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Lifestyle, not surgery key to combating stroke, Monash University study shows

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Lifestyle, not surgery key to combating stroke, Monash University study shows

MONASH UNIVERSITY

Lifestyle changes and medication are more effective in combating the risk of stroke than invasive procedures, a Monash University study shows.

A Monash researcher has analysed more than four decades of data relating to common treatments for advanced carotid artery stenosis, one of the leading causes of stroke, and found surgery and stents have very limited impact, if any, in preventing stroke.

Carotid artery stenosis is a disease caused by the build-up of fatty deposits (plaques) in the main artery that delivers blood to the brain. The disease affects one in 10 people by age 80 and it is a major cause of stroke – the third-biggest cause of death, occurring when blood supply to the brain is restricted.

The Monash analysis, published in the open science journal Frontiers in Neurology, found that lifestyle factors – such as diet, exercise and quitting smoking – had a significant impact in reducing stroke risk when combined with appropriate medication.

The stroke risk in symptom-free patients with advanced carotid stenosis fell by at least 65 per cent to 1 per cent or less in those using non-invasive measures alone, the study showed. This is similar to, or lower than, the stroke rate in patients who underwent carotid surgery or stenting in past trials.

Study author Associate Professor Anne Abbott from Monash’s Central Clinical School, said the findings dispel a common misconception that surgery or stenting is the best treatment for carotid artery stenosis, when the procedures often cause more harm than good.

“This is a widespread furphy that leads to inappropriate patient care, causing large-scale harm and premature death, while wasting vital health resources,” Associate Professor Abbott said.

“People need to understand that they have the greatest power to prevent their own stroke. Healthy life habits, including physical activity, diet and quitting smoking, combined with appropriate medication, help mitigate major risk factors such as high blood pressure and cholesterol, and very effectively reduce the risk of stroke and heart attack.”

There are currently four types of intervention used to reduce stroke risk in carotid stenosis patients: carotid surgery (endarterectomy), carotid stenting, a new hybrid procedure known as trans-carotid arterial revascularisation (TCAR), and medical (non-invasive) intervention with lifestyle coaching and medication.

“Stroke rates are now so low with non-invasive intervention alone that carotid artery procedures are unlikely to provide benefit to the vast majority of patients and have no current proven benefit for any patient,” Professor Abbott said. “Yet carotid artery procedures are still very commonly done in Australia and overseas and they continue to cause significant complications, including stroke, death and heart attack, and they are costly.”

Professor Abbott is calling on the health sector to incorporate best practice non-invasive interventions and stop unnecessary procedures in order to deliver the best outcomes for their patients.

 

 

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How AI is Empowering People with Disability to Achieve Their Goals

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How AI is Empowering People with Disability to Achieve Their Goals

 

By Robert Heyward

In a world increasingly dominated by digital visuals, images, and videos, advancements in Artificial Intelligence (AI) are helping bridge accessibility gaps for the more than 453,000 Australians living with vision impairments. Though AI is still evolving, its early applications are already making significant impacts, particularly for people with disabilities who find it an empowering tool for independence and career development.

John Zambelli, who has a vision impairment, exemplifies this impact. A Supported Employee at Summerland Farm in the Ballina-Byron hinterland, John leverages AI technology to enhance both his professional and personal life. “I use AI to assist me at work, and it’s amazing,” John shares. “When doing data entry, I can snap a photo of a document, and the AI program extracts the information I need, like the invoice number, date, or total, and reads it to me. It’s faster and less straining on my eyes.”

Over the years, John has experimented with various technologies, yet AI and smartphone apps have proven to be the most accessible and reliable. His favorited, the ‘Seeing AI’ app, has transformed tasks both at work and while out in the community. “If I need to read a menu or sign, I simply take a photo, and it reads it aloud. I’ve used the app for years, and it keeps improving, making my life easier.”

When asked if he would recommend technology to others with low vision, John said, “I always encourage others to explore new tech. It has been an invaluable tool in my life, providing support in ways I never imagined.”

Celebrating nearly 14 years at Summerland Farm, operated by Aruma—one of Australia’s largest disability service providers and charities—John works with more than 100 other Supported Employees, all contributing to what he proudly calls the “farm with heart.” Reflecting on his journey, John remarked, “When I started, I mostly handled reception duties, but now I work on a range of technology and IT tasks. Technology, especially AI, has been a game-changer, helping me build a fulfilling career.”

John’s experience is a testament to how AI and assistive technology can empower people with disabilities, opening doors to independence and meaningful employment. As AI continues to evolve, the potential for more inclusive and accessible opportunities grows, offering individuals like John the chance to achieve their goals and thrive in both work and life.

 

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Experts Shine a Spotlight on ‘Dyslexia for Maths’

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Experts Shine a Spotlight on ‘Dyslexia for Maths’

 

By Ian Roberts

Dyscalculia: The Overlooked Learning Disability

While many Australians are familiar with dyslexia, fewer have heard of dyscalculia, a learning disability that impacts an individual’s ability to process numbers and mathematical concepts. This condition, which affects up to one in seven Australians, disrupts areas of the brain associated with numerical understanding, often going undiagnosed or misunderstood.

Dyscalculia can significantly affect an individual’s ability to perform basic arithmetic, comprehend number sequences, and understand mathematical symbols. Like dyslexia, its severity varies widely, from mild challenges to profound difficulties.

A Personal Perspective

Tasmanian artist Alfie Barker is one of many living with dyscalculia. He explains how it affects his everyday life: “People find it odd that I can’t even visualise two centimetres. It impacts my social interactions in ways most wouldn’t imagine.”

Similarly, Chris Long, from Queensland, shared his struggles: “I’ll be looking at the number four, but my brain registers it as a six. I also have trouble interpreting tables or graphs—it’s hard to connect values to numbers.”

The Science and Stigma of Dyscalculia

Despite its prevalence, dyscalculia remains under-researched and often misunderstood. Jodi Clements, President of the Australian Dyslexia Association (ADA), highlighted the broader consequences of undiagnosed learning disabilities, which can persist from childhood into adulthood. “Unidentified dyscalculia eroded my confidence in school,” she said. “Even today, there are no clear guidelines for screening, and public awareness remains limited.”

Neuroscientist Brian Butterworth, who has spent two decades studying dyscalculia, emphasized that it is distinct from simply being “bad at maths.” He explained: “Even the simplest numerical tasks can be challenging for someone with dyscalculia. For instance, if you show them four dots on a screen, they may need to stop and count them instead of instantly recognising the quantity.”

Understanding Dyscalculia

What is Dyscalculia?

Dyscalculia is a lifelong condition that often begins in childhood, although it may go unnoticed for years. Many individuals develop coping mechanisms or avoid situations involving numbers, delaying diagnosis well into adulthood—or even old age.

People with dyscalculia may struggle with:

  • Understanding numbers and their relationships.
  • Performing basic arithmetic (addition, subtraction, multiplication, division).
  • Estimating quantities or grasping concepts of time and money.
  • Following multi-step problem-solving sequences.
  • Retaining mathematical facts, such as multiplication tables.

Causes of Dyscalculia

While research is ongoing, potential causes include:

  • Genetics: The condition often runs in families.
  • Brain Development: Atypical neurological development may play a role.
  • Environmental Factors: Prenatal exposure to toxins or malnutrition may increase risk.
  • Neurological Injury: Children who experience brain trauma are more susceptible.

Although dyscalculia is increasingly diagnosed in school-aged children, adults often remain undiagnosed.

Overcoming Dyscalculia

Author and academic Paul Moorcraft didn’t confront his dyscalculia until his 50s. In his memoir, It Just Doesn’t Add Up, he coined the phrase: “Just because you can’t count doesn’t mean you don’t count.” Reflecting on his school years, he shared:
“Maths teachers would throw chalk dusters at me. I was in detention daily, struggling to keep up. Mental arithmetic felt like facing a firing squad. As an adult, I’d discreetly count on my fingers under the table. But I found success—I’ve written 50 books.”

Raising Awareness

As experts like Brian Butterworth and Jodi Clements call for better screening tools and public education, it’s clear that dyscalculia deserves greater attention. With increased awareness and support, individuals with dyscalculia can navigate their challenges and unlock their full potential.

 

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NSW Melanoma Hotspot Map Unveils High-Risk Areas

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NSW Melanoma Hotspot Map Unveils High-Risk Areas

 

By Robert Heyward

The Cancer Institute NSW has released a new melanoma hotspot map, highlighting regions with the highest melanoma rates in the state. According to the data, local government areas (LGAs) of Ballina, Lismore, Byron, Clarence Valley, and Coffs Harbour lead with the most cases, with nearly 350 diagnoses anticipated across these areas in 2024.

Rounding out the top 10 are Sutherland Shire, Port Macquarie-Hastings, Tweed, Kempsey, and Richmond Valley. Meanwhile, Mosman, Mid-Western Regional, Shoalhaven, Cessnock, and Wagga Wagga LGAs have entered the top 25.

Melanoma is one of the most common cancers affecting young Australians and ranks as the third most diagnosed cancer in NSW, with over 5,000 new cases projected statewide this year. As the deadliest form of skin cancer, melanoma is expected to claim the lives of nearly 500 people in NSW in 2024.

While most cases are due to UV overexposure, this type of skin cancer can largely be prevented with proper sun protection. The Cancer Institute NSW, under its 2023–2030 Skin Cancer Prevention Strategy, is working to reduce skin cancer rates through various initiatives, including the “If You Could See UV” campaign. This award-winning campaign, which has proven effective in inspiring skin protection among young adults, is being relaunched this summer with geo-targeted UV alerts and outdoor advertising, especially in high-exposure areas frequented by young people.

To guard against UV radiation, the Cancer Institute NSW advocates for these essential steps before heading outdoors:

  1. Slip on protective clothing
  2. Slop on SPF50+ sunscreen, applied 20 minutes before sun exposure and reapplied every two hours
  3. Slap on a wide-brimmed hat
  4. Seek shade
  5. Slide on sunglasses

NSW’s Top 25 Melanoma-Prone LGAs:

  1. Ballina
  2. Lismore
  3. Byron
  4. Clarence Valley
  5. Coffs Harbour
  6. Sutherland Shire
  7. Port Macquarie-Hastings
  8. Tweed
  9. Kempsey
  10. Richmond Valley
  11. Nambucca Valley
  12. Kiama
  13. Port Stephens
  14. Bathurst Regional
  15. Mid-Coast
  16. Lake Macquarie
  17. Mosman
  18. Mid-Western Regional
  19. Northern Beaches
  20. Shoalhaven
  21. Cessnock
  22. Wagga Wagga
  23. Central Coast
  24. Wingecarribee
  25. Newcastle

For additional resources on skin cancer prevention, visit the Cancer Institute NSW website.

Health Minister Ryan Park commented:
“This melanoma hotspot map is a critical reminder to practice sun safety, especially as summer approaches. While melanoma cases are highest in regional areas, everyone in NSW faces the risk of skin cancer. Given Australia’s global ranking in skin cancer rates, we all have a responsibility to follow protective measures to mitigate this deadly disease.”

Member for Wakehurst Michael Regan shared:
“Here on the Northern Beaches, outdoor activities are part of life. However, enjoying the sun safely is essential. I lost my father to melanoma, and I understand the need for prevention. Sun safety starts with each of us embracing and promoting a sun-smart culture. Slip, slop, slap, seek, and slide should be a daily routine.”

NSW Chief Cancer Officer, Professor Tracey O’Brien AM, stated:
“Two in three Australians will develop skin cancer in their lifetime. Consistent protection from UV exposure, starting young and continuing into adulthood, is essential to reducing risk. Even short periods in the sun without protection can be dangerous. Whether it’s a beach day or running errands, I urge everyone to practice sun safety.”

Personal stories highlight the risks and importance of sun protection:

  • Anne Gately, a melanoma survivor, emphasised the need for community responsibility in sun protection, saying, “Every bit of UV exposure contributes to cumulative damage, whether you feel it or not.”
  • Sonia Knight, currently undergoing immunotherapy for melanoma recurrence, stressed, “Tanning isn’t worth the risk. My daughters never leave the house without sunscreen. I encourage others to lean on resources like Canteen and Melanoma Patients Australia for support.”

This comprehensive approach to melanoma awareness and prevention aims to foster a culture of sun safety across NSW.

 

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