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From cauldrons to cardigans - the lurking prejudices behind the name ‘Granny’

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/kate-burridge-130136">Kate Burridge</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/catherine-barrett-12661">Catherine Barrett</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> <blockquote> “Honestly, I can’t wait to have grandkids and spoil them — but I don’t want to be called ‘Granny’” (overheard on the No. 96 tram in Melbourne) “I love it. It’s not the word that needs to change, it’s our culture” (Deborah, proud granny) </blockquote> <h2>What’s wrong with “granny”?</h2> From its debut in the early 1600s, “granny” has been more than an affectionate term for grandma — and a cursory glance at its history tells a depressingly familiar story. First, the instability and decline of words associated with women. “Granny” joins a long list of words, particularly for older women, that that have acquired negative meanings — spinsters were originally spinners; sluts were untidy people; slags and shrews were rogues; scolds were poets; bimbos were men, and so on. Many started life referring to men, but quickly narrowed to female application — and with this sexual specification came further decline. Right from the start, grannies were also people engaged in trivial (often self-serving) chatter; in other words, grannies were gossips, tell-tales and nosy parkers. In the 1700s, more negative meanings piled on — grannies became fussy, indecisive or unenterprising persons, and in many places stupid as well. The online crowdsourced Urban Dictionary now has a flourishing of additional disparaging senses for “granny” that have yet to make it into more mainstream collections. In sport, grannies refer to those who perform poorly, or they’re a kind of dead leg injury (which leaves you “<a href="https://www.urbandictionary.com/define.php?term=Granny">hobbling around</a> like an old granny for the rest of the day”). <h2>“Don’t be a granny”!</h2> Tellingly, the negative uses of granny have never been restricted to women — one <a href="https://books.google.com.au/books/about/The_Folk_speech_of_South_Cheshire.html?id=_6ETAAAAQAAJ&redir_esc=y">19th-century dictionary</a> defines “granny” as “a simpleton: used of both sexes”. It’s another telling asymmetry in our lexicon. Terms for women are insulting when used of men (“Dad, don’t be such a granny”), but terms designating men when used of women have little or no affront. If you were to call a women a grampa or an old man, there’s really no abuse — it just seems odd. Unflattering “granny” compounds are plentiful in English: a “granny knot” is one that’s inexpertly tied, while “granny gear” is an extremely low first gear. New ones are arriving all the time: “granny weed” is low-quality marijuana that is old or dried out; “granny shot” is said of a basketballer with little skill; “granny mode” in video games is a slower speed than normal, “granny pants” (like other “granny-like” items) are naff “old lady” styles (in the fashion world, the phrase ‘not your granny’s’ describes edgy or trendy clothes — not fashion choices made or worn by grandmothers). The Oxford English Dictionary gives 29 “granny” compounds, but provides not a single compound with “grandpa”, “grampa” or “gramps”. These terms for one’s grandfather have also been remarkably stable over time. This dictionary gives a single definition: “One’s grandfather. Also used as a familiar form of address to one’s grandfather or to an elderly man”. Even Urban Dictionary, not known for its politeness, has little in the way of slangy senses for “grandpa” or “gramps” — the closest are playful entries referring to older men or grandfathers. You might compare “codger” or “geezer” — sure, they’re not exactly flattering, but they don’t pack anywhere near same punch as do “crone”, “hag”, “battle-axe”, “old bat”, “old bag” and so on. <h2>Granny goodness and greedy granny</h2> Current films, comics and games reveal another way words for women evolve. To set the scene, consider the fate of “witch”, now a slur for older women. Originally, witches could be male sorcerers, but when used of women they became something very nasty — witches were females who had dealings with the devil. Our jokey image of witches these days can’t capture the potency of this word in early times, but it has never completely shed its connotations of evil. We still retain abusive epithets like “(old) witch” and also expressions like “witches’ cauldron” to describe sinister situations. And now here’s granny in the very same cauldron. <a href="https://villains.fandom.com/wiki/Granny_Goodness_(DC)">Granny Goodness</a> is one of the most well-known evil grannies in entertainment. Known for her cruelty and manipulation, this super villain hides under a façade of grandmotherly affection. <a href="https://villains.fandom.com/wiki/Granny_(Granny)">Granny</a> is a survival video game where the main antagonist, Granny, is a hideously sadistic serial killer who locks people in her house and taunts them for days before brutally killing them. Then there’s <a href="https://dishonored.fandom.com/wiki/Vera_Moray">Granny Rags</a>, a mad, decrepit old woman whose vulnerable and destitute appearance conceals a very dark nature underneath. Of course, there are sometimes dark older male figures too, but they’re not explicitly grandfathers (for example, Emperor Palpatine in Star Wars or Dr Wily, an older, mad scientist who creates robotic menaces to achieve world domination). And they’re not in the same league as those decrepit, old, malicious women — the “witches” of pop culture. And now there’s the <a href="https://www.bigw.com.au/product/greedy-granny/p/89891">Greedy Granny</a> toy for the little ones. The aim is to steal from this grasping grandma and get away with it. <h2>Words make worlds</h2> Words are declarations of social attitudes and belief systems. Through the way we speak, the words we use and our interactions, the language reveals and reinforces psychological and social roles — status, power dynamics and relationships. Here is some context for grannies: • older women are <a href="https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0010/2437426/HILDA-SR-med-res.pdf">the lowest income earning family group</a> • 34% of single older women <a href="https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0010/2437426/HILDA-SR-med-res.pdf">live in poverty</a> • 60% of older women <a href="https://officeforwomen.sa.gov.au/womens-policy/womens-employment-and-economic-status/superannuation">leave paid work with no super</a> and women with super have <a href="https://assets.kpmg.com/content/dam/kpmg/au/pdf/2021/addressing-gender-superannuation-gap.pdf">28% less than men</a> • 60% of older women rely entirely <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Economics/Economic_security_for_women_in_retirement/Report/c09">on the old age pension</a> • 40% increase in <a href="https://www.aihw.gov.au/reports/homelessness-services/specialist-homelessness-services-annual-report/contents/older-clients">homelessness for older women</a> • older women are more likely to <a href="https://humanrights.gov.au/about/news/speeches/safety-and-security-older-women">experience workplace discrimination</a> • 23% of women aged 60 years+ have experienced <a href="https://aifs.gov.au/sites/default/files/2022-08/22-01_prevalence-of-elder-abuse.pdf">intimate partner violence</a>. <h2>Don a granny cardy</h2> Negative senses of expressions have a saliency that will dominate and eventually expel other senses. This transformation has a name: <a href="https://books.google.com.au/books/about/Forbidden_Words.html?id=b2rCLYHjDMgC&redir_esc=y">Gresham’s Law of Semantic Change</a> (“bad meanings drive out good”). So what can be done to help drag “granny” out of this semantic abyss? Many older women are giving themselves the term and doing this playfully or as a way to reclaim power (for example the <a href="https://www.pastagrannies.com/">Pasta Grannies</a> and the <a href="https://www.abc.net.au/news/2023-05-30/granny-grommets-albany-western-australia-middleton-beach/102398172">Granny Grommets</a>). Reframing expressions in this way may not neutralise them, but it can make us more aware of the lurking prejudices. And why not slip into a cardigan? September 22 marks the world’s first <a href="https://www.celebrateageing.com/cardiganpride.html">Cardigan Pride Festival</a>. Australians around the country will don cardigans in a call to combat the inequalities older women face — and to show they’ve got older women’s backs (and shoulders) covered.<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/238200/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kate-burridge-130136">Kate Burridge</a>, Professor of Linguistics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/catherine-barrett-12661">Catherine Barrett</a>, Director, Celebrate Ageing Ltd, <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/from-cauldrons-to-cardigans-the-lurking-prejudices-behind-the-name-granny-238200">original article</a>. </div>

Family & Pets

How cutting edge AI technology is helping doctors reduce waitlists

<div> Artificial intelligence is now being used by Australian specialist doctors to reduce patient wait times and experts say it could be a game changer for the health sector, where some patients are waiting months or even years for an appointment. </div> <div> Leading Australian tech company <a title="https://www.medowhealth.ai/" href="https://www.medowhealth.ai/" data-outlook-id="ad0ccae0-1f97-484e-ba83-d8d566a7608a">Medow Health</a> has developed an AI “co-pilot” technology which automates medical reports for specialist doctors while operating in the background during patient consultations, saving clinicians hours which allows them to see more patients each day. </div> <div> “This technology transforms the way medical reports are formulated and processed, helping specialists reduce their paperwork and freeing up valuable time and resources which can be better spent on patient care,” said Joel Freiberg who co-founded Medow Health with his brother after his own experience with a chronic illness coupled with watching their father who is a respiratory specialist dictate reports until 10pm from the dinner table, prompting them to come up with a more efficient way for clinicians to work. </div> <div> “The idea was to improve what really is an archaic reporting system, which saw specialists taking notes with their back to the patient during consultations or having to speak into a dictaphone to be transcribed later, instead of solely focusing on the patient in front of them,” Mr Freiberg said. </div> <div> The uptake from specialists utilising the new technology has been swift, with doctors reporting the technology is giving them back two to three hours a day, reducing burnout and allowing them to see multiple more patients in that time if they choose. </div> <div> “Instead of your doctor staring into the computer typing notes, they can really concentrate on your needs and wellbeing while the technology does the note taking in the background and creates an almost instant report that the doctor just has to review rather than formulate from scratch,” Mr Freiberg said. </div> <div> Data from the Australian Medical Association on “hidden waitlists” for a specialist outpatient appointment shows some people are languishing for years for an initial consultation - up to 800 days for an initial appointment for an Ear, Nose and Throat Surgeon, up to 898 days for an urgent appointment with a neurosurgeon, while waitlists for a gastroenterologist or ophthalmologist can be as long as five years and up to 36 months to see a paediatrician. </div> <div> Mr Freiberg said the new cutting edge technology could supercharge a reduction in waitlists and speed up the appointment process. </div> <div> “We’re not trying to replace doctors, we’re trying to help them. Manually producing medical reports is a time-consuming and complex process that requires extensive paperwork and hours of labour-intensive work,” he said. </div> <div> “By using cutting edge AI specific to each medical specialty to examine patient interactions, formulate reports, and provide valuable insights we can enable doctors to do what they do best - focus on patient care,” Mr Freiberg said. </div> <div> Chris O’Brien Life House Chief Executive and medical oncologist Professor Michael Boyer who is on the Medow Health Clinical Advisory Council agreed the technology will improve patient care and help reduce waiting lists. </div> <div> "Any piece of technology that allows doctors to focus on the patient, helps deliver better care,” Prof Boyer said. </div> <div> "This technology helps the health professional to really turn their attention to the patient and what matters, instead of worrying about what notes they need and what letters they need to write. It allows them to focus on what is important. </div> <div> "There's no doubt this technology saves time and while it might only allow a single doctor to see an extra one of two patients a day, if you multiply that across the health system then it makes a big difference,” Prof Boyer said. </div> <div> Engagement with Medow Health is taking off in Australia, with the company reporting growth of more than 50 percent month on month across 15 different specialties including Cardiology, Gastroenterology, ENT, Geriatric, Orthopaedic Surgery, Paediatric, Neurology, General Surgery and Breast Surgeons, with some of Australia’s leading specialist doctors among the investors and Medtech Entrepreneurs to invest in its recent Seed round. </div> <div> About Medow Health AI </div> <div> Medow Health AI is a pioneering Australian based healthcare technology company dedicated to revolutionising the medical industry through the power of artificial intelligence to streamline processes, improve patient care, and enhance overall efficiency in healthcare settings. </div> <div> The company was founded by Joel Freiberg and soon after his brother Josh and former CTO and colleague Andrew joined as co-founders using their combined 30 years experience in technology and software to help build the business into the leading Specialist AI platform it is today. </div> <div> Joel lives with Crohn’s disease and has experienced long waits to see a specialist. The pair recognised there was a need for change growing up as they watched their father, a respiratory physician spend endless hours doing admin after work. </div> <div> The company has just completed a $1M funding round in the first half of 2024, grown the team to 10 full time employees and signed a partnership with Magentus the owner of leading specialist electronic medical record systems Genie & Gentu (who Medow Health integrates with). Image credits: Shutterstock </div>

Caring

Ozempic, Wegovy, Rybelsus: Are we losing sight of overall health? Here’s what the science says

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters. The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>. Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized. As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments. <h2>The best of both worlds</h2> GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight. The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction. This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>. <h2>A new era</h2> GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger. These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope. Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions. Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support. <h2>Treating the effects but not the causes</h2> To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again. In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta). Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise. <h2>Prescribe and treat</h2> A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it. This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance. This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic. <h2>What lessons can we learn?</h2> The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment. We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<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/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</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/ozempic-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>. </div>

Body

Jelena Dokic's powerful message on body image

Jelena Dokic has shared a powerful message about body image, after years of online trolls commenting on her weight. The tennis great took to Instagram to share before and after photos of her from nine months ago with the caption: "NOW THE SAME PERSON REGARDLESS OF MY SIZE". "Whether 30 kilos more on the left 10 months ago or now. Proud of myself in exactly the same way," she said. "Because my size and number on the scale doesn't define me. "My kindness, hard work, humility, loyalty, good heart, resilience, strength in face adversity and fighting spirit does. And that's what really matters." "Nobody at your funeral will ever talk about your size," Dokic continued. "They will talk about who you were as a person. So make sure they can say what an amazing and kind person you were. And that's what it's about. Legacy of kindness and being a good person. "And if you do it at a size 20 or a size 2, it really doesn't matter. But don't ever judge anyone and don't ever base your opinion on others based on their size. "Because then you are just not a good person and it's not kind." She then urged her followers to be kind before saying that she is not ashamed of who she was "because it doesn't matter what size I am as long as I am a good person." She continued saying that no matter what size she is "nobody will shame me into feeling bad about myself and who I am especially nobody that sits behind a keyboard or phone and takes time out of their life to write something negative to someone else especially someone that you don't even know." "And the same goes if you see me or anyone else in person and you judge us and base your opinion of us based on our size," she said. "That's just terrible. And what you think of me and others based on size says everything about you. Full stop." Dokic has been a vocal advocate for body positivity, after years of online trolls commenting on her changing body size. Just last month she opened up about her <a href="https://www.oversixty.com.au/health/body/jelena-dokic-s-candid-admission-on-weight-loss" target="_blank" rel="noopener">body transformation </a>and struggles with depression and an eating disorder. Images: Instagram

Body

What is ‘health at every size’ lifestyle counselling? How does it compare with weight-focused treatments?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Health at every size (or HAES) is a lifestyle counselling approach that promotes mindful eating and lifestyle behaviours to pursue health and wellness, without focusing on weight loss. Weight loss is seen as a <a href="https://www1.racgp.org.au/newsgp/clinical/understanding-the-%E2%80%98health-at-every-size%E2%80%99-paradigm">beneficial side effect</a>, rather than a goal. The <a href="https://www.sizeinclusivehealth.org.au/What-is-HAES">Association for Size Diversity and Health</a> first developed the approach in 2003 and revised it in 2013 and 2024. Its current <a href="https://asdah.org/haes/">core principles</a> promote: <ul> <li>minimising weight discrimination</li> <li>encouraging body acceptance</li> <li>intuitive eating</li> <li>enjoyable physical activities.</li> </ul> It also aims to address <a href="https://theobesitycollective.org.au/our-work/#weight-stigma-awareness">stigma and discrimination</a> that people in larger bodies may experience when seeking medical care. Internationally, a <a href="https://asdah.org/listing/">range of health professionals</a> have incorporated the HAES approach into their treatment and services. Some organisations, such as <a href="https://obesitycanada.ca/guidelines/nutrition/">Obesity Canada</a>, have included HAES in their <a href="https://pubmed.ncbi.nlm.nih.gov/32753461/">guidelines for obesity treatment</a>. <h2>How does it compare with weight-focused treatments?</h2> We conducted a <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">systematic review and meta-analysis</a> of all the research studies published until November 2022 that had used HAES-based programs. Across 19 scientific papers, we compared the outcomes of people living in larger bodies who used HAES-based programs <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">with</a>: <ul> <li>conventional weight loss programs (six studies)</li> <li>people on waiting lists receiving no treatment at all (six studies)</li> <li>groups where people received weekly social support in groups (four studies).</li> </ul> We evaluated the program’s impact on appetite, weight, physical health measurements including cholesterol and blood pressure, and also wellbeing and mental health. Our analysis found HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches, meaning people had less subjective perceptions of hunger or eating in response to emotions. However, compared to control interventions, HAES did not show superior results for improving any other physical health outcome – weight loss, blood cholesterol levels, blood pressure – or wellbeing or mental health outcomes. Given the results to date, the choice about whether to use a HAES-based approach (or not) will depend on each person’s preference, needs and goals. <h2>Don’t get your health advice from influencers</h2> While HAES has been used in clinical practice for many years, some United States and Canadian anti-diet practitioner’s motives have been scrutinised because of their links <a href="https://www.washingtonpost.com/wellness/2024/04/03/diet-culture-nutrition-influencers-general-mills-processed-food/">with processed food companies</a>. The spotlight was put on the <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">very small number</a> of dietitian “influencers” (roughly 20 from a membership of more than 80,000 dietitians in the US and Canada) promoting “eat what you feel like” and discouraging people from making weight loss attempts, under the banner of HAES. They failed to mention they were being paid to promote products sold by food, beverage or supplement companies. US <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">author and dietitian Carrie Dennet</a> urges people to not look to influencers for health advice. Instead, seek non-judgemental health care from your GP. <h2>What might treatment look like?</h2> When improving your health is a treatment goal, a good place to start your journey is to have a health check-up with your doctor, as well as to assess your relationship with food. A healthy relationship with food means being able to eat appropriate amounts and variety of foods to meet your nutritional, health and wellbeing goals. This might include strategies such as: <ul> <li>keeping a <a href="https://theconversation.com/what-does-having-a-good-relationship-with-food-mean-4-ways-to-know-if-youve-got-one-202622">food mood diary</a></li> <li>reflecting on factors that influence your eating</li> <li>practising <a href="https://theconversation.com/thinking-youre-on-a-diet-is-half-the-problem-heres-how-to-be-a-mindful-eater-99207">mindful eating</a></li> <li>learning about nutrient needs</li> <li>focusing on food enjoyment and the pleasure that comes from preparing, sharing and eating with others.</li> </ul> If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist. <h2>What if your goal is weight loss?</h2> When it comes to medical nutrition therapy to treat weight-related health conditions, such as high blood pressure and type 2 diabetes, the approach will depend on individual needs and expectations. Broadly, there are three graded energy intake target levels: <ol> <li> a reduced-energy diet where the goal is to lower energy intake by 2,000 to 4,000 kilojoules (kJ) per day by identifying food substitutions, like swapping soft drinks and other sugar-sweetened drinks for zero or diet versions or water. </li> <li> a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">low-energy diet</a>, which uses an energy intake goal in the range of 4,200-5,000 kJ, up to 7,000 kJ per day depending on an individual’s energy expenditure. </li> <li> the most restricted regime is a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a>, has an energy intake target less than 2,500 kJ/day, achieved using formulated meal replacement products. </li> </ol> The aim of a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a> is to facilitate rapid weight loss when this is essential to improve health acutely such as poorly controlled type 2 diabetes. Such a diet should be used under supervision by your doctor and dietitian. When selecting an initial <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">strategy</a>, seek a balance between energy intake goals and your ability to stick to it. Your approach may change over time as your health needs change. If you need personalised nutrition advice, ask for a referral to an accredited practising dietitian. The <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">register of service providers though Dietitians Australia</a> allows you to view their expertise and location. Regardless of whether your practitioner uses a HAES approach or not, your health providers should always treat you with respect and address your personal health and wellbeing.<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/234376/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, Postdoctoral Researcher, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, Post Doctorate Fellow, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, Dietitian and early career researcher, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</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-is-health-at-every-size-lifestyle-counselling-how-does-it-compare-with-weight-focused-treatments-234376">original article</a>. </div>

Body

Final message from doomed Titan sub revealed

It was supposed to be the trip of a lifetime, a chance to explore the Atlantic depths and visit the wreck of the Titanic. But last year, a dive by OceanGate's Titan submersible went horribly wrong when the vessel imploded as it neared the sea floor, killing all five people onboard. Now, the US Coast Guard has revealed the final words communicated by the crew, on the first day of what will be a two week hearing examining why the disaster occured. A visual animation of the Titan journey before it imploded was revealed, and one image showed the final words from the crew to those on the support ship Polar Prince. "All good here," they said. The audio became more spotty as the vessel descended, with the Polar Prince asking if they could see the Titanic on their on-board display. The Titan was reportedly still able to send one message an hour-and-a-half into it's journey saying they “dropped two wts” before they were pinged for a final time at a depth of 3,346m. There was no communication between the Titan and the Polar Prince that indicated any trouble or emergency on board the sub. It was only when there was no response to their repeated attempts of communication when they realised that the worst had happened. US authorities said a “catastrophic implosion” occurred, killing all on board instantly. On board the Titan were British explorer Hamish Harding, British-Pakistani businessman Shahzada Dawood and his son Suleman, OceanGate’s CEO Stockton Rush and French deep-sea explorer Paul-Henri Nargeolet. The US Coast Guard also revealed the first image of the Titan sub after it imploded, which showed the vessel's tail cone eerily resting on the ocean floor. Four days after the Titan vanished, the vessel's wreckage was found about 500 metres from the bow of the Titanic, and a few months later, divers found human remains among debris. It was also revealed that OceanGate was plagued with equipment problems years before the disaster, and they even fired an engineering director who would not approve a deep sea expedition, according to a testimony at the hearing. Investigators said in 2018 the vessel was struck by lightning which left “significant blow to the structure” and caused it to fail a test by a wide margin. Less than two weeks before the ill-fated voyage, the Titan was tested and found "partially sunk". According to the testimony, Rush, the OceanGate CEO onboard the sub, had "no desire" to gain certification or meet regulatory standards for the vessel. Two dozen witnesses will testify before the board over the next two weeks. Images: OceanGate Expeditions

Travel Trouble

"Enough is enough": Pauline Hanson calls for ban on Welcome to Country

Pauline Hanson has called for a ban on Welcome to Country ceremonies at events, after an unusual version of the acknowledgement was performed at the AFL semi-final on Saturday. Aboriginal Elder Brendan Kerin performed the unique Welcome at Sydney’s Engie Stadium on Saturday night, sparking widespread debate as Kerin tried to explain that the Welcome to Country ceremony is intended to welcome all visitors to the land they have gathered on, rather than welcoming people to Australia itself. He also added other seemingly divisive aspects to his speech, stating the ceremony was not “invented to cater for white people” and Aboriginal people have been conducting the ceremony “for 250,000 years-plus”. After the controversial Welcome, One Nation senator Pauline Hanson took to X to call the ceremonies “racially divisive” and declaring her belief Australians are “sick and tired of them”. “As I have said in the past, these Welcome to Country and Acknowledgement of Country performances are one of the most racially divisive features of modern discourse in Australia,” she began. “Australians are sick and tired of them. They are sick of being told Australia is not their country, which is what these things effectively do. Welcomes and acknowledgements deny the citizenship and sovereignty held equally by all Australians and they need to stop." Hanson concluded her post by stating: “Australians should not be forced to participate in or be subjected to these divisive performances. Enough is enough.” While many of Hanson's followers were quick to agree with her comments, others said that they have often observed the Welcome to Country be respected and applauded, and said Elder Kerin's version of the acknowledgment was "informative" and "really respectful". One person wrote, “This welcome to country will have annoyed all of the right people.” <p style="box-sizing: inherit; border: 0px; font-stretch: inherit; line-height: inherit; 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; margin: 0px 0px 24px; padding: 0px; vertical-align: baseline;">Image credits: Getty Images

Legal

"Never been seen before": Fergie reveals new details from 9/11 near miss

Sarah Ferguson, affectionately known as Fergie, has taken to Instagram overnight to share new details of her 9/11 near miss. 24 years on, the Duchess of York, who has previously revealed that she was meant to be in the World Trade Centre's North Tower when the plane struck the building, has shared more details of the day. Fergie recalled how her friend, billionaire businessman Howard Lutnick, gave her an office on the 101st floor of the World Trade Centre at the time, for her charity Chances for Children. The charity's logo had a mascot called Little Red, which was eventually made into a doll for a child named PJ who survived the 1995 Oklahoma City Bombings. On the day of the 9/11 attacks Fergie was due to attend a meeting in the office, but was running late because of an earlier engagement, so she was still on route to the building when the terrorists struck. "I was driving in the car and I was late for work... and Little Red was found in the rubble," she said in the video. Fergie opened a box to reveal her own Little Red doll that survived the attacks. While she has previously talked about the doll, this is the first time she revealed what it looked like. "A fireman picked her up, carried her out, like the fireman that picked up PJ all those years ago in the Oklahoma City Bombing," she continued. "And CNN filmed it and said, 'Look, a child's doll.' And Larry King said, 'That's no child's doll. That's Fergie's Little Red' and she stands for children's rights all over the world and she's a sign of hope for children. "What no one has ever seen before and I would like to share this with you is the actual doll that survived in 9/11. "So here, I have it at home. Normally I talk about Little Red and here is the actual doll that survived. "You can see the dust from the building — that's never been seen before. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C_xjdvMKSCn/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C_xjdvMKSCn/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Sarah Ferguson (Fergie) (@sarahferguson15)</a> </div> </blockquote> "And I hope Little Red will be talked about all over the world because she's just a very strong, stoic little person." She also shared that on the day, Little Red "sat on her desk overlooking Manhattan on that fateful day when the towers came down." "She came down through the rubble and landed fully intact," she wrote. "Little Red was carried out of the rubble in the fireman's hat exactly as PJ, a child burn victim, was carried years earlier in the Oklahoma City bombing, where the doll was first inspired to bring hope during difficult times and raise money for aid. "Little Red now sits in the 9/11 memorial museum and serves as a reminder of hope within the darkness. We will #neverforget," she continued before encouraging her followers to donate to the Cantor Relief Fund, to support families affected by disaster. Images: Instagram

Caring

Aussies top global list for biggest gambling losses

A new report has revealed that Australians are the biggest gambling losers in the world, with the average Australian adult gambling away $1635 per year according to the Grattan Institute think tank. That is more than most households pay for power and exceeds the average spend in similar countries like the US and New Zealand. Collectively, Australians lost $24 billion to gambling in 2020-21, with half of that amount lost through poker machines. The rest was lost on sports or race betting, in casinos, and on lotteries and Keno. The report also claims that there are more pokies than post boxes and public toilets across Australia, bringing light to the "lax approach" that has let the industry "run wild". "Gambling products are designed to be addictive, and the consequences can be catastrophic: job loss, bankruptcy, relationship breakdown, family violence, even suicide," the report's authors wrote. People in the Northern Territory and NSW lost the most amount of money, with the two states having the highest concentration of polies in their jurisdiction. The report recommended the federal government ban all gambling advertisements and urged them to cut the number of pokies in each state over time. They also suggested a mandatory pre-commitment system for online gambling and pokies, which would put a limit on daily losses. There are many different ways to get help and information about gambling. Call the National Gambling Helpline on 1800 858 858; use <a href="https://www.gamblinghelponline.org.au/tools-resources/chat-counselling" target="_blank" rel="noopener">online counselling</a>. Images: SNEHIT PHOTO / Shutterstock.com

Money & Banking

Six old-school strategies to cope with disruptive airport tech

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christopher-schaberg-1451119">Christopher Schaberg</a>, <a href="https://theconversation.com/institutions/arts-and-sciences-at-washington-university-in-st-louis-5659">Arts & Sciences at Washington University in St. Louis</a> Ten years ago I wrote a book titled “<a href="https://www.bloomsbury.com/us/end-of-airports-9781501305498/">The End of Airports</a>” about how digital technologies and commercial air travel were on a collision course. Earlier this summer, I was proved right. In July, <a href="https://theconversation.com/massive-it-outage-spotlights-major-vulnerabilities-in-the-global-information-ecosystem-235155">a cybersecurity software outage</a> snarled airports around the world. Airlines took weeks to get back to normal. Delta was particularly <a href="https://www.cnn.com/2024/08/07/business/delta-passengers-sue-crowdstrike-meltdown/index.html">hard hit</a>, with some <a href="https://apnews.com/article/crowdstrike-technology-outage-fallout-delta-c287aaded657a1092724b222435c3d16">7,000 flights canceled</a> and delays lasting well into August. As an expert on air travel who contemplates flight from <a href="https://www.bloomsbury.com/us/textual-life-of-airports-9781441189684/">a humanistic and cultural studies perspective</a>, I think the new technologies woven into air-travel management are a double-edged sword. While they enhance elements of safety and efficiency, they can also make the entire system <a href="https://www.theatlantic.com/ideas/archive/2024/07/crowdstrike-failure-warning-solutions/679174/">more fragile and vulnerable</a>. <h2>The downsides of digital technology</h2> To be fair, aviation depends on technology. Humans would never have gotten off the ground without it. But new technology can create new problems even as it solves old ones. The latest digital tech offers necessarily imperfect ways to manage a vast, intricate network of places, machines and people. And as the computer systems get more fine-tuned and integrated, they also can result in catastrophic failures, precisely because of the connective nature of tech. And let’s not even talk about <a href="https://theconversation.com/how-hot-weather-and-climate-change-affect-airline-flights-80795">the weather</a>. The past summer’s <a href="https://www.cbsnews.com/news/crowdstrike-outage-bug-bad-data-falcon-update-microsoft/">software glitch event</a> won’t be the last time some unforeseen variable brings air travel to a halt. Fortunately, travelers don’t have to depend solely on airport technology systems or our own smart devices for seamless travel. Here are six analog strategies that travelers can use to cope with air travel debacles: <h2>Old-school flying suggestions</h2> <ol> <li> Pack smart for potential delays. Make sure you have a carry-on that includes whatever you’d need for an unplanned overnight stay at a hotel – or worse, on an airport floor. Take <a href="https://www.tsa.gov/travel/security-screening/liquids-rule">Transportation Security Administration-approved toiletries</a> and enough clothes so you can deal with a layover somewhere you didn’t expect. And wear comfortable shoes. </li> <li> Be kind to airline employees and airport staff, who can’t control delays or cancellations. Remember that no one airline employee can automatically fix the problem when a software malfunction happens or a freak storm grounds planes. But if you are kind and patient, an airline employee may just comp you a hotel room or give you a more generous rebooking arrangement. Also: It’s just the humane thing to do. </li> <li> Purchase your tickets directly from airlines. It’s not worth saving $20 or $50 on a ticket deal from a third-party vendor. When delays and cancellations happen, if you have such a ticket, the airline will have less interest in aiding you. Buying tickets directly from the airline will help you get back in the air quicker. </li> <li> Have a plan B. In the event that your connecting flight is canceled mid-trip, have you contacted someone you know in that city? Or have you researched hotels easily accessible from the airport? What would it take to get a comfortable spot for a night? A little homework can go a long way if you end up stranded. </li> <li> Bring healthy snacks and other supplies. It’s smart to pack vitamins, zinc, hydration packets, a reusable water bottle, medications, hand sanitizer, or whatever helps bolster your health during a travel stint. If you get waylaid for a few hours or overnight, preplanning some self-care items can help you avoid contagious illnesses and general fatigue. </li> <li> Enjoy the airport. It’s a fascinating place where so many people converge. If you’re <a href="https://stuckattheairport.com">stuck at the airport</a> for several hours, use that time to find interesting things in the concourses. You might discover art shows, a great bookstore, a yoga room or a movie theater. It can be tempting to just stand around the gate area and seethe. But it’s more fun to move around the airport and explore what’s there.<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/237372/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ol> <a href="https://theconversation.com/profiles/christopher-schaberg-1451119">Christopher Schaberg</a>, Director of Public Scholarship, <a href="https://theconversation.com/institutions/arts-and-sciences-at-washington-university-in-st-louis-5659">Arts & Sciences at Washington University in St. Louis</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/if-new-technologies-snarl-your-airline-experience-here-are-old-school-strategies-to-cope-237372">original article</a>. </div>

Travel Trouble

Readers response: What have you had to cut out of your life to cope with cost of living pressures?

As the cost of living continues to rise, many people have had to cut things out of their day to day spending to cope with the financial struggles. We asked our readers what they have had to cut out of their budgets to cope with cost of living pressures, and the response was overwhelming. Here's what they said. Wendy Oliver - We don’t eat out often at all… I spend too much in the supermarket. Christine Brooks - I've cut out steak, good nutritional foods, TV streaming, entertainment, haircuts, new clothes, pets, pool cleaning, and more. Kerrie Dare - I limit steak meals. I've stopped my haircuts to every 4 months. Internet is getting chopped. I can only afford exercise classes twice a week. I don't eat as much fruit as I used too. I only buy groceries when on special. One bottle of wine per fortnight. One slice of sourdough in the morning, which means the loaf lasts a week. I turn on my washing machine around every 10 days & I have quick showers. No eating out or take away. Maybe one cup of coffee per week with a friend. Movies once every 6 weeks as a social group. No concerts or clubs. I drive only locally, so a tank of petrol lasts 1 month. No weekends away. Jane Dawes - No coffees, beauty treatments, hairdresser, eating out, takeouts etc. The trouble is not affording to spend on certain items has a flow on effect for businesses. Everyone is suffering. Lois E. Fisk - Going out to eat or see movies in the cinema or live plays or new clothes. I shop at the least expensive grocery stores as much as possible, and good cuts of meat rarely happen. Janice Stenning - Don't go to the hairdressers as often and don't buy as many clothes. Debra Dugar - Thinking about dropping my extras cover of my insurance. By the time I pay for it, I can't afford the gap you have to pay. Robyn Lee - Living in my own house. I now live with my family. Rhondda Hughes - Well, petrol is expensive so I have to really think if I can afford to visit anyone. I can’t eat meat much and even vegetables can be expensive. We have three chickens so they give us eggs but good quality eggs and healthy chickens require money too. Fortunately I live in Perth so, in comparison to other states, it isn’t as cold however the cost of heating is a significant consideration and therefore I just tend to go to bed. <div style="font-family: inherit;">Felicity Jill Murphy - Stopped going out to shopping centres. That's where I spend money unnecessarily.</div> <div style="font-family: inherit;">Image credits: Shutterstock </div> <div style="font-family: inherit;"> </div> <div class="x6s0dn4 x3nfvp2" style="font-family: inherit; align-items: center; display: inline-flex; min-width: 584px;"> <ul class="html-ul xe8uvvx xdj266r x4uap5 x18d9i69 xkhd6sd x1n0m28w x78zum5 x1wfe3co xat24cr xsgj6o6 x1o1nzlu xyqdw3p" style="list-style: none; margin: 0px -8px 0px 4px; padding: 3px 0px 0px; display: flex; min-height: 15px; line-height: 12px; caret-color: #1c1e21; color: #1c1e21; font-family: system-ui, -apple-system, BlinkMacSystemFont, '.SFNSText-Regular', sans-serif; font-size: 12.000001px;" aria-hidden="false"> <li class="html-li xdj266r xat24cr xexx8yu x4uap5 x18d9i69 xkhd6sd x1rg5ohu x1emribx x1i64zmx" style="display: inline-block; padding: 0px; margin: 0px 8px;"> </li> </ul> </div>

Money & Banking

Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<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/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross 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/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

Body

New support system helps older Aussies who have fallen victim to scams

A new support system has been set up to help vulnerable older Australians who have fallen victim to dangerous scams. With millions of Aussies targeted every year, many of these targets are elderly with 30 percent of victims hesitant to come forward because they are too embarrassed to admit what's happened to them. One such victim, 86-year-old Mary, said she was humiliated after falling for a scam saying she is old enough to know better. "It serves me right, I shouldn't have been so trusting," she said. "You blame yourself and you don't really want to tell people how stupid you are, so you think, 'Well, I'll just have to bear it'." Mary was scammed when she received a call from a man pretending to be a technician, saying he needed access to her computer to resolve a problem in her area. Step by step, the "technician" got Mary to log-in and give him complete access to her entire online identification, completely cleaning her out of $20,000 in savings. This is why <a title="ID Support NSW" href="https://www.nsw.gov.au/id-support-nsw" target="_blank" rel="noopener">ID Support NSW</a> is now offering a free service to help older Australians be able to protect themselves online and spot suspicious activity. "The most common scams are romance and impersonation scams, where people pretend to be someone they're not," ID Support NSW's Jacqueline Wilson told <a href="https://9now.nine.com.au/today/scam-awareness-week-id-support-nsw-offering-free-help-for-older-australians/20d3f8d6-fe32-4b1d-af32-294e47f4412d" target="_blank" rel="noopener">Today</a>. "Most start with a text or call and once someone responds or engages, they usually end up losing money." Jacqueline said the best thing you could do if you even suspect a scammer was to just hang up the phone, saying, "You don't need to indulge them, you don't need to be polite, you don't need to engage in a long conversation." Image credits: Today

Legal

Grandmother's body found 800km from home

Police have revealed the body of a Queensland grandmother has been found 800km from home in bushland near a main tourist area. Wendy Hansen, 63, was last seen at an ATM in her hometown Monto - about 170km west of Bundaberg, Queensland - on February 29 this year. She was reported missing when she didn't return home, with police finding CCTV footage of her driving 400km south on Queensland's main highway on February 29. Queensland Police continued their public push for information in the months that followed, but on Thursday, NSW police revealed that they found her body half buried in bushland near Jordan Esplanade in Coffs Harbour on June 18. NSW homicide detectives are now looking for her vehicle, a silver 2007 two-door Mitsubishi Pajero with Queensland registration plates 645TCZ. In a statement on Thursday, NSW detectives appealed to the public for help with finding her car. "As investigations continue detectives are appealing to the public for any information, CCTV or dashcam footage that may assist the investigation to contact NSW Police or Crime Stoppers on 1800 333 000," they said. "Detectives are specifically interested in the location of Wendy’s car which has not yet been located and are urging anyone with dashcam vision of the car to contact police immediately." Images: NSW Police

Caring

New device could help GPs detect Alzheimer's in minutes

GPs could soon be able to screen their patients for Alzheimer's Disease in a matter of minutes, using a handheld device the size of a credit card. The first-of-a-kind finger-prick blood test was developed by engineers at Melbourne's Monash University and it can detect the hallmark protein biomarkers of early Alzheimer's Disease within minutes. This could become an important tool for doctors in diagnosing patients before the symptoms progress. In Australia alone there are around 420,000 people living with dementia, with that number set to double by 2054. Associate Professor Sudha Mokkapati, from Monash Materials Science and Engineering, helped lead the development of the testing device. "Detecting very early disease in large populations could dramatically change the trajectory of this burdening disease for many patients, and shave millions off associated healthcare costs," Mokkapati said. "We've completed testing that shows the technology is highly advanced by design and capable of detecting ultra-low levels of several disease biomarkers in blood." The device also has the potential to remove the need for laboratory-based pathology tests, making diagnoses faster and cheaper. The university is currently seeking funding to complete the next stage - clinical validation, which will help bring the device one step closer to reality. "Most patients with neurodegenerative disease are typically diagnosed at advanced stages. Sadly, treatments targeting late-onset disease provide limited therapeutic benefit," Associate Professor Matthew Pase, at Monash's School of Psychological Sciences, said. "Earlier screening could change the outlook for many patients diagnosed with cognitive impairment, increasing the chance of halting or slowing symptom development and the rapid progression of the disease." Image: Monash University/ Nine

Caring

Jelena Dokic's candid admission on weight loss

Jelena Dokic has opened up on her 20kg weight loss and her previous struggles with depression and an eating disorder. The former tennis player took to Instagram on Sunday to share before and after shots from her weight loss, taken seven years apart, and her past battles with self-worth. She explained to her followers that her current weight loss was a result of her prioritising her mental health. "This is not about body size but feeling that I am not worthy enough to even live!!! On the left 7 years ago," she said. "Even though I have a bit less weight now on the right, this is not about weight. Because even if I was half the size on the left, I would still feel the same. And how is that? Not worthy enough to even live!!" She explained that in the first photo she was afraid to leave the house and was "broken" from her battle with depression and PTSD. "My face, body language and even clothing on the left says it all. This is how low my self worth was. I was afraid to get out of the house," she shared. "I was not able to look people in the eye, I just wanted to wear black or dark grey and cover myself up. I even remember wishing to somehow fully cover my face and head and could I possibly not even need to go out of the house for the rest of my life." "This was anxiety, depression, debilitating effect of trauma that made me feel I was worthless and not even worthy of living. "This was the result of being put down my whole life especially by people close to me." "The person on the left was broken, shattered, battling anxiety, depression, PTSD, BPD and an eating disorder. At times I hoped I wouldn't wake up so that I don't have to feel like this anymore," she continued. She then explained that she wasn't asking for pity as she didn't want to victimise herself. "I wanted to survive and thrive and I got there." She then shared a few motivating words on courage and resilience, saying: "Fight hard. Every single day, don't give up and no matter how scary it is get outside of your comfort zone. It will get easier and more comfortable to do so." "Keep going after it even when it's scary. Be brave and never give up. The way to start feeling good in your own skin and life is to be who you really are and embrace and love yourself." "Don't be afraid of mistakes and failures, they make you learn and as long as you get back up, that's all that matters." "Don't you ever give up on yourself and your goals. Don't ever be defined by someone else's judgement and comments." She encouraged her followers to stay true to themselves and remember their self-worth. "Be yourself. Being authentic, real and vulnerable is the way to being happy and thriving. You are worthy and never allow anyone to tell you otherwise." Images: Instagram

Body

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

Kyle Sandilands' warning about new "right to disconnect" laws

Kyle Sandilands has warned Aussies against "abusing the system" put in place by new 'right to disconnect' laws. As of August 26th, employees of large companies can legally refuse to respond to "unreasonable" after-hours calls from their employer. Discussing the new laws on KIIS FM on Monday morning, Sandilands warned workers about celebrating the laws too soon, as they could come with a catch depending on the leniency of employers. "It doesn't mean they won't railroad you out behind the scenes," the radio host said. Kyle then argued that while it would be illegal under the new legislation for bosses to punish workers for not responding after hours, some devious managers could find ways around the laws. "Don't think for a second: 'Screw that real estate agent boss'," Kyle said. "Because eventually they will find a way to get rid of you to work around the boundaries." Sandilands then urged Aussies not to "abuse the system", saying, "Everyone you can say, 'oh by law, I don't have to respond to that' and they will then go, 'no worries'." "And then they get you for every little tiny infringement. You will go if they want you to go, one way or another. So, don't abuse the system." Jackie O then chimed in on the debate, saying the laws were a direct response to a modern working problem. "I feel like that might happen," Jackie said. "I think it's sometimes because the thing is that work hours now are infinity. When you didn't have email and mobile phones, you never got bothered outside of work hours." Kyle replied, "And nothing got done. It was the late 1970s. The world spun very slowly back then." Image credits: KIIS FM

Legal

I’ve recovered from a cold but I still have a hoarse voice. What should I do?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Cold, flu, COVID and <a href="https://theconversation.com/rsv-is-everywhere-right-now-what-parents-need-to-know-about-respiratory-syncytial-virus-208855">RSV</a> have been <a href="https://www.abc.net.au/news/2024-06-21/flu-whooping-cough-rsv-cases-up-as-covid-cases-unkown/104002964">circulating across Australia this winter</a>. Many of us have caught and recovered from <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">one of these</a> common upper respiratory tract infections. But for some people their impact is ongoing. Even if your throat isn’t <a href="https://theconversation.com/sore-throats-suck-do-throat-lozenges-help-at-all-184454">sore</a> anymore, your voice may still be hoarse or croaky. So what happens to the voice when we get a virus? And what happens after? Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved. <h2>Why does my voice get croaky during a cold?</h2> A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear. The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds. When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse. <figure class="align-center "><img src="https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?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/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=366&fit=crop&dpr=1 600w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=366&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=366&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=460&fit=crop&dpr=1 754w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=460&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=460&fit=crop&dpr=3 2262w" alt="Two drawn circles comparing normal vocal cords with inflamed, red vocal cords." /><figcaption>Viruses such as the common cold can inflame the vocal cords. <a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458117">Pepermpron/Shutterstock</a></figcaption></figure> Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky. In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether. Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (<a href="https://www.health.harvard.edu/staying-healthy/treatments-for-post-nasal-drip">post-nasal drip</a>). But coughing slams the vocal cords together with force. Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs. Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality. <figure class="align-center "><img src="https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?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/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=376&fit=crop&dpr=1 600w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=376&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=376&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=473&fit=crop&dpr=1 754w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=473&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=473&fit=crop&dpr=3 2262w" alt="Diagram compares healthy vocal cords with cords that have nodules, two small bumps." /><figcaption>Coughing and exertion can cause inflamed vocal cords to thicken and develop nodules. <a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458126">Pepermpron/Shutterstock</a></figcaption></figure> <h2>How can you care for your voice during infection?</h2> People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478078/">more at risk</a> of forcing their voice before it’s ready. The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold. Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest. Drink plenty of water, avoid alcohol and exposure to cigarette smoke. <a href="https://www.healthdirect.gov.au/laryngitis#:%7E:text=You%20can%20help%20your%20voice%20recover%20by%3A%201,avoid%20nasal%20decongestants%20%28these%20make%20your%20throat%20drier%29">Inhaling steam</a> by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords. Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199704001730">strains the muscles</a>. Instead, consider using “<a href="https://www.instagram.com/reel/C0d-oNIMM1y/">confidential voice</a>”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by. During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally. <h2>What should you do if your voice is still hoarse after recovery?</h2> If your voice hasn’t returned to normal after <a href="https://www.healthdirect.gov.au/laryngitis">two to three weeks</a>, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist. If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be <a href="https://britishvoiceassociation.org.uk/voicecare_vocal-nodules.htm">treated</a> with voice therapy and don’t require surgery. You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold. In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, <a href="https://www.youtube.com/watch?v=fwNPp-RS4IY">lip trills</a> (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.<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/236398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> 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/ive-recovered-from-a-cold-but-i-still-have-a-hoarse-voice-what-should-i-do-236398">original article</a>. </div>

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Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care. So what is knee osteoarthritis and what are the best ways to manage it? <h2>More than 2 million Australians have osteoarthritis</h2> Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year. Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles. Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs. <h2>Is it caused by ‘wear and tear’?</h2> Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”. <a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions. Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain. This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis. <h2>What’s the best way to manage osteoarthritis?</h2> Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines. Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms. Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management. Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future. Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you. Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time. Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>. Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs. Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits. <h2>What about surgery?</h2> People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement. Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain. However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis. Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis. Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management. The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments. <h2>I have knee osteoarthritis. What should I do?</h2> The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include: <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<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/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <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/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>. </div>

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I’ve recovered from a cold but I still have a hoarse voice. What should I do?

Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

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