment depends on age, weight, health, lifestyle, medical history and the severity of the snoring. It is usually administered by a sleep physician who specialises in treating patients with sleep disorders and can inform the patient of the best option. Povent Therapy Disposable, adhesive devices used to treat snoring and apnoea, which control the amount of airflow in and out of the nasal passage, increasing pressure in the airway and preventing it from collapsing and vibrating. Mandibular Advancement Splint Similar to a mouthguard, and is worn between the teeth during sleep to push the lower jaw forward, widening the airway. Fitted by an oral surgeon or dentist. There are a number of similar oral appliances. Continuous Positive Airway Pressure (CPAP) CPAP is an effective and commonly used treatment for simple snoring, and involves the use of a compact air pump that delivers pressurised airflow to the airway. This prevents collapsing and vibrating of the throat. Tonsil Removal This is common in both adults and children whose enlarged tonsils result in breathing difficulty. UPPP Surgery (uvulopalatopharyngoplasty) This surgery involves widening the back of the throat permanently to assist airflow. Positional Therapy and Changing Sleep Habits Sleeping on the back worsens snoring, therefore therapy seeks to train the body to sleep more on its side. One trick involves sewing something round into the back of pyjamas to prevent the person lying on their back. Losing Weight Overweight snorers may find relief from weight loss and reducing the pressure on the neck. Avoid Alcohol Before Sleep Try to keep four hours between drinking and going to bed, so that the throat muscles don’t remain too relaxed during sleep. Quit Smoking Smokers are four to five times more likely than nonsmokers to snore, while nicotine contributes to insomnia and poor sleep-habits. Quitting cigarettes will help with both these sleep issues.
Where do I find more information?
If snoring creeps onto the nightly agenda, it is time to seek help. For the benefit of your family, physical and mental health, and quality of life, visit your local GP and talk to them about your experience. More information can be found at www.sleephealthfoundation.org.au and www.snoreaustralia.com.au. Now, get back to your beauty sleep. pm
2015
Men’s health
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Women’s Health
TIME magazine picks 3D mammography to top its list of “11 Remarkable Health Advances From 2014” By Dr Nicholas Hall, South Coast Radiology & The Women’s Imaging Centre
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Women’s Health
Time Magazine has chosen 3D Mammography as its top “remarkable health advance“for 2014. This was due to the numerous studies published in 2014 demonstrating 3D Mammography to be a highly accurate screening tool for detecting breast cancer with fewer false positive results. These studies were performed using Hologic, 3D Mammography which has been available on the Gold Coast, at The Women’s Imaging Centre in Southport since August 2013.
A summary of the latest research:
3D mammography improves cancer detection in dense breasts A major new study presented at the annual meeting of the Radiological Society of North America (RSNA) has found that digital breast tomosynthesis, also known as 3D Mammography, has the potential to significantly increase the cancer detection rate in mammography screening of women with dense breasts (significant fibrous or glandular tissue with minimal fatty tissue). Research has shown that dense breasts are more likely to develop cancer, a problem compounded by the fact that cancer in dense breasts can be difficult to detect on mammograms. Other imaging modalities like ultrasound and MRI are often used to help find cancers that can't be seen on mammograms, but both modalities have higher rates of false-positive findings which often results in more tests and unnecessary biopsies. The study compared compared 3D Mammography (3D Mamm) with digital mammography (DM) to just DM on its own in 25,547 women between ages 50 and 69. The 3D Mamm screening method detected significantly more cancer than DM alone: 211 cancers compared to only 163. When it came to dense breasts, the 3D Mamm + DM identified 80% of the cancers, versus 59% via DM alone. These findings are very positive and demonstrate an overall relative increase in the cancer detection rate of about 30%, and a relative increase in invasive cancer detection of approximately 40%. 3D Mamm not only improved the cancer detection rate in women with dense breasts, it also helped increase detection for women in the "fatty breast" categories from 68% to 84%. pindaramagazine.com.au
3D Mammography significantly increases the detection of breast cancer whilst reducing false positives. Published in the June 2014 issue of the Journal of the American Medical Association (JAMA), a study of almost half a million women led by Dr Sarah Friedewald found that Hologic's 3D Mamm found significantly more invasive cancers than traditional mammography. The researchers also demonstrated that 3D Mamm reduces the number of women called back for unnecessary testing due to false positives. This study is the largest to date assessing 3D mamm technology - involving 13 U.S. academic and community-based sites. The study, "Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography," included a total of 454,850 examinations (281,187 conventional mammograms compared to 173,663 3D mamms). Significant findings include: • A 41% increase in the detection of invasive breast cancers • A 29% increase in the detection of all breast cancers • A 15% decrease in women recalled for additional imaging • A 49% increase in PPV for a recall. • A 21% increase in PPV for biopsy • No significant change in the detection of ductal carcinoma in situ (DCIS). The JAMA 3D study validates the findings of previously published studies but on a much larger scale and addresses some of the common concerns with breast cancer screening – that we are finding too many cancers that don't need to be treated and too many women are being called back for unnecessary additional testing. Each of the outcomes measured was statistically significant and reinforced the benefits of Hologic 3D Mammography in addressing these challenges. Our experience with this technology at The Women’s Imaging Centre has replicated the research findings of numerous clinical studies and increased our diagnostic accuracy and confidence in our decision of positive or negative study across all patient populations and breast densities. Reducing false positive is an additional bonus due to the patient anxiety associated with a potentially positive finding. We feel that 3D Mammography has made a significant and positive impact on patient management. pm
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Women’s Health
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Women’s Health
Feeling it in Your Bones A rthritis in Wom e n There’s not much that will stop a woman from fulfilling her daily tasks, but arthritis will certainly slow her down. Arthritis affects the lives of around 3.85 million, or one in six, Australians and costs nearly $24 billion in medical care and loss of earnings each year. Moreover, these figures are growing as our population ages, with experts predicting that by 2050, seven million Australians will suffer from some form of arthritis. Are you a woman living with arthritis? Or is your wife, mother or sister suffering? Learn more about the condition to understand how it impacts the daily lives of the ladies we love.
What is Arthritis?
Although often referred to as a single health problem, arthritis is the umbrella term for over 100 musculoskeletal medical conditions. It takes place in the joints, and is the major cause of disability and chronic pain in Australia. Despite what many think, arthritis is not a natural part of ageing and can affect people of all ages. According to Arthritis Australia, 2.4 million patients in Australia are of working age. The general symptoms of arthritis-related conditions are: • Pain in the joints • Stiffness • Inflammation • Damage to cartilage • Weakness and instability • Deformities The experience of arthritis is more intense and prolonged than a stiff neck or sore shoulder. These symptoms hinder a woman’s ability to perform everyday tasks, such as driving, walking, cooking and writing. The main types of arthritis – osteoarthritis, rheumatoid arthritis and gout – make up 95% of patients in Australia, but there are many other equally debilitating forms. There is no cure for arthritis yet; it can only be managed through medication and lifestyle habits and choices.
Main Types of Arthritis Osteoarthritis Osteoarthritis (OA), the most common form, affects the entire joint, including the bone, ligaments and muscles. As well as inflammation pindaramagazine.com.au
and deteriorated ligaments and cartilage, bony spurs may develop around the edge of a joint. OA develops slowly over months or sometimes years, more commonly among people aged over 40. Rheumatoid Arthritis Rheumatoid Arthritis (RA) is an autoimmune disease that causes the body’s immune system to attack its own tissues. While it begins with painful swelling and stiffness, RA is a systemic condition and gradually affects other organs such as the heart, respiratory system and digestive system. The second most common form of arthritis, RA is more common in women aged over 55, who are 1.6 times more likely to develop RA than men. It is also associated with a family history of the disease. Gout Gout is caused by small crystals that form in and around the joint, creating inflammation, pain and swelling. These crystals are made from uric acid that hasn’t been expelled from the body through the kidneys and urine. Gout occurs among all ages, however, it is rare among pre-menopausal women, and should be investigated promptly in this case. While the other common forms of arthritis develop gradually, gout can occur over night, hence why it is often referred to as an ‘attack’ of gout. The joint will quickly become inflamed and may be very sensitive to touch.
Causes
The type of arthritis that a woman develops is dictated by a range of individual health and environmental factors. However, most forms of the conditions are caused by: • Overweight or obesity, which places excess pressure on the muscles, bones and joints • Family history • High cholesterol, high blood pressure or glucose intolerance (Diabetes) • Previous injuries • Repetitive use of the joint (occurs among pianists and guitarists) • Jobs with heavy lifting, climbing and squatting • Kidney disease and taking diuretics, in the case of gout • The cause for RA remains uncertain, but it is more common among smokers and those with a family history of RA.
Medical Treatment Analgesics Analgesics (painkillers) are prescribed by your doctor to help alleviate pain. Some types, such as paracetamol, have few side effects but can cause severe liver damage over long periods of usage. Consult your doctor or pharmacist for advice. NSAIDs Non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation, swelling and stiffness and are most often administered for RA. Some types, such as ibuprofen, don’t require prescription. NSAIDs stop the body from producing inflammatory substances (prostaglandins). Corticosteroid Corticosteroids, similarly to NSAIDs, are used to treat inflammation, and are taken as a tablet or liquid, or are injected into the joint. DMARDs Disease-modifying anti-rheumatic drugs (DMARDs) cause ‘immunosuppression’, which slows the immune system from attacking the joints. These can relieve pain and minimise the risk of long-term damage. Surgery Surgery is generally undertaken when other treatments have not been effective. Surgery can improve joint movement, flexibility, alignment and alleviate pain associated with daily tasks and ultimately improve quality of life.
Lifestyle Treatment Weight loss Weight loss reduces pressure on the joints, eases pain and inflammation, improves function of the bones, muscles and joints, as well as decreases the risk of other chronic diseases. Tai Chi Tai Chi for Arthritis was developed in 1997 by Dr Paul Lam and includes 12 movements especially designed for patients to improve strength, balance and posture and decrease stress. Diet Monosaturated and Omega-3 fats have been shown to reduce inflammation and RA disease activity and can be consumed through vegetable, avocados, nuts and oily fish, such as salmon and sardines. Fish oil supplements are also recommended. Water exercise ‘Hydrotherapy’ is gentle exercise undertaken in a warm pool, and is a comfortable and effective method for strengthening joints and recovering from surgery.
Learn More
To learn more about arthritis and its prevalence in women, visit www.arthritisaustralia.com.au and www.arthritis.org.au, or visit your local GP to discuss how to help prevent arthritis, or how you can help the lady you love regain control of her life. pm Pindara Magazine
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Children’s Health
Play School The importance of play-based learning
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Children’s Health
When we think about child development, we tend to think books, pencils and blackboards, before we think of the playground. But time spent building castles and mimicking animals is just as important to a child’s social and intellectual development as learning to read and write. Play is the interaction with others that helps us to experience and make sense of our world. As a major key to active learning, which is using the brain in many ways, play-based learning is encouraged throughout all stages of childhood. Play-based learning is defined by the Department of Education, Employment and Workplace as a ‘context for learning through which children organise and make sense of their social worlds, as they actively engage with people, objects and representations.’ For this reason, growing up isn’t all work and no play. Read on to learn about the benefits and impacts of play-based learning.
What is play?
Make-believe, talking, toys and tumbling – there is no one definition of playtime. Child development experts do agree on, however, a number of characteristics. Play looks like: • Enjoyable and pleasurable activity, where fun is the key feature • Solitary, partner or cooperative group activity, in which the child assumes a leadership or team member role • Structured play with rules, or unstructured and improvised symbolic ‘make-believe’ play • Active play that involves physical, verbal or mental engagement with material, people and the environment.
What happens during play?
We might not remember our own experience of play and how it has shaped our adulthood behaviour, but we can observe its role in our children’s development. Joy Cottrell from Joy’s Place for Children in Southport, who has been an early childhood educator for 46 years, says play is an allinclusive educational experience. “Children learn absolutely everything in play. Socialising, fine and gross motor skills, compassion, language – there is nothing they can’t learn during play.” Whether equipped with Barbie or a set of blocks, children are undergoing similar learning processes: • Exploring the natural and social world • Thinking and expressing themselves freely and creatively • Expanding and challenging their fine and gross motor skills • Absorbing and reacting to social situations with or without language • Experimenting with ideas • Developing their identity and relations with others. During this time, the job for educators and childcare providers is to recognise the strengths and curiosities in the children every day. “As the kids play, we can see how they develop an interest or an aptitude for an activity. For example, we might see how a group of children are playing with foliage and pretending to serve it as food. So we respond by taking them to the vegetable garden that afternoon to talk about permaculture and healthy food,” explains Joy. “You can’t script playtime; the children play and pretend without boundaries. Numeracy, creativity and cognitive skill are all developed in this kind of incidental learning.”
Skills gained during play
According to researchers, all evidence agrees that playtime has a critical role in children’s learning and development, regardless of culture or
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language. During play, children gain some of the social and communication skills and behaviours that set them up for life. • Positive attitudes • Self-motivation and self-direction • Cooperation • Respect for others and property • Curiosity, persistence and concentration • Language and numeracy • Group values.
Brain development
Research makes many connections between play and intellectual capacity, as well as the structural design of the brain. Lester and Russell, prominent researchers in this area, show that play increases the brain’s flexibility and improves the potential for learning later in life. Earlier research also links colourful and play-oriented environments with bigger brains and higher cognition. Make-believe, or ‘sociodramatic play’, also improves children’s performances in cognitivelinguistic and social activity, as well as their capacity for creative problem solving. Experts attribute children’s ability to solve divergent problems (problems with multiple solutions) to regular imaginary play, in which the child thinks outside the box. Think about the last time you lost your temper, or the last time you consoled yourself – your ability to feel, control and express your emotions was once learnt through play. Research shows that frequent engagement with other children in make-believe spaces has led to stronger selfregulation and negotiation. One child cannot play make-believe without the other’s cooperation, and therefore we see how they negotiate rules and behaviours to play without specific instruction. In her Considering Counterfactuals paper, professor of psychology and child development expert, Alison Gopnik from the University of California Berkeley, illustrates how play and exploration lead to a child’s revision of casual theories.
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Children’s Health
Consider a young child in the bath, whose intuitions tell her that heavy objects sink and light objects float, the result of failure to differentiate between weight and density. This casual theory is challenged when a marble sinks to the bottom, while the heavier toy truck stays afloat. This leads to the child forming a range of hypotheses and investigations as to why the bigger, heavier objects floats, and rethink her original theory of floatation. Play provides the opportunity for children to master the sorts of activities undertaken in adulthood. In this context, play is a sort of ‘practice’ for the future, whereby they simulate adult activities, such as cooking, communicating, settling disputes and trading. There is something magical about playing part in children’s make-believe – assuming the role of a fairy or wizard whose powers bring toys to life. But despite classical research linking play with children’s inability to distinguish fantasy from reality, children by the age of three are quite proficient at making that distinction, a skill fostered by play. Additionally, play creates an environment for expanding generic knowledge, even when represented through symbols. As psychology PhD
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Sandeep Prasada explains, generic knowledge is the knowledge about kinds of things; for example, that sharks eat fish. Using a rock as the shark and leaves as fish, an adult can demonstrate this generic knowledge to the child, from which she makes inferences about a real shark’s behaviour. According to Joy Cottrell from Joy’s Place for Children, physical activity, whether make-believe or structured, should be encouraged everyday, especially to prevent childhood lethargy that can derive from excessive computer game use. “We want to see more children throwing themselves in the mud and flocking to the streets to play cricket. We want to encourage children to experience life and learn outdoors instead of sitting on the couch with a video game. Getting messy, playing around, falling over – it’s all part of the learning process.”
Fostering play-based learning
Parents, educators and childcare providers create opportunities for play-based learning every day within the home and childcare establishments, which are dynamic physical and social spaces. Adults can work together in assessing the child’s learning and interests, and provide a range of
games and activities to help her develop a broad skill set. The play-based learning environments (social and physical) should: • Contain a mindful layout of furniture, space and resources to encourage exploration, adventure, fun and safety • Be secure, warm and loving • Provide encouragement and assistance in exploration and risk taking • Facilitate connections with other children • Provide sufficient amounts of time for play to allow children to develop themes and theories and converse • Be colourful, brightly lit and inspire creativity and expression.
Learn more
To read more about the importance of play-based learning, visit www.earlychildhoodaustralia.org.au, speak with your childcare provider or pull on the fairy wings and watch how the magic happens.
2015
Children’s Health
Help your kids learn and play at home with these
Fun Activities! Match It
Nature's Paint Brush
(3-5 years)
(2-6 years)
What you need • 1 sheet of cardboard • 1 felt tip pen • 8-12 items of different shapes and sizes (bottle caps, playing cards, shells, household items
What you need • String and sticky tape • S ticks and small branches collected from the garden/park • Paint and paper
Instructions • With the felt tip pen, trace each item on the cardboard so that their outlines are spread out • Place all items in a bowl • Instruct children to fit the item within the corresponding outline while saying the item’s name out loud.
Instructions • Take children into the garden or to the local park, and together collect a number of small, durable sticks, leaves and leafy branches from the ground – advise against sharp sticks and indicate size.
• Take findings home • Tie bunches of leaves and leafy branches to the end of the sticks using string and stick tape – this should create a sort of natural paint brush • S tick paper to aisle or on an outside wall. Instruct children to paint using the paints and their new paintbrushes. • Discuss the different textures, patterns and names of the leaves
Name Collage
Bottle Top Fishing
Bags, bags, bags
(3-4 years)
(3-5 years)
(2-5 years)
What you need • 1 piece of coloured A4 cardboard per child • 1 felt tip pen • Glue • S oft craft material, glitters, buttons Instructions • In block letters, drawn each child’s name, leaving enough room in the letters to glue material • Instruct the children to fill in the latters of their name as they wish, using the craft material. Encourage use of all colours and textures, and discuss how the material feels and looks • E xplain and repeat the letters so that children become familiar with those in their name • A sk the child to choose a place to hang the picture.
What you need • 1 large tub, filled ¼ with water (add glitter and food colouring for sensory fun!) • 3 0-40 bottle tops of different colours, some with specific markings • 1 Slotted spoon • 1 small basket • 1 towel laid under tub Instructions • Place bottle tops in water • Instruct the child to fish out the bottle tops, gradually specifying the game by electing which colour must be fished out or left in the water • Also, categorise the activity by the marked bottle tops. For example, collect three yellow bottle tops, and two marked with a flower. • Count out loud how many bottle tops are in the basket each round and discuss their details.
What you need • Multiple bags of different sizes and styles • Toys, objects, tools and clothing placed around the play area • Audio player and CD with the ‘Bags, bags, bags’ song Instructions • Instruct children to choose a bag • Playing the song, instruct the children to explore the area to see what they find • Sing with the children and incorporate your own object into the song. For example, “If we didn’t have bags, what would we use to put our hats in?” • The children must then fill their bags with the hats they can find • Repeat with different objects, and add urgency to create excitement. pm
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Children’s Health
No Jab No Play & No Pay What the new government policy means for families While ‘to jab, or not to jab’ is a prominent decision for parents in Australia, national consensus supports immunisation for children of all ages, especially those attending day care and pre-school. Recent efforts to persuade Australian parents to fully immunise their children at one, two and five years of age includes the Liberal National Party’s ‘No Jab – No Play and No Pay’ policy. Aimed at parents who haven’t immunised their children, the policy restricts access to the Family Tax Benefit (TFB) Part A end-of-year payment, and restricts children’s enrolment into childcare without necessary vaccination documentation. History and science conveys that immunisation prevents millions of viral and bacterial deaths each year, and that it’s both a parental and community responsibility. Significant debate persists, however, around whether this policy is the best way to encourage parents to vaccinate. So, what are the implications of ‘No Jab – No Play and No Pay’?
What is the policy?
In April this year, this Commonwealth Government removed the ‘conscientious objector’ exemption on children’s vaccination for access to a number of childcare benefits, which will be active from 1 January 2016. A ‘conscientious objector’ is recognised as a parent who has registered with the Australian Government an objection to their child being immunised on religious or moral grounds. This now means that parents who refuse to vaccinate their children for personal beliefs will be unable to access these government childcare payments. The Government has expressed that the new policy will tighten up the immunisation rules and reinforce the importance of immunisation for public health. It also acts to remind parents to keep on top of their children’s immunisation schedule. Not all parents condemn vaccinations; it’s also a matter of awareness and access. Additionally, in 2014, the NSW State Government introduced a change to their Public Health Act that prevents parents from enrolling their child into childcare facilities without approved documentation that shows the child has been fully vaccinated, or approval of medical or conscientious objection if they haven’t. This doesn’t stop enrolment altogether, but enables childcare facilities to send unvaccinated children home in the event of an outbreak.
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Children’s Health
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Children’s Health
Immunisation among Australian children
Since its introduction to Australian children in 1932, deaths caused by preventable diseases have fallen by 99%, despite a corresponding three-fold increase in the population. It’s hard to imagine, but before major vaccination campaigns of the 60s and 70s, diseases such as tetanus, diphtheria and whopping cough killed thousands of children every year. According to the National Health Performance Authority (NHPA), as recorded in March 91% of one year olds, 87.6% of two year olds and 92.3% of five year olds are fully vaccinated. In order for immunisation to work effectively, experts say that 90% of the population must be immunised, and even 95% for some diseases, such as measles. Although the rate of immunisation in Australia has increased since the Childhood Immunisation Register was established in 1996, so too have vaccination objection rates. Around 70,000 children are currently unvaccinated, with 39,000 of those because their parents are vaccine objectors.
NHPA has also recognised that of 325 Medicare ‘statistical areas’ that are used to compare vaccination rates, 32 are at risk of outbreak of contagious diseases like measles and whooping cough.
Why do people support immunisation?
It is estimated that vaccinations save around three million lives around the world each year. Immunisation is the most significant public health intervention in the last 200 years, and is considered a safe and efficient safeguard for the health of your family and community. Being vaccinated protects those that are too young to be vaccinated or are vulnerable to serious health complications, such as the elderly or critically ill. History shows a number of examples of vaccination success, including the eradication of smallpox in 1980 following a World Health Organisation campaign, the near-elimination of polio following the Global Polio Eradication Initiative, and the elimination of measles from Australia in 2014.
The Department of Health highlights that immunisation not only protects your child, but it also prevents the spread of disease through contact with other children. Through communal, or ‘herd’ immunity, in which the high majority of people are immune to disease, those who are vulnerable and/ or unvaccinated will not be exposed. This is pertinent to the ‘No Jab – No Play and No Pay’ policy, as young children are not only more vulnerable to disease, but experience higher amount of physical contact in childcare environments with other kids and carers.
Criticism to the policy
Despite the majority of Australians supporting child immunisation, there has been some criticism towards the policy. Some critics have pointed out that instead of addressing under-vaccination through engaging and working with parents, the policy can polarise communities and label these parents as ‘irresponsible’ and ‘free-riders benefitting off the immunity of others.’
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Phone: (07) 5598 0098
Pindara: Suite 11, Lvl 2, Pindara Pl 13 Carrara St Benowa QLD, 4217
|
2015 www.goldcoasturologist.com.au
Children’s Health
Other views consider the ‘No Jab – No Pay’ measure unnecessarily punitive and believe it could push committed ‘anti-vaxxers’ further towards objection, as well as cut low-income families from the financial support that would assist their visit to the doctor in the first place. Removal of income could also impact on a family’s ability to send their child to day care or educational facilities, which is devastating for their consistent social and intellectual development. Some children may be unvaccinated due to a disjointed family situation, or because they’re parents are uneducated about vaccination. Nonvaccinating parents who aren’t objectors tend to be from low-income households and low education backgrounds (34% have Year 10 or less education). Conversely, the ‘No Jab – No Play’ measure is acknowledged as an encouragement approach. Rather than chastise and deny anti-vaxxers financially, this is a financial and practical disincentive as parents are forced to seek other childcare facilities or miss work to care for their unvaccinated children when they are sent home from day care.
Moreover, in order to enrol their unvaccinated child, parents must have their objection document officially recognised by a doctor. This meeting provides another opportunity for face-to-face discussion and for the GP to reason with the parents on their views. Many objectors have gone on to vaccinate their children after these meetings. 2012 research shows that openness and trust between the health service provider and parents are pivotal in guiding parents towards a comfortable decision about immunisation. Most importantly, it should be acknowledged that objecting parents aren’t acting out of self-interest. Like pro-vaxxers, they are concerned for the welfare and safety of their child against the potential, but very rare, side effects of immunisation.
To jab, or not to jab?
The decision doesn’t have to be made on assumptions or misinformation. By visiting your GP and discussing the benefits of immunisation, and the implications of recent policy, parents can feel informed about their vaccination decisions and confident about their child’s health. pm
Obstetrics Gynaecology IVF / Infertility Laparoscopic Surgery Adolescent Gynaecology Dr Penelope Isherwood is happy to see you for Obstetric, Gynaecology and IVF-infertility consultation and treatment. Her wish is to provide her patients with the best care possible, tailored to their circumstances and preferences.
Phone. (07) 5597 2660 Fax. (07) 5597 2667 Email. reception@drpenelopeisherwood.com.au Web. www.drpenelopeisherwood.com.au pindaramagazine.com.au
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Children’s Health
Loud nights for little ones Snoring in Kids Words by Dr Dan Robinson
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Children’s Health
Kids who snore might bring about a giggle in their siblings or classmates but, unfortunately for some kids, snoring indicates a serious health issue. Snoring children may not be getting the oxygen they need for a good night’s sleep or for cognitive development during the day.
Side effects of this include: • • • • •
Irritability Always being tired Poor concentration Poor performance at school Consistent bed wetting beyond the age of 3
Is you child’s snoring problematic?
Snoring every night is abnormal and, in this case, needs to be assessed by an Ear, Nose, Throat (ENT) surgeon to identify any accompanying symptoms: • Pause in the breathing whilst asleep • Gasping • Waking tired in the morning • Excessive restlessness during sleep • Night terrors • Sleep apnoea (consistent pauses in breathing throughout the night)
What causes snoring?
Snoring children have partial or complete upper airway obstruction during sleep, which creates turbulent airflow and disrupts normal ventilation and sleep. This creates a lack of oxygen, which causes the more serious symptoms of this condition. This condition is now referred to as Sleep Disordered Breathing (SDB).
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What causes SDB?
While there are a number of causes of SDB, some which are quite rare, the most common cause is tonsil and/or adenoid enlargement.
Will SDB affect my child’s behaviour?
Your child may experience behavioural changes in the form of: • Increased aggression • Hyperactivity • Signs of depression • Symptoms similar to ADHD • Wetting the bed – up to 50% of children with SDB wet the bed • Poor memory • Poor attention • Poor performance at school
What is the treatment for SDB?
If your child has SDB, it’s recommended they have an adenotonsillectomy, an operation to remove the adenoids and tonsils. The benefits can be dramatic in improving the child’s life. They may experience: • Increased quality of life • Improvement in behaviour • Improved school performance • Reduction in bed wetting
What to do next?
If you think your child has SDB, make an appointment to see an ENT surgeon. Along with the referral, it helps to take a video of your child sleeping to show the surgeon the child’s symptoms. pm
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2015
Keeping It
Napoleon Perdis Mattetastic Lipstick in Marlene $38.00 RRP
$27.99 RRP
Pout darker this winter with Napoleon’s Mattetastic Lipstick in the sultry Marlene berry shade. Named after the glamorous Marlene Dietrich, this long lasting, hydrating lip colour with vitamin E and antioxidants protects and plumps for the nights ahead.
Bathe your skin in the right ingredients whilst building a light and natural tan. Naked Tan Goddess Gradual Tan is a sunless bronzing product that nourishes skin as it glows. With active DHA, shea butter and Aloe Vera, welcome a smooth complexion kissed with a colour that lasts. You’ll forget which season you’re in.
Napoleon Perdis, Pacific Fair and Robina Town Centre Free delivery Australia wide
nakedtan.com.au
muk Spa Argan Oil Repair Mask 250ml $26.95 RRP Created with the liquid gold of the hair world, muk Spa’s Argan Oil Repair fortifies damaged and dry hair with concentrated conditioning and the delicious fragrance of sandalwood and wheatgrass. A powerful rinse-out mask free of sulphates, parabens, silicone and mineral oils. Price Attack, Robina Town Centre
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Naked Tan Gradual Tan 150ml
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EVOHE Mist 30ml $18.99 RRP
100% Pure Coffee Bean Caffeine Eye Cream $39.95 RRP Dark circles, puffy skin and tired eyes; it’s time to drink up! 100% Pure brings you its best-selling, revolutionary Coffee Bean Caffeine Eye Cream, celebrated as one of the country’s best treatments for dark circles and wrinkles. Made with green tea, coffee, anti-ageing ingredients, Rosehip Oil and antioxidants, this product delivers a youthful glow and awakens your skin – just like a shot of coffee! Made with all vegan and natural ingredients. nourishedlife.com.au
It’s too cold for water, and your lotion’s at home – this is where pocket size hydration steps in. EVOHE’s Mist, formulated with Australian bush flower and tissue salt ingredients, is for instant, one-pump hydration round the clock. Along with its calmative and anti-inflammatory properties, EVOHE’s Mist is great for refreshing your face and tired eyes. Your next work desk companion. Go Vita stores Gold Coast
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2015
HEALTH & BEAUTY
This season's best beauty buys BEARD OIL
1.7fl oz
50ml
WOODPECKER $39AUD Weirdy Beardy Woodpecker Beard Oil not only has subtle hints of the forest to keep you smelling fresh during the day. With Coconut and Jojoba oils, it will condition your skin and moisturise your beard. Vitamin B5 will protect your skin and beard from the elements. A great oil for day to day wear with a scent to be adored. Throw some of this in your beard of a morning, oh what a glorious day!
Sanctuary Spa Peptide Replenish Night Cream 50ml
Molten Brown London Oudh Accord & Gold Body Wash
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$39.00 RRP
In age we see beauty. But as our skin grows older, it struggles to retain moisture like it used to. The Peptide Replenish Night Cream works while you sleep, with its signature formula Matrixyl Synthe’6, shea butter, lavender and other active ingredients, which are clinically proven to reduce the appearance of fine lines and wrinkles.
Smell of nutmeg and shimmer in gold. Molton Brown London’s Oudh Accord & Gold Body Wash is a luxurious bath and shower gel made with oudh oil, real gold leaf and a blend of intoxicating woody aromas. Spicy, resinous and rich – a body wash that radiates class.
As the bearded population grows, Weirdy Beardy have taken a stance against wild, unkempt facial hair by introducing their Woodpecker Beard Oil. Scented subtly like a forest, and soft with Jojoba oils, coconut oil and Vitamin B5, this is the ideal product for a gentlemanly lumberjack, groomed in all the right places. Nourishes and protects skin and beard.
David Jones, Robina Town Centre
Weirdy Beardy Woodpecker Beard Oil 50ml
Priceline
Shiseido’s ZEN Eau de Parfum 100ml
weirdybeardy.com.au
$139.00 RRP Absorb a little peace with Shiseido’s ZEN fragrance, which is layered with amber, wood and musk with a breath of floral sweetness. The combination of citrus fruits, rose, lily and raspberry with the woody notes brings a garden of fragrance to life, with a stunning bottle design that sharpens its place in the bathroom. Be calm, but do it with style. David Jones, Robina Town Centre
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HEALTH & BEAUTY
Education
A Journey of Discovery for Patient, Practice & Surgeon The Layt Clinic
Education is a key part of any medical practice. This is enshrined in the Hippocratic Oath - “I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow”.
Dr Layt explains, “We are obliged to keep ourselves educated to ensure that we are at the peak of our professional skills and that obligation extends to educating our colleagues.” But it is more than that. Education extends throughout the whole of the practice. It is important to ensure that the practice staff, both clinical and non-clinical, are continually educated to improve the service delivered by the practice and to continue the professional development of
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the staff, which also is important in maintaining quality outcomes and staff engagement in the activities of the practice. Obviously in all medical practices education of patients is paramount. A well-informed patient will engage in the treatment process with an enthusiasm and becomes a partner in the outcome of the treatment. At the Layt Clinic, Plastic Surgeon, Dr Craig Layt, the Medical Practitioners and staff are passionate about education on all of these levels.
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HEALTH & BEAUTY
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The Layt Clinic
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Dr Layt states, “I make it my mission to attend numerous conferences throughout the year in order to continually hone my skills. I have also taken on leadership roles in the past, as President of the ASAPS, with the responsibility to provide and hone educational materials for my fellow plastic surgery professionals.” Through this society, a ground-breaking conference called The Non-Surgical Symposium was established, bringing together plastic surgeons, dermatologists, cosmetic doctors and nurses to learn the latest techniques in non-surgical treatments. This has now become the ‘gold standard’ within this medical and cosmetic medicine field in Australia. This passion for education has led to some very interesting opportunities for Dr Layt over the last few years. Dr Layt is now the Director of the Allergan Academy Education Program in Aesthetic Breast Surgery, which involves educating younger plastic surgeons in the field of aesthetic breast surgery with live demonstrations as well as lectures and designing operations on live models. “This has been a very fulfilling and interesting development in my professional career and it has provided numerous opportunities to travel overseas to various Asian countries,” Dr Layt says. The most recent of these teaching trips for Dr Layt was a four-day visit to South Korea. “The interaction with my colleagues in South Korea was incredibly interesting. These programs are ongoing and very exciting, albeit sometimes tiring. However, I look forward to continuing my involvement in them as it is wonderful to share with the world, the surgical techniques and new equipment and implants that are being utilized for surgery here in Australia.” One of the most recent additions for surgical training available on the Gold Coast has been the strong commitment by professionals to develop The Breast Academy, Gold Coast. This gives young plastic surgeons the opportunity to work with recognised and experienced Plastic Surgeons in a fellowship to further their experience under the supervision of the Senior Plastic Surgeons. This enables the Fellow to have access to a greater number of patients and to learn from a number of highly experienced Plastic Surgeons. The education and experience available in this program to the Plastic Surgical Fellow has been so successful and well recognised that world renowned institutions such as Harvard and other European Medical Centres have requested to send their Graduating Plastic Surgeons to the Academy. Obviously the most important part of education within the practice area is that of educating patients, and in this world of constantly evolving multimedia, there are many interesting ways for this to be done. Historically, education would be limited to educational articles in magazines and newspapers, as well as perhaps letterbox drops or mailed materials. Nowadays, this has been replaced by mediums such as websites, email, social media and other mind-boggling interfaces.
2015
The Layt Clinic has introduced various new technologies to improve the educational experience for patients. The most notable of these technologies introduced is the VECTRA-3D imaging software system. The software enables patients to have a 3D image of a face or body part. This image is then used to educate the patient in the realistic possibilities that may be achieved through surgery for their particular physical attribute. The two types of surgery where the software is particularly useful are rhinoplasty and breast augmentation. With regard to rhinoplasty, the software enables the patient to be shown types of possible results, which would balance their current facial features. Interestingly, the result suggested by the software is often very different to the photos or magazine images, which a patient may have brought with them to their consultation. “These photos often feature celebrities such as Hilary Duff or other similar faces,” explains Dr Layt. “We are able to demonstrate to the patient that a particular celebrity’s beautiful nose will not necessarily suit their own facial structures. After all, just like life, facial proportions are all about balance and are very individual to each person.” The VECTRA 3D-imaging system is also a popular educational tool for breast augmentation.
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The software enables Dr Layt to place the implant, chosen from clinical and mathematical dimensional planning principles, into the breast to show a prediction to the patient on how that particular implant will look within their body. This is a great communication tool, as it enables the surgeon and the patient to clarify that they are on the ‘same page’ when it comes to desired outcomes. The ability to see one’s face in three dimensions on a big screen also helps with the discussion regarding facial balance, and particularly, the use of facial fillers. The over-plumped, out-of-proportion lips, or excessively filled cheeks, can detract negatively from the natural beauty of facial features, rather than enhancing one’s natural features. “At a recent conference there was significant discussion regarding the approach to facial enhancement using fillers. This is certainly an approach that is very advantageous to the patient and by analyzing the areas of the face that are out of balance, and returning those to their youthful appearance, one can create an excellent natural result. This approach demonstrates the importance of educating patients as to the positive and negative attributes of their facial structure and how these can be enhanced by the use of strategically placed fillers of various types,” states Dr Layt.
Further, it is important to recognise the influence that each patient contributes to the continued education of doctors, clinical and administration staff. Every patient and their situation is different, and as such presents a unique combination of what can clinically be anticipated, as well as any new and interesting variables to consider. Further, surgery outcomes can be individually diverse, and complications, which present themselves, should be considered as an opportunity to further knowledge and understanding of medicine and surgery. In all aspects of life and business, and in the medical field in particular, it is paramount that one takes every opportunity to further one’s education. Life is a journey, not a destination, and it is important to grasp that journey as an opportunity to learn along the way. “At The Layt Clinic, we embrace the philosophy of education in every aspect of our practice with a strong focus on the continued education of our team and our patients. A continued investment in education means that we can provide a high level of the clinical and professional experience for each patient, with the assurance that our methods and applications are on point.” pm
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HEALTH & BEAUTY
Baby Body Why the r ace to get back to your pre-baby weight can be unhealthy
Renowned plastic and cosmetic surgeon Dr Dilip Gahankari says post-pregnancy wellness procedures can address many of the unwanted, permanent physical changes women may experience after childbirth. However, he warns against the race to get back to a pre-baby body. “Almost every woman who has been through child birth says it is one of the most rewarding and monumental events in her life, and one she would not trade for anything in the world. But pregnancy and child birth can take their toll on the female body,” Dr Gahankari says. “We have many clients who have shared with us that the changes pregnancy has made to their bodies have left them feeling unhappy, often depressed. Sometimes the breasts and stomach will not return to their pre-baby form, no matter how much she diets or exercises. As a result, a woman can feel selfconscious and her self-esteem can plummet.” Dr Gahankari says these unwanted physical changes can cause serious emotional problems for new mothers, who are often already feeling anxious and vulnerable, focusing on these issues. “Mothers play perhaps the most important role in a child’s life, and if a mother is experiencing feelings of depression or hopelessness as a result of these physical changes, it can impact on the wellbeing of the whole family.” Dr Gahankari says it is important to distinguish between the short-term changes that can be addressed with diet and exercise, and the permanent changes which cannot. He says it is often helpful for a new mother to know that these more permanent changes can be addressed surgically. “As a society we should not be putting pressure on women to get back to their pre baby body quickly. It is always my advice in the months following childbirth that a woman focuses on the beautiful life they have created. Yes, there may be a little weight gain but with proper diet and exercise – and time – this can
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be addressed. If, after a time, there are ongoing issues that are causing distress, then we offer a surgical solution.” Surgical advancements mean that post pregnancy wellness surgical procedures can be tailored to give women back their pre-baby body, and in many cases, also correct issues that pre-date the pregnancy. These surgical options include breast enlargement, breast reduction, breast lift, liposuction and tummy tuck. Dr Gahankari says it is important for women to allow themselves time to adjust to motherhood and give their body a chance to recover, then, if there are problem areas, they can be corrected surgically, restoring the woman’s self-esteem and allowing her to regain her life with confidence. “The results we see from these post pregnancy surgeries are life-changing,” Dr Gahankari says. “Often when the patients first come to us they are incredibly self-conscious and depressed, and it is impacting on their experience as a mother, and a woman. It gives us a real sense of pride and accomplishment to restore a woman’s confidence and allow her to get back to a rich and full life.” However, he stresses the decision to turn to surgical procedures to restore body image such as breast lifts, implants or tummy tucks were best undertaken when family planning was complete. “Procedures such as breast lift and breast augmentation may interfere with future breast feeding and the tummy tuck procedure often involves tightening of the stretched muscles in the tummy,” he says. “Any future pregnancy therefore, can undo all the good work from surgery and re-stretch the muscles. My recommendation is to allow at least one year after your last planned pregnancy, complete breastfeeding if you wish, and allow nature to revert the physiologic changes caused by pregnancy and lactation.
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HEALTH & BEAUTY
"...unwanted physical changes can cause serious emotional problems with new mothers, who are often already feeling anxious and vulnerable, focusing on these issues." - Dr Gahankari. “This period also allows women to make the crucial decisions about their family size. Also psychologically, I believe women seem to be in much better shape to cope with the decisions and recover from the stresses of the surgery. “Some of the surgical procedures for breasts and tummy tucks may attract Medicare and private health fund rebates after at least one year after a last pregnancy, which is very reasonable." Dr Gahankari says the effect of pregnancy on the tummy varies widely in women and it is not uncommon to see severely stretched stomach muscles after a large nine or ten-pound baby, or after a twin pregnancy. “Stretched muscles can shrink back remarkably after pregnancy – especially with exercise – but often, the muscles remain ‘splayed apart’ causing lower tummy bulge while standing. This weakness in the lower abdomen in some women may be a cause of low backache, soreness or even stress incontinence,” he says. “There is some evidence to show that a tummy tuck procedure, performed appropriately by qualified and experienced plastic surgeons with muscle layer repair, may result in relieving these symptoms.” pm
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SKIN HEALTH ○ New York Facial ○ Microdermabrasion ○ Transdermabrasion ○ Acne Peel ○ Hydration Peel ○ Pigmentation Peel ○ Anti-Ageing Peel ○ Dermapen Skin Needling
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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
Nutrition & Fitness
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Nutrition & Fitness
Losing it in the
Cold Winter weight loss 5.48am The light just splits across your windowsill as the morning birds beckon from their branches. The wind is whistling, leaves whirl in the dark, but you wrap yourself in blankets.
5.55am The window fogs as winter exhales a raspy breath outside. Your joggers creep further into the wardrobe.
6.06am You’ve already snoozed the alarm twice. It’s time to get moving. Some days, exercising in winter is a battle. As the mornings grow colder and the afternoons darker, it is difficult to find the time, location and motivation to exercise. However, keeping active during winter is just as important as shaping up for bikini season. Our health and wellbeing depends on it. Conquer the battle, and the snooze button, with these winter exercise tips, alternatives and food advice.
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Nutrition & Fitness
Winter Exercise Tips • Set time goals
Winter Weight Behaviour
Heated pool swimming
Common belief holds that winter weight gain is inevitable and that humans are predisposed to gain a few kilograms to protect against the cold. Sadly, while it occurs among hibernating animals, humans do not experience any biological or hormonal change to store fat during winter. The colder weather does, however, impact our emotional and behavioural management of weight. While enjoyable in summer, there isn’t much appeal to pulling on the tights and braving the pavement in below 15 degrees Celsius. As well as this, we tend to reach for warmer, richer ‘comfort foods’ to accompany lowerintensity activities, such as watching movies, reading and snuggling up. And winter weight is easily hidden under those woollen jumpers and scarves, right? But while it's important to enjoy some down time, we shouldn’t let winter sabotage our yearlong weight loss achievements, nor forget that excess weight has a significant impact on our health, regardless of the season.
Winter is no excuse not to get wet, so head to your local heated, indoor pool for some laps. Swimming is low impact with moderate resistance, and will keep you warm while you move. Indoor trampoline centres have recently taken off in Australia, and not just for kids. Jumping constitutes great cardio and is low impact on joints. Grab the kids and head to Air Factory Trampoline Park in Burleigh Waters.
Winter Food Goals Plan your meals
Winter Exercise Alternatives
Pick up the pen. From an epicurean’s perspective, winter is not a time for deprivation and dieting. Rather, we should take advantage of the seasonal produce whilst being mindful of extra fats and sugar. By planning the meals for the week ahead, we can avoid sporadic bingeing and unexpected trips to the supermarket, where chocolates and chips lure. This is also great for saving money and food wastage!
Kick it indoors
Get garden wise
Can’t bear to leave the house this morning? There are plenty of exercises you can do inside your house, including lunging and climbing the stairs, burpees, jumping jacks, skipping and all forms of weight training. You can even use household objects, such as canned food and books, for weights.
Hot yoga Hot yoga and Bikram yoga are great for warming up and keeping the muscles and joints flexible in the colder weather. Regular hot practice also helps to fight seasonal affective disorder, depression and stress, boost circulation and burn those ‘comfort food’ calories.
Indoor rock climbing Get a little adventurous and take your work out to the wall. Indoor rock climbing builds strength, balance, coordination and concentration, and is great exercise for the body and mind. 64
Trampolining
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Do you know when eggplants are at their sweetest, and when apples are at their crispest? Winter is abundant with delicious and nutritious fruit and vegetables, including leafy greens, mushrooms and root vegetables perfect for roasted salads and Mediterranean casseroles. Find out what is in season around you at www.seasonalfoodguide.com or by chatting to growers at your local farmers’ market.
Swap it In winter movie weather, chocolate and popcorn is a match made in heaven. But there are hundreds of healthier snacks and treats that will keep the weight off. Make some raw treats from dates, cacao, coconut oil and Brazil nuts, or a bowl kale chips baked in the oven with olive oil and sea salt. pm
The Australian Physical Activity Guidelines recommend that people aged between 18 and 64 incorporate some physical activity into each day and to limit sedentary behaviour. This doesn’t mean running for two hours daily – half an hour of brisk walking is enough to manage a healthy weight. Commit to an achievable amount of time per day for exercise, such as a 30-minute morning walk and 20 minutes of weights in the afternoon. Start small and gradually increase the session.
• Phone a friend Exercise with one or a group of friends to motivate each other and keep on track. It will be harder to ignore the alarm when someone is waiting at your door!
• Dress appropriately Let’s face it. The first step outside is a shock to the system, especially after the warmth of indoors. So cover up your limbs and kidney area. But don’t overdress! As the body begins to move, blood circulates faster and body temperature increases within the first 10 minutes.
• Work out at work If the mornings and evenings are too cold, take your exercise clothes to work and exercise during lunch. Take a half hour jog, or hit the park for some body weight exercises. Choose workout attire made from fabrics that wick moisture from the body, insulate heat and dry quickly.
• Group gym sessions By committing to a time and day to attend a local gym class, you will feel more inclined to show up and get moving with everyone else. Gym trainers also provide real-time feedback and advice on how to avoid winter weight. 2015
Nutrition & Fitness
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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
Warm Up, Slim Down Are you struggling to eat well, and feel satisfied whilst losing the winter weight? Follow our sample daily meal plan for a delicious and nutritious kick-start to better eating.
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Nutrition & Fitness
DINNER Moroccan Fish & Spiced Lentils Fish • • • 1.
BREAKFAST Creamy Cinnamon Porridge • • • • • • 1.
1 cup quick-cooking oats 1 1/2 cups milk (to cook) 1/2 cup warm milk (to serve) 1/4 teaspoon ground cinnamon Brown sugar or honey to serve Fresh berries to serve Combine the oats and milk in a small saucepan and bring to boil. 2. As soon as the mixture comes to the boil, reduce heat and simmer for one minute, stirring constantly. 3. Spoon into serving bowls and drizzle over some of the warm milk. 4. Serve with honey or brown sugar and fresh berries.
LUNCH Slow Cooked Southwest Tomato Soup • • • • • •
2kg fresh tomatoes, quartered 1 large brown onion, diced 6 cloves garlic crushed 1 teaspoon ground cumin 1 teaspoon ground coriander seed 1/4 cup roughly chopped coriander leaves & stalks • 1/4 cup brown rice • 1 litre good quality salt-reduced vegetable stock • 1 litre water • Salt & pepper to taste • 1 cup sour cream 1. In a small frying pan, heat a little olive oil and saute the onions and garlic until the onions turn translucent. 2. Transfer to your slow cooker along with the remaining ingredients except the sour cream, salt & pepper. 3. Cook on low for 8 hours. 4. Transfer to blender along with the sour cream and blitz until smooth. Season to taste. 5. Serve with warm flat bread. NOTE: Make this ahead and freeze in individual serves for an easy lunch.
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2 x 150 gram grouper fillets 2 tablespoons Moroccan spice blend Olive oil Preheat oven to 200 degrees Celsius. Drizzle the fish with some olive oil and season with Moroccan spice blend. 2. In a small oven-proof frypan, brown the fish for 1-2 minutes on each side. Put the frypan in the oven and cook for 10 minutes, or until fish is cooked through. 3. Serve on spiced lentils and top with lemon yoghurt sauce and baby herb salad (recipes follow).
Spiced Lentils • • • • • • • • • • • 1.
2. 3.
2 cups lentils, rinsed and sorted 2 cloves garlic, chopped 1/2 Spanish onion, finely diced 2 stalks celery, finely diced 1 sweet red chilli pepper, diced 3 tablespoons ground cumin 1 tablespoon ground coriander 1 teaspoon hot cayenne pepper 2 cups good quality, salt-reduced vegetable stock 2 cups hot water Salt & pepper to taste Saute the onion and garlic in a little olive oil, adding salt to prevent the garlic from burning. Add the celery and chilli pepper and cook until the celery begins to soften. Add the spices, stock and water and stir well to combine. Cover the pan with a tight fitting lid and reduce heat to low. Cook for 30 minutes, stirring frequently. If the lentils become dry before they are cooked through, add more water.
Lemon Yoghurt Sauce • • • 1.
1 cup Greek style yoghurt Juice of half a lemon Salt & pepper to taste Mix all ingredients thoroughly and chill before serving.
Baby Herb Salad • • • • • 1.
1/2 Spanish onion, very finely sliced 2 cups baby herb leaves Juice of half a lemon 1 tablespoon extra virgin olive oil Salt & pepper to taste Soak the onion in the lemon juice for at least five minutes. 2. Combine all ingredients in a bowl and toss to coat.
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Nutrition & Fitness
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Travel
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Travel
Port Douglas
Fr om Luxe to Less Photographer and Port Douglas local, Jessie Goetze, shares her ultimate travel guide to the beautiful Tropical North Queensland town.
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Travel
"Here you will escape all crowds and spend your days snorkelling or diving remote and colourful reefs, dining on five-star food and sipping on your favourite French Champagne."
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Travel
EXPLORE
REST
Being a small seaside town, Port Douglas offers visitors a more intimate experience when it comes to exploring the Great Barrier Reef. There are two ways of accessing the world's most famous Marine Park.
Back on dry land, Port Douglas is certainly known for its beautiful resorts, where you can rest your sea legs after a day on the water.
Luxe Your own private luxury yacht, Enterprise II, is captained by Rod Sherlock. The 68ft Fairline Squadron is your boat for the day, or for the very lucky, the week. Here you will escape all crowds and spend your day/s snorkelling or diving remote and colourful reefs, dining on five-star food and sipping on your favourite French Champagne. Your personal hostess will be at your service, and the first mate can teach you all there is to know about the marine life that you see. Whale sightings of the impressive Humpback and curious Mink Whales are common between June and September. Enterprise II rates begin at $4,950. Less Calypso Reef Charters will take you to three reef sites. The boats are suitable for all age groups and can cater to all levels of experience. The guests very often get to play with the resident Maori Wrasse – a giant rainbow coloured fish who has met thousands of people from around the world. He is very much like a playful puppy. Calypso Reef Charters rates begin at $199 for outer reef and also have a gorgeous Catamaran 'Aquarius', which departs each afternoon for a glorious sunset sail.
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Luxe No resort does this better than Niramaya Resort & Spa with its individual three and four bedroom villas. You are surrounded by a mix of wood, reflective glass & cool stone making it one of the most luxurious stays in Port Douglas. You will also find in its beautiful grounds a wonderful restaurant and spa...but I will tease you with that later. Villas are available from $550 per night. Less Rattle & Hum is in the heart of Port Douglas – right on the main street – and only 100 metres from Four Mile Beach. Downstairs is a fantastic bar and grill where you will find other travellers enjoying the famous Rattler pizza, a beer and a game of pool or pinball. With accommodation from $22, it's a bargain!
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OUT TO SEA
Port Douglas is heralded for its culinary offerings, utilising ultra fresh, local seafood. From Asianinspired flavours to Modern Australian cuisine featuring local indigenous ingredients, Port Douglas has it all.
It’s hard to imagine a more relaxing place than Port Douglas to indulge in some pampering. Zone out to the sound of waterfalls and birds quietly chirping away while you enjoy a massage or beauty treatment.
Port Douglas also lays claim to some of the best fishing in the world. The two skippers that I recommend are conservationists. They are operators who understand the importance of preserving our beautiful reef and the unique marine life that lies within.
Luxe Nautilus sits high above Macrossan Street on the famous Murphy Hill. You would be forgiven for thinking that you had taken a wrong turn and ended up in a secret Daintree mountain. With its open-air dining and cocktail lounge set amongst the lush rainforest canopy, the atmosphere alone is breathtaking. The seven-course degustation is highly recommended.
Luxe Not only are the services and products worldclass, but when you book a spa service you are also given day access to the beautiful amenities on the grounds of Niramaya Villas, which is a treat in itself. This means 'His & Hers' plunge pool soaks, relaxing by the pool, sitting in the tea house, enjoying the sauna or the serenity zone. There is also an incredible restaurant within the grounds and cocktail lounge, which I recommend. Everything is beyond my expectations here. I would recommend the custom Gold Facial and the Lunch & Massage Special.
Less There are two brilliant options here. Go for a walk to the new-look marina, which has recently undergone a huge extension, and visit the prawn trawler, Santiago, for freshly caught prawns. Enjoy them in Rex Park as the sun goes down. Alternatively, seek out The Surf Club which sits on Four Mile Beach at the end of The Esplanade. I cross my heart you will receive the biggest plate of the freshest gourmet 'surf club' food that you have ever seen. I recommend the Crispy Prawn Sushi or their incredible Trout Tacos.
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Less Right in town you will find a Chinese Massage parlour. The studio is basic but tidy and the massages are wonderful, with prices starting from $15.
Luxe Reel Chase Charters’ captain, Brett, has over 20 years experience in light and heavy tackle Game Fishing. Think of his boat Amokura more as a floating apartment on water with three bedrooms, ensuites, saloon and a chef! Prices from $3,300 a day. Less Port Douglas Sportfishing has to be the town’s busiest shared charter boat with prices starting at $110. With a maximum of five guests you can be assured that your guide, Jake, will be 100 per cent attentive to you. I had a fantastic time catching Cobia, Nannygai & Coral Trout – a huge success and all thanks to Jake's calm and professional help.
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WHEN TO VISIT There are two seasons in Port Douglas – high and low – which some say equate to hot and hotter! You can see why people from all spectrums of life fall in love with Port Douglas and its charm. Port Douglas is both unassuming and discerning. A place for recuperation, relaxation, indulging and exploring. The only downside to visiting Port Douglas is that you may not ever want to leave, so allow plenty of time to explore. There are many more secrets waiting to be discovered. pm
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Luxury Sp irit Exploring the contemporary new Rolls-Royce Ghost Since its launch in 2009, Ghost has become the ultimate symbol of success for leading entrepreneurs across the globe. Winning critical media and customer acclaim, and driving the company to four consecutive historic sales records, Ghost has led a new, younger generation of highly successful men and women to Rolls-Royce ownership; a key pillar in the marque’s highly successful sustainable growth strategy.
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Ghost is a thoroughly contemporary representation of Rolls-Royce luxury – perfectly balancing effortless dynamism and modern luxury in a car that is composed under all circumstances. Owners enjoy a quietly assured, exquisitely refined modern motor car with an interior ambiance that offers a sense of calm and serenity in an often frenetic and chaotic business world. The Power of Simplicity A single defining principle came to characterise the Ghost design process – to harness the power of simplicity. The notion that no complication should ever distract from driver or passenger pleasure, informed every facet of the design and engineering process. An uncompromising approach to materials and craftsmanship remained and traditional visual tenets were re-imagined to express the car’s modernity and dynamism. For example, the stately presence of Phantom’s grille made way for a softer, less formal design – its subtle curvature more akin to a jet air-intake than traditional pantheon facia. Flowing ‘yacht lines’ and powerful flanks hint at the car’s inherent dynamism, whilst traditional Rolls-Royce DNA is expressed in the elevated prow, large uninterrupted surfaces, long bonnet and short overhang. Ghost Series II – design evolved Clad in a subtle re-design, Ghost Series II ensures the timeless yet modern quality that the marque’s customers cherish. The eye is immediately drawn towards the re-sculpted headlights, with unbroken daytime running lights framing a new, more dynamic shape, giving Ghost Series II a distinct visual signature from the front. This blends perfectly with revised surface treatments to the front of the car. A tapered ‘wake channel’ on the bonnet, emanating from the Spirit of Ecstasy’s wings, evokes the sight of a jet’s vapour trail, hinting
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at the car’s dynamism. Subtle re-sculpting of Ghost’s bumpers creates a stronger stance and a sense of extra width and height, whilst the contemporary aesthetic is further enhanced with the addition of chrome inserts to the front air intakes, which now feed more air cooling to the front brakes. One of Rolls-Royce’s defining visual signatures is given an enhanced dynamic edge. The famous waft line has been redesigned on Ghost Series II to lean further forwards, with a view to emphasising the car’s effortless dynamism. These features, married with new optional 21” forged wheels and standard 19” wheels, ensure Ghost remains a perfectly executed, contemporary expression of Rolls-Royce luxury. Interior comfort and style are enhanced with re-designed seats. Electronically adjustable thigh supports for front seat passengers complement a new seat structure, enhancing Ghost’s unchallenged interior comfort levels. A revised rear seat design ensures absolute comfort for those wishing to conduct business or simply relax. In ‘lounge seat’ configuration, the seats are gently angled towards each other to create a more intimate setting, allowing passengers to communicate more easily. The seats are available with three-level heating as standard, with optional massage function, and can be reclined for comfort. Chrome surrounds to the sun visor lights and a new soft-feel dashboard treatment enhance the car’s premium tactility, whilst sumptuous natural grain leather can now be optionally extended to the A and C pillars. The instrument dials and clock have also undergone subtle enhancements with individually applied polished metal chaplets around the dials evoking the precision design of hand-made, luxury wrist watches, whilst the matte chrome centres ‘float’ in the middle of each instrument.
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Finally, the scope for bespoke customisation is widened with the introduction of two new, exquisitely crafted veneers; Paldao and Walnut Burr Crossband. Discreet technology for a calm atmosphere Throughout the marque’s storied history, engineers have sought to refine the experience for drivers and occupants by applying the very latest technologies. Ghost Series II is no different, presenting a full suite of the latest technological updates. On opening the car’s coach doors, one is met with a calming, light and uncluttered space. Occupants can work, relax or simply enjoy the pleasure of driving in a cosseting, peaceful atmosphere, assure that they are fully connected to the outside world of business affairs through the car’s peerless connectivity suite. Calmly connected Ghost Series II is the ultimate contemporary combination of luxury, technology and connectivity available to the successful entrepreneur on the move today. It is an oasis of calm in a busy connected world where he or she can do business in peace. It presents the driver and occupants with a comprehensive example of effortless Rolls-Royce connectivity, a network where communication between car, environment and driver helps lower the pulse, ease the journey and delight the occupants. Key to this is the discreet placement of the car’s technological functions. Accessed through a onetouch call button or the Spirit of Ecstasy Rotary Controller, on-board Wi-Fi facilitates email, file sharing, telephony and video-conferencing. The user is also able to watch televised business news in order to remain ahead of the game. Navigation assistance is summoned by the same one-touch call button. Then by simply saying “navigate to Brisbane CBD” or wherever else the owner wishes to go, directions that anticipate and avoid unnecessary delays are offered. Voice commands also allow phone calls to be made and in-car entertainment options to play. Information from the significantly updated Multimedia Interface and Navigation system is displayed beautifully on a new 10.25” high definition screen. Spirit of Ecstasy Rotary Controller The Spirit of Ecstasy Rotary Controller presents a touch pad with the ability to write characters by finger, as well as the ability to scroll through function menus by turning the chrome dial and pressing down to select its functions. The system recognises English, Latin and Arabic characters as well as Mandarin, to assist drivers in China, where character selection can otherwise be a time-consuming process. The Rotary Controller’s touch pad also allows ‘pull and pinch’ features, replicating intuitive smart phone functionality. These help the user pinpoint chosen areas on the screen or help to 82
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make them larger. For example, different areas of a map can be found by moving a finger across the touch pad, whilst street resolution can be made larger or smaller by pinching or pulling. Bespoke Audio Rolls-Royce employs experts for all aspects of high end craftsmanship, from hand-painted coach lines to finely-tuned audio systems. Finely tuned by expert Rolls-Royce audio engineers and naturally incorporating the finest hardware and latest advances in connectivity, Bespoke Audio is the most exhaustively designed automotive hi-fi system ever developed. Ensuring perfect acoustic balance and performance was central to the design process of the car. Rolls-Royce’s in-house audio engineers were consulted throughout the design process of the car on the effect proposed changes
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in the wider design of the car may have on the performance of the system – a practice unparalleled in the automotive world. Eighteen individually-tuned speakers, with both theatre and studio settings, deliver a pure ‘larger than live’ sensation. Two bass speakers located in the boot complement seven speakers meticulously placed throughout the cabin. Two ‘exciter’ speakers in the roof-lining bring the sound to occupants’ ear level creating a completely unique listening sensation. The system utilises a highly sensitive microphone to constantly monitor ambient exterior noise, subtly adjusting the volume and tone settings accordingly to ensure the system delivers consistent perfection. The technology complements this, with frequency and phase correction for individual speakers eliminating potential loud and dead spots caused by outside influences.
Supplementing this industry-leading audio engineering in the true spirit of Sir Henry Royce, Ghost Series II’s on-board hard drive holds 20.5 GB of storage, meaning it can host approximately 5,700 items of music downloaded via the USB port located within the centre console or glove compartment. iPod and iPad connections allow the importation of music, but also podcast and audio book downloads. Bluetooth audio streaming is an option too, from one of two phones that can be paired with equal functionality. A number of music searches can be made via the Spirit of Ecstasy Rotary Controller, including a 'play more like this' function while online Gracenote® access for CDs with hit selection make navigating music collections an effortless experience. But it is the sound quality itself that places Ghost Series II at the pinnacle of in-car audio.
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Illuminating technology shows the way The most recent developments in LED lighting technology have also been applied to Ghost Series II. The way this light is managed is significantly enhanced by adaptive technology. Electronically controlled reflectors move in the direction of travel in response to steering-wheel turns to give a greater depth of vision when cornering and a whiter, brighter light ensures effortless and safe driving on dark roads whilst helping reduce driver tiredness. In addition, automatic dipping of full-beam headlights has been replaced with revolutionary new glare-free technology. When a car approaches, light is deflected to ensure the oncoming driver is not dazzled. Ghost Series II drivers therefore enjoy the safety benefits of constant full-beam visibility. A daytime running bar frames Ghost Series II’s contemporary light design, giving the car a distinctive signature whilst augmenting safety at the same time.
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Satellite Aided Transmission Ghost Series II’s effortless dynamism is augmented with the addition of Satellite Aided Transmission, a technology that made its debut on Wraith in 2013. Satellite Aided Transmission utilises GPS data to allow the car to see beyond what the driver sees, anticipating their next move based on location and driving style. It uses this information to select the most appropriate gear from the Ghost Series II’s 8-speed ZF gearbox to ensure the driver is able to appropriately exploit the power from the Rolls-Royce 6.6 litre twin-turbo V12, ensuring an effortless and seamless driving experience. For example, when approaching a sweeping bend, the car will predict how you wish to drive through it. When the driver lifts the accelerator it will hold the lower gear to ensure maximum power is available on accelerating through the exit of a corner.
Satellite Aided Transmission comes as standard on all Ghost Series II cars. Dynamic driving package and suspension enhancements Ghost presents the perfect blend of driving dynamics and hallmark Rolls-Royce comfort. Ghost Series II customers can specify a Dynamic Driving Package that offers a more involving driving experience with no compromise to ride quality. Re-designed front and rear struts married to new steering gear and adjusted dampers significantly increase Ghost Series II’s cornering ability, whilst enhanced feedback levels can be felt through a thicker steering wheel. In all specifications, ride quality and rear stability is further enhanced thanks to new rear hydraulic axle bearings.
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Ghost Series II – changes at a glance Evolutionary design Ghost Series II presents significant recent technological updates in an exterior package that represents evolutionary changes to Ghost’s timeless aesthetic. • A contemporary re-imagining of Ghost’s front face; re-engineered and re-designed LED headlights are framed by daytime running lights. • Revised surface treatments including resculptured bumpers that present a wider, more dynamic stance. • A new bonnet design featuring tapered ‘wake channel’ emanating from the Spirit of Ecstasy that hints at Ghost Series II’s dynamism. • The waft line leans further forwards, giving further expression to Ghost’s dynamic driving experience. • New paint and wheel options giving customers greater scope for bespoke personalisation. Interior design • Re-designed front seats include electronically adjustable thigh supports and depth adjustment. Rear seats have been subtly reangled to augment effortless communication with fellow passengers. • The clock fascia and instrument dials are enhanced with the addition of polished metal chaplets that evoke premium watch design. • Option of extending natural grain leather to the A and C pillars. • The scope for Bespoke customisation is extended with the introduction of two new, exquisitely crafted veneers: Paldao and Walnut Burr Crossband. Technological and engineering enhancements • Re-designed LED headlights incorporating the latest technologies. A whiter, brighter light augments driver safety whilst electronic reflectors move in the direction of travel in response to steering wheel turns. New anti-glare technology deflects light when a car approaches in the other direction, giving Ghost Series II drivers the benefit of full-beam headlights at all times. • Suspension enhancements include reengineered front and rear struts, new steering gear and adjusted dampers that increase the car’s cornering ability when the Dynamic Driving Package is specified. • New hydraulic rear axle bearings enhance ride quality and rear stability whilst reducing vibrations and cabin intrusions. • All Ghost Series II motor cars feature Satellite Aided Transmission as standard – a technology that utilizes GPS and mapping data to ensure the car is always in the correct gear when negotiating turns, motorway exists and roundabouts. pm
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CAR
Once you have power, it’s difficult to let go. Something you’ll find with the F-TYPE R. Supercharged and super agile, it will give you control of the road you never thought possible. And with up to 404kW, capable of 0-100km/h in 4.2 seconds, there’s no doubting its power. Just remember, with great power comes great responsibilty.
Contact Sunshine Jaguar today on (07) 5582 7888.
HOW ALIVE ARE YOU?
SUNSHINE JAGUAR
LMCT1303030
179 Nerang Rd, Southport Queensland 4215 Tel. : 5582 7888 · www.sunshinejaguar.com.au
BOATING
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Best of Both Worlds Maritimo M61
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In exciting news for fans of Maritimo’s M65, the luxury boat builders have announced the launch of a smaller version of the cruising motor yacht. Boasting many of the same features and benefits as its big brother, the bonus is that the M61 is available at a substantially lower cost. The M65, which was publicly launched at the recent Sanctuary Cove International Boat Show, has been a popular model for the company with negotiations now underway on boat number seven, but Maritimo saw a niche for a similar styled vessel that sat between the M65 and the M58. The first M61 cruising motor yacht is in build and was delivered to its Gold Coast owner in February 2015, who is a Maritimo fan, having owned three of the company’s vessels previously. Even big boat enthusiasts are expected to embrace the new M61, which requires less berthing space than its larger sibling, but still has almost all the same features (albeit proportionally smaller) for less than $2.5 million. The company is expecting strong orders for this model. “Like the M65 this is a serious motor yacht and the interest we have had in this new model has been tremendous,” says Maritimo Sales and Marketing Manager, Greg Haines. The boat is available in a three-cabin, threebathroom configuration, or with four cabins and two
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bathrooms. You can even include an onboard office by eliminating one of the bathrooms. “It has the full beam master suite and virtually everything else that the M65 delivers, only slightly smaller. It would be ideal for people who have limited berthing area and cannot accommodate the M65,” suggests Haines. “It is a go-anywhere motoryacht which can accommodate a family in style, safety and comfort for some genuine blue water passage making.” The M61 is powered by D13 900s and can be set up to include crew quarters or accommodate a gyro. Interiors include the popular Wenge timber finish, and the quality of soft furnishings and overall fit out are on par with the M65. With Maritimo’s efficient shaft drive and hull design technology, the company has been able to deliver even better fuel consumption figures than its competitors using pod-drives across the full range of Maritimo models. The M61 will be no exception, with an estimated fuel capacity of 5,800 litres and a range of 720 nautical miles, at a speed of 21-22 knots. Onboard catering is made easy with a massive galley with the option of side-by-side domestic sized refrigerators and luxury Miele appliances come as standard. Room to relax and kick back is no problem, with the saloon lounge measuring 1.8 metres long.
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According to Maritimo, the flybridge is larger than the saloon on most competitors’ 50-foot boats. There are options for convertible berths, relocatable tables and a wet bar. “Some our buyers like the idea of having a separate area for their teenage children to have their own space,” says Haines Like the M65, the new M61 could have the popular Euro style transom, or it could be optioned to have Maritimo’s traditional island transom, or even a fishing version. For more information, visit www.maritimo.com.au pm
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Gizmo guide
2015
The Vitamix Professional Series 500 $1195.00 RRP Why choose Vitamix? Because Vitamix is not your average line of blender. The Vitamix Series 500 delivers restaurant-quality results and velvet smoothness every time, no matter the ingredients you choose. Its smart blending technology makes juicing, blending, dry and wet chopping, frozen desserts, heating, grinding and emulsifying simple without losing nutrients. Myer, David Jones and Wheel & Barrow stores
Hex Pendant Light $239.95 RRP Famous Floor Lamp $299.00 RRP Light it up with these striking and ultra chic lights at Domayne. Made from quality materials and inspired by the vintage era. Domayne
go Fitbit Flex $129.95 RRP You’ve heard of the Fitbit, but do you know what it does? This slim, stylish device tracks your activity and sleep, syncs your stats to your computer wirelessly, provides real-time data on your health progress and makes fitness fun. By recording calories burnt, steps taken and distance travelled, you can set fitness and weight goals and make them happen! Dick Smith, Target and JB Hi-Fi
Excalibur 5 Tray D502SHD Series $879.00 RRP Dehydrating intensifies flavours, preserves food, increases food quality and saves you money! The Excalibur 5 Tray D502SHD Series defines high quality at-home dehydration, and is perfect for dehydrating fruit, vegetables, herbs, flowers, bread, meats and nuts. And with its sleek stainless steel exterior, it looks awesome in the kitchen. natureswonderland.com.au
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winter 2015
Fujifilm X-T1 Graphite Silver Edition with XF35mm F1.4 lens $2,099.00 RRP for body, $699.00 RRP for lens Have you ever seen a slicker camera? From its milled magnesium top cover, to its chemical conversion coating, to its new silver texture and hand coloured logo, the X-T1 Graphite Silver Edition is dressed to impress. Oh, and it takes a pretty flawless photo too, assisted with the Lens Modulation Optimiser, multiple exposures and Focus Peaking. Great camera equals great photography. fujifilm.com.au
Cool Jams Innovative Sleep and Travel Wear $59.99 – $89.99 RRP With renowned doctor and author Dr John Tickell’s tick of approval, Cool-Jams sleepwear is changing the lives of night sweaters everywhere. These innovative pyjamas have been scientifically engineered to evaporate heat and moisture from the body. Recently featured in the Gold Coast Bulletin for their success among cancer patients, CoolJams are great for hot flushes, night sweats, menopause and travel. cool-jams.com.au
gadget Husky 115L Undercounter Retro Bar Fridge Red
$619.00 RRP Your beers never looked cooler in this retro, vintage-style bar fridge from Husky. Both spacious and compact, with a 115L capacity and premium shelving, it mirrors the designs of authentic 1950s fridges with a curved, fire engine red exterior and a right-hinged door. Great for small kitchens or entertainment areas. Harvey Norman
SmartMat yoga mat $565.00 RRP Yogis –meet your next yoga instructor! The SmartMat is the world’s first intelligent yoga mat, designed to detect your alignment and provide real-time feedback using Advanced Sensor Technology and baseline readings for each pose. It also syncs with your smartphone to provide video lessons, and stores a Personal Profile through the SmartMat App, which continuously updates data and helps guide your practice. smartmat.com
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At the movies
2015
At the movies
ALOHA (CTC)
JURASSIC WORLD (CTC)
INSIDE OUT (PG)
In cinemas June 4
In cinemas June 11
In cinemas June 18
A celebrated military contractor returns to the site of one of his greatest career triumphs and re-connects with a long-ago love while unexpectedly falling for the hard-charging Air Force watchdog assigned to him.
Twenty-two years after the events of Jurassic Park (1993), Isla Nublar now features a fully functioning dinosaur theme park, Jurassic World, as originally envisioned by John Hammond. After 10 years of operation and with visitor rates declining, in order to fulfill a corporate mandate, a new attraction is created to re-spark visitor’s interests, which backfired horribly.
Growing up can be a bumpy road, and it’s no exception for Riley, who is uprooted from her Midwest life when her father starts a new job in San Francisco. Like all of us, Riley is guided by her emotions – Joy, Fear, Anger, Disgust and Sadness. The emotions live in Headquarters, the control centre inside Riley’s mind, where they help advise her through everyday life. As Riley and her emotions struggle to adjust to a new life in San Francisco, turmoil ensues in Headquarters.
Starring Bradley Cooper, Emma Stone, Rachel McAdams
Starring Chris Pratt, Bryce Dallas Howard
Voices by Amy Poehler, Phyllis Smith, Bill Hader, Lewis Black, Mindy Kaling
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FAR FROM THE MADDING CROWD (M) In cinemas June 25 The story of independent, beautiful and headstrong Bathsheba Everdene who attracts three very different suitors: Gabriel Oak, a sheep farmer, captivated by her fetching wilfulness; Frank Troy, a handsome and reckless Sergeant, and William Boldwood, a prosperous and mature bachelor. The timeless story of Bathsheba’s choices and passions explore the nature of relationships and love – as well as the human ability to overcome hardships through resilience and perseverance.
At the movies
MARVEL’S ANT MAN (CTC)
TED 2 (CTC)
In cinemas June 18
In cinemas June 25
Armed with the astonishing ability to shrink in scale but increase in strength, con man Scott Lang must embrace his inner-hero and help his mentor, Dr Hank Pym, protect the secret behind his spectacular Ant Man suit from a new generation of towering threats. Against seemingly insurmountable obstacles, Pym and Lang must plan and pull off a heist that will save the world.
The world’s naughtiest teddy bear is back. In the sequel to the blockbuster hit, Ted must prove his personhood in a court of law so that he and his wife can adopt a baby. Starring Seth MacFarlane, Mark Wahlberg, Amanda Seyfried
Starring Paul Rudd, Michael Douglas, Corey Stoll
Starring Carey Mulligan, Mattias Schoenaerts, Michael Sheen, Tom Sturridge
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Top reads
2015
Top reads
Creative Schools: Revolutionising Education from the Ground Up Ken Robinson & Lou Aronica $32.99 RRP When his online TED talk ‘How Schools Kill Creativity’ is the most viewed in history, Ken Robinson is probably someone worth listening to. Sir Ken Robinson PhD is an internationally recognised leader in the development of creative thinking, education and innovative business. Throughout his career, he has argued the global need for a reinvigorated schooling system that embraces children’s individual creativity and ability. In Creative Schools, Robinson details his practical vision about how education can be transformed to enable young people to thrive and succeed in the 21st century, and to instil a love of learning in all children. Inspirational, proactive; a great read for all parents.
Quicksand
Agent Storm: A Spy inside Al Qaeda
Steve Toltz $32.99 RRP With wild comedy, stark lucidity and honest insight into our society, Toltz explores themes of resilience and suffering in the story of two mates, Aldo and Liam. Liam, a failed writer with an unsteady marriage and a dangerous job he doesn’t want, finally finds inspiration to write about his mate Aldo’s constant struggle against misfortune, the latest episode which could see him come undone. As Liam begins to document Aldo’s improbable but foreseeable experiences, the two embark on an exploration of fate, fear and friendship. In what the critics are calling a ‘dose of fierce iconoclasm and dark-peppered wit’, Quicksand observes Australian tradition and paints it red with humour.
Mortem Storm $19.99 RRP If you were asked to kill your mentor, the one who gave you an identity and purpose, would you do it? What if they were a terrorist leader? Agent Storm is the story of unlikely Danish terrorist, Mortem Storm, a former bikie turned Islamic convert ready to wage Holy War in the name of Allah. His mentor, Anwar al-Awlaki, the American-Yemeni Islamic leader who was once the West’s most wanted member of al-Qaeda and second only to Osama bin Laden, involves Storm in a world of idolised preachers, shoe bombers and skewed ideology. When he loses his faith in 2006, Storm contacts European domestic intelligence agencies and eventually becomes an insider to the al-Qaeda movement for the CIA. His mission: to take out al-Awlaki. A gripping true story.
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I See You Made an Effort: Compliments, Indignities, and Survival Stories from the Edge of 50 Annabelle Gurwitch $19.99 Actress and comedian Annabelle Gurwitch lets us in on something very real: reaching 50 is one hell of a ride. Through a series of wickedly funny and scorchingly honest essays, Gurwitch explores the indignities, pleasures and challenges faced by femmes d’un certain àge. From lusting over strangers, coping with her best friend’s assisted suicide, to navigating the horrendously pricey anti-ageing section at the beauty counter, Gurwitch is at the same time hilarious, insightful, inquisitive and witty. A must-read for anyone facing middle age that isn’t afraid to deepen their laugh lines.
Top reads
Craft for the Soul: How to get the most of out your creative life Pip Lincolne $35.00 RRP Crafter and blogger Pip Lincolne brings us an all-inclusive and very inspirational guide to creativity in her Craft for the Soul. With a lifetime of craft wisdom and ideas, Lincolne helps us to incorporate creativity into everyday life, motivate ourselves to create more, be positive, love our work and above all, get crafty! It includes stepby-step guides, light and easy explanations and beautiful imagery, and welcomes us to a world of colour, craft and fun.
Herbs & Spices: The Cook’s Reference Jill Norman $35.00 RRP Your pantry is bursting with Mexican epazote and Greek sage, but do you know use them? The most fragrant and exotic herbs and spices from all around the world have never been more available, so it’s time to get to know them. Jill Norman’s Herbs & Spices teaches kitchen novices and master chefs how to best choose, use, store and grow over 200 international herbs and spices, and offers over 100 recipes for blends, spice rubs and homemade sauces. Explore worldly cuisines from your cutting board.
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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Cucina Vivo Many Italian chefs on the Gold Coast might lower their Dolce & Gabbana’s as I say this, but Cucina Vivo is doing it right. Words by Lizzy Keen
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On the coast, we are too familiar with the pastas, pizzas and parmigianas of a slightly repetitious series of Italian restaurants. ‘Mama’ this, ‘Roma’ that, and this ‘Mario’ character seems to get around. Moreover, as a result of the Western palette, many modest recipes have been sadly confused. Carbonaras arrive swimming in cream, ‘chocolate’ desserts are guised in folds of Nutella, and I still can’t quite grasp the meaning behind a cheese-stuffed crust or a New Mexican style pizza. Call the bread, bread and the wine, wine, per favore. But Cucina Vivo at Jupiters Casino is different. Cream doesn’t enter the menu, and the formaggio sticks to a level between “just a little grated” and those delectable webs of melted Mozzarella. I also can’t recall another venue that offers such a fine perspective of the Broadbeach skyline and a twinkling pool below. Alongside its sibling restaurant Kiyomi, Cucina Vivo captures the direction of Jupiters’ $345 million revamp, which will introduce a number of world-class dining venues to the city’s heart of entertainment. Great dining isn’t new to the Gold Coast, but Cucina Vivo’s introduction to Italian is. Firstly, the restaurant’s size and interior. The discreet entrance opens to an enormous single-floor restaurant divided into sections by coastal timber Venetians that match ceiling panels overhead. The 240 high and low table settings create a coastal optic texture with 104
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timber and pastel tones, while inside blends seamlessly through wooden bi-fold doors to the north-facing balcony, atop of the Poolside and curtained by palms. Ruby-red tomatoes and bottles of vinegar march along bench tops before a two-metre wood fire oven like the set of a cooking show. It all creates a sense of Mediterranean comfort food, made even more palatable by the currents of basil and lemon sweeping through the room. The gallery-come-boat shed theme features ashy wood tables, multiple booths of powder blue, and sand and sky-coloured crockery throughout. White, yellow and cream repeats in the awnings, cushions and lamps, and the entire room is lit softly to render a beach villa feel. Another masterstroke by Sydney interior design firm, Luchetti Krelle, the brains behind Kiyomi’s striking layout. I imagine the balcony is a selling point for diners tossing between Kiyomi and Cucina Vivo. Open and bright, it’s an urban analogy of the Amalfi Coast, lapped by the turquoise pool and clusters of bleach-white sun beds beneath. While the Amalfi Coast is renowned for its redfish, pezzogna and sea urchins, rather than equipping diners with a phrase book and tweezers, the kitchen delivers humble Australian seafood favourites prepared with the spirit of Salerno. Enter the calamari fritti. These lightly fried calamari strips served with dill aioli and frisée salad attest the chef’s understanding of bright and balanced battering. Fried calamari isn’t 2015
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original, but this dish offers addictive oceanic flavour, creamy dill and crunch. Tossed together in ceramic and flecked with yellow and fuchsia petals, it’s damn pretty too. Dishes like the parmigiana di melenzane are a rich and powerful beginning to the meal, and should be enjoyed with something dry or tannic to equalise the density. This dish is fragrant with tomato sauce, melting Mozzarella and eggplant, whose skin peels silently from the seeded flesh as if in a dream. Perhaps a small nightmare for parents with freshly clothed children. The wine list is the kind that rests on the table between meals, offering an exciting range of new and old European wines by glass and bottle. But mainly, it’s a firm nod to Australia and New Zealand’s vineyards. Wave the white flag? New Zealand’s Catalina Sounds Sauvignon Blanc yields soft stone fruits sharpened with citrus and mineral; ideal with black muscles and garlic. The Fickle Mistress Pinot Noir from Central Otago is a nice and easy, candied red that dances with the calamari, while the things turn darker with the Pepperjack Shiraz from South Australia, all plum pudding, fruit and chocolate; an awesome wine. Okay now, back to Italy. Pizza in hand, I challenge anyone to refute the saying that ‘one cannot live by bread alone’. Made on order, with a wickedly gratifying base that softens under toppings but crunches at the crust, the pizzas pouring out of that wood fire oven score on substance and flavour. Tear apart the schiacciata garlic flatbread with pesto or classic margherita as an entree, but allow room for the likes of prosciutto e arugula, whose buffalo mozzarella, prosciutto San Daniele, rocket and Parmigiano shards melt together lavishly and barely stick to the base. Although wanting of zest or something spicy, pindaramagazine.com.au
topped with some house olive oil and salt flakes, it skirts on bellíssimo. The quick transition from pizza to pasta might evoke visions of clueless tourists searching Rome for the real deal of flavour, but again, Cucina Vivo doesn’t do clichés. Especially when their pasta is all homemade. The pasta menu covers land and sea, from the simple roots of mince ragù with fresh egg pasta, to the more decadent tortelloni ripieni of crab and ricotta nestled in green pea purée and a scatter of micro-herbs and dill. It tastes as sweet as it looks, but packs a moreish punch of salt on each bite. The wait team is friendly and prompt, but depending on the speed of indoor custom, it is sometimes difficult to call attention from the balcony. But aside from a few service overlaps and a used fork left behind here and there, their service is as crisp as their peppermint pinstripe uniforms. Our spritely waitress offers suggestions when due, which all harmonise with our other selections. When pondering the pasta menu, she lifts a hand. “Tonight’s pasta special is gnocchi with mushrooms and truffle oil. We just tested it in the kitchen earlier and…” Her words stall and eyes flutter as she recalls the moment. With a Don Corleone accent, it’s an offer we can’t refuse. Each mouthful of gnocchi is airy and smooth, enveloped in a light kiss of oil that resembles buttered toast. Oh, but it’s substantial all right, and draws a quick thirst with all the salt and generous wedges of fungi. In all its richness, it’s just one step away from the Light Meal Premier League. Another Birra Moretti, please. By this stage, Gold Coast’s unique Italian sojourn is rounding off well. Urban groove music pulses gently into the night while rays of restaurant lamp dance on the water below. The
soft clink of cutlery and chitchat continues. The skyline keeps on a’glistening. Your mind begins to float like a dandelion spore over the Med Sea before the next dish arrives. Its intention is clear. The cioccolato rosso Ferrari comes to surprise, indulge and provide some evening theatrics. Our waitress lowers a red-dusted dome of tempered chocolate to our table, and pours a tiny bottle of Grappa infused liquid chocolate into a hole in its top. Cold steam erupts from the dome and cascades down its circumference, while the waitress smirks and leaves us to ‘ooh’ and ‘aah’. A pistachio crostata base rests beneath a creamy scoop of stracciatella ice cream, partly encased with liquid chocolate, and as we spoon-tap the dome, it breaks and falls apart like a jewellery box of frozen delight. All the ingredients melt and blend in a not-too-richtake-me-back-to-the-gnocchi sort of way, and it’s both warm and cool like the night around us. This dessert is an instant classic. Now might be the time to revaluate your idea of quality Italian. Cream is out, balance is in, and the location of the venue is another factor of the feast. This isn’t a restaurant trying to be Italy; Cucina Vivo is a venue blending the flavours and favourites of two worlds to create an Italian experience that is still very much Gold Coast. So, before you begin rolling your R’s and checking out Vespa prices, remember you’re still at home, content in the hands of a restaurant that’s doing it right. pm
Cucina Vivo Address Jupiters Hotel and Casino, Broadbeach 4218 Phone 07 5592 8100
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New Shanghai Words by Lizzy Keen
First things first. It isn’t customary to review restaurant chains. And given its reputation for slippery juliennes and unnerving, sweet-andsour meats, to review a Chinese restaurant chain inherits some risk. But the ubiquity of Chinese food in Australia signifies something. Almost every town features a Chinese restaurant, fried rice is as commonplace as Vegemite or Arnott’s, and ask the person next to you what their go-to home recipe is. All bets on stir-fry. So, visiting New Shanghai in Queens Plaza of Brisbane’s CBD is not far a step from the usual. We do like Chinese cuisine; we are just waiting for something exciting.
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This particular Shanghainese adventure begins at the door. Located on the underground level of Queens Plaza, drenched in the clinical light of David Jones, one reaches the dimly lit entrance of New Shanghai. It’s a stark contrast to the illumination of Coles next door, and surrounded by brands and polished windows, it gives the impression of having been thrust into its mall-erific location. But as the waitress ushers diners through, one pauses to watch what’s happening in the kitchen, whose glass walls put its inner action on show. Inside, six Chinese chefs quickly mould pork mince and gossip. In a moment of joy, the elder female chef, a rare sight in today’s commercial kitchens, throws her head back in laughter, and the younger join. There is something very familial about it. This isn’t so surprising given that New Shanghai, which has seven venues across three states, is based on authentic, generations-old family recipes. The restaurant centres on share dining, making it ideal for extended family feasts or after-work catch-ups, best enjoyed with a cold one. Chinese custom in the pulse of Brisbane. That’s exciting. Inside is very black and red. Passing teams of low, cedar wood-like tables and stools, canopied by red flags and backdropped by black brick, the large dining room transforms into a bustling
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Shanghai alleyway. Floor-to-ceiling, gold-painted panels by the window filter the gleam of the retail realm outside. Tables of friends and family talk and clink glass as the aroma of XO swirls around their heads, each group negotiating multiple plates of dim sims. Clearly an Urbanspoon winner for Brisbanites. If you’re down to dine in peace, the eightperson private dining room waits in the back corner. Given its hollow interior and awkward acoustics, however, I’d stay in the main room where the action is. I’m getting the vibe you want to start at the dumplings, known as Xiao Long Bao. Servings arrive as eight nestled in a steaming basket, rich in ricey fragrance and twisted on top, like the topknot of a Youxia warrior (or a New Farm hipster). The vegetarian dumplings of carrot, tofu, vermicelli and greens are simple yet moreish, whilst the lamb and leek dumplings yield a richer, more mouth-filling texture in pools of soy. Along with the crispy-bottomed, fried pork dumplings, other Shanghainese street foods ensue, including mini pork short soup, deep fried pastry filled with shallot, ham and sesame and a battery of Chinese pork buns in various combinations. Did we mention the average Chinese person eats 39 kilograms of pork per year?
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But to prove their flair outside the pen, New Shanghai also dishes out some addictive vegetarian and seafood, with a special nod towards the prawn wonton tossed in peanut butter and red chilli oil, the wrappers viscid, spicy and warm from the steamer. How do you take your jellyfish? At New Shanghai it will come chilled, sliced and tossed with radish, sea salt and light soy. Though alarmingly cold, the flesh is delicately salty from the soy and sea, which neutralises the palette between dishes. The shredded kelp with carrot, a tangle of black and orange, provides an unrivalled ocean taste with a tang like salt and vinegar chips. This isn’t an ultra-hip tapas joint offering edible art, so stop searching for microherbs. At New Shanghai, the entrees and dim sims are plainly garnished (return of the parsley sprig) but are substantial enough to be mains. Meanwhile, the mains are really just larger portions of street food, so prepare to share. Order the rainbow beef, for instance, a mountain of deep-fried, shredded beef tossed with sweet and sour sauce, and you’ll likely end up asking neighbouring tables for help. Overtly sweet, the heavily battered pieces of beef resemble moist pretzels that have been left in a jam jar. It’s not quite there, texture or taste-wise. Textural intrigue does triumph, however, in the
deep-fried tofu coated with salted egg yolk. Pop one golf ball-sized cube in your mouth and enjoy the sensation of crunch-come-cream when the batter and silken tofu combine. Scoring on balance and oddness of ingredient are the stir-fried clams. It’s a very flavoursome dish, the caramelised shallot and fresh ginger reviving sweet-and-sour’s reputation in a sauce that puddles deliciously in the shells. No wonder they’re so damn happy. New Shanghai isn’t trying to redesign Chinese tradition, nor assume the role of Australian dining’s Next Big Thing. It simply offers traditional Shanghainese cooking in a casual Brisbane City dining. And hey, just because they’re more than one doesn’t dilute the experience. Rather, it means that New Shanghai have got the drill down pat. That is: walk in, sit down, order up and cheers. Sounds pretty exciting to me. pm
New Shanghai Address LG23 Queens Plaza, Brisbane 4000 Phone 07 3108 7652
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The Small Business Benefit As good as it sounds? Since the government changed the rules in May to allow an immediate tax deduction for asset purchases under $20,000, there has been an unprecedented level of interest across the small business community. But as Darren Hagarty, Director of accounting firm PT Partners explains, there are a number of myths and misconceptions that have surfaced as to how the rules actually work.
In the May 2015 Federal Budget the Government increased the instant asset write-off threshold for small businesses to $20,000 (up from $1,000). This new threshold applies to assets purchased and installed ready for use or actually used in your business between 7.30pm on 12 May 2015 and 30 June 2017. Assets valued at $20,000 or more (which cannot be immediately written-off) can continue to be depreciated at 15% in the first income year and 30% each income year thereafter. With a massive twenty-fold increase to the instant write-off threshold, and with more than 2.3 million small businesses in Australia, the impact of this measure is profound. For small business owners therefore, a working knowledge of how the new law applies and the opportunities it presents is important. Who is Eligible? There are two key eligibility criteria. Firstly, you must be running a business. Therefore, non-business taxpayers such as salary and wage earners and most investors are ineligible. Provided this criterion is met, all business structures may be eligible – sole traders, partnerships, companies and trusts. Secondly, your business’s turnover must be less than two million dollars in the current financial year or in the previous financial year. This includes the turnover of any related or affiliated entities. Which Assets? This new instant write-off threshold applies to all types of depreciable assets purchased and installed ready for use between the above dates, including tools, machinery, vehicles, furniture, computer equipment etc. Therefore, virtually all businesses will have assets that will be eligible for this new concession. The new law also applies to second-hand assets you acquire. Generally, the only assets that are not eligible are those that have their own specific tax depreciation rules (such as horticultural plants, buildings, and in-house software). Eligible assets must cost less than $20,000. There are a number of key points to note with this threshold:
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• The threshold applies on a per-asset basis. Therefore, there is no limit on the amount you can spend under this new measure. For example, you could purchase three small vehicles each worth $15,000 for your business (totalling $45,000) and each vehicle would be able to be immediately claimed as a tax deduction, as the value of each is below $20,000. When purchasing items in bulk, ensure that each asset is individually itemised on the invoice/receipts you receive from the supplier. • The threshold is GST-exclusive. Therefore $22,000 when GST is factored in, with the GST component claimed on your Activity Statement if your business is GST-registered. • The threshold applies to the asset’s cost, not your outof-pocket cost. If your business purchased a $25,000 motor vehicle for example, and received $8,000 for a trade-in, the new vehicle would not be eligible for the new $20,000 write-off despite you being only $17,000 out-of-pocket. The threshold is based on the cost of the asset purchased. What’s the Benefit? To clear up one common misconception, the new $20,000 instant asset write-off will not result in an ATO refund for the amount of the asset purchase. Rather, the cost of the asset can be totally written-off (i.e. its total cost claimed as a tax deduction) in your year-end tax return. Therefore, instead of a deduction for a $15,000 asset, for example, being spread over a number of years (as it would have been under the old law, as the asset cost more than $1,000), the deduction under the new law is brought forward and claimed entirely in the year the asset is acquired and used. This deduction then reduces your business’s taxable income and the amount of tax that is required to be paid. Thus the new measure essentially provides cashflow relief to your business by bringing forward your deductions, rather than having them spread out over a number of years. With cashflow being a major cause of small business failure, the new law is most welcome.
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Example Assume Mike is a sole trader with a turnover less than two million dollars but is in the top marginal tax rate of 47%. Mike purchases a small vehicle for $19,000 solely for use in his business. Old Law As the vehicle exceeds the $1,000 instant writeoff threshold, it would be placed in the small business pool, whereby it would be depreciated at 15% in the first year, and 30% in subsequent years. This would mean that in the first year, Mike’s taxable income would reduce by $2,850 ($19,000 x 15%) resulting in a tax saving of $1,339 ($2,850 x 47% tax rate, excluding Medicare). The remaining value of the vehicle would then be claimed at 30% in subsequent years until its value fell below $1,000 at which point it could be written-off. New Law If Mike purchases this vehicle during the period the new law applies, as it does not exceed the instant write-off threshold of $20,000, he will receive a tax deduction for the entire $19,000 cost of the vehicle. This will reduce his taxable income by this amount, resulting in a tax saving of $8,930 in the year of purchase ($7,591 more than under the old law).
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Strategies With the introduction of this new measure, small business owners may wish to consider the following strategies going forward: • Leading up to 30 June 2016 and 30 June 2017, you may wish to bring forward any planned expenditure on depreciable assets to before 30 June and therefore improve your year-end tax position. Bear in mind that to claim a tax deduction in the year of purchase, the asset must also be installed ready for use in your business or actually being used by 30 June. • This new, generous write-off threshold adds to the many tax benefits of being a small business. As we have seen, to be classified as a small business your turnover must be less than two million dollars. If your business’s turnover is around two million dollars (the Federal Treasury estimates that approximately 5,500 companies and thousands of other non-corporate entities fall into this category) it’s worth keeping a close eye on it at yearend. While we do not suggest that you avoid growing your business just to stay under the two million dollar threshold, if your turnover is nearing that mark at year-end, it certainly pays to stay under that threshold from a tax perspective – perhaps by deferring year-end invoicing, where practical, to the following financial year (post 30 June).
How Do I Claim? The instant asset write-off is claimed on your tax return under the standard depreciation labels. You do not need to do anything special to claim the benefits under this new measure. The way you or your accountant complete your business’s tax return (i.e. by claiming appropriate deductions) is evidence of the write-off being claimed. All you need to do is to retain invoices/receipts evidencing your purchases.
Darren Hagarty is a Chartered Accountant and a director of PT Partners, a progressive accounting firm based in Springwood, in Brisbane's southern suburbs. PT Partners specialises in tax advice, cloud accounting, and strategies for small and medium business, individuals, selfmanaged super funds and retirees. Visit www.ptpartners.net.au for more information.
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