Organ Donation

A few years ago, I signed up to be an organ donor. I even said they could take the piano.

Welcome, to those of you who are new to my lame puns and public health interests. Today I am talking organ donation. If you can't be bothered reading ahead, here is my argument:

Australia needs to adopt an Opt-out (Or presumed consent) stance on organ donation, and my reason is thus: you don't need your organs once you are dead. Blunt, but 100% accurate.

In Australia, somewhere around 1500 people are on organ donation waiting lists at any time. This could be your Mother, Father, Sister, Brother, Cat or Dog, or your entire Facebook friends list....several times over in my case. A single person donating their organs, if viable, can change up to 10 peoples lives, and in 2014, 378 viable donors were able to save the lives of 1117 fellow Australians. That still leaves a shortfall of around 400 people and that's just lousy.

The tricky thing with organ donation is that not everyone who is signed up to be an organ donor will have a viable death, that is, the most viable organs are harvested from those who are declared brain dead - but whose other organs are still working. Often, this means that the most viable donors need to already be in hospital in their final stages of life, as the use of ventilators to keep oxygen to the blood and therefore the organs is critical. Many people with long term illness are not treated in hospital, as they may prefer to stay in their homes, and most without long term illness who find themselves in a fatal situation will be no-where near a hospital when the time comes - getting these people to a hospital in their dying moments so they can have their organs donated isn't always feasible or even possible.

It is for this reason that we need to maximise the number of people who are even organ donors in the first place, so that we are maximising the potential number of donors.

There are a number of countries in the world who have adopted opt-out or assumed consent method -which works by saying ' You are an organ donor. Unless you tell us you don't want to be' rather than the current opt-in situation in Australia where it is a case of 'You are not an organ donor. Unless you get around to filling in some forms to tell us that you want to be when you already have a pretty busy life and really it's not something you want to think about right now so maybe I will just leave it for a bit'.

A quick Google tells me that Israel has a funky system whereby if you are signed up to be an organ donor, and you require medical treatment, you will get preferential treatments over someone needing treatment who isn't a donor! Yay organ donors!

Wales brought in assumed consent in 2013!

Austria, Belgium, Croatia, Hungary, Luxembourg and Slovenia all have presumed consent!

Like what seems like a lot of things at the moment, Australia is dragging its arse on this topic, and I suspect this is for political reasons; too many politicians are afraid to bring controversial things to the table for fear of losing political seats.

There is one potential barrier to this, and it is paying people to become organ donors - this leads to a minefield of ethical questions and in my mind, could lead to an increase in crime, and an appearance on the black market of illegally harvested organs.

To finish up today: who are you helping by donating your organs? Up to ten people, as I said before. Babies, children, teenagers, parents.... anyone with failing organs, and this includes sufferers of Cystic Fibrosis. What a thing to be able to do!

To repeat my earlier line, you don't need your organs once you are dead. Statistically, they probably won't even be able to use yours. But if you aren't signed up, it's not going to happen either way, and the ten people whose lives you could have saved will have to wait for someone else to pass away in a way that allows for organ donation.

While we wait for changes to organ donation, and I do think it will happen one day, what you can do is this - CLICK HERE AND SIGN UP - and make sure you tell your loved ones about your decision so if the time comes, your wishes are respected.

Over and out bloggers, and blogesses!

Cash back offers and Skinner's Rats

If you, like me, my blogging friends, use the Internet, watch television, read the papers or listen to radio, you will have noticed in the past 5 years or so a massive increase in the amount of advertising for sports betting.

You know the ones; funny ads, relatable schmucks, hot chicks who just loooove a man who bets.

Current Sportsbet advertisement feat. relatable bloke. 

No longer do you have to walk into your local TAB (or interstate equivalent), but you can now bet anywhere, any time (as the advertisements tell me) by using your mobile! Now, mobiles are perfect for bringing things into our lives that we otherwise would have needed to leave the house for; shopping (personally - yes!), watching a new movie, schoolyard bullying, and now of course, spending your hard earned on an event you are not even witnessing. 

The thing that has really riled me up though is the concept of cash back. I know it exists because it is all but rammed down my throat on a daily basis by listening to radio or turning on the television. There's a couple of reasons this pisses me off. Firstly is the wording, cash back. The way the advertisements paint it, it's almost like you go home with more money in your pocket than you started with. 

Take this ad, the final picture shows a man with money raining down on him, and jumping in joy. Uh, mate, that was your money to begin with. You may as well have just opened your wallet, thrown your cash on the ground, and then picked it up again! Cash back indeed! 

And this is the other reason.

Negative reinforcement.

What is negative reinforcement? Well, let's have a sneaky Google here. 

"Negative reinforcement occurs when the rate of a behaviour increases because an aversive event or stimulus is removed or prevented from happening".

This was made famous in the Skinner's Rat experiments you may have learned about in Psychology classes at High School. 

Growing up this day and age, many people would understand - at the very least - that actions such as smoking or gambling can end up with negative consequences; for gambling, this is losing your money. But now, with offers such as cash back, this previously unpleasant stimulus (losing your money) is taken away, so you can bet to your little hearts content.

Let's put this into a food context. I love me some Cheese and Bacon Balls. I just love them. But I don't buy them and I only eat them if someone already has them or given them to me, because they probably aren't a real food and they are terrible for you. But I do love them (note to people that give them to me: please do not stop). If someone was to say to me "Sarah, we've changed the recipe, they taste the same but these no longer have any negative impacts on your health" then my god I would eat a pack a day minimum. And happy I would be. 

BUT. 

What if they changed the recipe again? What if only some of the packets I was eating every day had this promise of good health?

What if not all betting attracted the same cash back offer as they did the ten weeks before it? 

Well, by this time, I'm probably hooked. I've been doing this action over and over again for weeks or months now and it was all good then - so you know what - I may as well keep doing it, because hell, I was really enjoying it.

I mean, it's so, so clever, but the simple fact is, gambling can damage lives. Some stats: In 2011, Australia spent 1.1 BILLION DOLLARS on online betting. It can lead to suicide, depression, relationship breakdown, lowered work productivity, job loss, bankruptcy and crime. 

I think these are facts that are hard to ignore, and make the fact that betting agencies spend so much money trying to get people hooked on betting absolutely deplorable and reminiscent of the advertising of cigarettes in the 1950's.

So what do we do? Knowing that is a marketing ploy to get you hooked is the start. Seeking help if you need it is another. But I think that there needs to be a change in policy to remove or reduce sports betting advertising from the media, including mid-broadcast by televised sport. Betting will always exist - just look at that historical documentary Game of Thrones; fighting pits and the betting that surrounds them are a part of life. 

Things were going so well until those damn harpies showed up. 

You're never going to be able to remove betting all together. But you can make it less appealing, and you can certainly stop advertising, as has been done, pretty successfully with cigarettes.

What do you think bloggers?

The Ice Problem

Last week, before I published my last post, I spent AN HOUR looking through Google Images for a specific level of Lemmings.

Lemmings was a game I used to play on my first computer around 1995 - the good old MS/1.Lemmings is a strategy game where you guide adorable and hapless Lemmings from an entry point to an exit point - but in your way are obstacles where you need to build bridges and dig holes and sometimes, blow up the odd Lemming or two.

As I was driving home from work the other day, I was reminded of a level which provides a useful metaphor for the current battle against the drug Ice.

What has been frustrating me lately is so much of the effort to tackle the drug Ice is targeted at the end of the issue - rehabilitation etc. While this end is undoubtedly important - where is the money for preventative health?

The level this reminded me of was one where there were a TONNE of obstacles in your way to the exit point, and you sit there thinking, "Oh my, how will I tackle all of this? But in the level, it was a case of actually scrolling backwards, and there was another exit right there - you just had to turn everyone around. This is the same way I feel about the battle against illicit drugs - maybe if we look at some of the simplest options - look at things we can do at the beginning rather than at the end, then we might be looking in the right direction.

As it turned out, I couldn't find a screenshot of this level - some 20+ years after playing it. but the point remains. Prevention is always better than a cure.

What can we do then?

Again though, a lot of this comes down to education. As a society, Australia is battling with excessive eating and limited physical activity, as well as poor attitudes towards drinking and the current hot topic, family violence. We need to really go back to the drawing board and look at how we are bringing up our kids, the values we instil in them, and encourage them to become strong, independent and healthy adults. We need to break the cycle and we need to change attitudes

.

Suggestions welcome bloggers, how are we going to break the cycle?

Why it costs more to be unhealthy

I was listening to the radio the other day (AM talkback radio because I am a super cool, hip and trendy 26 year old) and someone, when talking about obesity, rang through and said "But it's cheaper for me to get drive through McDonalds/KFC because they have lunch deals where I can get a hamburger, chips, a drink and a soft serve for $4.95!. I sighed - knowing that overconsumption of energy rich nutrient poor foods (and almost total lack of exercise) is what is leading to this country, and many other countries, struggle with weight.

The next caller, Curtis Stone I expect, rang up and said "Nah mate, not if you've got a family of five to feed, 5 times $5 is $25 and I could go to the supermarket and make some really delicious and healthier food for that much" And this caller is right. For $25, you could get about 2kg of lean beef mince and all the ingredients for an awesome batch of spaghetti - you might even get leftovers! And ultimately, it will taste a hellava lot better than fast food!

Curtis Stone, long time listener, first time caller.

Over the weekend, The Age published this article on the Obesity epidemic, feel free to go read it and come back to. I'll wait. For those that can't be bothered, here are the key points.

The story beings with a woman who is obese, and her story of 35 kilogram weight loss, and then looks at one of Victoria's health providers, Bendigo Health, and the building of their new hospital, including the Bariatric rooms.

"It will house 27 custom-designed "bariatric" rooms, exclusively to be used by obese patients. Every ward will house one or two such rooms...Four square metres larger than standard, each $266,000 bariatric room in the new hospital will be equipped with a bigger, reinforced bed, a larger toilet, shower, wheelchair and trolley, and will be fitted with an electronically operated ceiling track hoist capable of moving patients weighing up to 300 kilograms.Equipment costs alone are $30,000 - more than three times that of a standard room."

The article goes on to say that the addition of these bariatric rooms has added $1.67 Million to building costs - something I heard previously from the CEO of Bendigo Health, John Mulder, at the Loddon Mallee Health Promotion Conference I attended last year. Mr Mulder explained that for whatever reason (sorry, can't remember), the Bariatric rooms were not on the first floor, and for this reason, the floor underneath these rooms had to be given additional reinforcement because of the weight they needed to support. 

This is insane.

Mr Mulder went on to explain that this is why Bendigo Health are looking to put more money and efforts towards preventative health - because the money spent there is significantly less than money required to build rooms which cost more than 3 times the cost of a regular room, and don't require extra reinforcement which costs so much more. 

This is something our governments, local state and federal need to be looking at as well. It costs a lot less to put efforts into preventative health than sending the money to the end of the spectrum where people are already overweight. The issue with this is simple. 

The average term of a state government, 4 years and federal, 3 years, is simply not enough time to invest money in preventative health and see a return on those investments. Preventative health takes years to see the results, like lower levels of certain cancers, obesity, heart disease etc. This is contrasted with results you can see in a 3/4 year term - more beds in hospitals, more police on the streets, and more roads. It boils down to KPI's. In my retail job, I can't say, look, I didn't make any sales this week, but I talked to a lot of people who are going to come in next week and buy some stuff. You know who will get my shifts next week? The person who had sales this week. Alexander is right, it really is simple. 

Alexander gets it. 

So what do we do about it? We keep talking about how expensive it is to look after people who are obese, you approach it from this angle and it becomes more savory to those concerned with dollars and cents. Invest money now in prevention and save money when it comes time for their treatment. We need to increase education around food choices and the importance of physical activity. And on a personal note... people need to stop believing that a 'cure' or a 'magic pill' or a 'tea' or a 'juice cleanse' is going to shed their weight while they continue to sit on their collective arses and eatting shitty food the rest of the time.

A meat pie pizza. Well done Australia.