Monday, April 09, 2007

Paracetamol causes liver damage

Aspirin used to be the first-choice analgesic but it tends to promote bleeding so paracetamol became the new religion. I wonder what the next religion will be now? That any drug that does anything also has side effects is a REAL "inconvenient truth". I have always stuck with aspirin, myself. Its ratio of benefit to risk is huge

PARACETAMOL, the drug commonly found in headache tablets, has surpassed hepatitis and alcohol to become the most common cause of liver failure in Australia. Doctors are being urged to exercise caution when prescribing paracetamol following cases of patients suffering accidental poisoning after taking only the recommended dose of the painkiller, often sold under the brand Panadol.

A report published in The Medical Journal of Australia found people who didn't eat enough, drank a lot of alcohol or took certain medications were vulnerable to toxic effects from paracetamol. Elderly people with kidney or heart and lung problems may also be at increased risk. "Accidental paracetamol poisoning should be suspected in any patient with acute liver failure," the report said. "Clinicians should be cautious about prescribing regular doses of paracetamol for pain control in malnourished or fasting patients, and need to counsel patients who are regular users of the drug." Healthy people are usually able to metabolise paracetamol, most of which is excreted from the body in urine. But the drug can accumulate in people with risk factors, rendering even a normal dose toxic.

The Accidental Paracetamol Poisoning report, compiled by experts from Austin Health in Victoria, describes the case of a 45-year-old Australian woman who died from liver failure. She was taking paracetamol for abdominal pain after having a hysterectomy and suffering complications. Her eating had been poor because of pain, vomiting and treatment. "The patient ... was noted to be displaying odd behaviour," the record states. "The following morning she became increasingly confused and drowsy. "She was admitted to the intensive-care unit, where her conscious state deteriorated rapidly and she required intubation." The woman was transferred to a liver transplant unit but died before a donor organ became available. A post-mortem examination found a toxic level of paracetamol in her body.

Hepatitis and alcoholism is another major cause of acute liver failure. Parents are warned not to give children painkillers unless they have high fever or severe pain. Dr David Thomas, pediatric spokesman for the Australian Medical Association, said: "Paracetamol and ibuprofen are drugs - they aren't without risks or side-effects


Victorian policing getting as hopeless as Britain's

ALMOST half of Victorians convicted of serious crimes escape jail, an audit of sentencing shows. The "soft approach" is underscored by Victorian courts jailing far fewer criminals than the national average... Crime Victims Support Association spokesman Noel McNamara said the leniency displayed by Victoria's judges was an insult to the community. "Victoria is the justice joke of the nation. If you are a criminal you would want to come to Victoria." People Against Lenient Sentences president Steve Medcraft said the figures showed criminals had good odds of avoiding prison. "Crime does pay in Victoria. The legal system is weighted in favour of criminals," he said.

Police chiefs and the Government are also facing scrutiny over a curious force statement on resourcing trends. The website states: "Since Victoria Police first began providing police services in 1853, its role has expanded from one focused primarily on law enforcement, to one of community assistance, guidance and leadership. "Only about 20 per cent of police work is directly related to fighting crime."

Opposition scrutiny of government spokesman Murray Thompson said the statement represented "an extraordinary admission". "Maybe some piccolo players from the police band could change their tune and start catching crooks," he said. Police Association secretary Paul Mullett said at least 80 per cent of policing work should involve fighting crime. "Police are not out there preventing street crime from occurring," he said. "Patrolling is not happening. It is not an issue of police numbers, it is where and how they are deployed." He said too much time was now spent preparing data, filling in forms and meeting increasingly convoluted demands relating to briefs of evidence. "Some general duties police are becoming little more than data entry clerks," Mr Mullett said. The association said extended leave, secondments to external agencies and policy development roles could also be impacting on numbers of police on the beat.

A State Government spokesman said greater restrictions on judges handing out suspended sentences had been bought into force after law changes last year. "When offenders are sentenced to jail for serious crimes they will go to jail unless there are exceptional circumstances," the spokesman said. He said the issue of how police were deployed was an operational matter for the force.

Asked about the website statement, a Victoria Police spokeswoman said: "A large part of our role includes targeting community needs such as road safety, promoting and maintaining harmonious relationships within Victoria's diverse community, identifying crime and safety issues and establishing effective solutions. "Victoria Police also strives to continually improve our forensic services."


Another stupid birthday cake ban

Why not ban milk? It is highly calorific. No-one even THINKS of offering any evidence that the cake ban will make anyone slimmer, of course. Who needs evidence when you KNOW?

[NSW] schools are banning students from bringing birthday cakes to class in an effort to curb unhealthy eating habits. They say the no-cake policy will also help reduce the risk of allergic reactions among students, such as the potentially fatal anaphylaxis that can be triggered by peanuts. The move follows a crackdown on junk food in most school canteens that has involved a ban on items such as chips and soft drinks.

Cranbrook School's junior school is among the first to ask pupils not to bring birthday cakes, also requesting that parents do not send in other types of celebratory treats. Its new "nutritious food and beverage" policy also encourages parents to provide healthy school lunches and covers food eaten while on school camps and excursions. Pupils are discouraged from bringing sports or carbonated drinks. The junior school's latest newsletter to parents says: "There are many other enjoyable ways for the boys to celebrate their friends' birthdays at school and we will be exploring these instead. The boys can always enjoy a birthday cake with family and friends outside of school time." Junior school head Michael Dunn said the policy would come into effect at the start of the new term. He said that, as well as being health-conscious, the policy showed respect for children with allergies. Some Sydney preschools have already introduced a strict no-cake policy, as well as lunch-box inspections, to ensure children do not eat junk food during the day.

"This could be something that is going to become bigger," NSW Parents and Citizens Federation president Di Giblin said. "If you have got 30 children, you have got 30 birthday cakes coming through. "We have got to acknowledge that it's a treat, and part of healthy eating is a balance and choice, so while we understand it is a celebration, we can do it in a way that is healthy."

Tina Jackson said an all-out ban on birthday cakes at school seemed too strong. At Mosman Public, attended by her year 2 daughter Angelica, pupils can bring cakes but smaller-sized treats are recommended. "The school does prefer that you give cupcakes," Ms Jackson, executive director of the National Trust of Australia, said. "The kids so enjoy having the cupcakes and it makes the day really special. A ban does seem a bit harsh." She said there had been efforts to ensure the school canteen offered healthy options.


Labor using old maps to chart new territory

Developing a national curriculum has become the Lasseter's Reef of education, says Kevin Donnelly. Lasseter's Reef is a legendary "lost" Australian gold mine that many have tried to find -- but none have. Donnelly fears that a national syllabus may be a dumbed-down one

Next week's meeting of Australian education ministers, under the auspices of the Ministerial Council on Education, Employment, Training and Youth Affairs, has much to consider. Issues include performance pay for teachers, national benchmark testing and implementing a national curriculum. The proposal to introduce a national curriculum is especially contentious and politically sensitive.

The ALP has taken the lead on the issue with the publication of a document outlining its plan to establish a national curriculum and to improve our children's educational outcomes. Apart from suggesting that the states may be forced to implement a national curriculum by linking it to federal funding, the Coalition has yet to detail its plans.

Superficially, the idea of a national curriculum, as with a unified railway system or a common approach to Australia's environmental problems, seems worthwhile. But, judging from past experience, mandating what all Australian schools should teach and how it is measured and assessed - what in the US are called content and performance standards - is fraught with problems.

The idea of developing a national curriculum has become the Lasseter's Reef of Australian education. Beginning in 1980 with the publication of Core Curriculum for Australian Schools, continuing with the Keating government's national statements and profiles and, most recently, embodied in what are termed "statements of learning", millions of dollars and thousands of hours have been wasted in the search for a curriculum that can be used by all schools.

Although the 1980 core curriculum document had little, if any, effect on schools and it is too early to judge the effectiveness of the statements of learning, the substandard state of Australian education can be traced to the influence of the outcomes-based education-inspired national statements and profiles developed during the early 1990s.

Failed experiments such as Tasmania's Essential Learnings, Western Australia's attempt to introduce outcomes-based education into years 11 and 12, and fads such as whole language, fuzzy maths and a feel-good assessment system where everyone wins, are all children of the Keating government's national curriculum plan. Imagine the consequences if next week's MCEETYA meeting agrees to impose an outcomes-based education-inspired, politically correct curriculum on Australian schools, government and non-government, and all teachers, as a requirement for promotion, have to acquiesce to a second-rate, government-mandated curriculum.

Such an outcome is more than likely if the Kevin Rudd-Stephen Smith model is adopted because the federal ALP, if elected, has promised to give the Curriculum Corporation and the Australian Council for Educational Research key roles in developing a national curriculum; two organisations responsible for the present mess.

There is an alternative to a centrally imposed curriculum. The first step is for the federal Government to establish a body to evaluate and rank state and territory curriculum documents against one another and international best practice. This is the case in the US, where groups such as the American Federation of Teachers and the Thomas B. Fordham Institute evaluate state-based curriculum documents on an annual basis.

In contrast to Australia's approach, with its politically correct orientation and promotion of progressive shibboleths such as constructivism and developmentalism, the US approach is premised on the conviction that curriculums must be concise and teacher-friendly, related to year levels, internationally benchmarked and based on the academic disciplines. For too long curriculums in Australia have been the preserve of an educational cabal more concerned with promoting its own remedies, however misguided, and excluding the public, and the media, from debate. The second step is for the federal Government to develop syllabuses in key subjects across all year levels, including years 11 and 12.

Such intended curriculum documents would be unashamedly elitist - based on the assumption that not everyone is suited to a university education - and academic, given the consensus that generic skills and competencies are best taught within the context of the established disciplines. Instead of being centrally developed, far from the realities of the classroom, such a national curriculum would be primarily developed by practising teachers and discipline specialists within university departments, not schools of education, and offered to schools on a voluntary basis and in competition to state-developed alternatives.


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