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New study finds epilepsy drug could reduce sleep apnoea symptoms

New research has found that a drug used for epilepsy could be used to reduce the symptoms of sleep apnoea. Obstructive sleep apnoea, which affects about one in 20 people, according to the National Institute for Health and Care Excellence in England, includes symptoms like snoring and it causes a person's breathing to start and stop during the night, with many requiring an aid to help keep their airways open. An international study has identified that taking sulthiame, a drug sold under the brand name Ospolot in Europe, may help prevent patients' breathing from temporarily stopping. This provides an additional option for those unable to use mechanical breathing aids like the Cpap machines. “The standard treatment for obstructive sleep apnoea is sleeping with a machine that blows air through a face mask to keep the airways open. Unfortunately, many people find these machines hard to use over the long term, so there is a need to find alternative treatments,” Prof Jan Hedner from Sahlgrenska university hospital and the University of Gothenburg in Sweden said. Researchers conducted a randomised controlled trial of almost 300 obstructive sleep apnoea patients across Europe, who did not use Cpap machines. They were divided into four groups and given either a placebo or different strengths of sulthiame. The study measured patients’ breathing, oxygen levels, heart rhythm, eye movements, as well as brain and muscle activity while asleep. It found after 12 weeks, those taking sulthiame had up to 50% fewer occasions where their breathing stopped, and higher levels of oxygen in their blood. However, a bigger study needs to be done to confirm the beneficial effects on a larger group. The findings, were presented at the European Respiratory Society Congress in Vienna, Austria. Erika Radford, the head of health advice at Asthma + Lung UK said the findings were a positive step forward in moving away from having to rely on mechanical breathing equipment. “This potential alternative to the current main treatment would make it easier for people to manage their condition,” she said. Image: Shutterstock

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What the government’s home care changes mean for ageing Australians

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The Albanese government has this week announced it will introduce one of the <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">largest reforms</a> to Australia’s aged-care sector to date. The package includes a A$4.3 billion investment in home care, now called “<a href="https://www.health.gov.au/our-work/support-at-home">Support at Home</a>”, to come into effect from July 2025. This reflects both the desire of many people to remain living at home as they age, and the government’s desire to reduce the costs of residential aged care. So what changes is the government making to home care packages? And what will these changes mean for ageing Australians? <h2>Reducing waiting times</h2> One of the major complaints about the current home care system is the long waiting times. Estimates suggest there’s a <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">6–to-12-month wait</a> for the higher level 3 and 4 home care packages. For people with the highest needs, this is far too long. As of March this year, around <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">45,000 people</a> were waiting for any level of home care. An additional 14,000 were already receiving a package, but on a lower level of home care than they were entitled to. With additional funding, the new system will <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">support more participants</a>. It aims to shorten wait times to <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">an average of three months</a> from July 2027. <h2>Changes to services</h2> The new system will replace the current four levels of home care packages with <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">eight classifications</a> of funding for services. When participants are assessed, they will be assigned the most suitable category. There’s currently very limited information on what these classifications are, but the idea is they will provide more targeted services. A number of short-term supports will also be available. These include assistive technology (such as mobility aids) and home modifications. Some people will be able to access 12 weeks of restorative care – a more intensive program designed to build function after injury or illness – as well as palliative care support. The way different types of services are subsidised is also changing. Previously, the same means-tested co-contribution applied regardless of the type of service. Under the new system, services are categorised into clinical care (for example, physiotherapy or wound care), independence (such as help with bathing or cooking) and everyday living (for example, gardening or home maintenance). The new reforms fully subsidise clinical services regardless of income, whereas independence and everyday living services will attract co-contributions based on means testing. For example, <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-support-at-home.pdf">a self-funded retiree</a> would pay nothing out of pocket for physiotherapy, but would pay 50% for help with showering and 80% towards gardening costs. A full pensioner would also pay nothing for physiotherapy, but pay 5% for help with showering and 17.5% of the cost of gardening. This is a positive change. Our research has previously highlighted a tendency for people with home care packages to choose everyday living services <a href="https://onlinelibrary.wiley.com/doi/full/10.1155/2023/4157055">such as gardening</a> and cleaning and refuse clinical care such as allied health and nursing as these types of services were more expensive. These changes should make older people more likely to choose allied health and clinical care services, which will help them maintain their function and stay fitter for longer. <h2>Some challenges</h2> For the government’s reforms to deliver faster and better support at home, a number of issues need to be addressed. As people stay at home for longer, we also see that these <a href="https://academic.oup.com/ageing/article/52/5/afad058/7147101">people are frailer</a> and have more health conditions than in the past. This requires a different and more highly skilled home care workforce. The current <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">home care workforce</a> consists largely of personal care and domestic support workers alongside a much smaller skilled workforce of registered nurses and allied health professionals. But with the changing profile of people receiving care at home, there will need to be a greater focus on maintaining functional capacity. This might mean more allied health input will be required, such as from physiotherapists and occupational therapists. It’s difficult to source an appropriately skilled workforce across the sector, and almost impossible in <a href="https://www.ruralhealth.org.au/sites/default/files/publications/fact-sheet-allied-health.pdf">rural and remote areas</a>. Alternative models, such as training personal care workers to act as allied health assistants, and effectively using technology such as telehealth, will be necessary to meet demand without compromising on quality of care. One example of the need for upskilling in specific areas relates to caring for people with dementia. The majority of people who are living with dementia at home receive care from family carers, supported by home care workers. It’s vital that these care workers have adequate knowledge and skills specific to dementia. However, research has shown the home care workforce may <a href="https://pubmed.ncbi.nlm.nih.gov/31646701/">lack the knowledge and skills</a> to provide best-practice care for people living with dementia. Specialised <a href="https://onlinelibrary.wiley.com/doi/10.1002/gps.6140">dementia training</a> for home care workers is effective in improving knowledge, attitudes and sense of competence in providing care. It should be rolled out across the sector. <h2>What about unpaid care at home?</h2> Unpaid carers, such as family members, provide <a href="https://www.pmc.gov.au/resources/draft-national-strategy-care-and-support-economy/goal-1-quality-care-and-support/support-for-informal-carers">significant amounts of care</a> for older people. The value of this unpaid care is estimated to be in the billions. As older people stay at home for longer, this is set to increase even further. However, carers with high care burdens are particularly vulnerable to <a href="https://www.sciencedirect.com/science/article/pii/S2352827316300283#s0025">poor physical and mental health</a>. Without adequate support, we may find extra caring pressures lead to a breakdown in caring relationships and an increase in other health-care costs for both the carer and care recipient. So we need to ensure carers have adequate financial, psychological and practical support. But the currently available detail on the reforms doesn’t indicate this has been adequately addressed. With careful implementation and ongoing evaluation, these reforms have the potential to significantly enhance the home care system. However, their success will depend on addressing workforce challenges, ensuring adequate support for unpaid carers, and maintaining a focus on the holistic needs of older Australians. More information about Support at Home is <a href="https://www.health.gov.au/our-work/support-at-home/about">available online</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238890/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, Executive Director, National Ageing Research Institute; Professor, Centre for Health Services Research, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, Director Clinical Gerontology & Senior Principal Research Fellow, National Ageing Research Institute, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">original article</a>. </div>

Legal

The hidden epidemic: How ageism affects Australians over 60

Ageism, the stereotyping and discrimination against individuals or groups based on their age, is a pervasive issue that significantly impacts the daily lives of Australians over 60. While often overlooked, this form of prejudice can have far-reaching consequences on various aspects of life for older Australians. Employment discrimination: barriers to work One of the most prominent ways ageism impacts older Australians is through employment discrimination. Approximately 35% of individuals aged 55-64 report experiencing age-related discrimination in the workplace. This often manifests as difficulty in finding new jobs or securing additional work hours. Many qualified and experienced seniors find themselves overlooked for positions or passed over for promotions simply due to their age, despite their wealth of knowledge and skills. Financial insecurity: a growing concern The repercussions of employment discrimination often lead to financial insecurity among older Australians. Alarmingly, about 80% of Australians aged 65 and over rely at least partially on the Age Pension for their income. Even more concerning is that more than one in four older Australians live in poverty. This financial strain can severely impact quality of life, limiting access to healthcare, social activities, and basic necessities. Negative stereotypes: the invisible senior Society often views older people as frail onlookers rather than active participants. This perception can lead to patronising treatment and exclusion from various aspects of public life. Seniors may find themselves ignored in conversations, their opinions dismissed, or their capabilities underestimated. Such treatment can erode self-esteem and lead to a sense of worthlessness among older Australians. Mental health: the psychological toll The constant barrage of ageist attitudes and behaviours takes a significant toll on the mental health of older adults. Research has shown that ageism is associated with increased stress, anxiety and depression among seniors. It can also lead to lower life satisfaction, impacting overall well-being and quality of life. The psychological impact of feeling devalued or irrelevant in society should not be underestimated. Healthcare discrimination: unequal access to treatment Perhaps one of the most alarming manifestations of ageism is in healthcare. Some older Australians report being denied health services or treatment because of their age. This discrimination is particularly pronounced among those 90 and over, with 20% having experienced such treatment. This not only violates the principle of equal access to healthcare but can also have severe consequences for the health and well-being of older Australians. Loss of independence: unwanted assistance Many older Australians find their independence undermined by well-meaning but misguided attempts to help. About 21% of those over 50 report people insisting on doing things for them that they are capable of doing themselves. This can lead to a loss of confidence and a sense of helplessness, even when seniors are fully capable of managing their own affairs. Social isolation: going it alone Ageism can lead to social isolation, with 28% of those over 50 saying they have been ignored or made to feel invisible due to their age. This invisibility can occur in social settings, public spaces or even within families. Social isolation not only impacts mental health but can also lead to physical health issues and a decreased quality of life. Technological exclusion: the digital divide In our increasingly digital world, ageism manifests in assumptions about older adults' ability to use technology. About 36% of those over 50 say people have assumed they cannot understand or learn new technology. This stereotype can lead to exclusion from digital services, information and social connections, further isolating older Australians in a tech-driven society. Workplace issues: feeling out of place Even for those who remain in the workforce, ageism can create a hostile environment. A quarter of Australians in their 50s and 60s report feeling too old for their work. This sentiment can lead to decreased job satisfaction, lower productivity, and even early retirement, depriving workplaces of valuable experience and knowledge. What to do about it To combat ageism in Australia, a multi-faceted approach is necessary. This includes launching education and awareness campaigns to challenge stereotypes, implementing intergenerational programs to foster positive interactions between age groups, and introducing workplace initiatives to promote age-inclusive practices. Policy and legislative changes are crucial to strengthen anti-discrimination laws, while improved media representation can help shift societal perceptions. Empowering older adults through self-advocacy and promoting active ageing can showcase the valuable contributions of seniors. In healthcare, training professionals to avoid ageist practices is essential. Ongoing research and data collection will inform evidence-based interventions, and promoting positive self-perceptions of ageing can help individuals challenge their own ageist beliefs. Addressing these issues requires a societal shift in attitudes towards ageing, policy changes to protect older Australians, and increased awareness of the valuable contributions seniors make to our communities. By implementing these strategies across various sectors, Australia can work towards creating a more age-inclusive society that values and respects individuals of all ages. Only by combatting ageism can we ensure that all Australians, regardless of age, can live with dignity, respect and full participation in society. Image: Shutterstock

Retirement Life

Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack. We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many. But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack. This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people. <h2>Are constipation and heart attacks linked?</h2> Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks. For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age. A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes. It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital. These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated. <h2>How about this new study?</h2> The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population. The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom. The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation. People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation. The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension. The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations. A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day. <h2>How might constipation cause a heart attack?</h2> Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels. As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure). The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks. <a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing. This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure. Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>. This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack. This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease. <h2>What can we do about this?</h2> Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health. Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>. </div>

Body

"So Australian": Local trust praised for response to illegal tree cutting

A resident's decision to cut down a tree for a better view of Sydney Harbour has backfired after a sign was erected where the tree once stood, to condemn tree vandalism. Following multiple reports of resident carrying out tree vandalism along affluent streets, the Sydney Harbour Federation Trust has called out the behaviour by setting up the sign in the Sydney lower North Shore suburb of Woolwich. "Tree vandalism has occurred in this area," the sign read. "The Sydney Harbour Federation Trust protects and manages this land for the enjoyment of the public. "Acts of vandalism like this deprive all of us of the natural environment." The sign also warned that offenders could be subject to fines and/or prosecution as punishment, and urged those who notice any suspicious activity to contact 8969 2100. After an image of the sign was shared to a Sydney group on social media, the local trust's actions have been praised, with many saying they "loved how petty this is" and one even declaring the response "so Australian". "I hope they keep this sign, as a reminder to anyone contemplating doing something similar," one commented. "We're petty but we have a right to be. You don't f**n poison or cut down trees. F**n unacceptable behaviour," another added. Others accused the person who cut down the tree of being "entitled". In last November alone, over 300 native trees and shrubs vanished in front of multi-million dollar homes along the Sydney Harbour waterfront strip. Lane Cove Council believe that hand tools were used to silently cut down the trees, which impacts plants, and local wildlife including wallabies, possums and dozens of other species. On Monday, the council put out a statement saying its "pursuit of justice" is now ramping up, referring to the incident as "the largest tree vandalism case in Lane Cove’s recent history". They are trying to obtain permission to put up a sign to block "the harbour view of the property which would most benefit from the mass clearing of the trees." "As the area is classified as a Threatened Ecological Community and contains some items of Aboriginal Heritage, it was important the appropriate approvals were in place before installing the signage," the council added. "The legal case and banner installation are important steps in our commitment to seeking the strongest possible recourse response to send a message that we stand tall against tree vandalism." Images: Reddit

Legal

New study links Ozempic and Wegovy to suicidal thoughts

A new study has found a link between weight reduction drugs and reports of suicidal thoughts. Semaglutide, the drug sold under the brand names Ozempic and Wegovy, has been widely used for weight loss despite only being approved for the treatment of diabetes. An analysis of data on the adverse drug reactions database of the World Health Organisation found a disproportionate number of people reporting suicidal thoughts while using semaglutide. The research published in JAMA Network also found that the effect was "significant" compared to other diabetes medication, and that people with anxiety and depression were more likely to report suicidal thoughts when taking the drug. The researches have called for "urgent clarification" and larger studies around how semaglutide medications impact the brain. "The study raises key questions about whether additional precautions are needed when prescribing semaglutide," Trevor Steward, a neurobiology researcher from the University of Melbourne said. However, there are a few limitations with the study as there were a lack of information about the dosages, and did not adjust for things like alcohol and substance misuse and off-label use. While the study did not find a direct cause between suicidal thoughts and the use of semaglutide, it is important to raise concerns, especially for those who may want to use these drugs based on information they found on social media, and therefore do not fully understand the risks. The use of semaglutide for weight loss in Australia is considered 'off label', meaning that it has been prescribed for purposes outside of its approved use. The Therapeutic Goods Administration (TGA) believes that these prescriptions have been driving shortages, which they are trying to address and believe will last until 2025. Images: Shutterstock

Caring

11-year-old Australian girl identified as London stabbing victim

The Department of Foreign Affairs and Trade (DFAT) has confirmed that the 11-year-old girl stabbed in Leicester Square in London on Monday is Australian. “Owing to our privacy obligations we cannot provide further comment,” a DFAT spokesperson said. The girl's mother, 34, was initially believed to have also been hurt, but UK police have confirmed that blood from her daughter's injuries had been mistaken for injuries of her own. The young girl was taken to hospital with serious but not life threatening injuries to the face, shoulder, wrist and neck area, and will require plastic surgery for the injuries she sustained. The DFAT are providing consular assistance to the pair reportedly from NSW, according to the ABC. A 32-year-old man, Ioan Pintaru, was arrested and appeared in court on Tuesday charged with the attempted murder. The girl and her mother were visiting the busy tourist area at the time of the random attack. Pintaru is a Romanian citizen with no fixed address, and spoke through a translator during the court hearing. Prosecutor David Burns told the court: "the defendant has approached the 11-year-old girl, placed her into a headlock and he has then stabbed her eight times to the body." Pintaru was detained by members of the public and allegedly found with a steak knife. Abdullah, a security who was working nearby during the random attack said he “heard a scream” before tackling the alleged offender to the ground. “I just saw a kid getting stabbed and I just tried to save her. It’s my duty to just save them,” he told the Press Association. “I jumped on him, held the hand in which he was [carrying] a knife, and just put him down on the floor and just held him and took the knife away from him.” He performed CPR on the child before emergency services arrived at the scene. Police have said that Pintaru did not know the girl or her mother and do not believe the stabbing was terror-related. Pintaru was remanded in custody and is due to appear in court again on September 10. Images: 9News

Caring

Your legacy. Their future. Will you be the difference in an uncertain world?

Connection. Safety. Friendship. Family. When you <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener">leave a gift in your Will for Australian Red Cross</a>, there’s no end to the difference you can make. Just ask Elsie. At 95 years old, Elsie has been transformed by weekly visits from Fiona, her Red Cross volunteer. For Fiona, her visits to see 95-year-old nursing home resident Elsie quickly turned into a family affair. "My children, Tom and Meg, have become very attached to her and vice versa. They're like, 'Are you going to see Elsie, can we come too?' They see how lovely it is to be kind to someone like Elsie," says Fiona. "Elsie tells me, 'You're my special family.'" Fiona's dog, Mia, is even a regular visitor at the Tasmanian nursing home. "Mia's like a celebrity. All the residents love her." The family marks all the big milestones with Elsie, like Christmas Day when they brought her home for a special morning tea. "When she turned 95 in December, we took her to a café. She said that was the best birthday she'd had for a long time." <img src="https://oversixtydev.blob.core.windows.net/media/2024/08/RedCross_01.jpg" alt="" width="1280" height="720" /> Elsie celebrating her birthday with Fiona's children, Tom and Meg. It is very much a two-way friendship, says Fiona. "I wasn't expecting it to be like that. I thought it was going to be more me doing lots of things for Elsie. But she gives back a lot." Like when Fiona's daughter, Meg, didn't pass her driver's license test. "Meg was quite upset. Elsie goes to her, 'That's why they invented pencils with rubbers at the end. They are there for you to rub out your mistakes, and then you can have another go.' "She's wise. She gives them little bits of advice and words of wisdom, and they listen to what she says … I can't believe she's 95 years old. Her mind is so unbelievably sharp." Fiona says that, lately, Elsie has not been as mobile as she was, and so they often spend their time together at the nursing home. "We find a nice spot and have a cuppa … She likes telling stories about her life. She talks a lot about her husband, her upbringing, people she's met. "Often, I'll bring her some magazines, or she will have asked me to get some stamps. And my kids have been great with her with technology, how to do this and how to do that. "We chat with other residents as well. Even though Elsie's our person, there are other people we've got to know. She introduces us as 'This is my family.'" Fiona says the first time they met, she and Elsie discovered they had much in common. They both grew up in the same country town and had travelled around Australia managing hotels. They care a lot about each other, she says. "I think it's given her more of a will to live. That sounds pretty deep, but I know how much she looks forward to seeing us; it's giving her more purpose in life. "Elsie always says, 'You make me feel so happy. I love seeing you, it's such a highlight.' I say it back to her because it's the same for me, 'I get so much joy out of seeing you.'" Fiona says she hopes her story inspires other people to volunteer, too. Your generosity, captured in your Will, can help fund programs like our Aged Care Volunteer Visitors Scheme and foster social connections like Elsie and Fiona’s. The program supports more than 1000 participants across the country with the majority between the ages of 78 and 89. Everybody deserves the warmth of kindness and friendship, and your Will can help Australian Red Cross share that with people for generations to come. <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener"><img src="https://oversixtydev.blob.core.windows.net/media/2024/08/RedCross_02_wQRCode.jpg" alt="" width="1280" height="638" /></a> If you would like a free <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener">Will Planning Checklist</a>, or more information, our <a href="mailto:litran@redcross.org.au" target="_blank" rel="noopener">Gifts in Wills Specialist</a> would love to help. You <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="mailto:litran@redcross.org.au" target="_blank" rel="noopener">get in touch here</a> or call 1800 733 276. All images: Supplied. This is a sponsored article produced in partnership with Australian Red Cross.

Caring

Pet cat lost in the outback ends in purr-fect reunion months later

A beloved pet cat who went missing in the South Australian outback while on a road trip with his owner has been miraculously returned to his family months later. In June, Murry Rantall was travelling from Warnambook Victoria to Darwin in a caravan when he made a pit stop on the Stuart Hwy so his Burmese cat Raj could use the litter box. Rantall went for a walk and came back assuming that his 14-year-old feline friend was still inside so he drove off. It wasn't until 200km later, when he went to check on Raj, that he realised the cat was missing. “I was just about bawling … I knew he was in trouble,” Rantall said. Rantall who had recently lost his wife said that Raj was the only loved one he had left at home. “We were sort of looking after each other more or less,” Rantall said. He turned back to search for Raj, and even had his daughter, Katrina drive from Victoria to South Australia to help find the cat, but they had no luck. The feline was lost but not fur-gotten as Rantall's children put up Facebook posts about Raj missing in the South Australian outback. Two months later, the outback cat-astrophe ended with the purr-fect homecoming when Raj was found in Port Augusta, about 50km from where he ran away. Raj was found in Milla Dey’s backyard on Thursday, August 8. “I just saw that he was there and covered in prickles. We got him some food and water and he spent probably 15 to 20 minutes just eating,” Dey said. He was taken to a local vet to scan his microchip, but the details were outdated. Locals managed to track down Rantall's family on social media after seeing the Facebook posts about Raj, and they were reunited over the weekend. Rantall said Raj had lost a lot of weight but was content to be back in his arms. “We’ll feed him up, he’ll be all right,” Rantall said. Port Augusta City Council animal control officer Kylie McKerlie said the reunion was thanks to the care and dedication of the local community. “It’s just a really good town and a really good feeling for everyone,” she said. Rantall also thanked everyone who helped saying, “it’s unbelievable, the help I’ve had.” Images: 7News

Family & Pets

Retirement tips for Australians without a full superannuation safety net

Most people who commenced paid work before the 1992 launch of compulsory employer contributions won’t have enjoyed money going into their retirement fund for the full duration of their working lives. Others have spent most or all of their adult lives as caregivers – stay-home parents, carers for elderly parents or relatives living with disability. Unquestionably valuable work, yet sadly unpaid – meaning no superannuation. Then there other factors impacting retirement savings – the gender pay gap, periods of unpaid leave, unemployment, working abroad, being a low income earner and more. So don’t think you are alone if you don’t have enough in superannuation for a comfortable retirement. Consider the following options to fall back on instead of, or as well as, your super: Age pension This is the most obvious alternative. What fewer realise, though, is that you may still be eligible for a part-pension, even if your assets exceed the eligibility threshold for the full amount. Claiming a part-pension will stretch what super you do have further. Plus, the related concession card entitles you to a range of discounts, reducing your living costs. Don’t overestimate the value of your assets under the pension means test – potentially denying yourself a legitimate source of income. Semi-retirement Consider transitioning to part-time work instead of retiring outright, allowing you to reduce your workload while still generating both income and employer contributions into your super. This could include self-employment – many retirees begin building a business out of their hobby or do paid consulting work within their industry (often a much higher hourly rate than as a permanent employee). Your home If you own your home, chances are you are sitting on a pile of equity. Yes, you would need to sell and move in order to unlock those funds. But it’s tax-free money. And it can be as much of a lifestyle opportunity as a financial one: downsize to a home with less maintenance needs; relocate nearer to grandkids; enjoy a seachange or treechange. Downsizer provisions also allow you to contribute a chunk of the proceeds into your superannuation over-and-above voluntary contribution caps. Investments Certain investments can deliver a lucrative passive income stream, which you can use in lieu of – or alongside – income from super. Think investment property rents, share dividends, even renting out your car/caravan/boat when you’re not using it. Or you could sell investments you own and use the proceeds to top up your super, which is typically more tax effective than holding as cash. Family business/trust If you have a family business or family trust, you may be able to draw down a regular income from it if structured correctly. Doing so over time from operating profits/investment returns, rather than as a lump sum, means a trust can continue as normal without being forced to sell assets or be wound up, while a business can continue trading under family ownership without the remaining directors having to find the cash to buy out your share (though this may be another option to explore with them). Living costs Your living costs are quite different in full-time retirement compared to full-time work. Goodbye to many commuting, clothing, personal grooming, professional development, registration/certification, lunches and coffees, and work-from-home expenses. Hello to greater energy bills (more time at home and no more remote working tax deductions), travel and lifestyle spending. Don’t overlook the power of updating your household spending and investments plan to reflect this new reality, cancel work-related outgoings and cut unnecessary spending. Timing Perhaps the most far-reaching, yet most commonly overlooked, aspect around retirement is timing. For instance: <ul> <li>the later in the financial year you retire, the more employment income you have accrued – potentially pushing you into a higher tax bracket and ballooning your tax bill.</li> <li>the proceeds from investments differ depending on when in the market cycle you sell them.</li> <li>retiring early may reduce employment bonuses, leave payouts, share option entitlements etc.</li> <li>both spouses/partners retiring simultaneously may reduce overall employment earnings, while conversely unlocking greater opportunities to do things together (like travel, shared hobbies, visiting family).</li> </ul> A qualified financial adviser can help you work through your various options and alternatives, allowing you the peace of mind to enjoy your golden years comfortably – whether that is with or without superannuation. Helen Baker is a licensed Australian financial adviser and author of On Your Own Two Feet: The Essential Guide to Financial Independence for all Women. Helen is among the 1% of financial planners who hold a master’s degree in the field. Proceeds from book sales are donated to charities supporting disadvantaged women and children. Find out more at <a href="http://www.onyourowntwofeet.com.au/">www.onyourowntwofeet.com.au</a> Disclaimer: The information in this article is of a general nature only and does not constitute personal financial or product advice. Any opinions or views expressed are those of the authors and do not represent those of people, institutions or organisations the owner may be associated with in a professional or personal capacity unless explicitly stated. Helen Baker is an authorised representative of BPW Partners Pty Ltd AFSL 548754. Image credits: Shutterstock

Retirement Income

Antarctic heat, wild Australian winter: what’s happening to the weather and what it means for the rest of the year

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/martin-jucker-379172">Martin Jucker</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Australia’s south and east have seen <a href="https://theconversation.com/southern-australia-is-freezing-how-can-it-be-so-cold-in-a-warming-climate-233977">freezing temperatures</a> and <a href="https://www.theguardian.com/australia-news/article/2024/jul/29/australia-winter-weather-forecast-east-coast-colder-records">wild weather</a> this winter. At the same time, the continent as a whole – and the globe – have <a href="https://www.abc.net.au/news/2024-08-03/australia-suffers-cold-winter-weather-despite-mild-forecast/104176284">continued to warm</a>. What’s going on? As ever, it’s hard to pinpoint a single cause for weather events. But a key player is likely an event unfolding high above Antarctica, which itself may have been triggered by a heatwave at surface level on the frozen continent. Here’s what’s happening – and what it might mean for the rest of this year’s weather. <h2>When the stratosphere heats up</h2> Out story begins in the cold air over Antarctica. July temperatures in the stratosphere, the layer of air stretching between altitudes of around 10 and 50 kilometres, are typically around –80°C. The winds are also very strong, averaging about 300 kilometres per hour in winter. These cold, fast winds loop around above the pole in what is called the <a href="https://sites.krieger.jhu.edu/waugh/research/polarvortex">stratospheric polar vortex</a>. Occasionally, persistent high air pressure in the lower atmosphere can influence large-scale waves that extend around the globe and up into the stratosphere. There they cause the strong winds to slow down, and the air high above the pole to become much warmer than normal. In extreme situations the stratospheric winds can completely break down, in what is called a “sudden stratospheric warming” event. These events occur every few years in the northern hemisphere, but only one has ever been observed in the south, in 2002 (though another <a href="https://theconversation.com/the-air-above-antarctica-is-suddenly-getting-warmer-heres-what-it-means-for-australia-123080">almost happened in 2019</a>). <h2>Pushing polar weather our way</h2> Once the polar vortex is disturbed, it can in turn influence the weather at the surface by steering weather systems from the Southern Ocean towards the Equator. However, this is a slow process. The impact at the surface may not be felt until <a href="https://doi.org/10.1175/JCLI-D-22-0425.1">a few weeks or even months</a> after the initial weakening of the stratospheric polar vortex. Once it begins, the stratospheric influence can prevail for more weeks or months, and helps meteorologists make <a href="https://doi.org/10.5194/acp-22-2601-2022">long-range weather forecasts</a>. In climate science terms, the weak stratospheric winds put an atmospheric system called the <a href="http://www.bom.gov.au/climate/sam/">Southern Annular Mode</a> into a negative phase. The main effect of this on surface weather is to bring westerly winds further north. In winter, this means polar air outbreaks can reach places like Sydney more easily. As a result, we see more <a href="https://doi.org/10.1175/JCLI4134.1">rain over much of southern Australia</a>, and snowfall in alpine regions. In spring and summer it means westerly winds blow over the continent before reaching the east coast, bringing warm and dry air to southeastern Australia. The exact impact of a weaker polar vortex depends on how much and for how long the weather systems are being pushed further northward. It will also depend on other weather influencers such as El Niño and the Indian Ocean Dipole. <h1>This winter’s weirdness</h1> Unpicking exactly why any weather event occurs is tricky at the moment, because global weather has been absolutely crazy over the past 12 months or so. Global temperatures are <a href="https://theconversation.com/we-just-blew-past-1-5-degrees-game-over-on-climate-not-yet-213364">much higher than usual</a>, which is making unusual weather very common. But there are indications that the stratosphere is having some influence on our weather this winter. The stratospheric polar vortex started to warm in mid-July, and is about 20°C warmer than the long-term average. At the time of writing, the winds slowed down to about 230 kilometres per hour, 70 kilometres per hour slower than average. These numbers mean that, technically, the event does not qualify as a sudden stratospheric warming. However, further warming may still occur. If we look at how southern hemisphere winds have evolved in the past few weeks, we see a pattern which looks like what we would expect from a sudden stratospheric warming. First, we see warming in the stratosphere which is <a href="https://doi.org/10.1029/2021GL095270">at first accompanied by a poleward shift of weather systems</a>. The stratosphere’s influence then propagates downward and seems to <a href="https://doi.org/10.1175/JCLI-D-22-0425.1">induce many weeks</a> of weather systems shifted towards the equator. This coincides with the period of cold and rainy weather along Australia’s east coast in late July and the beginning of August. Forecasts suggest the Southern Annular Mode will be a long way from normal conditions in the first half of August – four standard deviations below average, which is extremely rare. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/611211/original/file-20240804-19-sp862a.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" alt="Diagram showing atmospheric warming and winds" /></a><figcaption>How initial warming high in the stratosphere ends up changing winds near the surface and pushing polar weather further north. <a class="source" href="https://stratobserve.com">Z.D. Lawrence / StratObserve / Annotated by Martin Jucker</a></figcaption></figure> <h1>A surface disturbance</h1> The main reason for the polar vortex to slow down is disturbances from the surface. Weather over the Amundsen Sea near Antarctica in the South Pacific is <a href="https://doi.org/10.1175/JCLI-D-22-0425.1">an important source</a> of these disturbances. This year, we have seen disturbances of this sort. There have been <a href="https://www.theguardian.com/world/article/2024/aug/01/antarctic-temperatures-rise-10c-above-average-in-near-record-heatwave">near-record surface temperatures around Antarctica</a>. These disturbances may be due to the globally high ocean temperatures, or even lingering effects of the <a href="https://doi.org/10.1175/JCLI-D-23-0437.1">eruption of the Hunga Tonga volcano in 2022</a>. But more research will be required to confirm the causes. <h1>What should we expect for the rest of the year?</h1> There are two pathways until the end of the year. One is that the stratospheric winds and temperatures recover to their usual values and no longer influence surface weather. This is what the forecasts from <a href="https://ozonewatch.gsfc.nasa.gov">Ozone Watch</a> seem to suggest. Another is that the stratosphere keeps warming and the winds keep being slower all the way into summer. In this scenario, we would expect a persistent negative Southern Annular Mode, which would mean a spring and potentially even summer with warmer and drier than usual weather over southeastern Australia, and a small ozone hole. The seasonal forecasting models from the European Centre for Medium Range Weather Forecasts <a href="https://x.com/drahbutler/status/1819142206348759170?s=46&t=sayfGwpo3_s310BwYpcdcQ">seem to favour this second scenario</a>. <a href="https://theconversation.com/profiles/martin-jucker-379172">Martin Jucker</a>, Senior Lecturer in Atmospheric Science, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/antarctic-heat-wild-australian-winter-whats-happening-to-the-weather-and-what-it-means-for-the-rest-of-the-year-236067">original article</a>. </div>

Travel Trouble

Last Australian 'Rat of Tobruk' dies age 102

Thomas Pritchard, Australia's last "Rat of Tobruk" has passed away at the age of 102. Pritchard was part of the famous garrison who held the eponymous Libyan port against a furious Nazi siege in World War II. The Rats of Tobruk Association announced Pritchard's death on Saturday, honouring his service to his country. "Tommy was a stalwart member of our association and a most humble veteran, having served with the 2/5th field ambulance throughout the Middle East and the South West Pacific," the association wrote in a post. "We as an Association are extremely grateful to have had Tommy for so long yet we mourn his loss and the last direct linkage with some 14,000 Australian servicemen who served in Tobruk." The post added that Pritchard would be farewelled in a private family funeral, as was Tommy's wishes. However, they added that a public memorial for all Rats of Tobruk will take place in Melbourne, with the date yet to be confirmed. The Rats of Tobruk were an Allied garrison of about 26,000 soldiers, including 14,000 Australians, commanded by Australian Lieutenant-General Leslie Morehead. They were besieged by the Nazi Afrika Korps, comprised of German and Italian troops, from April 10th to November 27th 1941. The Africa Korps, under the leadership of Nazi general Erwin Rommel, had never known defeat, until he faced the Rats for 231 days, who denied Rommel a port on the Libyan coast as the Nazis were unable to take control of Tobruk. The nickname came from American-born Nazi propagandist William Joyce, who, when he heard the Allied soldiers were taking cover in the pre-existing below-ground defences of the city, derided them as living like "rats". However, Aussies took the nickname with pride as they celebrated their victory. Image credits: Rats of Tobruk Association

Caring

Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Around <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&inline=true">3.2 million</a> Australians live with depression. At the same time, <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&inline=true">few</a> Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other? Our world-first trial, <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065%2824%2900136-6/fulltext">published this week</a>, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression. Previous studies (including <a href="https://link.springer.com/article/10.1186/s12916-017-0791-y">our own</a>) have found “lifestyle” therapies are effective for depression. But they have never been directly compared with psychological therapies – until now. Amid a nation-wide <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">shortage</a> of mental health professionals, our research points to a potential solution. As we found lifestyle counselling was as effective as psychological therapy, our findings suggest dietitians and exercise physiologists may one day play a role in managing depression. <h2>What did our study measure?</h2> During the prolonged COVID lockdowns, Victorians’ distress levels were <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50831">high and widespread</a>. Face-to-face mental health services were limited. Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful. We partnered with our <a href="https://www.barwonhealth.org.au/mhdas/">local mental health service</a> to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals. Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals: <ul> <li>eating a wide variety of foods</li> <li>choosing high-fibre plant foods</li> <li>including high quality fats</li> <li>limiting discretionary foods, such as those high in saturated fats and added sugars</li> <li>doing enjoyable physical activity.</li> </ul> The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2730724">groups and when delivered remotely</a>. In both groups, participants could continue existing treatments (such as taking antidepressant medication). We gave both groups <a href="https://link.springer.com/article/10.1186/s12888-022-03840-3">workbooks and hampers</a>. The lifestyle group received a food hamper, while the psychotherapy group received items such as a colouring book, stress ball and head massager. <h2>Lifestyle therapies just as effective</h2> We found similar results in each program. At the trial’s beginning we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program. Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful so we could conclude both treatments were as good as each other. There were some differences between groups. People in the lifestyle program improved their diet, while those in the psychotherapy program felt they had increased their social support – meaning how connected they felt to other people – compared to at the start of the treatment. Participants in both programs increased their physical activity. While this was expected for those in the lifestyle program, it was less expected for those in the psychotherapy program. It may be because they knew they were enrolled in a research study about lifestyle and subconsciously changed their activity patterns, or it could be a positive by-product of doing psychotherapy. There was also not much difference in cost. The lifestyle program was slightly cheaper to deliver: A$482 per participant, versus $503 for psychotherapy. That’s because hourly rates differ between dietitians and exercise physiologists, and psychologists. <h2>What does this mean for mental health workforce shortages?</h2> Demand for mental health services is increasing in Australia, while at the same time the workforce <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">faces worsening nation-wide shortages</a>. Psychologists, who provide <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&inline=true">about half</a> of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap. Lifestyle therapies can be combined with psychology sessions for multi-disciplinary care. But diet and exercise therapies could prove particularly effective for those on waitlists to see a psychologists, who may be receiving no other professional support while they wait. Many dietitians and exercise physiologists already have advanced skills and expertise in motivating behaviour change. Most accredited practising dietitians are trained in managing <a href="https://link.springer.com/content/pdf/10.1007/978-3-030-67929-3_38-1.pdf">eating disorders</a> or <a href="https://www.nature.com/articles/s41572-020-0200-2">gastrointestinal conditions</a>, which commonly overlap with depression. There is also a cost argument. It is <a href="https://journals.sagepub.com/doi/full/10.1177/1355819616668202">overall cheaper</a> to train a dietitian ($153,039) than a psychologist ($189,063) – and it takes less time. <h2>Potential barriers</h2> Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite <a href="https://dietitiansaustralia.org.au/sites/default/files/2024-04/Dietitians%20Australia%20Mental%20Health%20Evidence%20Brief%202024.pdf">peak bodies</a> urging them to do so. Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues. <a href="https://foodandmoodcentre.com.au/academy">Our training</a> and clinical <a href="https://www.tandfonline.com/doi/full/10.1080/15622975.2022.2112074">guidelines</a> are intended to help clinicians practising lifestyle-based mental health care within their scope of practice (activities a health care provider can undertake). <h2>Future directions</h2> Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running <a href="https://foodandmoodcentre.com.au/projects/the-harmone-trial/">a study</a> open to Australians with mental health conditions such as major depression or bipolar disorder. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235952/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, Professor, Food & Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, Associate Research Fellow, Food and Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/food-and-exercise-can-treat-depression-as-well-as-a-psychologist-our-study-found-and-its-cheaper-235952">original article</a>. </div>

Mind

Our research shows 4 in 10 Australians in aged care are malnourished. What can we do about it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In the next 40 years <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150-fs.pdf">in Australia</a>, it’s predicted the number of Australians aged 65 and over will more than double, while the number of people aged 85 and over will more than triple. If you’re not really interested in aged care, you should be. Given these figures, you will almost certainly be engaging with aged care services at some stage – either for yourself, or supporting family members or friends seeking aged care. One service you are likely to encounter is residential aged care homes. In the past few years this sector has been under more scrutiny than ever before. Changes to legislation, workforce and funding are in motion. But the question remains as to whether these changes can happen fast enough to meet our ageing population’s needs. One area of need not being adequately met at present is nutrition. In a <a href="https://www.mdpi.com/2227-9032/12/13/1296">new study</a>, we’ve found four in ten older Australians living in residential aged care are not receiving enough of the right types of nutrients, resulting in loss of weight and muscle. This is known as malnutrition. <h2>Good nutrition is essential for healthy ageing</h2> Malnutrition in older people is <a href="https://www.agedcarequality.gov.au/providers/food-nutrition-dining/why-meals-matter">associated with</a> poorer overall health, such as increased risk of falls and infections. This can accelerate loss of independence for older people, including the need for extra assistance with basic activities such as bathing and dressing. Older people are at increased risk of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02612-5/abstract">malnutrition</a> for a range of reasons. These can include decreased appetite, difficulties with chewing and swallowing, and the presence of other chronic diseases such as Parkinson’s disease or dementia. Importantly, ensuring adequate nutrition is about more than just offering healthy foods. We eat not only to meet nutritional requirements, but for enjoyment and socialisation. We each have different preferences around what we want to eat, when and with whom. Food provision poses a challenge for residential aged care providers who must navigate the range of residents’ preferences together with dietary restrictions and texture modifications. This must also be balanced against the practicalities of having the right number of appropriately trained kitchen and mealtime assistance staff, and working within funding constraints. Understanding more about who is malnourished in aged care can help providers better address this problem. <h2>Malnutrition is an ongoing problem in aged care</h2> We looked at more than 700 aged care residents in New South Wales, Queensland and South Australia. We assessed participants for malnutrition using a screening tool that collects data on medical history and dietary intake, and includes a physical examination of muscle and fat. We found 40% were malnourished, including 6% who were severely malnourished. This likely underestimates the true rate of malnutrition, as residents with dementia were excluded. International <a href="https://www.mdpi.com/2072-6643/15/13/2927">studies</a> have shown an average of 80% of aged care residents with dementia are malnourished or at risk of developing malnutrition. Our findings are broadly in line with a synthesis of <a href="https://www.sciencedirect.com/science/article/pii/S0378512219301148">38 international studies</a>, which reported an average malnutrition rate in residential aged care of 52%. In Australia, malnutrition was highlighted as <a href="https://www.royalcommission.gov.au/aged-care">a priority</a> for immediate attention in the 2021 Royal Commission into Aged Care Quality and Safety. Its report cited <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dairy-food-supplementation-may-reduce-malnutrition-risk-in-institutionalised-elderly/52E93ADD586C634A3913A2AFE9D07847">an Australian study</a> of 215 residents, published in 2017, which found 68% were malnourished or at risk of malnutrition. It’s difficult to directly compare malnutrition rates between studies due to differences in diagnostic measurements. But it’s clear malnutrition is an ongoing challenge in aged care. <h2>What can we do about it?</h2> Since the royal commission, we’ve seen the strengthening of the <a href="https://www.agedcarequality.gov.au/providers/quality-standards/strengthened-quality-standards">quality standards</a> to be included in the new Aged Care Act, anticipated to be introduced to parliament in 2025. The strengthened quality standards provide an important framework to guide action by aged care providers on malnutrition. Key requirements include partnering with residents to design food options, regular assessment and reassessment of resident nutrition requirements, developing systems to monitor and improve satisfaction with food, designing pleasant dining environments, and providing staff with the training they need to achieve all of the above. However, achieving these standards will require investment of money and time. At the moment, <a href="https://kpmg.com/au/en/home/insights/2023/09/australian-aged-care-sector-analysis.html">64% of residential aged care providers</a> in Australia are operating at a financial loss. While we know carers and facility managers want to provide the best care possible, it’s difficult to achieve this when contending with underlying financial problems. As such, our teams at Monash and Griffith universities are focusing on strategies that minimise the burden on staff and providers. We are working on automating malnutrition screening. Current tools take 10–15 minutes and should be used when a new resident moves into an aged care home and regularly during their stay. But anecdotal evidence suggests providers lack the staff and funding needed to routinely carry out this screening. Instead, we aim to use existing data from aged care providers, including quarterly reports from the <a href="https://www.health.gov.au/our-work/qi-program">National Aged Care Mandatory Quality Indicator Program</a>, to detect malnutrition automatically. This will allow staff to focus more on care. Given the complexity of malnutrition, it’s likely that addressing the issue at a national scale will take some time. In the short term, for those with loved ones in aged care homes, we encourage you to be actively involved in their care, including noticing and speaking up if you think more can be done to optimise their nutrition.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235507/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, Lecturer, Physiotherapy, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, Senior Lecturer, School of Health Sciences and Social Work, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/our-research-shows-4-in-10-australians-in-aged-care-are-malnourished-what-can-we-do-about-it-235507">original article</a>. </div>

Body

Mysterious leg pain that’s quietly killing older Australians

Peripheral Artery Disease (PAD) has long been overshadowed by its more widely recognised counterparts, such as heart attacks and strokes. Often referred to as the “poor cousin” or “Cinderella” of cardiovascular diseases, PAD affects one in five older Australians, yet it remains largely under-diagnosed and misunderstood. However, a wave of optimism is sweeping through the medical community with the launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a>, an Australian-first facility dedicated to pioneering research and improving patient outcomes. Spearheaded by the Heart Research Institute, the Centre for Peripheral Artery Disease, marks a significant step forward in addressing the challenges posed by PAD. The centre aims to fill critical gaps in our understanding of the disease, which is responsible for a limb amputation in Australia every two hours. This initiative promises to enhance diagnosis, transform patient care, and raise awareness about PAD. Associate Professor Mary Kavurma, the Centre Lead, is at the forefront of this ground-breaking effort. “We’re supercharging research into PAD because there are still many unknowns about the disease’s biology that could unlock new methods for early detection and better management,” she explains. This research is particularly urgent given the prevalence of PAD among women and First Nations Australians, groups that remain disproportionately affected by this condition. The centre’s mission is to develop a simple blood test for early diagnosis and explore novel therapies that could reduce the need for limb amputations and significantly improve patients’ quality of life. Unlike current treatments that primarily focus on symptom management, this new approach seeks to prevent the disease from progressing. One of the most inspiring aspects of the centre is its commitment to involving patients and their families in the research process. At the inaugural consumer meeting, nearly 20 patients and their carers shared their personal experiences with PAD. Take the story of Simon Josephson, a renowned advertising guru – who famously designed the Solo logo. PAD almost cost him his life after taking more than five years to diagnose. He woke up one morning with a sore leg, thinking he’d overdone it exercising but the 73-year-old – who was otherwise healthy and active – unknowingly had Peripheral Artery Disease, caused by a build-up of plaque in his arteries causing them to narrow and stiffen. It wasn’t until a trip to the hospital emergency department years later that doctors would discover his aorta had expanded to more than twice the usual size and was at risk of rupturing. He immediately underwent open heart surgery and has faced a lengthy recovery. The launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a> heralds a new era of hope and progress in the fight against PAD. Through world-leading research, community engagement, and a commitment to patient-centred care, the CPAD is poised to make a profound impact on the lives of many Australians. As Assoc Prof Kavurma aptly put it, “By understanding more about this debilitating condition, we are paving the way for better health outcomes and a brighter future for all those affected by PAD.” Images: CPAD

Caring

Aussie flag bearers for Paris Olympics announced

The Australian flag bearers have been announced for the upcoming opening ceremony of the Paris Olympics. Chef de mission Anna Meares officially confirmed the flag bearers for the event on the River Seine to massive applause at a function in Paris on Wednesday, announcing Jess Fox and Eddie Ockenden as the two champions who will carry the flag. Meares admitted that she told Fox, an award-winning canoeist, about the special honour two months ago so she could break the news in person. “Even though I’ve known a little while, it’s really hit me today ... all the emotions came up,” Fox said. “It is probably the greatest moment of my career ... just visualise us, leading our team down the Seine.” History-making Kookaburra Eddie Ockenden, who will become the first Australian hockey player to play five Games, will join Fox in carrying the flag. He also carried the flag at the opening ceremony of the Commonwealth Games in Birmingham two years ago. “This really means a lot to me ... if I get emotional, it’s because of gratitude, so thank you,” Ockenden said. “I feel special, to represent Tasmania. It’s something that I’ve always felt a real connection to and if I could even say to kids in Tassie - dream big and chase your dreams, sport or otherwise. “It doesn’t feel real yet ... it’s a huge honour. I never thought this was something that could be a possibility.” The opening ceremony of the Paris Games will be like none other in history with boats taking athletes from each county down the Seine River. Image credits: Pete Dovgan/Speed Media/Shutterstock Editorial

International Travel

We have too few aged care workers to care for older Australians. Why? And what can we do about it?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> In a country like Australia, we all expect that when we get old, we’ll be able to rely on a robust aged care system. But aged care providers can’t find staff and a crisis is brewing. If the problem isn’t fixed, there are serious risks to quality and access to services for older people who need support. There are also broader social, economic and political consequences for undervaluing the rapidly expanding health and social assistance workforce. Aged care <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">employs</a> around 420,000 people. Around 80% of those are front line staff providing care and demand for them is increasing rapidly. <h2>Australians are ageing</h2> The number of people aged 80 and over is <a href="https://treasury.gov.au/sites/default/files/2019-03/IGR_2010_Overview.pdf">projected to double</a> by 2050. At the same time, informal family care is becoming less available. In the next 25 years, <a href="https://www.australianageingagenda.com.au/executive/shortfall-of-400000-aged-care-workers-predicted-by-2050/">twice as many</a> aged care staff will be needed. Currently, about 1.4 million older people <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/aged-care">receive</a> aged care services, including basic and more intensive home care and residential care. Health care and social support job vacancies and ads are the highest of any industry. Between 30,000 and 35,000 additional direct aged care workers a year are already needed. By 2030 the <a href="https://cedakenticomedia.blob.core.windows.net/cedamediacontainer/kentico/media/attachments/ceda-duty-of-care-3.pdf">shortfall</a> is likely to be 110,000 full time equivalent workers. <h2>Why don’t enough people want to work in aged care?</h2> Despite recent <a href="https://www.health.gov.au/topics/aged-care-workforce/what-were-doing/better-and-fairer-wages">pay increases</a>, it is difficult to attract and retain aged care workers because the work is under-valued. The Australian workforce is undergoing profound change. A generation ago, manufacturing made up 17% of the workforce. Today it has fallen to 6%. By contrast, the health care and social assistance workforce has doubled from 8% to 16%. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The manufacturing workforce has declined, while health, aged care and social assistance has risen. ABS 6291.0.55.001 Labour Force, Australia.</figcaption></figure> Manufacturing jobs were <a href="https://australiainstitute.org.au/wp-content/uploads/2020/12/Manufacturing-Briefing-Paper-FINAL.pdf">mainly</a> secure, full-time, reasonably paid jobs dominated by male workers. By contrast, jobs in aged care are often insecure, part-time and poorly paid, dominated by women, with many workers coming from non-English speaking backgrounds. Since moving to take over aged care in the 1980s, the federal government has over-emphasised <a href="https://arena.org.au/a-genealogy-of-aged-care/">cost constraint</a> through service privatisation, activity-based funding and competition, often under the cover of consumer choice. The result is a highly fragmented and poorly coordinated aged care sector with almost 3,200, often small and under-resourced providers centrally funded and regulated from Canberra. This has <a href="https://www.health.gov.au/sites/default/files/a-matter-of-care-australia-s-aged-care-workforce-strategy.pdf">led to</a> high levels of casualisation, low investment in training and professional development, and inadequate supervision, particularly in the home care sector. Aged care is facing a perfect storm. Demand for care and support staff is increasing dramatically. The sector is poorly coordinated and difficult to navigate. Pay and conditions remain poor and the workforce is relatively untrained. There are no minimum standards or registration requirements for many front-line aged care staff. <h2>What are the consequences?</h2> An understaffed and under-trained aged care workforce reduces access to services and the quality of care and support. Aged care providers <a href="https://www.agedhealth.com.au/content/compliance-and-governance/news/troubled-outlook-for-aged-care-reforms-1224428737#:%7E:text=Its%20report%20found%20that%2053.8,was%20%22impossible%20to%20achieve%22.">routinely report</a> it is difficult to attract staff and they can’t meet the growing demand for services from older people. Staff shortages are already having an impact on residential care occupancy rates falling, with some regional areas now down to only 50% occupancy. That means older people either don’t get care or they are at increased risk of neglect, malnutrition, avoidable hospital admissions and a poorer quality of life. Inevitably, lack of aged care workers puts pressure on hospital services when older people have nowhere else to go. <h2>What needs to be done?</h2> Addressing these challenges requires a multifaceted approach. Australia will need a massive increase in the number of aged care workers and the quality of the care they provide. Wages have to be competitive to attract and retain staff. But better pay and conditions is only part of the story. Unless aged care becomes a career the community recognises, values and supports, it will continue to be difficult to train, attract and retain staff. The recent <a href="https://www.royalcommission.gov.au/aged-care">Royal Commission on Aged Care Quality and Safety</a> highlighted the need for a more skilled workforce, emphasising the importance of ongoing professional development for all staff. To date the federal government’s aged care workforce initiatives have been underwhelming. They are a limited and piecemeal rather than a coherent workforce strategy. In the short term, skilled migration may be part of the solution. But progress to bring in skilled aged care workers has been glacial. Currently only about 1% of providers <a href="https://theconversation.com/overseas-recruitment-wont-solve-australias-aged-care-worker-crisis-189126">have agreements</a> to bring in staff from overseas. At best, overseas migration will meet only 10% of the workforce shortfall. Registration, qualifications and training for direct care work have to become mandatory to make sure care standards are met. Much more significant and systematic incentives and support for training will be needed. Supervision, career progression and staff development will also have to be dramatically improved if we are to attract and retain the workforce that is needed. “Learn and earn” incentives, including scholarships and traineeships for aged care, are needed to attract the future workforce. At the same time, a much broader investment in upskilling the entire workforce through continuing professional development and good quality supervision is necessary. Like manufacturing a generation ago, aged care needs to become valued, skilled, secure and well-paid employment if it is going to attract the staff that are needed to avoid a looming crisis.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232707/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, Emeritus Professor of Public Health, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-have-too-few-aged-care-workers-to-care-for-older-australians-why-and-what-can-we-do-about-it-232707">original article</a>. </div>

Caring

Australian couple killed in the Philippines identified

An Australian couple who were allegedly murdered in the Philippines have been identified. The bodies of 54-year-old David Fisk and his de-facto partner Lucita Barquin Cortez, 55, were found with their hands and feet tied by hotel staff at the Lake Hotel in Tagaytay city, south of Manila, on Wednesday. The body of another woman, Cortez's 30-year-old daughter-in-law Mary who lives in the Philippines, was also found in the room. Hotel staff were alerted to the issue when they knocked on the door repeatedly to tell the couple it was time to check out. Fisk allegedly had his throat was slit with a sharp object that may have caused his death while the two women apparently may have been suffocated using a pillow, Tagaytay police chief Charles Daven Capagcuan told The Associated Press. Ongoing autopsies would verify those initial indications, he said. Fisk's family, based in NSW's Sutherland Shire, issued a statement saying they "pray for answers and the truth in this horrific matter". "The love we have for our Father and Lucita is so dear and this situation is like living a nightmare," the family said. Capagcuan said the motive for the killings was not immediately clear and added some valuables of the victims, including their mobile phones, were not taken by the suspect. "We were shocked by this incident," Tagaytay Mayor Abraham Tolentino said, apologising to the families of the victims. "We're very sorry to our Australian friends. We will resolve this as soon as possible." Tolentino said investigators were interviewing witnesses and examining security cameras at the hotel which could help identify the suspect or suspects, as a suspicious hooded figure was seen in the corridors of the hotel around the time of their deaths. A Filipino relative of the Australian woman told the AP that the Australian couple flew from Sydney to the Indonesian resort island of Bali for a vacation then headed to the Philippines on Monday to visit her two children from a previous marriage in the country. It's understood the Australian couple had been due to fly back home to Sydney on July 13th. Image credits: Cavite Provincial Police Office

Caring

‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians

<a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Our <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">ageing population</a> brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss). Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are <a href="https://www.senseswa.com.au/wp-content/uploads/2016/01/a-clear-view---senses-australia.pdf">living with dual sensory impairment</a>. Combined vision and hearing loss <a href="https://doi.org/10.1177/0264619613490519">describes</a> any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is <a href="https://doi.org/10.1016/j.annepidem.2012.02.004">increasingly common</a> as people get older. The experience can make older people feel isolated and unable to participate in important conversations, including about their health. <h2>Causes and conditions</h2> Conditions related to hearing and vision impairment often <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">increase as we age</a> – but many of these changes are subtle. Hearing loss can start <a href="https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/highlighting-priorities-for-ear-and-hearing-care">as early as our 50s</a> and often accompany other age-related visual changes, such as <a href="https://www.mdfoundation.com.au/">age-related macular degeneration</a>. Other age-related conditions are frequently prioritised by patients, doctors or carers, such as <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview">diabetes or heart disease</a>. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our <a href="https://hdl.handle.net/2123/29262">research</a> told us <blockquote> I don’t see too good or hear too well. It’s just part of old age. </blockquote> <h2>An invisible disability</h2> Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts <a href="https://doi.org/10.1080/09638280210129162">social activities and communication</a>, making it difficult for older adults to manage. It is underdiagnosed, underrecognised and sometimes misattributed (for example, to <a href="https://doi.org/10.1093/geronb/gbz043">cognitive impairment or decline</a>). However, there is also growing evidence of links between <a href="https://doi.org/10.1002/dad2.12054">dementia and dual sensory loss</a>. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, <a href="https://doi.org/10.1002/dad2.12054">feel happy and be safe</a>. A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us: <blockquote> There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else. </blockquote> <h2>Isolated yet more dependent on others</h2> Global trends show a worrying conundrum. Older people with dual sensory impairment become <a href="https://doi.org/10.1002/dad2.12054">more socially isolated</a>, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing. One aspect of this is how effectively they can <a href="https://doi.org/10.1001/jamanetworkopen.2020.25522">comprehend and communicate in a health-care setting</a>. Recent research shows <a href="http://dx.doi.org/10.3390/healthcare12080852">doctors and nurses in hospitals</a> aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, <a href="https://www.mdpi.com/2227-9032/12/8/852">researchers note</a>. It facilitates: <ul> <li>shorter hospital stays</li> <li>fewer re-admissions</li> <li>reduced emergency room visits</li> <li>better treatment adherence and medical follow up</li> <li>less unnecessary diagnostic testing</li> <li>improved health-care outcomes.</li> </ul> <h2>‘Too hard’</h2> Globally, there is a better understanding of how important it is to <a href="https://www.who.int/publications/i/item/9789240030749">maintain active social lives</a> as people age. But this is difficult for older adults with dual sensory loss. One person told us <blockquote> I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people. </blockquote> Again, these experiences increase reliance on family. But caring in this context is tough and largely <a href="https://doi.org/10.3389/feduc.2020.572201">hidden</a>. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring <a href="https://doi.org/10.1159/000507856">frustration, social isolation and depression</a> for carers too. One spouse told us: <blockquote> He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair. </blockquote> So, what can we do? Dual sensory impairment is a growing problem with potentially devastating impacts. It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers. We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to <a href="https://www.tandfonline.com/doi/full/10.1080/09649069.2019.1627088">navigate health care</a>. Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232142/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, Lived Experience Research Fellow, Centre for Disability Research and Policy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, Postdoctoral research fellow, Department of Linguistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-keep-away-from-people-combined-vision-and-hearing-loss-is-isolating-more-and-more-older-australians-232142">original article</a>.

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Tucker Carlson hits back at "stupid" Aussie journalist

The poster boy for conservative America has locked horns with an Aussie journalist in a heated exchange that has gone viral. Tucker Carlson, a former Fox News host in the USA and all round controversial figure, is currently doing the rounds Down Under as a guest of Clive Palmer, and took to the stage to make a speech at the Australian Freedom Conference at the Hyatt Hotel in Canberra on Tuesday. With his signature move being to look for an argument, Carlson found a worthy opponent in AAP Newswire’s Kat Wong, who wasted no time in attempting to get under the 55-year-old’s skin. Wong quizzed Carlson about his controversial immigration views, saying he had “talked” about the “Great Replacement Theory” and how “white Australians, Americans and Europeans” are being replaced by “non-white immigrants”, but Carlson was quick to challenge the question. “Whites are being replaced? I don’t think I said that,” he interjected. “Well, it’s been mentioned on your show 4000 times,” Wong replied. “Really? When did I say that? I said ‘whites’ are being replaced?” he responded. When Wong insisted he had, Carlson challenged her to “cite that”. “I said native-born Americans are being replaced, including blacks,” he continued. “African-Americans have been in the United States, in many cases, for more than 400 years and their concerns are as every bit as real and valid and alive to me as the concerns of white people whose families have been there for 400 years." “I’ve never said that ‘whites’ are being replaced. Not one time and you can’t cite it.” When Wong said “I believe that’s untrue”, Carlson took it up a level. <blockquote class="twitter-tweet"> Meet the Australian media. <a href="https://t.co/IyiEqihPkb">pic.twitter.com/IyiEqihPkb</a> — Tucker Carlson (@TuckerCarlson) <a href="https://twitter.com/TuckerCarlson/status/1806034521369776406?ref_src=twsrc%5Etfw">June 26, 2024</a></blockquote> “We just met, but when our relationship starts with a lie, it makes it tough to be friends,” he said. “You actually can’t cite it because I didn’t say it and I don’t believe it, and I’m telling you that to your face. So, why don’t you just accept me at face value?” Carlson doubled down on his views by calling immigration "immoral", saying governments were negligent by “shifting their concern” to immigrants in order to solve the population growth. “In my view, happy people have children,” he said. “And a functioning economy allows them to do that.” “So you need to fix the economy and fix the culture so the people who want to have kids can,” he continued. “You don’t just go for the quick sugar fix of importing new people. That’s my position and if you think that’s racist, that’s your problem.” Wong replied by saying “I never called you a racist” but it only fired Carlson up more. “But of course, you are suggesting … I must say one of the reasons why people don’t like people like you in the media is that you never say exactly what you mean,” Carlson said. “Your slurs are all by implication. You’re about to tell me the Great Replacement Theory is racist or antisemitic, whatever. I’ve said what I’ve said to you right now like 100 times in public." “I hope to, if I live long enough, to say it 100 more times. I think it’s completely honest and real, not racist or scary. It’s factually true. It’s not a theory, it’s a fact." Carlson then took the fight to the issue of gun control when Wong suggested that it is Americans the same immigration theories that turn to violence and commit mass shootings, to which Carlson quickly rejected as he took aim at Wong. “Oh god, come on,” Carlson said. “How do they get people this stupid in the media? I guess it doesn’t pay well. Look, I’m sorry, I’ve lived among people like you for too long. I don’t mean to call you stupid, maybe you’re just pretending to be." He clarified his stance by saying, "But I’m totally against violence." But Wong wouldn’t stop her line of questioning, asking “Right, so therefore you support gun control?” “What?! I thought it couldn’t get dumber, but it did,” he said. “No, I don’t support disarming law-abiding people so they can’t defend themselves, so the government has a monopoly on violence. I don’t think so." Before leaving the stage, Carlson took a broad swipe at Australian media, saying, "I got here and the country is so unbelievably beautiful, and the people are so cheerful and funny, and cool, and smart. " “I’m like, ‘your media has got to be better than ours. It can’t just be a bunch of castrated robots reading questions from the boss’." “And then it turns out it’s exactly the same. Maybe even a tiny bit dumber.” A lengthy clip of the tense exchange has since gone viral amongst conservative X users, with Sky News Australia host Rita Panahi chiming in on the discourse. “If you are going to show up and make outrageous claims and try to connect Tucker Carlson to mass killers, then I don’t know, perhaps go to the trouble of citing a source, have a direct quote from the man,” Ms Panahi said. “Otherwise, you are going to look like an absolute fool.” Image credits: LUKAS COCH/EPA-EFE/Shutterstock Editorial <p style="box-sizing: inherit; margin: 0px 0px 24px; padding: 0px; border: 0px; font-stretch: inherit; line-height: inherit; font-family: 'Helvetica Neue', HelveticaNeue, Helvetica, Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; font-size: 18px; vertical-align: baseline;">

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