Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, June 23, 2024

AusHealthIT Poll Number 752 – Results – 23 June 2024.

Here are the results of the poll.

Should Chiropractors Be Prevented From "Treating" Patients Who Cannot Provide Their Own Verbal Consent?

Yes                                                                               22 (85 %)

No                                                                                  4 (15 %)

I Have No Idea                                                              0 (0%)

Total No. Of Votes: 26

A very clear cut vote but seemingly of little interest considering the vote count! The feeling seems to be to keep chiropractors away from non-adults!

Any insights on the poll are welcome, as a comment, as usual!

A poor voting turnout. 

0 of 26 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

Friday, June 21, 2024

Is This Technology Gone Mad Or An Essential Investment?

 This appeared last week:

We tried the $2000 baby tech dividing parents

There’s one question that many of today’s new parents or parents-to-be are asked over and over again. “Have you got a Snoo?”

For the unenlightened, the Snoo is a controversial $2000 piece of baby tech that automatically soothes your baby to sleep by imitating calming sensations of the womb.

It’s a smart bassinet that can listen for when your baby is fussing or crying and gently rock them, claiming to often calm crying in less than a minute.

The Snoo is like an extra set of arms for new parents – if that set of arms also had in-built Wi-Fi, microphones, white noise speakers and a motor.

The device is the brainchild of American pediatrician Harvey Karp, who wrote the book The Happiest Baby on the Block and pioneered a “5 S” approach to newborn babies: swaddle, side-stomach position, shush, swing and suck.

It’s become wildly popular with many new parents, given its allure of extra sleep for babies and their parents alike. Sleep deprivation can be one of the toughest aspects of parenting.

Snoo’s parent company, Happiest Baby, says Snoo boosts sleep by one to two hours a night from the very first days of life, and that by two to three months of age, most “Snoo babies” sleep more than nine hours a night.

Those are lofty claims and it’s understandable that some parents would be open to shelling out thousands of dollars for a bassinet, even one with plenty of bells and whistles.

A couple of disclaimers: Snoo parent company Happiest Baby sent over a review unit for the purposes of this write-up, so I didn’t pay the RRP. Secondly, I’ve only had one baby so far, who is at this stage a happy little two-month-old boy, so I don’t have a non-Snoo baby to compare.

Our experience, two months in at least, has been pretty remarkable. It’s no silver bullet by any means: our baby can often wake up at random times as all babies do, and sometimes won’t settle in the Snoo at all. But there have been plenty of moments of calm in what can otherwise be a chaotic, stressful and intense time.

One stand-out feature is that the Snoo automatically ramps its rocking speed up or down depending on if the baby is crying or settled, and often it works.

It’s not a cure-all for a crying or fussing baby. But at the same time, it’s hard to put a dollar value on a decent night’s sleep.

It does sometimes feel like a bit of a cheat code, and that’s what can make some parents and some paediatricians feel uncomfortable with it.

And that’s where the controversies come in. Critics say technology such as the Snoo could potentially negatively affect baby bonding, and that it can create bad habits by making the baby too reliant on rocking or white noise.

“I remain somewhat reluctant to have so much gadgetry around a newborn baby,” Australian pediatrician Dr Daniel Golshevsky, better known as Dr Golly, says in a blog post.

The Tweetycam baby monitor was one of our favourites.

“I see countless babies with untreated causes of unsettled behaviour, from colic to eczema, protein intolerance to reflux, and everything in between. I deeply believe that glossing over these treatable conditions does a disservice to babies.

“Prevention is the key, so yes – babies should/can snooze without Snoos.”

Snoo parent company Happiest Baby says, on the other hand, that its device is safe to use, and that it’s easy to wean babies off its sound, swaddle and motion.

It points to research commissioned by the company that has found that Snoo’s rocking, swaddling, and white noise combo works just as well as parents’ soothing to calm fussy babies quickly, and that 90 per cent of nurses surveyed say that Snoo reduces infant fussing.

We haven’t yet reached the weaning phase ourselves, given babies can use Snoo for up to six months and our little one is just two months. On some occasions, we have had to settle him in bassinets that aren’t the Snoo, and we’ve found we are doing all the same things the Snoo does for us – rhythmic rocking, swaying and playing varying levels and types of white noise.

Is it worth the $2000? Like so many baby purchases, you need to keep your expectations in check. It’s not a cure-all for a crying or fussing baby. But at the same time, it’s hard to put a dollar value on a decent night’s sleep. And we’ve been having an increasing number of those in recent weeks.

It’s not for everyone, but the Snoo has been the most useful, high-impact gadget I’ve used in a long time. And I’ve used a lot. Like so many baby purchases, it’s also worth checking out Facebook Marketplace: used Snoos typically retail for around half the price of their brand-new counterparts.

What else did we try?

Australian company Tweetycam’s range of products really impressed and its baby monitor ($239) was our favourite.

The monitor doesn’t use Wi-Fi – meaning no real security concerns– instead relying on a technology called FHHS to send the signal from the camera to the monitor.

The Tweetycam also monitors the room temperature, which is a real plus, and its picture and sound quality are excellent. The monitor itself is easy to use with no smartphone app required, and its battery life lasts about 12 hours. There’s definitely benefit in having a standalone monitor rather than needing to open a smartphone app every time you want to check on your baby.

The Tweetydreams nightlight and sound machine is also strongly worth considering, and at $120 is good value. That product requires a smartphone app, however, which can be a bit fiddly. A basic nightlight that just switches on and off has worked best for us, particularly when trying to bumble your way around in the middle of the night.

Our other favourite baby monitor for those who do prefer a smartphone app is the Lollipop smart baby camera ($319). It’s incredibly versatile, wrapping around the baby’s cot or bassinet, for example, or standing upright on its own. The Lollipop sends you phone notifications whenever it detects a noise, and you can monitor it from any device, be it a smartphone, tablet or desktop. Its picture quality is top-notch and it comes in fun colours such as cotton candy, pistachio and turquoise.
Other things to consider

The Snotty Boss nasal aspirator has been a godsend, and is superior (and decidedly less gross) to the manual method of sucking snot from baby’s nose. I didn’t try a “smart sock” – the baby monitor that tracks pulse and oxygen levels via a sock on the baby’s foot. That felt like a step too far.

And lastly, it might seem obvious to say, but technology is no replacement for human interaction. Parenting is a messy, tricky and intense thing, but no amount of technology will substitute for spending time with your little one. There are just some things that can make it that little bit easier.

https://www.smh.com.au/technology/we-tried-the-2000-baby-tech-dividing-parents-20240528-p5jh5y.html

It seems the life of infants in the 2020’s is a fair bit different from the time I was a nipper!

Amazing…

David.

Thursday, June 20, 2024

I Do Wonder About The ‘One Size Fits All’ Nature Of This Discussion.

This appeared last week:

Anthony Albanese backs under-16 social media ban


By Sarah Ison
Political Reporter

Updated 12:26PM June 14, 2024, First published at 10:30PM June 13, 2024

Anthony Albanese says a total ban on under-16s from accessing social media is a “good way to go” in curbing the serious online harms impacting children, declaring that Peter Dutton was just playing “catch up” by promising to legislate such a ban within the first 100 days of the Coalition taking office.

The Opposition Leader on Thursday doubled down on his pledge to use age verification to stop children accessing social media before the age of 16, saying it was “inconceivable” for tech giants to allow 13 year olds on to their platforms.

CyberCX chief strategy officer and former eSafety commissioner Alastair MacGibbon told The Australian tech giants made significant profit from allowing as large a cohort on to their platforms as possible and that mandates stopping them from “monetising our kids” were needed.

“I applaud politicians for ­actually starting to talk about taking action on something that I think deep down most people in the public have wanted a stance on for a while,” he said.

However, Mr MacGibbon said the technology that would be needed to implement such a ban “still has a long way to go”.

Opposition communications spokesman David Coleman said the Coalition would announce the measures it would use to implement the ban in due course, but pointed to the fact social media platforms were already using age verification technology in some circumstances.

“They do it for Facebook dating in the US, they do it for Instagram if you change your age from say 15 and say you’re 18 – because in that case it’s so obvious the person is probably a child, they have to look into it – but they’ve been doing that for some time. So the idea that the technology doesn’t exist, or it’s not possible, is wrong,” he said.

“We’ll release further details in due course, but plainly, the companies will be required to comply with the new law, and that will include penalties if they don’t.”

Labor invested more than $6m into an age assurance trial earlier this year, but the initiative is largely aimed at investigating technologies that can prevent people under 18 accessing adult content such as pornography.

It is not yet clear whether the trial will look to test the technology on social media access.

In response to Mr Dutton on Thursday handing “an offer of friendship to the government to make sure that we can join up together on this really important issue”, the Prime Minister indicated a ban would have bipartisan support.

“A ban, if it can be effective, is a good way to go,” he said.

But in a veiled swipe at Mr Dutton, Mr Albanese said the Opposition Leader was a latecomer to the issue. “It’s good that he’s caught up, and I welcome him catching up,” he said.

When asked if raising the age to 14, as South Australia is currently investigating, or 16, Mr Albanese said 16 was reasonable.

The increase in momentum for social media bans comes as eSafety research found a small number of “harmful voices”, including that of Andrew Tate – known for his misogynistic views – dominated online conver­sations about masculinity.

Here is the link:

https://www.theaustralian.com.au/nation/politics/anthony-albanese-backs-under16-social-media-ban/news-story/602f0cc94b74c1fe3863e7cd5d22623c

As an oldie this proposal has no effect on me, but I wonder about the choice of 16 as the cut off age. As at that age, the range of the level of maturity is very wide with some pretty mature and some really still pretty immature and young.

My feeling is that above age 12 or 13 there is a role for parents to decide what usage privileges are appropriate.

Of course as the article points out it is pretty hard to find or implement technology to regulate just what happens!

How do readers think this issue should be managed?

David.

Wednesday, June 19, 2024

Apple Seems To Really Be Convinced That “Apple Intelligence” Is Important! Time Will Tell.

This appeared last week:

What Apple Intelligence means for you

Though the “where” and “when” of Apple’s new AI system are still a mystery, we do know lot about the “who”, “what” and “why”.

John Davidson Columnist

There is one important thing to know about Apple’s big move this week into artificial intelligence: it’s not here yet, and strictly speaking it may never be here.

On Monday, US time, Apple announced dozens of new AI features for its phones, tablets, virtual-reality headsets and PCs, including a long-awaited overhaul of its Siri voice assistant, new ways to handle incoming emails and write outgoing ones, and new ways to generate, find and manage photos on Apple devices.

Many of the headline announcements, including the Siri overhaul and the deal Apple struck with OpenAI, which may see OpenAI’s ChatGPT occasionally popping up in response to Siri requests, fall under an AI system Apple calls “Apple Intelligence”.

Technically, Apple has only announced Apple Intelligence for the USA (or, to be even more pedantic, for “US English”), promising to start rolling out some AI features in the American autumn as part of the next major software update to the iPhone, iPad and Mac.

Apple has yet to reveal when, or even if, Apple Intelligence will come to Australia. The only public (or indeed private) statement is that “additional languages will come over the course of the next year” after the US English launch. So it could be 2025 before it rolls out here.

While it’s possible Australian users will be able to get earlier access to the features simply by going into the settings menus of their device and switching its language to US English, the geographic limit appears to be about more than just language (see private cloud compute below).

Early indications are Apple may enforce the limit through other means, too, such as checking the home address of the Apple iCloud account users will need to access the services. All is not lost, however. 


Apple Intelligence versus machine learning

Apple Intelligence refers primarily to the set of services that will require up-to-date hardware to run: the stuff that will need a Mac or iPad running an Apple Silicon chipset, or an iPhone greater than, or equal to, the iPhone 15 Pro.

Many of the interesting new AI features don’t fall under that umbrella. The enhancements to Apple’s browser Safari, for instance, which will allow web users to summarise and even index the content of websites, come under a different category that Apple generally refers to as “machine learning” rather than “Apple Intelligence”.

(In numerous background briefings I’ve had in the Apple Park headquarters in Cupertino this week, that’s the pattern that has emerged. If Apple is calling it “machine learning”, you won’t need a new iPhone for it, and it won’t be initially limited to the USA. Technically, Apple Intelligence could accurately be described as machine learning, too, but as you’ll see in a moment, it’s a much bigger and more ambitious framework than adding a bit of ML to a single app.)

The new calculator for the iPad falls under “machine learning” and should be available when iPadOS 18 is launched in September or October

Another example of this machine learning/Apple Intelligence divide is the Photos app that appears on iPhones, iPads, Macs and, from July 12, on Apple’s Vision Pro.

It’s receiving a significant update, with new features such as the ability to organise photos according to the grouping of people and pets in them. All the photos with only you and your dog will be separated out into one group, while photos with you, your dog and your mother will have another group.

That’s a machine learning feature that every Apple user will get.

But click on one of those photos to edit it, and only customers who qualify for Apple Intelligence will see a button for a new “Clean Up” tool that scans an image, finds people who don’t belong in the photo, and deletes them.

In addition to the machine learning and Apple Intelligence features, Apple has also announced scores of other new features in devices that have nothing to do with AI or ML.

iPhone users will be able to type in messages and schedule their delivery up to two weeks in advance, so they can send birthday wishes when they remember to do so, rather than risk forgetting to do so on the day itself.

(A handy tip coming from Apple insiders who have been testing that feature for months is to schedule the message for a random time – 8.07am rather than 8.00am, for example – so the recipient doesn’t realise they’re not top of mind.)

It’s fair to say, however, that the most exciting features fall under Apple Intelligence, and that the wait for them to arrive could feel like a long one.

How it will work

At the core of Apple Intelligence is a database called the semantic index.

Whenever an iPhone, iPad or Mac gets a new message or takes a new photo, or whenever the user creates a new document, the same mechanism that indexes the file so it can be found by Apple’s existing Spotlight search system will also send it off for processing by an AI indexer, which will extract the meaning of that document and store the meaning in the semantic index.

Where Spotlight might index, say, a new iPhone photo by the date and time it was taken, the semantic indexer might identify the people in the photo, match them up to people in the phone’s contacts database, and index them by the relationship they have to the iPhone’s owner.

Semantic indexes are protected by the same hardware-based “secure enclave” system that Apple uses to secure ultra-sensitive information such as passwords, and Apple insists they will never leave the device they’re created on.

Even when an Apple customer has multiple devices sharing data, the semantic index will never be shared between them. It will be created and maintained separately on each device.

Another database sitting on an Apple Intelligence device will contain a list of what Apple calls “app intents”.

It’s like an app store, except instead of holding lists of apps, it holds a list of the functions that the installed apps on the device can perform in an automated way.

If, say, the iPad version of Adobe’s Photoshop was able to take an image saved in the PNG format, and automatically export it as a JPEG file, Adobe would be able to inform the iPad of that function by calling up the app intent system when Photoshop was first installed on the iPad.

In addition to all of that, every Apple Intelligence device will contain dozens of different AI language models for analysing and generating text, as well as “diffusion” models for analysing and generating images.

Compared to the large language and diffusion models used in the cloud by chatbots such as OpenAI’s ChatGPT and Google’s Gemini, Apple’s models will be smaller and more numerous, each of them fine-tuned to perform a specialised task using as little processing power as possible.

(Samsung’s latest Galaxy phones and Google’s latest Pixel phones employ the same architecture: they contain numerous small models, which swap in and out of the phone’s AI processor depending on the task.)

Now, sitting above all of this will be a software layer known as an “orchestrator”, and it’s here that the fun begins.

The orchestrator takes incoming requests from the user, decides what data from the semantic index is needed to fulfil those requests, which model is best suited for the task, looks into the list of intents to see what apps might be able to perform functions useful to that task, and sets the wheels in motion getting the job done.

Using Apple Intelligence, it might be possible, for instance, for a user to ask Siri to find a picture of an uncle (identified using the semantic index), put a party hat on his head (using a diffusion model), convert that picture to a jpeg file (using the Photoshop function listed in the app intent database), and email it him (address from the semantic index, email function found in the app intent database) on his birthday (from the calendar, via the semantic index).

Private Cloud Compute

Some jobs, however, will require language or diffusion models that are simply too large, or require too much processing power, to be stored on the iPhone, iPad or Mac.

To run such models, Apple is filling data warehouses around the world with custom AI servers it’s building using the Apple Silicon chips that go into Macs and iPads, and running a highly secure version of the iPhone’s operating system, iOS.

That rollout is starting in the US, and it’s part of the reason Apple Intelligence will be only in US English when it first appears.

These “Private Cloud Compute” data warehouses are integral to Apple Intelligence, since they’re the only way Apple can send data from the user’s very private semantic index to the cloud, without breaking Apple’s promise that Apple Intelligence is private and secure.

When the orchestrator on a device running Apple Intelligence decides a job is too big for the models stored on the device itself, it may decide to bundle up the job, together with context data from the semantic index, and upload it to Private Cloud Compute.

There, the model will process the request, return the results, and then delete any record of the request.

(Unusually for a cloud server, PCC computers have no storage devices whatsoever, so not only can they not save semantic index data, they can’t even save the error logs and other logs that administrators usually rely on to manage server farms. It’s an ambitious strategy designed to assuage concerns about AI privacy.)

OpenAI

There is a final scenario, however, that has led to some controversy with the likes of Elon Musk.

If the orchestrator decides that the job is too big even for Private Cloud Compute, it will put some warning messages on the screen telling the user they’re about to leave Apple airspace 

and fly off into the unknown.

If the user agrees to throw caution to the wind, the orchestrator will bundle up the job and send it to a third-party system for processing.

On Monday, the only third-party Apple had inked a deal with was OpenAI, though officials said they expected to get Google on board, too, allowing jobs to be sent to Gemini.

It’s likely, however, that OpenAI and Google are both stopgap measures, until Apple’s own Personal Cloud Compute systems have models that can handle generic generative AI tasks themselves.

The real point of giving the orchestrator the last-resort option of going to a third party is to handle highly specialised AI tasks, such as medical models that take images of skin shot on an iPhone, and look for signs of skin cancer.

The very moment Apple gets its own Personal Cloud Compute system to a level good enough to handle more generic generative AI queries, it’s nearly certain it will decide it’s cheaper, more private and better PR for the orchestrator to take that option instead of using OpenAI or Google.

The only thing uncertain is how long it will take Apple to get its models to that level. But before we even get to worry about that uncertainty, we have another one to deal with.

Just when is any of it coming here?

John Davidson attended Apple’s Worldwide Developer Conference as a guest of Apple.


Here is the link:

https://www.afr.com/technology/what-apple-intelligence-means-for-you-20240613-p5jlie

I have to say I have read this through a couple of times and I am not sure just where it is all heading.  I suspect it will be a while before that is clear as well as when it is going to reach good old OZ

I suspect this is more of the revolution I have been chatting about in the last few months.

These newer technologies are seeming to have a life all of their own as they advance and I have to say I am still not sure what the actual destination is!

As with all things time will tell I guess….

David.

Tuesday, June 18, 2024

I Have To Say This Is Really A Worrying Story That Gets Worse The More You Think About It!

\This appeared last week:

Circumcision doctor accused of ‘amputation’ fails to have ban lifted amid appeal

A prolific circumcision doctor has lost his battle to perform operations while he appeals a medical board decision, as new details emerge about one of his newborn patients suffering an “amputation or partial amputation” of his penis and another needing a blood transfusion.

Dr Hershel Goldman, who estimates he has performed 20,000 circumcisions, has sought to overturn an April ban imposed by the Medical Board of Australia that prevents the Melbourne doctor from performing circumcisions. His appeal remains ongoing, and Goldman applied to have the ban lifted until the appeal concluded.

But the Victorian Civil and Administrative Tribunal rejected the 63-year-old’s request to delay the ban ahead of a full appeal hearing and decision this year.

In a May 30 decision published by the tribunal this week, it was alleged that Goldman performed a circumcision on a seven-day-old baby “where amputation or partial amputation of the penis occurred”.

The baby’s family claims that Goldman “pressed on with the ritual prayers for several minutes and delayed providing care to the infant” after their baby bled more than usual after the operation.

“Further, once confirming the amputation, concerns have been raised that Dr Goldman had no procedures in place to manage the complication, with management of the emergency being undertaken by guests at the party who were also medical practitioners,” the family told the Medical Board of Australia’s immediate action committee.

Goldman’s clinical records do not detail when he phoned an ambulance.

In another case considered by the board, another of Goldman’s seven-day old patients required sutures and a blood transfusion after a circumcision in a family home.

It is alleged that after the procedure, Goldman applied a bandage to the baby boy and instructed the parents to keep his nappy on for four hours.

Goldman then advised the family he was travelling interstate and provided no on-call coverage after he left their home, they told the committee.

When the parents removed their son’s nappy four hours later, they said they discovered “significant bleeding”. They said they contacted Goldman and he advised them to travel to a hospital 40 minutes away for a review. The baby required stitches and a blood transfusion at the hospital.

The family in the second case also raised concerns about Goldman’s hygiene practices and claimed he washed his hands in the kitchen sink and used a tea towel to dry them before performing the procedure.

Goldman told the committee that bleeding requiring sutures was not a sign of any error, but that sutures were required in a small number of circumcision cases.

He denied telling the infant’s parents that they should not remove his nappy for four hours after the circumcision.

Goldman said he told the parents to check the infant during routine nappy changes within four hours of the procedure.

He also denied he had poor hygiene and submitted that he used surgical antiseptic after washing his hands with soap and water and dried them on a clean tea towel supplied by the baby’s parents.

In the first case, Goldman maintains that a partial amputation – not full – occurred but acknowledged the seriousness of this complication. He also denied the parents’ claims he performed the circumcision in poor lighting.

The doctor submitted to the tribunal that he should be allowed to continue performing circumcisions in clinical settings only, and not in people’s homes, while the appeal process was ongoing.

Goldman told VCAT he had performed circumcisions for 40 years, and that what he referred to as the partial amputation was his first major complication in that time.

He argued he would suffer a “devastating financial impact” if he was banned from performing circumcisions. It would also have a detrimental impact on the Jewish and non-Jewish community, as half his clients were Muslim, he said.

But VCAT deputy president Ian Proctor said the evidence did not give him confidence that the serious risk posed by Goldman could be satisfactorily reduced by banning only in-home religious procedures.

“The paramount principle of the protection of the public and public confidence in the safety of services provided by registered health practitioners outweighs Dr Goldman’s personal interest in continuing his circumcision practice and community interest in him being able to do so,” Proctor said.

The substantive appeal will be heard at a later date.

Here is the link:

https://www.smh.com.au/national/victoria/circumcision-doctor-accused-of-amputation-fails-to-have-ban-lifted-amid-appeal-20240612-p5jlad.html

Surely this is a procedure that should only happen in ideal conditions (light, anti-sepsis etc.) in the hands of someone who is fully trained in the procedure and how to manage any complications.

The idea of this procedure happening at a party suggests to me all those involved had / have essentially “taken leave of their senses!” You can die of hemorrhage from this for heaven’s sake!!!!

Worse still , it seems this bloke is only in it for the money!

Heaven spare us from such nonsense, and practitioners of this ilk. What a terrible story!

David.

Sunday, June 16, 2024

I Wonder Why We Can’t Get Our Heads Around The Fact That Chiropractic Treatment Is Non-Evidence Based Mumbo Jumbo!

The first rule in the caring professions is “first do no harm” and for this reason alone for-profit back meddlers should stay away from all those who can’t provide informed consent for their treatment on their own behalf!

A few days ago this appeared:

Chiropractors give themselves green light to crack babies’ backs after four-year ban

Chiropractors have given themselves the green light to resume manipulating the spines of babies following a four-year interim ban supported by the country’s health ministers.

In a move that has been slammed by doctors as irresponsible, the Chiropractic Board of Australia has quietly released new guidelines permitting the controversial treatment for children under two.

The Royal Australian College of General Practitioners (RACGP) hit out at the decision, saying there was no evidence supporting the spinal manipulation of babies and children and that the practice should be outlawed.
“There is no way in the world I would let anyone manipulate a child’s spine,” said Dr James Best, the College’s Specific Interests Child and Young Person’s Health chair.

“The fact that it hasn’t been ruled out by this organisation is very disappointing and concerning. It’s irresponsible.”

Spinal manipulation involves moving the joints of the spine beyond a child’s normal range of motion using a high-velocity, low-amplitude thrust.

In March 2019, the Chiropractic Board of Australia announced an interim ban on the spinal manipulation of children under two, following public outcry over a video of a Melbourne chiropractor holding a two-week-old baby upside down.

The chiropractor then used a spring-loaded device on the newborn’s spine and tapped him on the head. Then-Victorian health minister Jenny Mikakos described the footage as “deeply disturbing”.A Safer Care Victoria report at the time, which involved a systematic review by Cochrane Australia, found no strong evidence that spinal manipulation helped childhood conditions such as colic, back/neck pain, headache, asthma, ear infections or torticollis (twisted neck), despite it commonly being spruiked as a solution to these issues.

“The major finding of this review is that the evidence base for spinal manipulation in children is very poor,” it said.

A follow-up review last year by Cochrane Australia, commissioned by the national healthcare watchdog AHPRA (the Australian Health Practitioner Regulation Agency), reached the same conclusion.

The initial review, provided to all Australian health ministers, recommended that spinal manipulation should not be done on children under 12. It also recommended urgent research to develop an evidence base for spinal manipulation on children and advanced training for those providing paediatric care.

However, in November the Chiropractic Board of Australia put out a statement to “clarify” to members its expectations regarding paediatric care. It said a range of care could be provided to children, including manual therapy, soft tissue therapy and manipulation, if practitioners understand how children’s needs differ from adults and modify their care appropriately.

Neurosurgical Society of Australasia Board executive Dr Patrick Lo, who is also the Victorian chair of the Royal Australian College of Surgeons, said children were particularly vulnerable to injuries from spinal manipulation.

Melbourne chiropractic Dr Ian Rossborough has been criticised for performing a controversial technique on a four-day-old baby.

“Adults have a balanced neck, head and shoulders – everything is supported – whereas kids have a very big head-to-neck ratio,” the neurosurgeon said.

“If you flick it around, the lollipop ball will fall off. That’s our major concern. Those areas are so critical to the function and development of the child and we are putting those at risk.”

Lo said he had treated young adults who had suffered disc prolapses following spinal manipulations performed by chiropractors. He said some of his colleagues had treated patients who had experienced strokes following spinal manipulation.

Lo will raise his concerns about the new guidelines for chiropractors at an upcoming meeting with Safer Care Victoria.

Doctors have been at war with chiropractors over the treatment of babies and children for more than a decade.

In 2013, The Age reported on the disputed case of a Melbourne paediatrician who claims he treated a four-month-old baby after one of her vertebrae was fractured during a chiropractic treatment for torticollis, which causes the neck to twist to one side.

And in 2016, the RACGP urged its members to never refer patients to chiropractors after a YouTube video emerged showing a Melbourne chiropractor flexing a newborn baby’s back before pressing firmly on her spine to produce a cracking sound. The movement, which was meant to treat colic and reflux, caused the baby to cry.

A spokesman for the Chiropractic Board of Australia said its updated policy would ensure safe and appropriate care by chiropractors who treat children under 12. He said this guidance was based on current evidence and information.

When asked why Safer Care Victoria’s key recommendation – that spinal manipulation not be performed on children under 12 – had not been incorporated into the new policy, he said the board had considered the review’s common themes. He said these included “best practice and evidence-based care, proper informed consent, practice within the chiropractor’s skill”.

AHPRA has received 335 notifications about chiropractors since 2021, with five of these relating to child patients. A total of 96 notifications resulted in regulatory action, such as cautioning a practitioner, imposing conditions on their registration or accepting an undertaking from a practitioner.

A Safer Care Victoria review identified very little evidence of patient harm occurring in Australia, but noted “it was clear that spinal manipulation in children is not wholly without risk”.

“We respect every parent’s right to choose appropriate healthcare options for their child – when weighing up treatment options, you need to consider any risk associated with that care against any potential benefits,” a Safer Care Victoria spokeswoman said.

The Australian Chiropractors Association said the review found that chiropractic care for children was extremely safe. It said that in more than 29,000 online submissions, there were no reports of harm to a child receiving chiropractic care.

“Chiropractors are registered professionals, completing a rigorous five-year university degree-level course, equipping them with the expertise to appropriately tailor their care to children of all ages,” a spokesman said.

The association welcomed the board’s updated statement on paediatric care.

Here is the link:

https://www.smh.com.au/healthcare/chiropractors-give-themselves-green-light-to-crack-babies-backs-after-four-year-ban-20240605-p5jjih.html

My view is that consenting adults can do what they like with their bodies but they should not impose non evidence based interventions on their progeny! It follows therefore that chiropractors should stay away for all under 18 IMVHO!

This view is confirmed when we read this saga:

Call for age limit after chiropractor breaks baby's neck

By Julia Medew and Amy Corderoy

A baby's neck has been broken by a chiropractor in an incident doctors say shows the profession should stop treating children.

The injury was reported to the Chiropractic Board of Australia, which closed the case without reporting it to the public and allowed the chiropractor to keep practising as long as they undertook education with an ''expert in the field of paediatric chiropractic".

The Sun-Herald has also seen evidence that chiropractors have been entering Sydney hospitals, including neo-natal intensive care wards and surgical wards, to treat patients without the required permission.

NSW Health has warned that any chiropractor working in a hospital without permission could put patients at risk, while the Australian Medical Association NSW says the behaviour is "outrageous".

Melbourne paediatrician Chris Pappas cared for a four-month-old baby last year after one of her vertebrae was fractured during a chiropractic treatment for torticollis - an abnormal neck position that is usually harmless. He said the infant was lucky to make a full recovery.

''Another few millimetres and there would have been a devastating spinal cord injury and the baby would have either died or had severe neurological impairment with quadriplegia,'' he said.

Dr Pappas complained to the Australian Health Practitioner Regulation Agency, which referred the case to the Chiropractic Board. Three weeks ago, he received a letter from AHPRA saying the case had been closed after the chiropractor committed to completing further education.

Dr Pappas said he was concerned the decision was an endorsement of chiropractic treatment for infants when there was no scientific evidence to support it.

''I think they have put the chiropractor's interests before the interests of the public,'' Dr Pappas said. ''[Treating infants] is inappropriate and it carries a very small but real risk of causing damage, and in some cases, devastating damage.''

A review published in the Pediatrics journal in 2007 also found serious adverse events relating to spinal manipulations in children, including a brain haemorrhage and paraplegia.

However, the president of the Chiropractors' Association of Australia, Laurie Tassell, says chiropractic treatment is as safe for children as it is for adults, and chiropractors should be able to treat patients in hospital, if authorised.

"Chiropractic care can be remarkably gentle," he said. "Being a five-year, university-trained spinal health expert, a chiropractor will modify their adjustment techniques to suit the age and spine of each individual child."

President of the Australian Medical Association Steve Hambleton said the board needed to either produce evidence supporting chiropractic treatments for children or rule out paediatric care. ''The AMA is not aware of any evidence that chiropractic manipulative treatment of infants and children offers any benefit at all,'' he said.

The Sun-Herald has seen Facebook conversations in which chiropractors discuss methods of sneaking into hospitals. Images, obtained by blogger Reasonable Hank, include one of a baby being adjusted in a hospital.

AMA NSW head Brian Owler said it was "absolutely outrageous" for chiropractors to treat patients in hospital without permission. "None of us can go into an emergency department of a hospital and start treating patients without proper credentials and medico-legal coverage," he said.

A spokeswoman for NSW Health said treating patients without notifying the hospital may be improper conduct and it could be reported to the Health Care Complaints Commission.

Here is the link:

https://www.smh.com.au/healthcare/call-for-age-limit-after-chiropractor-breaks-babys-neck-20130928-2ul6e.html

FWIW my view is that chiropractic is non-scientific rubbish that should only be practiced between consenting adults!

We could ignore the whole topic but for the potential for real harm on defenseless individuals.

Enough said – and seek chiropractic treatment at your own risk!

It is really absurd that this is all not illegal...and revoking bans is plain stupid! See here!

https://www.theaustralian.com.au/nation/ruling-revokes-ban-safeguarding-babies-from-chiropractic-procedure-of-spinal-manipulation/news-story/b2be807526cb90f5a9be0377206b29ae

David.

LATE NEWS

p.s. 5:30 pm 

https://www.smh.com.au/healthcare/it-s-about-safety-chiropractors-once-again-banned-from-manipulating-babies-spines-20240617-p5jmha.html

‘It’s about safety’: Chiropractors once again banned from manipulating babies’ spines

Chiropractors have once again been banned from manipulating babies’ spines after a health board reversed its controversial decision to allow the practice.

The about-face by the Chiropractic Board of Australia follows revelations in this masthead that practitioners had quietly given themselves approval to resume spinal manipulation of children younger than two from November after a four-year ban.

D.