BURN BABY BURN
THE REAL COST OF A TAN
DEM BONES EXERCISES FOR BONE DENSITY
SUN SAFETY ISSUE
Complimentary Pindara Magazine ISSUE EIGHT 2016
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ABOVE ALL, IT’S A JAGUAR.
Welcome to Jaguar as you’ve never seen it before. Now you can enjoy the dramatic drive and beauty Jaguar is renowned for, with added practicality. A master of sporting performance and everyday practicality, F-PACE raises the game. And every new F-PACE is available with Jaguar Freedom, so you’ll have the certainty of knowing your Guaranteed Future Value1 before your very first drive. Plus, the convenience of an optional 5-year servicing plan.^ Added practicality, indeed. Bruce Lynton Jaguar Corner of Southport-Nerang Road and Bailey Crescent, Southport (07) 5655 2222 firstname.lastname@example.org www.brucelyntonjaguar.com 1. The Guaranteed Future Value is a not a representation by Jaguar Financial Services as to the likely market value of your vehicle at the maturity of your finance contract and does not apply if your finance contract terminates early. The Guaranteed Future Value option is available on select vehicle models only. If the vehicle is not returned in an acceptable condition as stipulated in the GFV terms the Guaranteed Future Value will be reduced accordingly and you will be required to pay the difference. Terms and conditions are available upon application. Available to approved applicants of Jaguar Financial Services subject to normal credit criteria. ^Consult Bruce Lynton Jaguar for terms and costs of Service Plans. Jaguar and the associated logo are registered trademarks of Jaguar Land Rover Limited (incorporated in England with company No. 01672070). Jaguar Financial Services is a registered trading name of Jaguar Land Rover Australia Pty Ltd. The registered trademarks and trading name referred to above are operated and used under licence by St.George Bank – A Division of Westpac Banking Corporation ABN 33 007 457 141 AFSL and Australian credit licence 233714. JGAU1364_AFRQ_0408
THE ART OF PERFORMANCE
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REGULARS From the CEO Editorâ€™s Desk Pindara News Finance GENERAL HEALTH Seeing is Living Technological advances in opthamology
6 8 10 110
Melanoma 28 Early detection and prevention remain the key message Humans of Pindara 31 Getting to know the real people at Pindara Private Hospital Life After Breast Cancer Improving your quality of life
Back to the Future A robotic medical breakthrough
Total Disc Replacement A better surgical solution for low back pain?
Flight Mode Who deems a pilot fit to fly?
Iron 40 The element of vitality
Burn Baby Burn The real cost of a tan
Preganacy Loss Working through your grief
Supporting Someone Who is Grieving 48 Helping loved ones in their time of need Sun Smart 50 Helping teenagers undersand the message Obesity 54 The facts A Wrinkle in Time Australia's new botox laws
LIFESTYLE Spring Fling 58 Top ten spring sun care products Australian Resort & Swim Week 60 Fashion meets function Sunscreen 66 Fact or Fiction 20 Questions About Vitamin D 69 Everything you need to know
Dem Bones Exercise for bone density
Motoring 76 It's a new Dawn GC 600 Party in paradise
Gizmo Guide Swing into spring
At the Movies 96 Picks and pans from the latest movie releases Dining 100 Local & Co Spring Recipes Light on the waistline but heavy on flavour
Top Reads 94 Our pick of the latest book releases
FROM THE CEO
Pindara Private Hospital Trish Hogan CEO Pindara Private Hospital Katriya De Vincentiis Nude Publishing Executive Group Editor Published by Nude Publishing a division of Nude Creative Pty Ltd www.nudepublishing.com.au Art Direction, Editorial & Production Nude Creative email@example.com www.nudecreative.com.au National Advertising Manager Peter Wastie firstname.lastname@example.org Assistant Editor Elizabeth Kennedy Marketing Coordinator Pindara Private Hospital
From the CEO Trish Hogan CEO Pindara Private Hospital With spring well and truly in the air, the warmer weather has brought with it a busy and exciting time for Pindara Private Hospital. The stage three expansion project is well under way with the expanded and fully refurbished emergency department and South Coast Radiology due to be finished by early December. This development continues on from the Stage 2 expansion project, which I am proud to say recently won the ‘Health Facilities Over $5Million’ category in the Master Builders Housing & Construction Awards. Thank you to ADCO constructions for building this beautifully designed luxurious facility. We are also busily making progress in opening The Southport Private Hospital in Spendelove Avenue, Southport. This hospital, due to open in early 2017, will offer comprehensive mental health services, including care for drug and alcohol dependency, depression, anxiety and eating disorders to help meet the community’s demand for further mental health facilities on the Gold Coast. The campus will also provide mainstream rehabilitation inpatients and day programs, with specialised facilities. We are looking forward to sharing more as the project progresses.
Spring is also the time for babies! With our aim to continually improve patient experience here at Pindara, we have introduced the option of a king size bed into the Maternity Regal Suites to accompany the new gourmet, all-day refreshment menu. Make sure you check out the Pindara Private Maternity Instagram and Facebook pages to keep up to date with all the latest news from our maternity team. As always at this time of year, it’s important to keep up to date with your skin checks and to slip, slop, slap. We at Pindara Private Hospital are taking a proactive approach to sun safety by sponsoring the SunSafe Design Category in the 2016 Australian Resort & Swim Week Design Awards. These are set to be held at the Gold Coast Convention and Exhibition Centre from 17-20 November and I, for one, can’t wait to see the stylish sun-safe designs this year’s entrants come up with. Until next time, take care Warm regards Trish Hogan
MEDICAL CONTRIBUTORS Adrian McDonald, Diabetes Educator Pindara Private Hospital Dr Benjamin Walters, Emergency Specialist Dr Brent McMonagle, ENT Specialist Dr Charles Chabert, Urologist Dr Claire Allanach, O & G Specialist Dr Craig Layt, Plastic Surgeon Dr Daniel de Viana, Breast Surgeon Dietician team Pindara Private Hospital Dr Dilip Gahankari, Plastic Surgeon Dr Frank Howes, Ophthalmologist Dr Hanlon Sia, Clinical Haematologist Dr Herman Lee, Clinical Haematologist Jan Bond, Clinical Counsellor Dr John Gault, General Surgeon Dr Jorrie Jordaan, General Surgeon Dr Laurence McEntee, Orthopaedic Surgeon Dr Portia Millar, Dermatologist Paul Hunt, Physiotherapist and Allied Health Services Manager Pindara Private Hospital Dr Ross Sharpe, Cardiologist Dr Shannon Emmett, Clinical Haematologist EDITORIAL CONTRIBUTORS Annie Lyon Angela Metohianakis
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.
Jordaan surgical 02
Hello and welcome to our Spring Sun Safety issue of Pindara Magazine. The warmer weather has made a welcome return and with it comes a timely reminder to slip, slop and slap. This issue is packed full with stories, tips and ideas to help you stay safe in the sun this spring. If you are a fan of tanning, you will want to read our story on page 24 about the dangers of burning and how to prevent lasting damage to your body when spending time in the sun. On page 58 we round up the best spring sun care beauty buys, and on page 105 we have compiled some delicious spring recipes for you to try out at home. Get revved up with our story on the Castrol Gold Coast 600 Supercars event on page 86 and plan ahead for all this year’s action. We hope you enjoy the read!
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Doctor Benjamin Walters with the first patient in the new ED, 4.5 year old Connor Lean, who came in with an infected splinter from his cubby house.
Emergency Department Phase One Opens
Pindara Private Hospital has opened the first stage of the long-awaited new emergency department. The first stage of the new building, finished in August, is the latest completed phase of a $12-million, three-stage expansion project for the hospital, which began in November 2015 and has so far seen the completion of two new operating theatres. The emergency department will move into the newly finished building in the coming weeks in preparation for the redevelopment of the existing areas and patient waiting lounge. Emergency Department Director, Doctor Benjamin Walters, said that while the department team are looking forward to the new facilities,
patients can expect the same reliable, familyorientated, emergency department they have trusted for the last 25 years. “Our long-serving team prides themselves on providing continuity of care for all our patients and maintaining existing relationships with inpatient specialists and local GP networks.” “We will continue to have a full range of specialties including a 24-hour cath lab, interventional electrode physiology, and a paediatric service backed by established onsite in-patient specialist consulting suites.” Once complete, the upgraded emergency department will be triple the size of the original department, which opened in 1987 as the first private emergency department in Australia. “Not only were we the first but we will now also be the biggest private emergency department in Australia - certainly the biggest on the Gold Coast
- and the only one with a purpose-built isolation room for infectious disease,” Dr Walters said. The new facility will feature a well-equipped undercover ambulance bay as well as purposebuilt paediatric areas and spacious, adult treatment bays. New administrative, educational and consulting spaces will also be created and a tranquil patient waiting lounge will be the standout centrepiece. “We are committed to developing a stable team of Specialist Emergency Physicians (FACEMs) and Advanced Emergency Medicine Registrars at Pindara and the new areas will assist us to continue the extensive teaching program we have, including further simulation training for all staff,” Dr Walters said. The entire new emergency department is due to be completed well before Christmas.
Pindara set to Begin Study into Curing Migraines Cardiologist Ross Sharpe will begin research at Pindara Private Hospital into profiling migraine sufferers to examine why his unique selection process is curing migraine by a ‘simple’ procedure to close a hole in their heart and thereby develop a blood test. A migraine is a specific neurovascular headache that involves a unilateral throbbing pain, usually over the temple region of the head. Additional neurological symptoms or auras can also accompany a migraine, such as seeing stars, temporarily going blind or losing speech. Sufferers of migraines can experience symptoms so severe and sudden that they are mistaken for a stroke including being paralysed down one side of the body. Migraines with auras most often affect women in the productive age range of 20 to 50 and can be a major cause of social and economic disruption in the community. Approximately a quarter of the population has a hole in the heart known as a Patent Foramen Ovale (PFO) and it is largely unknown why this hole does not close over within three months of birth as it does with the rest of the population. Many of the people with a PFO develop no symptoms at all, while it is understood that, for some, it can be a major contributor to severe migraines with aura. Dr Sharpe says doctors can use suffering from regular severe migraines with aura as a predictor for cardiovascular events occurring in young people such as stroke. “For years it has been recognised that this hole in the heart plays a major role in contributing to migraines and that a PFO is also a risk factor in young people for stroke and cardiovascular death,” Dr Sharpe says. Dr Sharpe was intrigued about this link after receiving feedback from his patients whom he
had closed the PFO after a stroke due to clot travelling across the hole. Many indicated that they had suffered severe migraines before the operation were no longer experiencing them. “We have also found that some people also don’t respond in terms of migraines when you close the hole, so it has been a challenge to know which people will have results and which won’t after the procedure.” After presenting his paper at a major international conference in Paris, patients who are regular severe sufferers of migraines with aura and cannot tolerate or have failed to respond to anti-migraine medication are now being referred to Dr Sharpe. “These were generally young people who couldn’t work, had relationships break down, who were depressed and were basically at the end of the road.” “We performed a very specialised brain scan on these patients and found that if you take those patients with a certain size hole and pattern, then close those holes using a 30-minute day case keyhole technique, about 90 percent of them will be completely cured and about another eight percent will go from a severe disabling situation to minimal or no disability.” Dr Sharpe and his team are about to begin a study where blood is taken on both sides of the circulation pre and post closure to determine the biological footprint which is unique to people who suffer migraine, have a PFO and will get better once the hole is closed. Eventually, it is hoped that this study will lead to patients being able to have a blood test that will predict that they have a hole in the heart and that their migraines will be cured from performing the closure procedure.
Pindara Private Diabetes Clinic
Nearly 200,000 Queenslanders have Type 2 Diabetes, while 93,000 more have the disease but don't yet know it, and the numbers are increasing. Pindara Private Hospital recognises that early recognition and treatment of diabetes is crucial to the health of our community and as such, has a dedicated, bulk billed Diabetes Clinic and a Credentialed Diabetes Educator and Registered Nurse, Adrian McDonald (RN CDE). Adrian is available to see every patient with diabetes admitted for any reason and also patients admitted for other reasons who find out they have diabetes as well. Adrian says many people don’t know they have Type 2 Diabetes until they are admitted for another reason and diagnosed while in hospital. “Some people don’t recognise that signs such as excessive thirst, increased urination, blurry vision and slow healing wounds are actually warning signs of the disease,” says Adrian, “Some patients come in for a simple surgical procedure and are discharged with a new glucometer and armed with some great new knowledge to control their diabetes.” This is important because untreated Type 2 Diabetes increases the risk of complications such as heart attack, stroke, blindness, kidney failure and nerve damage leading to amputation. “The good news is that if you manage your blood sugar well you can prevent the insidious onset of these terrible complications,” says Adrian. A referral from your doctor is needed to access Pindara Private Diabetes Clinic. The clinic is bulk billed with no out-of-pocket expenses.
Seeing is Living TECHNOLOGICAL ADVANCES IN OPHTHALMOLOGY Our eyes are our most important sensory organ. The human brain obtains over 80 percent of its information via the sense of sight. Our eyes are the windows to the world. Seeing is recognising. Seeing is experiencing. Seeing is independence and freedom. Seeing is living!
Dr Frank Howes (Eye and Laser Centre Gold Coast)
Our eyes are our most important sensory organ. The human brain obtains over 80 percent of its information via the sense of sight. Our eyes are the windows to the world. Seeing is recognising. Seeing is experiencing. Seeing is independence and freedom. Seeing is living! More than half the world’s population relies on contact lenses or glasses to see well but many find that being dependent upon optical appliances interferes with their professional lives and leisure time. Thanks to ongoing developments in medicine and technology, refractive visual correction techniques have been scientifically recognised and clinically tested over the last few decades. For this reason they have come to represent an important alternative to traditional correction methods such as contact lenses and glasses. One of the latest surgical advances within the refractive surgical fields of ophthalmology is the Visumax Femtosecond Laser technology.
This technology stands on the shoulders of the knowledge, experiences and success of its predecessors and represents the third generation of laser correction. Refractive eye surgery began in the 1980s with Photorefractive Keratectomy (PRK) where the surface of the cornea is lasered into a new shape to correct vision. The term used for this process is ‘ablation’, meaning that the corneal substance is evaporated by an excimer laser. This was the first generation of laser correction and is still used under specific circumstances today. The second generation of laser treatment is the well-known LASIK (Laser Intrastromal Keratomilieusis). This process involves cutting a surface flap of corneal tissue and requires a 340-degree surface cut, leaving a small portion uncut to act as a hinge that allows lifting replacement of the flap. The ablation is performed in the bed of the flap, creating the corneal reshaping for correction of the visual defect.
During the initial years of this procedure, the flap was created by a mechanical microkeratome but this was superseded by sophisticated Femtosecond laser technology. There were a number of Femtosecond lasers built that were capable of creating a flap as described, more reliably and accurately than the microkeratome. The drawback with procedures requiring a flap, no matter the method of creation, is the fact the strong outer ‘eggshell' of the cornea is cut through 340-degrees, marginally weakening the cornea. The flap area never heals completely, so full strength never returns, and the flap can be displaced, even years later. Additionally, the extent of the surface 340-degree entry through the outer ‘eggshell’ cuts through many of the corneal nerves, producing the propensity for dry eye symptoms which is quite common after LASIK. This procedure has nevertheless produced excellent visual results over the last few decades. Enter the third generation laser procedure – the Femtosecond. Laser engineers at Zeiss quickly realised that with Femtosecond laser technology,
separation did not have to be restricted to the single nature of a flap interface separation, but if measured accurately enough, a second pass below the first of a flap could generate enough separation to allow the tissue in between - called a lenticule - to be removed and create the necessary shape change to correct vision. The extensive 340-degree cut is no longer necessary as the small amount of tissue that makes up the lenticule can be separated, folded and removed from a small incision only the size of the old hinge in the LASIK technique (approximately three millimetres). This has represented a huge paradigm shift in the concept of Refractive Laser Correction, as we can now remove the appropriate amount of tissue from the inert centre of the cornea without disturbing the strong outer ‘eggshell’. This means less corneal nerves are cut, less dry eyes, and less susceptibility to trauma while maintaining outstanding visual results. It is also an advantage that only one type of laser is required for this procedure unlike the two which are required for LASIK.
The extensive 340 degree cut is no longer necessary
PHONE 07 5564 6501 Suite 2, Pindara Professional Centre 8 - 10 Carrara Street, Benowa QLD email@example.com www.surgerygoldcoast.com.au
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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 Clinicâ€™s surgeon Dr Jason Free is one of Australiaâ€™s most highly-regarded experts in weight-loss surgery, with extensive specialist bariatric training, and is known as a foremost surgeon in the field.
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That brings us to one of the latest advancements in minimally invasive flapless surgery, The Zeiss Visumax laser. This laser still maintains the ability to do LASIK flaps and do the Femto-LASIK procedure where necessary and where circumstances dictate, but can now offer the Small Incision Lenticule Extraction (SmILE) - giving everyone a reason to SmILE with this treatment! The Zeiss Femto-LASIK surgery has already impressed patients and physicians alike with its sophisticated technology, its precision and reliability. Femto-SmILE or Femtosecond Laser Small Incision Lenticule Extraction has taken this a step further. This even higher precision, lower energy laser procedure provides targeted correction of a vision defect while leaving the surrounding corneal tissue virtually unaffected. The Visumax laser is capable of not only performing the cuts and separations as described but can also perform corrections for astigmatism and provide deep corneal stromal tracks for the insertion of splints or rings to correct the visual defects of keratoconus. With continuously improving technological advances in refractive visual correction techniques, more and more people will be able to trade in their glasses or contact lenses for an improved sense of sight with minimal interference. Seeing is believing!
The figure below demonstrates the concepts of the three generations of laser correction.
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Total Disc Replacement A BETTER SURGICAL SOLUTION FOR LOW BACK PAIN?
Assistant Professor Laurence McEntee, Spine Surgeon
If you suffer from low back pain that is interfering with your daily life, this minimally invasive procedure with a quick recovery period could be the answer for you.
What is a total disc replacement? In many ways, a total disc replacement is similar to a hip or knee replacement. It is implanted to replace a moving joint, in this case the intervertebral disc, which is the shock absorber between the bones of the spine. Degenerative disc disease is a condition where the intervertebral disc wears out and becomes painful, and is the most common cause of chronic low back pain in the young and middle aged. In addition to low back pain, people can also experience leg pain or sciatica due to the irritation or compression of their spinal nerves. The total disc replacement is designed to replace the painful disc and restore the normal disc space, thereby relieving both the symptoms of low back pain and leg pain. It is a surgical solution for individuals with degenerative disc disease who are unsuccessful in managing their condition non-operatively.
Is a total disc replacement the same as a fusion? No, there are some differences. Fusion surgery can also be used for degenerative disc disease but, with a fusion, the motion of the spine is lost at the fused level. This places more stress on the adjacent levels of the spine, as they try and compensate for the fused level. In contrast, total disc replacement surgery maintains motion at the level of surgery and does not put extra stress on adjacent levels of the spine.
Is total disc replacement experimental surgery? Not at all. Total disc replacement surgery has been performed for over 20 years and, over that time, the surgical technique and the technology has been refined significantly. There is now a large body of published evidence from across the world, including here in Australia, confirming the effectiveness and durability of total disc replacement surgery.
How is the surgery performed? The intervertebral discs are on the front of the spine so, for the lower back, the surgery is performed through a small minimally invasive incision in the lower abdomen. This anterior approach has many advantages: no muscles are cut, stripped, or split (which aids in a faster recovery from surgery), the operation can be performed in a relatively short time with minimal blood loss, and there is minimal risk of nerve damage (as the spinal nerves are on the back and side of the spine, not the front).
What is the recovery period and what are the restrictions after surgery?
TOTAL DISC REPLACEMENT
ASSISTANT PROFESSOR Laurence McEntee works with Associate Professor Matthew Scott-Young at Gold Coast Spine. Both are orthopaedic surgeons and fellowship trained spine surgeons, specialising in all aspects of adult spine surgery. Gold Coast Spine is widely regarded as the leading centre for total disc replacement surgery in Australia and as one of the leading centres worldwide.
Recovery after total disc replacement surgery is relatively quick. In general, patients are up and walking the day after surgery. Our patients have a brief stay in hospital for postoperative observation, pain relief and to work with our team from Physio Next Door to ensure that they are able to safely return home. It is essential, for an optimal result, that patients to continue to participate in a physiotherapist supervised rehabilitation program after their discharge. Total disc replacement surgery is designed to get people back to normal life and, from around three months post-surgery, there are no particular restrictions and patients generally can go back to all their usual activities of daily living.
Is everyone with low back pain a candidate for total disc replacement surgery? Not everyone is a suitable candidate for total disc replacement surgery. Surgery is only appropriate in those people whose pain is significantly interfering with their life and when non-operative treatments, such as physiotherapy, have failed to improve their symptoms adequately. If surgery is indicated, it is the surgeonâ€™s job to match one of the many surgical technologies available today with the individual patientâ€™s clinical problem. Total disc replacement is just one of the many technologies available to spine surgeons today but, in my opinion, it is an excellent surgical treatment option in clinically appropriate patients with chronic low back pain.
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Dr Dilip Gahankari is an Australian qualified specialist Plastic Surgeon based on the Gold Coast. His experience, commitment and skills have seen him become one of Australia’s leading plastic surgeons, both here in Australia and around the world. Pindara Specialist Suites, Level 3, Suite 305, 29 Carrara St, Benowa, Gold Coast, QLD 4217 Ph. 07 5539 4611 advancedaesthetics.com.au firstname.lastname@example.org
Have you ever wondered who deems a pilot fit to fly a plane, and how? Dr. Claire Allanach, a specialist in Aviation Medicine as well as an Obstetrician and Gynaecologist at Pindara Private Hospital, explains the process.
Aviation medicine is the medical specialty concerned with the interaction between the aviation environment and human physiology, psychology and pathology. Australia has a network of approximately 700 Designated Aviation Medical Examiners (DAMEs) who are practitioners of aviation medicine, although most are also qualified in other specialties or general practice. DAMEs are required to have a post graduate qualification in aviation medicine to be a member of the Australasian Society of Aerospace Medicine and to undertake appropriate continuing medical education. They are accountable to the Australian Civil Aviation Safety Authority (CASA) and are authorised to perform medical examinations and issue aviation medical certificates, which are required by pilots and air traffic controllers in order to be able to exercise the privileges of their licence.
THERE ARE THREE TYPES OF MEDICAL CERTIFICATE: CLASS 1 - Commercial or Air Transport Pilot Licence Valid for one year (or six months if over age 60) CLASS 2 - Private Pilot Licence Valid for four years (or two years if over age 40) CLASS 3 - Air Traffic Controller (ATC) Valid for two years
The aviation medical evaluates the functional ability to conduct aviation tasks, the effect of a medical condition on aviation, the effect of aviation on a medical condition and the stability of the condition for the period of the certification. Pilots and ATCs may need to undergo other tests in addition to the standard medical examination, depending on their age and class of licence applied for. These tests may include an ECG, audiogram, blood tests for fasting lipids and glucose, calculation of cardiovascular risk and an eye examination by a CASA Designated Aviation Ophthalmologist. Traditional bias has been to physical disease, although many high profile accidents have highlighted the importance of human factors in aviation. The study of human factors is about understanding human behaviour and performance, and optimising the relationship between people and the environment in which they work in order to improve safety and performance. There are similarities in this regard, between the medical industry and the aviation industry, and medical practitioners have been able to draw some valuable lessons from airline industry safety practices. Checklists, structured communication techniques, pre-event briefings, error reporting pindaramagazine.com.au
and simulator training are just a few of the aviation safety methods that have been implemented into the medical environment. There are very few medical conditions that are an absolute contraindication for aviation certification. Exceptions include epilepsy and psychiatric conditions such as bipolar disorder and schizophrenia. Similarly, there are few medications that pose an absolute contraindication to flying. Exceptions include insulin, narcotics and sedating medications. A ‘ground trial’ of one to two weeks is recommended when commencing new medications such as antihypertensives. Mental health in aviation is a major concern among airlines, regulators and passengers. This has become more prominent in recent times following high profile cases involving murder-suicide by commercial pilots, including the Germanwings flight 9525 in March 2015. In response to this incident, aviation authorities in Australia and many other countries implemented new regulations, which require the presence of two authorised personnel in the cockpit at all times. Serious psychological conditions involving sudden psychosis are rare and difficult to predict or screen for but more symptomatic conditions such as depression, anxiety, mania and substance abuse do show patterns that facilitate early detection, and are more likely to be identified on screening tests. Increased resources are also being channelled into educating pilots, their families and others in the aviation community on what to look for and how to report it, in a manner that avoids retribution and social stigma for the pilot. For example, depression is common and some conditions associated with aviation can exacerbate the symptoms of people suffering from anxiety and depression e.g. fatigue, sleep deprivation, time zone changes, social isolation and irregular access to medical care and surveillance. Depressive episodes during aviation can lead to either overt or subtle incapacitation. Well-managed depression is compatible with medical certification and CASA makes aeromedical decisions on a case by case basis. Every pilot has an obligation under the Civil Aviation Act to report any change in medical condition or the diagnosis of any previously unknown medical condition that may interfere with flight safety. Pregnancy falls into this category and must be reported. Even a ‘normal’ pregnancy results in changes in physical size, shape and agility as well as the potential for mood and cognitive changes. There are approximately 37,000 pilots and ATCs in Australia, of which only five percent are female. A medical certificate held by a pregnant woman is automatically suspended until the end of the 12th week of pregnancy, and from the end of the 30th week of pregnancy due to the increased risk of potentially incapacitating complications such as miscarriage and premature labour in the early and late periods of gestation respectively. Australia has an excellent record of aviation safety, which must remain the top priority for airlines and all operators involved. It is the role of CASA to ensure airlines as well as other aviation organisations are meeting the necessary requirements and continually working to enhance safety. Pindara Magazine
Words by Dr Craig Layt
THE REAL COST OF A TAN Some of you may be old enough to remember the days when a day at the beach meant covering yourself in baby oil and getting as red as a lobster. This would be followed by trying to tear off the biggest sheets of peeling skin and repeating the process over the summer until eventually the tan meant you no longer peeled. This all changed after the release of the iconic 'Slip Slop Slap' health campaign, which became known as one of the most successful in Australia’s history. Underpinned by extensive research and endorsed by the Cancer Council of Australia in 1981, the SunSmart campaign played a key role in the dramatic change in approach and behaviour towards sun protection from that time. However, whilst a cheerful Sid the Seagull dressed in board shorts, t-shirt and hat singing a catchy jingle had a significant influence over past generations, it appears to have lost its edge with the new generation of sun-worshippers. As little as three instances of blistering sun burn as a child in Australian conditions can drastically increase the risk of fatal skin cancers such as melanoma. With two in three Australians being diagnosed with some form of skin cancer before the age of 70, continuing to instil this decadesold message is as important as ever. A good suntan is a desirable quality according to today’s youth, and the act of sun baking is a regular occurrence. The undesirable effects that such a suntan has on collagen in the skin, skin pigmentation, and the production of skin cancers are often overlooked until the damage is already done. When we are young we are ‘ten feet tall and bullet proof’ and skin cancers and pigmented, wrinkly skin seems a long way off.
Premature sun-induced ageing is a significant problem in the Queensland population, but it often doesn’t come to the person’s attention until it is a case of trying to turn back the clock, rather than preventing the problem to begin with. Whilst some sun exposure is beneficial in stimulating vitamin D production, too much exposure to ultraviolet radiation (UVR) can cause an inflammatory response in the skin, and over time cause skin cancer. UVR may come from natural sunlight or artificial sources, such as phototherapy and tanning beds. There are two types of UVR, both of which can cause sunburn – UVA (long wave) and UVB (short wave). UVA makes up to 95 percent of the UV radiation reaching Earth, and hence our dominant tanning ray. UVA penetrates deeper into the dermis of skin, causes skin ageing, wrinkling and skin cancers. UVB damages the skin’s epidermal layers and is the main cause of skin reddening and sunburn. If we were to compare the skin of a 40-yearold Australian woman of Irish descent who has resided in Queensland her whole life to an Irish woman of the same age who grew up in Ireland, we would notice considerable differences in the ageing process. Most of these are due to the ageing effects of sun exposure. This is significant enough just with the unavoidable incidental sun exposure without the added stress to the skin of a pastime such as sun baking. To illustrate, think about sowing seeds in a field, with the seeds themselves an analogy for sun damage, and the act of fertilisation an analogy for exposure to the sun. The more fertilisation that the seeds receive, the more they grow and develop. It is the same relationship with the skin and sun exposure. The more we expose our skin to a harmful level resulting in sun damage, the more we give the sun damage the chance to grow and develop, and as a result we increase the chance that we could develop skin cancers. Once a skin cancer has been diagnosed, removal can be quite extensive. Depending on the size, severity and type of skin cancer, removal can leave the patient with scarring and sometimes deformity. If left too long, severe and aggressive skin cancers can even be fatal. The best solution to skin cancer is prevention, and the best way to go about prevention is to understand proper protection. Understanding protection and creating awareness of how to go about it is the very principle behind the Slip Slop Slap campaign, and in 2007 it was updated to include Seek and Slide: 26
1. SLIP on a shirt – make sure it is one that has enough sun protection. Long sleeved is better. Surf rash shirts are great when swimming.
SLOP on sunscreen – 30+ at least. It is important to understand that SPF50 sunscreens only offer marginally better protection than 30+. The most important thing is frequent application and that it is water resistant. There are some newer sunscreens that have microfine particles which decrease the sunscreen's visibility and these are considered safe and excellent. Some others have nanoparticles and at this time research shows them to be safe and effective.
3. SEEK – seek shade seems obvious but is worth remembering especially between 10am and 2pm.
The Layt Clinic treats the results of sun exposure every day, from the excision of a Basal Cell skin cancer and repair of the resultant defect through to attempting to reverse the premature ageing effects of sun exposure via effective and proven treatments. The Layt Clinic offers a range of treatment techniques including:
• CUTER LASER GENESIS uses a non-invasive laser technology to safely and effectively treat fine lines, wrinkles, large pores, uneven skin texture and redness. • CUTERA IPL LIMELIGHT to improve skin tone and surface imperfections associated with ageing and sun damage. • DERMAPEN SKIN NEEDLING uses multiple needles that virtually pierce the skin to stimulate collagen and elastin.
SLIDE – the eyes too are affected by the sun, with disease such as pterygium caused by sun exposure.
• PEARL AND PEARL FRACTIONAL LASER treatments will renew skin’s surface and minimise wrinkles, uneven texture and discolouration. The fractional treatment will further treat photo damage. • ANTI-AGEING injectables can help give volume back to the face, lips, cheeks and other areas. Wrinkles can also be corrected, along with other treatment concerns.
5. SLAP on a hat – caps are better than nothing but a broad brimmed hat is the way to go.
The Layt Clinic also offers full skin checks and skin monitoring with qualified medical professionals and subsequent treatment of skin cancers and other skin concerns with experienced plastic surgeons. Whilst prevention is always better than cure, if you suspect any unusual spots on your skin, a mole or freckle that is changing in shape or increasing in size or colour, early diagnosis is important so have it checked out as soon as possible.
Mel a nom a EARLY DETECTION AND PREVENTION REMAIN THE KEY MESSAGE FOR SKIN CANCER
Words by Dr John Gault
Recent figures released from the Cancer Council reported that over 460 people on the Gold Coast are diagnosed with melanoma each year. Melanoma has been named “The Queensland Disease” by authorities, as the state registers the highest rate of skin cancer in the world. Cancer Council Qld reports that across the state, 3,000 melanoma and 133,000 non-melanoma skin cancers are detected and diagnosed each year. With these statistics it really is vital that people adopt a 'sun smart' approach to our outdoor lifestyle on the Gold Coast. Melanoma is most commonly linked with sun exposure. The risk later in life is accumulated in childhood; the more sun exposure you had as a child, the greater the risk long term. The Melanoma Institute of Australia’s current recommendation for prevention is to “protect your skin from UV radiation, avoid sun exposure between 11am and 3pm. Seek shade, wear protective clothing that covers as much of your body as possible, wear a broad brimmed hat and apply SPF 30+ broad spectrum sunscreen at least every two hours”. For more on sun safety visit www.sunsmart.com.au. So what is melanoma? It is a potentially fatal form of skin cancer that affects the pigment cells in the skin called melanocytes. If left untreated, melanoma grows very quickly. It can spread outwards or downwards into the lower layers of the skin, enter your lymphatic system or blood stream and spread to other parts of the body such as the brain, liver lungs or bones. The good news about melanoma is that if it is detected early, treatment can be very effective. The current recommendation of the Melanoma Institute of Australia is to check your skin regularly (every three months). This includes your whole body, even the soles of your feet together with a yearly check up by a professional. Regular skin check ups aid in identifying any new changes to the skin. 28
Most melanomas can develop from a long-standing mole that changes or a new spot that forms on the skin. Warning signs of melanoma are as follows: • An increase in size - mole that expands sideways or becomes raised. • A change in colour – blue, black, pink, red, purple or grey colour may develop in melanoma. • Change in shape/irregular border – in contrast, most harmless moles are smooth and regular. • Itch or bleeding – note this sign is often associated with other noticeable changes. • Recent appearance – a mole or freckle that has appeared recently and is rapidly growing or changing colour. If any of these warning signs appear, get your skin checked as soon as possible. An initial diagnosis of melanoma involves a physical examination, inspection of the mole under a dermascope and an excisional biopsy. An excisional biopsy is a surgical procedure performed to remove the suspicious lesion. A local anaesthetic is injected in the area near the lesion. The lesion and a small area around the lesion will be removed using a scalpel. Stitches are then used to close the wound. This biopsy is then sent to a pathologist for examination; this examination will provide information about the lesion. At this time, if the pathologist has found melanoma cells, the next step involves staging of the melanoma to determine the likelihood of spread and if further treatment is required. In cases where there is a safe margin of healthy tissue and the staging is favourable, further treatment may not be required. If however, the melanoma is greater than one millimetre deep or is ulcerated or has a high mitotic count i.e. is dividing quickly, further surgery including surgical removal of a lymph node pindaramagazine.com.au
for investigation (sentinel lymph node biopsy) may be required. At this stage, referral to a melanoma surgeon is appropriate. If further tissue is required to be removed, this is referred to as a re-excision. This procedure removes a safe ‘margin’ of healthy tissue around the site the melanoma ensuring complete removal of the melanoma. In addition to the re-excision other investigations are required to determine if the melanoma has spread to other parts of the body. A sentinel lymph node biopsy, which is a surgical diagnostic tool to examine the spread of the disease is required if the melanoma is more than one millimetre deep, ulcerated and its cells are dividing quickly. The sentinel lymph node is the first lymph node that the melanoma cells will be present in if the melanoma has spread. This lymph node is identified and surgically removed for examination. If there are melanoma cells present in the lymph node taken for biopsy, further surgery is required to remove more lymph nodes and possible melanoma cells. In addition to surgery, melanoma that has spread (metastatic) can be treated with radiation therapy, targeted molecular therapy and immunotherapy. The stage of the melanoma will dictate the treatment required. It is important to have the appropriate level of investigation, treatment and follow up for the stage of the melanoma given with the initial diagnosis. The melanoma surgeon will discuss appropriate treatment, the likely outcomes and possible side effects, together with risks and benefits. A group of specialists referred to as a multi-disciplinary team will also be involved with discussing and planning treatment for each individual patient to optimise overall care. Melanoma left untreated or under treated can be fatal. Melanoma detected and treated early results in good outcomes. The message of melanoma continues to be about early detection and prevention. Stay sun smart and check your skin regularly. Pindara Magazine
Expert care without reservation Pindara Cardiac & Emergency Centre
Allchurch Avenue, BENOWA QLD 4217
Humans of Pindara Get to know the real people providing the world-class medical care at Pindara Private Hospital. This issue we meet Dr Brent McMonagle, an experienced ENT surgeon who has a passion for stand-up paddle boarding.
Dr McMonagle was born and raised on the Gold Coast (born at Pindara Hospital!), and educated at The Southport School, graduating from the University of Queensland Medical School in 1996. He underwent advanced surgical training in ENT surgery at Royal Children’s Hospital, Ipswich Hospital, Royal Brisbane Hospital, and Princess Alexandra Hospital, receiving his surgical fellowship in 2004. Brent then undertook additional training in Sydney (St Vincent’s Hospital, Sydney Children’s Hospital), London (Guys and St Thomas’ Hospitals, The National Hospital for Neurology and Neurosurgery Queen Square and King’s College Hospital) and Adelaide (Royal Adelaide Hospital, Queen Elizabeth Hospital, Flinders Medical Centre) in the areas of advanced ear surgery, cochlear implantation, lateral skullbase surgery, paediatric ENT surgery, advanced sinus surgery, and endoscopic skullbase surgery. PM: What made you choose ENT as a specialty? BM: Even before I knew about ENT, I was already interested in the anatomy of the head and neck. In medical school, we started off with really basic sciences such as anatomy and physiology. I don’t know why, but I liked head and neck anatomy. It is also quite complex and you need to invest time in it to understand it. You pindaramagazine.com.au
can’t easily see some of the structures in the head and neck region and you have to have a 3D way of putting things together in your mind to work it out. All that appealed to my complex ‘Type A’ personality. I also enjoyed neurophysiology and understanding how the nervous system works, particularly the special senses: your hearing, your vision, your balance, your smell, your taste - I thought that was just incredibly interesting. So without realising it, I was already heading in the direction of ENT. I wasn’t someone who wanted to do surgery first and then chose which surgical specialty I wanted to do after that. I was actually attracted to ENT for all of its aspects, not just because it was a surgical specialty. And what is unique about ENT is that it is a medical and a surgical specialty. It is quite a broad specialty and there is a lot of variety, dealing with newborn babies all the way through to elderly people. Some problems are medical and some are surgical; some operations are quick and simple to fix and other things take up to 15 hours where you may work with other specialties such as plastic surgeons and neurosurgeons. And the most important thing of all is you get to sit down to
operate! No way do I want to stand up for 10-12 hours. There is also such amazing technology in ENT. I also was always someone that wanted to do small, delicate procedures rather than orthopaedics and the ‘bang crash’ type of stuff. PM: What do you like to do in your spare time? BM: I have three boys aged five, nine and 12, so they take up a fair bit of my time. They are at such great ages where they are getting into sport and regular activities on the weekends, although we try to control that and not go too hard. My wife and I try to preserve time to do family stuff, such as hanging out as a family, playing a board game or watching a movie. I am pretty much the only person with my subspecialty interests of otology, neurotology and skullbase between Brisbane and Newcastle, which is a big area. There are a lot of retirees in that area who could benefit from cochlear implants so I am trying to figure out ways to get the message down there. More than 90% of people who would benefit from a cochlear implant actually have one, when offered one, within a year. I was recently involved in Hearing Awareness Week where we
had some audiologists from NSW and QLD come to the Gold Coast for a dinner presentation on this. I have also recently completed my PhD thesis on nerve repair and regeneration using unique nerve cells (olfactory ensheathing cells) from the nose to regenerate peripheral nerves. The olfactory (smell) nerves in the nose regenerate throughout life, and if theses cells are transplanted elsewhere they appear to have a similar effect. I am the Scientific Director of the Perry Cross Spinal Research Foundation. Perry Cross is a friend from school who was injured playing rugby 22 years ago. The foundation is working hard to support spinal research and we have had two PhD students go through Bond University and have another two going through Griffith University with the Foundation’s support. We are working hard to raise the funds to get a world-class human trial going in South East Queensland, so that is a big charity project I am working on as well. PM: With so much on your plate, how do you relax? BM: I like to go stand-up paddle boarding at the end of my street in Mermaid Beach. It
You’re Exceptional. Expect the same. 3D mammography is the most advanced technology for early detection of breast cancer 3D mammography when compared to standard mammography: - 41% more effective at detecting invasive breast cancers; - 27% more effective at detecting breast cancers; - 15-40% reduction in recall rates For expert diagnostic breast imaging, choose The Women’s Imaging Centre in Southport & South Coast Radiology at Pindara Private Hospital
Also specialising in: CT MRI X-ray DEXA
Nuc Med Ultrasound Pelvic Imaging Dental Imaging
The Women’s Imaging Centre Level 6 Premion Place 101 Queen Street, Southport 5564 0851 www.twic.com.au
South Coast Radiology Pindara Hospital Allchurch Avenue, Benowa 5597 0677 www.scr.com.au
PART OF THE SOUTH COAST RADIOLOGY GROUP
is so relaxing, even if the waves aren’t that great. Just paddling around and being out there bobbing around with the sun and the waves is so enjoyable. It is just me doing it at the moment but as soon as the boys get a little bit older I will get them involved as well. For now though I am enjoying have those few minutes where it’s just me and the water! PM: What's your favourite holiday destination and why? BM: That depends if it’s with kids or without! The best holiday I have ever had was with my wife in the Maldives for our honeymoon. I also love Europe and am desperate to get back there. For a family holiday with our three boys, we regularly go to Spicer’s Hidden Vale near Ipswich, which is great for our boys as they can ride bikes, climb trees, go horse riding and do really outdoorsy stuff.
don’t live near the beach, the Gold Coast still has that sea-breezy feeling all around. I couldn’t live in a city like Brisbane without that. Also, both of our families are here.
PM: What do you like the most about living on the Gold Coast? BM: The really relaxed lifestyle and beachy feel. We live at Mermaid Beach but even if you
PM: What is your favourite restaurant on the Coast? What is your favourite meal there? BM: Bonita Bonita and Sparrow Eating House are the two we go to the most at the moment and everything is good there. We used to go to Social
Eating House and Bar a lot as well. I really enjoy my food and wine, and I would like to understand molecular gastronomy better. Celebrity chefs such as Heston Blumenthal play with it, but they have not really looked at it from a neurophysiological point of view. Why is it that duck and pinot noir pair so well or raspberries and white chocolate? Is there something going on in the nose and taste buds which makes sense of it, or is it an individual thing? My wife is a great cook, which is really helpful for that too.
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AFTER BREAST CANCER
Words by Dr Daniel de Viana
It is stating the obvious to say that being diagnosed with breast cancer is a life-changing event. The fear of recurrence is often the primary concern, however it must be noted that mortality from breast cancer has consistently declined over the last few decades in Australia, with current five-year survival sitting around 90%. Our success in treating breast cancer means that in Australia, in any one year, well over sixtythousand women will be breast cancer survivors. This means that many can put their breast cancer fears behind them and focus on lifestyle issues to improve their quality of life. It is not an uncommon objective for women, after being treated - and even after receiving the diagnosis - to want to reduce the possibility of ever having to go through the same ordeal twice and request removal of the other breast (prophylactic mastectomy). The risk of developing a contralateral tumour (tumour in the other breast) is approximately 0.5 - 1% per year, or around 10 - 15% over 20 years. There has been a noticeable trend in women selecting
contralateral mastectomy over the last decade to eliminate this risk as much as possible. Those more likely to choose this avenue include younger women, caucasian women and those with a family history. Such women are more likely to choose breast reconstruction, typically implant reconstruction. There is no risk in detecting any recurrence of breast cancer for women choosing reconstruction and there is no risk to their long-term survival if they proceed with reconstruction. Reconstruction can be either at the time of mastectomy (immediate reconstruction) or delayed, to be performed at a suitable time after treatment (delayed reconstruction). The choice of the type of reconstruction is complex and it must be individualised but the broad choices are either tissue from the body (autologous flap reconstruction) or implant reconstruction often involving a tissue expander first, or a combination of both. There has been a ground swell of evidence, largely from population-based studies, but also interventional studies showing that lifestyle
modifications can be very powerful methods to reduce the risk of the recurrence of breast cancer. Diet is certainly one important aspect in reducing calories, and has been shown to be very successful. The Womenâ€™s Interventional Nutrition Study (WINS) randomised over 2,400 patients who had previously had breast cancer to either a normal diet or a reduced-fat diet. Those on the reduced-fat intake had resulting weight loss which lowered breast cancer events (recurrence) by around 25%. This effect was seen to be more powerful in more aggressive types of breast cancer such as those that are not oestrogen dependant and are often harder to treat. Other studies have shown that exercise after breast cancer diagnosis can also have a protective effect in reducing risk. There is good evidence that three to four hours a week or half-an-hour a day of moderate to heavy exercise, which leaves you feeling sweaty and tired on completion, can reduce risk of recurrence by 30% or more. This benefit can be seen even without significant weight loss opinion.
In terms of benefit or risk of specific food groups, unfortunately there is a lot of misinformation found on Dr Google. Dairy products and meats carry no extra risk beyond the calories they provide. And no, there are no hormones in chicken! Hormone supplementation has been banned in Australia for over 40 years. Specific dietary risks that are important include alcohol; three standard drinks per day will increase the risk of breast cancer by about 25 30%, similar to the risk of long term hormone replacement therapy. Although any amount of alcohol contributes to the risk, it is unreasonable to expect everyone to cut all alcohol out so a reasonable compromise is to have one to two standard drinks per day with a few alcohol-free days a week. Another important dietary factor appears to be vitamin D. Vitamin D can be found in fatty fish, eggs and mushrooms. In the body, conversion to active forms of vitamin D occur in the skin with sunlight exposure, and in the kidneys. Vitamin D appears to inhibit cancer pathways including
cell proliferation and invasion. The importance of vitamin D in breast cancer is still debated but there is epidemiological evidence that low vitamin D increases the risk of breast cancer. It is also observed that more aggressive forms of breast cancer are associated with lower vitamin D levels and after diagnosis of breast cancer, correction of vitamin D insufficiency appears to improve breast cancer outcomes. Vitamin D supplementation is an easy way to correct any insufficiency. What about phytoestrogens? Phytoestrogens are plant products with oestrogen-like activity. Soy beans and tofu would be typical examples. This effect is one thousand to ten thousand times less than natural oestrogens and so in reality, there is probably little risk in consuming these foods in small to moderate amounts after one has been diagnosed with breast cancer. It would be sensible though not to over indulge with large amounts of phytoestrogens. For younger women, being diagnosed with breast cancer not uncommonly interrupts their
plan to have a family. Chemotherapy can often further add to the problem by affecting their fertility subsequently. Women over 40 are more likely to be pushed into permanent menopause with chemotherapy. For those remaining fertile and wishing to have a family after diagnosis and treatment, there is no data to indicate that pregnancy will significantly affect their risk of recurrence. It is generally recommended to wait at least two years after treatment before getting pregnant. High-risk disease, particularly in the setting of an oestrogen dependant cancer, should really be advised on an individual level. The best approach is to discuss fertility issues at the time of diagnosis and include a fertility expert. It is important to remind women struggling through their stressful and often convoluted journey that there is life after breast cancer. They are able to make a number of lifestyle choices during this time that can be a powerful way of reducing further risk and as effective as, although complementary to, many of the conventional treatments we have to offer.
Back to the
Future Pindara Private Hospital trials robotic medical breakthrough
Pindara Private Hospital recently trialled worldleading robotic technology for prostate biopsies, enabling more accurate diagnosis and treatment. According to Urologist Dr Charles Chabert, the Artemis/ProFuse platform uses innovative robotic and MRI technology combined with the latest transperineal surgical approach to produce safer and more precise biopsies. "The first global application of the Artemis transperineal system was in Switzerland recently. It’s pleasing to see this world-class technology now available to benefit patients at Pindara Private Hospital," said Dr Chabert. Prostatic biopsies have traditionally been performed using transrectal ultrasound guided needle placement. This can be associated with an increased risk of infection and can make access of anteriorly placed lesions difficult. In more recent times there has been a trend towards performing these biopsies in a ‘transperineal’ fashion. This avoids placing needles through the bowel wall, which allows better access to the front part or anterior aspect of the prostate. The introduction of multiparametric (mp) MRI prostate scans has led to not only a reduction in the number of biopsies that need to be performed but also results in a more targeted, focused approach. Until recently, cognitive fusion - which relies on a surgeon’s ability to cognitively overlay real time ultrasound images with a previously obtained mp MRI - has been performed. Whilst this is a significant step forward, there are potential limitations with this approach, particularly with larger sized prostates and smaller sized lesions or ‘targets’. To overcome this pitfall, there are different platforms now available that aim to remove the guesswork with the fusion process and provide a more accurate, reliable, and reproducible platform to perform targeted prostatic biopsies. The Artemis/ProFuse platform is one such platform and is the only system available that is based on a combination of 3D semi-robotic tracking and deformable MR-Ultrasound fusion. The Artemis platform uses a mechanical robotic pindaramagazine.com.au
arm to stabilize and hold the ultrasound probe (i.e. no freehand) and track it continuously in 3D. This eliminates the deformation of the prostate during the biopsy procedure and leads to accurate and reproducible biopsy targeting. Artemis' motion compensation feature allows real time correction for intra-procedure prostate motion. In addition, all biopsies that are taken are recorded on a 3D map, which lets the doctor know where a patient’s disease might be located so that if they were to be managed with active surveillance, a precise map of the area requiring any future monitoring is available, once again removing the guesswork. The Artemis platform also allows for accurate overlay of MRI-defined lesions on real-time ultrasound. The prostate is not static, moreover, it is prone to significant movements due to
breathing, bladder volume and changes in bowel filling. Deformable fusion is necessary to account for these shape changes during the initial MRultrasound fusion planning, and in conjunction with robotic mechanical tracking, it eliminates subsequent freehand deformation during the procedure as well. The Artemis system is the first MRI/trus fusion system able to function in a transperineal as well as a transrectal approach. The Artemis/ ProFuse platform provides a unique, accurate and reproducible biopsy targeting and therapy planning platform which can allow more accurate and selective prostatic biopsies. The first global application of the Artemis transperineal system was in Switzerland recently followed by Pindara Private Hospital.
Iron the Element of Vitality Shannon Emmett (Clinical Haematologist), Herman Lee (Clinical Haematologist) and Hanlon Sia (Clinical Haematologist)
We are all aware of the prevalence and importance of water. Similarly, iron is the most common element on earth and is critical to the healthy functioning of our bodies. Despite this, iron deficiency is the most common micronutrient deficiency in the world and affects billions of people, particularly women of childbearing age. The World Health Organization has defined health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Many people with low iron levels do not have a diagnosable disease but the physical, mental and social effects of low iron prevent them from living with complete health. Poor iron status has been shown to affect cognition (attention, memory, spatial ability and executive functioning), mood (irritability, apathy and depression), work productivity, athletic performance and immunity.
Why do we need iron? Approximately 65% of all the bodyâ€™s iron is found in red blood cells where it forms part of the haemoglobin structures. These complexes carry oxygen from the lungs to the rest of the bodyâ€™s tissues. If there is inadequate iron then haemoglobin production is reduced (anaemia) and the ability of red cells to transport oxygen drops. The result is fatigue and reduced physical performance. But one doesnâ€™t have to develop anaemia to be affected by low iron levels. Every organ and tissue in our bodies is made up of cells and each cell contains mitochondria, which are the powerhouses of cells. These organelles use the breakdown products of carbohydrate (glucose), fat or protein to fuel the production of energy for cells to function. They are like the solar panels
of every cell that provide energy for muscles (including those in our limbs, hearts, blood vessels and guts) to contract and relax, for nerves to transmit messages, and for the lining of our guts to absorb nutrients. Iron is needed to produce substrates and enzymes needed for mitochondria to function. The cells of our hearts and skeletal muscles have particularly high energy demands and are very sensitive to iron deficiency.
How much iron do we need? Pregnant women have the greatest need for iron at approximately 27milligrams of iron per day. This is due to 50% more red cells being made during pregnancy and the iron requirements of the developing baby and placenta. Many women develop iron deficiency during pregnancy or struggle to regain their iron stores after pregnancy, meaning that they enter into another pregnancy iron deficient. The effects on the growing baby can be significant. Maternal iron deficiency is associated with intrauterine growth restriction and prematurity. Of further concern is that babies who are born iron deficient may experience delayed growth and development and there is an association with cognitive and behavioral problems for some of these children later. Women of childbearing age need 18 milligrams per day, due to menstrual blood loss. This is more than double the requirement for men at eight milligrams per day. Many women are not able to keep up with this high daily requirement and develop iron deficiency. Interestingly, even growing children as young as one to three years old need more iron per day than their fathers. This highlights the importance of nutrient-rich foods for our children.
RECOMMENDED DAILY INTAKE
All 1-3 years
9mg per day
10mg per day
8mg per day
15mg per day
8mg per day
11mg per day
18mg per day
8mg per day
8mg per day
PREGNANT & LACTATING WOMEN
RECOMMENDED DAILY INTAKE
All pregnant women
27mg per day
Lactating women, 14–18 years
10mg per day
Lactating women, 19–30
9mg per day
NUTRITION AUSTRALIA’S RECOMMENDED DAILY INTAKE OF IRON:
How does iron deficiency develop? Iron deficiency can occur if one does not eat enough iron rich foods, if there are problems with the absorption of iron in the gut, or if blood loss is occurring. Blood loss is most commonly through heavy menstrual bleeding or from bleeding in the gastrointestinal tract. The iron status (how much iron a person has stored) has the greatest influence on the absorption of non-heme iron. Heme iron absorption is not regulated by the bodyâ€™s control mechanisms but non-heme iron is, so that less iron is absorbed if a person has good iron stores. This process is regulated by the peptide hepcidin that is produced by the liver and fat cells (adipose tissue). Hepcidin reduces the absorption of iron so that less iron is absorbed if a person has good iron stores. But the process goes awry in the setting of inflammation or obesity. In both of these situations, the amount of hepcidin produced is not related to the amount of iron stored and iron deficiency can develop. Coeliac Disease is an autoimmune condition in which antibodies develop against gluten, which is found in wheat, barley, rye and some oats. These antibodies attack the cells lining the small intestine, particularly the duodenum, and reduce the absorption capacity of nutrients including iron. Coeliac Disease occurs in approximately one percent of people and can be diagnosed with a blood test and a biopsy at the time of gastroscopy.
Optimising iron in our diets The Australian Food, Supplement and Nutrient Database provides a breakdown of macro and micro nutrients of foods per 100 grams. Interestingly, the iron content in just over a tablespoon (18 millilitres) of dried herbs or spices is equal to the iron content in a 100-gram beef steak.
MG IRON PER 100G OF FOOD
HEME IRON (ANIMAL SOURCES)
dried herbs and spices (cloves, coriander, cumin, ginger, nutmeg, thyme, cinnamon and oregano)
pumpkin seeds (pepita)
dried soya bean
6.5 - 7.5mg
chia seeds, fresh coriander, dried lentils, fresh rosemary
5 - 5.7mg
mutton, venison, sardines, lamb
linseed, red kidney beans, sundried tomatoes, tahini, cashews
4.2 - 4.8mg
spelt flour, spinach, quinoa, dark chocolate
3.5 - 4mg
wild dugong fish
almond nuts, oats
1.5 - 2mg
1mg 0.5 - 0.6mg
NON-HEME IRON (PLANT SOURCES)
coconut flesh (dessicated, shredded or chips), cooked bok choy broccoli, wheat flour
chicken, most fish
lettuce, sweet potato, kale, cauliflower, capsicum, sweet corn, potato and zucchini, cooked brown rice
Unfortunately, despite many plant sources of iron being very iron rich, the absorption of iron from animal sources (heme iron) and from plant sources (non-heme iron) is not the same. Heme iron is absorbed more uniformly than non-heme iron with 15% to 35% of that which is eaten being absorbed. The absorption of non-heme iron depends on the balance between factors in our food that inhibit or enhance iron absorption. In meat eaters it is estimated that heme iron makes up 10% to 15% of the iron that we eat, but it contributes more than 40% of the total iron that is absorbed. When trying to improve your iron levels it is imperative that you eat foods that are rich in iron in combination with those that are high in enhancers and low in inhibitors of iron absorption. When examining diets and the foods that are consumed most regularly, and in combination, it starts to become clear why iron deficiency is so prevalent.
Inhibitors of iron absorption The factors in our foods that inhibit iron absorption are calcium, certain proteins, phytates and polyphenols. Calcium is the only inhibitor that reduces absorption of both heme and non-heme iron, while the other inhibitors only affect non-heme iron.
If calcium-rich foods are ingested at the same time as iron, then calcium can prevent the absorption of iron. The inhibitory effect is from 165 milligrams calcium and higher. A cup of milk contains approximately 300 milligrams of calcium. Milk, cheese and yoghurt (but not cream or butter) are particularly high in calcium.
In addition to the effect on iron absorption caused by calcium in milk, the two milk proteins - casein (used to make cheese) and whey - as well as the proteins in egg whites and soya beans all decrease iron absorption.
Phytic acids are the phosphorus storage unit found in many plants, particularly grains, nuts and seeds. This anti-nutrient inhibits the absorption of the important minerals calcium, magnesium, zinc and iron. If the molar ratio of phytate to iron is more than 1:1 then iron absorption will be reduced. For example, the molar mass ratio of phytate to iron in cocoa is approximately 10:1, so unless one reduces the phytate content in cocoa, one isnâ€™t absorbing this excellent source of iron. Methods of reducing phytic acids in foods are cooking or roasting (so choosing cocoa rather than cacao), sourdough fermentation rather than yeast fermentation of breads and soaking and then toasting or dehydrating (activating) seeds and nuts.
Polyphenols are a group of antioxidants that are abundant in foods and have been associated with improvements in various diseases including cardiovascular, neurodegenerative, diabetes and cancers. For example, several studies have reported that regular intake of dark chocolate that contains high levels of polyphenols improves the functioning of the lining of blood vessels (endothelium) so that blood vessels can open up (vasodilate) better. So, polyphenols are micronutrients that we want in our diet, but unfortunately they bind to iron and reduce iron absorption. Depending on their structure, polyphenols are grouped into the phenolic acids (including tannins), flavonoids, stilbenes and lignans. These micronutrients are found in black and green tea, coffee, red wine, berries, plums, apples, pears, potatoes, wheat, rice, corn, capsicums, tomatoes, dry legumes (soya beans), tofu, beans, cherries, grapes, citrus and chocolate.
Foods that enhance iron absorption
ASCORBIC ACID (VITAMIN C)
Vitamin C is a powerful enhancer of iron absorption. Foods that are rich in vitamin C (in descending order) are limes, basil, seaweed, guava, chilli, red capsicum, parsley, lemon, broccoli, brussels sprouts, kiwi fruit, watercress, green capsicum, orange juice, cauliflower, red cabbage, dill, pawpaw, orange, kale, mandarin, snow pea, lychee, coriander, strawberries, white cabbage, spring onion, rockmelon, spinach, leek, sweet potato, spices (cloves, coriander seed, cumin seed, nutmeg, thyme, turmeric, allspice, cinnamon), zucchini, feijoa, plum, broad beans, tomato, mango and chicken liver. Cooking, processing and storage can lead to the degradation of vitamin C in foods.
The presence of meat, fish or chicken in a meal can increase the iron absorbed from vegetables/plant sources (non-heme iron) by two to three-fold. Thirty grams of muscle tissue has the same effect as 25 milligrams of ascorbic acid.
The role of the garden in your gut Our gastrointestinal tract, particularly our colon, is home to trillions of microbes. This gut microbiota is a mix of bacteria, viruses and protozoa. Although most iron is absorbed in the duodenum, iron absorption proteins are pindaramagazine.com.au
present in the colon and it appears that healthy gut bacteria can improve the absorption of iron that occurs here. One can improve the quality and quantity of one’s gut bacteria with both pre and probiotics. Prebiotics are the foods needed for gut flora to thrive and probiotics are supplies of good bacteria. Examples are kombucha, sauerkraut and Inner Health Plus supplements. In summary, animal sources of iron are absorbed with the least interference, and livers are the best animal source. Calcium interferes with the absorption of all iron so it makes sense to eat separate calcium-rich meals (with milk, cheese and yoghurt) and iron-rich meals that don’t contain high levels of calcium. There are many plant foods with excellent iron content. A non-heme iron-rich meal would need to be free of dairy (other than butter and cream), eggs, soya and low in polyphenols. Phytates would need to be reduced, for example by activating seeds and nuts. One would include vitamin C rich foods and some meat, fish or chicken to improve the iron absorption. Lastly, tend to “the garden in your gut”.
Blood loss For many women, iron deficiency is caused by heavy periods (menorrhagia) and this requires treatment by a gynaecologist. When there is no clear cause for iron deficiency, then bleeding from the gastrointestinal tract requires exclusion with a gastroscopy and colonoscopy.
How do we test for iron deficiency? The best marker of iron stores is the ferritin level. A level less than 30 mcg/L is consistent with iron deficiency. But if one is about to lose blood, for example during major surgery, then a ferritin of greater than 100 mcg/L is required to enable the bone marrow to produce adequate red blood cells to recover. Ferritin does rise due to infection, inflammation or obesity (independently of the iron present). In these situations iron deficiency may still be present despite having ferritin of greater than 100 mcg/ so the transferrin saturation and/or the soluble transferrin receptor levels are required to determine if iron stores are low.
How do we treat iron deficiency? Oral iron can be an effective treatment but many people experience gastrointestinal side effects including nausea and constipation or diarrhoea. In pregnancy, once a woman is iron deficient it is not possible to correct the deficiency with diet alone. The dose of oral iron required to treat iron deficiency is 65 milligrams of elemental iron daily and 100 – 200 milligrams elemental iron
daily is required once anaemia has developed. Enteric coated and sustained release preparations are often better tolerated but are less effective as they carry most of the iron past the duodenum where it is predominantly absorbed. Liquid iron is also better tolerated but this is because of the small amount of elemental iron present. The alternative is intravenous iron. For many people, this treatment is the difference between struggling through every day and functioning at full speed again. It is particularly indicated for those who are intolerant to oral iron, have poor absorption, for those who have such significant blood loss that oral and dietary iron alone cannot keep up with their requirements (for example very heavy periods), or for those who need to have a rapid rise in their haemoglobin and/or iron stores due to severe symptoms or imminent surgery or delivery. When compared to oral iron, intravenous preparations improve the haemoglobin levels faster and replenish the iron stores better. Ferric carboxymaltose (Ferinject) can be given as a single, rapid (less than 15 minutes) intravenous infusion.
Disease states that benefit from iron therapy There are several conditions in which it has recently been recognised that iron deficiency plays a key role. In people with heart failure it has been shown that iron deficiency, with or without anaemia, is associated with lower exercise tolerance, poorer quality of life, more time in hospital and, most significantly, higher rates of death (mortality). Notably, in these studies iron deficiency was defined as a ferritin of less than 100 mcg/L or a transferrin saturation of less than 20%. Unfortunately it has been shown that in those with heart failure, iron absorption from oral iron is often poor and gastrointestinal side effects are common. Treatment with intravenous iron has been shown to improve symptoms and exercise tolerance (NYHA functional class) and reduces hospitalisation. People with diseases of the gastrointestinal tract that reduce the ability for the gut to absorb iron, such as Coeliac Disease or inflammatory bowel disease, as well as those who have had gut resections or gastric bypass surgery, can benefit greatly from IV iron therapy. Other diseases in which anaemia is prevalent and has been shown to be associated with poorer outcomes are renal failure, intracerebral hemorrhage, chronic obstructive pulmonary disease, acute coronary syndrome and people undergoing cardiothoracic surgery. Anaemia that is present prior to surgery is associated with higher rates of complications and even death. Several guidelines recommend treatment of iron deficiency prior to surgery if the expectation is that blood loss will exceed 1,200 millilitres. Treatment is offered if ferritin levels are less than 100mcg/L or transferrin saturations is less than 20%. Pindara Magazine
Pregnancy Loss 46
WORKING THROUGH YOUR GRIEF • Avoid making major life changes for the first few months. • Take a list of questions about this pregnancy or subsequent pregnancies to your General Practitioner or Specialist Obstetrician for discussion. • Send notes to family and friends informing them of the birth and death of your baby. • Keep a journal, write poetry or write a letter to your baby. Words by Jan Bond, Clinical Counsellor
It is important to note that not everyone who loses a baby to miscarriage will be significantly affected by their loss. Also, those who have terminated a pregnancy for medical or social reasons will differ in their reactions, with some people experiencing intense grief or a delayed grief reaction at some time during their lives. The severity of the loss depends on circumstances (social, psychological and spiritual) of the individual at that particular moment in time. Those who have been significantly affected will grieve the loss of their baby. All too often, friends, family and the greater community minimise the grief of parents’ whose baby has died. Comments such as, “you will have another”, “it wasn’t meant to be”, “it was God’s will”, “there must have been something wrong”, are not helpful and can exacerbate feelings of isolation. When your baby died, life as you experienced it during your pregnancy changed, and the hopes and dreams of becoming parents to this child have been shattered. You will find yourself assaulted by conflicting emotions, which will ebb and flow in no specific order. No two people grieve the same and you will be doing yourself an injustice by comparing yourself to your partner or others. Grieving is natural, normal and necessary. As you work through your grief, you will learn to live healthily with your loss and find a safe place in your life to keep precious memories of your pregnancy and baby. Take time to communicate your feelings and needs to significant others, and give yourself permission to seek professional help if required. Sometimes finding a safe place to talk to someone who is impartial can be helpful.
• Plan ahead for significant dates, e.g. birth date, due date, Mother’s Day, Father’s Day, Christmas, Easter. Sometimes just lighting a candle in memory of your baby on these days can bring comfort. • Try to establish some routine in your day and go to bed around the same time each night. • Drink lots of water, maintain healthy eating and exercise. • Discuss your feelings and needs with friends and family. Don’t be afraid to ask for help or accept offers. Be specific about what you need and how you want to be supported. • Consider contacting a pregnancy loss organisation, a support group, or an online forum. If you have spiritual beliefs, you may wish to seek counsel with a religious minister. • Find some time for self-care, beginning with small steps e.g., short walk on the beach or park, time out with your partner or a friend, massage, pedicure etc.
• Remember it’s ok and healthy to have some fun, sing, dance and laugh. This doesn’t mean you are dishonouring your baby (feeling guilty about doing these things is also normal).
CREATING MEMORIES • Purchase or make a memory box large enough to keep pregnancy indicator stick, photos, birth records, wrist bands, lock of hair, ultrasound pictures, medical reports etc. • Plant a tree or shrub in memory of your son or daughter. • Create a scrapbook. A number of scrapbooking stores run classes specifically for memory albums. • Choose a name for your baby, or name a star in memory of your child. • Paint or draw a picture of your baby or have a professional artist paint or sketch from a photo or description of your child. • Buy a piece of jewellery or keepsake. Some parents choose a tattoo in memory of their baby.
However your pregnancy ended is your journey and yours alone. Do not judge yourself harshly. You did the best you could at the time. If you find yourself struggling to cope, contact a counselling telephone line, support group, a counselling health professional or spiritual leader for support.
(Source: J. Barletta, & J. Bond, (Eds.). The Home Therapist: A practical, self-help guide for everyday psychological problems. Brisbane, Australia: Australian Academic Press. ©)
Supporting Someone who is grieving
Words by Jan Bond, Clinical Counsellor
When someone you know is grieving there is often a sense of helplessness about how best to help and a fear of saying or doing the wrong thing. However, doing or saying nothing at all can exacerbate their pain and leave them feeling isolated, confused, and hurt around the perceived loss of support. If you are feeling lost and can’t find the words, one of the most precious gifts you can give someone who is grieving is not to try to fix them or fill the gaps with words, but to sit in silence and listen. • Accept that you cannot take away the pain or gloss over the loss with wise words and stories about your own and others’ losses. • A personal visit, phone call or hand written note can be comforting. Potted plants, flowers, or small personal, thoughtful gifts are also an acceptable way to express your feelings. • When someone is grieving, their energy levels are low and they will tire easily, so be aware of keeping your visits short, or ask them to let you know when they want some time alone. • Offer to be available to help out with the practical day-to-day chores, such as driving, cleaning, cooking, shopping, gardening. Be mindful about asking permission before jumping in to help, and check out their specific needs. • Realise that your friend is a unique individual, and will grieve in their own unique way, in their own time.
• Remember you don’t have to say anything, sometimes your presence in their life is all they need. • Make a note of the date of your friend’s loss and give them a call or send a note on the anniversary of that day. Family holiday times may also be tough. • In the initial stages of grief there is a degree of shock and denial, and for the first few weeks or so they have lots of support and personal details to take care of. However, there comes a time when they begin to realise the finality of their loss. When this occurs they sometimes feel they are going crazy. You can help by making regular contact throughout the months ahead. • While it is a privilege to walk with someone through grief, it is also important to nurture and care for yourself. Don’t get onboard the guilt train. If you feel tired and overwhelmed, it’s okay to take time out to reboot your own energy levels. Taking a break for you will enrich your body, mind and spirit. • Most importantly, be proud that you have had the courage to face your fears and be available to make a difference to someone who’s grieving. It is not unusual for those who are grieving to make statements about being with their loved one or verbalising a belief like they can’t go on without them. If you are concerned about the mental health of the person you are supporting, talk to them, acknowledge their pain and ask the hard questions.
• Give them permission to express their pain without judging or dismissing their feelings. Let them know they are safe and that it’s okay to cry, shout, scream or be angry about their loss in your company. • When we see someone hurting, it is a normal human response to want to ease their pain. However, with the best of intentions, our words can be insensitive. Avoid statements such as, “I know how you feel”, “It’s for the best”, “Be grateful he/she didn’t suffer”, “There are plenty of fish in the sea”, “You are blessed to have had so many years together”, “Get on with it”, “You’ve got to be strong”. Instead, validate their pain by listening and reflecting.
(Source: J. Barletta, & J. Bond, (Eds.). The Home Therapist: A practical, self-help guide for everyday psychological problems. Brisbane, Australia: Australian Academic Press. ©)
H E L P I N G T E E N AG E R S TO B E
SUN SMART Australians have been listening – and adhering – to the highly successful Sunsmart campaign for more than 35 years. Indeed, the key sun protection message of Slip, Slop, Slap, launched in 1980, has played an important role in changing our attitudes and has helped to achieve reductions in personal sun exposure. Adolescents, however - who spend more time in the sun than any other population group generally adopt sun protection behaviours less frequently than adults, and it is more challenging to achieve attitude and behaviour changes among teenagers. If the attitudes and behaviours of teenagers are to change, how can we influence their choices? St Hilda’s School Deputy Principal Ms Wendy Lauman recommends focusing on healthy, practical and realistic approaches that can be sustained by this sector of the community. Here are nine ways St Hilda’s School, with 1,170 girls from ages four to 18 years, tailors the ‘sun smart’ message.
Consistency is key to success. Keeping on message about the importance of self-protective behaviour provides a solid foundation for dealing with challenges such as fashion trends and tanning promotions.
Easy access to sunscreen. Students are educated about the correct use of sunscreen and the level of protection it provides. Dispensers for SPF 30+ broad spectrum, water resistant sunscreen are placed in busy areas, change rooms and at sporting venues, offering a practical means for all students and community members to adopt life-long habits.
Accentuate the positive aspects of planning. Where possible, outdoor activities and events are scheduled earlier in the morning or later in the afternoon, or at indoor venues, to avoid long periods of exposure to the sun. Planning for outdoor activities includes consideration of sun protective clothing and hats, sunglasses, sunscreen and shelter.
Integrate aims of the Sunsmart campaign with other activities, such as service leadership and community fundraising campaigns. Raising funds for melanoma research, for example, has the added benefit of teaching young people about a number of serious issues related to sun exposure.
Develop partnerships with people and organisations that support your health promotion messages. This may include sporting, training and media professionals.
Curriculum focus. Students may be challenged to include self-protective ideas and initiatives in their school lives by examining the goals of the Sunsmart campaign.
Role modelling. Adolescents are highly influenced by people they interact with and look to for guidance. Making the Slip, Slop, Slap routine highly visible involves using a combination of sun protection measures (sun protective clothing and hats, sunglasses, sunscreen and shade) when participating in and attending outdoor school and family activities.
There’s Slip, Slop, Slap and the fourth ‘S’ – Shade. St Hilda’s School Council ensures shade is available in the school grounds, particularly in areas where students congregate. Shade provision is considered in plans for future buildings and grounds and the redevelopment of existing facilities. Shade is a ‘must’ when the school day is concentrated between approximately 10am and 4pm when the sun's rays are strongest.
Share your experiences or those of your close friends and relatives. Australia and New Zealand have the highest melanoma rates in the world with the Queensland incidence rate of 71 cases per 100,000 people (for the years 2009-2013), vastly exceeding rates in all other jurisdictions nationally and internationally. Your personal story will have more impact on your teenager than any reasoned advice and cut through these statistics.
ST HILDA’S SCHOOL – Dream and Achieve JUNIOR SCHOOL OPEN DAY 9am to 12 noon, Friday 14 October Come and meet St Hilda’s students and staff. Enjoy classroom activities from Pre-Prep to Year 6 and see girls’ education in action. Book your tour online: sthildas.qld.edu.au
STEM-TASTIC PROGRAMS FOR GIRLS St Hilda’s Prep to Year 6 girls are embracing abstract concepts such as principles of Atomic Theory and Coding. To encourage our girls to change the world and create unimaginable futures, we have designed a $1.3 million STEM (Science, Technology, Engineering, Mathematics) centre.
NEW BUS ROUTES IN 2017 St Hilda’s School, located at Southport, will introduce bus services on North and South-bound routes in 2017.
For information contact Head of Admissions 07-5577 7232 sthildas.qld.edu.au firstname.lastname@example.org
LOVE COMPASSION FORGIVENESS HOPE GRACE
Words by Dr Jorrie Jordaan
No longer considered a cosmetic issue caused by a lack of self-discipline, the World Health Organisation (WHO) has recognised that obesity is a chronic progressive disease, associated with multiple health problems.
Obesity adversely affects every system in the body. Research has shown that an increased BMI is associated with an increased rate of death from all causes. Obesity has become one of the leading causes of preventable death in Australia, second only to smoking tobacco. At any age, having obesity shortens your lifespan. Younger people (aged 25-35), who have severe obesity are 12 times more likely to die early than their peers without obesity. Adults who have obesity at 40 years of age die on average seven years sooner than adults whose BMI is within the healthy range. The impact of years of life lost is greater for men than for women. It has been estimated that the steady rise in life expectancy over the last 200 years may come to an end due to the increasing prevalence of obesity.
How can I tell if I have obesity? The important distinction for people to make is that an individual is not obese, they have obesity. Obesity is not part of a person’s identity; it is a disease to overcome. Body Mass Index (BMI) is a practical way to evaluate whether your weight is appropriate for your height. We tend to label the BMI 18.5-24.9 category as ‘Healthy’ rather than ‘Normal’ as people with obesity can be sensitive to the implication that they are abnormal if they are outside this range (and since the majority of Australians have BMI >24.9 this has become the new ‘normal’).
160 120 100 80 60 40 160
How is obesity affecting my health? Out of ten people with obesity, eight people will develop one of the following obesity related co-morbidities and six people will develop at least three:
Type 2 Diabetes Heart disease Stroke Cholesterol problems High blood pressure Chronic kidney disease Respiratory disease Obstructive Sleep Apnoea Polycystic Ovarian Syndrome Infertility Osteoarthritis Fatty liver Heartburn and reflux Cancer – particularly breast, bowel, liver, kidney, prostate or endometrial Depression Blood clots Gall stones Abdominal hernias
What can I do about it? Fortunately, obesity can be treated. Weight loss can reverse most of the damage done by obesity. For people with severe obesity, diet, exercise and lifestyle intervention typically causes sustained weight loss of between 5 to 10% of excess weight. Sustained weight loss of more than 5% of initial body weight is regarded as a good medical result. For example, an average height female weighing 150 kilograms who achieves a sustained weight loss of kilograms would be considered to have a good medical result. However, this amount of weight loss is not likely to significantly reduce her medical co-morbidities. The American National Institutes of Health (NIH) has reported that people with severe obesity are resistant to sustaining weight loss achieved by the traditional recommendation of reducing calories and increasing exercise. Indeed, the NIH has recognised that bariatric surgery is the only effective long-term treatment for severe obesity. Gastric sleeve and gastric bypass surgery typically produce sustained weight loss of between 60-80% of excess weight. For an average height female weighing 150kg, this
would be weight loss of between 51 to 68 kilograms. Some patients achieve and sustain 100% excess weight loss. The exceptionally high reduction in morbidity and mortality that results from weight loss surgery is due to the improvement or resolution of obesity-related disease. The benefit to the health system is that bariatric surgery also reduces the cost of managing these obesity related disease. Researchers in the United Kingdom found insurers fully recovered the cost of bariatric surgery within two to four years as patients became healthier and had fewer medical problems. Bariatric surgery is a tool that is most effective when combined with a comprehensive treatment plan delivered by a multi-disciplinary team. At the Surgical Weight Loss Centre, Dr Jordaan heads an-established team of dietitians, psychologist, nurses, anaesthetists and medical specialists to support their patients through an intensive two-year programme followed by annual reviews for life, to ensure excellent long-term patient results. Pindara Magazine
A Wrinkle in Time
Words by Dr Dilip Gahankari
WHAT AUSTRALIA’S NEW BOTOX LAWS MEAN FOR THE CONSUMER
Anti-wrinkle injections and fillers are now a booming industry worldwide. With growing demand, unscrupulous practices have emerged to make a quick buck, offering these injections to the unsuspecting and unaware. Often promoted using the power of social media, these ‘bargain deals’ take advantage of loopholes in advertising guidelines, or rather, a lack of more stringent ones! Although these injections have always been regarded as "Schedule 4 Medications" – meaning they can only be prescribed by registered medical practitioners – many of these injections have been administered by inadequately qualified or trained nurses, or even non-health professionals such as beauty therapists. Often, the injections were administered in unlicensed premises or even at home under the trendy banner of ‘BTX Parties’. For some time, the Australian Society of Plastic Surgeons has been demanding stricter guidelines to regulate the appropriate use of these potentially harmful 'medications'. After accepting submissions from health professions, nonprofessionals, community groups and others, the Australian Health Practitioner Regulation Agency (AHPRA) finally released their guidelines earlier this year.
These guidelines are effective from October 1, 2016 and I believe they are a major step forward in providing much needed regulations in this burgeoning ‘health industry’. The guidelines are applicable to all health professionals who undertake these cosmetic surgical or nonsurgical procedures. It is mandatory, according to the guidelines, that clients seeking antiwrinkle or filler injections have their first consultation with a registered medical practitioner either in person or by video consultation (Skype or FaceTime). The guidelines further recognise the important role that proper supervision and post-operative care from qualified medical practitioners plays in providing safety and assurance to patients seeking these injections. In my view, these guidelines will certainly curb unscrupulous corner shops, beauty clinics and home-based anti-wrinkle and filler injectors, and hopefully prevent the adverse effects that often arise as a result of inappropriate techniques and a poor knowledge base. Although they are designed to be followed by health professionals, I believe it is important that all our readers and clients are familiar with these guidelines, so they don't fall prey to the advertising gimmicks from non-qualified clinics or personnel.
These new laws will mean that in addition to stricter guidelines for injectables, doctors must also: • Allow a seven-day cooling off period for all patients considering a major procedure. • Allow a three-month cooling off period for patients under the age of 18. • Insist on mandatory counselling by a psychologist, psychiatrist or GP for patients under the age of 18. • Take "explicit responsibility" for postoperative care, as well as emergency facilities when using anaesthesia. • Provide mandatory consultations either in person or via Skype/ FaceTime for patients considering prescriptiononly injectables such as Botox and fillers. • Provide detailed written information about costs for patients. The full guidelines can be viewed on the AHPRA website at www.ahpra. gov.au
Spring Sun Care Products
1. Elizabeth Arden Eight Hour® Cream Nourishing Lip Balm with Sunscreen
3. Jurlique Sun Specialist After Sun Replenishing Moisturising Lotion
This daily moisturising treatment replenishes lips with eight essential vitamins, nutrients and minerals while providing advanced broad spectrum SPF 20 sun protection against damaging UVA/UVB rays. Lips feel softer and smoother with a healthy-looking, radiant shine.
This post-sun hydrator is designed to help restore moisture to the skin and maintain a lasting, even tan. Deeply hydrating and comforting, it is suitable for both the face and body.
2. Aveda Sun Care After-Sun Hair Masque
RRP $49.95 Aveda’s intensive cream masque restores sun-exposed hair, moisturises, and helps defend against free radicals. Fortified with Morikue™ protein, tamanu oil, certified organic shea butter, green tea extract and vitamin E, the treatment will leave your hair feeling ultra soft and silky smooth.
4. Clinique After Sun Rescue Balm with Aloe This moisturising balm contains soothing aloe vera to help calm sun-exposed skin. Clinique’s unique post-sun formula helps prevent sun exposure from becoming visible damage by minimising peeling. Suitable for face and body, this lotion is oil-free and non-acnegenic.
5. Origins Never A Dull Moment Scrub Tube RRP $43.00
6. Giorgio Armani Lasting Silk UV Foundation SPF 20
8. Aesop Geranium Leaf Body Scrub RRP $39.00
RRP $90.00 If your skin has been left dry and flaky from too much time in the sun, this brightening face polisher will help to dissolve dead skin cells, giving you softer, more radiant skin. Natural ingredients such as finely ground apricot, mango seeds and papaya extract scrub gently without irritation or friction.
This revolutionary water-based foundation is a favourite with makeup artists around the world, revered for its long-lasting coverage without the cakey look or feel. Containing UV SPF20, it offers sun protection for day-to-day wear, while keeping skin soft and moisturised.
7. Sephora Collection Rouge Balm RRP $20.00 You don’t have to forsake fashion for sun safety with this range of dazzling lip colours by beauty house Sephora. With SPF 20, shea butter, yuzu extract and vitamin E, this lip formula is just as nourishing as it is pretty!
This stimulating gel-based exfoliant's precise blend of pumice and bamboo stem sloughs away dead surface cells while botanical oils purify and calm skin. Ideal for all skin types, this is the ultimate body treatment after a day in the surf.
9. Invisible Zinc® Tinted Daywear RRP $14.99 (20g) This all-in-one beauty solution contains SPF 30+ sunscreen as well as moisturiser and sheer foundation to help prevent the appearance of premature ageing of the skin caused by UV exposure. Ideal to use on the go!
10. Kiehl’s Actively Correcting & Beautifying BB Cream RRP $40.00 (30ml) This multi-purpose cream offers lightweight, buildable coverage that instantly conceals imperfections and blemishes, while significantly improving tone and texture for long-lasting luminosity, with the added bonus of SPF 30 PA+++.
Australian RESORT & SWIM WEEK
Australia has long been renowned for its sunny weather and beautiful beaches. Lately, it has also been turning heads on the international fashion stage, with the industry touted as one of the strengths of the nation’s economy, generating $12 billion annually and employing more than 220,000 Australians. Aside from fortifying the country’s reputation as a land of leisure, it might be difficult to see what these two concepts have in common, but according to Pindara Private Hospital CEO Trish Hogan, there’s a strong correlation. With skin cancer rates continuing to rise in Australia, despite ample warning and education, it is more important than ever for people to do more to protect their skin from the sun. The time has come for fashion designers to pay more heed to Australia’s harsh sun when designing their product lines. In order to encourage swimwear designers to explore designs that are not only aesthetically pleasing but also protect wearers from the sun, Pindara Private Hospital is taking a proactive approach to sun safety by sponsoring the SunSafe Design Category in the 2016 Australian Resort & Swim Week Design Awards. Set to be held at the Gold Coast Convention and Exhibition Centre from November 17 – 20, the Design Awards are a part of an annual competition that recognise the 14 most talented emerging designers in the Asia Pacific region, across a range of categories including Resort Wear, Active Wear and Swim Wear.
Coordinated by Gold Coast Swim Fashion Festival, whose purpose is to establish a creative hub on the Gold Coast for young designers from the Asia Pacific region, the Australian Resort & Swim Week is a celebration of the beach and summerinspired fashion that is unique to Australia. The event incorporates a range of key elements including a one-of-its-kind designer development and mentoring program. Between January and November, sessions run by Australia’s leading fashion experts, business minds and digital commercialisation trainers are offered to emerging designers from the Asia Pacific region. During this time, designers are given the opportunity to present a mini collection of swim and over-swim styles, resort wear and accessories, with an emphasis on both creative design and commercial viability. The most promising designers of the group are then selected to showcase their ranges at the Design Awards, which are the largest of their kind in Australia in the area of swim, resort wear and accessories for students and emerging designers. The Pindara Private Hospital SunSafe Design Award will be presented by Pindara Private Hospital skin cancer surgeon Dr Craig Layt to the designer who is judged to have created the most practical, innovative and yet attractive swimwear option. It recognises emerging designers with creative flair, sound business acumen skills, and foresight, and most of the entrants in the category have been inspired by their own lifestyle or personal experiences. Kate Davis-Steer, the creative mastermind behind emerging Australian swimwear label SunSoaked, was so inspired by her mother’s experience with melanoma she decided to create a sun protection label that was chic and fashion focused without compromising on UV protection. For Lucy Tait and Beth Neville, the design duo behind The Selkie Project, the decision to launch their label was borne out of their frustration at not being able to find sun smart but fashionable “rashies” or surfing shirts. Both women are surfers from Byron Bay and identified a gap in the 62
Australian swimwear market for functional surfing tops that protected them from the sun, while still being stylish. The Selkie Project and SunSoaked are just two of the designers in contention for this year’s Pindara Private Hospital SunSafe Design Award. More information about their sun safe swimwear can be found at their websites: sunsoaked.com.au and theselkieproject.com According to Dr Layt, avoiding excess sun exposure is the best way to prevent developing skin cancer: “Prevention is much better than cure and over the years 'slip slop slap' has been a good message but we can do better. It’s even better to have a well-designed piece of apparel that has the appropriate sun protection than it is to put on sunscreen.” One in 13 Queenslanders will be diagnosed with melanoma before the age of 85, two in three Australians will be diagnosed with skin cancer by the time they are 70, and more than 434,000 people throughout the country are treated for one or more non-melanoma skin cancers each year. Given its close proximity to some of the world’s best beaches and its average of 300 days of sunshine per year, the Gold Coast is one of the country’s leading skin cancer hotspots. In the last financial year, Dr Layt treated 700 Gold Coasters for skin cancer-related cases and he expects numbers to rise again this year, which is why he and his colleagues at Pindara Private Hospital are so passionate about supporting preventative measures and educational campaigns wherever possible. The Design Awards present Pindara Private Hospital with a unique opportunity to provide emerging designers with the encouragement and tools required to create protective swimwear that can help play an important role in saving lives. More information about Australian Resort and Swim Week including ticket details can be found at goldcoastswimfashionfestival.com.au
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Fact or fiction There’s been a lot of talk lately about the efficacy of commercial sunscreen products, following paleo chef Pete Evans’ advice to avoid using sun creams, as they are full of ‘poisonous chemicals’ and a review by CHOICE that found only two of six products tested lived up to their SPF claims. So what is the truth? Dermatologist Dr Portia Millar breaks it down.
This is categorically untrue. Up to 40% of UV radiation reaches earth on completely cloudy or overcast days.
NANOPARTICLES IN SUNSCREEN ARE TOXIC Nanoparticles (particles less than 100nm, mostly zinc oxide and titanium dioxide) are controversial, with health professionals disagreeing as to whether or not they penetrate underlying layers of skin. In 2013 the TGA, and in 2014 the Cancer Council, reported that nanoparticles can penetrate outer “dead” layers of skin and research to date has not found living cells are damaged in healthy intact skin. Tiny amounts of zinc penetrate but it is unclear if it was nanoparticles themselves or zinc ions from nanoparticles. Ions are not the same as nanoparticles – and zinc itself is an essential nutrient. Overall, the weight of evidence is clear. There are more risks from not using sunscreen than there are from using it, whether or not it contains nanoparticles.
A COMMERCIAL SUNSCREEN CONTAINS: Organic molecules that absorb UV Inorganic pigments that reflect, scatter and absorb UV
80% OF SUN EXPOSURE COMES AS A CHILD, SO IT IS TOO LATE TO DO ANYTHING AS AN ADULT A recent multi study showed we get less than 25% of our total sun exposure by age 18. In fact, men over 40 who are mostly outdoors get higher annual doses.
The ultraviolet radiation in sunlight has both positive and negative health effects, as it is the principal source of Vitamin D and is a mutagen (causes genetic mutation). The shorter UVB rays do not penetrate skin deeply; they cause sunburn and skin damage. The long UVA rays penetrate deeper layers of skin, where they produce free radicals and are the chief cause of premature aging, damaging collagen, elastin fibres, blood vessels and immunosuppression.
Sun protection factor (SPF) in simple terms can be viewed as a “sunburn” protection factor. A sunscreen of SPF 20 allows only five out of every 100 photons of UVB light to reach skin. The SPF factor covers only the UVB protection but the sunscreen can still allow a significant percentage of UVA photons to reach skin. For example, using a standard Australia SPF 50 sunscreen provides you with an equivalent SPF 20 UVA level of protection. Consequently, deeper damage can be happening despite no obvious sunburn occurring. If your unprotected skin normally burns in 10 minutes, applying an SPF 30+, would allow you to stay in the sun for 300 minutes without burning. However, for this to happen, the application of sunscreen would have to be uniformly thick – something that rarely happens, especially when applying sunscreen yourself. Thus, UVA penetration can still be causing deep damage without any outward signs of burning.
IF IT IS COLD AND CLOUDY, YOU DON’T NEED SUNSCREEN
3 NIVEA SUN KIDS CARING ROLL ON
CANCER COUNCIL CLASSIC ZINC
CONSUMER ADVOCACY GROUP CHOICE recently tested six top-selling sunscreen products on the Australian market and found that only the following two lived up to their claims:
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ques t ions
Everything you've ever wanted to know about this essential vitamin.
WHAT IS VITAMIN D AND WHY DO WE NEED IT? Vitamin D is a fat-soluble vitamin, which acts as a hormone in the body. We produce our own vitamin D from cholesterol through a process starting with the action of sunlight on our skin. We can obtain a small amount from food, however this form is less biologically active; most people only get about 5-10% of their vitamin D from food. Vitamin D plays a major role in regulating calcium and phosphate levels, and contributes to the health of bones, muscles, teeth and the immune system. There is some evidence adequate vitamin D can reduce the risk of multiple sclerosis and some types of cancer (e.g. colorectal cancer) and the risk of food allergies in infants - more research is underway in these areas. WHAT IS VITAMIN D DEFICIENCY? Deficiency is determined by measuring the levels of 25(OH)D in the blood; levels above 50nmol/L are considered adequate. Pindara Magazine
WHAT CAUSES VITAMIN D DEFICIENCY?
ICI DEF ENCY S
Vitamin D deficiency is caused by inadequate sun exposure or the reduced capacity to make and store vitamin D in older people. People under the age of 50 have the capacity to store about six months’ worth of vitamin D after adequate sun exposure, which is usually enough to get us through the winter months, however in older people the ability to synthesise vitamin D in the skin is reduced, leaving them at higher risk of deficiency. Other population groups more prone to deficiency include naturally darker skinned people, pregnant women, and people who cover all their skin with clothing. WHAT IS THE RECOMMENDED DAILY INTAKE OF VITAMIN D TO PREVENT VITAMIN D DEFICIENCY? Children and adults under age - 50 5mcg/day Adults in 51-70 age group - 0mcg/day Adults over 70 years - 15mcg/day There is no increased requirement during pregnancy or lactation.
WHO IS AT RISK OF GETTING VITAMIN D DEFICIENCY • Older Australians living in the community • Those in residential care with limited mobility • Dark-skinned people • People who have little sun exposure • Breast-fed infants of mothers with low vitamin D levels
WHAT ARE THE SIGNS AND SYMPTOMS OF VITAMIN D DEFICIENCY AND HOW DOES IT AFFECT PEOPLE? There may be no obvious signs or symptoms of vitamin D deficiency. However, without treatment it can lead to significant health effects including poor bone mineralisation (soft bones), rickets (bone deformity) in children and osteomalacia in adults. There have also been links with increased risk of bowel cancer, heart disease, infection and autoimmune diseases, although research is continuing in these areas.
WE GET VITAMIN D FROM THE SUN, FACT OR FICTION? Fact! Vitamin D status is generally maintained in the population by exposure to sunlight.
DOES SUNSCREEN AFFECT THE ABSORPTION OF VITAMIN D? While in laboratory testing sunscreen appears to reduce formation of vitamin D, in real life, studies have shown no appreciable difference in vitamin D levels between people who use sunscreen regularly and those who do not. It is theorised that people who use sunscreen may not use enough to compromise vitamin D synthesis or that in fact those who use sunscreen regularly may spend more time in the sun and thereby still produce sufficient vitamin D.
p eop l e under t he age of 50 h av e t he c a paci t y t o s t ore a b ou t six mon t hs of v i ta min D
THE GOLD COAST IS A SUNNY PLACE; SURELY WE ARE NOT AT RISK OF VITAMIN D DEFICIENCY? Provided you get outdoors a few times a week with at least five to 15 minutes of sun exposure, and are not in one of the high-risk categories, you are likely to produce enough vitamin D. However, for people who never get outdoors there is the risk of deficiency, wherever you live.
WHAT IS THE DIFFERENCE BETWEEN GETTING VITAMIN D THROUGH DIET AND GETTING VITAMIN D FROM THE SUN? We produce our own vitamin D from cholesterol through a process starting with the action of sunlight on our skin. We can obtain a small amount from food, however this form is less biologically active; most people only get about 5-10% of their vitamin D from food.
HOW DO WE FIND OUT IF WE ARE VITAMIN D DEFICIENT? Contact your doctor who can arrange for a blood test to assess your level of vitamin D and determine if a supplement is necessary
EX P O SU
WHAT ARE THE WAYS PEOPLE CAN INCREASE THEIR VITAMIN D LEVELS? Generally five to 15 minutes of sun exposure on the hands, face and arms (or equivalent area) four to six times a week is sufficient in summer. Recommendations based on geographical location can be found on the Cancer Council website www.cancer.org.au
ge t ou t door s a f e w t ime s a w eek w i t h at l e a s t 5 t o 15 minu t e s of sun e x p o sure
M VITA IN D S
DO VITAMIN D SUPPLEMENTS FROM THE CHEMIST WORK AND WHICH IS THE BEST FORM E.G SPRAYS, DROPS, TABLETS ETC?
ARE THERE COMPANION FOODS OR VITAMINS WE NEED TO BE TAKING WITH VITAMIN D TO HELP ABSORPTION?
CI U M A
No, however vitamin D helps to optimise the absorption of calcium from foods in the intestine.
Most vitamin D supplements are the D3 form, and usually come in a dose of 1000IU. Some multivitamins and calcium supplements contain low levels of vitamin D. The dose required depends if you are treating a deficiency, and the extent of the deficiency, or if you are trying to prevent deficiency due to being in a high-risk category. Your doctor can advise if supplements are required, and the dose needed.
WHAT ARE THE BEST FOODS TO EAT IF YOU ARE VITAMIN D DEFICIENT? Very few foods contain significant amounts of vitamin D. In Australia, the main food sources of vitamin D are fortified margarines, fatty fish such as salmon, mackerel and herring, and eggs. WHATâ€™S THE SITUATION WITH VITAMIN-ENRICHED FOODS SUCH AS MUSHROOMS?
S H AS ALMO UC
FATTY FISH S
Currently in Australia, vitamin D fortification is mandated for edible oil spreads (table margarine) and voluntary for milk products including yoghurts and cheese, and soy milk products. Vitamin D mushrooms are mushrooms that have been exposed to UV rays during the growing process.
Vitamin D supplements are safe to take when pregnant, and pregnancy multivitamins generally contain a low dose of vitamin D. For people with an identified deficiency, a higher dose may be recommend by your doctor. Vitamin D deficiency in pregnancy is associated with a range of conditions including pre-eclampsia, gestational diabetes mellitus and preterm birth.
ARE THERE ANY SPECIFICS OR RISKS AROUND TAKING VITAMIN D OR BEING VITAMIN D DEFICIENT WHEN PREGNANT?
ED F O O DS ICH
See question 12!
M VITA IN D E
WHAT IS RECOMMENDED IN REGARDS TO SUN EXPOSURE AND GETTING VITAMIN D?
M VITA IN D T O XIC
CAN YOU HAVE TOO MUCH VITAMIN D?
Vitamin D toxicity can occur from taking very large doses of vitamin D supplements - this can lead to excessive levels of calcium in the blood. CAN VITAMIN D DEFICIENCY BE CURED OR IS THIS SOMETHING THAT WE WILL HAVE TO MONITOR FOR THE REST OF OUR LIVES? Vitamin D deficiency is something that will need to be monitored for the rest of your life, with the risk of developing a deficiency becoming greater as you age.
Dem Bones EXERCISES FOR BONE DENSITY
Stay strong from the inside with these exercises that will help to maintain bone density.
Bone formation and strengthening is promoted by weight-bearing activities in which the bones are stimulated by the pressures applied by gravity and muscle activity. Weight-bearing exercises that benefit bone health do not need to be highimpact exercises. Many of these exercises are simple, yet effective in their ability to maintain and increase bone density. Examples of weight-bearing exercises which help bone density include:
Walking – brisk walking is great for the health of our bones, as well as our heart and lungs, and even helps to clear the mind! Yoga – a form of exercise which includes breath control, simple meditation, and the adoption of specific bodily postures, which is widely practiced for health and relaxation. Tai-Chi – based on a centuries-old Chinese form of exercise which focuses on slow, rhythmic, meditative movements designed to help you find peace and calm. Pilates – a form of low-impact exercise that aims to improve the activation of the core muscle groups, which give stability to the spine, trunk and pelvis. Dancing – there are a wide variety of dance styles which appeal to people of all ages, and are a popular way to meet new people. Resistance training – moving your limbs against resistance provided by your body weight, gravity, bands, or weights such as bars, balls, or machines.
Participating in these activities at least three times per week for 20-60 minutes provides the necessary level of stimulation for good bone health. If you have any concerns about your ability to safely participate in any of these activities it is suggested to see your GP prior to commencing an activity program.
Itâ€™s a New
Compromise is not a word recognised in the RollsRoyce lexicon. Indeed the company continues to live by the clarion cry of co-founder Sir Henry Royce to, “Strive for perfection in everything you do. Take the best that exists and make it better. When it does not exist, design it. Accept nothing nearly right or good enough.”
The first part of this maxim – “Strive for perfection in everything you do” – guides the company’s every action particularly during the creation of a new motor car. The second – “Take the best that exists and make it better” – was clearly evident in the success of both Phantom Series II and Ghost Series II as they were carefully updated in 2012 and 2014 respectively. And when Rolls-Royce judged that it was time for an authentic gentleman’s Gran Turismo to return to the world stage, it was guided by the third part of Sir Henry’s maxim: “When it does not exist, design it.” And thus, Wraith was born. Now, the final part of this maxim has guided the Rolls-Royce design and engineering teams as they have worked to initiate a new age for open-top, super-luxury motoring. In a sector exclusively populated by the biggest of automotive compromises – the 2+2 seat configuration – Rolls-Royce has chosen to “accept nothing nearly right or good enough.” And so, the new Rolls-Royce Dawn, the world’s only true modern four-seater super-luxury drophead, was born. “It is always darkest just before the dawn” In the most challenging times, the phrase “It is always darkest just before the dawn” – originally coined by English Restoration preacher Thomas Fuller – resonates as a beacon of hope. This early morning darkness, where apparitions such as phantoms, ghosts or wraiths have been imagined, and where one’s apprehensions lurk, is brushed aside by an energising burst of early morning sunlight as one awakens to a new dawn and the endless possibilities of a new day. Such was the feeling in 1952 as the world was finally emerging from a period of economic austerity following protracted war. That year, the world looked forward in hope as the world’s first passenger jet, the British deHavilland Comet, made its first commercial flight, the Big Bang Theory of the creation of the Universe was first propounded, and Queen Elizabeth II ascended the throne of the United Kingdom. That very same year, the Rolls-Royce Silver Dawn drophead, which became the muse for the designers of the new Rolls-Royce Dawn, was finished by Rolls-Royce coachbuilders Park Ward and delivered to its first customer, Colonel W.A. Phillips in Canada. Pindara Magazine
A new beginning for Rolls-Royce at the time, the original Silver Dawn was the first RollsRoyce to be offered with a factory-built body. However, the drophead Rolls-Royces that carried the name Silver Dawn continued to be coachbuilt for individual customers, ensuring their uniqueness and rarity, and embodied the optimism of the age as we began to enjoy life again and pursue La Dolce Vita. This famous and rare RollsRoyce name was only ever applied to 28 very special drophead bodies between 1950 and 1954. Rolls-Royce’s new Dawn has taken inspiration from the Silver Dawn, whilst delivering a world first in super-luxury motoring – a cool, contemporary interpretation of what a superluxury four-seater convertible motor car should be in 2016 – rare, refined and the most social super-luxury car there is. Much like the 1952 Silver Dawn drophead, the new Rolls-Royce Dawn stands apart from its stable mates, featuring 80% unique body panels. Indeed such attention has been paid to ensuring this amazing new dawn for super-luxury motoring delivers on its promise, even the tyres that connect the new Rolls-Royce Dawn to the roads it will glide over have been specially developed to deliver the pinnacle ‘magic carpet’ ride expected of every Rolls-Royce that leaves The Home of Rolls-Royce at Goodwood, England. And, specific engineering and manufacturing attention has been paid to the creation of the 78
Dawn’s roof. Unheard of anywhere in the modern motor industry until now, the roof of the RollsRoyce Dawn delivers the silence of a Wraith when up and operates in almost complete silence in just over 20 seconds at a cruising speed of up to 50kph. It is safe to say that the new Rolls-Royce Dawn is the quietest open top car ever made.
Design 2+2 ≠ 4 “In the world of Rolls-Royce, day to day mathematical norms don’t always apply. That’s why I say in the case of the new RollsRoyce Dawn, 2+2 does not equal 4.” Giles Taylor, Director of Design, Rolls-Royce Motor Cars. Studying the open-top motor car sector, and specifically its high-value luxury niche, it became apparent to Rolls-Royce’s designers that customers were being short-changed. The myopic focus on one specific configuration – the 2+2 setup – was, in the view of Rolls-Royce, a compromise too far. Commonly held, a 2+2 is a configuration with seating for the driver and one passenger in the front plus two smaller seats for occasional passengers or children in the rear. Space in the rear is most noticeably absent in terms of
longitudinal legroom, thereby reducing the comfort and practicality of the car. In the case of a convertible body type, this reduction in space is often the result of the manufacturer’s inability to package the convertible roof together with boot and rear passenger space. The result is a sector populated exclusively by open-top cars that Rolls-Royce would consider compromised and ‘anti-social’. “At Rolls-Royce, we pride ourselves as creators of fine motor cars that also serve as social spaces,” comments Taylor. “The idea of creating a car like Dawn that can be used in comfort by only two adults on a day to day basis is anathema. In creating Dawn we have accepted no compromise to the comfort and luxury of four adults who want to travel together in the pinnacle of style.” A striking, seductive encounter “Dawn is a Rolls-Royce that feels completely at home on the Route Napoleon. It is a contemporary homage to a life on the Côte d’Azur. The car is a contemporary take on the ‘Casino’ lifestyle. Perhaps seen as cavalier in character it is intended to attract people who relish both freedom and sophistication,” explains Giles Taylor. “At Rolls-Royce Motor Cars we design without compromise, and this uncompromising approach brings new challenges with each new motor car,” continues Taylor. “In the case of the new RollsRoyce Dawn, we have designed it from the road up to deliver a striking, seductive encounter.”
The new Rolls-Royce Dawn greets the observer with a striking yet elegant exterior design with classic Rolls-Royce appearance and presence. It is the most vibrant Rolls-Royce yet with charming and alluring qualities that bring a new level of finesse, sophistication and refinement in a drophead coupé – a serene yet exhilarating sense of uncompromised freedom. It offers a new level of effortlessness and a relaxed sensory experience with an underlying exhilaration and dynamism. All this without a single compromise to comfort and space. This new Rolls-Royce embodies dynamic and social qualities that will attract a broader, younger and more socially-aware audience around the world. Contrary to media speculation, the new RollsRoyce Dawn is not a Wraith drophead. 80% of the exterior body panels of the new Dawn are newly designed to accommodate an evolution of RollsRoyce’s design language and to encapsulate highly contemporary, four-seat super-luxury drophead architecture. The aim was clear. To do what no other car manufacturer had achieved so far – make a car that looks as beautiful with its roof up as with it down. One could almost say that the result of the design team’s restless endeavours has been to make the new Rolls-Royce Dawn two cars in one.
Exterior design The Rolls-Royce Dawn maintains timeless RollsRoyce design principles – 2:1 wheel height to body height, a long bonnet, short front overhang, a long rear overhang, an elegant tapering rear graphic and a high shoulder line. All this tradition is delivered in a beautiful and thoroughly contemporary design. Like an athlete, Rolls-Royce Dawn appears poised, taught and ready to go. The latent acceleration and tension in the surfaces are increased through completely new panels which evince curvature that creates a tighter surface and a more powerful silhouette, hinting at what lies beneath. Dawn’s powerful and striking front end gives it a sensuous yet edgy, almost masculine look whilst the bold sweeping shoulder line becomes even more sensuous as it flows over the swell of the rear wheels, accommodating a wider track. 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 at the car’s dynamism. With its high shoulder line, massive C-pillar and horizontally narrow side window aperture, when viewed from side-on and roof up, the car looks akin to a lowslung ‘hot rod’. At the front, the grille is recessed by approximately 45mm whilst the lower front bumper has been extended 53mm compared to Wraith. This has been done to focus the eye on the jet air intake face and to make the car feel focused, even when standing still. The grille design helps accelerate the tension of the car towards the rear shoulders, again emphasising the unique elegance of Dawn.
Dawn is a Rolls-Royce that feels completely at home on the Route Napoleon.
The grille and bumper focus attention on the horizontal lines of the car rather than the traditional vertical lines of the other members of the Rolls-Royce family. The bumper now incorporates the number plate surround and a new focused lower air dam. The mesh in the lower valance is recessed and black in colour, helping create a sense of depth, which supplements the depth in the grille. Also, chrome ‘blades’ act to plant the car while also complementing the horizontal lines and accelerating the flow of the eye around the car thus increasing the impression of power and width. When viewing the Rolls-Royce Dawn in side profile, one’s eye is instantly drawn to the elegant profile of the car. The soft-top shape is completely harmonious and homogenous without the ugly concave areas or sharp struts seen in other manufacturers’ soft tops. In addition, new 21” polished and 21’’ and 20” painted wheels ensure Dawn remains a perfectly executed, contemporary expression of Rolls-Royce luxury. The rear end of the car, having swelled over the feminine ‘hips’ of Dawn, tapers in towards the rear, echoing the elegant design of early ‘boat tail’ Rolls-Royce drophead coupés and indeed the beautiful motor launches of the early 20th Century that inspired them. The silent lowering of the soft top transforms the Rolls-Royce Dawn, delivering a true Dawn moment. In hero specification of Midnight Sapphire exterior and Mandarin leather interior, night becomes day as rays of sunshine burst forth, bringing the inside out, joining this social space with the wider world of possibilities. Roof down, the sexiness of the Rolls-Royce Dawn is even more apparent. From the side, the steep rake of the windscreen, the swage line that flows over the rear haunches plus the high beltline that rises along the profile give the impression of effortless swiftness. The very same rising beltline wraps around the rear passenger cabin akin to the collar of a jacket pulled up to protect the neck. The stainless steel waistline finisher that wraps around the cabin encompasses the deck that covers the soft top when stowed, and integrates the high-level brake light. This beautiful metal feature works in harmony with the stainless steel door handles, polished wheels, visible exhausts and front and rear bumper jewellery, to create a priceless look and feel. The deck itself is an amazing work of modern craftsmanship. Clothed in open-pore Canadel panelling that traces the horseshoe shape of the rear cabin, it demonstrates the great advances that the craftspeople in the Woodshop at the Home of Rolls-Royce in Goodwood have made in wood crafting technology and techniques. The wood on the deck, chosen by the customer to suit their individual taste, flows down the ‘Waterfall’ between the rear seats, and around the cabin clothing the interior door panels and enticing the owner to enter Dawn. 80
Interior design Once again Rolls-Royce’s unique coach doors come into their own in a drophead format. The coach doors are impressive and graceful. The doors complement the long front wings and relaxed waft line, creating a long body profile and a cosseted cabin. Evocative of the classic sports car profile, they add considerably to the easy entry and egress of rear passengers from Dawn’s luxurious embrace. The rear passengers do not merely ‘get out’ of a Rolls-Royce Dawn, but rather stand and disembark as if from a Riva motor launch onto a glamorous private jetty in Monaco or on Lake Como. Of course as one would expect of a RollsRoyce, the coach doors also serve a more fundamental purpose than simply a means of access. Perhaps just as importantly, they also add significantly to the overall strength and stiffness of the body as they allow the construction of an uninterrupted A-pillar. The first impression upon entering Dawn is of the four separate bucket seats set in the midst of a sartorial slingshot of wood and leather. The slingshot concept runs from the driver’s A-post towards the rear of the car, around the rear seats before returning to the passenger A-Pillar. The slingshot form is reminiscent of a barchetta, pulled back, poised and ready to launch the occupants of the car to the horizon, even whilst stationary. This design complements the accelerated tension seen in the exterior of the car. The interior complements the exterior, a place of opulence, security and presence. The Rolls-Royce Dawn offers four very individual, cosseting seats. The vehicle is a full four seater and so there is no compromise in comfort wherever you sit. The seats have been designed to help emphasise the energetic, yet elegant intent and sense of purpose of the car, complemented by an intersecting full-length centre console. The upper seat back houses the seat belt harness, which together with the pillarless bodywork enhances and emphasises the slingshot of wood or leather with no breaks in the flow-lines. The wood on the surfaces of the trays is also book-matched down the centre console in a chevron pattern pointing forward providing an accelerated feel. The instrument dials 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 matt chrome centres ‘float’ in the middle of each instrument. In addition, a new clock design featuring the new motor car’s name has been introduced.
Engineering & Technology The Silent Ballet Without question, the engineering highlight of the new Rolls-Royce Dawn is the new roof. To be a true Rolls-Royce, Dawn had to deliver the hushed driving experience associated with all Rolls-Royces. At the same time the only choice for a Rolls-Royce was a fabric roof for reasons of aesthetics, romance and brand appropriateness. There is nothing more romantic than driving a convertible in the rain at night and hearing the drops pattering on the roof. In conversation with its customers, Rolls-Royce realised that they felt the same way. Working with a fabric roof configuration, the Rolls-Royce engineering team set themselves a challenging goal, which they were unwilling to compromise on – to make the quietest convertible car in the world today. This quest for silence applied to all aspects of the engineering of the new roof and by extension the new motor car. Firstly, the passengers’ on-board aural experience roof up and roof down while in motion had to be pure Rolls-Royce. The design of the roof had to be graceful, beautiful and sensuous whilst remaining one of the largest canopies to grace a convertible car. Of particular note is how the canopy wraps around the rear seats and down over the window tops of Dawn thereby optically lowering the roofline of the car to contribute to its low-slung appearance. Another point to note is the small size of the rear glass – a carefully-judged proportion which heightens the sense of a private sanctuary when motoring with the roof up. Two key techniques were employed to ensure the roof not only appears beautiful and sensuous in its form, but also contributes to the silence of the car in its function. A perfectly smooth surface, combined with an innovative tailored ‘French Seam’ ensures that the airflow over the car with the roof up creates no noticeable wind noise. Inside, the Rolls-Royce Dawn is as silent as a Rolls-Royce Wraith – a first in convertible motoring. Secondly, the actual opening and closing of the roof mechanism had to be both beautiful and unobtrusive at the same time. The engineering team even went so far as to invent a phrase for what they wished to achieve with the roof mechanism: The Silent Ballet. And a silent ballet is what they achieved. Operating in complete silence in just 22 seconds, and at cruising speeds of up to 50km/h this ‘Silent Ballet’ engages the majority of one’s senses as silence and seclusion are exchanged for the sounds, light and aromas of the outside world. As if opening an airlock, Dawn lifts the lid on the outside world and its cabin becomes a wider part of the owner’s social space. pindaramagazine.com.au
Bespoke Audio For those not so worried about silence and more interested in sharing music and entertainment with their friends, Rolls-Royce’s Bespoke Audio system has been specially calibrated for the unique configuration of the Rolls-Royce Dawn. Finely tuned by expert Rolls-Royce audio engineers, Bespoke Audio is the most exhaustively designed automotive hi-fi system ever developed and has been minutely calibrated to compensate for the dual personality of Dawn. Whether the roof is open or closed, Bespoke Audio ensures perfect acoustic balance and performance. Audio engineers were consulted throughout the design process of the car on the effect proposed changes may have had on the performance of the audio system – a practice unparalleled in the automotive world. Sixteen 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 tweeters meticulously placed throughout the cabin. 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. Engineering a new Dawn for open-top motoring In addition to the undisputed leaps forward made in the engineering of soft-top cars by the Rolls-Royce team, the new Rolls-Royce Dawn also introduces several other tailor-made engineering innovations. The challenge in designing any convertible lies in retaining a high degree of torsional rigidity throughout the body while keeping weight down. Torsional rigidity is vital to minimise the scuttle shake associated with most convertible cars and to help maintain the car’s dynamic composure. Extensive testing and research were carried out before the engineering team was completely satisfied. Tens of thousands of kilometres were driven over rough road surfaces to help identify and eliminate potential problems. The result is a chassis that makes the Rolls-Royce Dawn the most rigid four-seater convertible available today. A newly designed suspension configuration takes care of the specific behaviour of this opentop motor car in the areas of body stiffness and mass distribution, guaranteeing ultimate cruising comfort and the expected Rolls-Royce ‘magic carpet’ ride. Fewer aerodynamic lifts in front and rear and a lower centre of gravity, in combination with
newly designed air springs and active roll bars, deliver surprisingly agile handling capabilities for this super-luxury boulevardier. The flared, sensuous rear flanks of the Dawn indicate a rear track that is 24mm wider compared to Ghost, giving Dawn a lower, sleeker profile. In addition, the car’s wide hip not only adds to the seductiveness of the car, its broad shoulders underline the masculine muscularity and strength of the vehicle, helped by the 180mm shorter wheelbase. The beating heart and soul of any Rolls-Royce motor car is the beloved twin-turbo 6.6-litre V12 powertrain. With a power output of 563bhp or 420kW @ 5,250rpm and a torque rating of 780Nm or 575 lb ft @ 1,500rpm, Dawn’s driving experience is exceptional. This experience is enhanced by dynamic accelerator pedal mapping, which delivers up to 30% increased response at medium throttle. Dawn maintains Rolls-Royce’s typical steering characteristics providing superb driver feedback thereby ensuring that the car is effortless but precise to drive, while also providing a great sense of safety, even at higher speeds, no matter if the top is up or down. The result is that the new Dawn is Rolls-Royce’s most powerful full four-seat drophead motor car to date, and thanks to its advanced engineering is lighter and more fuel efficient than the majority of compromised 2+2 convertibles in the market. Grip is provided by runflat tyres, metrically sized at 540mm (20 inches) in diameter. These tyres enable the Dawn to run on a deflated tyre for at least 100 miles/160km at speeds up to 50mph/80km/h before needing a replacement. A remarkable level of control still exists, even with a tyre fully deflated. Optional 21” wheels are also available, mounted on 10-spoke rims. The inclusion of runflat tyre technology removes the need for a spare wheel and jack, freeing up space in the luggage compartment. In common with the entire Rolls-Royce family of fine motor cars, the new Dawn is at the very vanguard of automotive design and technology. Dawn presents drivers with a suite of discreet technologies that ensure their leisure time in the car is a super-luxurious effortless experience. Key is the discreet placement of the car’s technological functions. Dawn is therefore fitted with the Spirit of Ecstasy Rotary Controller, an intuitive, onetouch solution that allows the user effortless access to media and navigation functions. For example, characters for navigation input or media searches can be finger-drawn onto its surface, echoing seamless smartphone functionality. A one-touch call button located conveniently on the steering wheel allows users to summon the car’s functions using simple voice commands.
The beating heart and soul of any Rolls-Royce motor car is the beloved twin-turbo 6.6-litre V12 powertrain
Both features remove the need for superfluous buttons and ensure absolute ease of use. For example, simply press the button and say the command: “Navigate to St. Tropez” and the car’s Satellite Navigation system will plot the fastest possible route. This Spirit of Ecstasy Rotary Controller presents a touch pad (rather than a touch screen which might leave unsightly fingerprints at driver and passenger eye level), 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 Latin and Arabic characters as well as Mandarin. 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 make them larger. Information from the significantly updated multimedia interface and navigation system is displayed beautifully on a new 10.25” highdefinition screen, whilst hardware and software changes have improved processing speeds for faster route calculations. An automatic cruise control system helps to reduce constant small precision adjustments of distance and speed, reducing continuous creep, stop and start. The driver can now move along in city traffic in a confident and relaxed manner relying on the system to monitor conditions and react to changes in traffic patterns – for example
when entering a new road or slip road. New software for the radar and camera – located in the front bumper valance and centre upper windscreen respectively – provides faster system response times, including faster pre-conditioning of the brakes to expect emergency pressure. Should the worst of circumstances arise, Dawn will deploy a concealed roll-over protection system from behind the rear head restraints in just a fraction of a second. A ratchet system then locks them in place. This roll-over protection system also encompasses the entire windscreen surround of the car.
Satellite aided transmission The Rolls-Royce Dawn’s effortless dynamism is augmented with the addition of Satellite Aided Transmission, a technology that made its global debut on Wraith. 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 Dawn’s 8-speed ZF gearbox to ensure the driver is able to appropriately exploit the power from the RollsRoyce 6.6 litre twin-turbo V12, ensuring an effortless and seamless drive 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 the corner. Satellite aided transmission comes as standard on Dawn. The most recent developments in LED lighting technology have also been applied to the Rolls-Royce Dawn. The way this light is managed is significantly enhanced by adaptive technology. Electronically controlled reflectors move in the direction of travel in response to 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. Dawn drivers therefore enjoy the safety benefits of constant full-beam visibility. A day-time running bar frames Dawn’s contemporary front light graphic, giving the car a distinctive signature whilst augmenting safety at the same time. Night-time driving safety is boosted by the head-up display and heat detection system that detects both human and animal heat signatures. In this instance, the system issues an audible warning, alerting the driver to the possibility of danger. To discover this feature - and more - for yourself, book your test drive now.
For more information, contact Brand Manager James Staniforth at Rolls-Royce Motor Cars Queensland on (07) 5509 7197 www.rolls-roycemotorcars-queensland.com.au
GHOST SERIES II
Dramatic, yet graceful. Effortlessly simple, with cutting-edge technology. Ghost Series II forges a silent path of serenity through an ever-changing world. No ordinary power. Experience it for yourself. Brand Manager James Staniforth on 0450 638 046
Rolls-Royce Motor Cars Queensland 179 Nerang Road, Southport Queensland 4215 Tel: 07 5509 7197 www.rolls-roycemotorcars-queensland.com.au DL 1303030 ÂŠ Copyright Rolls-Royce Motor Cars Limited 2013 . The Rolls-Royce name and logo are registered trademarks.
Off-track fun With its famous balmy weather and enviable lifestyle, the Gold Coast provides the perfect backdrop for the Castrol Gold Coast 600, which attracts racing fans from across the country. Home to world-class beaches, some of the nation’s best shopping destinations, and a thriving food scene, the region promises more than just a weekend pit stop to watch the race. There’s something for every member of the family on the Gold Coast, making it a holiday hot spot for racing enthusiasts.
There is plenty to do closer to the action too! For those looking for a place to escape the heat of the day or who are revving to get the party started early, Club 600, is an exclusive 18+ trackside, Las Vegas-inspired day club where the drinks are as fresh as the all-female DJ line up. Kate Foxx, Havana Brown and Some Blonde will take to the decks and are sure to set the mood for a party in paradise. Over two massive nights of entertainment at the Broadwater Parklands, 600 Sounds powered by Sea FM will continue the offtrack fun into the evening. On Friday night Peking Duk and L D R U are set to take to the stage, while The Living End, The Rubens and Birds of Tokyo will rock the crowd on Saturday night.
On-track entertainment Robby Gordon’s Stadium Super Trucks return to this year’s Castrol Gold Coast 600 bill, ramping up the on-track action with their impressive, adrenalin-pumping stunts. Generating speeds upwards of 210 kilometres per hour, jumping man-made ramps and flying 100 metres through the air, the Stadium Super Trucks are a sight not to be missed!
No team has clean swept all the wins in a round on the Gold Coast since Triple Eight Race Engineering did with Jamie Whincup in 2008.
BROADWATER ENTERTAINMENT PRECINCT
Making its first appearance on the Australian motorsport calendar in 1991, the Gold Coast street circuit is a high speed, concrete-lined track covering 2.96 kilometres. The street layout provides fans with premium viewing opportunities of the world’s best Supercar drivers battling it out on the notoriously tricky streets of Surfers Paradise. Following on from the other two key Supercars races on the calendar – the Wilson Security Sandown 500 and the Supercheap Auto Bathurst 1000 – the Castrol Gold Coast 600 marks the third and final round of the PIRTEK Enduro Cup where the highly coveted first prize is awarded to the best team at the completion of an intense weekend of racing on the Gold Coast.
COATES HIRE CORNER
S8 TAFE QLD BEACH T6-10 CHICANE
CASTROL EDGE HAIRPIN
S20B STADIUM SUPER TRUCKS JUMP
S1 ARMOR ALL PIT ENTRY CASTROL EDGE PIT STRAIGHT
MAIN BEACH STATION
S18 S19 S5 QLD GOVT CHICANE
S15 SURFERS PARADISE NORTH STATION
FOOD & BAR
DESIGNATED OUTDOOR SMOKING AREAS COOPERS ROLL BAR
EQUITABLE ACCESS PLATFORM
UNDER TRACK WALKWAY MCINTOSH ISLAND PEDESTRIAN BRIDGE
PARENTS ROOM/BABY CHANGE
LIGHT RAIL STATION
PIT LANE COLLECTION BOX
PIT WALK MEETING POINT
TICKETEK COLLECTION BOX
ATM SUPPORT CATEGORIES:
STADIUM SUPER TRUCKS
PORSCHE CARRERA CUP
VEHICLE ACCESS ONLY
*This Map is indicative only. Not to scale. Correct at time of printing. Please note - Super Screen locations are subject to change.
The drivers The main drawcard of the Supercars Castrol Gold Coast 600 is the impressive bill of drivers it attracts. This year there will be 52 drivers in 26 cars going head to head for the title including some of the biggest names in the Supercars racing world such as Mark Winterbottom, Garth Tander, Jamie Whincup and Craig Lowndes.
TURN SLOWEST POINT
4 + 15 Pindara Magazine
TIM SLADE Team BOC and Freightliner Racing YOU COME WITHIN MILLIMETRES OF WALLS, BARRICADES AND OTHER DRIVERS. HOW DO YOU GET TO BE SO PRECISE?
As with any professional in their chosen industry or field, precision comes with practice. I think go-karting and driving race cars from a young age helped me develop my skills. You also can’t be afraid to give it everything you’ve got. On street tracks like the one on the Gold Coast, if you don’t come away with a few scrapes or lost mirrors, you probably haven’t tried hard enough!
DO YOU HAVE A PRE-RACE REGIME? IF SO, WHAT DOES IT INVOLVE?
No, I don’t. I don’t have any superstitions or rituals. I like to keep it very simple before my races.
HOW DID YOU GET INVOLVED IN SUPERCAR RACING?
My dad was always involved in the racing scene – he actually used to do a little bit of racing himself, although nothing too competitive. As a kid I spent a fair bit of time at racetracks and it was always on the TV at home so that’s what sparked my interest. For my ninth birthday Dad bought me a go-kart and right from an early age I started racing. I spent my childhood travelling around Australia competing in different go-kart tournaments but it wasn’t until I was 16 that I realised I wanted to make racing a career.
WHAT DOES YOUR TRAINING REGIME INVOLVE?
I think what a lot of people don’t realise is that as Supercar drivers, our time in the car is limited. We only drive the cars three times a year outside of race meetings so for me training involves other forms of fitness. I enjoy cycling, a little bit of running, and going to the gym. My friends on the Gold Coast are also into fitness and my girlfriend Dani is actually a reformer Pilates instructor, so lately I’ve been getting into that too.
WHAT IS THE PHYSICAL TOLL OF SUPERCAR RACING?
Supercars get extremely hot; sometimes it can get up to 60 degrees in the cabin, which definitely takes its toll on your body. And because the races we compete in are long – on average twoand-a-half hours – they require a high level of endurance. For me the main toll is on my lower body. People might not realise how much we use our lower body but the brake force and input on the accelerator is intense. Plus it’s repetitive and we’re strapped in place super tight so we can’t readjust our positions to get more comfortable or stretch. After a race I usually feel it the most in my glutes and lower back. I think that surprises people because they assume steering would be the most difficult component but thanks to power steering, it’s actually not too bad on your arms.
HOW DO YOU MAINTAIN YOUR CONCENTRATION DURING RACES?
Concentrating under extreme pressure is definitely something you learn over time but I think this is probably where physical fitness comes into play. Being physically fit helps you mentally because when you’re tired your body is strong enough to sustain you. It’s also really important to focus on good hydration and nutrition leading up to a race. When your core temperature rises it does become difficult to concentrate so you need to remember to be well hydrated.
HAVE YOU COMPETED ON THE GOLD COAST BEFORE? WHAT DO YOU LIKE ABOUT THE CASTROL GOLD COAST 600 TRACK?
Yes, every year since 2009. The Gold Coast track is fun because there’s always a good vibe and a buzz among spectators. Street circuits in general are pretty fun. They’re the most physically demanding and tactically challenging so when you compete well, it’s even more rewarding.
IN COMPARISON TO OTHER TRACKS HOW CHALLENGING IS THE GOLD COAST?
Because it’s shorter than most, the Gold Coast track is a little more challenging because there’s no time at all for rest. There are lots of variables including different surfaces, tight bends, chicanes and concrete walls.
WHAT ROLE DO THE SPECTATORS PLAY IN A RACE? DO YOU EVEN KNOW THEY’RE THERE?
During the race not so much but we’re at the racetrack for four days and in that time we spend a fair bit of time outside of the cars, so it’s nice when there’s a good atmosphere. You definitely pick up on the vibe and it does help. The Gold Coast is one of the best tracks in that respect because not all of them attract the same fun buzz.
HOW DO YOU GO IN A NORMAL CAR? DO YOU EVER LET DANI DRIVE?
I’m fine – it’s like chalk and cheese and I get my fix for speed and adrenalin on the race track anyway. I’m probably more of a critical passenger than most people but luckily Dani is a good driver!
IF YOU WEREN’T RACING SUPERCARS, WHAT WOULD YOU BE DOING?
My honest answer is I don’t know because I’ve been doing it for so long. I have worked on race teams before and I really enjoy that team environment so maybe something like that? When I was a kid, before I started go-karting, I used to think it would be cool to be a fighter pilot.
DO YOU GET ANY TIME AT THESE EVENTS TO ENJOY THE OFF-TRACK ENTERTAINMENT AND ACTIVITIES?
During the week of racing it’s all business but if we get a good result at the end of the day on Sunday, I might join in on the activities that night.
TICKETING INFORMATION TICKETS FOR SUPERCARS CASTROL GOLD COAST 600 CAN BE PURCHASED FROM TICKETEK.COM.AU AND ALL TICKET PURCHASES INCLUDE SAME-DAY ACCESS TO THE 600 SOUNDS CONCERTS. PRE-PURCHASED TICKETS ALSO INCLUDE FREE PUBLIC TRANSPORT TO AND FROM THE EVENT ON SELECT SERVICES. FOR MORE INFORMATION VISIT SUPERCARS.COM/GOLD-COAST/EVENT-GUIDE/TRANSPORT-PARKING 90
Peropon PAPA Self Watering Dog with Clover $44.95 RRP
This adorable glazed ceramic Peropon PAPA Dog is a slurping, self-watering indoor planter! Your dog has a long felt tongue that will sneakily soak up water from it's bowl and moisten the soil to grow clovers like magic!
with this selection of fun gadgets, brought to you by Peter Harback, the self-titled Professor of Gadgetology from CoolThings.com.au
Pug Stressball $12.95 RRP If you canâ€™t give a pug a hug, then give one a squeeze instead. This stressball will always be on hand to help when youâ€™re under pressure or feeling agitated. With a couple of gentle clutches on this cute canine cranium you will feel your tension instantly evaporate.
Emojinal Sound Machine RRP $16.95 Your Emojinal Sound Machine allows you to produce nine loud and unmistakable sound effects; it's a whole new way to get emotive! What a great gift for cartoon fans and pranksters to have hilarious animated sounds and the touch of a button when hidden in their pocket!
Liquifly Fizz Rocket
$12.95 With the explosive power of bi-carb and vinegar, you can launch your very own mini rocket into the air in an exciting, repeatable experiment!
This heavy-duty inflatable cushion comes with its own pump. Simply place the Fly-Tot on the floor in front of your child’s seat and use the pump to firmly inflate the cushion, turning a regular economy seat into a fully flat space, perfect for stretching out and watching movies and (hopefully) sleeping in comfort!
RRP $69.00 (USD)
Tangle NightBall Mini RRP $12.95 It's time to light up the night with the ultimate illuminated sports ball, available in three cool colours and designs! Your Tangle NightBall Mini is perfect for playtime, anytime! With its unique, airless Matrix™ design (about the size of a tennis ball), your miniature NightBall is the ideal size for small hands, and the super bright motion sensor LeDs allow for onthe-go play night and day!
La Lucie Recycled Summer Picnic Table – RRP $79.00 Don’t cry over spilled milk, and with La Lucie Recycled’s Summer Picnic Table you won’t have to cry over spilled wine either! These unique, lightweight, foldable picnic tables hold a bottle and up to four wine glasses, and have a space big enough to accommodate a plate of nibblies. They are available in square or oval designs in three colour ways.
The Boy Behind the Curtain
Holding Up The Universe
The remarkable true stories of The Boy Behind the Curtain reveal an intimate and rare view of Tim Winton’s imagination at work and play.
The latest from the bestselling thriller writer of all time is now a major movie. When Harvard symbologist Robert Langdon awakes in a hospital bed with no recollection of where he is or how he got there. Nor can he explain the origin of the macabre object found hidden in his belongings.
Everyone thinks they know Libby Strout, the girl once dubbed 'America's Fattest Teen'. But no one's taken the time to look past her weight to get to see who she really is. Since her mum's death, she's been picking up the pieces in the privacy of her home, dealing with her heartbroken father and her own grief. Now, Libby's ready: for high school, for new friends, for love, and for every possibility life has to offer.
In Tim Winton’s fiction, chaos waits in the wings and ordinary people are ambushed by events and emotions beyond their control. Winton’s own life has also been shaped by havoc. The extraordinarily powerful true stories that make up The Boy Behind the Curtain take us behind the scenes, revealing the accidents, both serendipitous and traumatic, that have influenced his view of life and fuelled his distinctive artistic vision.
A threat to his life will propel him and a young doctor, Sienna Brooks, into a breakneck chase across the city. Only Langdon's knowledge of the hidden passageways and ancient secret that lie behind its historic facade can save them from the clutches of their unknown pursuers. With only a few lines from Dante's Inferno to guide them, they must decipher a sequence of codes buried deep within some of the Renaissance's most celebrated artworks to find the answers to a puzzle which may, or may not, help them save the world from a terrifying threat.
Everyone thinks they know Jack Masselin too. Yes, he's got swagger, but he's also mastered the art of fitting in. What no one knows is that Jack has a secret: he can't recognize faces. Even his own brothers are strangers to him. He's the guy who can re-engineer and rebuild anything, but he can't understand what's going on with the inner workings of his own brain. So he tells himself to play it cool.
Same hotel. DIFFeReNt PRIceS. 94
Magnus Chase and the Hammer of Thor: Magnus Chase (Book 2)
Changing the Game: Football in Australia Through My Eyes
The Family Secret
Thor's hammer is missing again. The thunder god has a disturbing habit of misplacing his weapon - the mightiest force in the Nine Worlds. But this time the hammer isn't just lost, it has fallen into enemy hands.
Ange Postecoglou has been at the centre of Australian football for more than thirty years. In this book, he shows us the game through his eyes, from the changing room to the boardroom, to reveal how Australia must boldly re-imagine its place in the world.
Kim Richards is a creative woman of the land, a rural ambassador who’s renowned for her contribution to her community. But deep down, she’s lonely. She’s already watched the man she loves falls for someone else, and her dream of starting her own family feels like it’s slipping through her fingers.
If Magnus Chase and his friends can't retrieve the hammer quickly, the mortal worlds will be defenseless against an onslaught of giants. Ragnarok will begin. The Nine Worlds will burn. Unfortunately, the only person who can broker a deal for the hammer's return is the gods' worst enemy, Loki - and the price he wants is very high.
Ange’s story is one of fostering a culture of success, and turning history – or precedent – on its head. He candidly relays key moments and meetings in his life, reflecting on how these have shaped his beliefs and practices, and gives frank views on where the game is currently going right and wrong. What’s revealed is a bold and impassioned account of the game he loves. Changing the Game is a privileged glimpse inside the mind of a living legend.
Enter Charlie McNamara, an older man who’s arrived in Lake Grace on business. Sparks fly between Kim and Charlie, but he seems to have a hidden agenda and a past life he’s trying to hide. They’re both drawn to local hermit Harry, a Vietnam veteran who’s haunted by memories from the war. What ties these three lost souls together? Can they solve a long-held family mystery and heal fractures of the heart?
Finding the right Hotel just got a whole lot easier. Compare and Book 100’s of travel sites at once.
AT THE MOVIES
At the movies
MICHAEL BUBLÉ – TOUR STOP 148 Enjoy a front row seat of the superstar’s phenomenally successful sold out To Be Loved Tour which concluded in 2015, and which showcases thrilling live performances of many of the Grammy Award winning singersongwriter’s biggest hits, including Home, It’s A Beautiful Day, Cry Me A River and Haven’t Met You Yet. The performance is intercut with never-before-seen behind-the-scenes footage of Team Bublé bringing this moveable feast from arena to arena for two years.
THE GIRL ON THE TRAIN
On April 20th, 2010, one of the world’s largest man-made disasters occurred on the Deepwater Horizon in the Gulf of Mexico. Directed by Peter Berg, this story honors the brave men and women whose heroism would save many on board, and change everyone’s lives forever.
Based on the best-selling novel by Paula Hawkins, The Girl on the Train is an electrifying thriller directed by Tate Taylor (The Help) and starring Emily Blunt. Devastated by her recent divorce, Rachel (Emily Blunt) spends her daily commute fantasising about the seemingly perfect couple who live in a house that her train passes every day, until one morning she sees something shocking happen there and becomes entangled in the mystery that unfolds.
Starring Mark Wahlberg, Kurt Russell, John Malkovich, Gina Rodriguez, Dylan O’Brien, Kate Hudson.
Starring Emily Blunt, Rebecca Ferguson, Haley Bennett.
This must-see event includes a special 15-minute introduction with Michael Bublé EXCLUSIVE to cinemas.
AT THE MOVIES
BATMAN: RETURN OF THE CAPED CRUSADERS It’s back to the 1960s as Batman and Robin spring into action when Gotham City is threatened by a quartet of Batman’s most fiendish foes – Penguin, The Joker, Riddler and Catwoman. The four Super-Villains have combined their wicked talents to hatch a plot so nefarious that the Dynamic Duo will need to go to outer space (and back) to foil their arch enemies and restore order in Gotham City. It’s a truly fantastic adventure that will pit good against evil, good against good, evil against evil … and feature two words that exponentially raise the stakes for both sides: Replicator Ray. Holy Multiplication Tables!
WAR ON EVERYONE
War On Everyone follows corrupt cops Terry Monroe (Alexander Skarsgard) and Bob Bolano (Michael Pena) as they break the law for a living in New Mexico. Terry is an alcoholic who loves Glen Campbell, and Bob is a closet intellectual who loves his wife and kids.
From the creators of Shrek comes the most smart, funny, irreverent animated comedy of the year, DreamWorks' Trolls. This holiday season, enter a colorful, wondrous world populated by hilariously unforgettable characters and discover the story of the overly optimistic trolls, with a constant song on their lips, and the comically pessimistic Bergens, who are only happy when they have trolls in their stomach.
When Terry and Bob try to shakedown stripclub manager Birdwell (Caleb Landry Jones), the crooked pair come up against criminal kingpin, James Mangan(Theo James).Things then get very, very personal. It’s not about the money anymore. Terry and Bob put everything on the line for the sake of an innocent, and shooting their way to rough justice turns out to be their unlikely redemption.
Featuring original music from Justin Timberlake, and soon-to-be classic mash-ups of songs from other popular artists, the film stars the voice talents of Anna Kendrick, Justin Timberlake, Russell Brand, James Corden, Kunal Nayyar, Ron Funches, Icona Pop, Gwen Stefani, and many more. DreamWorks' Trolls is a fresh, broad comedy filled with music, heart and hair-raising adventures.
Lifestyle Resort Takes Retirement to New Heights In an era when many Australians want to remain living in their home as they age, a Gold Coast lifestyle resort is positioned as a game-changer. The Henley on Broadwater has already won acclaim for offering retirees a haven in a worldclass site. All apartments have ocean views and private balconies and are located on the doorstep of restaurants, parklands, Australia Fair Shopping Centre, transport, hospitals and medical facilities. Residents have access to recreational facilities such as barbecue terraces, a community lounge and bar, pool and gymnasium, sky-deck garden and bowling green, and lead a socially engaged and active life made easy by The Henley’s location adjacent to three kilometres of Broadwater Parklands, as well as the Southport Aquatic centre. What truly makes The Henley unique is Henley Home Services, offering homecare-style support that gives residents the assistance they need now, with the flexibility to add services as their needs evolve. You no longer have to be in a care environment to receive all levels of care. Options include personal care such as help with showering, dressing and grooming, domestic services including household chores and cleaning, meal preparation that ensures nutritious homemade food, and other miscellaneous tasks such as shopping or looking after pets. Nurses are at the resort every day of the week to provide you with all levels of nursing care such as wound dressing,
medication management and health assessments. They also act as a ‘care concierge’ coordinating allied health professionals, liaising with other practitioners and sourcing government funding. Managing Director Patrick Smith says, “The Henley is leading the trend towards multi-storey retirement living whereby residents enjoy apartments with a luxury hotel feel – and the privacy, security and superb views that go with it – along with onsite wellbeing support and ageingin-place care services. Life at The Henley is about doing what is important to you with Henley support to maintain your independence.” Mr Smith believes Henley Homecare Services will set the standard for other retirement-living facilities. “Our model offers all the benefits of home care, but with the added advantage of having services available onsite and around the clock,” he says. “The beauty of such an ageing-in-place model is that our service delivery can be adjusted to meet the changing needs of residents, resulting in the real prospect that they may never have to move home again.” The services are underpinned by three guiding principles: individuality (providing tailored support), independence (helping residents live the best possible life) and flexibility (designing services to suit people’s varying schedules). Mr Smith says in the event of residents becoming ill, having falls, needing wound care
or experiencing other health concerns, they can quickly get onsite nursing care, making the recovery process much smoother and, in many cases, eliminating the need to go offsite to medical centres or hospitals. Having friendly, familiar staff who can help out adds to the appeal for residents. “It’s like having homecare on your doorstep,” Mr Smith says. Significantly, residents of The Henley can access all onsite support services while still being eligible for supported government funding.
For more information on how The Henley on Broadwater could be your next choice of home, email info@thehenley. com.au or call one of the team on 0488 006 677. Brand-new luxury onebedroom apartments start from $425,500.
Local & Co After a few years of local foodies heading south to get their brekky fix, we have some exciting news â€“ Main Beach is back in fashion! Alongside a handful of new cafĂŠs and restaurants to recently open on Tedder Ave, Local and Co. is breathing new life into the once-booming locale.
Dishing up deliciously innovative breakfasts and lunches alongside what we are calling the best coffee on the Coast, Local and Co. has been warmly welcomed by local food critics and diners alike. We arrive for our first visit on a Saturday morning and the place is packed. The efficient service means just a short wait until we are seated at a table though – two points for that! Scanning the menu, I mentally divide the dishes into two categories – naughty and nice. The angel on my shoulder is telling me to choose the Super Greens Breakfast Bowl ($18): mixed quinoa, sautéed kale, asparagus, broccolini, Persian feta, dukkah, smashed avocado and freerange poached eggs with blackcurrant vinaigrette. Unfortunately the devil on my other shoulder is encouraging me to go for the Nutella Waffles: classic Belgian-style waffles topped with Nutella, vanilla bean mascarpone, macadamia crumble and strawberries. In the battle of naughty versus nice, nice wins and I settle on the brekky bowl. Any momentary regret I have about my order subsides with the first bite. I’m not usually a huge fan of quinoa, but in this dish its presence is totally warranted. The greens are all cooked to perfection, with just the right amount of bite, and the feta and dukkah add some texture and spice to counteract the sweetness of the blackcurrant vinaigrette. I wash it all down with a fresh green juice and one of the best coffees I have ever had, made with freshly ground beans from Social Espresso. My husband has opted for the Healthy Start: roasted sweet potato cubes, cauliflower hash brown, house made beetroot labneh, sliced avocado, free range poached eggs, dukkah and organic light rye toast. The cauliflower hash browns are mind-blowingly good, and my husband has to fend them off with his fork. Yum! I love a restaurant that offers healthy options for kids, and Local and Co. really delivers on this with the kids’ fruit salad. The freshly cut fruit is beautifully displayed in the bowl, with the chef taking extra care to ensure the various fruits are barely touching, because we all know how much kids hate that! With a queue now forming outside, we take pity on the waiting diners and vacate our table, with full bellies and happy taste buds. We’ll definitely be back for more soon though! 102
top picks NAUGHTY Brekkie Bruschetta ($17.50) Choice of bacon, haloumi or smoked salmon with smashed avocado, tomato, red onion, fresh basil, balsamic reduction and poached eggs on organic sourdough toast. Nutella Waffles ($17) Classic Belgian-style waffles topped with Nutella, vanilla bean mascarpone, macadamia crumble and strawberries.
NICE Healthy Start ($18) Roasted sweet potato cubes, cauliflower hash brown, house made beetroot labneh, sliced avocado, free range poached eggs, dukkah and organic light rye toast. Super Greens Breakfast Bowl ($18) Mixed quinoa, sautĂŠed kale, asparagus, broccolini, Persian feta, dukkah, smashed avocado and free-range poached eggs with blackcurrant vinaigrette.
Local & Co, Main Beach Shop 6, 20-22 Tedder Avenue, Main Beach
Spring Recipes Welcome back the warmer weather with these fresh and tasty recipes that are light on the waistline but heavy on the flavour.
12 - 16
Spring Breakfast Bars 1.
Grease and line baking dish and preheat oven to 175 degrees Celsius.
Combine the rolled oats, sunflower seeds, pumpkin seeds, walnuts and wheat germ in a bowl. Toss to combine and then spread onto a baking sheet. Place in oven and toast for 15 minutes, stirring occasionally.
While the oat mixture is toasting, combine the coconut oil, maple syrup, coconut sugar, cinnamon, vanilla and salt in a large saucepan over medium heat and stir until the sugar has completely dissolved.
When the oat mixture is nice and toasty, remove it from the oven and add it to the maple syrup mixture. Add the dried fruit and stir well to thoroughly combine.
Turn mixture out into the prepared baking dish, packing down firmly. Bake at 150 degrees Celsius for 30 minutes and then remove from oven. Allow to cool completely before cutting into bars.
• • • • • • • • • • • • •
2 cups rolled oats ¼ cup sunflower seeds ¼ cup pumpkin seeds 1 cup walnuts, roughly chopped ½ cup wheat germ ½ cup pure maple syrup 1 tablespoon coconut sugar 1 tablespoon coconut oil 2 teaspoons vanilla extract ½ teaspoon ground cinnamon Pinch of salt ½ cup diced dried figs ½ cup diced dried apples
6. Store in an airtight container for up to a week.
Miso Glazed Coral Trout Warm Soba Noodles in Green Tea Vinaigrette • • • • • • •
4 skinless coral trout fillets 1 teaspoon grated ginger 1 clove garlic, crushed 1 tablespoon hot water 2 tablespoons rice wine vinegar 2 tablespoons white miso paste 2 teaspoons mirin
• • • • • •
2 bundles organic soba noodles 1 tablespoon rice wine vinegar 1 teaspoons soy sauce 1 cup green tea 1 teaspoon grated ginger Juice of half a lemon
Combine all ingredients except fish in a small pot and whisk until smooth. Simmer on a medium heat for 2 – 3 minutes to take the raw edge off the garlic. Allow to cool.
Boil the soba noodles according to packet directions.
While the noodles are cooking, combine the rest of the ingredients in a small bowl and whisk well.
Pour over fish in a shallow dish and allow to marinate at room temperature for 30 minutes.
Preheat oven grill to very hot. Place the fish on a baking tray lined with foil and grill for 6 – 8 minutes, depending on the size of your fish fillets.
Drain the noodles and dress immediately, reserving two tablespoons of dressing for the baby herb salad.
Serve on warm soba noodles in green tea vinaigrette and top with baby herb salad (recipes follow).
Baby Herb Salad • • •
1 cup of mixed baby herbs of choice 1 medium red chilli, deseeded and finely sliced 2 tablespoons green tea vinaigrette
1. Combine all ingredients in a small bowl and toss.
STARTING YOUR OWN SELF-MANAGED
$UPERANNUATION FUND 110
A Self-Managed Superannuation Fund (SMSF) is a very popular choice for people who would like complete control over their retirement nest egg, with almost 600,000 SMSFs in operation in Australia. However, before you decide to start your own, it is wise to ask yourself these five critical questions first, writes Jason Skinner.
Is it expensive to start up my own Self-Managed Superannuation Fund? According to the Rice Warner Costs of Operating SMSFs Report (May 2013) there are many legal and accounting costs to be considered when establishing your own Self-Managed Super Fund so you will need to allow for these establishment fees. In return you will receive expert advice from those who understand the implications and advantages of SMSFs, as well as invaluable advice on what ASIC and the ATO require of you to establish your SelfManaged Superannuation Fund.
What ongoing costs do I need to consider? Just as with a retail fund, there will be fees associated with running your SMSF. However, you should be aware there are extra expenses incurred when you opt for a Self-Managed Superannuation Fund. You'll need to put more aside in the budget for accounting fees, including the compulsory auditing of your SMSF. It's important to remember these costs will cut into your final retirement balance. You should also be aware of the penalties that can be incurred by the ATO should you not adhere to the strict compliances in place. From 1 July pindaramagazine.com.au
2014 the costs and penalties for making SMSF mistakes drastically increased, with fines ranging into the tens of thousands of dollars, right through until possible prison sentences. To show just how serious they are about these new SMSF rules, the ATO disqualified 660 trustees, issued 92 notices of non-compliance and wound up 44 self-managed superannuation funds in the 2014/15 financial year, because of the contraventions under the new penalty regime. As well, if the SMSF fails to comply, it will lose its concessional tax status and will have to pay to the tax office 47% of the market value of the fund's assets.
Should I have a minimum superannuation balance? Currently there is no mandated minimum balance required when setting up your own SMSF. However, research suggests $200,000 - $250,000 in super is the average starting point. It's an amount seen as cost effective when you consider the fees and time you need to spend in maintaining your SMSF. However, if you are interested in starting your own SMSF but are concerned your current balance isn't high enough to justify the costs, consider this: regulations allow up to four members per SMSF so if you combine your current superannuation amount with potentially three other members you suddenly have a higher balance to begin with, and can also share the costs of the fees. Pindara Magazine
Do you know enough about your responsibilities?
For more information on starting a Self-Managed Superannuation Fund, contact Skinner Hamilton Medical Accountants on (07) 5594 34 or email email@example.com
While you can have your accountant help with this, it is still imperative you have a sound knowledge of your responsibilities in operating a SMSF. It's a very serious commitment to have your own SMSF so you will need to be aware of your legal obligations, how the different investment markets operate, what strict governances are in place in terms of what you can invest in, your insurance liabilities, as well as the tax implications. It is also wise to be very familiar with the strict governances in place with regards to Self-Managed Super Funds. The ATO imposes penalties for those who fail to adhere to these.
Is it difficult to wind up a SMSF? Circumstances can change quickly in life; therefore it's just as important to know how to get out of a Self-Managed Superannuation Fund before you decide to get into one. So, should you find yourself in a situation where your SMSF needs to be shut down, you will be required, according to the Australian Taxation Office, to do the following: • • • •
Advise the ATO within a strict 28-day timeframe. Dispose of all the assets in the fund. Arrange for a final audit of the fund to take place Carry out your reporting responsibilities.
Disclaimer: Skinner Hamilton and its related businesses make no representations and give no warranty as to the accuracy of the information in this document and such accepts no liability for any errors, misprints or omission herein (whether negligent or otherwise). Skinner Hamilton Pty Ltd shall not be liable for any loss or damage whatsoever arising as a result of any person acting or refraining from acting on any information contained herein. This article is prepared for general information purposes only and we recommend that at all times individual advice be sought before acting on the information contained in this document.
Bluetooth Wireless Sportsbuds & Headphones Premium sports audio to inspire fitness. Push harder, run faster, train longer. blueantwireless.com Pump Zone available in Black, Blue, Green and Red. Pump Lite available in Black, Green, Red and Teal. Not all products available at all retailers, check with your local store.
ULTIMATE EVOLUTION Vanquish is the culmination of an extraordinary determination to create the ultimate Grand Tourer. The lastest evolutionary stride redefines perfection. – boasting a new 8 speed Touchtronic III gearbox, more power, faster top speed, improved acceleration and leaner fuel economy. Performance, refinement, and poise are elevated to unprecedented heights. Vanquish knows no limits.
urban 31.0 (9.1); combined 22.1 (12.8). CO2 emissions 298 g/km. real driving experience, which may vary depending on factors including road conditions, weather, vehicle load, and driving style.