Midwives Blame California Rules for Hampering Birth Centers Amid Maternity Care Crisis
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Jessie Mazar squeezed the grab handle in her husband’s pickup and groaned as contractions struck her during the 90-minute drive from her home in rural northeastern California to the closest hospital with a maternity unit.
She could have reached Plumas District Hospital, in Quincy, in just seven minutes. But it no longer delivers babies.
Local officials have a plan for a birth center in Quincy, where midwives could deliver babies with backup from on-call doctors and a standby perinatal unit at the hospital, but state health officials have yet to approve it.
That left Mazar to brave the long, winding road — one sometimes blocked by snow, floods, or forest fires — to have her baby. Women across California are facing similar ordeals as hospitals increasingly close money-losing maternity units, especially in rural areas.
Midwife-operated birth centers offer an alternative for women with low-risk pregnancies and can play a crucial role in filling the gap left by hospitals’ retreat from obstetrics, maternal health advocates say.
Declining birth rates, staffing shortages, and financial pressures have led 56 California hospitals — about 1 in 6 — to shutter maternity units over the past dozen years.
But midwives say California’s regulatory regime around birth centers is unnecessarily preventing new centers from opening and leading some existing facilities to close. Obtaining a license can take as long as four years.
“All they’ve essentially done is made it more dangerous to have a baby,” said Sacramento midwife Bethany Sasaki. “People have to drive two hours now because a birth center can’t open, so it’s more dangerous. People are going to be having babies in cars on the side of the road.”
Last month, state Assembly member Mia Bonta introduced legislation to streamline the regulatory process and fix what she calls “a broken system” for licensing birth centers.
“We know that alternative birth centers lead to often better outcomes, lower-risk births, more opportunity for children to be born healthy, and also to lower maternal mortality and morbidity,” she said.
The proposed bill would remove various bureaucratic requirements, though many details have yet to be finalized. Bonta introduced the bill in its current form as a jumping-off point for discussions about how to expedite licensing.
“It’s a starting place,” said Sandra Poole, health policy advocate for the Western Center on Law & Poverty, a co-sponsor of the legislation.
For now, birth centers struggle with a gantlet of rules, only some clearly connected to patient safety. Over the past decade, the number of licensed birth centers in California dropped from 12 to five, according to Bonta.
Plumas County officials are trying to address one key issue: how far a birth center can be from a hospital with a round-the-clock obstetrics unit. State regulations say it can be no more than a 30-minute drive, a distance set when many more hospitals had maternity units.
The first-of-its-kind “Plumas model” aims to take advantage of flexibility provisions in the law to address the obstacle in a way that could potentially be replicated elsewhere in the state.
But the hospital’s application for a birth center and a perinatal unit has been “languishing” with the California Department of Public Health, which is “looking for cover from the legislature,” said Robert Moore, chief medical officer of Partnership HealthPlan of California, a Medi-Cal managed-care plan serving most of Northern California. Asked about the application, a CDPH spokesperson said only that it was under review.
The goal should be for all women to be within an hour’s drive of a hospital with an obstetrics unit, Moore said. Data shows the complication rate goes up after an hour and even higher after two hours, he said, while the benefit is less compelling between 30 and 60 minutes.
Numerous other regulations have made it difficult for birth centers to keep their doors open.
Since August, birth centers in Sacramento and Monterey have had to stop operating because their heating ducts failed to meet licensing requirements. The facilities fall under the same state Department of Health Care Access and Information regulations as primary care clinics, though birth centers see healthy families, not sick ones, and don’t need hospital-grade ventilation, said midwife Caroline Cusenza.
She had spent $50,000 remodeling the Monterey Birth & Wellness Center to include state-required items, such as nursing and hand-washing stations and a housekeeping closet. In the end, a requirement for galvanized steel heating vents, which would have required opening the ceiling at an unaffordable cost, prompted her heart-wrenching decision to close.
“We’re turning women away in tears,” said Sasaki, who owned Midtown Birth Center in Sacramento. She bought the building for $760,000 and spent $250,000 remodeling it in a way she believed met all licensing requirements. But regulators would not license it unless the heating system was redone. Sasaki estimated it would have cost an additional $50,000 to bring it into compliance — too much to keep operating.
She blamed her closure on “regulatory dysfunction.”
Legislation signed by Gov. Gavin Newsom last year could ease onerous building codes such as those governing Sasaki’s and Cusenza’s heating systems, said Poole, the health policy advocate.
The state has taken two to four years to issue birth center licenses, according to a brief by the Osher Center for Integrative Health at the University of California-San Francisco. The state Department of Public Health “works tirelessly to ensure health facilities are able to be properly licensed and follow all applicable requirements within our authority before and during their operation,” spokesperson Mark Smith said.
Bonta, an Oakland Democrat who chairs the Assembly’s health committee, said she would consider increasing the allowable drive time between a birth center and a hospital maternity unit as part of her new legislation.
The state last updated birth center regulations more than a decade ago, before hospitals’ mass exodus from obstetrics. “The hurdle is the time and distance standards without compromising safety,” Poole said. “But where there’s nothing right now, we would say a birth center is certainly a better alternative to not having any maternal care.”
Moore noted that midwife-led births in homes and birth centers are the mainstay of obstetric care in Europe, where the infant mortality rate is considerably lower than in the U.S. More than 98% of American babies are born in hospitals.
Babies delivered by midwives are more likely to be born vaginally, less likely to require intensive care, and more likely to breastfeed, the California Maternal Quality Care Collaborative has found. Midwife-led births also lead to fewer infant emergency room visits, hospitalizations, and neonatal deaths. And they cost far less: Birth centers generally charge one-quarter or less of the average cost of about $36,000 for a vaginal birth in a California hospital.
If they catered only to private-pay clients, Cusenza and Sasaki could have continued operating without licenses. They must be licensed, however, to receive payments from Medi-Cal and some private insurance companies, which they needed to remain in business. Medi-Cal, the state’s Medicaid health insurance program, which covers low-income residents, paid for about 40% of the state’s births in 2022.
Bonta has heard reports from midwives that the key to getting licensed is hunting down the right state health department advocate. “I don’t believe that we should be building resources based on the model of ‘Where’s Waldo?’ in finding a champion inside CDPH,” she said.
Lori Link, director of midwifery at Plumas District Hospital, believes the Plumas model can turn what’s become a maternity desert into an oasis. Jessie Mazar, whose son was born in September without complications at a Truckee hospital, would welcome the opportunity to deliver her planned second child in Quincy.
“That would be convenient,” she said. “We’re not holding our breath.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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Red Cabbage vs Cauliflower – Which is Healthier?
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Our Verdict
When comparing red cabbage to cauliflower, we picked the cabbage.
Why?
In terms of macros, there’s no meaningful difference between them; they’re both mostly water with just enough fiber to hold them together, a small amount of carbs, and an even more trivial amount of protein. So, a tie on macros.
Looking at the vitamins, red cabbage has more of vitamins A, B1, B2, B6, C, E, and K, while cauliflower has more of vitamins B3, B5, B9, and choline. So, a 7:4 win for red cabbage.
In the category of minerals, red cabbage has more calcium, manganese, and iron, while cauliflower has more copper, phosphorus, and potassium. The margins of difference are comparable too, thus, a 3:3 tie on minerals.
It’s always worth taking a look at polyphenols for plants like these, but in this case, once again, there’s not much to set one above the other. However, it’s good to note also that despite them both being Brassica oleracea (same species, different cultivar), there isn’t much overlap in their polyphenol content, meaning they complement each other very well. In particular, red cabbage is a source of luteolin and quercetin, while cauliflower is a source of gallic acid and caffeic acid, for example.
Adding up the three ties and the one win for red cabbage, gives the cabbage the victory today—but do enjoy either or both; diversity is good!
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21 Most Beneficial Polyphenols & What Foods Have Them
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Is it OK if my child eats lots of fruit but no vegetables?
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Does it seem like most vegetables you serve your children end up left on the plate, or worse, strewn across the floor? But mention dessert, and your fruit skewers are polished off in an instant.
Or maybe the carrot and cucumber sticks keep coming home in your child’s lunchbox untouched, yet the orange slices are nowhere to be seen.
If you’re facing these struggles with your child, you’re not alone. Many children prefer fruit to vegetables.
So if your child eats lots of fruit but minimal or no vegetables, is that OK? And how can you get them to eat more veggies?
Children have an innate preference for fruit
The Australian Dietary Guidelines’ recommended daily intakes for vegetables and fruit depend on a child’s age.
Fruit and vegetable serving sizes by age. The Conversation.
National Health and Medical Research Council, CC BY-SAConsumption among Australian children falls well below recommendations. Around 62.6% of children aged over two meet the recommended daily fruit intake, but only 9% meet the recommended vegetable intake.
This is not surprising given children have a natural preference for fruit. At least in part, this is due to its sweetness and texture, whether crispy, crunchy or juicy. The texture of fruit has been linked to a positive sensory experience among children.
Vegetables, on the other hand, are more of an acquired taste, and certain types, such as cruciferous vegetables, can be perceived by children as bitter.
The reason children often prefer fruit over vegetables could also be related to the parents’ preferences. Some research has even suggested we develop food preferences before birth based on what our mother consumes during pregnancy.
Balance is key
So, a preference for fruit is common. But is it OK if your child eats lots of fruit but little to no vegetables? This is a question we, as dietitians, get asked regularly.
You might be thinking, at least my child is eating fruit. They could be eating no veggies and no fruit. This is true. But while it’s great your child loves fruit, vegetables are just as important as part of a balanced eating pattern.
Vegetables provide us with energy, essential vitamins and minerals, as well as water and fibre, which help keep our bowels regular. They also support a strong immune system.
If your child is only eating fruit, they are missing some essential nutrients. But the same is true if they are eating only veggies.
Fruit likewise provides the body with a variety of essential vitamins and minerals, as well as phytochemicals, which can help reduce inflammation.
Evidence shows healthy consumption of fruit and vegetables protects against chronic diseases including high blood pressure, heart disease and stroke.
Consumed together, fruit and vegetables in a variety of colours provide different nutrients we need, some of which we can’t get from other foods. We should encourage kids to eat a “rainbow” of fruit and vegetables each day to support their growth and development.
What if my child eats too much fruit?
If your child is eating slightly more fruit than what’s recommended each day, it’s not usually a problem.
Fruit contains natural sugar which is good for you. But too much of a good thing, even if it’s natural, can create problems. Fruit also contains virtually no fat and very little to no protein, both essential for a growing child.
When overindulging in fruit starts to displace other food groups such as vegetables, dairy products and meat, that’s when things can get tricky.
6 tips to get your kids to love vegetables
1. Get them involved
Take your child with you when you go shopping. Let them choose new vegetables. See if you can find vegetables even you haven’t tried, so you’re both having a new experience. Then ask them to help you with preparing or cooking the vegetables using a recipe you have chosen together. This will expose your child to veggies in a positive way and encourage them to eat more.
2. Sensory learning
Try to expose your child to vegetables rather than hiding them. Kids are more likely to eat veggies when they see, smell and feel them. This is called sensory learning.
3. Have fun with food
Use colourful vegetables of different sizes and textures. Make them fun by creating scenes or faces on your child’s plate. Add edible flowers or mint for decoration. You can even serve this with a side of veggie-based dip such as hummus or guacamole for some bonus healthy fats.
4. Teach them to grow their own
Teach your child how to grow their own vegetables. Evidence shows kids are more inclined to try the food they have helped and watched grow. You don’t need to have a big backyard to do this. A windowsill with a pot plant is a perfect start.
5. Lead by example
Your child learns from you, and your eating habits will influence theirs. Ensure they see you eating and enjoying veggies, whether in meals or as snacks.
6. Practise persistence
If your child refuses a particular vegetable once, don’t give up. It can take many attempts to encourage children to try a new food.
Yasmine Probst, Associate Professor, School of Medical, Indigenous and Health Sciences, University of Wollongong; Olivia Wills, Accredited Practising Dietitian, PhD candidate, University of Wollongong, and Shoroog Allogmanny, Accredited Practising Dietitian, PhD candidate, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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10almonds Subcribers Take The Wheel!
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❓ Q&A With 10almonds Subscribers!
Q: What kind of salt is best for neti pots?
A: Non-iodised salt is usually recommended, but really, any human-safe salt is fine. By this we mean for example:
- Sodium chloride (like most kitchen salts),
- Potassium chloride (as found in “reduced sodium” kitchen salts), or
- Magnesium sulfate (also known as epsom salts).
Q: You talked about spearmint as reducing testosterone levels, what about ginseng for increasing them?
A: Hormones are complicated and often it’s not a simple matter of higher or lower levels! It can also be a matter of…
- how your body converts one thing into another
- how your body responds (or not) to something according to how the relevant hormone’s receptors are doing
- …and whether there’s anything else blocking those receptors.
All this to say: spearmint categorically is an anti-androgen, but the mechanism of action remains uncertain.
Panax ginseng, meanwhile, is one of the most well-established mysteries in herbal medicine.
Paradoxically, it seems to improve both male and female hormonal regulation, despite being more commonly associated with the former.
- It doesn’t necessarily increase or decrease testosterone or estrogen levels (but it can, even if indirectly)
- It does improve sexual function
- …and alleviates symptoms associated with conditions as varied as:
- Late-onset hypogonadism (common for men during the andropause)
- Benign prostate hyperplasia (again common for men during the andropause)
- …and also counteracts unwanted side-effects of finasteride. Finasteride is often taken by men as a hair loss remedy or, less often but critically, in the case of an enlarged prostate.
But it also…
- Alleviates symptoms of PCOS (polycystic ovary syndrome, which effects around 20% of women)
- May even be an effective treatment for PCOS (rat model only so far)
- It also may improve female reproductive fertility more generally (the studies are down to fruit flies now though)
Bottom line: Panax ginseng is popularly taken to improve natural hormone function, a task at which it appears to excel.
Scientists are still working out exactly how it does the many things it appears to do.
Progress has been made, and it clearly is science rather than witchcraft, but there are still far more unanswered questions than resolved ones!
Q: I like that the quizzes (I’ve done two so far) give immediate results , with no “give us your email to get your results”. Thanks!
A: You’re welcome! That’s one of the factors that influences what things we include here! Our mission statement is “to make health and productivity crazy simple”, and the unwritten part of that is making sure to save your time and energy wherever we reasonably can!
Q: Do you know if adrafanil is as good as modafinil? It seems to be a lot cheaper for the same result?
A: Adrafinil is the pro-drug of modafinil. What this means is that if you take it, your own liver will use it to make modafinil inside you. So the end result is chemically the same drug.
As to whether it’s as good, it depends what you need. It’s worth noting that anything that taxes liver function can be harmful if you take too much, and/or your liver is already strained for some reason.
If in doubt, consult a doctor! And if it’s something that’s accessible to you, a recent lipids test (a kind of blood test that checks your liver health) is always a good thing to have.
Q: Would love to see your take on polyphasic sleep!
A: Watch this space
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Hitting the beach? Here are some dangers to watch out for – plus 10 essentials for your first aid kit
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Summer is here and for many that means going to the beach. You grab your swimmers, beach towel and sunscreen then maybe check the weather forecast. Did you think to grab a first aid kit?
The vast majority of trips to the beach will be uneventful. However, if trouble strikes, being prepared can make a huge difference to you, a loved one or a stranger.
So, what exactly should you be prepared for?
FTiare/Shutterstock Knowing the dangers
The first step in being prepared for the beach is to learn about where you are going and associated levels of risk.
In Broome, you are more likely to be bitten by a dog at the beach than stung by an Irukandji jellyfish.
In Byron Bay, you are more likely to come across a brown snake than a shark.
In the summer of 2023–24, Surf Life Saving Australia reported more than 14 million Australian adults visited beaches. Surf lifesavers, lifeguards and lifesaving services performed 49,331 first aid treatments across 117 local government areas around Australia. Surveys of beach goers found perceptions of common beach hazards include rips, tropical stingers, sun exposure, crocodiles, sharks, rocky platforms and waves.
Sun and heat exposure are likely the most common beach hazard. The Cancer Council has reported that almost 1.5 million Australians surveyed during summer had experienced sunburn during the previous week. Without adequate fluid intake, heat stroke can also occur.
Lacerations and abrasions are a further common hazard. While surfboards, rocks, shells and litter might seem more dangerous, the humble beach umbrella has been implicated in thousands of injuries.
Sprains and fractures are also associated with beach activities. A 2022 study linked data from hospital, ambulance and Surf Life Saving cases on the Sunshine Coast over six years and found 79 of 574 (13.8%) cervical spine injuries occurred at the beach. Surfing, smaller wave heights and shallow water diving were the main risks.
Rips and rough waves present a higher risk at areas of unpatrolled beach, including away from surf lifesaving flags. Out of 150 coastal drowning deaths around Australia in 2023–24, nearly half were during summer. Of those deaths:
- 56% occurred at the beach
- 31% were rip-related
- 86% were male, and
- 100% occurred away from patrolled areas.
People who had lived in Australia for less than two years were more worried about the dangers, but also more likely to be caught in a rip.
Safety Beach on Victoria’s Mornington Peninsula. Still bring your first aid essentials though. Julia Kuleshova/Shutterstock Knowing your DR ABCs
So, beach accidents can vary by type, severity and impact. How you respond will depend on your level of first aid knowledge, ability and what’s in your first aid kit.
A first aid training company survey of just over 1,000 Australians indicated 80% of people agree cardiopulmonary resuscitation (CPR) is the most important skill to learn, but nearly half reported feeling intimidated by the prospect.
CPR training covers an established checklist for emergency situations. Using the acronym “DR ABC” means checking for:
- Danger
- Response
- Airway
- Breathing
- Circulation
A complete first aid course will provide a range of skills to build confidence and be accredited by the national regulator, the Australian Skills Quality Authority.
What to bring – 10 first aid essentials
Whether you buy a first aid kit or put together you own, it should include ten essential items in a watertight, sealable container:
- Band-Aids for small cuts and abrasions
- sterile gauze pads
- bandages (one small one for children, one medium crepe to hold on a dressing or support strains or sprains, and one large compression bandage for a limb)
- large fabric for sling
- a tourniquet bandage or belt to restrict blood flow
- non-latex disposable gloves
- scissors and tweezers
- medical tape
- thermal or foil blanket
- CPR shield or breathing mask.
Before you leave for the beach, check the expiry dates of any sunscreen, solutions or potions you choose to add.
If you’re further from help
If you are travelling to a remote or unpatrolled beach, your kit should also contain:
- sterile saline solution to flush wounds or rinse eyes
- hydrogel or sunburn gel
- an instant cool pack
- paracetamol and antihistamine medication
- insect repellent.
Make sure you carry any “as-required” medications, such as a Ventolin puffer for asthma or an EpiPen for severe allergy.
Vinegar is no longer recommended for most jellyfish stings, including Blue Bottles. Hot water is advised instead.
In remote areas, also look out for Emergency Response Beacons. Located in high-risk spots, these allow bystanders to instantly activate the surf emergency response system.
If you have your mobile phone or a smart watch with GPS function, make sure it is charged and switched on and that you know how to use it to make emergency calls.
First aid kits suitable for the beach range in price from $35 to over $120. Buy these from certified first aid organisations such as Surf Lifesaving Australia, Australian Red Cross, St John Ambulance or Royal Life Saving. Kits that come with a waterproof sealable bag are recommended.
Be prepared this summer for your trip to the beach and pack your first aid kit. Take care and have fun in the sun.
Andrew Woods, Lecturer, Nursing, Faculty of Health, Southern Cross University and Willa Maguire, Associate Lecturer in Nursing, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What Most People Don’t Know About Hearing Aids
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Dr. Juliëtte Sterkens, a doctor of audiology, makes things clearer in this TEDx talk:
The sound of the future
Half of all adults experience hearing loss by the age of 75, and by 85, that goes up to two thirds. Untreated hearing loss leads to depression, social isolation, cognitive decline, and even an increased fall risk.
It’s not just about reduced volume though; Dr. Sterkens points out that for many (like this writer!) it’s more a matter of unequal pitch perception and difficulty in speech clarity. Most hearing aids just amplify sound, and don’t fully restore clarity, especially beyond a short range.
However, technology keeps marching forwards there have been improvements in the move from analog to digital, and today’s bluetooth-enabled hearing aids often do a lot better, especially in the case of things like TV transmitters and clip-on microphones.
Out and about, you might see signs sometimes saying “Hearing Loop Enabled”, and those transmit sound directly to telecoil-equipped hearing aids—venues with public address systems are legally required to provide hearing accommodations like this. Many hearing aids include telecoils, but users often aren’t informed or don’t have them activated, which is unfortunate, because telecoils improve hearing dramatically in loop-enabled venues.
Dr. Sterkens makes a plea for us to, as applicable,
- Activate telecoils and insist on them in new hearing aids.
- Advocate for assistive listening systems in public venues.
- Use available resources like the Hearing Loss Association of America for tools and information.
- Familiarize ourselves with accessibility laws and report non-compliance.
- Aim to make the world more accessible for people with hearing loss through advocacy, technology, and awareness.
For more on all of this, enjoy:
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Is it OK to lie to someone with dementia?
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There was disagreement on social media recently after a story was published about an aged care provider creating “fake-away” burgers that mimicked those from a fast-food chain, to a resident living with dementia. The man had such strict food preferences he was refusing to eat anything at meals except a burger from the franchise. This dementia symptom risks malnutrition and social isolation.
But critics of the fake burger approach labelled it trickery and deception of a vulnerable person with cognitive impairment.
Dementia is an illness that progressively robs us of memories. Although it has many forms, it is typical for short-term recall – the memory of something that happened in recent hours or days – to be lost first. As the illness progresses, people may come to increasingly “live in the past”, as distant recall gradually becomes the only memories accessible to the person. So a person in the middle or later stages of the disease may relate to the world as it once was, not how it is today.
This can make ethical care very challenging.
Pikselstock/Shutterstock Is it wrong to lie?
Ethical approaches classically hold that specific actions are moral certainties, regardless of the consequences. In line with this moral absolutism, it is always wrong to lie.
But this ethical approach would require an elderly woman with dementia who continually approaches care staff looking for their long-deceased spouse to be informed their husband has passed – the objective truth.
Distress is the likely outcome, possibly accompanied by behavioural disturbance that could endanger the person or others. The person’s memory has regressed to a point earlier in their life, when their partner was still alive. To inform such a person of the death of their spouse, however gently, is to traumatise them.
And with the memory of what they have just been told likely to quickly fade, and the questioning may resume soon after. If the truth is offered again, the cycle of re-traumatisation continues.
People with dementia may lose short term memories and rely on the past for a sense of the world. Bonsales/Shutterstock A different approach
Most laws are examples of absolutist ethics. One must obey the law at all times. Driving above the speed limit is likely to result in punishment regardless of whether one is in a hurry to pick their child up from kindergarten or not.
Pragmatic ethics rejects the notion certain acts are always morally right or wrong. Instead, acts are evaluated in terms of their “usefulness” and social benefit, humanity, compassion or intent.
The Aged Care Act is a set of laws intended to guide the actions of aged care providers. It says, for example, psychotropic drugs (medications that affect mind and mood) should be the “last resort” in managing the behaviours and psychological symptoms of dementia.
Instead, “best practice” involves preventing behaviour before it occurs. If one can reasonably foresee a caregiver action is likely to result in behavioural disturbance, it flies in the face of best practice.
What to say when you can’t avoid a lie?
What then, becomes the best response when approached by the lady looking for her husband?
Gentle inquiries may help uncover an underlying emotional need, and point caregivers in the right direction to meet that need. Perhaps she is feeling lonely or anxious and has become focused on her husband’s whereabouts? A skilled caregiver might tailor their response, connect with her, perhaps reminisce, and providing a sense of comfort in the process.
This approach aligns with Dementia Australia guidance that carers or loved ones can use four prompts in such scenarios:
- acknowledge concern (“I can tell you’d like him to be here.”)
- suggest an alternative (“He can’t visit right now.”)
- provide reassurance (“I’m here and lots of people care about you.”)
- redirect focus (“Perhaps a walk outside or a cup of tea?”)
These things may or may not work. So, in the face of repeated questions and escalating distress, a mistruth, such as “Don’t worry, he’ll be back soon,” may be the most humane response in the circumstances.
Different realities
It is often said you can never win an argument with a person living with dementia. A lot of time, different realities are being discussed.
So, providing someone who has dementia with a “pretend” burger may well satisfy their preferences, bring joy, mitigate the risk of malnutrition, improve social engagement, and prevent a behavioural disturbance without the use of medication. This seems like the correct approach in ethical terms. On occasion, the end justifies the means.
Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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