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Australian aged care and youth mental health are systems abdicated by governments | Rhys Kierkegaard



Over the course of the past year as a trainee social worker, I have spent months in residence in both a residential aged care facility and in a youth mental health service operated by a hospital in Melbourne.

My first experiences as a clinician are of stepping into service systems in crisis, deprived of resources and beset by fatigue. It’s true that everyone has made sacrifices during this pandemic, but the cost of those sacrifices is borne more by vulnerable community members than privileged others.

For the elder residents of the aged care facility I was placed in, there were only three weeks between April and October where visitors could enter. Internet and phone reception in the home was severely limited by a coverage blackspot.

So insidious were the effects of loneliness that some residents had only 15 minutes of human contact a day; their primary relation was now with television.

On the day before the sixth lockdown of Melbourne was announced, case numbers were climbing, as was anxiety in the building. On several occasions immobile residents called out into the hallway for help; the alert bell located in their rooms had been unplugged. On one occasion, a resident disclosed that care staff had told them to soil themselves.

Such acts constitute a breach of aged care quality standards, but they were not motivated out of maliciousness but rather the sheer inability of staff to meet demand in a resource-constrained environment. They are not forgivable, but no amount of individual responsibility can bear the weight of structural failure.

For young people in the mental health system, the impact of the pandemic is yet to be fully realised. Prolonged experiences of disconnection and emergent care responsibilities are exacerbating already-existing inequalities and disrupting developmental trajectories.

The importance of friendship and the relational dimension of our lives is perhaps best understood by young people, who have been asked to adopt a stoic acceptance that their futures be defined as much by the speed of their internet connection as their commitment to education.

For these young people, disengagement from school and university, inescapable family instability, and the misuse of drugs for self-soothing will have lasting consequences for their life courses.

Several months ago, a youth mental health service in Victoria chopped hundreds of young people from its impossible waitlist with a text message asking them to respond within a few days. It is this sort of structural decision-making that is the cause of the yet unseen consequences of the pandemic.

As organisations and institutions attempt to deliver effective care to those in most need, those with seemingly less-urgent needs are abandoned. And how could these experiences be defined in any other way?

Now after months, indeed years, of the grief that important and essential decisions affecting our lives have caused, governments have abdicated the space. It’s a matter of individual responsibility, we are told.

In my early professional experiences, it is my observation that it is those who are surrounded by robust communities, be they family or more broad, that are able to access the intrinsic value required to protect themselves as they are now asked to take responsibility for.

Feelings of loneliness, abandonment and even shame are the substance of an emergent public health crisis that is going to take years to address. Most people will not experience severe illness or need help to make sense of their grief, but for those who bear the most responsibility – those who live with disability, are affected by long Covid or for whom disconnection is of significant consequence – the rest of us need to recognise the inequality of individual responsibility.

For our governments, who have failed to adequately plan for this moment, I hope they understand the role of forgiveness in recovery.

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Solar storms may cause up to 5500 heart-related deaths in a given year



In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart


17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus



Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer



Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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