Citizens of the Great Barrier Reef: going beyond our backyard to protect the reef

 Protecting and saving icons like the Great Barrier  
reef needs a global response triggered by local action

From place-based to problem-based campaigns, we are seeing a rise in initiatives aiming to foster collective environmental stewardship among concerned citizens across the globe. These international communities have arisen to meet new environmental challenges and seize the opportunities presented by our increasingly connected world.

Traditional approaches to community engagement have tended to focus only on the involvement of local people. However, the recently launched Citizens of the Great Barrier Reef initiative highlights the changing nature of community engagement aimed at fostering environmental stewardship.

In a globalised world, maintaining treasures like the Great Barrier Reef and other ecosystems affected by global-scale threats demands new approaches that involve participation not only of people living locally, but also those in distant places.

A connected world

Today’s environmental problems tend to be characterised by social and environmental connections with distant places.

In terms of environmental connections, places such as the Great Barrier Reef are increasingly affected by global threats. These include: poor water quality associated with port dredging driven by international mining; reef fisheries influenced by national and international markets; and, most importantly, coral bleaching caused by climate change. Social and political action beyond the local is need to combat these threats.

Social connections are increasing through both ease of travel and social media and other forms of virtual communication. This provides opportunities to engage more people across the globe to take meaningful action than ever before. People are able to form and maintain attachments to special places no matter where they are in the world.

Our recent research, involving more than 5,000 people from over 40 countries, shows that people living far from the Great Barrier Reef can have strong emotional bonds comparable to locals’ attachments. These bonds can be strong enough to motivate them to take action.

Harnessing social media

Increasing social connections across the globe don’t only allow people in distant locations to maintain their attachments to a place. They also provide a vehicle to leverage those attachments into taking meaningful actions to protect these places.

Such strategies can now be used even in the most remote of locations – such as 60 metres above the forest floor in a remote part of Tasmania.

Environmental activist Miranda Gibson, who remained engaged with activists around the world during a tree-sitting protest in the Tyenna Valley, southern Tasmania. AAP

During her 451-day tree sit, activist Miranda Gibson co-ordinated an online action campaign. She was able to engage a global audience through blogging, live streaming and posting videos and photos.

Social media provide a new way to foster a sense of community among people far and wide. In this sense, “community” doesn’t have to be local; individuals with common interests and identities can share a sense of community globally. Indeed, this is a key ingredient for collective action.

Employing images and language targeted to appeal to people’s shared attachments to a place can help increase collective stewardship of that place.

These global communities reflect “imagined communities”, a concept developed by political scientist Benedict Anderson to analyse nationalism. Anderson suggests that nations are imagined in the sense that members “will never know most of their fellow members or even hear of them, yet in the minds of each lives the image of their communion”.

Such communities of environmental stewardship can have significant impact. For example, this type of community – which UTAS Professor Libby Lester termed “transnational communities of concern” – played a key role in the decline in Japanese market demand for Tasmanian forest products.

Beyond slacktivism

An important challenge in engaging distant communities in environmental stewardship is to avoid the pitfalls of “slacktivism”.

This refers to the phenomenon of people taking online actions that require little effort, such as joining a Facebook group. It makes them feel good about contributing to a cause but can stop them from taking further action that has real on-the-ground impacts.

More meaningful options are available to people in remote places that can result in real change. These include lobbying national governments, international organisations (such as the World Heritage Committee), or transnational corporations (to prioritise corporate social responsibility, for example). Most organisations that have successfully engaged distant people in environmental stewardship, including Fight for Our Reef, have tended to take a political approach to help with lobbying efforts.

Other meaningful actions that can be undertaken remotely include supporting relevant NGOs and reducing individual consumption.

A new approach to global citizenship

The Citizens for the Reef emphatically state that they are “not looking for Facebook likes” but seek “real action”.

The six actions being promoted include reducing consumption of four disposable products, eliminating food wastage, and financially supporting crown-of-thorns starfish control. Signed-up citizens are given an “impact score”, based on undertaking these actions and recruiting others, and can compare their progress to others around the world.

The initiative provides an example of a new form of environmental activism that is emerging in response to increasing global environmental and social connection. The significant challenge for this initiative is to gain the sustained engagement of enough people to achieve real-world impact.

Ultimately, however, while the local to global public certainly have a critical part to play in addressing these threats, this does not diminish the responsibility of government and the private sector for safeguarding the future livelihood of the Great Barrier Reef.

This article was written by:
Image of Georgina GurneyGeorgina Gurney – [Environmental Social Science Research Fellow, James Cook University]




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New online tool can predict your melanoma risk

 People who are unable to tan and who have moles on 
their skin are among those at heightened risk of developing melanoma.

Australians over the age of 40 can now calculate their risk of developing melanoma with a new online test. The risk predictor tool estimates a person’s melanoma risk over the next 3.5 years based on seven risk factors.

Melanoma is the third most common cancer in Australia and the most dangerous form of skin cancer.

The seven risk factors the tool uses are age, sex, ability to tan, number of moles at age 21, number of skin lesions treated, hair colour and sunscreen use.

The tool was developed by researchers at the QIMR Berghofer Medical Research Institute. Lead researcher Professor David Whiteman explained he and his team determined the seven risk factors by following more than 40,000 Queenslanders since 2010, and analysing their data.

The seven risk factors are each weighted differently. The tool’s algorithm uses these to assign a person into one of five risk categories: very much below average, below average, average, above average, and very much above average.

“This online risk predictor will help identify those with the highest likelihood of developing melanoma so that they and their doctors can decide on how to best manage their risk,” Professor Whiteman said.

After completing the short test, users will be offered advice, such as whether they should see their doctor. A reading of “above average” or “very much above average” will recommend a visit to the doctor to explore possible options for managing their melanoma risk.

But Professor Whiteman cautions that people with a below average risk shouldn’t become complacent.

“Even if you are at below average risk, it doesn’t mean you are at low risk – just lower than the average Australian,” he said.

Read more: Explainer: how does sunscreen work, what is SPF and can I still tan with it on?

An estimated one in 17 Australians will be diagnosed with melanoma by their 85th birthday.

The test is targeted for people aged 40 and above as this was the age range of the cohort studied.

However, melanoma remains the most common cancer in Australians under 40.

Professor Whiteman said that the test may be useful for those under 40, but it may not be as accurate, as that wasn’t the demographic it was based on.

But he added complete accuracy couldn’t be guaranteed even for the target demographic.

“I don’t think it’s possible that we’ll ever get to 100%. I think that’s a holy grail that we aspire to, but in reality, cancers are very complex diseases and their causality includes many, many, factors, including unfortunately some random factors.”

The prognosis for melanoma patients is significantly better when it is detected earlier. The University of Queensland’s Professor of Dermatology H. Peter Soyer explained that the five-year survival rate for melanoma is 90%. But this figure jumps to 98% for patients diagnosed at the very early stages.

“At the end of the day, everything that raises awareness for melanomas and for skin cancer is beneficial,” Professor Soyer said.

Dr Hassan Vally, a senior lecturer in epidemiology at La Trobe University, said the way risk is often communicated is hard for people to grasp. But he said this model would provide people with a tangible measure of their risk of disease, and point them towards what they may be able to do to reduce it.

“Everything comes back to how people perceive their risk, and how can they make sense of it.

“If it makes people more aware of their risks of disease that’s a good thing, and if that awareness leads to people taking action and improving their health then that’s great.”

This article was co-authored by:




Yes, too much sugar is bad for our health – here’s what the science says

 More than half of Australians consume too  
much sugar. Sharon McCutcheon

The World Health Organisation recommends limiting “free sugars” to less than 10% of our total energy intake. This equates to around 12 teaspoons a day for an average adult.

But more than half of Australian adults exceed this limit, often without knowing. “Free sugars” don’t just come from us sweetening coffees and teas or home-cooked dinners; they are added by manufacturers during processing.

It’s often a surprise to learn just how many teaspoons of sugar are added to popular foods and drinks:

The Conversation, CC BY-ND

Most of the concern about excess sugar consumption has been focused on weight gain, and rightly so. Our livers can turn sugar into fat. Too much sugar – and too much soft drink, in particular – can cause fat to be deposited on our waist. This is known as visceral fat.

Visceral fat is especially harmful because it increases the risk of heart disease and type 2 diabetes, even when blood sugar levels are higher than normal.

But what does the science say about sugar and the raft of other conditions we see in the headlines every other week? Let’s look at two examples: dementia and cancer.


Dementia is an umbrella term for brain disorders that cause memory loss, confusion and personality change. It’s the greatest cause of disability among older Australians and the third-biggest killer. Alzheimer’s disease is one type of dementia.

The research does not show that sugar causes dementia. But there is emerging research that suggests high-sugar diets may increase the risk of developing the disease. What we can say is that there is a link between high-sugar diets and dementia, but we don’t have evidence to show that one causes the other.

Too much sugar makes us gain weight but there are also other ways it an increase our risk of diseases. Giuliana M/Shutterstock

2016 New Zealand study of post mortems on human brains assessed seven different regions of the brain. The researchers found that the areas of greatest damage had significantly elevated levels of glucose (sugar). Healthy cells don’t usually have elevated levels of glucose.

This was also found in a separate analysis of post-mortem brain and blood samples from Baltimore in 2017. Using blood samples collected from the patients over a 19-year period before they died, the brain glucose concentration at death was found to be highest in those with Alzheimer’s disease. What’s more, this glucose level had been slowly increasing for years.

The levels of blood glucose were not indicative of diabetes. So otherwise healthy people could have rising levels of glucose in the brain well before any obvious signs of disease prompt any action.

Together, these studies tell us that the brains of people with Alzheimer’s disease struggle to metabolise sugar for energy. The changes in the brain seem to be linked to persistent increases in blood glucose over a long period of time. And the damage to brain cells is occurring well before overt symptoms of Alzheimer’s appear.

We don’t know if simply consuming high amounts of sugar results in the build-up of glucose in the brain. But other research also supports this theory.

recent analysis of more than 3,000 people found that those who drink sugary beverages were more likely to have smaller brains and perform worse on a series of memory tests.

The researchers calculated that consuming one to two or more sugary drinks per day could be equivalent to up to 13 years of additional brain ageing. And a separate analysis of soft drink versus fruit juice reported similar affects.


Cancer is a condition in which the cells in the body mutate and rapidly multiply. It’s Australia’s second biggest killer and will affect half of Australians if they live to 85.

There is no evidence that sugar causes cancer, but there are at least two ways in which they are linked.

Too much soft drink can cause fat to be deposited on your waist. Dilok Klaisataporn/Shutterstock

First, if you are overweight or obese, you have an increased risk of developing 11 different types of cancer. Consuming too much sugar (and too many kilojoules overall) leads to weight gain, which increases the risk of cancer.

A second, more direct pathway linking sugar to cancer is the capacity for sugar to stimulate insulin secretion. This is a potent hormone signal for cell growth. Cancer cells also rely on sugar for energy to fuel their continual growth.

This suggests that independent of any change in your weight, consuming too much sugar may increase your risk of developing cancer.

But we need to be cautious about the quality of data available directly linking cancer to sugar consumption.

recent study of 35,000 people, for instance, reported a link between higher obesity-related cancer risks and heavy consumption of soft drink. But the authors point out that it was impossible to specifically separate drinking soft drinks from other unhealthy behaviours, such as smoking or lower levels of physical activity.

What does it all mean?

Much of the current discussion about sugar focuses on the effects of excess energy intake and weight gain, and the subsequent risk of diabetes, heart disease, cancer and some forms of dementia.

But while being overweight or obese increases your risk of these diseases, excess weight is not a prerequisite.

While the development of diseases are no doubt also based on genes and lifestyle factors other than diet, the evidence of the potential harms of high-sugar diets is accumulating. It’s certainly compelling enough for many to consider limiting how much sugar we eat and drink.

Whether or not the sugar itself is the culprit, sugary foods are linked to health problems – and that should be reason enough to cut down.

This article was written by:
Image of Kieron Rooney
Kieron Rooney – [Senior Lecturer in Biochemistry and Exercise Physiology, University of Sydney]





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Weekly Dose: cocaine, the glamour drug of the ’70s, is making a comeback

 In Australia, cocaine is most commonly snorted. 
Ralf Geithe/Shutterstock

Cocaine is derived from the leaves of the coca plant, which is native to Central America. For thousands of years, the leaves were used by the local inhabitants such as the Incas, who chewed or made them into a tea, because of the alertness and energy they provided.

German chemist Albert Niemann eventually isolated the active ingredient in 1859 and it was named cocaine. This was the beginning of the drug’s use as a medicinal and recreational substance in Western culture.

How many people use it

Cocaine is the second most commonly used illicit substance in Australia, after marijuana. Reports of cocaine use in the 12 months to June 2017 more than doubled since 2004 – from 1% to 2.5% (or around 170,000 to 500,000 people).

The number of people who have ever used cocaine has had a similar percentage increase – from 4.7% in 2004 to 9% in 2016. Cocaine use has reached a 15-year high.

History and use over time

Cocaine gained prominence in the 1880s. Sigmund Freud broadly praised its uses, including in overcoming morphine addiction and treating depression.

Viennese ophthalmologist Carl Koller performed the first operation using cocaine as an anaesthetic on a patient with glaucoma, which led to its use as a local anaesthetic.

But, soon after, practitioners began reporting side effects. Cocaine doses were administered at such high concentrations that there were 200 cases of intoxication and 13 deaths (in around seven years) as a result.

At the 1912 Hague International Opium Convention cocaine (and heroin) was added to the drug control treaty as problematic substance. This sparked the introduction of new drug control laws relating to cocaine in various countries.

Crack cocaine is a solid, rock-like version of the drug which can be smoked. from

Cocaine use decreased after this, but later experienced a surge in popularity in the 1970s, peaking in the 1980s. During this time, cocaine was associated with celebrities, high rollers and glamorous parties.

Then a new, crystallised form of cocaine (crack cocaine) was developed. Crack cocaine is processed with ammonia or baking soda, producing a solid “rock” version of the drug which could be smoked.

Not only was crack cocaine more potent, but the effects of the drug (typically after smoking) were felt faster. It was also much cheaper, which allowed it to spread quickly into poorer communities. Its use became recognised as an “epidemic” around 1985, which lasted for ten years.

How it works

The nervous system uses chemicals called neurotransmitters to communicate. These move across the space between two nerve cells and bind to receptors on the receiving cell.

Neurotransmitters do different things. Dopamine, for instance, is involved in the reward system of the brain. It creates feelings of pleasure and contributes to motor control, reinforcement and motivation.

The more neurotransmitters are present in the space between two cells, the more can bind to receptors and have a stronger effect. When the body no longer needs the neurotransmitter in its system, it gets reabsorbed into the cell that released it. This is called re-uptake.

One way to increase the level of a neurotransmitter in the brain is to prevent this re-uptake process from occurring. Cocaine inhibits the re-uptake of dopamine in the brain. The resulting increase in dopamine can cause heightened feelings of pleasure and well-being, among other effects.

The coca plant, from which cocaine is derived, is native to Central America. Olmez/Shutterstock

Some evidence suggests cocaine also inhibits the uptake of the stimulant norepinephrine and the mood regulator serotonin.

Nerves also communicate through electrical signals. Cocaine inhibits electrical communication. In this way, it also works as an anaesthetic by blocking communication between peripheral nerve cells. Cocaine produces a numbing effect when applied to mucous membranes such as the mouth, throat and inside the nose.

How much it costs

The average price for cocaine is around A$300-$350 per gram. That’s A$50 more per gram than methamphetamine (ice). In 2017, Australia ranked as the most expensive country to buy cocaine.

How it’s used

Cocaine is used primarily as a recreational drug. In Australia it’s most commonly snorted. Injecting, swallowing and smoking are less common.

How it makes you feel

The effects of cocaine depend on the dose, form, method of use and what the cocaine is cut with. Cocaine is commonly taken in doses of between 10mg and 120mg. A high lasts between 15-30 minutes and has a half-life (time required before 50% of the drug has left the user’s system) of one hour.

Lower doses will cause a person to experience increased heart rate, body temperature and blood pressure. Cocaine also brings out feelings of euphoria, confidence, giddiness, alertness and enhanced self-consciousness.

Higher doses can cause additional effects such as sleep deprivation, hyper-vigilance, anxiety and paranoia.

Some people who use cocaine may also experience tactile hallucinations. A common example of this is the feeling of bugs crawling on the skin.

Cocaine users can experience tactile hallucinations, such as the feeling of bugs crawling on their skin. from

Using cocaine over a long time or in binges may lead to depression, irritability, disturbances of eating and sleeping, and tactile hallucinations.

Cocaine is also very addictive. Withdrawal symptoms last up to ten weeks.

Cocaine can cause severe heart and neurological issues, and even death, when taken in too large a quantity.

Recent data show that seven people died due to cocaine overdose in 2013 in Australia.

Cocaine used to be added to Coca-Cola. from

Other points of interest

In the 1880s in the US, cocaine was included in numerous medicines, and even in Coca-Cola. Coca-Cola had about 60mg of cocaine in a 250ml bottle.

In ColombiaMexico and Peru, possessing small amounts of cocaine for personal use is decriminalised.

One of the more recent concerns about the resurgence of cocaine is the potentially deadly effect it has when cut with fentanyl, a potent opioid. A number of recent drug overdoses in Sydney have been linked to heroin cut with fentanyl, highlighting its deadly effects. While this hasn’t yet become popular with cocaine, it very well could.

This article was co-authored by:
Image of Jason FerrisJason Ferris – [Associate Professor, The University of Queensland];
Image of Barbara WoodBarbara Wood – [Research Assistant, The University of Queensland]
Image of Stephanie Cook Stephanie Cook – [Research Assistant at the Institute for Social Science Research, The University of Queensland]




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White, brown, raw, honey: which type of sugar is best?

 Sugar is sugar in the body. But the way they’re  
processed can make small differences. from

In nutrition, sugar refers to simple carbohydrates consisting of one or two basic carbohydrate units such as glucose, fructose and galactose. Consumers often use “sugar” to describe simple carbohydrates that taste sweet, but not all sugars are sweet.

There are many different types of sugars we add to our baking or hot drinks such as white sugar, brown sugar, raw sugar and honey. But when we’re looking at a packaged product the ingredients list will have many more options still. Corn syrup, palm sugar, molasses, maple syrup and agave nectar are but a few.

Despite the large variety of sugars, they are very similar nutritionally. They are comprised predominantly of glucose, fructose and sucrose, which are the basic forms of sugar. Glucose and fructose are slightly different in chemical structure, while sucrose is a sugar composed of one glucose and one fructose.

The factors that distinguish sugars are their sources (from sugarcane, beet, fruit, nectar, palm or coconut saps), flavour profiles, and the levels of processing.

Types of sugar

White sugar: also called table sugar, is the final product of the processing and refining of sugarcane or beet. During the refining process, moisture, minerals and compounds that give sugars their colour are removed, and white refined sugar is formed. The byproduct containing the removed compounds during sugar refining is known as molasses.

Raw sugar: is formed if the final refining process is bypassed.

Brown sugar: is refined white sugar with varying amounts of molasses added. Raw sugar, brown sugar and molasses are higher in compounds that provide colour, from natural sources or byproducts of the breakdown of sugar (caramel) during sugar processing.

Honey: is sugar-rich nectar collected by bees from a wide variety of flowers. Fructose is the main sugar found in honey, followed by glucose and sucrose. The sweet taste of honey is attributed to its higher fructose content, and fructose is known to be sweeter than glucose or sucrose. Honey is about 17% water.

Honey contains a sweeter type of sugar, meaning you don’t have to use as much. It also contains more water than table sugar. from

Syrups: can be produced from a wide range of plant sources in the forms of sap and fruits. Some examples include agave (a desert succulent), corn, date, grape, maple and pomegranate syrup.

Because agave and corn are more complex carbohydrates, they’re first broken down into sugar during food processing before being concentrated into syrup. Corn syrup is often further processed into the sweeter version, high fructose corn syrup.

Fruit sugar: can be made from the drying and grinding of fruits such as dates. Sugar produced through this process shares similar nutrient composition with the fruit (such as fibre and minerals) but it is lower in water content.

Which type is best?

Several studies have reported adverse effects of white sugar and high fructose corn syrup on our health. So should we substitute these types of sugars with another?

Sweetness and sugar content

Some sugars such as honey and agave syrup are higher in fructose. Fructose is sweeter than glucose and sucrose, hence a smaller amount may be needed to achieve similar level of sweetness from white sugar. Honey and syrups also have a higher water content. So the sugar content is less than the equivalent weight of white sugar.

Antioxidant capacity

Due to the different levels of processing and refining, sugars that are less processed and refined tend to have higher contents of minerals and compounds that give plants their colour. These compounds have been found to increase antioxidant capacity, which reduces the cell damage in the body that causes several chronic diseases.

Although the antioxidant capacity of date sugar and molasses is many-fold higher than white sugar and corn syrup, it’s still relatively low compared to antioxidant-rich foods. For example, more than 500g of date sugar or molasses need to be consumed to get the same amount of antioxidant contained in a cup (145g) of blueberries.

Glycemic index

Different types of sugar raise the amount of sugar in our blood at different rates after being consumed. The glycemic index (GI) concept is used to compare the ability of different carbohydrate-containing foods in raising blood sugar levels over two hours.

Pure glucose is used as the reference carbohydrate and it’s given a value of 100. Higher GI indicates greater ability of a food in raising blood sugar levels, and having high levels of sugar in the blood can lead to disease. High GI foods tend to be less filling too.

The GI values in the table below are compiled from the GI database. Corn syrup has the highest GI as it is composed mainly of glucose. White sugar, composed of 50% glucose and 50% fructose, has slightly lower GI. Based on available values in the GI database, agave syrup has the lowest GI value. Therefore, it’s a better option than other sugars in term of blood sugar management.

Glycaemic Index of sugars. Source: GI database

Antimicrobial activity

Honey has been reported to possess several germ-killing capabilities due to the presence of several naturally-occurring compounds. But it’s still unclear how the antimicrobial property of honey may be obtained.

In the end, sugar in our body is still sugar. So while honey, raw sugar, date sugar and molasses are “better” than white and other types of sugar, everyone should try to cut down their sugar intake.

This article was written by:
Image of Sze-Yen TanSze-Yen Tan – [Senior Lecturer in Nutrition Science, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University]




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For Australians to have the choice of growing old at home, here is what needs to change

 When an ageing person is forced to move out of  
their family home, that can trigger a host of problems that policy is 
doing little to prevent. Diego Cervo/Shutterstock

Ooh, a storm is threatening my very life today / If I don’t get some shelter / Oh yeah, I’m gonna fade away…

Mick Jagger won’t ever need to be concerned about having somewhere to live, but older people have worried about where they will spend their final years since long before the Rolling Stones sang to a generation’s insecurities in 1969. Many wish to stay in their homes, but current policy doesn’t support age-friendly housing. It also makes it difficult for ageing people to manage their finances.

The population of people aged 65 and over in Australia is projected to grow from 3.7 million to 8.7 million by 2056. Cities, towns and housing need to be designed to help people stay at home as they age. Financial policy should be updated to enable them to better manage their assets.

Gwen’s story

Five years before her death, Gwen (not her real name) and her family faced a dilemma. Like many Australians, Gwen had juggled a succession of jobs, eventually owning her modest home. Following a fall, hospitalisation and rehab, her prognosis was not good.

Gwen wanted to die at home, or with her family. Should members of the family move into her house? Should she move into one of her adult children’s houses? What about their children?

Should they rent out the family properties, so Gwen and volunteering family members could cohabit in a more suitable rented property? Could they afford a house with the flexibility to handle two adults, one elderly person, possibly kids and pets?

For families like Gwen’s, there are few viable, let alone affordable, housing options. Gwen’s housing shuffle proved stressful for everyone. She was ultimately placed, against her wishes, in a nursing home. Aged 82, deprived of any sovereignty in her decision-making, Gwen passed away, but the family arguments and blame continued.

What is stopping people ‘ageing in place’?

Gwen’s deck of dominoes could not be reconfigured because of the housing, tax and financial barriers imposed by the same governments that are trying to implement “ageing in place”.

Ageing in place isn’t just about ageing at home. It’s about keeping older people connected to their neighbourhood and community as part of a broader framework of “active ageing”, with the aim of improving their quality of life and giving them more control over their circumstances.

Since the World Health Organization (WHO) released its Active Ageing policy framework in 2002, federal governments have endorsed this approach. The 2013 Living Longer Living Better reforms and last year’s Legislated Review of Aged Care promote emotional and mental preparation for old age, which is important for active ageing.

However, many aspects of policy in Australia undermine successful ageing in place.

A lack of suitable housing

First, ageing Australians have a limited choice of suitable housing, as the Productivity Commission has highlighted.

Livable Housing Australia’s guidelines recommend installing nonslip floors and grab rails and retrofitting rooms to help keep them at a comfortable temperature. This improves home liveability and reduces risks of harm for occupants. Incremental measures like these also have beneficial ripple effects by making housing suitable for all ages. However, such guidelines are not yet widely implemented.

The ability to influence what is built, and where, can greatly enhance or inhibit well-being. Denmark and Canada are already running with the 8 80 Cities concept, which aims to transform cities so they meet the needs of people of all ages. It’s a good example for Australian planners.

Greater Sydney Commission Chief Commissioner Lucy Turnbull inspects transport construction work in Sydney. Danny Casey/AAP

Local governments need to embrace redevelopment models that provide better ageing-in-place options for communities. The Greater Sydney Commission recently took a step in the right direction with its plans to increase housing supply and affordability. Its investigation into improving transport options and amenities could also enhance liveability.

The City of Melbourne’s Places for People strategy and the Age-Friendly Victoria initiative commit to housing that meets the WHO’s essential age-friendly city features. These programs recognise that placemaking is strongly linked with successful ageing in place.

Read more: Eight simple changes to our neighbourhoods can help us age well

Financial penalties for moving

Most Australians lack the financial means to customise their homes as they age. Safety concerns will eventually collide with their desire for independent living, forcing a devil’s choice. The decision to enter aged care can be very difficult for people and their families. Taxation and pension rules that prevent them managing their assets without losses worsen the situation.

If governments want to promote active ageing, then older people must be given more flexibility in managing their assets. This means allowing them to sell the family home, take the tax-free asset value, downsize to a suitable smaller property, and put the leftover money into their super without penalties in the form of stamp duty, tax or loss of benefits.

Many people don’t want to give up home ownership, especially as a family home doubles as a tax shelter. Ideally, a compact property would be preferable, designed to accommodate any generation, and with better access to the amenities and services needed later in life. Then, should they eventually need high-level care, the home could be rented out, providing an income stream to help cover medical and care expenses.

Future-proofed properties like this mostly do not exist in Australia. They don’t exist because, thanks to current policy, the elderly are reluctant to monetise their tax-free asset (the family home) to buy such properties and thus generate a demand to be met by developers.

Read more: Downsizing cost trap awaits retirees – five reasons to be wary

Where do you want to die?

Baby boomers are living longer and are more mindful of their health and lifestyle. However, a recent survey found that only a small percentage were planning their financial future so they could live independently for as long as possible. And a growing number of seniors lack the income to cover the unforeseen costs that arise later in life.

Governments need to step up public information campaigns to encourage people to prepare for their old age. Without it, the confronting question “Where do you want to die?” cannot be feasibly answered.

Governments and the private sector can also take action to:

  • acknowledge the tax shelter status of private homes alongside the tax shelter status of superannuation
  • reduce transaction costs such as stamp duty that discourage moving before it becomes essential, as it often does for the over-80s
  • remove disincentives to releasing equity in the family home (for example, the pension means tests on proceeds in interaction with the pension and superannuation systems)
  • with the growth of the tiny house movement, ensure a wider variety of housing stock, styles and locations to support ageing in place
  • encourage emerging home ownership models, such as home equity release, reverse mortgages, fractional property investment and co-operative housing – to name a few.

These initiatives would allow people to find and create homes that offer shelter from the ageing “perfect storm” already under way in Australia.

This article was co-authored by:




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Child tooth decay is on the rise, but few are brushing their teeth enough or seeing the dentist

 Early dental visits are essential to help parents keep 
their children’s teeth and gums healthy. from

One-third of preschoolers have never seen a dentist and most parents believe children don’t need to see one before they’re three years old. Yet one-quarter of Australian children have tooth decay that requires filling by early primary school. One in ten require an extraction.

Results released today from the latest Royal Children’s Hospital National Child Health Pollalso reveal one in three children (33%) aren’t brushing their teeth twice a day and almost half of parents (46%) don’t know that tap water is better for teeth than bottled water.

Read more: Four myths about water fluoridation and why they’re wrong

Rates of tooth decay are on the rise in Australia, particularly among young children. More than 26,000 Australians under the age of 15 are admitted to hospital to treat tooth decay every year. This makes it the highest cause of acute, preventable hospital stays.

Untreated dental disease can cause chronic infection and pain. This can affect a child’s ability to eat, play and learn, and so impact their growth, development and quality of life. It’s also linked to long-term health outcomes like heart disease and diabetes.

Our poll shows that many parents, despite meaning well, lack the basic knowledge to prevent tooth decay in their children. Others are confused when it comes to recommendations about brushing teeth, diet and when to see the dentist for a check-up.

When a child should see the dentist

Children should visit the dentist when their first tooth comes through, or at 12 months of age. Our poll found only 17% of children had seen a dentist by the age of two.

Early visits are essential to provide parents with support and education to help keep their children’s teeth and gums healthy, before teeth break down and start to cause trouble. Children as young as two can require treatment in hospital for severely broken down, infected and painful teeth.

Tooth decay develops over time and early decay can be hard to spot. Starting dental check-ups from 12 months will help identify any red flags and allow parents to make changes to diet and lifestyle. Regular check-ups allow decay to be detected and treated early and more complex and costly treatments avoided. Some children require check-ups more often than others and parents should consult with their dentist on how often their child should go.

Tooth decay can develop quickly and be hard to stop. from

Seeing a dentist can be costly though. In our poll, one in five parents cited cost as a reason for delaying a visit to the dentist. But many were unaware of the free dental services that may be available to their children. All Australian states and territories offer public dental care to children at no or minimal cost, up to a certain age.

In addition to this, the federal Child Dental Benefits Schedule provides eligible families with up to A$1,000 worth of treatment over two years. This can be used for private as well as public dental services for children aged 2-17. All children in families receiving Parenting Payment or Family Tax Benefit Part A are eligible for the program. One-quarter of eligible families we surveyed weren’t aware of the program.

Ultimately, only dental professionals are registered to provide dental examinations to children. But young children often see a range of healthcare providers for different reasons. Every visit to the GP, pharmacist or child health nurse is an opportunity for dental education and decay prevention. GPs and child health nurses can also help direct families to appropriate and affordable dental services.

When should children brush their teeth?

While brushing once a day is better than not at all, brushing teeth twice a day further reduces the chance of tooth decay. Our poll found one-third of children aren’t brushing their teeth often enough, with one in four parents believing once a day is adequate.

RCH Child Health PollAuthor provided (No reuse)


Dentists recommend using a cloth to clean a baby’s gums from birth, moving onto a toothbrush with water when the first tooth erupts. A pea-sized amount of children’s strength toothpaste is recommended from 18 months of age. Children can use adult-strength toothpaste from the age of six. Parents should help children with brushing their teeth up to the age of eight to ensure it’s done properly.

Most children will begin losing their primary teeth, also known as “baby” or “milk” teeth, from around the age of six. The last falls out about age 12. One in five parents indicated they thought it didn’t matter if young children got tooth decay since their baby teeth fall out anyway.

Parents should help children brush their teeth until they are about eight years old. from

Primary teeth may be temporary, but they need to be strong and healthy so children can chew, speak and smile with confidence. They also act as “space savers” for adult teeth. If a child prematurely loses a milk tooth, the tooth beside it may drift into the empty space, preventing the adult tooth from erupting into its proper place.

What about diet?

Our poll found one in four children under five years are put to bed most days of the week with a bottle containing milk-based or sweetened drinks. This practice is strongly linked to tooth decay due to the prolonged exposure of teeth to sugar during sleep. Babies should finish their bottles before being put into bed. From around one year of age, they should be encouraged to drink from a cup instead.

But sugar-sweetened drinks are not the only worry when it comes to teeth. In recent years, bottled water intake in kids has increased considerably, and half of parents think bottled water may be better for teeth than tap water. More than 90% of Australians have access to fluoridated tap water, which helps strengthen teeth and prevent decay. Unlike tap water, most bottled water in Australia contains very little fluoride, making it a less healthy choice for teeth.

Most parents know consuming sugary food and drinks can contribute to tooth decay. But more than 70% of Australian children and adolescents exceed World Health Organisation recommendations for sugar intake and many parents report finding it hard to know how much added sugar is in food.

The recommended maximum daily intake of added sugar for children is around five teaspoons. According to parents polled, one-third of Aussie kids have sugar-sweetened drinks most days of the week, including one in five preschoolers. A 375ml can of soft drink contains around nine teaspoons of sugar.

It’s not just up to parents and dentists to tackle the growing problem of child tooth decay. Other healthcare providers and policymakers have a critical role to play. We need to make sure all parents have access to the right information and support to make healthy choices for their children’s teeth every day from birth.

This article was co-authored by:
Anthea Rhodes – [Paediatrician and Lecturer in Child and Adolescent Health, Department of Paediatrics, University of Melbourne]
Mihiri Silva – [Paediatric dentist and PhD candidate, Murdoch Childrens Research Institute]




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Health Check: what caused my stye and can I get rid of it?

 There are a few different types of stye –  
and if you’re in lots of pain you’ll know yours is the infected kind. 

Many of us will have a stye in our lifetime. While they can be quite sore, the concern for most is the aesthetics of a swollen and red eyelid, especially as it’s hard to cover up something on your eye.

So what is a stye, and what causes them?

Styes occur when glands on the eyelid become blocked and infected. This infection is usually caused by common bacteria that reside on the lids, such as one you’ve probably heard of called Staphylococcus aureus (of Golden Staph fame).

When these glands become infected, the oils they secrete, which usually have a smooth olive oil consistency, become thick and waxy and resemble more of a toothpaste-like texture. This obstructs the glands and they fill up, and more bacteria can grow. It’s a similar process to when pimples form on your skin.

There are actually a number of conditions that may be considered under the colloquial umbrella of a stye: an acute infection called a “hordeolum”; and a long-term, inflammatory response called a “chalazion”.

You will know which of these two forms of lid bumps you have because the acute hordeolum is rather painful, red and may feel hot to the touch, but it will resolve within a few weeks. Whereas a chronic chalazion appears as a firm lump which is a only a little uncomfortable but annoyingly doesn’t seem to go away for months.

Although styes are very common conditions, and anecdotally are the most common infection of the eye and the structures that surround the eyes, the prevalence for these conditions is not actually known.

Acute styes can be further categorised as either external or internal. External hordeola are infections of the glands that sit right next to your eyelashes and they look exactly like a little pimple on your lid.

Internal hordeola are infections of the Meibomian glands, which are the glands responsible for contributing oil to our tears. These glands are located in a firm plate inside the lid and when they swell they can rub against sensitive parts of our eyeball causing double discomfort; both in the lid and on the front surface of the eye.

Both internal and external styes are painful, swollen, red and radiate heat but typically, external styes are less painful then internal ones. This may be because the external glands are smaller so have less potential to fill up with secretions than the large internal glands, so there’s less infected tissue.

Chalazia, the chronic form of styes, develop when the Meibomian gland becomes blocked but not infected. The secretions that build up in the gland may become surrounded by immune cells to form a solid, cyst-like lump. So while chalazia may be large and lumpy, and last for months, they are not overly painful or red – because they’re not infected.


Hordeola, the acute styes, will resolve spontaneously. The smaller external hordeola will usually resolve within seven to ten days; just like a pimple it will pop, sometimes spectacularly, giving almost instant relief. Don’t try to pop them yourself though, this risks causing scarring and may promote further blockage in future.

The internal stye takes longer to resolve and usually the pain and redness is sufficient to get you to see an optometrist, GP or ophthalmologist.

They will probably suggest hot compresses and gentle lid massage to soften the material trapped in the gland and encourage it to come out of the gland opening.

Acute styes will pop on their own. from

Chalazia, while generally only mildly irritating, may cause concern due to their cosmetic appearance. If these benign lumps bother you they can be treated with hot compresses and massage, or minor surgery.

Studies have attempted to look at hot compresses (to encourage blood flow to speed up the body’s natural immune response to infection), lid scrubs (to remove bacteria and oily secretions) and topical antibiotics as treatments, but they were unable to establish any superiority over placebo.

One study by Thai ophthalmologists found warm compresses are the most commonly prescribed treatment (91% of cases) whereas oral antibiotics are rarely used (only in 2.4% of cases).

If you notice you’re developing a stye, using warm compresses and gently massaging the lid with clean hands (from the centre to the outside where the gland openings lie) is the most sensible treatment, but it could also be just as effective as leaving it alone.

If the stye has not resolved within two weeks, see your optometrist, GP or ophthalmologist who can discuss further treatment. A short course of antibiotics might be needed to encourage the infection and inflammation to subside.

How can we avoid styes?

People with certain skin conditions (such as eczema) may be more prone to styes, but generally they’re best prevented by keeping the eyelids clean. A stye is just a blocked gland duct, like a pimple, so just like avoiding pimples, keeping your skin clean and clear of excessive oils or grime that might block the ducts is the best prevention.

So, clean off eye makeup before bed to keep the gland opening from blocking. Use dedicated hypoallergenic lid cleaners if you are sensitive to other cleaners. Change eye makeup a few times a year to prevent it harbouring bacteria and don’t share facecloths or similar with someone who has a stye.

Anything else to look out for?

Styes are common and unlikely to cause other problems so for the vast majority of people there’s nothing else to worry about. In very rare circumstances tumours such as cutaneous squamous cell carcinomas present as masquerades for chalazia.

If you have what you think is a chalazion but after a few months it hasn’t gone away, see your optometrist, GP or ophthalmologist who can examine, take a photograph and monitor or even biopsy the lesion to rule out the remote possibility of carcinoma.

Also very rarely, the infection from a stye can spread from the glands and into other lid structures or even the eyeball. So if a stye is not getting better, you feel unwell or your vision is affected, see your optometrist, GP or ophthalmologist immediately.


This article was co-authored by:
Image of James ArmitageJames Armitage – [Associate Professor in Vision Science, Optometry Course Director, Deakin University]
Image of Jacqueline KirkmanJacqueline Kirkman – [Optometrist, PhD Candidate, Sessional Academic, Deakin University]




This article is part of a syndicated news program via

It’s not just sex: why people have affairs, and how to deal with them

There are many reasons people have affairs.Alex Iby/Unsplash

Barnaby Joyce’s affair with his former staffer Vikki Campion, and his subsequent downfall from the position of deputy prime minister and head of the National Party, made headlines for weeks. It’s not surprising. From politicians to actors and entertainers, stories of high profile individuals caught “cheating” on their partner often make front-page news.

We believe a romantic partner is there to provide us with love, comfort and security. So people are quick to make judgements and lay blame on perpetrators of what they see as a significant violation of relationship norms and betrayal of trust. Infidelity highlights the potential fragility of our closest and most important of relationships.

But despite the blunt belief infidelity is the result of immoral and over-sexed individuals wanting their cake and eating it too, the reality is far more nuanced. For instance, infidelity is rarely just about sex. In fact, when it comes to purely sexual infidelity, the average occurrence across studies is around 20% of all couples. However, this rate increases to around a third of couples when you include emotional infidelity.

An affair is generally a sign things aren’t right with someone’s relationship. Without the necessary skills to heal the issues, a partner may engage in an affair as an ill-equipped way of attempting to have their needs fulfilled – whether these be for intimacy, to feel valued, to experience more sex, and so on. So, the straying partner views an alternative relationship as a better way to meet these needs than their existing relationship.

Who has affairs, and why?

Studies into why people cheat are many and varied. Some find people who lack traits such as agreeableness and conscientiousness are more likely to be sexually promiscuous, as are those higher in neurotic and narcissistic traits. Other studies find infidelity is more likely to occur among people who hold less restrictive views about sex, such as that you don’t have to limit yourself to one sexual partner.

Other important factors relate to people’s commitment to their partner and relationship satisfaction. Those low on these measures appear more likely to have an affair. Recent work suggests one of the biggest predictors of having an affair is having strayed before.

A survey of 5,000 people in the UK found striking parallels between men and women’s reasons for infidelity, and neither prioritised sex. The top five reasons for women related to lack of emotional intimacy (84%), lack of communication between partners (75%), tiredness (32%), a bad history with sex or abuse (26%), and a lack of interest in sex with the current partner (23%).

For men the reasons were a lack of communication between partners (68%), stress (63%), sexual dysfunction with one’s current partner (44%), lack of emotional intimacy (38%) and fatigue or being chronically tired (31%).

Both men and women cheat.

So if we have difficulty genuinely communicating with our partner, or they don’t make us feel valued, we may be more likely to stray. People need to invest time and energy into their relationships. Experiencing chronic tiredness over many years means one’s capacity to put in the necessary work to keep a relationship strong is also compromised.

While some couples report additional reasons, which can include a greater desire for sex, the majority speak to issues that reside either within the couple or outside the relationship. The latter can be stressors that challenge the couple’s ability to make the relationship work.

If you’re experiencing relationship difficulties, getting help from a therapist may well short-circuit the risk factors that can lead to infidelity.

Disclosure and therapy

Some people choose to keep their affair secret because they may want it to continue, feel too much guilt or believe they’re protecting their partner’s feelings. But the secret only perpetuates the betrayal. If one is serious about mending their existing relationship, then disclosure is necessary, along with seeking professional guidance to support the couple through the turbulent period towards recovery.

Most relationship therapists suggest issues around infidelity can be improved through therapy. But they also report infidelity as one of the most difficult  issues to work with when it comes to rebuilding a relationship.

Both partners can experience mental health issues following the revelation of an affair. Jonas Weckschmied/Unsplash

There are various evidence-based approaches to dealing with infidelity, but most acknowledge the act can be experienced as a form of trauma by the betrayed person, who has had their fundamental assumptions about their partner violated. These include trust and the belief that the partner is there to provide love and security rather than inflict hurt.

But it’s not only the betrayed person who can experience mental health issues. Research has found that, when the affair is revealed, both partners can experience mental health issues including anxiety, depression and thoughts of suicide. There can also be an increase in emotional and physical violence within the couple.

So a couple should seek professional help to deal with the aftermaths of an affair, not only to possibly heal their relationship but also for their own psychological well-being.

There are many approaches to counselling couples after an affair, but generally, it’s about addressing the issues that precipitated and perpetuated the infidelity. One of the most well researched methods of helping a couple mend these issues involves addressing the initial impact of the affair, developing a shared understanding of the context of the affair, forgiveness, and moving on.

Choosing to stay or go

Overall, therapy seems to work for about two-thirds of couples who have experienced infidelity. If a couple decides to stay together, they must identify areas of improvement and commit to working on them.

It’s also vital to re-establish trust. The therapist can help the couple acknowledge the areas of the relationship in which trust has already been rebuilt. Then the betrayed partner can be progressively exposed to situations that provide further reassurance they can trust their partner without having to constantly check on them.

But if therapy works for two thirds of couples, it leaves another one third who experience no improvement. What then? If the relationship is characterised by many unresolved conflicts, hostility, and a lack of concern for one another, it may be best to end it. Ultimately, relationships serve the function of meeting our attachment needs of love, comfort and security.

Being in a relationship that doesn’t meet these needs is considered problematic and dysfunctional by anyone’s definition.

In some cases it may be the right decision to end the relationship.

But ending a relationship is never easy due to the attachment we develop with our romantic partner. Even though in some relationships, our attachment needs are less likely to be fulfilled, it doesn’t stop us wanting to believe our partner will (one day) meet our needs.

The impending end of a relationship fills us with what is termed “separation distress”. Not only do we grieve the loss of the relationship (no matter how good or bad), but we grieve over whether we will find another who will fulfil our needs.

The period of separation distress varies from person to person. Some may believe it’s worth celebrating the end of a toxic relationship, but they will still experience distress in one form or another. If the couple decides to end the relationship and are still in therapy, the therapist can help them work through their decision in a way that minimises feelings of hurt.

So infidelity is less about sex and more about matters of the heart and a misguided quest to have one’s relationship needs met. The problem is that some people choose to seek their relationship needs in the arms of another rather than working on their existing relationship.

This article was written by:
Image of Gery Karantzas Gery Karantzas – [Associate professor in Social Psychology / Relationship Science, Deakin University]




This article is part of a syndicated news program via


What is listeria and how does it spread in rockmelons?

 Ten cases have been reported so far,  
including two deaths. Shutterstock/Doug J Moore

Two people have died after eating rockmelon (cantaloupe) contaminated with listeria. A total of ten cases have been confirmed in New South Wales, Queensland and Victoria between January 17 and February 9, and more are expected.

Listeriosis is caused by eating food contaminated with a bacterium called listeria monocytogenes. It’s an uncommon illness but can be deadly if it causes septicaemia (blood poisoning) or meningitis (inflammation of the membranes around the brain).

The ten reported cases are among people aged over 70. The elderly are particularly susceptible to listeriosis, as are pregnant women and their fetuses, and those with weakened immune systems.

Past outbreaks have been linked with raw milk, soft cheeses, salads, unwashed raw vegetables, cold diced chicken, pre-cut fruit and fruit salad.

How does it spread?

Listeria is found widely in soil, water and vegetation, and can be carried by pets and wild animals.

A vegetable or fruit food product can become contaminated anywhere along the chain of food production: planting, harvesting, packing, distribution, preparation and serving.

Even on a farm, sources of contamination can include irrigated waters, wash waters and soil. Listeria can survive for up to 84 days in some soils.

Heavy rains on a crop can splash listeria from soils onto the surface or skin of the vegetable, especially those that grow low to the ground, such as rockmelons.

Listeria contamination can also occur in restaurants and home kitchens, where the bacterium can be found – and spread – in areas where foods are being handled.

Listeria monocytogenes is quite a hardy bacterium. It can survive at refrigerated temperatures and has adapted mechanisms to survive acidic environments such as the stomach.

What are the symptoms?

First, it’s important to note that eating foods that contain listeria bacteria won’t necessarily make you sick.

Listeria monocytogenes can survive in the body, moving between cells (human phagocytes) for long periods of time. This is, in part, why there can be a long period of time between ingestion and onset of illness. This “incubation period” can be as long as 70 days but is usually around three weeks.

Symptoms include fever, muscle aches, and gastrointestinal problems such as nausea, vomiting and diarrhoea.

In severe cases, symptoms can include collapse and shock, particularly if there is septicaemia. If the infection has spread to the central nervous system, more worrying symptoms will occur, such as headache, stiff neck, confusion, seizures and the person may go into a coma. In such cases, the fatality rate is as high as 30%.

In pregnant women, the bacteria are thought to cross the lining of maternal blood vessels and then enters the fetal circulation of the placenta. Infection during pregnancy can lead tomiscarriage, stillbirth and newborn infections.

Treatment for confirmed infections involves antibiotics and supportive measures such as intravenous fluids for dehydration.

When infection does occur in pregnancy, the early use of antibiotics can often prevent infection of the fetus or newborn.

But even with very prompt treatment, infections can be deadly in high-risk groups.

Why are some groups at higher risk?

Pregnant women are a special group known to be at higher risk for listeriosis. The underlying mechanisms for why pregnant women are susceptible to listeriosis are not well understood but it’s thought an altered immune system is involved.

People with weakened immune systems such as those on cancer treatment or medications that suppress the immune system are more susceptible to developing listeriosis because their bodies are less able to fight off the bug.

Newborn babies are also extremely vulnerable as their immune systems have not yet matured, as are the elderly, whose immune systems are declining.

Tracking and finding the source

The life cycle of the bacteria can make it difficult to track the source of the outbreak. Listeria is able to contaminate a variety of foods, which may have a long shelf life, and listeriosis has a long incubation period.

All ten people in the current outbreak consumed rockmelon before they fell sick and state and territory health departments were able to pinpoint the source to a farm in the NSW Riverina district.

But it’s not always that easy. The current South African listeriosis outbreak is the worst outbreak in recorded history with 172 deaths recorded to date. The source has not yet been identified.

How can you prevent listeriosis?

Here are some practical things you can do to prevent the spread of listeria:

  • Thoroughly cook raw food from animal sources, such as beef, lamb, pork, and poultry
  • wash raw vegetables and fruit thoroughly before eating
  • use separate cutting boards for raw meat and foods that are ready to eat
  • wash your hands with soapy water before and after preparing food
  • wash knives and cutting boards after handling uncooked foods
  • wash your hands after handling animals.

If you are at greater risk for listeriosis, consider avoiding:

  • Pre-cut melons such as rockmelon or watermelon
  • pre-packed cold salads including coleslaw and fresh fruit salad
  • pre-cooked cold chicken, cold delicatessen meats, pâté
  • raw and uncooked smoked seafood (such as smoked salmon)
  • unpasteurised milk or milk products, soft cheeses (such as brie, camembert, ricotta or blue-vein)
  • sprouted seeds
  • raw mushrooms.

The NSW Food Authority is also advising consumers who are most at risk of listeriosis to avoid eating rockmelon and discard any rockmelon they already have at home.

This article was written by:
Image of Vincent HoVincent Ho – [Senior Lecturer and clinical academic gastroenterologist, Western Sydney University]
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