June 18 - 24, 2017: Issue 317

Pittwater Online News receives and finds a lot of information from various sources each week. This page shares some of this news relevant to you and the world you live in.

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NSW Budget: record $100m palliative care funding

13 June 2017: NSW Minister for Health, The Hon. Brad Hazzard 
The NSW Government will provide record funding for palliative care across NSW to support people suffering terminal illness and their families.

Premier Gladys Berejiklian, Treasurer Dominic Perrottet and Minister for Health Brad Hazzard said the upcoming NSW Budget will invest an additional $100 million in palliative care services over the next four years.

“From additional nurses in frontline palliative care to funding for 24-hour community care services, this is a package of funding that will have a powerful and tangible impact across the State,” Ms Berejiklian said.

“At a time in people’s lives where every moment is incredibly precious, this investment is about providing the care options to lessen the strain on them and their loved ones.”

Palliative care aims to improve the quality of life of patients with an active, progressive disease that has little or no prospect of a cure.

Mr Perrottet said: “I am incredibly proud that this Budget includes the most serious commitment of any government in NSW history to give people at the end of life’s journey, and their families, the peace, comfort and support they deserve.

“We have an obligation to honour the dignity of everyone in our community to the very end, and this funding demonstrates our Government’s commitment to meeting that obligation.”

Mr Hazzard said the initiative includes a range of professional training measures.

“This package includes training for 300 nurses and allied health staff, 300 scholarships for rural and regional staff to enhance palliative care skills and 30 additional nurses in hospitals, homes and nursing homes,” Mr Hazzard said.

“We have listened to communities at palliative care roundtables across the state and the message from Broken Hill to Sydney, from Griffith to Lismore is that we need to expand our palliative care resources and choices at a local level.”

“We want the community to have confidence and choice in their end-of-life care and this Budget is a giant leap towards that outcome.”

The 2017-18 State Budget includes funding for:
  • palliative care training for 300 nurses and allied health staff ($900,000)
  • 300 scholarships for rural and regional staff to enhance palliative care skills ($300,000)
  • an additional six palliative care specialists in rural and regional areas ($2.4 million)
  • two specialist positions to provide relief to other specialists in rural and regional areas ($795,000)
  • an additional 30 palliative care nurses providing care in hospitals, homes and nursing homes ($5 million)
  • community-based palliative care services in Western Sydney, including a 24 hour, seven day a week on-call specialist palliative care service at home ($6.9 million)
  • the development of comprehensive and integrated palliative care services, in line with community expectations and need ($1 million in 2017- 18 as part of a $22 million investment over four years)
  • community pharmacy initiatives to improve medication management for palliative care patients ($200,000).

Providing $400,000 life-saving drug to Australian kids with rare disease

15 June, 2017: Media Release - The Hon Greg Hunt MP, Minister for Health, Minister for Sport
The Australian Government will provide a life-saving treatment to Australian patients who have a rare medical condition known as Morquio A Syndrome, at no cost.
Vimizim® (elosulfase alfa) will be available under the Life Saving Drugs Program from 1 August.

With treatment costing around $400,000 each year, many Australian children suffering from Morquio A have been unable to receive treatment as it has simply been out-of-reach. 

It’s an awful disease that cruelly affects children. Having access to Vimizim will be life-changing and indeed life-saving for some of our youngest Australians.

Morquio A Syndrome, or mucopolysaccharidosis (MPS) type IV A is an inherited metabolic condition, with Vimizim the only available treatment. 

People born with the syndrome are either missing, or don’t have enough of, a crucial enzyme needed to break down long chains of sugar molecules. As a result they have abnormal development and a possible early death.

Before accessing this new drug, patients will need to undergo a clinical assessment and then yearly checks to ensure Vimizim treatment continues to be effective and appropriate for their condition. 

Adding medicines to the Life Saving Drugs Program is rare and Vimizin is only the 13th medicine to be added. 

It will cost of $44 million over five years to treat 20 children. We are able to make this life-changing listing today because of our responsible financial management of the cost of medicines. 

Since coming into Government, we have added over 1400 new and amended drug listings to the Pharmaceutical Benefits Scheme to improve the health of Australians. 

Unlike Labor, we are adding medicines recommended by the Pharmaceutical Benefits Advisory Committee without fear or favour. Labor delayed the listing of seven vital drugs.

Australia’s PBS is one of the foundations of our universal health care system and is the envy of many countries.

The Turnbull Government has a rock solid commitment to Medicare and part of this commitment is ensuring people have access to medicine when they need it. 

For further information go to the Life Saving Drugs Program website. 

Muscle growth finding may assist with cancer treatment

June 14, 2017: Monash University
Monash University's Biomedicine Discovery Institute (BDI) researchers have collaboratively developed a therapeutic approach that dramatically promotes the growth of muscle mass, which could potentially prevent muscle wasting in diseases including muscular dystrophy and cancer.

The approach, jointly developed with Baker Heart and Diabetes Institute scientists, combines -- for the first time -- molecules that inhibit three proteins which in turn repress muscle growth.

Published this week in the journal Proceedings of the National Academy of Sciences, the scientists found that inhibiting activin A, activin B and myostatin resulted in skeletal muscle mass increase by as much as 150 per cent in preclinical models.

Myostatin has long been recognised as the body's major negative regulator of skeletal muscle mass, helping to maintain muscle homeostasis in the body, but creating molecules to target all three related proteins together was a novel approach.

"As a result of the study we can now more precisely regulate -- and increase -- muscle mass in the setting of disease," co-lead author from Monash BDI, Dr Craig Harrison, said.

Dr Harrison said the study, the culmination of many years of research with the Baker Institute's Dr Paul Gregorevic, was aimed mostly at developing a way of preventing muscle loss in the wasting condition cachexia, in cancer.

Dr Harrison said cachexia, observed in the end stages of cancer, was thought to contribute or directly cause 20 to 30 per cent of all cancer-related deaths. Palliative care is currently the only treatment for cancer cachexia. The condition is also seen in other diseases including diabetes, AIDS, and in heart and kidney failure.

The paper showed that the combination treatment could prevent muscle wasting in a cancer cachexia model as well as in muscular dystrophy. It could also potentially be used after clinical development in healthy and in ageing individuals undergoing a slow wasting of muscles, Dr Harrison said.

Activins and myostatin belong to the transforming growth factor-β (TGF-β) family of proteins, which both researchers have been investigating for a number of years.

Further pre-clinical research is proceeding.

The findings were recently corroborated by a similar study by US scientists, although those experiments did not target activin B and did not demonstrate as great an effect, Dr Harrison said.

The research was supported by the Australian National Health and Medical Research Council.

Justin L. Chen, Kelly L. Walton, Adam Hagg, Timothy D. Colgan, Katharine Johnson, Hongwei Qian, Paul Gregorevic, Craig A. Harrison. Specific targeting of TGF-β family ligands demonstrates distinct roles in the regulation of muscle mass in health and disease. Proceedings of the National Academy of Sciences, 2017; 201620013 DOI: 10.1073/pnas.1620013114

Bacteria from cystic fibrosis patient could help thwart antibiotic-resistant TB

June 14, 2017: American Chemical Society
The number of drug-resistant tuberculosis (TB) cases is rising globally. But a newly discovered natural antibiotic -- produced by bacteria from the lung infection in a cystic fibrosis patient -- could help fight these infections. Lab testing reported in the Journal of the American Chemical Society shows that the compound is active against multi-drug resistant strains.

Starting with the famous first discovery of penicillin from mold, scientists have continued to search for natural sources of antibiotics. And as pathogens develop resistance to once-reliable medicines, the search has taken on a new urgency. By 2040, more than a third of all TB cases in Russia, for example, could show resistance to first-line drugs currently used to fight the disease, a recent report published in Lancet estimates. 

Among potential new drug sources are species of the bacterial genus Burkholderia that thrive in a wide range of habitats, from soil to the human lung. One way these microbes have adapted to these diverse environments is by making potent antibiotics to take out their competition. In light of the growing threat of drug-resistant bacteria, particularly among TB strains, Gregory L. Challis, Eshwar Mahenthiralingam and colleagues wanted to see if Burkholderia might produce a promising anti-TB compound.

The researchers discovered that one species, Burkholderia gladioli, which was isolated from the sputum of a child with cystic fibrosis, produces an antibiotic called gladiolin. The compound belongs to the same structural class as etnangien, another antibiotic that has been investigated for its ability to jam bacterial cell machinery. But etnangien is highly unstable. The researchers found that gladiolin is much more stable than etnangien, and could therefore potentially be a better drug candidate. Lab testing also showed that gladiolin blocked the growth of four drug-resistant TB strains.

Lijiang Song, Matthew Jenner, Joleen Masschelein, Cerith Jones, Matthew J. Bull, Simon R. Harris, Ruben C. Hartkoorn, Anthony Vocat, Isolda Romero-Canelon, Paul Coupland, Gordon Webster, Matthew Dunn, Rebecca Weiser, Christopher Paisey, Stewart T. Cole, Julian Parkhill, Eshwar Mahenthiralingam, Gregory L. Challis. Discovery and Biosynthesis of Gladiolin: A Burkholderia gladioli Antibiotic with Promising Activity against Mycobacterium tuberculosis. Journal of the American Chemical Society, 2017; 139 (23): 7974 DOI: 10.1021/jacs.7b03382 

Gluten-free beer from Witkop teff grains

June 14, 2017: American Chemical Society
For celiac patients and others on gluten-free diets, it seems like gluten is everywhere -- cakes, cookies and breads. It's even in most beers. But now, one team reports in the Journal of Agricultural and Food Chemistry that beers made with Witkop teff grains may be a good alternative to traditionally brewed barley beers.

Gluten based sensitivities impact millions of people each year, leading to a dramatic rise in gluten-free food products on grocery store shelves. According to the Celiac Disease Foundation, one percent of the global population has celiac disease, which results in the immune system attacking the small intestine when gluten is consumed. Currently, no medicinal treatments are available, and the only option is to follow a strict, gluten-free diet. As a result, breweries have been exploring alternative grains, such as corn, rice and buckwheat, to replace barley in the malting and brewing process. Teff, a small cereal native to Ethiopia that doesn't contain gluten, is another possibility that researchers have tested. Now, Valeria Sileoni and colleagues wanted to examine, for the first time, the potential of a variety of teff called Witkop as a raw material for malting and brewing.

The researchers examined the Witkop teff malting process, in which grains are steeped, germinated and dried, to determine the optimum conditions. Witkop teff took longer to malt than barley, and the team found that the teff had different enzymes to break down sugars than barley. The researchers concluded that Witkop teff grains have potential as a raw material for beer production but would likely require custom malting equipment on an industrial scale.

Lidia Di Ghionno, Ombretta Marconi, Eung Gwan Lee, Christopher J. Rice, Valeria Sileoni, Giuseppe Perretti. Gluten-Free Sources of Fermentable Extract: Effect of Temperature and Germination Time on Quality Attributes of Teff [Eragrostis tef (zucc.) Trotter] Malt and Wort. Journal of Agricultural and Food Chemistry, 2017; 65 (23): 4777 DOI: 10.1021/acs.jafc.7b01717

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.

Disability Employment Services Reforms Underway

14 June 2017:  Joint Media Release with: Minister for Social Services, The Hon. Christian Porter and  Assistant Minister for Social Services and Disability Services, The Hon Jane Prentice MP
The Australian Government has released an industry information paper that provides essential information for those delivering Disability Employment Services (DES) from 1 July 2018.

Minister for Social Services, the Hon Christian Porter MP, said the paper is the next step in implementing the Government’s $3 billion plan over the next four years to strengthen DES.

“I want to ensure a smooth transition from the current arrangements to the new DES program, and to provide certainty and clarity for the sector,” Minister Porter said.

“We are continuing current provider contracts to 30 June 2018 and ensuring a new DES provider panel is in place to support jobseekers and employers from 1 July 2018.

“The industry paper is essential reading for current providers and for organisations that would like to apply to deliver DES.”

Assistant Minister for Disability Services, the Hon Jane Prentice MP, said existing providers may be offered an ‘invitation to treat’ after they have registered their interest.

“Making it easier for existing providers that are already delivering services to an acceptable standard to continue, will help stabilise the DES market and provide continuity for job seekers and employers,” Mrs Prentice said.

“The industry information paper also outlines the revised funding model for DES providers, offering stronger incentives for them to achieve sustainable employment outcomes for participants that may require more support than others.

"In addition, the Government will provide more than $300 million over the next 10 years to index funding to DES.”

Industry information sessions will be held in capital cities and selected regional areas from 20 June to 25 July 2017, and an online information session will also be available.

To read the industry paper, and register for an information session, visit www.engage.dss.gov.au.

Dawn of humanity: Neanderthal-Homo sapiens transition

June 14, 2017: Australian National University
Archaeologists at The Australian National University (ANU) and the University of Sydney have provided a window into one of the most exciting periods in human history -- the transition between Neanderthals and modern humans.

An archaeological dig in a cave in the Moravian region of the Czech Republic has provided a timeline of evidence from 10 sedimentary layers spanning 28,000 to 50,000 years ago. This is the period when our modern human ancestors first arrived in Europe.

The dig, in a cave near the Czech border with Austria and around 150kms north of Vienna, has unearthed over 20,000 animal bones as well as stone tools, weapons and an engraved bone bead that is the oldest of its kind in Central Europe.

A stone tool thought to be a speartip made from radiolarite sourced over 100km to the east of the cave. Credit: Miroslav Kralík

ANU archaeologist Dr Duncan Wright said the project was so important because it gives some of the earliest evidence of modern human activity in the region. This was a period when humans were moving substantial distances and bringing with them portable art objects.

"In the early layers the items we've found are locally made flakes, possibly used by small communities living and hunting in the vicinity to kill animals or prepare food, but around 40,000 years ago we start to see objects coming from long distances away," Dr Wright said.

"Dating from this same time we unearthed a bead made from mammal bone. This is the oldest portable art object of its type found anywhere in central Europe and provides evidence of social signalling, quite possibly used as a necklace to mark the identity of the wearer.

"So between these two periods, we've either seen a change in behaviour and human movement or possibly even a change in species."

Archaeologist Ladislav Nejman of the University of Sydney said one of the biggest questions is the beginnings of human exploration of this landscape by Homo sapiens who arrived in this area for the first time. "We've found that somewhere between 40-48,000 years ago people became highly mobile," Dr Nejman said.

"Instead of moving short distances near the cave where they lived, they were walking for hundreds of kilometres quite often. We know that because we found various artefacts where the raw material comes from 100-200 kilometres away.

"The artefacts were also made of different materials from different regions. Some from the North-West, some from the North, some from the East."

However in layer 10, which represents an earlier time period between 48-45,000 years ago, all the recovered stone artefacts were made using local raw material, which indicates that the high residential mobility came later.

Dr Nejman said the study also revealed valuable new information about the climate of the region.

"We haven't had such a long sequence of sedimentary layers before that we could test," he said.

"The climate changed quite often from warmer to colder, and vice versa, but at all times it was much colder than the interglacial period that we have lived in for the past 10,000 years."

Samples from the site have been sent through for analysis using a new technique, called ancient sediment DNA analysis. This is the first scientific method that can detect which species were present even without the bones of these species. It tests remnant DNA preserved in the sediment.

Dr Wright said the results will shed new light on a period of transition between two species of humans and also give clearer evidence about the activities of our modern human ancestors in a period and region where little is known.

"We can tell by the artefacts that small groups of people camped at this cave. This was during glacial periods suggesting they were well adapted to these harsh conditions" Dr Wright said.

"It's quite possible that the two different species of humans met in this area."

The study was initially funded by a grant from SoMoPro program with a financial contribution from the European Community within the Seventh Framework Programme. The study has been published in the Journal of Human Evolution.

L. Nejman, R. Wood, D. Wright, L. Lisá, Z. Nerudová, P. Neruda, A. Přichystal, J. Svoboda. Hominid visitation of the Moravian Karst during the Middle-Upper Paleolithic transition: New results from Pod Hradem Cave (Czech Republic). Journal of Human Evolution, 2017; 108: 131 DOI: 10.1016/j.jhevol.2017.03.015

Solar paint offers endless energy from water vapor

June 14, 2017: RMIT University
Researchers have developed a solar paint that can absorb water vapour and split it to generate hydrogen -- the cleanest source of energy.

The paint contains a newly developed compound that acts like silica gel, which is used in sachets to absorb moisture and keep food, medicines and electronics fresh and dry.

But unlike silica gel, the new material, synthetic molybdenum-sulphide, also acts as a semi-conductor and catalyses the splitting of water molecules into hydrogen and oxygen.

Lead researcher Dr Torben Daeneke, from RMIT University in Melbourne, Australia, said: "We found that mixing the compound with titanium oxide particles leads to a sunlight-absorbing paint that produces hydrogen fuel from solar energy and moist air.

"Titanium oxide is the white pigment that is already commonly used in wall paint, meaning that the simple addition of the new material can convert a brick wall into energy harvesting and fuel production real estate.

"Our new development has a big range of advantages," he said. "There's no need for clean or filtered water to feed the system. Any place that has water vapour in the air, even remote areas far from water, can produce fuel."

Watch the video: https://youtu.be/Ci6LKz0ajfI

His colleague, Distinguished Professor Kourosh Kalantar-zadeh, said hydrogen was the cleanest source of energy and could be used in fuel cells as well as conventional combustion engines as an alternative to fossil fuels.

"This system can also be used in very dry but hot climates near oceans. The sea water is evaporated by the hot sunlight and the vapour can then be absorbed to produce fuel.

"This is an extraordinary concept -- making fuel from the sun and water vapour in the air."

Torben Daeneke, Nripen Dahr, Paul Atkin, Rhiannon M. Clark, Christopher J. Harrison, Robert Brkljača, Naresh Pillai, Bao Yue Zhang, Ali Zavabeti, Samuel J. Ippolito, Kyle J. Berean, Jian Zhen Ou, Michael S. Strano, Kourosh Kalantar-zadeh. Surface Water Dependent Properties of Sulfur-Rich Molybdenum Sulfides: Electrolyteless Gas Phase Water Splitting. ACS Nano, 2017; DOI: 10.1021/acsnano.7b01632

Making art activates brain's reward pathway

June 13, 2017: Drexel University
Your brain's reward pathways become active during art-making activities like doodling, according to a new Drexel University study.

Girija Kaimal, EdD, assistant professor in the College of Nursing and Health Professions, led a team that used fNIRS (functional near-infrared spectroscopy) technology to measure blood flow in the areas of the brain related to rewards while study participants completed a variety of art-making projects.

"This shows that there might be inherent pleasure in doing art activities independent of the end results. Sometimes, we tend to be very critical of what we do because we have internalized, societal judgements of what is good or bad art and, therefore, who is skilled and who is not," said Kaimal of the study that was published The Arts in Psychotherapy. "We might be reducing or neglecting a simple potential source of rewards perceived by the brain. And this biologocial proof could potentially challenge some of our assumptions about ourselves."

For the study, co-authored by Drexel faculty including Jennifer Nasser, PhD, and Hasan Ayaz, PhD, 26 participants wore fNIRS headbands while they completed three different art activities (each with rest periods between). For three minutes each, the participants colored in a mandala, doodled within or around a circle marked on a paper, and had a free-drawing session.

These are examples of the doodling activity. Picture Courtesy of Drexel University

During all three activities, there was a measured increase in bloodflow in the brain's prefrontal cortex, compared to rest periods where bloodflow decreased to normal rates.

The prefrontal cortex is related to regulating our thoughts, feelings and actions. It is also related to emotional and motivational systems and part of the wiring for our brain's reward circuit. So seeing increased bloodflow in these areas likely means a person is experiencing feels related to being rewarded.

There were some distinctions between the activities in the data collected.

Doodling in or around the circle had the highest average measured bloodflow increase in the reward pathway compared to free-drawing (the next highest) and coloring. However, the difference between each form of art-making was not statistically significant, according to analysis.

"There were some emergent differences but we did not have a large-enough sample in this initial study to draw any definitive conclusions," Kaimal said.

It was noted and tracked which participants in the study considered themselves artists so that their results could be compared to non-artists. In that way, Kaimal and her team hoped to understand whether past experience played a factor in triggering feelings of reward.

Doodling seemed to initiate the most brain activity in artists, but free-drawing was observed to be about the same for artists and non-artists. Interestingly, the set coloring activity actually resulted in negative brain activity in artists.

"I think artists might have felt very constrained by the pre-drawn shapes and the limited choice of media," Kaimal explained. "They might also have felt some frustration that they could not complete the image in the short time."

Again, however, these results regarding artists versus non-artists proved statistically insignificant, which might actually track with Kaimal's previous research that found experience-level did not have a bearing on the stress-reduction benefits people had while making art.

Overall, though, the finding that any form of art-making resulted in the significant activation of feelings of reward are compelling, especially for art therapists who see art as a valuable tool for mental health.

In fact, in surveys administered to the participants after the activities were complete, respondents indicated that they felt more like they had "good ideas" and could "solve problems" than before the activities. Participants even said they felt the three-minute time spans for art-making weren't long enough.

"There are several implications of this study's findings," Kaimal said. "They indicate an inherent potential for evoking positive emotions through art-making -- and doodling especially. Doodling is something we all have experience with and might re-imagine as a democratizing, skill independent, judgment-free pleasurable activity."

Additionally, Kaimal felt that the findings of increased self-opinion were intriguing.

"There might be inherent aspects to visual self-expression that evoke both pleasure and a sense of creative agency in ourselves," she said.

Girija Kaimal, Hasan Ayaz, Joanna Herres, Rebekka Dieterich-Hartwell, Bindal Makwana, Donna H. Kaiser, Jennifer A. Nasser. Functional near-infrared spectroscopy assessment of reward perception based on visual self-expression: Coloring, doodling, and free drawing. The Arts in Psychotherapy, 2017; 55: 85 DOI: 10.1016/j.aip.2017.05.004