October 2001 - Newsletter
In this issue:
For readers who were unable to attend the Anniversary Seminar, notes from the Speakers' presentations will be published in the next Newsletter.
From the Welfare Staff
September is buzzing away and the Association is up to 99 with preparations for the 25th Anniversary Seminar and Dinner, and I would say a pretty busy time for all! We are really looking forward to facilitating this event and certainly hope that many positives are gained through the sharing of information and experiences that are always a major part of such a get together!
I have recently returned from a very big get together in the Northern Hemisphere and still popping with all the information that I tried to store away! Many of you would be aware that I was the lucky representative of the AHDA (Q) chosen to attend the 14th Biennial Meeting of the International Huntington Association (IHA) that is held in conjunction with the International Meeting of the World Federation of Neurology Research Group on Huntington's Disease (WFN). This year the 5-day conference was held in Denmark, so it was a long trip for us from Australia but well worth it.
Several members/representatives of the Australian HD associations attended, namely Robyn Kapp from NSW, Anne Middleton from South Australia, and Del Weston from Western Australia. Cliff and Jenny Farmer from Queensland also dropped in for the first 3 days (breaking their trip around Europe) and there were 6 other medical professionals from around Australia attending the conference - so plenty of Aussie interest! We all agreed it was a very interesting and educational program.
Highlights of the International Huntington Association Meeting:
This part of the meeting was conducted over 3 days with the WFN meeting happening at the same time right next door so I was able to pop around the corner and hear some of their presentations as well!
World Federation of Neurology sessions:
· Gene and Gene expression
You may be interested to know that a presentation from Australia caused quite a bit of excitement at the WFN Meeting 'Structural Changes of the Caudate Nuceus in Pre-Clinical Huntington's Disease: MRI analysis using voxel-based morphometry'. A technique developed in Sydney at West Mead Hospital would allow researchers who are trialing potential disease-modifying treatments to objectively monitor without bias longitudinal changes in pre-clinical patients who have tested positive to HD.
The World Federation of Neurology also had a poster section illustrating other research activities and a prize was given for the best one. There were 37 entries in the competition.
· New and developing associations and the international reports, and the IHA business meeting and a review of the Diagnostic and Research Guidelines and new Literature, Videos, TV & Radio programmes.
Overall I thought that the meeting was extremely valuable, although many of the presenters were involved in ongoing research that we have mostly read about it was inspiring to hear about their progress. To hear about the initiatives of other associations and benefits they are providing for their members. And how others have found practical applications of what we know so far and just to know that no one is giving up. We all share a common goal and everyone is very positive that treatments for HD will be available at sometime in the not so distant future.
Back home in Queensland it is business as usual with Gwen and myself planning to finish up the year with hopefully, more regional visits to areas including the Gold Coast and hinterland, Toowoomba, the Sunshine Coast and hinterland, Charters Towers, Townsville, and Cairns. We are also hoping to conduct a number of inservices at nursing homes, hostels etc in these areas. In addition we are planning a respite holiday north of Brisbane. And then, the usual round of Christmas celebrations - already!
We hope that those of you who would like to make contact do so and please always let us know if there is something you would particularly like us to attend to.
Take care everyone, until next time.
REPORT ON THE WORLD FEDERATION OF NEUROLOGY RESEARCH GROUP ON HUNTINGTON'S DISEASE
No breakthroughs, but continued promising progress
The first sessions focussed on basic sciences which form the background to understanding the disease. These included molecular biology and genetics, and papers on the disease process at the cellular level. Often this research was done on animals such as rodents, and methods for developing meaningful animal models were described. Processes which might disrupt normal brain function include: toxic build-up of the naturally occurring neurotransmitter glutamate; abnormal metabolism of glucose; and disturbance of the activity of proteasomes (enzymes which control the shape of protein molecules). Further work was reported on how "triplet repeats" such as are found in the Huntington's gene interfere with the proper production of proteins in the cell. The latest on "heat shock proteins" suggested they had less of a role in causing disease than might have been previously thought. A Dutch study indicated that in a sample of 755 persons, overall a greater number of CAG repeats was associated with earlier onset of the illness, although in the individual case it is of course not possible to predict age of onset from a knowledge of the person's repeat number.
New more accurate research methods of imaging brain damage were described (Voxel-based morphometry, VBM) which allow comparisons of brain appearance between groups of persons who have Huntington's and those who do not. Glucose metabolism has been seen to be decreased in certain areas of the brain in correlation with cognitive impairment. Changes in striatal glucose metabolism, and in evoked potentials (electrical feedback circuits passing through the brain), sometimes occur years before motor symptoms develop, according to a German group.
The role of gene testing was discussed. As a predictive test it is still opted for by more at-risk women than men, and there is a high rate of prenatal testing in at-risk pregnancies. Test results have been found to have a significant influence on the decision to have children. Some persons previously identified as carriers by linkage studies have now also opted to have the gene test. The gene test is now beginning to have a role in confirming the diagnosis in cases suspected on clinical grounds (for example persons with a family history and a suspicious movement disorder). This latter application warrants careful thought as to what guidelines there need to be to ensure that proper counselling and support is in place for patients and their families. A study of caregiver burden found this to be related more to functional and cognitive impairment than to psychiatric disturbance, although in this study caregiver exposure to the affected person may have been relatively low.
The bulk of at-risk persons do not opt for gene testing, and a large-scale study of this group, PHAROS, is under way. At this stage one notable finding is no increased incidence of depression.
A Belgian research group found subtle neuropsychological abnormalities in otherwise asymptomatic gene carriers, while a Dutch group found that in the few years following gene testing, overall higher rates of behavioural disturbances were found among gene carriers. Depressive problems appeared to subside among gene carriers but aggressive behaviour did not. These findings suggest that psychological changes may precede chorea in some cases. The Manchester group used cartoon interpretations to demonstrate abnormalities of abstraction in HD.
Some promising new pharmacological agents include riluzole which at least in the short term (8 weeks) improves chorea, and a large multi-centre trial (the EHDI trial) is now well under way. Additionally Dr Kieburtz of Rochester USA addressed the IHA on the 2½ year results of the CARE-HD trial, in which the naturally occurring substance Coenzyme Q10 (CoQ) showed a trend towards slowing functional deterioration (although the numbers in the trial were insufficient to provide statistical certainty). In the same trial the drug Remacemide reduced chorea.
At a much earlier stage of progress are animal experiments using new types of interleukins which appear to have the effect of protecting neurons from degeneration, and "antisense" gene therapy to prevent the abnormal Huntington gene from producing its deleterious effects. Implantation of stem cells shows some promise in taking the place of damaged nerve cells. Addressing the IHA, Roger Barker from Cambridge, UK, reviewed positive animal experiments with transplantation of neural tissue, and reported initial encouraging results with the handful of human subjects so far who have received neural transplants.
Those hoping for a dramatic breakthrough, a rare thing in science, may have been a little disappointed, but clearly there is a worldwide body of dedicated and capable researchers making steady progress in understanding and finding ways to control this most complex and devastating of diseases.
I would like to share with you my understanding of the impact of secrets in families. I have chosen to do this because if there is a pattern of secret keeping in families, discussions of rights, choices and decision making become meaningless.
We all know about secrets. Secrets surrounding gift giving, Father Christmas and surprise parties are fun and exciting and enhance family bonds and relationships. I even used to have a joke about secrets. Question "What is the definition of a secret?" Answer "Something that you tell one person at a time?"
The secrets that I want to talk about today are not fun or exciting or a joke. They are toxic secrets. Toxic to relationships and toxic to emotional well being, and they greatly impact on our rights, choices and decision making capacity. In this context a more appropriate definition of a secret is "relevant information that is kept from the people who need it" or alternatively "information that is either withheld from or unequally shared amongst family members".
Secrecy is distinct from privacy on the basis of the relevance of the information for those who are unaware.
With privacy the information has little or no relevance to the unaware, so the withholding of private information has little or no impact on the unaware.
I will use a personal example to illustrate my point. I grew up with a secret. I only discovered the existence and the content of the secret at the age of 34. The secret was that my paternal grandmother had Huntington's Disease. My grandmother had lived with us when I was little. She walked with difficulty, had uncontrollable movements and did not make any sense to me when she talked. She eventually went into a nursing home and died when I was 5. I had always been told my grandmother had had senile chorea.
When in medical school I read that senile chorea may not exist and may be late onset Huntington's Disease, I was understandably concerned about this information. I quizzed my father about the possibility that senile chorea didn't exist. He was adamant that I was wrong. He also produced a letter from a prominent specialist confirming senile chorea and disputing Huntington's Disease. As a medical student I believed the specialist, as a daughter I trusted my father. He also didn't have any obvious symptoms at the age of 53, so I left the topic alone.
My father had been a market gardener but sold his garden in 1956 at the age of 32. This was the year before I was born. Fortunately my father managed his finances well and with wise investments and the occasional odd job he didn't need to work again.
In my childhood it was great to have a dad around all of the time. In my adolescence I judged my father as being lazy and irritable, in my 20s and early 30s he seemed to be eccentric, irrational, stubborn, untidy, unkept, unreasonable and depressed. I was embarrassed and tried to get him to conform to the behaviour standards that he had taught me. The more I tried to control his behaviour the more exaggerated the behaviour became. Our relationship became distant and strained. I was confused and frustrated about what was happening.
In 1991 when he visited my husband and I when we were living in England I realised that he had obvious signs of Huntington's Disease. Could I talk to him about it? No. Could I keep this information to myself? No. Who did I tell? First my husband and then my mother. We were united by a secret. He was on the outside and we were on the inside. I have since discovered that he had been aware of involuntary movements for years and had been wondering if he had the same disease that his mother had had. He hadn't shared these concerns with anyone. In effect he had been keeping a secret from us.
Even to this day I do not know how much of his cranky behaviour was related to the strain of keeping his fears away from us and from himself, how much was his personality and how much was the disease itself.
I told my mother because she needed an explanation for his behaviour. Neither she nor I knew how to tell my father, mainly because by this stage we were so emotionally distant. We also each were dealing with our own issues. My mother was aware of the ramifications of my father having the same disease as my grandmother. She was confronting the possibility of caring for my father whilst dealing with the anxiety of both of her children have a 50% risk of having Huntington's Disease and her only grandchild having a 25% risk. I was confronting a 50% risk. Neither of us could support the other and none of us could be there for dad. He was in some way to blame.
This demonstrates how secret keeping operates. There are secret alliances formed and the unaware are cut off from those who know the secret. Because there is a secret, it is often difficult to know who knows, so that family members don't know who they can talk to and who they can't. Everyone who knows the secret tip toes around the off limit topic for fear of blowing the secret apart. Eventually conversations become so limited that there is no intimacy at all. The most important issues are never discussed and everyone deals with their own personal fears alone, or outside the most important natural support network of the family.
Often tensions are so great that some family members deal with the strain on their relationships by cutting themselves off from some or all family members.
Such is the nature of toxic secrets. It is not the content of the secret that is toxic. It is that there is a secret.
We tend to keep secret things we are ashamed of, or things that we fear we cannot face. Avoidance of facing our fears makes our fears worse. Additionally if we keep a secret we need to create a network of lies to keep the secret alive. The strain on relationships created by such dynamics is enormous. Usually when the secret is eventually disclosed the feared catastrophic consequences never occur.
My brother and sister in-law, and my husband and I could access exclusion testing. My niece, who was born in 1993, does not have the risk of Huntington's Disease hovering above her. My mother and father could renegotiate their relationship to make the appropriate adjustments to accommodate for Huntington's Disease.
Sadly my mother was diagnosed with leukemia some 9 months after my father's formal diagnosis. She died seven months later. I am grateful that they were able to have this precious 16 months to pull together, rather than be pulled apart, by a secret. My relationship with my father is now very close. I am now proud of the way he is managing his significant disabilities with dignity and I am able to tell him this with openness, honesty and love. It has been rewarding to watch his growing self-esteem when he hears my praise. I am grateful, that I have had the opportunity to meet my dad and see him for who he is. This would not have happened if he had died before the secret was exposed.
Significantly when my father attended the Huntington's Disease clinic in Melbourne for his formal diagnosis the doctor pulled out my grandmother's death certificate from his filing cabinet. The stated cause of death was Huntington's Disease. I can't believe that my father was previously unaware of this information, as he was the primary care giver. I have also discovered that my cousins have been aware of this knowledge all of their lives.
Interestingly we were cut off from this side of the family after my grandmother died. In other words, this death certificate confirms that there was a secret about my grandmother having Huntington's Disease. Whether this secret was being kept by my father, or by the medical profession, is still a secret to me.
This brings up another issue. What are the ethics of the medical profession keeping medical information a secret? I am pleased that I didn't discover that I was at risk of Huntington's Disease until I was 34, but I do not have children. My brother has a son who was born 12 months before my father was diagnosed. I am sure that my brother and sister-in-law would have made different life choices if they had been aware that there was a risk of Huntington's Disease. When will my 10 year old nephew be old enough to make choices regarding knowing his genetic status? I would be interested to hear comments about this issue from those in the audience who discovered at a young age that they were at a risk of Huntington's Disease. Currently my nephew cannot legally access predictive testing until he is 16 because it is believed that prior to this age he is not wise enough to be able to make an informed choice. If treatment strategies become available for prevention of the disease progression will the policy of waiting until the age of 16 be reversed?
When I initially identified that dad had Huntington's disease I had blown apart the family secret. What did I do with the associated knowledge that I had a 50% risk of Huntington's Disease? Ironically my only role model for handling such information was my father, so I kept my risk status a secret from all except my immediate family. I was anxious and depressed during these years but due to the fact that the underlying reason for this was a secret, I had cut myself off from the supports of friends and health professionals.
It was distressing to know that someone knew something about me that I didn't know. I have also discovered that predictive testing is not black and white - to know, or not to know. Genetic testing is far more complex than this.
Once you have the information you can't give it back. In effect you jump off the path of being ignorant of your genetic destiny and onto the path of awareness. Being forewarned about what it may be like on this new path is an important part of the decision making process. It is therefore the responsibility of the keepers of genetic secrets to ensure that people wishing to discover this knowledge about themselves are made as aware as possible of the consequences of making this choice to know. To know or not to know - either choice has many pros and many cons. To choose not to know is also a valid life choice.
In summary, all in this audience are aware that life often presents difficult choices and decisions. We have a right to be supported with respect and dignity when these decisions are being made. We also have an obligation to support and respect our family members when they are making similar decisions.
Such support and respect can only occur if there is openness and honesty in families. This does not happen if there are secrets. We also demand more understanding and respect from the community. How can we get this if we keep our experiences a secret? We demand our rights to access such tests as pre-implantation diagnosis.
All family members also have a right to privacy, so whilst there is ignorance and prejudice in the community it is important for the family as a unit to decide how much to disclose about themselves to others. I applaud Damon and Tracey for their recent efforts to inform the public about Huntington's Disease. Hopefully their courageous endeavours, and workshops, will break down some of the barriers surrounding the secrecy of Huntington Disease.
By Dr Kaye Miller, MBBA (Hons), FRACGP, Dip (RACOG), DA (UK), Masters of Social Science in Counselling.
Reprinted from "Contact" Australian HDA (Inc) WA, Volume 3 Issue 8 December 2000.
Exercise is also a great stress buster, helping release tension and re-energise you. It also combats the energy-draining effects of stress hormones, which are released if you push yourself too hard.
To keep energy levels high each day, start - and stick to - a regular program. It doesn't have to be madly energetic (30 minutes walking is enough), or involve expensive gym membership or equipment.
Eat regularly and well. Eat plenty of fresh fruit and vegetables, some lean meat, chicken or fish, grains and cereals, and drink plenty of water. Eat something healthy every three hours. Eating little and often prevents energy levels falling.
Don't skip breakfast. It's been proven in many studies that those who eat breakfast are more alert, concentrate better and feel more energetic than those who skip it. Choose foods that provide a steady and prolonged boost to block sugar levels, such as porridge with fruit and brown sugar, a low-fat milkshake, or low-fat breakfast cereals, or muesli with milk or yogurt and fruit. Other suitable foods include pulses and heavy, wholegrain breads.
Avoid the dreaded mid-afternoon slump. Try to stick to foods containing moderate levels of carbohydrate and fat for lunch. Good choices include chicken with salad, a lean meat and tomato sandwich on wholemeal bread, or an omelette. Research shows that people who eat these kinds of lunches are more likely to describe themselves as cheerful and less likely to feel drowsy and confused.
If you want to lose weight, reduce your kilojoule intake by more than about 2,000kj a day. Eat regularly and base half your meals on high-carbohydrate foods such as pasta, bread, rice, potatoes, cereals and noodles. Make sure you also eat plenty of fruit and vegetables and unless you're vegetarian, some lean meat, chicken or fish. This way you should be able to lose 500g-1kg a week without any decline in energy levels.
For a quick energy boost, try a piece of fruit (bananas are particularly good, because they're filling) or some vegetables - aim for five portions a day, including meals.
Other snacks that will help maintain your energy levels are: four dried apricots; six dates; a handful of sunflower, sesame and pumpkin seeds; a glass of fresh fruit juice; a small bowl of plain popcorn; a plain wholemeal roll; or a small bowl of cereal.
Avoid high-fat, high-sugar snacks. Although they will give you a fast energy boost, it won't last. An hour or so later you'll feel even more lethargic; plummeting blood sugar levels caused by the after-effects of sugary snacks can also leave you feeling irritable.
Eat more fibre. A sluggish bowel will make you feel tired. Eating plenty of fruit and vegetables, wholemeal bread and whole-grain cereals will increase your fibre intake and keep your intestines working smoothly. Try and drink plenty of water every day, as this is vital in helping to prevent constipation.
Complex carbohydrates, found in pasta, whole grains and vegetables, are broken down slowly by the digestive system and provide your body with a steady flow of energy over a long period.
Drink water. If you are even mildly dehydrated, it can reduce your energy levels and make you feel lethargic. To be on the safe side, experts recommend you drink 1.5 litres of water - or six to eight glasses - a day.
Cut down on caffeine. Don't have more than four cups of coffee a day or you'll find your energy levels drained, not boosted. Tea or coffee before bed may also disturb your sleep.
Avoid too much alcohol. Not only will it stop you from getting a good night's sleep, it also destroys B-complex vitamins and vitamin C, which are vital for stamina. You don't have to turn teetotal but try to keep within the recommended safe limits - up to two standard drinks a day for women, with at least two alcohol-free days every week.
Get out of the office at lunchtime, even if only for 10 minutes, for a bit of sunlight and fresh air to blow the cobwebs away.
Break up your day. It's very easy to get into the habit of working without breaks if you're very busy. But your eyes, body and brain need regular breaks from computers and being stuck at your desk for hours on end. So get up, make a cup of tea, have a stretch and a chat to keep you stimulated.
Laugh! A good laugh - also known as stationary aerobics - is as beneficial as going to the gym, lowering blood pressure, relaxing tense muscle, boosting your immune system as well as releasing endorphins, the feel-good hormones.
Have a siesta. When possible, if you're tired or stressed, take a short, invigorating nap. Twenty minutes should be enough and won't stop you from sleeping at night.
Be positive. If you keep telling yourself you're too tired to do something, it'll become a self-fulfilling prophecy. Instead, tell yourself you're feeling great and looking forward to the tasks ahead.
Don't be too hard on yourself. Realise you can't and don't have to be perfect all the time and reduce self-imposed stress and anxiety.
Watch less television. Lack of effort can also sap energy reserves. You'll feel more energetic when you're totally involved in something you enjoy - reading a novel, gardening, cooking, playing sport.
Get enough sleep. If you think lack of sleep is making you tired all the time, try going to bed 15 minutes earlier for a week. Add another 15 minutes if you need to. But don't be tempted to sleep in on the weekends. It plays havoc with your body clock and can make you more tired.
The one-minute recharge. For 60 seconds, look around the room and let your eyes rest on each object. As soon as your brain registers what the object is, move on rapidly to the next object. This technique is used by many sportspeople to help them refocus and energise.
Tap your head! If you start falling asleep during a meeting or a talk, tap the top of your head vigorously with your fingers. It gets the blood flowing and sharpens the senses, although you may prefer to do it in the loo where no one can see you.
Go to the beach. Most people feel invigorated after a day at the beach, according to recent research. It is thought that this may be because of the higher number of negative ions, which are produced over seawater, in the air.
Look after yourself. Make a habit of doing something for yourself every day. Focus on you, not your family or commitments. Take a luxurious bath, play your favourite music, read - anything to revive your spirits.
Sit up straight. Poor posture causes shallow breathing because it constricts the chest, and reduces energy levels.
Try aromatherapy oils. For an invigorating bath, mix essential oils of peppermint, rosemary and juniper with a carrier oil such as almond or vitamin E oil. The mixture is also wonderful for a footbath to relieve tired feet. (If you are pregnant, do not use any essential oils without first checking they are safe to use during pregnancy.)
Some supplements are thought to help increase energy. Among them are B-complex vitamins, which help convert carbohydrates to glucose for energy; co-enzyme Q10, a powerful anti-oxidant, said to boost physical and mental energy; and chromium, supplements, thought to stabilise energy levels.
Indulge in a shiatsu massage which works according to the ancient principals of meridians and acupressure points. It can boost energy levels, de-stress you and aid relaxation.
Try this modified yoga stretch for an instant lift. Stand up straight, breathe deeply and stretch your arms above your head. Slowly bend from the waist until your back and outstretched arms are parallel to the floor. Hold for a few seconds. Then bend further, aiming to wrap your hands around your ankles and touch your forehead to your knees. You may not be able to reach that far - just go as low as you can - with practice you'll become more supple. Stay in that position for 30 seconds, breathing naturally.
The Easiest Energiser of All.
Acknowledgement: Health and Wellbeing Winter 1999.
Avocado - Don't feel guilty if you love avocado. Research claims that it gives you so much health protection that it should be a vital part of your health diet. Packed full of potassium, antioxidants, dietary fibre, folic acid, and all the B vitamins, avocados are full of taste and goodness.
Mango - This fleshy, exotic fruit does everything from spring cleaning your kidneys to reducing muscle inflammation and warding off body odour. It contains acidic acid and anacradiol, both said to be antidepressants, and is a rich source of vitamin A, C, potassium, calcium, iron and niacin.
Capsicum - Full of vitamin C, capsicum is often known as the protective vegetable. The key ingredient is capsaicin, a proven anti-inflammatory, which also reduces both triglycerides and LDL (bad cholesterol).
Cabbage - The humble cabbage hides a combination of beneficial nutrients beneath its plain exterior. These include sulphurs which inhibit colon cancer, indoles which increase enzyme detoxification, sulphoraphanes to block carcinogens, and sulph9ides which inhibits tumour growth.
Plums - These juicy fruits not only taste great, but contain high quantities of vitamin E, a powerful antioxidant.
Bananas - Often eaten for an energy boost, bananas contain a dietary amino acid which stimulates production of serotonin (the body feel-good chemical) and thus are said to reduce stress. They are also a rich source of thiamine, riboflavin, niacin, potassium, and dietary fibre.
Health is a high priority for most of us. In the search for good health we are faced with some great myths. When we start talking good, fat and fitness, there are many fallacies.
All fat is bad for you: FALSE - Fat is the main fuel of the body. Unsaturated fats contained in foods like nuts, avocados and fish are essential fats needed by the body.
Walking a kilometre burns around the same number of calories as running a kilometre: TRUE - About the same number of kilometres is burned running a set distance as walking that distance. So you don't necessarily need to sweat it out to lose weight - it just takes longer if you decide to walk.
You can eat as much protein and carbohydrates as you like without putting on weight: FALSE - Eating too much fat is not the only thing that will make you put on the kilos. Excessive amounts of alcohol, protein and carbohydrates, can all be broken down and converted into fat. The bottom line is: if you take in more energy than you burn up, you'll put on weight.
Exercise can turn fat into muscle: FALSE - Muscle and fat are two completely different tissues, and one can never "turn into" the other.
Eating at night makes you fat: FALSE - Years ago it was thought that the digestive system closed down during sleep, and food eaten before bedtime would most likely turn to fat. That's not true - it's still okay to have a meal because your body will manage to digest just about all the food, regardless of the time you eat it.
Acknowledgement: "The Memory Stirrer" June/July 2001.
Reprinted from "Contact" August 2001, a monthly Newsletter for people interested in mental health in the Bundaberg district.
Future Fundraising Activities -
Cookie Drive - Order forms are enclosed with this Newsletter. New products are now available including the Macadamia Cookies packaged in a 200g decorative gift box with a gold seal - ideal for gift giving during the festive season. Please forward your orders to the HD Office by the 28th November.
Bayside Spring Festival - 12th - 14th October, 2001. This year the Bayside Spring Festival is being held on the Esplanade at Wynnum (Penfold Parade area). Our Association is the charity to benefit from the event.
Entertainment begins on Friday evening the 12th October with a Lantern Parade, Fireworks, Rides and Stalls. Saturday's and Sunday's activities include a Street Parade, Tots to Teens Quest, Community Queen Quest, Talent Quest, Classic Car Show, Battle of the Bands etc.
We will be staffing an information table within the sponsor's tent and in addition both of the Association's cars will be featured in the Street Parade on Saturday.
Please support this event in any way possible and if you are available to assist as a volunteer please contact the HD Office.
Melbourne Cup Calcutta - 5th November, 2001 to be held at the HD Centre in Annerley.
The Lord Mayor's Award for Excellence
For your Diary
October 4 Townsville Family Support Meeting - 7.30 pm at 59 Cambridge St., Vincent