Antibiotic resistance - the continuing threat to human health remains potent

Research from The Economist rates the most common biological threats

The 20th Century was a period of considerable advancement in medical science, not the least due to the development of effective treatment regimes of antibiotics to both treat disease and to provide a range of protective measures as a almost routine part of surgical procedures. In the 21st Century, this appears to be progressively unravelling.

Increasingly multi-drug resistant and extensively drug resistant  strains of  bacteria are materialising outside of the hospital systems where they already pose a direct threat to patient health and safety. In the United States, the Centres for Disease Control (CDC) produced a list of 18 of the drug-resistant microbes which threaten human health three years ago (as displayed above). Yet progress with new forms of drugs to counteract this threat is painfully slow.  Commonly referred to as 'superbugs', these new generation bacteria pose a threat for surgical procedures such as hip replacements and increasingly for patients with suppressed immune systems due to cancer chemotherapies or organ transplants. The risk is also tangible for Caesarean sections in childbirth. 

The impact of drug resistant bacteria is measurably high. Cases of sepsis in the United States almost doubled from 2000 to 2008  due to the emergence of MRSA, a variety of  Staphyloccus aureas. It cannot be killed by methicillin, one of the most potent current versions of penicillin. MRSA is a major  problem in Australian hospitals and can be just as lethal. Neisseria gonorrhoeae is another bacteria which has now developed resistance to penicillin, tetracyclines, fluoroquinolones, cephalosporins. The only treatment option necessitates the use of a combination of ceftriaxone, a cephalospoorin and an azaline to have any effect.

So what are the causes of superbugs ? The primary reasons are twofold: overprescription or inappropriate prescription of drugs for patients who have a condition which either does not require this level of intervention or will not respond to it (poor use of the drugs by not following the required regime is a related problem); and misuse of antibiotics by farmers for animal husbandry which eventually leads to the drugs entering watercourses and into the soil.

The solutions are simple involving predominantly changes in practice and behaviour both in the health sector (clinicians and patients) and in primary industries for the animal husbandry methods used by farmers. Old habits remain hard to break but without resolute action at this point and the time taken to find new therapies, the medium to long future is looking much bleaker.

Australia has made considerable progress with managing the use of antibiotics in animals than elsewhere in the world. A report from Adelaide University in June 2016 found that  Australian pets and livestock had low rates of resistance to critically important drugs compared with higher rates around the world. This particularly refers to drugs used to treat serious or complicated infections. The Adelaide University study was based on isolettes obtained from veterinary diagnostic laboratories from across Australia providing a very solid base of evidence.

The link to the article is below:

The Economist - When the drugs don't work

Should directors of boards own shares in their companies ?

Investors and credit lenders have often raised concerns about the level of commitment and decision-making acumen when members of  company boards do not have any personal investment in the companies they are collectively directing. Often referred to as 'skin-in-the-game', there is now a stronger focus on directors own shareholdings in their companies. The Australian Shareholders Association (ASA) believe that non-executive directors and key management personnel should have sufficient 'skin-in-the game' to ensure greater alignment with shareholders' interests. While noting that more companies in recent years have been introducing minimum shareholding  guidelines, there are many who refuse to place a requirement in writing. The Australian Council of Superannuation Investors (ACSI) has a similar perspective to the ASA and believes that any well governed board requires their directors to hold equity in the company.  Yet ACSI's research has found that 11 per cent of the ASX 200 directors own no shares in the the companies they govern and many of these directors have been on their boards for over 10 years.  

Not surprisingly perhaps, the Australian Institute of Company Directors (AICD) while professing to have no set policy position cites all the reasons not to require directors to own shares - including discouraging potential candidates from accepting board positions; causing more caution and a short term focus for directors who do own shares; or potentially compromising a director's independence if they own more 5 per cent or more. These are weak arguments and not surprising given AICD's protective view which often seeks to minimise the level of guidance and compliance on directors from outside parties. It does not however resolve the question and the ASA and ASCI positions sit in stark contrast to AICD.

The Archibald Prize 2016 - Preview

Barry Humphries by Louise Hearman

The clink of champagne flutes, the swish of food trays and the furtive and not-so-furtive chatter of viewers heralded the first private viewing of the 2016 Archibald Prize before it opens to the general public on 16 July. Now in its 95th year (it was first awarded in 1921) and as popular as ever with hopeful artists (and often their subjects too) there is always that level of anticipation to see whom has been selected for the final cut and who were the subjects of their portraits. From well in excess of 2,000 entries, some 51 finalists were chosen to be hung this year with a smattering of regular entrants and some much newer artists appearing for the first time.

There were the usual swag of self protraits by artists Natasha Walsh, Nick Mourtzakis, Tsering Hannaford and one by Yvette Coppersmith where she envisaged herself as actress, Rose Byrne. Various politicians of current note - Woollahra Mayor, Toni Zeltzer (by artist Sinead Davies), Troy Grant, NSW Deputy Premier and Minister for the Arts (by artist Mark Horton) and Federal Liberal Minister for Energy and Resources, Josh Frydenberg (by artist Camillo De Luca). The well-known established and perennial favourites are there such as Imants Tillers, Guan Wei, Nick Stathopoulos, Nicholas Harding who all have entries although none are really so striking as to be controversial. Some of the portraits are almost naive in their structure and texture such as the portrait of art gallery owner, Roslyn Oxley (by artist, Sally Ross) or Dinosaur Designs co-founder, Louise Olsen (by artist, Belynda Henry).

The selected finalists this year are something of a staid collection - vanilla, pedestrian and acceptable but nothing that would frighten the horses. Perhaps when its all said and done, the Archibald has reached gentrification and like the gallery in which it resides, merely sits in the realm of the comfortable, the obvious and the commercially unsurprising. 

1985 Archibald winner, Guy Warren by Danelle Bergstrom

UPATE: Artist Louise Hearman has won the 2016 Archibald Prize for her portrait of Barry Humphries (top of this posting)

2016 Australian Federal Election - The count goes on

The 2016 Federal election is now over and the citizens of Australia can ponder the reasons for the inconclusive result which eventuated from the ballot count. The current Liberal /National Party Coalition Government under the leadership of the Prime Minister, Malcolm Turnbull, was not immediately returned to office and  will have to wait for a further two days to establish how many seats in the House of Representatives it has won.

The Australian Labor Party (ALP) under the leadership of Opposition Leader, Bill Shorten, likewise did not achieve enough seats to immediately claim victory in the election either however their recovery of seats in previous lost heartland electorates has given them considerable hope that they are close. ALP members and campaign support staff had predicted the Liberal/National Government would be returned to office but with a slender 2 to 3 seat majority only. Given the uncertainty of many seats and the need to count a large number of postal votes that may or may not be the case. A national-wide average swing of 3.68% away from the Coalition and to the ALP was recorded with some seats showing margins of over 7%.

The real winners initially are the independents or minor parties (referred to in Parliamentary terms as the 'cross bench'). In the Upper House, the Australian Senate, the number of cross bench members was 18 members prior to the election. Senate voting reforms passed this year were due to reduce this number but the converse has occured as a result of the double dissolution election. On present trends, there are likely to be more cross bench members not less.

The current ballot count shows the Liberal/National Parties [LNP] have 70 seats, the Australian Labor Party [ALP] with 71 seats, the Greens with 1 seat, 4 seats to other Independents and 4 seats still undecided. In order to take Government, 76 seats are needed. The possibility of a minority Government remains strong.

UPDATE - 6 July 2016
Amusing to see how confusing the tally count has been going: the ABC has the LNP on 70, the ALP on 67, Independents on 5 with the remaining seats undecided. The Australian Electoral Commission  has the LNP on 68, the ALP on 68, Independents with 5 with the remaining seats undecided.