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Chapter 1: What is the main topic discussed in this episode?
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So you're a big exerciser. What are you up to today, Priya?
Oh, today's not a good day because I've been here with you. Oh, really? Well, look, I've walked to the tram stop both ways.
Oh, that's pretty good.
Yeah, there's some movement of my body. But look, yesterday I did a Pilates class. The day before that I did my cardio tennis, which you know I love.
Yeah, and I'm terrified you're going to invite me along to it.
I've invited you. You've not said yes yet.
No, I deliberately don't tell you when I'm in Melbourne. It feels like that.
It feels like that.
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Chapter 2: How does exercise influence biological age?
a vaccine against this particular form of Ebola as quickly as possible. So there's reasonable optimism that that will actually happen.
And I guess the only other update in this space is that the federal government has committed to $5 million in support to the global response. And so hopefully that is going to help things on the ground. But still a very worrying time for Congo and its neighbouring countries.
And another study suggesting quite disturbing levels of kids using AI chatbots for their mental health systems.
So this has been published in JAMA Pediatrics and it's used US adolescents and adults. So it's quite a broad age range, 12 to 21.
Yeah, what they did, it's not a huge study. They did a study of about 1,000 adolescents and inquired to look at what their AI usage was in association with mental health issues. Then they grossed it up. If that was true for 1,000 kids... how many children or young people would be consulting at a national level in the United States.
And it turned out to be millions, you know, if the original data were correct and it was extrapolated to the whole population. But nonetheless, there was significant usage even in the small sample.
So almost a fifth of the people surveyed reported using AI for mental health reason for advice. And that was up about 50% from the year prior.
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Chapter 3: What are the proposed changes to abortion access in Australia?
So the use is certainly escalating. Over 40% of the Norman were doing it monthly or more often. And the people who were doing this highest, who were going onto a chatbot and using it for mental health advice, the highest use was amongst those who were 18 to 21, women or females, and those who had spoken with their physician in the past six months about their mental health.
So it's not as if they weren't seeing somebody for assistance.
Yes, they were seeing somebody, but they also turned to the chatbot as well.
And what we know about chatbots is that they try and be nice to you. And although there are guardrails against self-harm, there have been some notorious examples where somebody's learned to get around the guardrails and the AI chatbot hasn't actually encouraged them to self-harm.
I think it's deeply concerning because we've covered and we can link these episodes in the show notes. We have done a little bit on the use of chatbots for mental health, for health advice, how safe they are. And it really can put people in troubling situations. And I think for me, when I read this, I thought...
I have a lot of these patients in my room and without the oversight of a psychologist or a parent, because a lot of these people did not disclose it to anybody, not their doctor, not a friend, not a parent, that's what makes me really nervous.
So just something to be alert for. And then a troubling story about the removal of a drug, not entirely, but partly, for women who have breast cancer. The brand name is Zolidex. The actual drug is called gocerilin. And it blocks oestrogen.
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Chapter 4: What impact do changes in bulk billing have on Aboriginal health services?
And it's also used in endometriosis.
Yes. So this is a drug that I think people would know it because it is used in prostate cancer, breast cancer, and for some patients with endometriosis. It does suppress the sex hormones. So if there is a tumor like a breast cancer that relies on estrogen to actually grow, if you block the estrogen, it can help reduce the recurrence of breast cancer.
Endometriosis, where estrogen and the normal cycle can actually facilitate growth of this endometrial-like tissue outside of the endometrial lining, cause problems, pain for people. Cutting off the estrogen can actually really help people with symptoms. Now, what we're talking about is AstraZeneca is the company. They have this drug, Zoladex, and it comes in two doses.
There's a 3.6 milligram implant and there's a higher dose one, which is 10 milligrams. Is that correct?
Yeah, sorry about 10 milligrams, and it's approved for men with prostate cancer.
This low-dose one, Norman, because what AstraZeneca have said is we are removing it off the PBS, we're removing it from the private market in Australia, so it will not be available, the low-dose one, 3.6 milligrams, to anybody because of commercial reasons. The lower dose pen is the one that women will often use for breast cancer. It's currently on the PBS for people with endometriosis.
There's eligibility criteria, but the lower dose one is the one that is for a wider range of uses. The higher dose one, which is going to remain, is predominantly in prostate cancer.
So what the drug company has said, they'll have a free access service for a few months after, for a while after they remove the drug in November of this year. And they're going to apply for PBS approval for the larger dose version for women with breast cancer and endometriosis. So I spoke to AstraZeneca about this because there's been some reports that this is actually punishment drugs.
to Australia for its pricing policy through the Pharmaceutical Benefits Advisory Committee.
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Chapter 5: What alarming trends are emerging with AI chatbot use among adolescents?
Taking away legal abortion rights will not reduce the number of abortions that happen. It will only reduce the safety of abortions.
Dr. Naisha Cott, obstetrician and president of the Royal Australian New Zealand College of Obstetricians and Gynaecologists.
On ABC Radio National, you're with Health Report. So Priya, this next story just suits you down to the ground, you know, because, you know, you're a fanatic exerciser. Oh, fanatic. Does it make you younger, is the question? No.
Well, that is the question. I wouldn't say fanatic exerciser though. No? I just, I really enjoy moving the body and I know I feel better when I do it. And now I have even more evidence that it's good for me.
Well, you do from this paper, which is about biological age and physical activity. So there's a bit of explaining to do before we come to our guest, who's Andrea Meyer from National University of Singapore, about biological age. Now, anybody who's reading the stuff about longevity at the moment, You'll hear people saying, oh, I've been doing all this stuff.
You know, Brian Johnson's the classic one. And I'm X number of years younger than my chronological age. There's lots of measures they use. But one of the core measures, I don't know how much Brian Johnson uses it, is based on what's called epigenetic clocks.
So this gets a bit technical, but if you are interested in all this information about people making themselves younger than they actually are, Epidemic clocks are really worth understanding. So as we age, chemical reactions occur around the outside of the double helix of our genes and the DNA.
So it's chemical reactions, if you like, on the outside there and on the inside too, but it's not mutations in our DNA. It's chemical reactions around the outside. They're called DNA methylation to be technical. Now, it happens fairly regularly in our genome that these reactions happen.
And what's definitely known is that biological clocks, these epigenetic clocks, if you say my age is 35, in your case 34, but if my age... 39. You don't need to be honest.
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Chapter 6: Why was the drug Zoladex withdrawn from the Australian market?
We wrote to the minister in November last year and had a response that indicated the department would be communicating with us and would... find some ways to make this work for us. Well, that didn't work. That didn't work. I've subsequently written again to the minister on the 28th of last month and I've spoken to the minister's office and there's been no response.
And I think around the remote sector, the communication from the Commonwealth has been pretty quiet lately. I think at the moment their intention is to go ahead with this.
Now, is the sector behind you here, Paul, the National Aboriginal Community Controlled Health Organisation and so on?
Look, they've been negotiations between NACCHO and the department and the minister's office. I'm not aware about where those arrangements are at the moment. I mean, our... Information is at the moment that what's been proposed is going ahead. So I don't think the negotiations have made a difference to that.
Well, thanks for coming on the Health Report, Paul. We will ask the Minister's Office for a response and monitor it accordingly.
Thanks very much for your time. I appreciate it.
And Paul Terzillo is Professor of Respiratory Medicine at Royal Prince Alfred Hospital in Sydney, the University of Sydney, but he's also Medical Director of Inunpa Health Council in Alice Springs.
So what's in the mailbag?
So we did a big deep dive into diphtheria last week.
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