OPINION: Interventions in birth need to be challenged

15/02/2019 // by admin

AUSTRALIA has high rates of medical and surgical intervention during birth, especially in private hospitals.
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While these interventions can be harmful if overused, people working in the private sector have argued they have resulted in better health for babies. Research using a large population-based sample shows this is not so.

Birth interventions include labour being induced, the mother being given an epidural, birth by caesarean section, the use of forceps or a suction cup on the baby’s head for delivery, and a surgical cut to the perineum to make the vaginal opening wider.

Such interventions should only be used where there is a medical need. And since they create new risk, women should be told about the benefits and risks of the intervention before it takes place.

In 2012, we published research showing low-risk women having their babies in private hospitals in NSW had much higher rates of obstetric intervention than those giving birth at a public hospital.

Expecting mothers are categorised as low-risk if they are under 35 years of age, have a full-term baby (37 to 42 weeks) with normal birth weight, do not smoke and have no medical or obstetric complications. The latter include high blood pressure, diabetes, a previous caesarean section, twins or breech birth, among other things.

Looking at data from 2000 to 2008, we found only 15 per cent of low-risk first-time mothers in private hospitals had a normal vaginal birth without intervention compared with 35 per cent in public hospitals. Overall, first-time mothers had a 20 per cent lower chance of having a normal birth in private hospitals compared with public hospitals. When we published our findings, privately practising obstetricians defended their intervention rate, recognising it was high, but noting it was worth doing to save babies’ lives. This makes perfect sense, but we wanted to know whether there was any evidence for this position.

The result was a paper we have just published in BMJ Open. We looked again at low-risk women giving birth in NSW between 2000 and 2008. This time, we examined problems that required medical attention following birth and re-admission to hospital within 28 days, as well as the rate of intervention at birth. We also looked at stillbirths and infant deaths up to 28 days following birth.

We found babies born in private hospitals were more likely to be born before 40 weeks gestation (as they are more likely to have their labour induced or have an elective caesarean section before 40 weeks) and they were more likely to have some form of resuscitation at birth.

They were also more likely to have a problem following birth and to be readmitted to hospital in their first 28 days for birth trauma, hypoxia (lack of oxygen during birth) jaundice, feeding, sleep or behavioural difficulties, and breathing problems.

All may be associated with higher rates of medical intervention. They also lead to a longer stay in hospital following birth, and separation of mother and child.

There was no difference in the death rates between babies born in the two types of hospitals.

But why had the obstetricians responding to our 2012 report thought their higher rates of intervention had been saving babies’ lives?

Part of the reason might be a 2009 paper that concluded better health for babies born in private Australian hospitals. This research had only looked at one data set (we looked at five) and did not control for important risk factors, such as low birth weight, which can lead to more deaths and medical problems in the baby.

And there is an even bigger problem with wider ramifications. A recent Queensland study showed a significant number of pregnant women are not consulted in decision-making about the medical procedures they undergo, or informed of their risks and benefits.

This can lead to trauma and disempowerment and can affect how mothers connect with their newborn babies. Some women are so traumatised, they become depressed and even develop post-traumatic stress disorder.

Women about to give birth should question interventions to assess whether they are necessary. For those with low-risk healthy pregnancies, private obstetric care in a private hospital, with higher rates of intervention, may lead to avoidable problems for babies.

Hannah Dahlen is professor of midwifery at the University of Western Sydney. Sally Tracy is professor of midwifery at the University of Sydney. This article ran on The Conversation

OPINION: Coal industry decline in Hunter inevitable

15/02/2019 // by admin

FEDERAL member for Hunter Joel Fitzgibbon responded to the recent loss of 500 more jobs in Hunter mines by saying the region would be an economic “basket case” if the coal industry is withdrawn.
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He is ignoring the fact that the industry is withdrawing anyway, and that we need a government willing to support the diversity of the Hunter economy and help coal workers transition to a low carbon future.

The coal industry is facing decline, and communities are bearing the costs of an industry that is ignoring economic logic. While the list of proposed coalmines and expansions is long, internationally the price of coal is falling – this oversupply of coal is to blame for these job losses.

Reports of a structural decline in coal and the risk of stranded assets are becoming daily news items, as demand for our coal from both India and China slows.

In our communities, farmers, winemakers, horse breeders, rural business people, workers, parents and grandparents are calling on governments to recognise that our future does not lie in coal, and that we need to plan ahead for a diverse and sustainable economy that is not reliant on mining.

Mining is not in the top five employers in the Hunter. It is ninth (at 5 per cent) behind healthcare and social assistance (13 per cent); retail; manufacturing; construction; education and training; accommodation and food services; public administration and safety; professional, scientific and technical services.

The price of coal has dropped from $US130 a tonne in 2011 to $US81.50 now. At least half of Australia’s mines operate at a loss when the price of coal is below $US87.

The coal industry has responded with attempts to improve “efficiency” by up to 25 per cent. Between August 2012 and August 2013, 11,000 jobs were lost nationally. It is clear that the times of having a well-paid, lifetime job in the mines are over.

International demand for coal is declining. Japan, our key long-term customer, is pushing the downward trend in coal prices.

Xstrata Coal has locked in a contract for the power station operator Tohoku Electric Power Company, setting the benchmark for export coal that indicates there is little hope for any price recovery.

Australia is vulnerable to these changes, as has been highlighted in a recent report by academics from the University of Oxford.

They note that the impact of the numerous mining projects proposed here will put further downward pressure on the price of coal, and that we are at risk of creating a swath of stranded assets if we do not plan properly.

The Institute for Energy Economics and Financial Analysis highlighted a decline in demand for coal from India, and said coal projects proposed for the Galilee basin were likely to be financially unviable because of this.

They expect India to follow China’s lead and move towards renewable energy, which is becoming increasingly cheaper – the cost of solar in India has fallen 65 per cent in three years.

Much of the recent growth we’ve seen in exports from the Port of Newcastle was an expansion into the Chinese market.

In 2008-09 our coal exports to China were 3.75 per cent of the make-up of exports.

Now they are nearly 20 per cent.

Yet China is moving away from coal.

Campaigns in China by communities concerned about air pollution have led to the Chinese government setting solid targets for reducing coal consumption, with 12 of 34 provinces committing to controlling the use of coal.

These provinces cover 44 per cent of China’s total coal consumption.

The NSW and federal governments here ought to heed these warnings.

Lee Rhiannon is a Greens senator

REVIEW: Boy&Bear

15/02/2019 // by admin

TIGHT UNIT: Boy & Bear at Newcastle Panthers. Picture: Max Mason-HubersBOY & BEAR
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Newcastle Panthers

May 17

THE club was bursting at the seams with Boy & Bear fans. There were young children in miniature rock T-shirts clutching parents, loved-up teens holding hands and adults who seem to span every walk of life packed tightly into the large auditorium.

There was even a smattering of old-timers throughout the crowd, likely the original indie rock fans from the early 1980s.

The Sydney five-piece’s second studio album, Harlequin Dreams, was recorded in Sydney and reached number 1 on the ARIA albums chart in its debut week.

And for good reason.

The band strikes you as talented musicians first and famous second, with their obvious musical skill and glowing passion for their smooth, folk-inspired rock sounds.

Band members David Hosking, Tim Hart, Killian Gavin, Jonathan Hart and relatively new addition David Symes each appeared on stage bathed in an orange glow, while Electric Light Orchestra’s Evil Woman played in the background.

They launched headfirst into the set with a lively spirit and vibrancy.

The crowd joined in on the harmonies of Rabbit Song, crooning along with the impressed band.

‘‘Can I just say, I had no idea so many people liked us!’’ said singer Dave Hosking between songs, which was met with screams of approval and applause.

The set slowed as title track Harlequin Dreams begun, with Hosking bathed in purple howling beautifully to the heavy bass line. The number was a welcome contrast in tempo from their earlier upbeat songs.

Lead single from the second album, Southern Sun, reinvigorated the crowded room once again with the catchy electric guitar riff in the chorus.

Three songs from the end of the set, the band announced to a slightly crestfallen crowd that they did not perform encores.

Fans who hoped to hear arguably the band’s best-known song, a cover of Crowded House’s Fall At Your Feet, were disappointed.

As the crowds poured out the doors there was more than one bewildered fan wondering why the rendition, which came in at number 5 on 2011’s Hottest 100, wasn’t on their set list.

REVIEW: APIA Good Times Tour

15/02/2019 // by admin

From left, Camilleri, Sayer, Clapton and Morris.APIA GOOD TIMES TOUR
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Civic Theatre

May 17

FOUR legends on one stage – Russell Morris, Joe Camilleri, Richard Clapton and Leo Sayer.

A packed house, most in the Apia target range (‘‘Celebrating over-50s, living at their best’’ as Glenn Ridge spruiks in the pre-gig video blog), rolled up for a trip down memory lane and the artists did not disappoint.

Backed by the Apia Good Times Band, the boys lifted the roof from start to finish, proving legendary. The songs are certainly soundtracks to multiple generations, but what really cuts it is the live experience.

All four vocalists command the room, riding on the power of a smokin’ backing band in full stride midway through their 18-date tour.

Morris opened with a couple of new tunes (Black Dog Blues, Van Diemen’s Land) before time travelling back to the Real Thing, Sweet Sweet Love and Wings Of An Eagle.

Joe Camilleri (Ain’t Love the Strangest Thing, Harley and Rose, Certified Blue) really impressed before taking it to another level when joined on stage in a surprise visit from Vika Bull for a pumping rendition of Never Let Me Go and Chained To the Wheel.

Clapton took over after the break.

His signature sweet growl contrasted neatly from the earlier performances on anthems like Lucky Country, Girls on the Avenue, Deep Water and a new one off his latest album, Harlequin Nights, Dancing with Vampires.

Leo brought it home with a cavalcade of his hits including More Than I Can Say, When I Need Love, Thunder In My Heart, Dreaming (which he co-wrote with Cliff Richard), and You Make Me Feel Like Dancing.

Yes it was nostalgic, but it’s fair to say the room was humming for nearly three hours.

The four stars and Vika reunited for a finale of tunes including Hush, Shape I’m In, I Am An Island and Good Times.

By the end of it there was no doubting everyone on and off the stage had.

There was a Newcastle connection in the form of bass player Mitch Cairns, who used to play with local bands Qwake and Fumi Boca.

He’s since gone on to perform with many Australian legends and has produced Morris’s latest Aria winning albums, Van Diemen’s Land and Shark Mouth.

Snapper fans on natural high (23/5/14)

15/02/2019 // by admin

FISH OF THE WEEK: Adrian Callaghan wins the Jarvis Walker tacklebox and Tsunami lure pack for this 21-kilogram longtail tuna caught while spinning for tailor off the rocks north of Hawks Nest. ‘‘What a surprise,’’ Adrian reported. ‘‘We could see a bait ball and thought we might get a few tailor from underneath. The tailor were absent, however, this fella made the trip a memorable one. How hard do they go off the rocks!!!’’ A HUGE high pressure system over the east coast of Australia has provided outstanding fishing conditions this week and the snapper have responded, according to Jason “One For” Nunn, from Fisherman’s Warehouse.
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“We’ve been seeing snapper up north and in local waters, and coming off the rocks. Not big fish, but good numbers,” he said.

“We’ve seen them at Flagstaff at Swansea Heads, up to 42 centimetres this week, and coming off Blacksmiths beach too. Inshore reefs are producing as well.”

Jason has a theory that the increase in snapper action may be put down to the decrease in professional fish trapping.

To quote Billy Joel, he may be right, he may be crazy, but guys have been getting them.

Ben Hayes got a nice pair off Newcastle recently and Rickie Turner scored one off Stockton beach.

BEN HAYES

RICKIE TURNER

But the biggest by far was this 16-kilogram snapper caught by Albany local Nathan Brown off the rocks in WA on May 12.

MONSTER: Albany local Nathan Brown with his 16kg red hooked off the rocks at Albany.

It measured 112 centimetres and was just shy of the Australian record of 18.4 kilograms.

Getting back to the weather, experts are tipping we may be heading into an El Nino phase and if the current conditions hold up we’ll have had the most 20-degree days in May on record.

Salmon find lake

AFTER a lean couple of years, the salmon are back bigger than Ben-Hur in Lake Macquarie.

The “Marks Point Marksman”, Patrick Nunn, and good mate Justin Worley have been working them over in Salts Bay.

The boys got 15 last Saturday using the ever-reliable Casper Clears with the deadly little resin heads. The biggest went 3.1 kilograms.

Unlike previous years, the salmon have entered the lake and have started to spread out over to Belmont Bay, right along the edge and south down Gwandalan/Pulbah Island way.

Porcupine fun

OFFSHORE out wide has been lifeless apart from the antics of the boys on Newcastle Game Fishing Club boat Rocket, who may well have kicked off a tradition to be known in future as the “Porcupine Challenge”.

Jason was with NGFC member Steve Norris.

“We didn’t see a fish all day, and we did a lot of miles,” Jason said.

“We were in 300 fathoms, 40 miles offshore, no boats, no birds, no nothing, except this four-inch puffer fish that happened to get hit dead centre in the head by a 14-inch marlin lure and big 11-0 hook as we trolled by.

“The unluckiest toad in the ocean. I turned to Steve and said ‘you truly are the champ’. He called me names I can’t repeat. So I said ‘I’m getting our boat, Running Bear, out here next year and we’ll have a Porcupine Challenge.’ It was a bit of fun on a slow day.”

Jason reports water temp was 23.8 degrees on the Shelf but the further out you went the worse the colour got.

Dollies boom

ON a more encouraging note, the inshore reefs have been firing.

There’s a bit of current about, but anglers have been getting perch, kings and trag off Terrigal. Meanwhile, the FAD off Swansea continues to attract dolphin fish.

It’s been one of the best years for dollies – they’ve been hanging around now for nearly five months.

Bream real studs

EVERYBODY is talking about the quality of bream this year – real studs.

“Allan McMaster fished Cave Beach and got bream up to 38 centimetres on worms this week,” Jason said.

“Steve Mason got 16 in two days through the week, some nice trevally and a flathead.

“They all made comment about the width of the bream, all travelling bream with travel fat.”

Tuna about

AS our Fish of the Week shows, there’s longtail tuna about off local rocks.

Broughton Island has been firing for snapper, and there was a bit of a buzz last week about some local lake anglers who got smoked by kingfish off Moon Island.

Lizards flat out

THERE’S good numbers of sand flathead around inshore reefs, according to Cameron Judd.

He fished the sand edges last Saturday with Brett Hayes and ended up with around 30 in an hour, all around 45 centimetres.

“I said to Brett they must be lying on top of each other down there, they were so thick.” Cam said. “When we got back to the cleaning tables there were a few other people with good catches of flattys from up Redhead way so they must have been on everywhere.”

Paul Lowe got this nice flathead in Lake Macquarie.

Outing winners

NINETEEN people fished the Budgewoi Fishing Club outing last weekend, with 82 fish recorded, weigh master Graeme Morgan said.

“The winners were deep sea John Rappa, estuary Bill Ingram, secret weight Allen Friend, female winner Kathy Dixon and junior winner Cody Ison.”

John Rappa

Around the traps

MATTHEW Burgess, from Kurri Kurri, caught a three-kilogram bonito at Stockton breakwall on a bait jig chasing yellowtail. Tom Sherwood got a seven-kilogram jew in Lake Macquarie on soft plastics. And three-year-old Anna James got a 73-centimetre flathead in the lake with minimal help from her dad.

Matthew Burgess

Tom Sherwood

Anna James