ACCC commences proceedings against Cryosite Ltd for alleged cartel conduct - The Australian Competition and Consumer Commission (ACCC) has commenced legal proceedings in the Federal Court against Cryosite Ltd (Cryosite), a biotech company which specialises in biorepository and cord blood and tissue banking in particular.
ACCC pings GAIA - Dreamz Pty Ltd, trading as GAIA Skin Naturals was found to allegedly be making misleading and deceptive representations after claiming their baby shampoo, moisturiser and bath wash were 'pure, natural and organic'. The company has paid fines worth $37,800 for including sodium hydroxyl methyl glycerinate and phenoxyethanol in its products.
ACCC takes action against hearing aid retailers for misleading statements - Last month, the ACCC commenced action against Oticon Australia Pty Ltd and Sonic Innovations Pty Ltd, both hearing aid retailers, for allegedly making false and misleading representations in advertisements for hearing aids available under the Australian Government Hearing Services Program (Hearing Program). The Hearing Program is available for pensioner concession card holders, veterans and defence force personnel.
AHPRA Register changes improve consumer access to public information - Following AHPRA and the Medical Board of Australia's independent review of the use of chaperone conditions in late 2016, the Medical Board of Australia, supported by AHPRA, has implemented the final recommendation from that review.
AHPRA releases new tool to help guide use of testimonials in advertising - The Australian Health Practitioner Regulation Agency ("AHPRA") has recently launched a new tool to assist practitioners and advertisers understand their obligations about using testimonials and reviews to advertise regulated health services.
AMA calls on COAG to urgently develop a national medical workforce strategy - AMA Medical Workforce and Training Summit was held at the Australian Medical Association ("AMA") Victoria in Melbourne on 3 March 2018 ("Summit"). More than 80 key stakeholders took part in the Summit to discuss key medical workforce challenges and how to better meet community need.
AMA disappointed with mandatory reporting recommendations - In a recent press release, the AMA expressed its disappointment at the decision of the Queensland Parliament Health, Communities, Disability Services, and Domestic and Family Violence Prevention Committee (the Committee) to pass proposed mandatory reporting laws for doctors treating other medical professionals for mental health issues.
AMA NSW supports safe access zones for women's health services - On 24 May 2018, the Public Health Amendment (Safe Access to Reproductive Health Clinics) Bill 2018 ("Bill") passed the NSW Legislative Council without amendments. The Bill proposes to make amendments to the Public Health Act 2010 (NSW) by introducing an 150-metre exclusion zone around reproductive health clinics to stop patients and staff members being harassed or intimidated by anti-abortion protestors. The change would bring NSW in line with ACT, Victoria and Tasmania, who already have similar legislation.
AMA Position Statements: men's health, drugs in sport and the NDIS - The Australian Medical Association ("AMA") has recently released position statements in relation to a number of health hot topics. First on the agenda is Men's Health, which the AMA believes requires a national strategy to address the greater vulnerability men have to various health disorders as well as substance abuse, suicide, and mental health problems. You can view the AMA's Position Statement on Men's Health in full here.
AMA raises concerns for human health as a result of climate change - The Australian Medical Association (AMA) has made a public statement following the release of the Intergovernmental Panel on Climate Change's (IPCC) recent report. In the report, the IPCC has urged that global warming should be limited to 1.5°C rather than 2°C but that the necessary measures would require far-reaching changes across society.
Australia's largest cosmetic surgery clinic subject to parliamentary inquiry - A Parliamentary inquiry commenced regarding the NSW Cosmetic Institute's failure to employ experienced and qualified surgeons to perform breast augmentation surgery.
Australia's tobacco plain packaging laws upheld by World Trade Organisation - A panel of the World Trade Organisation (WTO)has rejected complaints from Indonesia, Cuba, Honduras and the Dominican Republic that Australia's plain packaging laws infringed tobacco trade marks and were inconsistent with Australia's obligation under international agreements.
Australian Bureau of Statistics – Patient Experiences in Australia - The Australian Bureau of Statistics has released the results of the 2016-17 Patient Experience Survey, which collected data on access and barriers to a range of health care services.
Australian government responds to independent review of health providers' access to Medicare card numbers - The Australian government has released its response to the Independent Review of Health Providers' Access to Medicare Card Numbers ("Review"). The Review was commissioned following media reports that Medicare card numbers were available for sale on the 'dark web'. These reports were referred to the Australian Federal Police, and its investigation is ongoing.
Call for changes to mandatory reporting for treating practitioners - United General Practice Australia ("UGPA"), is seeking changes to mandatory reporting requirements for treating practitioners. The current requirement are seen to increase the risk that health practitioners will not seek independent medical assessment, advice and treatment to address a physical or psychological medical condition that they may be personally experiencing.
Changes to mandatory reporting under the National Law - The Queensland government introduced the Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2018 into parliament on 31 October 2018.
Changes to the therapeutic goods advertising framework commence - Following the Therapeutic Goods Administration's ("TGA") Review of Medicines and Medical Devices Regulation a range of changes to the regulatory framework will be made between 2018 and 2020, with the first changes commencing last month.
Children with gender dysphoria no longer have to seek court approval to undergo treatment - Parents, minors and doctors are being given their autonomy back when it comes to cases of gender dysphoria. The Family Court has determined that where all three agree, parents will not have to seek court consent for Stage 3 treatment for gender dysphoria in adolescents and adults.
Commissioner investigates drug & alcohol services - The Health Complaints Commissioner ("HCC") has used her new powers to prosecute a person who is prohibiting from carrying out a health service in South Australia, who is alleged to have contravened that ban by carrying out a counselling service in Victoria. Mr Mittiga was banned in 2015 from providing any health service in South Australia but has allegedly been practising in Victoria, in violation of that ban. If convicted, Mr Mittiga faces a penalty of up to $38,000, two years imprisonment or both.
Company fined over importing unapproved cosmetic therapeutic goods - ESCHOICE Pty Ltd, an Australia Company, has been fined over $25,000 after the Therapeutic Goods Administration (TGA) issued them with an infringement notice.
Conscientious Objection to Voluntary Assisted Dying - Patients suffering incurable and terminal illnesses or medical conditions may be eligible under the Voluntary Assisted Dying Act 2017 (Vic) (Act) for access to voluntary assisted dying. However, under the Act, a registered health practitioner who has a conscientious objection to voluntary assisted dying has the right to refuse to provide information about voluntary assisted dying, or to assist and prescribe the voluntary assisted dying substance (Substance).
Coroner urges for laxatives to be pharmacist-only medication - A South Australian coroner has recommended that laxatives be classed as 'pharmacist-only medications' following the death of a 28 year old woman.
Counsellor convicted after claiming to be a psychologist - Print The New South Wales Health Care Complaints Commission received complaints alleging that a counsellor, Mr David Citer, was falsely holding himself out to be a registered psychologist. Mr Citer had referred to himself as a "Specialist Child, Adolescent and Family Psychologist" in emails to a registered psychologist. However, Mr Citer had never been registered as a health practitioner or student under the Health Practitioner Regulation National Law (National Law).
Court of Appeal requires doctor to produce patient records to VCAT - Dr Kemp, a medical practitioner, was asked to produce medical records to the Victorian Civil and Administrative Tribunal (VCAT) as part of a professional regulation matter despite his patient's refusal to consent.
Department of Health offers enforceable undertaking following Medicare and PBS data breaches - In September 2016, the Office of the Australian Information Commissioner ("OAIC") was notified of vulnerabilities in the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme datasets published online. The datasets were based on personal information held by the Department of Health ("Department"). Following the notification, the OAIC opened an investigation to assess whether personal information had been compromised and the adequacy of the Department's processes.
Digital health meets international sport - ASX listed Melbourne based digital health company Global Health has announced its partnership with Jobs4Sport digital platform to enable athletes to take their medical records with them when they move between countries and clubs.
E-cigarettes lose puff in public places - New South Wales has introduced legislation to curb vaping and smoking of e-cigarettes in public places.
End of Life Directions for Aged Care project launched - On 15 June 2018, the Commonwealth Government formally launched the End of Life Directions for Aged Care (ELDAC) project. The project includes a new website which is intended to be a one-stop resource for support and advice on palliative care and advance care planning.
Experts call for ban on "Real Bodies – The Exhibition" - The Royal Australasian College of Physicians (RACP) has condemned the Real Bodies exhibition on the basis that the specimens were unethically and illegally obtained which breaches the NSW Health Regulations. RACP has called for the exhibition to be shut down.
Fake chiropractor and fake psychologist successfully prosecuted - AHPRA has successfully prosecuted two people for unlawful use of the protected titles psychologist and chiropractor and holding themselves out as registered health practitioners.
Family Planning NSW targeted by hackers with ransom demand - Family Planning NSW recently had its website hacked by a group threatening to release confidential data unless a ransom was paid.
Federal government announces mandatory flu vaccines for aged care - The Australian government has recently announced that flu vaccinations will be compulsory for all staff in residential aged care facilities ahead of this year's flu season. The announcement comes following research showing a significant link between greater staff immunisation and lower rates of flu outbreaks in aged care facilities.
Flaw in Telstra Health's Argus software exposed medical records to hackers - Telstra Health has urgently addressed potential privacy breaches caused by a flaw in its Argus software.
Funding for PrEPX to keep protecting Victorians - The Victorian Government has announced that it will provide an extra $400,000 funding to extend the PrEPX HIV prevention medication study. The additional investment means the study will now run until 30 June 2018 – three months longer than its initial period.
Government says it will take "sweeping steps" to support the transvaginal mesh implant recommendations - A recent Senate Inquiry into the adverse impacts of transvaginal mesh implants raised awareness of the traumatic experiences experienced by women who have undergone mesh-related procedures. As a result, the Inquiry was able to identify how women who have been affected by these procedures are being recognised and supported.
GST on feminine hygiene products to be removed from 1 January 2019 - On 28 November 2018, the Federal Government signed the determination that will remove the Goods and Services Tax (GST) from feminine hygiene products from 1 January 2019 (Determination).
Hair implants refusal puts company in HIV discrimination spotlight - A hair-loss treatment clinic was forced to apologise to a HIV-positive man it refused to treat after Queensland's Anti-discrimination Commission concluded its investigations. This is one of several cases highlighted in the Anti-Discrimination Commission Queensland's annual report for 2017-18 (Report).
Healthcare facility concedes privacy breach after specialist sends medical report to wrong GP - In NSW, the Health Privacy Principles (HPPs) contained within the Health Records and Information Privacy Act 2002 (HRIP Act) protect individuals in NSW in relation to the collection, storage, use and disclosure of their health information by NSW public sector agencies and health service providers. The NSW Civil and Administrative Tribunal (Tribunal) has recently considered whether there was a breach of HPPs as a result of the disclosure of personal information to a general practitioner not involved in the care of the patient due to a computing error.
HealthEngine may be in breach of privacy law in sharing patient data - Print Health Minister Greg Hunt has ordered an "urgent review" of Australia's biggest online doctor appointment service, HeathEngine.
Immediate action against a practitioner in response to serious forced labour offences - Three concurrent Victorian Civil and Administrative Tribunal (Tribunal) matters have found that the immediate action taken to supervise the practices of Dr Farshchi, a registered acupuncturist, chiropractor and medical practitioner, was appropriate.
Improved Health and justice outcomes for Victorians - To ensure vulnerable Victorians continue to have access to justice, the Victorian Government is providing $1.6 million of funding to Health Justice Partnerships. The money will be distributed amongst eight Health Justice Partnerships throughout Victoria until 2020.
Indemnity insurance changes possible - A review of the Indemnity Insurance Fund ("IIF") and seven associated schemes was recently completed and a report provided to the Department of Health. The First Principles Review Report - which consulted with key stakeholders including medical indemnity insurers and medical professional groups - assessed the cost, availability and viability of the current Indemnity Insurance scheme.
Inquiry into drug law reform - On 27 March 2018, the Law Reform, Road and Community Safety Committee published the Report into Drug Law Reform.
Investigation into complex pharmacy licence applications set to target franchise agreements - The Victorian Pharmacy Authority ("VPA") has announced that it is set to begin stricter investigations into complex pharmacy licence applications to ensure compliance with the Pharmacy Regulations Act 2010 (Vic).
Law Council of Australia makes submission on Drug Testing Trial Bill - The Law Council of Australia has provided a submission to the Senate Standing Committee on Community Affairs regarding the Social Services Legislation Amendment (Drug Testing Trial) Bill 2018. The Bill will establish a two year drug testing trial in three regions of Australia for 5000 new recipients of Newstart Allowance and Youth Allowance.
Medical Board revised guidelines on sexual boundaries a timely reminder for doctors - Revised Medical Board of Australia guidelines on sexual boundaries in the doctor-patient relationship took effect on 12 December 2018. The updated guidelines apply to all registered medical practitioners in Australia and define the standards of ethical and professional conduct expected of doctors by the Board, their peers and the community.
Medical practitioner convicted of fraud has registration suspended by VCAT - The Victorian Civil and Administrative Tribunal ("VCAT") determined Dr Pralay Mazumdar, a specialist psychiatrist, engaged in professional misconduct and unprofessional conduct in November 2017.
Medicine companies required to report medicine shortages under new law - Last month, the federal parliament passed the Therapeutic Goods Amendment (2018 Measures No. 1) Act 2018 (Act). The Act will commence on 1 January 2019 and requires medicine companies to report shortages of important medicines as soon as they occur.
Michael Gorton AM will conduct the review of the Assisted Reproductive Treatment Act - Russell Kennedy Principal, Michael Gorton AM will lead this 12-month review which is scheduled to commence this month. The primary focus of the review is to ensure women and families using assisted reproduction are supported through their entire treatment and receive the correct information throughout their journey.
My health Record privacy measures pass the Senate - The Federal Government has passed new My Health Record privacy and security protections through the Senate.
New clinical standard designed to prevent deaths related to blood clots - The first national Venous Thromboembolism Prevention Clinical Care Standard (Standard) has been developed by the Australian Commission on Safety and Quality in Health Care (Commission) to support clinicians and health services to implement the delivery of high-quality care to prevent venous thromboembolism (VTE) acquired in hospital and following hospital discharge.
New food labelling laws take effect in Victoria this month - As of 1 May 2018, fast food and supermarket chains in Victoria are required to display the kilojoule content of ready-to-eat food and drinks as well as the average adult daily energy intake of 8,700 kilojoules.
New laws requiring all Victorian hospitals to report cases of potentially fatal anaphylaxis - From 1 November 2018, Victorian public and private hospitals will be required to notify the Department of Health and Human Services of anaphylaxis presentations (Department) under an amendment to the Public Health and Wellbeing Act 2008 (Vic) (Act).
New National Rare Diseases Framework announced - Last month, the Federal Government announced their development of Australia's first Rare Diseases Framework and Action Plan in support of those people battling rare conditions. The framework will receive $170,000 in funding as part of the Government's Public Health and Chronic Disease Program.
Nick Xenophon's FOI - The Australian Information Commissioner ("AIC") handed down its decision on 8 February 2018 with respect to Nick Xenophon's application to review the Department of Health's ("Department") decision to refuse access to the legal costs invoiced in relation to arbitration between the Commonwealth and Phillip Morris Asia Limited (Hong Kong).
No Jab, No Play laws strengthened to protect Victorian children - From 1 November 2018, Victorian parents or carers of children who attend early childhood services are required to provide them with periodic Immunisation History Statements to prove that their child's immunisations are up to date. The Immunisation History Statements must evidence appropriate immunisation of the child and be submitted within 2 months after the child reaches a prescribed age or at intervals not exceeding seven months.
NRL to keep some concussion breaches secret - Last year the NRL issued fines to three clubs because they failed to observe the proper procedures when players suffered serious head collisions. The NRL has asked clubs about incidents where players have exhibited signs of concussion but have returned to the field of play. These inquiries are not made public.
NSW Coroner critical of failure to listen to parent concerns - On 23 November 2018, the Coroner's Court of New South Wales released its findings in the inquest into the death of Angelique Burton-Ho; a 12 year-old child who died as a result of cardio-respiratory failure shortly after being transported from Bowral Hospital to the Sydney Children's Hospital (SCH).
NSW unregistered dental practitioner receives timely conviction - Earlier this year on 14 May 2018, the Australian Health Practitioner Regulation Agency (AHPRA) charged a New South Wales man, Mr Majid Rahebi, with 44 counts of "falsely representing that he was a registered dentist" and 31 counts of "performing a restricted dental act".
Palaszczuk Governments acts on discrimination - The Palaszczuk Government in Queensland has committed to changing the Births, Deaths and Marriages Registration Act 2003 so that people who undergo gender reassignment will not have to divorce their partner.
Palliative Care Funding Model Review report published - In November 2017, the Victorian government engaged an expert panel to review palliative care offerings and services across Victoria to identify areas for improvement. The Panel, made up of Patricia Faulkner AO, Jennifer Williams and Carmel Smith published their Palliative Care Funding Model Review Report (Report) in October 2018. The Panel undertook a review and consultation process before making seven recommendations which are set out in the Report. The recommendations include additional funding for community-based palliative care services and seeking increased activity in the use of community-based services for certain patient cohorts. The Report also recommends better integration of palliative care with other services (such as hospitals) and supports the inclusion of more flexible palliative care arrangements which allow people to die at home. The Report acknowledges and recommends that further investment in technology and support systems is required to implement a more patient-centred approach to palliative care. In the last 12 months, the government has provided an additional $23.4 million in funding which is intended to address some of the recommendations by increasing palliative care beds and access to home-based palliative care. Read the Report here.
Pharmacist loses defamation case - A pharmacist convicted of six offences for failure to maintain a register in relation to dispensing oxycodone and fentanyl, failure to make an inventory of drugs of addiction and failure to keep the safe containing Schedule 8 drugs locked has lost a long running defamation case against the Pharmacy Board of Australia ("Board").
Proposed changes to provision of Medicare funded services by nurses rejected by AMA - The Australian Medical Association Limited (AMA) has called on the Government to immediately reject draft proposals which would expand the ability of nurse practitioners to provide Medicare funded services and remove the current requirement for them to collaborate with doctors in delivering care for patients.
QCAT finds anaesthetist did not make false statements about methyl-amphetamine use - On 21 December 2018, the Queensland Civil and Administrative Tribunal released findings in relation to disciplinary proceedings against an anaesthetist (Dr Euston) who was charged and convicted of supplying methyl-amphetamines and possessing dangerous drugs in breach of the Drugs Misuse Act 1986. The Tribunal was required to determine the factual disputes prior to the parties providing evidence and submissions in relation to any sanction being imposed. On 19 October 2013, Queensland Police Service members carried out a search of Dr Euston's home locating drugs and other items. Previously, he had denied suppling methyl-amphetamines or possessing dangerous drugs. He was later convicted on his own plea of guilty to various criminal charges relating to the unlawful supply and possession of a dangerous drug. AHPRA placed a condition, to which Dr Euston voluntarily submitted, on Dr Euston's registration requiring him to attend for drug testing. Results of urine and hair samples suggested the presence of methyl-amphetamine in his body but Dr Euston denied ever using methyl-amphetamines. Dr Euston deposed that in the six months prior to the testing he had taken Selegiline, a medication that metabolises to methyl-amphetamine and has been implicated in false positive hair tests in the past. He argued the quantity of methyl-amphetamine found was also significantly below international guidelines required to indicate methyl-amphetamine use. The Tribunal accepted Dr Euston's evidence as to his use of Selegiline and as a result did not accept that the positive hair test result was evidence of his methyl-amphetamine use. The Tribunal therefore found that Dr Euston was a truthful witness and the concerns regarding his false evidence and statutory declaration were unfounded.
Queensland court case allows a woman access to her deceased partner's sperm - On 20 June 2018, the Supreme Court of Queensland handed down a decision granting a young woman (Ms Creswell) to use her deceased partner's sperm for the purposes of reproduction.
Refreshed Food Allergen Portal released - Food Standards Australia and New Zealand (FSANZ) has launched its new Food Allergen Portal (Portal), which is designed to make it easier for people to navigate and access links to food allergy related resources and information.
Registered nurse suspended after inappropriately touching students - On 6 July 2018, the Victorian Civil and Administrative Tribunal (VCAT) suspended Mr Alfredo Crocetti, a registered nurse, after finding that he acted inappropriately while teaching student nurses at Victoria University (VU).
Regulatory review of Schedule 8 opioid use and misuse in Australia - The Commonwealth Department of Health's Therapeutic Goods Administration ("TGA") is in the process of conducting a review into a possible regulatory response to the potential misuse of prescribed Schedule 8 opioids in Australia. Australia is ranked eighth internationally for daily doses of prescription opioids per million population.
Royal Children's Hospital launches real-time emergency department updates - The Royal Children's Hospital (RCH) recently launched an online portal which allows parents to gauge how busy the Emergency Department is in real-time, 24 hours a day. The tool was developed in response to research which found that more than 60 per cent of patients with non-life-threatening illnesses sidestepped their local hospital and instead faced long delays at the RCH.
Rural Doctors Association of Australia given provisional green light to negotiate on behalf of rural doctors - The Australian Competition and Consumer Commission (ACCC) is currently considering expanding the Rural Doctors Association of Australia's (RDAA) capacity to negotiate contracts on behalf of General Practitioners (GP) and other rural doctors. The proposed extension to the RDAA's powers would see a continuation of the RDAA's current agreement allowing them to collectively negotiate on a state-wide level, and the additional authority to negotiate nation-wide, irrespective of the health system of a particular state.
Russell Kennedy Principal elected to international health body - Russell Kennedy Principal, Michael Gorton AM, was recently elected by the International Society for Quality in Health Care (ISQua) as a founding member of its new Academy of Quality and Safety in Health Care (IAQS).
SafeScript on track for October 2018 – Time to prepare - The real-time prescription monitoring service (known as "SafeScript") will be launched in October this year. SafeScript, will transmit pharmacy dispensing records for certain medicines in real-time to a centralised database, allowing prescribers and pharmacists to access an up-to-the-minute prescription history of certain high risk medicines for their patient at the point of consultation, enabling safer clinical decision making.
Senate Selected Committee into the Obesity Epidemic in Australia - The Senate Select Committee into the Obesity Epidemic in Australia (Committee) was established on 16 May 2018, and aims to introduce a federal National Obesity Strategy to tackle the dramatic increase of overweight and obesity in all age groups.
Special summit of experts to assess rural maternity services in Queensland - In a media statement dated 12 August 2018, the Queensland Government announced that it will convene a special summit of experts to assess the provision of maternity services in rural and remote parts of Queensland.
Taskforce appointed to implement voluntary assisted dying laws - The Voluntary Assisted Dying Implementation Taskforce met for the first time on 26 February 2018 and is chaired by former public advocate Julian Gardner.
Taskforce recommends time-tiered billing for specialists and consultant physicians - The Medicare Benefits Schedule Review Taskforce (Taskforce) has recommended that billing under the MBS be reviewed to better reflect the contemporary roles of specialists and consultant physicians. Under the proposed changes, a new simplified model of attendance items would be introduced – with the core change to set standard attendance schedule fees based on time. The Taskforce considers that changing to this model would strengthen the capacity of consumers to give informed financial consent.
Taskforce to map out stronger community health services in Victoria - The Community Health Taskforce ("Taskforce") has been established to advise the Victorian Government on opportunities to strengthen community health services to better meet the healthcare needs of vulnerable Victorians.
The Australian Medical Association (AMA) raises concerns on revised Code of Conduct for Doctors - The AMA submitted commentary on the revised Code of Conduct for Doctors in Australia to the Medical Board of Australia.
The Australian Medical Association renews its call for a sugar tax - The Australian Beverages Council recently pledged to reduce the amount of sugar added to beverages by 20 per cent by 2020, however the Australian Medical Association (AMA) has labelled the announcement "totally inadequate".
Time critical defined transfer guidelines - The Department of Health & Human Services (DHHS) published guidelines for time critical defined transfers in Victoria (Guidelines) on 6 February 2019. The Guidelines have been published to safe guard patient care in circumstances where demand for critical care beds exceeds the immediate supply, leading to no ICU bed being immediately available for a critically ill patients requiring timely and appropriate investigations, interventions or ICU care.
Townsville Hospital introduces body camera for staff to try to stop increasing number of attacks on staff - Following a successful trial in 2017 (read more here), Townsville Hospital has introduced body-worn cameras for its staff in an attempt to stop a rising number of attacks they experience.
Trainee doctors will get their money back for botched exam - The Board of Royal Australasian College of Physicians ("RACP") has agreed to reimburse the full exam fee of almost $2,000, which is estimated to cost the RACP more than $2 million, after 1,200 trainee doctors were affected by a computer glitch that occurred five hours into the Basic Training Written Divisional Exam.
Tribunal upholds patient Review Panel refusal to provide IVF treatment to couple - A couple, with the pseudonyms RGJ and OMU, sought IVF treatment as RGJ had Polycystic Ovarian Syndrome and they had struggled to conceive. However, they were refused treatment because OMU had been convicted of a violent offence, which trigged a presumption against treatment under the Assisted Reproductive Treatment Act 2008 (Vic) (Act).
Victims to have their say in forensic mental health cases - As a result of recent amendments to the Mental Health (Forensic Provisions) Act 1990 No. 10 (NSW), victims of forensic patients in NSW will now have a greater opportunity to be heard in the Mental Health Review Tribunal (Tribunal).
Victoria will partner with Seattle experts to implement voluntary assisted dying laws - The Victorian government has recently announced that it will partner with the Seattle Cancer Care Alliance to support the implementation of the voluntary assisted dying laws passed by Victorian parliament late last year prior to the people being able to access the scheme in June 2019.
Victoria's new information sharing scheme aimed at reducing family violence - A new information sharing scheme in Victoria will come into effect this month to address the concerns raised by the 2016 Royal Commission into Family Violence. The Family Violence Protection Amendment (Information Sharing) Act 2017 is aimed at minimising the legislative barriers that have prevented the timely sharing of information in cases of family violence.
Victoria's SafeScript system begins roll out in Western Victoria - Victoria's comprehensive real-time prescription monitoring system, SafeScript, goes online this month. SafeScript commences its roll out in the Western Victoria Primary Health Network catchment in October, before being introduced to the rest of Victoria early next year.
Voluntary Assisted Dying Review Board appointed - The Victorian Minister for Health, Jill Hennessy has recently announced the members of the Voluntary Assisted Dying Review Board (Board). Former Supreme Court judge, Betty King QC will chair the Board with ICU specialist, Charles Corke to act as deputy chair. The remaining 11 members are made up of health and legal experts.
Voluntary Assisted Dying Statewide Pharmacy Service FAQs - In January 2019, the Victorian government announced that the pharmacy service at The Alfred hospital will be the sole service for dispensing voluntary assisted dying medication when the scheme takes effect on 19 June 2019. The voluntary assisted dying medicine will be funded by the Victorian government and patients will not be required to be out-of-pocket to access the medication.


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Philosophy Nigel Warburton Edmonds and Warburton Society Arts Podcasting Education
By Nigel Warburton and Edmonds and Warburton. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.
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David Edmonds (Uehiro Centre, Oxford University) and Nigel Warburton (freelance philosopher/writer) interview top philosophers on a wide range of topics. Two books based on the series have been published by Oxford University Press. We are currently self-funding - donations very welcome via our website http://www.philosophybites.com
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Beginner friendly if listened to in order! For anyone interested in an educational podcast about philosophy where you don't need to be a graduate-level philosopher to understand it. In chronological order, the thinkers and ideas that forged the world we live in are broken down and explained.
History of Philosophy Without Any Gaps
Peter Adamson, Professor of Philosophy at the LMU in Munich and at King's College London, takes listeners through the history of philosophy, "without any gaps". www.historyofphilosophy.net
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1 phone call. 1 hour. No names. No holds barred. Thats the premise behind Beautiful Stories from Anonymous People, hosted by comedian Chris Gethard (the Chris Gethard Show, Broad City, This American Life, and one of Time Outs 10 best comedians of 2015). Every week, Chris opens the phone line to one anonymous caller, and he cant hang up first, no matter what. From shocking confessions and family secrets to philosophical discussions and shameless self-promotion, anything can and will happen! T ...
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So I was having a good old catch up with Ananda aka DJ Sister Rock yesterday and she happily agreed to give MLW readers a 10% discount on early bookings. Yippee!! A 10% discount on booking entertainment, and all the extras that go with it could actually save you a good few Dirhams. Perhaps that little saving could go towards your wedding day shoe fund or a trip to the spa. Anyway… I thought I'd refresh your memories and blog about it today. But don't forget to mention MLW to get your discount!
Also, sorry I've been a bit quiet the last week. There is a lot going on behind the scenes and I'm so excited to share it with you very soon. One more week and I think I can reveal everything.


"The Battle of Aughrim". Painting by John Mulvaney.
How the Battle of the Boyne, celebrated annually on July 12 in Northern Ireland by Ulster loyalist marching bands, and the Battle of Aughrim changed Ireland's religious and political infrastructure so much that we still see its effects nearly 330 years later.
On July 1, 1690, in Oldbridge, County Meath, the Battle of the Boyne took place between William of Orange, the recently crowned King of England, Scotland, and Ireland, and his Catholic father-in-law, the deposed James II and VII (he was King of Ireland and England as James II, and King of Scotland as James VII). The battle was extension of the Nine Years War raging across Europe, and even North America at the time, now considered the first global conflict.
Painting of King James II and VII, from the studio of Godfrey Kneller. Wikimedia Commons.
James and William's conflict in Ireland is called "Cogadh an Dá Ri" meaning "war of the two kings." James' forces, called the Jacobites after the Latin version of James, counted 25,000 French and Irishmen, including one of the best cavalry forces in Europe. The Irish supported James because of his promises to Ireland's parliament for eventual self-determination, legislative acts towards removing penal laws, and religious freedom. The French supported James because William was waging war against his old enemy, Louis XIV as the French king claimed territory across the Rhine as his and was seeking to extend his political dominance to the Holy Roman Empire.
William's force numbered 36,000 soldiers from England, Scotland, the Netherlands, and French Huguenots, who were persecuted by Louis. His soldiers had the best weaponry money could buy, and were even backed by the Papacy, due to the pope's alliance against Louis.
The battle was fought for control of a ford on the Boyne as it was the last hurdle in William's way to victory in Ireland. After four hours of fighting and trudging through water, where William's men were constantly being swarmed and pushed back by James' French cavalry, William made a reckless but, in the end, successful decision and began to cross the raging waters of the Boyne for a direct assault on James' men further down the river. He himself did not cross due to an asthma attack, and had to be pulled back to shore. Despite being matched up against the best horsemen in Europe, William's superior firepower enabled them to press on, convincing James to retreat, leaving with some of the last hopes of the Jacobites. Militarily, William's victory only cost James and his supporters 2,000 men, but his victory and James' fleeing back to France began to slowly unravel the hopes for Catholic rule and freedom in Ireland.
Jan van Huchtenburg's depiction of the Battle of the Boyne depicting William II I on the white horse. Wikimedia Commons.
In the aftermath of the battle, the Jacobite cause could have ended if it weren't for the ruthless peace terms that William drafted. In the Declaration of Finglas, William pardoned regular soldiers that took part in James' army but refused to pardon the Jacobite officers and the Irish Catholic landed gentry, resulting in their willing to fight on without their figurehead. They retreated into Connacht to gain a defensive position by using the River Shannon as a natural moat.
The Williamite forces were also willing to fight without their leader as William left Ireland to his right-hand man Godert de Ginkel in late 1690. After beating the odds by crossing the Shannon, de Ginkel besieged the city of Athlone. As he and his force of 20,000 marched through Galway, they eventually encounter Jacobite commander General Charles Chalmont, Marquis de St. Ruth and his army of roughly 20,000 on July 12, 1691 near the village of Aughrim in County Galway. The commanders and their armies took their positions but didn't realize the brevity of what was going to happen next.
The Marquis and his Jacobites held a strong position on Kilcommadan Hill, which was fortified by strong stone walls that could be used for cover. To their left, they had a bog which would slow down progress if de Ginkel decided to use that route. De Ginkel decided to go into the open flank and sent a direct assault with both cavalry and infantry. Seeing this, the Jacobite forces fired fiercely upon de Ginkel's men, turning the green grass red as each Williamite fell one by one and some Jacobites were able to steal Williamite artillery. The Irish Jacobites were confident that they were about to turn the war around in their favor. However, the Williamites saw that their enemy was running out of ammunition, so they took their last option, to charge through the bog. Unable to use the stolen cannon, they rushed the Jacobite position, enabling them to get past cannon fire from a nearby castle. This was the beginning of the end for the Jacobites. A Jacobite force under the command of a Henry Luttrell withdrew from the battle, enabling the Williamites to take over the castle and its garrison to the left of the Jacobites' position. Marquis de St. Ruth tried to quell the assault on the castle, believing if he and his forces routed them, they would win the day. As he gallantly rushed to his men's aid he was decapitated by a cannonball. The horsemen being demoralized by the loss of yet another leader left the battle to the Williamites, who proceeded to destroy the rest of the Jacobite force. At the end of the day, around 5,000 to 7,000 men were killed, many of whom were irreplaceable Jacobite officers. The combination of lack of leadership, and the carnage of 4,000 men killed on the Irish Jacobite side, with another 4,000 most likely deserted left only a small force before an ultimate surrender in Limerick in October 1691.
The Treaty of Limerick granted the Irish Catholic gentry the right to continue to bear arms, as well as having protection over their land as long as they swore an oath of allegiance to King William III and his Queen, Mary II. However, the civil articles of the treaty were broken when the ink wasn't even dry on the treaty, as the Catholic gentry was constantly harassed not only physically but also legislatively with the introduction of the Penal Laws. Catholic Emancipation wouldn't come for another 138 years.


We are happy to continue our success in Southeast Asia with the additions of Smooci Macau and Smooci Kuala Lumpur.
We have had a lot of interest from clients and companions in these areas and we are very excited to finally be able to bring Smooci to these two vibrant cities.
We invite all interest escorts and agencies in Macau and Kuala Lumpur to contact us and we will be happy to give you more details on how Smooci works and how it can help you get more genuine bookings and clients.
We will be looking to quickly follow up these launches with a launch campaign in Holland before the end of this month.
We will be launching in Holland with in partnership with several well established agencies and welcome any interested independents to join us.


text:
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        PyQt4 ::
        QtCore ::
        Qt ::
        Class Qt

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Class Qt

       object --+
                |
sip.simplewrapper --+
                    |
          sip.wrapper --+
                        |
                       Qt

        Nested Classes
        [hide private]

        Alignment

      Qt.Alignment(Qt.Alignment) Qt.Alignment(int) Qt.Alignment()

        AlignmentFlag

        AnchorAttribute

        AnchorPoint

        ApplicationAttribute

        ArrowType

        AspectRatioMode

        Axis

        BGMode

        BrushStyle

        CaseSensitivity

        CheckState

        ClipOperation

        ConnectionType

        ContextMenuPolicy

        CoordinateSystem

        Corner

        CursorMoveStyle

        CursorShape

        DateFormat

        DayOfWeek

        DockWidgetArea

        DockWidgetAreas

      Qt.DockWidgetAreas(Qt.DockWidgetAreas) Qt.DockWidgetAreas(int)
        Qt.DockWidgetAreas()

        DropAction

        DropActions

      Qt.DropActions(Qt.DropActions) Qt.DropActions(int) Qt.DropActions()

        EventPriority

        FillRule

        FocusPolicy

        FocusReason

        GestureFlag

        GestureFlags

      Qt.GestureFlags(Qt.GestureFlags) Qt.GestureFlags(int)
        Qt.GestureFlags()

        GestureState

        GestureType

        GlobalColor

        ImageConversionFlag

        ImageConversionFlags

      Qt.ImageConversionFlags(Qt.ImageConversionFlags)
        Qt.ImageConversionFlags(int) Qt.ImageConversionFlags()

        InputMethodHint

        InputMethodHints

      Qt.InputMethodHints(Qt.InputMethodHints) Qt.InputMethodHints(int)
        Qt.InputMethodHints()

        InputMethodQuery

        ItemDataRole

        ItemFlag

        ItemFlags

      Qt.ItemFlags(Qt.ItemFlags) Qt.ItemFlags(int) Qt.ItemFlags()

        ItemSelectionMode

        Key

        KeyboardModifier

        KeyboardModifiers

      Qt.KeyboardModifiers(Qt.KeyboardModifiers)
        Qt.KeyboardModifiers(int) Qt.KeyboardModifiers()

        LayoutDirection

        MaskMode

        MatchFlag

        MatchFlags

      Qt.MatchFlags(Qt.MatchFlags) Qt.MatchFlags(int) Qt.MatchFlags()

        Modifier

        MouseButton

        MouseButtons

      Qt.MouseButtons(Qt.MouseButtons) Qt.MouseButtons(int)
        Qt.MouseButtons()

        NavigationMode

        Orientation

        Orientations

      Qt.Orientations(Qt.Orientations) Qt.Orientations(int)
        Qt.Orientations()

        PenCapStyle

        PenJoinStyle

        PenStyle

        ScrollBarPolicy

        ShortcutContext

        SizeHint

        SizeMode

        SortOrder

        TextElideMode

        TextFlag

        TextFormat

        TextInteractionFlag

        TextInteractionFlags

      Qt.TextInteractionFlags(Qt.TextInteractionFlags)
        Qt.TextInteractionFlags(int) Qt.TextInteractionFlags()

        TileRule

        TimeSpec

        ToolBarArea

        ToolBarAreas

      Qt.ToolBarAreas(Qt.ToolBarAreas) Qt.ToolBarAreas(int)
        Qt.ToolBarAreas()

        ToolButtonStyle

        TouchPointState

        TouchPointStates

      Qt.TouchPointStates(Qt.TouchPointStates) Qt.TouchPointStates(int)
        Qt.TouchPointStates()

        TransformationMode

        UIEffect

        WidgetAttribute

        WindowFlags

      Qt.WindowFlags(Qt.WindowFlags) Qt.WindowFlags(int) Qt.WindowFlags()

        WindowFrameSection

        WindowModality

        WindowState

        WindowStates

      Qt.WindowStates(Qt.WindowStates) Qt.WindowStates(int)
        Qt.WindowStates()

        WindowType

        Instance Methods
        [hide private]

Inherited from sip.simplewrapper:
      __init__,
      __new__

Inherited from object:
      __delattr__,
      __format__,
      __getattribute__,
      __hash__,
      __reduce__,
      __reduce_ex__,
      __repr__,
      __setattr__,
      __sizeof__,
      __str__,
      __subclasshook__

        Class Variables
        [hide private]

        AA_CaptureMultimediaKeys = 11

        AA_DontCreateNativeWidgetSiblings = 4

        AA_DontShowIconsInMenus = 2

        AA_DontUseNativeMenuBar = 6

        AA_ImmediateWidgetCreation = 0

        AA_MSWindowsUseDirect3DByDefault = 1

        AA_MacDontSwapCtrlAndMeta = 7

        AA_MacPluginApplication = 5

        AA_NativeWindows = 3

        AA_S60DisablePartialScreenInputMode = 9

        AA_S60DontConstructApplicationPanes = 8

        AA_X11InitThreads = 10

        ALT = 134217728

        AbsoluteSize = 0

        AccessibleDescriptionRole = 12

        AccessibleTextRole = 11

        ActionMask = 255

        ActionsContextMenu = 2

        ActiveWindowFocusReason = 3

        AlignAbsolute = 16

        AlignBottom = 64

        AlignCenter = 132

        AlignHCenter = 4

        AlignHorizontal_Mask = 31

        AlignJustify = 8

        AlignLeading = 1

        AlignLeft = 1

        AlignRight = 2

        AlignTop = 32

        AlignTrailing = 2

        AlignVCenter = 128

        AlignVertical_Mask = 224

        AllDockWidgetAreas = 15

        AllToolBarAreas = 15

        AltModifier = 134217728

        AnchorBottom = 5

        AnchorHorizontalCenter = 1

        AnchorHref = 1

        AnchorLeft = 0

        AnchorName = 0

        AnchorRight = 2

        AnchorTop = 3

        AnchorVerticalCenter = 4

        ApplicationModal = 2

        ApplicationShortcut = 2

        ArrowCursor = 0

        AscendingOrder = 0

        AutoColor = 0

        AutoCompatConnection = 3

        AutoConnection = 0

        AutoDither = 0

        AutoText = 2

        AvoidDither = 128

        BDiagPattern = 12

        BackgroundColorRole = 8

        BackgroundRole = 8

        BacktabFocusReason = 2

        BevelJoin = 64

        BitmapCursor = 24

        BlankCursor = 10

        BlockingQueuedConnection = 4

        BottomDockWidgetArea = 8

        BottomLeftCorner = 2

        BottomLeftSection = 8

        BottomRightCorner = 3

        BottomRightSection = 6

        BottomSection = 7

        BottomToolBarArea = 8

        BusyCursor = 16

        BypassGraphicsProxyWidget = 536870912

        CTRL = 67108864

        CaseInsensitive = 0

        CaseSensitive = 1

        CheckStateRole = 10

        Checked = 2

        ClickFocus = 2

        ClosedHandCursor = 18

        ColorOnly = 3

        ConicalGradientPattern = 17

        ContainsItemBoundingRect = 2

        ContainsItemShape = 0

        ControlModifier = 67108864

        CopyAction = 1

        CrossCursor = 2

        CrossPattern = 11

        CustomContextMenu = 3

        CustomCursor = 25

        CustomDashLine = 6

        CustomGesture = 256

        CustomizeWindowHint = 33554432

        DashDotDotLine = 5

        DashDotLine = 4

        DashLine = 2

        DecorationRole = 1

        DefaultContextMenu = 1

        DefaultLocaleLongDate = 7

        DefaultLocaleShortDate = 6

        Dense1Pattern = 2

        Dense2Pattern = 3

        Dense3Pattern = 4

        Dense4Pattern = 5

        Dense5Pattern = 6

        Dense6Pattern = 7

        Dense7Pattern = 8

        DescendingOrder = 1

        Desktop = 17

        DeviceCoordinates = 0

        DiagCrossPattern = 14

        Dialog = 3

        DiffuseAlphaDither = 8

        DiffuseDither = 0

        DirectConnection = 1

        DisplayRole = 0

        DockWidgetArea_Mask = 15

        DontStartGestureOnChildren = 1

        DotLine = 3

        DownArrow = 2

        DragCopyCursor = 19

        DragLinkCursor = 21

        DragMoveCursor = 20

        Drawer = 7

        EditRole = 2

        ElideLeft = 0

        ElideMiddle = 2

        ElideNone = 3

        ElideRight = 1

        FDiagPattern = 13

        FastTransformation = 0

        FlatCap = 0

        FontRole = 6

        ForbiddenCursor = 14

        ForegroundRole = 9

        FramelessWindowHint = 2048

        Friday = 5

        GestureCanceled = 4

        GestureFinished = 3

        GestureStarted = 1

        GestureUpdated = 2

        GroupSwitchModifier = 1073741824

        HighEventPriority = 1

        HorPattern = 9

        Horizontal = 1

        IBeamCursor = 4

        ISODate = 1

        IgnoreAction = 0

        IgnoreAspectRatio = 0

        IgnoredGesturesPropagateToParent = 4

        ImAnchorPosition = 6

        ImCurrentSelection = 4

        ImCursorPosition = 2

        ImFont = 1

        ImMaximumTextLength = 5

        ImMicroFocus = 0

        ImSurroundingText = 3

        ImhDialableCharactersOnly = 1048576

        ImhDigitsOnly = 65536

        ImhEmailCharactersOnly = 2097152

        ImhExclusiveInputMask = -65536

        ImhFormattedNumbersOnly = 131072

        ImhHiddenText = 1

        ImhLowercaseOnly = 524288

        ImhNoAutoUppercase = 2

        ImhNoPredictiveText = 32

        ImhNone = 0

        ImhPreferLowercase = 16

        ImhPreferNumbers = 4

        ImhPreferUppercase = 8

        ImhUppercaseOnly = 262144

        ImhUrlCharactersOnly = 4194304

        InitialSortOrderRole = 14

        IntersectClip = 2

        IntersectsItemBoundingRect = 3

        IntersectsItemShape = 1

        ItemIsDragEnabled = 4

        ItemIsDropEnabled = 8

        ItemIsEditable = 2

        ItemIsEnabled = 32

        ItemIsSelectable = 1

        ItemIsTristate = 64

        ItemIsUserCheckable = 16

        KeepAspectRatio = 1

        KeepAspectRatioByExpanding = 2

        Key_0 = 48

        Key_1 = 49

        Key_2 = 50

        Key_3 = 51

        Key_4 = 52

        Key_5 = 53

        Key_6 = 54

        Key_7 = 55

        Key_8 = 56

        Key_9 = 57

        Key_A = 65

        Key_AE = 198

        Key_Aacute = 193

        Key_Acircumflex = 194

        Key_AddFavorite = 16777408

        Key_Adiaeresis = 196

        Key_Agrave = 192

        Key_Alt = 16777251

        Key_AltGr = 16781571

        Key_Ampersand = 38

        Key_Any = 32

        Key_Apostrophe = 39

        Key_ApplicationLeft = 16777415

        Key_ApplicationRight = 16777416

        Key_Aring = 197

        Key_AsciiCircum = 94

        Key_AsciiTilde = 126

        Key_Asterisk = 42

        Key_At = 64

        Key_Atilde = 195

        Key_AudioCycleTrack = 16777478

        Key_AudioForward = 16777474

        Key_AudioRandomPlay = 16777476

        Key_AudioRepeat = 16777475

        Key_AudioRewind = 16777413

        Key_Away = 16777464

        Key_B = 66

        Key_Back = 16777313

        Key_BackForward = 16777414

        Key_Backslash = 92

        Key_Backspace = 16777219

        Key_Backtab = 16777218

        Key_Bar = 124

        Key_BassBoost = 16777331

        Key_BassDown = 16777333

        Key_BassUp = 16777332

        Key_Battery = 16777470

        Key_Bluetooth = 16777471

        Key_Book = 16777417

        Key_BraceLeft = 123

        Key_BraceRight = 125

        Key_BracketLeft = 91

        Key_BracketRight = 93

        Key_BrightnessAdjust = 16777410

        Key_C = 67

        Key_CD = 16777418

        Key_Calculator = 16777419

        Key_Calendar = 16777444

        Key_Call = 17825796

        Key_Camera = 17825824

        Key_CameraFocus = 17825825

        Key_Cancel = 16908289

        Key_CapsLock = 16777252

        Key_Ccedilla = 199

        Key_Clear = 16777227

        Key_ClearGrab = 16777421

        Key_Close = 16777422

        Key_Codeinput = 16781623

        Key_Colon = 58

        Key_Comma = 44

        Key_Community = 16777412

        Key_Context1 = 17825792

        Key_Context2 = 17825793

        Key_Context3 = 17825794

        Key_Context4 = 17825795

        Key_ContrastAdjust = 16777485

        Key_Control = 16777249

        Key_Copy = 16777423

        Key_Cut = 16777424

        Key_D = 68

        Key_DOS = 16777426

        Key_Dead_Abovedot = 16781910

        Key_Dead_Abovering = 16781912

        Key_Dead_Acute = 16781905

        Key_Dead_Belowdot = 16781920

        Key_Dead_Breve = 16781909

        Key_Dead_Caron = 16781914

        Key_Dead_Cedilla = 16781915

        Key_Dead_Circumflex = 16781906

        Key_Dead_Diaeresis = 16781911

        Key_Dead_Doubleacute = 16781913

        Key_Dead_Grave = 16781904

        Key_Dead_Hook = 16781921

        Key_Dead_Horn = 16781922

        Key_Dead_Iota = 16781917

        Key_Dead_Macron = 16781908

        Key_Dead_Ogonek = 16781916

        Key_Dead_Semivoiced_Sound = 16781919

        Key_Dead_Tilde = 16781907

        Key_Dead_Voiced_Sound = 16781918

        Key_Delete = 16777223

        Key_Direction_L = 16777305

        Key_Direction_R = 16777312

        Key_Display = 16777425

        Key_Documents = 16777427

        Key_Dollar = 36

        Key_Down = 16777237

        Key_E = 69

        Key_ETH = 208

        Key_Eacute = 201

        Key_Ecircumflex = 202

        Key_Ediaeresis = 203

        Key_Egrave = 200

        Key_Eisu_Shift = 16781615

        Key_Eisu_toggle = 16781616

        Key_Eject = 16777401

        Key_End = 16777233

        Key_Enter = 16777221

        Key_Equal = 61

        Key_Escape = 16777216

        Key_Excel = 16777428

        Key_Exclam = 33

        Key_Execute = 16908291

        Key_Explorer = 16777429

        Key_F = 70

        Key_F1 = 16777264

        Key_F10 = 16777273

        Key_F11 = 16777274

        Key_F12 = 16777275

        Key_F13 = 16777276

        Key_F14 = 16777277

        Key_F15 = 16777278

        Key_F16 = 16777279

        Key_F17 = 16777280

        Key_F18 = 16777281

        Key_F19 = 16777282

        Key_F2 = 16777265

        Key_F20 = 16777283

        Key_F21 = 16777284

        Key_F22 = 16777285

        Key_F23 = 16777286

        Key_F24 = 16777287

        Key_F25 = 16777288

        Key_F26 = 16777289

        Key_F27 = 16777290

        Key_F28 = 16777291

        Key_F29 = 16777292

        Key_F3 = 16777266

        Key_F30 = 16777293

        Key_F31 = 16777294

        Key_F32 = 16777295

        Key_F33 = 16777296

        Key_F34 = 16777297

        Key_F35 = 16777298

        Key_F4 = 16777267

        Key_F5 = 16777268

        Key_F6 = 16777269

        Key_F7 = 16777270

        Key_F8 = 16777271

        Key_F9 = 16777272

        Key_Favorites = 16777361

        Key_Finance = 16777411

        Key_Flip = 17825798

        Key_Forward = 16777314

        Key_G = 71

        Key_Game = 16777430

        Key_Go = 16777431

        Key_Greater = 62

        Key_H = 72

        Key_Hangul = 16781617

        Key_Hangul_Banja = 16781625

        Key_Hangul_End = 16781619

        Key_Hangul_Hanja = 16781620

        Key_Hangul_Jamo = 16781621

        Key_Hangul_Jeonja = 16781624

        Key_Hangul_PostHanja = 16781627

        Key_Hangul_PreHanja = 16781626

        Key_Hangul_Romaja = 16781622

        Key_Hangul_Special = 16781631

        Key_Hangul_Start = 16781618

        Key_Hangup = 17825797

        Key_Hankaku = 16781609

        Key_Help = 16777304

        Key_Henkan = 16781603

        Key_Hibernate = 16777480

        Key_Hiragana = 16781605

        Key_Hiragana_Katakana = 16781607

        Key_History = 16777407

        Key_Home = 16777232

        Key_HomePage = 16777360

        Key_HotLinks = 16777409

        Key_Hyper_L = 16777302

        Key_Hyper_R = 16777303

        Key_I = 73

        Key_Iacute = 205

        Key_Icircumflex = 206

        Key_Idiaeresis = 207

        Key_Igrave = 204

        Key_Insert = 16777222

        Key_J = 74

        Key_K = 75

        Key_Kana_Lock = 16781613

        Key_Kana_Shift = 16781614

        Key_Kanji = 16781601

        Key_Katakana = 16781606

        Key_KeyboardBrightnessDown = 16777398

        Key_KeyboardBrightnessUp = 16777397

        Key_KeyboardLightOnOff = 16777396

        Key_L = 76

        Key_LastNumberRedial = 17825801

        Key_Launch0 = 16777378

        Key_Launch1 = 16777379

        Key_Launch2 = 16777380

        Key_Launch3 = 16777381

        Key_Launch4 = 16777382

        Key_Launch5 = 16777383

        Key_Launch6 = 16777384

        Key_Launch7 = 16777385

        Key_Launch8 = 16777386

        Key_Launch9 = 16777387

        Key_LaunchA = 16777388

        Key_LaunchB = 16777389

        Key_LaunchC = 16777390

        Key_LaunchD = 16777391

        Key_LaunchE = 16777392

        Key_LaunchF = 16777393

        Key_LaunchG = 16777486

        Key_LaunchH = 16777487

        Key_LaunchMail = 16777376

        Key_LaunchMedia = 16777377

        Key_Left = 16777234

        Key_Less = 60

        Key_LightBulb = 16777405

        Key_LogOff = 16777433

        Key_M = 77

        Key_MailForward = 16777467

        Key_Market = 16777434

        Key_Massyo = 16781612

        Key_MediaLast = 16842751

        Key_MediaNext = 16777347

        Key_MediaPause = 16777349

        Key_MediaPlay = 16777344

        Key_MediaPrevious = 16777346

        Key_MediaRecord = 16777348

        Key_MediaStop = 16777345

        Key_MediaTogglePlayPause = 16777350

        Key_Meeting = 16777435

        Key_Memo = 16777404

        Key_Menu = 16777301

        Key_MenuKB = 16777436

        Key_MenuPB = 16777437

        Key_Messenger = 16777465

        Key_Meta = 16777250

        Key_Minus = 45

        Key_Mode_switch = 16781694

        Key_MonBrightnessDown = 16777395

        Key_MonBrightnessUp = 16777394

        Key_Muhenkan = 16781602

        Key_Multi_key = 16781600

        Key_MultipleCandidate = 16781629

        Key_Music = 16777469

        Key_MySites = 16777438

        Key_N = 78

        Key_News = 16777439

        Key_No = 16842754

        Key_Ntilde = 209

        Key_NumLock = 16777253

        Key_NumberSign = 35

        Key_O = 79

        Key_Oacute = 211

        Key_Ocircumflex = 212

        Key_Odiaeresis = 214

        Key_OfficeHome = 16777440

        Key_Ograve = 210

        Key_Ooblique = 216

        Key_OpenUrl = 16777364

        Key_Option = 16777441

        Key_Otilde = 213

        Key_P = 80

        Key_PageDown = 16777239

        Key_PageUp = 16777238

        Key_ParenLeft = 40

        Key_ParenRight = 41

        Key_Paste = 16777442

        Key_Pause = 16777224

        Key_Percent = 37

        Key_Period = 46

        Key_Phone = 16777443

        Key_Pictures = 16777468

        Key_Play = 16908293

        Key_Plus = 43

        Key_PowerDown = 16777483

        Key_PowerOff = 16777399

        Key_PreviousCandidate = 16781630

        Key_Print = 16777225

        Key_Printer = 16908290

        Key_Q = 81

        Key_Question = 63

        Key_QuoteDbl = 34

        Key_QuoteLeft = 96

        Key_R = 82

        Key_Refresh = 16777316

        Key_Reload = 16777446

        Key_Reply = 16777445

        Key_Return = 16777220

        Key_Right = 16777236

        Key_Romaji = 16781604

        Key_RotateWindows = 16777447

        Key_RotationKB = 16777449

        Key_RotationPB = 16777448

        Key_S = 83

        Key_Save = 16777450

        Key_ScreenSaver = 16777402

        Key_ScrollLock = 16777254

        Key_Search = 16777362

        Key_Select = 16842752

        Key_Semicolon = 59

        Key_Send = 16777451

        Key_Shift = 16777248

        Key_Shop = 16777406

        Key_SingleCandidate = 16781628

        Key_Slash = 47

        Key_Sleep = 16908292

        Key_Space = 32

        Key_Spell = 16777452

        Key_SplitScreen = 16777453

        Key_Standby = 16777363

        Key_Stop = 16777315

        Key_Subtitle = 16777477

        Key_Super_L = 16777299

        Key_Super_R = 16777300

        Key_Support = 16777454

        Key_Suspend = 16777484

        Key_SysReq = 16777226

        Key_T = 84

        Key_THORN = 222

        Key_Tab = 16777217

        Key_TaskPane = 16777455

        Key_Terminal = 16777456

        Key_Time = 16777479

        Key_ToDoList = 16777420

        Key_ToggleCallHangup = 17825799

        Key_Tools = 16777457

        Key_TopMenu = 16777482

        Key_Touroku = 16781611

        Key_Travel = 16777458

        Key_TrebleDown = 16777335

        Key_TrebleUp = 16777334

        Key_U = 85

        Key_UWB = 16777473

        Key_Uacute = 218

        Key_Ucircumflex = 219

        Key_Udiaeresis = 220

        Key_Ugrave = 217

        Key_Underscore = 95

        Key_Up = 16777235

        Key_V = 86

        Key_Video = 16777459

        Key_View = 16777481

        Key_VoiceDial = 17825800

        Key_VolumeDown = 16777328

        Key_VolumeMute = 16777329

        Key_VolumeUp = 16777330

        Key_W = 87

        Key_WLAN = 16777472

        Key_WWW = 16777403

        Key_WakeUp = 16777400

        Key_WebCam = 16777466

        Key_Word = 16777460

        Key_X = 88

        Key_Xfer = 16777461

        Key_Y = 89

        Key_Yacute = 221

        Key_Yes = 16842753

        Key_Z = 90

        Key_Zenkaku = 16781608

        Key_Zenkaku_Hankaku = 16781610

        Key_Zoom = 16908294

        Key_ZoomIn = 16777462

        Key_ZoomOut = 16777463

        Key_acute = 180

        Key_brokenbar = 166

        Key_cedilla = 184

        Key_cent = 162

        Key_copyright = 169

        Key_currency = 164

        Key_degree = 176

        Key_diaeresis = 168

        Key_division = 247

        Key_exclamdown = 161

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Menstrual abnormalities and their association with lifestyle pattern in adolescent girls of Garhwal, India
Priyanka Negi, Aprajita Mishra, Pramesh Lakhera
Department of Zoology and Biotechnology, HNB Garhwal University, Srinagar, Uttarakhand, India
Date of Web Publication 4-Sep-2018
Dr. Priyanka Negi
Department of Zoology and Biotechnology, HNB Garhwal University, Srinagar, Garhwal, Uttarakhand
DOI: 10.4103/jfmpc.jfmpc_159_17
Background: This study tried to find out the prevalence of menstrual abnormalities in adolescent girls and their association with dietary and exercise pattern in Garhwal region of India. Materials and Methods: In this study, cross-sectional questionnaires survey was conducted in different schools of Garhwal. These questionnaires were based on socioeconomic data, dietary and physical activities, and menstrual abnormalities. Results: The age of menarche was 13.5 ± 0.64 years. Dysmenorrhea (62.75%), premenstrual syndrome (PMS) (40.42%), and irregular cycle (28.72%) were observed common problems among adolescent girls. The result showed that dysmenorrhea, PMS, and menstrual irregularities were directly associated with dietary habits and physical activities. Dysmenorrhea was associated with eating junk food (66.10%), and PMS was associated with lacking of physical activities (78.94%). Conclusion: The result suggests that feeding habit and physical activities directly affecting the menstrual health of adolescent girls.
Keywords: Adolescent, dysmenorrhea, menarche, menstrual abnormalities, premenstrual syndrome
Negi P, Mishra A, Lakhera P. Menstrual abnormalities and their association with lifestyle pattern in adolescent girls of Garhwal, India. J Family Med Prim Care 2018;7:804-8
Negi P, Mishra A, Lakhera P. Menstrual abnormalities and their association with lifestyle pattern in adolescent girls of Garhwal, India. J Family Med Prim Care [serial online] 2018 [cited 2020 Jan 19];7:804-8. Available from: http://www.jfmpc.com/text.asp?2018/7/4/804/240395
Adolescence is a high-risk group because during this stage major physical and mental change occurs. Menarche is a hallmark biological process of puberty [1] in adolescence girls and it leads to reproductive capacity. Menstrual abnormalities are common in adolescent and can lead to stressful conditions.[2] All over the world around 75% of girls are experiencing problems associated with menstruation.[3] The major abnormalities are dysmenorrhea, premenstrual syndrome (PMS), and menstrual irregularities.[4] These disorders may lead to problems in daily activities such as academic excellence, achievements in sports, and loss of self-confidence.[5],[6],[7] The lifestyle pattern of any individual leads to their prone of disease. Female reproductive cycle directly or indirectly influence with diet, physical work, and mental stress.
Dietary habits are directly related with individual quality of life,[6] and adolescence is a potential group to view the rapid growth and maturation which requests extranutrients and energy-rich food.[8] Food habits of adolescents in the recent past have changed [9] in their nutrient intake and needs such as widespread consumption of fast food, skipping of food intake.[5],[6]
The present study focused on a Garhwali population of Uttarakhand. Influence of globalization changes the lifestyle of local people in positive as well as negative aspect. In Uttarakhand, one-third of the females between 15 and 49 years are undernourished [10] due to poor energy intake and junk food. The dietary pattern in hilly region also shifts from local pahari food to Western foods among the adolescent age group. Hence, it is important to evaluate the influence of eating habits on menstrual disorders in young women. The relationship between food habit and menstrual dysfunction has been becoming an important issue in the world.[6] Apart from feeding habits, physical activities, daily routine lifestyle, and work stress also influence directly or indirectly the female reproductive cycle.
Although menstrual disorders are common among females, no study on regarding their prevalence and associate factors were found in hilly populations, especially in Garhwali communities. Hence, this study aims to find out the pattern of menstrual abnormalities in school going girls in Garhwali population and their association with dietary habits and physical work.
A school-based cross-sectional study was conducted in adolescent girls. In this study, 13–19-year age girls were selected from different location of Garhwal region. The purpose of the study was clearly explained to each student and after that who were willing to participate, selected for further study. The girls were asked to signed a consent form before participating in the study.
The questionnaires were explained properly to them, which dealt with different parameters such as socioeconomic data, feeding habits, physical activity, menstrual history, and irregularities. Students, who were suffering from any chronic health issues, were excluded from the study.
The healthy diet concluded based on nutritional value. The nutritional value calculated, based on the food present on particular area Garhwal region (green vegetables, pulses, wheat, finger millet, rice, and milk). The consumption of junk food was also including in the dietary habit. It is also categorized into two parts: (1) Junk food intake <3 days/week, (2) junk food intake 4–7 days/week. Physical activity calculated in terms of the number of days of regular exercise, household work, and sports per week. Physical exercise categorized into two: (1) <2 days of physical work per week and (2) 3–7 days of physical work per week.
Regarding menstrual abnormalities, girls were asking to date their Menarche. The questions regarding the menstrual pattern concerned duration of the most recent menstrual intervals, average days of bleeding, and regarding menstrual problem and their frequency with menstrual abnormalities.
Chi-square test was applied to compare the dietary and exercise patterns among students having menstrual disorders and those who do not have menstrual disorders. For statistical analysis, SPSS Ver. 14 (Inc, Chicago IL, USA) Software and MS Excel were used.
Lifestyle characteristics
In total, 470 girls were taken participation in this study. All the participants of this study belong to moderate middle-class families. The lifestyle pattern showed that 31.70% girls were taking healthy diet while maximum girls (68.29%) showed poor nutritional diet. Eating junk food habit was found in 65.95% girls. The study also revealed that 65.31% girls skipped their breakfast. The study showed 60.63% girls were worked <2 days/week and 39.36% girls were worked 4–7 days\week [Table 1].
Table 1: Lifestyle characteristics of adolescent girls in Garhwal region
Menstrual irregularities and their association with lifestyle characteristics
The age of menarche was 13.5 ± 0.64 years and the average days of period from 4 to 6 days were recorded. The menstrual abnormalities, such as dysmenorrhea, were present in 62.75% girls, PMS in 40.42%, and menorrhagia in 9.5% of the whole sampling population. The irregular cycle was observed in 28.72% girls [Table 2].
Table 2: Prevalence of menstrual abnormalities in adolescent girls of Garhwal region
[Table 3] showed the association between the menstrual problems and lifestyle factors. Dysmenorrhea was more frequently observed among those adolescents who were associated eating junk food (66.10%) and unhealthy diet (72.88%). Menstrual irregularities were also significantly more common among girls who were eating junk food regularly (70.37%) and who were not having a healthy diet (79.20%). Dysmenorrhea was also more common in the girls who were skipping breakfast (71.18%). The PMS showed a direct relationship with physical activity of girls. Participants who were doing less physical activities/work had a higher percent (78.94%) of PMS. Chi-square test was showed significant (χ2 = 213, P < 0.05) difference among students having menstrual abnormalities and those who do not have menstrual abnormalities on the basis of dietary and exercise.
Table 3: Association of menstrual abnormalities with feeding habit and physical work
Menstrual interference with life activities
The result also showed that menstrual abnormalities affecting the quality of life in girls. Nearly 45% percent of the girls indicated that they missed school because of their periods. Of the girls who missed school, dysmenorrhea (pain) was the most common reason reported for school absence (35%). The result also showed that in the severe pain 42% girls were using painkiller (Analgesic). Apart from dysmenorrhea, PMS (15%) and menstrual irregularities (4%) affecting daily routine work and social activities.
The study on the prevalence of menstrual disorder and its association with food habits was the first kind of study in Garhwali population. Most of the participants in this region were belongs to middle-class families. With the support of the schools, a very positive response observed for most of the questions. This study attempted to find a relation between various lifestyle factors such as eating junk food, healthy food, and lack of physical activities with the menstrual problems experienced by the adolescent girls.
In previous, it would be thought that menstrual abnormalities are found higher in metropolitan cities as compared to small hilly towns due to lifestyle pattern. Now, this study highlights that due to globalization, lifestyle pattern change in everywhere, which was affecting adolescent in every way. Yet, the age of menarche in Garhwal population show lower (13.5) compared to European and Western countries.[11] Most of the studies showed the menarcheal age stabilized at the age of 12 to13 year.[12],[13] The lower age of menarche could explain that the variation in age of menarche change according to the hereditary pattern, nutritional status, and climate difference.[7]
The result suggested that the dysmenorrhea is the highest among all menstrual abnormalities in a mountainous region, which support the fact that dysmenorrhea is common among 70%–90% adolescent girls [14],[15] globally. Overall, the prevalence of menstrual problems in girls of Garhwal is similar to other reported communities.[3],[16],[17] PMS was also more commonly present in this region, although its percentage is less in Garhwal region as compare to Lakkawar (69%), Sarkar (61.5%) and Rupa (51.2%) studies, which were conducted in other parts of India.[7],[18],[19]
The unhealthy and inadequate dietary habits affecting every female's quality of life not only in the present but also in the upcoming future. In this study, the majority of the girls, skipping their breakfast and associated with higher consumption of junk food. Dysmenorrhea was considerably higher in girls who were consistently eating fast food. Because junk foods are rich in saturated fatty acids, and these acids affect the metabolism of progesterone in the menstrual cycle.[6] Junk foods also lack micronutrients, which might be responsible for triggering dysmenorrhea, premenstrual symptoms, and menstrual irregularities. Nowadays, skipping breakfast is common habits among in adolescent, this pattern shows in Garhwali population also, which leads obesity [16] and menstrual abnormalities.[5],[20] The diet limitation and skipping breakfast lead gynecological problems [6] specifically the hormonal changes which cause menstrual disorders in most of the females.[21] This study clearly indicates that dysmenorrhea not only affected by the dietary habit but also with the physical activity. This study supporting the fact that there was a positive correlation between the lower risk of dysmenorrhea and followed regular exercise and healthy physical activity for adolescent girls.[22] A bunch of studies in nursing students also revealed that menstrual disorders are very common in adolescent girls and regular exercise and improved dietary habits are essential to prevent menstrual abnormalities.[23],[24]
In this study, premenstrual symptoms were present high in those girls who were not doing regular physical work. The PMS and physical work association also showed in school going girls of Pondicherry, India.[7] Other parts of worlds also showed similar kind of associations between positive diagnosis of PMS and lower level of physical work.[25],[26] The physical activities release more endorphins hormones, which can decrease the PMS symptoms such as pain, depression, and anxiety.[7],[27] In the present scenario, menstrual abnormalities are causing significant debility in adolescent girls. Self-medication was practiced by 42% of the adolescent girls, which indicate dysmenorrhea affecting the maximum population of adolescent girls. The study showed that routine activities, school absentees, and emotional distress were due to dysmenorrhea and PMS. Sickness absenteeism is notably more among dysmenorrheic girls, this conclusion also finds by other studies.[28],[29] Even Bergsjo's study in the USA disclosed that sickness absenteeism because of dysmenorrhea causes wastage of millions of dollars due to suffering work satisfaction, personal relationships, confidence, and concentration at workplaces.[30] Some other studies also show that dysmenorrhea and PMS were perceived as the most stressful symptoms leading to school absenteeism and household activities in girls.[31],[32],[33],[34] Overall, there is a significant association present between consumption of junk food, dieting,[35] and physical exercise with an abnormal flow.[18]
Hence, the changing lifestyle patterns such as eating junk food and reducing physical activities are directly affecting the menstrual cycle of females. Hence, it is important to promote the health education programs which should include promoting adequate dietary habit, regular exercise, and awareness on menstrual hygiene in school level for improving the menstrual health. The improvement of menstrual health is important for preventing the many present and future gynecological problems (infertility, obesity, and polycystic ovaries).
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Wyshak G, Frisch RE. Evidence for a secular trend in age of menarche. N Engl J Med 1982;306:1033-5.
Gaudineau A, Ehlinger V, Vayssiere C, Jouret B, Arnaud C, Godeau E, et al. Factors associated with early menarche: Results from the French health behaviour in school-aged children (HBSC) study. BMC Public Health 2010;10:175.
Papadimitriou A, Fytanidis G, Douros K, Bakoula C, Nicolaidou P, Fretzayas A, et al. Age at menarche in contemporary Greek girls: Evidence for levelling-off of the secular trend. Acta Paediatr 2008;97:812-5.
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Lakkawar NJ, Jayavani RL, Arthi N, Alaganandam P, Vanajakshi N. A study of menstrual disorders in medical students and its correlation with biological variables. Scholars J Appl Med Sci 2014;2:3165-75.
Sarkar AP, Mandal R, Ghorai S. Premenstrual syndrome among adolescent girl student in a rural school of West Bengal, India. Int J Med Sci Public Health 2016;5:408-11.
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Randhawa JK, Mahajan K, Kaur M, Gupta A. Effect of dietary habits and socio-economic status on menstrual disorders among young females. Am J Biosci 2016;4:19-22.
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Kafaei M, Ajorpaz N, Abbaszadeh F, Mohebbi Z, Asghari M. Association between menstrual cycle regularity and obesity-related anthropometric indices in dormitory students of Kashan University of Medical Sciences. Nurs Pract Today 2014;1:101-6.
Said AR, Mettwaly MG. Improving life style among nursing students regarding menstrual disorders through an educational training program. Int J Nurs Sci 2017;7:35-43.
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Negi P
Mishra A
Lakhera P
menstrual abnormalities


This is a competition entry for the new street kiosks in Stockholm, Sweden. The idea was to design a new urban pavilion with a strong identity. It should be clearly identified as "Stockholm Kiosk"
The pavilion would come in three different sizes, Mini, Midi, Maxi and should fit in three different urban conditions: in a sidewalk, a square and an urban beach.
In our proposal, we played with the idea of the crown (the city logo) as the basic shape that would define the volume of the kiosks. Taking one fourth of the crown as the basic module, we are able to configure many different elements, all of them related directly to the crown shape, but not all of them in a literal way.
This basic modules would have some "add-ons", light structures to hold signage, lights and other infrastructures. Kiosks would be standing in the sidewalks like urban Knights in their armor.
Changin booths closed with fabric divisions.