August 18 - 24, 2019: Issue 417

Jurassic world of volcanoes found in central Australia

August 13, 2019: University of Adelaide
An international team of subsurface explorers from the University of Adelaide in Australia and the University of Aberdeen in Scotland have uncovered a previously undescribed 'Jurassic World' of around 100 ancient volcanoes buried deep within the Cooper-Eromanga Basins of central Australia.

The Cooper-Eromanga Basins in the north-eastern corner of South Australia and south-western corner of Queensland is Australia's largest onshore oil and gas producing region of Australia. But, despite about 60 years of petroleum exploration and production, this ancient Jurassic volcanic underground landscape has gone largely unnoticed.

Published in the journal Gondwana Research, the researchers used advanced subsurface imaging techniques, analogous to medical CT scanning, to identify the plethora of volcanic craters and lava flows, and the deeper magma chambers that fed them. They've called the volcanic region the Warnie Volcanic Province, with a nod to Australian cricket legend Shane Warne.

The volcanoes developed in the Jurassic period, between 180 and 160 million years ago, and have been subsequently buried beneath hundreds of meters of sedimentary -- or layered -- rocks.

The Cooper-Eromanga Basins are now a dry and barren landscape but in Jurassic times, the researchers say, would have been a landscape of craters and fissures, spewing hot ash and lava into the air, and surrounded by networks of river channels, evolving into large lakes and coal-swamps.

"While the majority of Earth's volcanic activity occurs at the boundaries of tectonic plates, or under the Earth's oceans, this ancient Jurassic world developed deep within the interior of the Australian continent," says co-author Associate Professor Simon Holford, from the University of Adelaide's Australian School of Petroleum.

"Its discovery raises the prospect that more undiscovered volcanic worlds reside beneath the poorly explored surface of Australia."

The research was carried out by Jonathon Hardman, then a PhD student at the University of Aberdeen, as part of the Natural Environment Research Council Centre for Doctoral Training in Oil and Gas.

The researchers say that Jurassic-aged sedimentary rocks bearing oil, gas and water have been economically important for Australia, but this latest discovery suggests a lot more volcanic activity in the Jurassic period than previously supposed.

"The Cooper-Eromanga Basins have been substantially explored since the first gas discovery in 1963," says co-author Associate Professor Nick Schofield, from the University of Aberdeen's Department of Geology and Petroleum Geology.

"This has led to a massive amount of available data from underneath the ground but, despite this, the volcanics have never been properly understood in this region until now. It changes how we understand processes that have operated in Earth's past."

The researchers have named their discovery the Warnie Volcanic Province after one of the drill holes that penetrated Jurassic volcanic rocks (Warnie East-1), itself named after a nearby waterhole), but also in recognition of the explosive talent of former Australian cricketer Shane Warne.

"We wrote much of the paper during a visit to Adelaide by the Aberdeen researchers, when a fair chunk was discussed and written at Adelaide Oval during an England vs Cricket Australia XI match in November 2017. Inspired by the cricket, we thought Warnie a good name for this once fiery region," says Associate Professor Holford.

Jonathon P.A. Hardman, Simon P. Holford, Nick Schofield, Mark Bunch, Daniel Gibbins. The Warnie volcanic province: Jurassic intraplate volcanism in Central Australia. Gondwana Research, 2019; 76: 322 DOI: 10.1016/j.gr.2019.06.012

Flavonoid-rich diet protects against cancer and heart disease

August 13, 2019: Edith Cowan University
Consuming flavonoid-rich items such as apples and tea protects against cancer and heart disease, particularly for smokers and heavy drinkers, according to new research from Edith Cowan University (ECU).

Researchers from ECU's School of Medical and Health Sciences analysed data from the Danish Diet, Cancer and Health cohort that assessed the diets of 53,048 Danes over 23 years.

They found that people who habitually consumed moderate to high amounts of foods rich in flavonoids, compounds found in plant-based foods and drinks, were less likely to die from cancer or heart disease.

No quick fix for poor habits
Lead researcher Dr Nicola Bondonno said while the study found a lower risk of death in those who ate flavonoid-rich foods, the protective effect appeared to be strongest for those at high risk of chronic diseases due to cigarette smoking and those who drank more than two standard alcoholic drinks a day.

"These findings are important as they highlight the potential to prevent cancer and heart disease by encouraging the consumption of flavonoid-rich foods, particularly in people at high risk of these chronic diseases," she said.

"But it's also important to note that flavonoid consumption does not counteract all of the increased risk of death caused by smoking and high alcohol consumption. By far the best thing to do for your health is to quit smoking and cut down on alcohol.

"We know these kind of lifestyle changes can be very challenging, so encouraging flavonoid consumption might be a novel way to alleviate the increased risk, while also encouraging people to quit smoking and reduce their alcohol intake."

How much is enough?
Participants consuming about 500mg of total flavonoids each day had the lowest risk of a cancer or heart disease-related death.

"It's important to consume a variety of different flavonoid compounds found in different plant based food and drink. This is easily achievable through the diet: one cup of tea, one apple, one orange, 100g of blueberries, and 100g of broccoli would provide a wide range of flavonoid compounds and over 500mg of total flavonoids."

Dr Bondonno said while the research had established an association between flavonoid consumption and lower risk of death, the exact nature of the protective effect was unclear but likely to be multifaceted.

"Alcohol consumption and smoking both increase inflammation and damage blood vessels, which can increase the risk of a range of diseases," she said.

"Flavonoids have been shown to be anti-inflammatory and improve blood vessel function, which may explain why they are associated with a lower risk of death from heart disease and cancer.."

Dr Bondonno said the next step for the research was to look more closely at which types of heart disease cancers were most protected by flavonoids.

'Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort' was published today (13 August) in Nature Communications.

The ECU study was a collaboration with researchers from the Herlev & Gentofte University Hospital, Aarhus University, as well as the Danish Cancer Society Research Centre, Aalborg University Hospital, the Universities of Western Australia and the International Agency for Research on Cancer.

Nicola P. Bondonno, Frederik Dalgaard, Cecilie Kyrø, Kevin Murray, Catherine P. Bondonno, Joshua R. Lewis, Kevin D. Croft, Gunnar Gislason, Augustin Scalbert, Aedin Cassidy, Anne Tjønneland, Kim Overvad, Jonathan M. Hodgson. Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort. Nature Communications, 2019; 10 (1) DOI: 10.1038/s41467-019-11622-x

Treat insomnia before sleep apnoea

August 13, 2019: Flinders University
The 'double whammy' of co-occurring insomnia and obstructive sleep apnoea (OSA) is a complex problem best managed with non-drug targeted psych interventions, a new Australian study has found.

By following simple new guidelines, people with the concurrent conditions reported great improvement to both their sleep, and their health -- with about 50% improvement in global insomnia severity and night-time insomnia after six months.

'Co-Morbid Insomnia and Sleep Apnoea' (COMISA) is a little studied and debilitating disorder which can improve by identifying and treating insomnia separately.

The new Australian study of 145 patients aimed to work out better treatments for 'COMISA' patients who, in the past, have shown poor results from using continuous positive airway pressure (CPAP) therapy, compared to patients who do not report symptoms of insomnia.

As a result, the sleep experts are advising people living with both conditions to be treated first with a targeted, 4-10 week program of cognitive and behavioural therapy for insomnia (CBTi) -- before using CPAP machines to reduce the effects of sleep apnoea.

"We found that treating COMISA patients with non-drug CBTi before commencing CPAP significantly improved insomnia symptoms," says lead researcher Dr Alexander Sweetman, from the Adelaide Institute for Sleep Health at Flinders University.

"Importantly, we also found increased use of CPAP therapy by about one hour per night in patients treated with CBTi and CPAP therapy, compared to a group receiving treatment with CPAP alone."

OSA patients -- who comprise around 10% of the general population -- suffer from frequent airway narrowing events during sleep which leads to a poor quality of sleep and reduced daytime functioning.

About one-third of OSA patients also report clinically significant insomnia symptoms, including long-term difficulties falling asleep at the start of the night, or long awakenings during the night.

The study found the new routine resulted in CBTi patients increasing acceptance of CPAP devices by 87% and increased long-term CPAP use by one hour each night over the first four months.

At six months, combined CBTi and CPAP therapy led to significant improvements of:
  • 52% in global insomnia severity, compared to 35% in the control group,
  • 48% in night-time insomnia complaints, compared to 34%
  • 30% in dysfunctional sleep-related cognitions (compared to 10%).
Heart disease, obesity and depression have been connected to insomnia and sleep apnoea, so getting the best therapies are important to health and wellbeing for millions of people around the world, says co-author Professor Doug McEvoy.

"Long-term cardio-metabolic benefits for patients with COMISA is an important consideration, independent of those debilitating symptoms which can be relieved with the right treatment," Professor McEvoy says.

"This latest study suggests that sleep physicians and clinics should screen for insomnia symptoms and, if present, treat the insomnia with CBTi to improve subsequent acceptance and use of CPAP therapy. This will improve outcomes for both disorders."

Alexander Sweetman, Leon Lack, Peter G Catcheside, Nick A Antic, Simon Smith, Ching Li Chai-Coetzer, James Douglas, Amanda O’Grady, Nicola Dunn, Jan Robinson, Denzil Paul, Paul Williamson, R Doug McEvoy. Cognitive and behavioural therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnoea participants with co-morbid insomnia: A randomised clinical trial. Sleep, 2019; DOI: 10.1093/sleep/zsz178

Judge roasts ASIC bank crackdown; to borrowers' relief

August 14th, 2019: by Julian Lorkin, UNSW
Home loan applicants burdened by having to explain their spending habits will be pleased with a defeat for the corporate regulator, says UNSW Business School's Mark Humphrey-Jenner.

“The Australian Securities and Investments Commission should be cautious about being too litigious. The banking royal commission – and its wake – excoriated ASIC for being too collaborative,” says Associate Professor Mark Humphery-Jenner from UNSW Business School. “But, here, ASIC rejected a settlement, and then lost at court.”

The Federal Court has dismissed allegations against Westpac, brought by the corporate regulator, that it breached responsible lending laws for mortgages borrowers more than a quarter of a million times after a judge found borrowers could alter their ability to service a loan by changing their spending habits, such as ditching luxury food items like wagyu steak and shiraz for more humble fare.

“This is a landmark case for responsible lending, and no doubt many prospective borrowers will be raising a glass of shiraz to the judgement. Many people spend more than they need to because they can. When they have to budget, they can reduce expenditure,” he says. “In short, the decision was eminently sensible, but the case didn't turn entirely on the judge’s remarks about affordability.”

The judge found a bank could never fully assess a borrower's expenses because a borrower had the power to change some of their expenses after taking on a loan so that they could make payments.

“The case mainly turned on the fact that the parties couldn't agree on how many people were affected by the supposed breach. This evidentiary issue created major problem's for ASIC's case,” says Associate Professor Humphery-Jenner.

The crux of the issue is that Westpac used an automated way to assess expenditure, rather than relying on actual expenditure, in around 260,000 cases. “But, only in 50,000 did customers declare expenses below that automated calculation. Even then, only 5000 loans were approved when they might not otherwise have been had actual expenses been used. That is, fewer than 2.5% of all the loans that ASIC alleged breached proper procedure were given to people who potentially could not afford them. And, even then, evidence on that was lacking." 

Therefore, he says, it is quite reasonable to use a simple formula benchmark known as the Household Expenditure Measure, instead of having to trawl through a borrower's bank statements and calculate exactly what they spend before applying for a loan. “Borrowers who recently have found every expense scrutinised, will now be able to go back to putting down their rough expenses on an application, which should make the process of applying for a mortgage far easier. It is also more in line with the real world, where borrowers prioritise when faced with new budget constrains," says Associate Professor Humphery-Jenner.

Disclaimer: These articles are not intended to provide medical advice, diagnosis or treatment.  Views expressed here do not necessarily reflect those of Pittwater Online News or its staff.

Building a Mentally and Physically Healthy Australia

August 13, 2019: The Hon Greg Hunt MP, Minister for Health
Delivering the world’s best mental health system – stigma-free and focused on prevention, starting with children under 12 – is the major focus of the Australian Government’s Long Term National Health Plan, outlined today.

Under this Plan, we will build a mentally and physically healthy Australia. For the first time, mental health will be rated equally alongside physical health.

The Long Term National Health Plan recognises that depression, anxiety, bipolar disorder and psychosis are health problems to be treated just like diabetes, asthma and broken bones.

It charts the way forward over the next three and 10 years in the key areas of mental health, primary care, hospitals, preventive health and medical research.

The Long Term National Health Plan includes:
  • The 2030 mental health vision, including a new strategy specifically for children under 12 years
  • The 10-year Primary Health Care Plan
  • Continued improvement of private health insurance
  • The 10-year National Preventive Health Strategy
  • The 10-year Medical Research Future Fund (MRFF) investment plan.
To help inform the Plan, the Government is commissioning a multi-year study of more than 60,000 Australians to provide the most complete picture ever of our physical and mental health.

The Intergenerational Health and Mental Health Study will cover mental health, general health, nutrition and physical activity.

Mental health
The Government will build a mental health system that is integrated, simplified, trusted and comprehensive.

The new Children’s Mental Health Strategy focuses on the 0–12 age group, and aims to maintain mental wellbeing and prevent mental ill health. It will improve delivery of supports for early childhood, parenting and early education.

We know that half of all symptoms of mental illness begin before the age of 14, and that neuropsychiatric conditions are the leading cause of disability in young people. If untreated, these conditions severely influence how children develop, and how they do at school and in life.

The Children’s Mental Health Strategy will provide a framework to embed protective skills in early childhood, create mentally healthy home environments, support parents, and prevent or treat early childhood trauma.

The expert working group developing the Strategy will be co-chaired by Professor Frank Oberklaid and Professor Christel Middeldorp. Two internationally recognised leaders in child mental health.

Professor Oberklaid, Director of the Centre for Community Child Health at The Royal Children's Hospital, and Professor Middeldorp, conjoint Professor of Child and Youth Psychiatry at the Child Health Research Centre and Children’s Health Queensland Hospital and Health Service, are two of Australia’s leading child mental health experts.

The Government will continue to tackle stigma around mental illness and encourage people to seek help – and seek it early.

Enormous progress has been made on destigmatisation, but self-stigma – people’s self-consciousness about their own mental health concerns remains high. It is the main barrier to people seeking help.

As a Government, and through the nation’s leaders, organisations, schools and the community, we will work to ensure there will be no shame – in particular, no shame in our own mental health challenges – when we reach out for help.

The Government is undertaking unprecedented action to reduce the rates of suicide, particularly for our young people and Indigenous Australians. More than 3,120 recorded suicides in 2017 – part of an upward trend over the past decade – is a national tragedy.

The Government will establish a ‘towards zero’ suicide target and culture through a whole-of-government approach driven by Australia’s first National Suicide Prevention Adviser, Christine Morgan.

One of the specific priority areas for the next round of the Government’s Million Minds mental health research mission will be research on suicide prevention. Funding of $8 million will be made available to support this research with a round to be opened for competitive application in November 2019.

We will continue to improve service delivery. Funding of $111 million will establish 30 more headspace centres in this term, taking the total to 145 around Australia.

Funding of $110 million is allocated for the Early Psychosis Youth Services Program; $114.5 million to establish eight adult mental health centres; $63 million for residential eating disorder centres in each state and territory; and $36.7 million to expand Way Back services in selected regions, to support people after attempting suicide.

Between now and 2030, we will establish a network of adult mental health centres.

Australia’s mental health system needs to be better integrated. The Government will work towards a New National Mental Health Partnership with states and territories. This Partnership will be informed by the National Mental Health Commission and the Productivity Commission, which are currently working together on Vision 2030: Blueprint for the Future.

The Partnership will identify individual and shared responsibilities for states and territories, and the Commonwealth.

The goal of national partnerships with each of the states and territories is for a simplified mental health system from prevention to treatment to recovery.

Primary care
The Government will implement the 10-year Primary Health Care Plan.

A key reform is support for GPs to provide more flexible care for patients over 70 with chronic and complex conditions, through a new patient enrolment payment model rather than fee-for-service MBS items.

We will develop genomics testing as the new standard of care. Genomics will transform prevention, prediction, diagnosis and treatment by providing precision medical care, targeting the unique genetic makeup of individuals.

We will progressively roll out universal telehealth, modernising general practice, improving continuity and convenience, and particularly benefiting rural and remote Australia.

We will encourage more nurses to enter the primary care workforce.

We will make pharmacy an even more essential part of primary care. The Government is committed to early and inclusive negotiations for a new Community Pharmacy Agreement.

Through our Stronger Rural Health Strategy, we will better distribute the health workforce, with 3,000 new doctors and nurses and hundreds of allied health professionals to be located in areas of need, especially in regional and rural Australia.

Indigenous health is a key priority. We will complete the next iteration of the National Aboriginal and Torres Strait Islander Health Plan by mid-2020.

Through Medicare and the Pharmaceutical Benefits Scheme (PBS), we will continue to ensure Australians have guaranteed access to subsidised health care and medicines. We have provisioned $40 billion for PBS medicines over the next four years. Of this, more than $10 billion is for cancer medicines. We are also looking at ways to improve subsidised access, including streamlining processes for medicines that offer a real therapeutic advance.

Hospitals and private health insurance
We have begun the next wave of private health insurance reforms. We are working collaboratively with insurers, hospitals and doctors to deliver a better outcome for consumers. Our first round of reforms delivered the lowest premium changes in 18 years.

With $131 billion in record public hospitals funding on the table for the next five years under the National Health Reform Agreement, we will work with states and territories to better coordinate care for complex and chronic conditions, keep people out of hospital, and improve management, including self-management, of people with chronic and complex conditions.

Under our landmark $1.25 billion Community Health and Hospitals Program, we will continue to allocate funds for important health and hospital projects. So far, $100 million in signed bilateral agreements with states and territories has been released for 65 projects, including the Peter MacCallum Cancer Centre to bring CAR T – cell treatment to Australia ($80 million), Sydney Children’s Comprehensive Cancer Care Centre ($100 million), the Repat Brain and Spinal Centre, South Australia ($20 million), and the Logan Urgent and Specialist Care Centre, Queensland ($33.4 million).

Preventive health
The Government will develop and implement a 10-year National Preventive Health Strategy. This strategy will provide a better balance between treatment and prevention. It will be designed to keep people healthier and out of hospital.

We will continue to lift cancer screening rates across the three current population-based cancer screening programs – bowel, breast, and cervical – and have requested Cancer Australia to investigate the potential for a national lung cancer screening program.

Australia is set to be the first country in the world to eliminate cervical cancer through vaccination and screening.

We will continue to invest in the National Immunisation Program – $400 million for this year. We will develop a national obesity strategy with states and territories. A $20 million National Tobacco Campaign over four years will continue to reduce tobacco use. Our goal is to reduce smoking rates to below 10 per cent by 2025.

The National Preventive Health Strategy includes an Indigenous Preventive Health Plan. Under this plan, targets for improved health outcomes include:
  • Ending avoidable blindness by 2025
  • Ending avoidable deafness by 2025
  • Eradicating rheumatic heart disease by 2030
  • A 10 per cent annual increase in the number of people having at least one health check a year
  • 60 per cent of pregnant women to have at least one health check in the first trimester
  • Stopping the growth in type 2 diabetes among children and young people within five years.
Medical research
The 10-year, $5 billion MRFF investment plan and the $500 million Biomedical Translation Fund are giving funding certainty to our best and brightest researchers and start-ups. They are reaffirming Australia’s reputation as a world leader in the health and medical research.

A total of 54 clinical trials are now being funded through the MRFF. Within 10 years, we will have established Australia as a global centre for clinical trials.

Eight research missions covering brain cancer ($124.7 million), mental health ($125 million), genomics $500 million), ageing, aged care and dementia ($185 million), Indigenous ($160 million), stem cell ($150 million), cardiovascular ($220 million) and traumatic brain injury ($50 million) are funded through the MRFF. Over time, they will transform health care.

Work on breakthrough treatments includes the $20 million Mackenzie’s Mission to research rare genetic conditions like spinal muscular atrophy and fragile X syndrome, and the $50 million Genomic Cancer Medicine Program.

Fast food availability linked with more heart attacks

August 12, 2019
Areas with a higher number of fast food restaurants have more heart attacks, according to research presented at CSANZ 2019.1 The study also found that for every additional fast food outlet, there were four additional heart attacks per 100,000 people each year.

The 67th Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand (CSANZ) which took place 8 to 11 August in Adelaide, Australia. The European Society of Cardiology (ESC) and CSANZ are holding joint scientific sessions as part of the ESC Global Activities programme.2

Study author Tarunpreet Saluja of the University of Newcastle, Callaghan, Australia said: "The findings were consistent across rural and metropolitan areas of New South Wales and after adjusting for age, obesity, high blood lipids, high blood pressure, smoking status, and diabetes. The results emphasise the importance of the food environment as a potential contributor towards health."

"Ischaemic heart disease, including heart attack, is one of the leading causes of death worldwide," continued Mr Saluja. "It is known that eating fast foods is linked with a higher likelihood of fatal and nonfatal heart attacks. Despite this, there is rapid growth in the purchase and availability of fast food. This highlights the need to explore the role of food availability in the probability of having a heart attack."

This retrospective cohort study included 3,070 patients admitted to hospital with a heart attack in the Hunter Region between 2011 to 2013. The database contained each patient's home postcode, allowing the researchers to analyse their surrounding fast food environment.

Fast food outlets were defined as the ten most popular quick service food retailers in Australia, based on a population survey conducted in 2018. The researchers recorded the total number of outlets within each local government area and compared different areas to analyse the association between density of fast food restaurants and incidence of heart attack.

"Previous studies have shown that the poor nutritional value, high salt and saturated fat in fast food is connected to heart disease, yet the role of greater access to these restaurants has been less clear," said Mr Saluja.

"The ubiquitous presence of fast food is an important consideration for the ongoing development of rural and metropolitan areas," he added. "The link with poor health adds a community lens to cardiovascular disease management and stresses the need to target this issue in future public health promotion strategies and legislation. This is why ESC guidelines recommend the regulation of fast food outlet density in community settings."3

Professor Tom Marwick, Chair of the CSANZ 2019 Scientific Programme Committee, said: "This is an important paper that documents the association between fast foods and cardiac events, independent of risk factors. It will be crucial to explore whether this association is independent of the social determinants of disease, as we know that fast food outlets are often more common in disadvantaged areas. Nonetheless, the findings are a reminder that the fundamental drivers of cardiovascular disease burden may be altered by changes in public policy. The fact that the appropriate policy steps have not been taken, despite the cost of cardiovascular disease, remains as much a mystery in Australia as elsewhere in the world."

Professor Jeroen Bax, Past President of the ESC and course director of the ESC programme at CSANZ 2019, said: "Tackling heart disease requires individual responsibility and actions at population level. This study highlights the impact of the food environment on health. In addition to regulating the location and density of fast food outlets, local areas should ensure good access to supermarkets with healthy food."

Massimo F. Piepoli, Arno W. Hoes, Stefan Agewall, Christian Albus, Carlos Brotons, Alberico L. Catapano, Marie-Therese Cooney, Ugo Corrà, Bernard Cosyns, Christi Deaton, Ian Graham, Michael Stephen Hall, F. D. Richard Hobbs, Maja-Lisa Løchen, Herbert Löllgen, Pedro Marques-Vidal, Joep Perk, Eva Prescott, Josep Redon, Dimitrios J. Richter, Naveed Sattar, Yvo Smulders, Monica Tiberi, H. Bart van der Worp, Ineke van Dis, W. M. Monique Verschuren. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 2016; 37 (29): 2315 DOI: 10.1093/eurheartj/ehw106