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How do I know when it’s time to replace my running shoes?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/john-arnold-178470">John Arnold</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joel-fuller-2210202">Joel Fuller</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Any runner will tell you there’s nothing better than slipping on a brand new pair of shoes. But how regularly should runners fork out hundreds of dollars on their next pair? Conventional wisdom tells us the average lifespan of a running shoe is around 500 to 800 kilometres. But where did this advice come from, and is it based on science? Some evidence comes from <a href="https://doi.org/10.1177/0363546585013004">impact testing</a> with machines designed to simulate the shoe repeatedly contacting the ground during running. Other evidence comes from <a href="https://doi.org/10.1080/19424280.2010.519348">monitoring runners who have used shoes in the real world</a> for long periods. This research is often focused on shoe materials and structure. But we think more compelling markers for the runner are shoe comfort, performance benefit and injury risk. Rather than seeking a “one-size-fits-all” answer to how many kilometres your shoes should be limited to, it’s also better to consider individual signs based on your shoe type and its purpose. <h2>The three signs to watch for</h2> Runners tend to replace their shoes for three main reasons: <ol> <li>they believe their performance is being negatively impacted</li> <li>their shoes are leading to some bodily discomfort which may cause (or has already caused) an injury</li> <li>the shoes are no longer comfortable or “feel” as good as they used to.</li> </ol> So what does the evidence say about these factors? <h2>Performance</h2> Some shoe material properties do contribute to enhanced running efficiency. Degrading these materials by racking up the kilometres may hinder peak performance on race day. This is most clearly seen in carbon fibre plate shoes used by modern elite runners to achieve <a href="https://doi.org/10.1007/s40279-020-01420-7">rapid road race times</a>. The design features <a href="https://doi.org/10.1007/s40279-018-1024-z">thought to drive this</a> are the combination of highly compliant and resilient midsole foam and a stiff embedded carbon fibre plate, which support energy storage and return. Runners will typically “save” these shoes for race day and replace them after fewer kilometres, compared to conventional running shoes. The available research does support the <a href="https://doi.org/10.1007/s40279-017-0811-2">performance benefits of these shoes</a>. However, it’s not known how long the benefits last relative to kilometres of wear. To our best knowledge, there’s only one study on running performance and shoe wear, but unfortunately it did not involve carbon fibre plate shoes. A University of Connecticut 2020 <a href="http://hdl.handle.net/11134/20002:860659513">master’s thesis</a> investigated eight college-level runners over 400 miles (643km) of Nike Pegasus shoe use. Large reductions in running economy were reported at 240km, and this was statistically significant at 320km. No reduction was observed at 160km. So, if you’re chasing personal best times, the evidence above suggests that for peak performance, shoes should be replaced somewhere between 160 and 240km (although this is not directly based on carbon fibre plate shoe research). It appears that minimising training kilometres for your favourite racing shoes – keeping them “fresh” – could contribute to peak performance on race day, compared to racing in a pair of old shoes. <h2>Injury or discomfort</h2> The link between shoe wear and injury is unclear, and based on <a href="https://bjsm.bmj.com/content/37/3/239">minimal and often conflicting evidence</a>. One study did find that <a href="https://doi.org/10.1111/sms.12154">runners who alternate their running shoes</a> have a lower risk of injury than runners who run only in the same pair of shoes over a 22-week period. Runners who alternated shoes throughout the study period would have accumulated less wear in each shoe. This provides some support for the notion that accumulating too many kilometres in your shoes may increase risk of injury. Unfortunately, the exact age of running shoes was not reported in this study. However, based on the running characteristics reported, the single-shoe pair users completed an average of 320km in their shoes (after adjusting for a small fraction who had to replace shoes during the study). This was compared to the multi-shoe pair users who used an average of 3.6 pairs of shoes, ran more total kilometres, but accumulated an average of only 200km per shoe pair. <h2>Comfort</h2> Comfort and fit are the <a href="https://www.tandfonline.com/doi/full/10.1080/19424280.2024.2353597#abstract">two most important factors</a> to runners when selecting running shoes. Evidence linking improved shoe comfort to <a href="https://journals.lww.com/acsm-msse/fulltext/2001/11000/relationship_between_footwear_comfort_of_shoe.21.aspx">reduced injury rates</a> or <a href="https://www.tandfonline.com/doi/full/10.1080/17461391.2019.1640288">improved running economy</a> is mixed, but reducing harms from poorly fitting and uncomfortable shoes is clearly a priority for runners. Most <a href="https://commons.nmu.edu/isbs/vol35/iss1/293/">runners land on their heel</a>. The repeated compression of the midsole causes the material to harden, possibly after as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534152/pdf/ijspt-12-616.pdf">little as 160km</a>, according to one study from 2017. However, there was virtually no change in the amount of cushioning runners perceived under their heel after 160km. Even after using the shoes for 640km, they felt little difference – about 3%. While at first this might seem like runners are not very good at judging when shoes lose their cushioning, it also tells us changes in perceived shoe cushioning are very gradual and may not be important for runners until they reach a certain threshold. This amount will differ from person to person, and from shoe to shoe, but research suggests it’s not until perceived cushioning reaches about a <a href="https://www.tandfonline.com/doi/full/10.1080/02640414.2020.1773613?casa_token=P87vatZhOlgAAAAA%3ACu11TZmGjKc1xYsaUlEVfWvZDvcSnx3qgKL1E2DsRYwf6hMvBiyVAm-M_-4Iauq4lwHna0QMu1IRmw">10% change</a> that runners consider it meaningful. We must be careful when applying these findings to the latest running shoes which use newer materials. But you can use it as a rule of thumb – once you notice a drop in comfort, it’s time to get a new pair. <h2>When to choose new shoes</h2> Ultimately, there’s no one simple answer for when you should get new running shoes. You may also not keep close track of how many kilometres your favourite pair has racked up. Overall, we believe the most practical advice is to keep your racing shoes “fresh” (under 240km), alternate a couple of other pairs during regular training, and replace them when you detect a notable drop in comfort.<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/238997/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/john-arnold-178470">John Arnold</a>, Senior lecturer, Sport & Exercise Biomechanics, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joel-fuller-2210202">Joel Fuller</a>, Senior Lecturer, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/how-do-i-know-when-its-time-to-replace-my-running-shoes-238997">original article</a>. </div>

Beauty & Style

How can we improve public health communication for the next pandemic? Tackling distrust and misinformation is key

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/shauna-hurley-203140">Shauna Hurley</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/rebecca-ryan-1522824">Rebecca Ryan</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> There’s a common thread linking our <a href="https://www.visualcapitalist.com/history-of-pandemics-deadliest/">experience of pandemics</a> over the past 700 years. From the black death in the 14th century to COVID in the 21st, public health authorities have put emergency measures such as isolation and quarantine in place to stop infectious diseases spreading. As we know from COVID, these measures upend lives in an effort to save them. In both the <a href="https://www.thinkglobalhealth.org/article/pandemic-protests-when-unrest-and-instability-go-viral">recent</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559034/">distant past</a> they’ve also given rise to collective unrest, confusion and resistance. So after all this time, what do we know about the role public health communication plays in helping people understand and adhere to protective measures in a crisis? And more importantly, in an age of misinformation and distrust, how can we improve public health messaging for any future pandemics? Last year, we published a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015144/full">Cochrane review</a> exploring the global evidence on public health communication during COVID and other infectious disease outbreaks including SARS, MERS, influenza and Ebola. Here’s a snapshot of what we found. <h2>The importance of public trust</h2> A key theme emerging in analysis of the COVID pandemic globally is public trust – or lack thereof – in governments, public institutions and science. Mounting evidence suggests <a href="https://www.washingtonpost.com/world/2022/02/01/trust-lancet-covid-study/">levels of trust in government</a> were <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00172-6/fulltext">directly proportional</a> to fewer COVID infections and higher vaccination rates across the world. It was a crucial factor in people’s willingness to follow public health directives, and is now a key focus for future pandemic preparedness. Here in Australia, public trust in governments and health authorities steadily eroded over time. Initial information from governments and health authorities about the unfolding COVID crisis, personal risk and mandated protective measures was generally clear and consistent across the country. The establishment of the <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1920/Quick_Guides/AustralianCovid-19ResponseManagement#_Toc38973752">National Cabinet</a> in 2020 signalled a commitment from state, territory and federal governments to consensus-based policy and public health messaging. During this early phase of relative unity, <a href="https://theconversation.com/inflation-covid-inequality-new-report-shows-australias-social-cohesion-is-at-crossroads-195198">Australians reported</a> higher levels of belonging and trust in government. But as the pandemic wore on, public trust and confidence fell on the back of conflicting state-federal pandemic strategies, blame games and the <a href="https://theconversation.com/we-lost-the-plot-on-covid-messaging-now-governments-will-have-to-be-bold-to-get-us-back-on-track-186732">confusing fragmentation</a> of public health messaging. The divergence between <a href="https://www.theaustralian.com.au/nation/tale-of-two-cities-gripped-by-covid-fear-outbreak/news-story/cf1b922610aeb0b0ee9b0b53486bf640">lockdown policies and public health messaging</a> adopted by <a href="https://www.theage.com.au/national/victoria/a-tale-of-two-cities-that-doesn-t-seem-fair-20211012-p58z79.html">Victoria and New South Wales</a> is one example, but there are plenty of others. When state, territory and federal governments have conflicting policies on protective measures, people are easily confused, lose trust and become harder to engage with or persuade. Many tune out from partisan politics. Adherence to mandated public health measures falls. Our research found clarity and consistency of information were key features of effective public health communication throughout the COVID pandemic. We also found public health communication is most effective when authorities work in partnership with different target audiences. In Victoria, the case brought against the state government for the <a href="https://www.abc.net.au/news/2023-07-24/melbourne-public-housing-tower-covid-lockdown-compensation/102640898">snap public housing tower lockdowns</a> is a cautionary tale underscoring how essential considered, tailored and two-way communication is with diverse communities. <h2>Countering misinformation</h2> Misinformation is <a href="https://reutersinstitute.politics.ox.ac.uk/hydroxychloroquine-australia-cautionary-tale-journalists-and-scientists">not a new problem</a>, but has been supercharged by the advent of <a href="https://theconversation.com/health-misinformation-is-rampant-on-social-media-heres-what-it-does-why-it-spreads-and-what-people-can-do-about-it-217059">social media</a>. The much-touted “miracle” drug <a href="https://www.vox.com/future-perfect/22663127/ivermectin-covid-treatments-vaccines-evidence">ivermectin</a> typifies the extraordinary traction unproven treatments gained locally and globally. Ivermectin is an anti-parasitic drug, lacking evidence for viruses like COVID. Australia’s drug regulator was forced to <a href="https://www.theguardian.com/australia-news/2021/sep/10/australian-drug-regulator-bans-ivermectin-as-covid-treatment-after-sharp-rise-in-prescriptions">ban ivermectin presciptions</a> for anything other than its intended use after a <a href="https://www.theguardian.com/world/2021/aug/30/australian-imports-of-ivermectin-increase-10-fold-prompting-warning-from-tga">sharp increase</a> in people seeking the drug sparked national shortages. Hospitals also reported patients <a href="https://www.theguardian.com/australia-news/2021/sep/02/sydney-covid-patient-in-westmead-hospital-after-overdosing-on-ivermectin-and-other-online-cures">overdosing on ivermectin</a> and cocktails of COVID “cures” promoted online. The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltext">Lancet Commission</a> on lessons from the COVID pandemic has called for a coordinated international response to countering misinformation. As part of this, it has called for more accessible, accurate information and investment in scientific literacy to protect against misinformation, including that shared across social media platforms. The World Health Organization is developing resources and recommendations for health authorities to address this “<a href="https://www.who.int/health-topics/infodemic#tab=tab_1">infodemic</a>”. National efforts to directly tackle misinformation are vital, in combination with concerted efforts to raise health literacy. The Australian Medical Association has <a href="https://www.ama.com.au/media/action-needed-tackle-health-misinformation-internet-social-media">called on the federal government</a> to invest in long-term online advertising to counter health misinformation and boost health literacy. People of all ages need to be equipped to think critically about who and where their health information comes from. With the rise of AI, this is an increasingly urgent priority. <h2>Looking ahead</h2> Australian health ministers recently <a href="https://www.cdc.gov.au/newsroom/news-and-articles/australian-health-ministers-reaffirm-commitment-australian-cdc">reaffirmed their commitment</a> to the new Australian Centre for Disease Control (CDC). From a science communications perspective, the Australian CDC could provide an independent voice of evidence and consensus-based information. This is exactly what’s needed during a pandemic. But full details about the CDC’s funding and remit have been the subject of <a href="https://www.croakey.org/federal-budget-must-deliver-on-climate-health-and-the-centre-for-disease-control-sector-leaders-warn/">some conjecture</a>. Many of our <a href="https://www.cochraneaustralia.org/articles/covidandcommunications">key findings</a> on effective public health communication during COVID are not new or surprising. They reinforce what we know works from previous disease outbreaks across different places and points in time: tailored, timely, clear, consistent and accurate information. The rapid rise, reach and influence of misinformation and distrust in public authorities bring a new level of complexity to this picture. Countering both must become a central focus of all public health crisis communication, now and in the future. This article is part of a <a href="https://theconversation.com/au/topics/the-next-pandemic-160343">series on the next pandemic</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226718/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/shauna-hurley-203140">Shauna Hurley</a>, PhD candidate, School of Public Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/rebecca-ryan-1522824">Rebecca Ryan</a>, Senior Research Fellow, Health Practice and Management; Head, Centre for Health Communication and Participation, <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/how-can-we-improve-public-health-communication-for-the-next-pandemic-tackling-distrust-and-misinformation-is-key-226718">original article</a>. </div>

Technology

John Amos' daughter recalls how she learned of her father's death

John Amos, actor known for his role as James Evans Sr. on Good Times, passed away on August 21 in Los Angeles of natural causes. It wasn't until Tuesday, October 1 that his death was confirmed by his publicist, Belinda Foster, and not long after his son Kelly Christopher Amos confirmed it in a statement to <a href="https://people.com/john-amos-dead-roots-and-coming-to-america-actor-was-84-7510157" target="_blank" rel="noopener">People</a>. "It is with heartfelt sadness that I share with you that my father has transitioned," he said at the time. “He was a man with the kindest heart ... loved the world over. Many fans considered him their TV father.” “He lived a good life, and his legacy will endure through his remarkable work in television and film. My father loved acting, most recently appearing as himself in Suits LA and in our documentary America’s Dad, chronicling his journey as an actor. “He was my dad, my best friend, and my hero. Thank you for your prayers and support during this time.” Now, his daughter Shannon Amos, has revealed that she only learned about his death when it was reported by the media on Tuesday. She paid tribute to her late father in a video shared to Instagram that showed them dancing to the song Dance with My Father by Luther Vandross. "I am without words…Our family has received the heartbreaking news that my Dad, John Allen Amos, Jr., transitioned on August 21st," Shannon wrote in the caption. "We are devastated and left with many questions about how this happened 45 days ago, learning about it through the media like so many of you. "This should be a time of honoring and celebrating his life, yet we are struggling to navigate the wave of emotions and uncertainties surrounding his passing. Still, there is some semblance of peace in knowing my father is finally free," she continued, before thanking everyone for their "outpouring of love". <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/DAmTuS4x6ug/?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/DAmTuS4x6ug/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Shannon Amos | Health & Wellness | Retreats (@officialshannonamos)</a> </div> </blockquote> John Amos passed away at the age of 84. His children had disagreed on his care, which became public last year after she <a href="https://www.instagram.com/p/CtPYytYRyBx/?utm_source=ig_embed&ig_rid=19da7b24-9405-46b8-a697-309f9886c8c3" target="_blank" rel="noopener">raised concerns </a>that her father was "a victim of elder abuse and financial exploitation". She even raised her concerns to law enforcement as John was hospitalised at the time. However, he released a statement via his publicist insisting that he was fine. Images: Instagram

Family & Pets

How can I stop using food to cope with negative emotions?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/inge-gnatt-1425767">Inge Gnatt</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Have you ever noticed changes in your eating habits when you are sad, bored or anxious? Many people report eating either more, or less, as a way of helping them to cope when they experience difficult emotions. Although this is a very normal response, it can take the pleasure out of eating, and can become distressing and bring about other feelings of <a href="https://doi.org/10.1016/j.eatbeh.2018.02.008">shame and self-criticism</a>. Adding to the complexity of it all, we live in a world where <a href="https://butterfly.org.au/diet-culture-101/">diet culture</a> is unavoidable, and our relationship to eating, food and body image can become complicated and confusing. <h2>Emotional eating is common</h2> “Emotional eating” refers to the eating behaviours (typically eating more) that occur in response to difficult emotions. <a href="https://doi.org/10.3390/ijerph18041744">Research shows</a> around 20% of people regularly engage in emotional eating, with a higher prevalence <a href="https://doi.org/10.1371/journal.pone.0285446">among adolescents</a> and women. In a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285446#sec012">study</a> of more than 1,500 adolescents, 34% engaged in emotional eating while sad and 40% did so while anxious. Foods consumed are often fast-foods and other energy-dense, nutrient-poor convenience foods. <h2>Stress, strong emotions and depression</h2> For some people, emotional eating was simply a <a href="https://doi.org/10.1038/s41598-017-09519-0">habit formed earlier in life</a> that has persisted over time. But other factors might also contribute to the likelihood of emotional eating. The physiological effects of stress and strong emotions, for example, can influence hormones such as <a href="https://doi.org/10.1016/S0306-4530(00)00035-4">cortisol, insulin and glucose</a>, which can also increase appetite. Increased impulsivity (<a href="https://doi.org/10.1176/appi.ajp.158.11.1783">behaving</a> before thinking things through), vulnerability to depression, a tendency to ruminate and <a href="https://doi.org/10.1080/1047840X.2014.940781">difficulties regulating emotions</a> also <a href="https://doi.org/10.1097/FBP.0b013e328357bd4e">increase the likelihood</a> of emotional eating. <h2>So what do you do?</h2> First, know that fluctuations in eating are normal. However, if you find that the way you eat in response to difficult emotions is not working for you, there are a few things you can do. Starting with small things that are achievable but can have a huge impact, such as prioritising <a href="https://theconversation.com/no-sleep-challenge-the-dangers-of-sleep-deprivation-236608">getting enough sleep</a> and <a href="https://insideoutinstitute.org.au/podcasts/episode-3-the-mindful-dietitian-fiona-sutherland">eating regularly</a>. Then, you can start to think about how you handle your emotions and hunger cues. <h2>Expand your emotional awareness</h2> Often we label emotions as good or bad, and this can result in fear, avoidance, and <a href="https://youtu.be/NDQ1Mi5I4rg?si=lv9d8qjUThSsemXG">unhelpful coping strategies</a> such as emotional eating. But it’s also important to <a href="https://www.pspnet.ca/assets/the-gottman-institute-the-feeling-wheel-v2.pdf">differentiate</a> the exact emotion. This might be feeling isolated, powerless or victimised, rather than something as broad as sad. By <a href="https://headspace.org.au/online-and-phone-support/interactive-tools/activities/understanding-emotions/">noticing</a> what the emotion is, we can bring curiosity to what it means, how we feel in our minds and bodies, and how we think and behave in response. <h2>Tap into your feelings of hunger and fullness</h2> Developing an intuitive way of eating is another helpful strategy to promote <a href="https://insideoutinstitute.org.au/blog/what-is-normal-eating">healthy eating behaviours</a>. Intuitive eating means recognising, understanding and responding to internal signals of hunger and fullness. This might mean tuning in to and acknowledging physical hunger cues, responding by eating food that is nourishing and enjoyable, and identifying sensations of fullness. Intuitive eating <a href="https://doi.org/10.1002/eat.23509">encourages flexibility</a> and thinking about the pleasure we get from food and eating. This style of eating also allows us to enjoy eating out with friends, and sample local delicacies when travelling. It can also reduce the psychological distress from feeling out of control with your <a href="https://doi.org/10.1016/j.jand.2013.12.024">eating</a> habits and the associated negative <a href="https://doi.org/10.1016/j.appet.2015.10.012">body image</a>. <h2>When is it time to seek help?</h2> For some people, the thoughts and behaviours relating to food, eating and body image can negatively impact their life. Having the support of friends and family, accessing <a href="https://nedc.com.au/eating-disorder-resources/interactive-digital-resource-for-eating-disorders">online resources</a> and, in some instances, seeing a trained professional, can be very helpful. There are many <a href="https://doi.org/10.1007/s00787-020-01498-4">therapeutic interventions</a> that work to <a href="https://doi.org/10.1016/j.copsyc.2015.02.010">improve aspects</a> associated with emotional eating. These will depend on your situation, needs, stage of life and other factors, such as whether you are <a href="https://nedc.com.au/eating-disorders/types/neurodivergence">neurodivergent</a>. The best approach is to engage with someone who can bring compassion and understanding to your personal situation, and work with you collaboratively. This work might include: <ul> <li>unpacking some of the patterns that could be underlying these emotions, thoughts and behaviours</li> <li>helping you to discover your emotions</li> <li>supporting you to process other experiences, such as trauma exposure</li> <li>developing a more flexible and intuitive way of eating.</li> </ul> One of the dangers that can occur in response to emotional eating is the temptation to diet, which can lead to disordered eating, and eating disorder behaviours. Indicators of a potential <a href="https://nedc.com.au/eating-disorders/eating-disorders-explained/whats-an-eating-disorder">eating disorder</a> can include: <ul> <li>recent rapid weight loss</li> <li>preoccupation with weight and shape (which is usually in contrast to other people’s perceptions)</li> <li>eating large amounts of food within a short space of time (two hours or less) and feeling a sense of loss of control</li> <li>eating in secret</li> <li>compensating for food eaten (with vomiting, exercise or laxatives).</li> </ul> <a href="https://nedc.com.au/eating-disorders/treatment-and-recovery/treatment-options">Evidence-based approaches</a> can support people experiencing eating disorders. To find a health professional who is informed and specialises in this area, search the <a href="https://butterfly.org.au/get-support/butterflys-referral-database/">Butterfly Foundation’s expert database</a>. <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14, or the <a href="https://butterfly.org.au/get-support/helpline/">Butterfly Foundation</a> on 1800 ED HOPE (1800 33 4673).<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/238218/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/inge-gnatt-1425767">Inge Gnatt</a>, PhD Candidate, Lecturer in Psychology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</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/how-can-i-stop-using-food-to-cope-with-negative-emotions-238218">original article</a>. </div>

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30 years of Friends: how the US sitcom became an enduring global sensation

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/richard-howells-1225412">Richard Howells</a>, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a> I have to be honest – I didn’t actually watch the first episode of the classic TV series Friends when it originally aired in the US on September 22 1994. Nor did I bother when it first turned up on British television the following spring. But the final instalment was a different matter. I was on a road trip in the US at the time and checked into a motel on the outskirts of Cincinnati, Ohio specially to catch the concluding episode (The Last One) on May 6 2004. Room service arrived in the nick of time. My burger and beer only fuelled my appetite for what was to come – and the anticipation of guessing what the final line would be. So why the big change? How did my attitude evolve from indifference in the nineties to excitedly pulling off the interstate in the noughties? The answer is key to the show’s success – and why it remains so popular today. Back in 1994, the initial premise of Friends seemed to lack promise. The plot revolved round six not especially interesting characters, and none of the cast was especially famous (at least to me). The show was set mainly in two adjacent apartments in Manhattan and a coffee bar called Central Perk to which the characters returned almost every episode and in which (in the best sitcom tradition) the best seats were always available. Crucially, not a lot actually happened. <h2>The power of the ensemble</h2> So why did it work? The first important thing is that Friends was not so much a situation comedy as a character comedy. That meant it did not need a remarkable premise or dramatic incidents to drive the show. It was an ensemble piece in which we gradually got to know the characters and the friends became our friends. The show was built around everyday storylines – crushes, romances and misunderstandings or maybe something as gently amusing as Ross overdoing the teeth whitener. Viewers began to identify with individual characters (<a href="https://www.buzzfeed.com/ljune/are-you-more-rachel-or-monica-from-friends-alfsqwp6hf">“are you a Monica or a Rachel?”</a>) or to take sides on the issues of the day. What, for example, are the relationship rules of being “on a break”? <figure><iframe src="https://www.youtube.com/embed/TIK01MpwWGg?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>One episode of Friends revolves around Ross (David Schwimmer) getting his teeth whitened.</figcaption></figure> Friends was, of course, very well produced, cast and written. As it became even more successful, it survived the normally perilous inclusion of <a href="https://www.youtube.com/watch?v=xHLaISBRmdI">celebrity guest stars</a> and – vitally – it never “jumped the shark” (industry-speak for growing out of its initial premise or building up to dramatic, but ultimately silly, plot gimmicks from which it is impossible to recover). Ultimately, and hearteningly, the six characters all remained friends. Beneath the professional craft and production polish of Friends, it is the concept of friendship, underscored with by the viewer’s sense of aspiration, which ultimately explains the series’ success then and now. One of the functions of popular culture is to provide a better imaginary world than the one we actually inhabit. In some ways this is simply compensation for the reality of the everyday: we dream of that which we do not have. It’s what the great Utopian sociologist Ernst Bloch called <a href="https://www.marxists.org/archive/bloch/hope/introduction.htm">“wishful images in the mirror”</a> – except that the mirror here is a television screen. The world of Monica, Rachel, Joey, Chandler, Phoebe and Ross is certainly a wishful one for many. They live in improbably nice apartments for their jobs (or lack of them), and they are defined by their personalities rather than their careers. They are good looking and well dressed, and the series centres on their ample leisure and social time. Unlike reality, arguments are always overcome and – most importantly of all – friendship always triumphs. <figure><iframe src="https://www.youtube.com/embed/pPM7VxnVViw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>The first and last scene of Friends.</figcaption></figure> What a contrast this vision provides to the actual lives of so many people today. The real world is beset with isolation, loneliness, sometimes insurmountable problems, occasionally fear and certainly drudgery. But with Friends, as the <a href="https://www.youtube.com/watch?v=sLisEEwYZvw">chirpy theme song</a> reminds us, there is always someone “there for you” – if only in surrogate. Some critics today carp about the show’s <a href="https://metro.co.uk/2023/04/02/lack-of-diversity-on-friends-mocked-on-snl-after-years-of-criticism-18542168/">lack of diversity</a> and <a href="https://www.cosmopolitan.com/uk/entertainment/a38817/11-times-friends-sexist-homophobic/">outdated attitudes</a> to the cultural issues of the present day. While this may be true, like TV series, criticism also dates. And series which have long gone into reruns, repeats, streaming and syndication are virtually critic-proof in that they are recommended by word of mouth rather than increasingly ideologically centred reviews. Viewers just want it to be funny. Oh: And in case you were wondering, the final line in the whole of Friends went to the <a href="https://theconversation.com/matthew-perry-the-power-of-celebrities-speaking-publicly-about-their-addiction-216879">late Matthew Perry</a> as Chandler Bing. When Rachel suggests they all go for one last coffee, Chandler quips: “Sure. Where?” <a href="https://theconversation.com/profiles/richard-howells-1225412">Richard Howells</a>, Emeritus Professor of Cultural Sociology, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a> Image credits: NBC 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/30-years-of-friends-how-the-us-sitcom-became-an-enduring-global-sensation-239464">original article</a>. </div>

Yes, you do need to clean your tongue. Here’s how and why

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health. The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity. But there’s no need to wait for a trip to the doctor. Cleaning your tongue <a href="https://pubmed.ncbi.nlm.nih.gov/21797979/">twice a day</a> can help you check how your tongue looks and feels – and improve your breath. <h2>What does a healthy tongue look like?</h2> Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move. The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface. These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. <figure><iframe src="https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light <a href="https://my.clevelandclinic.org/health/symptoms/24600-tongue-color">pink</a>. A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or <a href="https://www.healthline.com/health/tongue-problems-2">other issues</a>. <h2>How should I clean my tongue?</h2> Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine. You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface. Or you can use a special <a href="https://pubmed.ncbi.nlm.nih.gov/26865433/">tongue scraper</a>. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush. Your co-workers will thank you as well – cleaning your tongue can help combat <a href="https://pubmed.ncbi.nlm.nih.gov/24165218/">stinky breath</a>. Tongue scrapers are particularly <a href="https://pubmed.ncbi.nlm.nih.gov/15341360/">effective</a> at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface. <h2>What’s that stuff on my tongue?</h2> So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP. Here’s what your tongue might be telling you. White coating Developing a white coating on the tongue’s surface is one of the <a href="https://pubmed.ncbi.nlm.nih.gov/31309703/">most common changes</a> in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days. In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause <a href="https://www.nature.com/articles/s41368-022-00163-7">serious illnesses</a>. Yellow coating This may indicate oral thrush, a <a href="https://www.nidirect.gov.uk/conditions/oral-thrush-adults">fungal infection</a> that leaves a raw surface when scrubbed. Oral thrush is <a href="https://www.aafp.org/pubs/afp/issues/2008/1001/p845.html">common</a> in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary <a href="https://pubmed.ncbi.nlm.nih.gov/7636666/">suppression of the immune system</a> or <a href="https://www.stanfordchildrens.org/en/topic/default?id=candidiasis-in-children-90-P01888">antibiotic</a> use. If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month. Black coating Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a <a href="https://my.clevelandclinic.org/health/diseases/17918-black-hairy-tongue">black hairy tongue</a>. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene. Pink patches Pink patches surrounded by a white border can make your tongue look like a map – this is called “<a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396">geographic tongue</a>”. It’s <a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/diagnosis-treatment/drc-20354401">not known</a> what causes this condition, which usually doesn’t require treatment. Pain and inflammation A red, sore tongue can indicate a <a href="https://medlineplus.gov/ency/article/003047.htm">range of issues</a>, including: <ul> <li>nutritional deficiencies such as folic acid or vitamin B12</li> <li>diseases including <a href="https://my.clevelandclinic.org/health/diseases/22377-pernicious-anemia">pernicious</a> anaemia, <a href="https://www.rch.org.au/kidsinfo/fact_sheets/kawasaki_disease/">Kawasaki disease</a> and <a href="https://www.childrens.health.qld.gov.au/health-a-to-z/scarlet-fever">scarlet fever</a></li> <li>inflammation known as <a href="https://www.ncbi.nlm.nih.gov/books/NBK560627/">glossitis</a></li> <li>injury from hot beverages or food</li> <li>ulcers, including cold sores and canker sores</li> <li><a href="https://www.nidcr.nih.gov/health-info/burning-mouth">burning mouth syndrome</a>.</li> </ul> Dryness Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt. <h2>What about cancer?</h2> White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a <a href="https://oralcancerfoundation.org/cdc/premalignant-lesions/">higher risk</a> of turning into cancer, compared to other parts of the mouth. <a href="https://pubmed.ncbi.nlm.nih.gov/36852511/">Oral cancers</a> have low survival rates due to delayed detection – and they are on the rise. So <a href="https://youtu.be/Y6QkKhEjS5M">checking your tongue</a> for changes in colour, texture, sore spots or ulcers is <a href="https://www.dhsv.org.au/oral-health-programs/oral-cancer-screening-and-prevention">critical</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, Professor and Head of Discipline - Oral Health, <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/yes-you-do-need-to-clean-your-tongue-heres-how-and-why-237130">original article</a>. </div>

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Why isn’t dental included in Medicare? It’s time to change this – here’s how

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> When the forerunner of Medicare was established in the 1970s, dental care was left out. Australians are still suffering the consequences half a century later. Patients pay much more of the cost of dental care than they do for other kinds of care. <a href="https://www.commonwealthfund.org/sites/default/files/2021-08/Schneider_Mirror_Mirror_2021.pdf">More</a> Australians delay or skip dental care because of cost than their peers in most wealthy countries. And as our dental health gets <a href="https://theconversation.com/reform-delay-causes-dental-decay-its-time-for-a-national-deal-to-fund-dental-care-217914">worse</a>, fees keep on rising. For decades, a litany of reports and inquiries have called for universal dental coverage to solve these problems. Now, with the Greens <a href="https://greens.org.au/news/media-release/tax-big-corporate-profits-fix-peoples-teeth-greens">proposing</a> it and Labor backbenchers <a href="https://www.theaustralian.com.au/nation/politics/dental-on-medicare-must-be-next-frontier-for-labor-backbenchers/news-story/1c69314d7609815b937ced5af4542ba0">supporting</a> it, could it finally be time to put the mouth into Medicare? <h2>What’s stopping us?</h2> The Australian Dental Association <a href="https://ada.org.au/ada-responds-to-the-greens-dentistry-in-medicare-proposal">says</a> the idea is too ambitious and too costly, pointing out it would need many more dental workers. They say the government should start small, focusing on the most vulnerable populations, initially seniors. Starting small is sensible, but finishing small would be a mistake. Dental costs aren’t just a problem for the most vulnerable, or the elderly. More than <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/2022-23/patient_experience_202223_tables_13_to_15.xlsx">two million</a> Australians avoid dental care because of the cost. More than <a href="https://www.aihw.gov.au/getmedia/a053aa74-c471-436e-ab7e-a82e83ae73a3/aihw_den_231_dentalcare_oralhealthanddentalcareinaustralia_tranche7_21NOV2023.xlsx">four in ten</a> adults usually wait more than a year before seeing a dental professional. Bringing dental into Medicare will require many thousands of new dental workers. But it will be possible if the scheme is <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">phased in</a> over ten years. The real reason dental hasn’t been added to Medicare is it would cost billions of dollars. The federal government doesn’t have that kind of money lying around. Australia has a <a href="https://theconversation.com/the-budget-is-full-of-good-news-but-good-news-isnt-the-same-as-good-management-230110">structural budget problem</a>. Government spending is growing faster than revenue, because we are a relatively <a href="https://grattan.edu.au/news/can-we-talk-about-a-fairer-more-prosperous-australia/">low-tax country with high service expectations</a>. The growing cost of health care is a major contributor, with hospitals and medical benefits among the top six fastest-growing major payments. The structural gap is only <a href="https://treasury.gov.au/publication/2023-intergenerational-report">likely to grow</a> without major policy changes. So, can we afford health care for all? We can. But we should do it with smart choices on dental care, and tough choices to raise revenue and reduce spending elsewhere. <h2>Smart choices about a new dental scheme</h2> The first step is to avoid repeating the mistakes of Medicare. Medicare payments to private businesses haven’t attracted them to a lot of the communities that need them the most. Many rural and disadvantaged areas are <a href="https://theconversation.com/if-you-live-in-a-bulk-billing-desert-its-hard-to-see-a-doctor-for-free-heres-how-to-fix-this-204029">bulk-billing deserts</a> with too few GPs. The poorest areas have more than <a href="https://grattan.edu.au/wp-content/uploads/2022/12/A-new-Medicare-strengthening-general-practice-Grattan-Report.pdf">twice</a> the psychological distress of the wealthiest areas, but they get about half the Medicare-funded mental health services. As a result, government money isn’t going where it will make the biggest difference. There are about <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/hospitalisations/potentially-preventable-hospitalisations">80,000</a> hospital visits each year for dental problems that could have been avoided with dental care. If there is too little care in disadvantaged and rural communities, where oral health is worst, that number will remain high. That’s why a significant share of new investment should be quarantined for public dental services, with those services targeted to areas where people are missing out on care. Another problem with Medicare is its payments often have little relationship to the cost of care, or the impact that care has on the patient’s health. To tamp down costs, Medicare funding for dental care should exclude cosmetic treatments and orthodontics. It should be based on efficient workforce models where dental assistants and therapists use all their skills – you might not always need to see a dentist. The funding <a href="https://apo.org.au/sites/default/files/resource-files/2019-06/apo-nid241086.pdf">model</a> should take account of a patient’s needs, reward giving them ongoing care, and have a <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">cap</a> on spending per patient. Oral health should be measured and recorded, to make sure patients and taxpayers are getting results. <h2>Tough choices to balance the budget</h2> Those steps would slash the cost of The Greens’ plan, which is hard to estimate but might reach more than <a href="https://www.pbo.gov.au/sites/default/files/2024-09/Putting%20dental%20care%20into%20Medicare.pdf">$20 billion</a> a year once it’s phased in. Instead, the cost would fall to roughly <a href="https://grattan.edu.au/report/filling-the-gap/">$7 billion</a> a year. That would be a good investment. But if you’re worried about where the money will come from, there are good ways to pay for it. Many reforms could reduce government health budgets without harming patients. There is waste in government funding of <a href="https://grattan.edu.au/wp-content/uploads/2016/02/935-blood-money.pdf">pathology</a> tests and <a href="https://grattan.edu.au/wp-content/uploads/2015/06/823-Premium-Policy4.pdf">less cost-effective</a> medicines. In some hospitals, there are <a href="https://grattan.edu.au/wp-content/uploads/2014/03/806-costly-care.pdf">excessive costs</a> and potentially harmful <a href="https://qualitysafety.bmj.com/content/qhc/28/3/205.full.pdf">low-value care</a>. Over the longer-term, investments in <a href="https://grattan.edu.au/wp-content/uploads/2023/02/The-Australian-Centre-for-Disease-Control-ACDC-Highway-to-Health-Grattan-Report.pdf">prevention</a> can reduce demand for health care. A <a href="https://grattan.edu.au/wp-content/uploads/2024/05/Sickly-Sweet-Grattan-Institute-Report-May-2024.pdf">tax on sugary drinks</a>, for example, would improve health while raising hundreds of millions of dollars a year. Measures like this would help the government pay for more dental care. But demand for health care will keep growing as the population ages, and as expensive <a href="https://www.abc.net.au/news/2024-09-11/proposal-to-speed-up-medicine-approvals/104338766">new treatments</a> arrive. This means a broader strategy is needed to meet the three goals of balancing the budget, keeping up with growing health-care demand, and bringing dental into Medicare. There are no easy solutions, but there are many options to reduce spending and boost revenue without hurting economic growth. Choosing Australia’s infrastructure and defence megaprojects <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">more wisely</a> could save several billion dollars each year. Undoing Western Australia’s special GST funding deal – <a href="https://www.austaxpolicy.com/western-australia-gst-deal-the-worst-australian-public-policy-decision-of-the-21st-century-thus-far/">described</a> by economist Saul Eslake as “the worst Australian public policy decision of the 21st Century thus far” – would save another <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$5 billion</a> a year. Reducing income tax breaks and tax minimisation opportunities – including by reining in superannuation tax concessions, reducing the capital gains tax discount, limiting negative gearing, and setting a minimum tax on trust distributions – could raise more than <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$20 billion</a> a year. Major tax reform like this offers economic benefits while creating space for better services such as universal dental coverage. No one likes spending cuts and tax hikes, but they will be needed <a href="https://theconversation.com/chalmers-has-a-70-billion-a-year-budget-hole-here-are-13-ways-to-fill-it-203331">sooner or later</a> regardless. Dental coverage might be just the sweetener taxpayers need to accept it.<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/239086/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, Deputy Program Director, Budgets and Government, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</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/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086">original article</a>. </div>

Money & Banking

How you can get the official Australian portraits of The King and Queen

Royal fans nationwide can now request a special keepsake online for free. All Australians are entitled to their very own free portrait of King Charles and Queen Camilla. The way one can obtain the monarchy keepsake is through sending an email to their local federal MP requesting one. The initiative comes under the constituents' request program, which allows registered Australian voters to receive their own printed portrait of the royals. Official portraits of the King and Queen were provided to the Australian Government by Buckingham Palace in July and are available for public access. Photos available include a photo of the royal couple standing together, and seperate ones of the monarch and her majesty posing alone. In the photos the King and Queen both donned royal blue outfits and their Commonwealth Insignia, with the King wearing The Sovereign's Badge of the Order of Australia and the Queen wearing the Wattle Brooch. The portraits were taken by royal photographer Millie Pilkington in Buckingham Palace's White Drawing Room in June. The digital images can be downloaded for free from the Department of the Prime Minister and Cabinet <a href="https://www.pmc.gov.au/government/official-australian-portraits-king-and-queen" target="_blank" rel="noopener">website</a> for private use. Those who want a physical copy can request printed versions through their Federal Member of the House of Representatives or Senator in their state or territory via email. The government-funded program, introduced in the Parliamentary Entitles Act 1990, is available for Australian citizens only. Image: Department of the Prime Minister and Cabinet/ Millie Pilkington

Art

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

How to revive your curls without paying salon prices

Maintaining curly hair takes a lot of time and effort and sometimes no matter what you do, the frizz just cannot be tamed. While getting your hair done at the salon can be a treat, having to pay salon prices to get softness, shine and definition for your curls is just not sustainable in the long run. Enter <a href="https://www.johnfrieda.com/en-au/home/" target="_blank" rel="noopener">John Frieda</a>'s newest Frizz Ease Miraculous Recovery range, which is now infused with repairing ceramides designed to transform frizzy and damaged hair. The Miraculous Recovery Repairing shampoo and conditioner are two of my personal faves, as I could feel the difference in how soft my hair felt after the first use. Not only are the products safe for colour-treated hair, they also made my curls more manageable and easy to style, with the effects lasting for two days, which is amazing considering how quickly my curls can go limp. I also loved how subtle the scent was, and found the most effective way of applying the conditioner was to comb it through my hair with a detangling brush in the shower, as it helps distribute the product evenly. While different curls all need slightly different care, I found the shampoo provided the perfect balance of cleaning build-up on my hair without leaving it dry or flaky. The star of the range was definitely the All-in-1 extra strength serum, which provided extra protection for my colour-treated and chemically treated hair. I love that you can apply this product through wet or dry hair, and it was the perfect way to revive my curls. The Finishing Creme was a bit too thick for my fine, curly hair, but for those with tighter curls or those looking for some extra moisture during more humid days, a light layer of the product would surely tame any flyaways or frizz. With most of their products retailing for around $20 it is an affordable solution to bringing life back into colour-treated and damaged curls. The product can be found in all major supermarkets and pharmacies across <a href="https://www.chemistwarehouse.com.au/shop-online/5571/john-frieda-haircare" target="_blank" rel="noopener">AU</a> and <a href="https://www.chemistwarehouse.co.nz/shop-online/5571/john-frieda-haircare" target="_blank" rel="noopener">NZ</a>. Images: Supplied

Beauty & Style

The good, the bad and the awful – how businesses reacts to online reviews

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mina-tajvidi-1192090">Mina Tajvidi</a>, <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a>; <a href="https://theconversation.com/profiles/nick-hajli-1426223">Nick Hajli</a>, <a href="https://theconversation.com/institutions/loughborough-university-1336">Loughborough University</a>, and <a href="https://theconversation.com/profiles/tahir-m-nisar-1050021">Tahir M. Nisar</a>, <a href="https://theconversation.com/institutions/university-of-southampton-1093">University of Southampton</a> Every day travellers across the globe are flocking to popular destinations, eager to relax and create memories. Alongside packing and planning, many turn to online reviews to choose the perfect hotel, restaurant, or activity. These reviews, often shared enthusiastically or with a hint of frustration, play a key role in shaping our experiences. But what happens to these reviews once they are posted? Do businesses truly read them, and if so, do they make changes based on customer feedback? The short answer is yes, businesses do read reviews and often act on them. In fact, for many, it’s a crucial part of their <a href="https://www.sciencedirect.com/science/article/abs/pii/S004016252100384X">customer engagement strategy</a>. Reviews offer a treasure trove of insights, from customer satisfaction and service quality to product usability and pricing perceptions. But beyond the numbers and star ratings, reviews provide a story of the customer experience that can highlight strengths and reveal weaknesses. Businesses, particularly in competitive industries like hospitality, often have dedicated teams or <a href="https://broadly.com/blog/reputation-management-tools/">software tools</a> to monitor reviews across platforms like Tripadvisor, Google, and Yelp. These tools can aggregate reviews, analyse sentiments, and even benchmark against competitors. For example, a hotel chain may use these insights to identify common themes in guest feedback, such as complaints about check-in delays or praises for room cleanliness. By doing so, they can prioritise issues and respond effectively. However, reading reviews is just the beginning. The real value lies in how businesses respond to them, and whether they take actionable steps to address the feedback. In many cases, customer reviews have become catalysts for change. For instance, a recurring complaint about outdated decor might prompt a hotel to refurbish its rooms. Similarly, consistent praise for a friendly staff member can lead to rewards or recognition programmes, boosting employee morale and enhancing the overall guest experience. <a href="https://ieeexplore.ieee.org/document/10614398">Some businesses</a> go a step further by engaging directly with reviewers. This engagement can take various forms, from public responses thanking customers for their feedback to private messages addressing specific concerns. <a href="https://www.emerald.com/insight/content/doi/10.1108/ITP-09-2018-0415/full/html">Such interactions</a> not only show that a business values its customers, but also humanises the brand, fostering trust and loyalty. A well-handled response to a negative review can even turn a dissatisfied customer into a loyal advocate. <h2>The role of negative reviews</h2> Negative reviews, while often dreaded by businesses, are an essential component of the feedback process. They provide honest, often blunt insights into what went wrong and where improvements are needed. For instance, during the holiday season, a restaurant might receive complaints about long wait times or underwhelming festive menus. Instead of viewing these reviews as setbacks, savvy businesses see them as opportunities to refine their offerings and enhance customer satisfaction. In some cases, businesses have <a href="https://ieeexplore.ieee.org/document/10614398">used negative reviews</a> as a springboard for innovation. A restaurant receiving feedback about limited vegetarian options might introduce new menu items, attracting a broader clientele and boosting sales. Similarly, a hotel criticised for lack of amenities might invest in additional facilities, improving its appeal and competitiveness. As technology evolves, the landscape of customer reviews and business responses is also changing. The rise of artificial intelligence and machine learning that uses algorithms has made it easier for businesses to analyse vast amounts of feedback and identify trends quickly. This capability allows for more proactive responses, with businesses anticipating issues before they become widespread problems. Moreover, the increasing use of video and photo reviews adds a new dimension to customer feedback. <a href="https://www.emerald.com/insight/content/doi/10.1108/JPBM-01-2019-2194/full/html?casa_token=adZDhhc3f0IAAAAA:7jPn1_y31gfB4BjJjLdl8QnnFixO3XCEOKbtemd0N2vhh_UCEHa1vjisRj3X3K1iw7UIRL1yylJGN6CCqPbW1Bs4CoSto1x0M1ntb_RtD7z-ZXHzj7Q">Visual reviews</a> can provide a more vivid portrayal of experiences, from showcasing a beautifully plated dish to highlighting a less-than-sparkling pool. Businesses are adapting to this trend by incorporating user-generated content into their marketing strategies, showcasing real-life customer experiences to attract new clients. However, the rise of fake reviews is a growing concern. In 2023, the popular travel website Tripadvisor <a href="https://www.tripadvisor.com/TransparencyReport2023#group-section-Fake-Reviews-HZjJZOxSZ4">saw an overwhelming influx</a> of user-generated content, with over 30 million reviews, however, amid this vast pool of feedback, 1.3 million reviews were flagged as fraudulent and subsequently removed. In the end, customer reviews are not just fleeting opinions left in the digital atmosphere. They are valuable conversations between businesses and their customers. For businesses, reviews offer an opportunity to understand their clients’ needs, address concerns, and celebrate successes. That is why businesses like <a href="https://www.aboutamazon.com/news/policy-news-views/how-ai-spots-fake-reviews-amazon">Amazon are using AI</a> to manage the reviews. By reading, responding, and, most importantly, acting on reviews, businesses can foster a loyal customer base and continually improve their offerings. So, the next time you leave a review, remember that someone is listening, and your words may just be the catalyst for positive change.<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/236194/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mina-tajvidi-1192090">Mina Tajvidi</a>, Lecturer in Digital Marketing, <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a>; <a href="https://theconversation.com/profiles/nick-hajli-1426223">Nick Hajli</a>, AI Strategist and Professor of Digital Strategy, <a href="https://theconversation.com/institutions/loughborough-university-1336">Loughborough University</a>, and <a href="https://theconversation.com/profiles/tahir-m-nisar-1050021">Tahir M. Nisar</a>, Professor of Strategy and Economic Organisation, <a href="https://theconversation.com/institutions/university-of-southampton-1093">University of Southampton</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/the-good-the-bad-and-the-awful-how-business-reacts-to-online-reviews-236194">original article</a>. </div>

Travel Trouble

The internet is worse than it used to be. How did we get here, and can we go back?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> When it comes to our experience of the internet, “the times, <a href="https://en.wikipedia.org/wiki/The_Times_They_Are_a-Changin%27_(song)">they are a-changin’</a>”, as Bob Dylan would say. You can’t quite recall how, but the internet certainly feels different these days. To some, it is “<a href="https://www.npr.org/2024/01/16/1224878097/everyday-users-are-complaining-that-the-internet-is-more-chaotic-than-ever">less fun and less informative</a>” than it used to be. To others, online searches are made up of “<a href="https://www.theverge.com/c/23998379/google-search-seo-algorithm-webpage-optimization?src=longreads">cookie cutter</a>” pages that drown out useful information and are saturated with scams, spam and content generated by artificial intelligence (AI). Your social media feeds are full of eye-catching, provocative, hyper-targeted, or anger-inducing content, from <a href="https://theconversation.com/the-dead-internet-theory-makes-eerie-claims-about-an-ai-run-web-the-truth-is-more-sinister-229609">bizarre AI-generated imagery</a> to robot-like comments. You’re lucky if your video feeds are not solely made up of exhortations to “subscribe”. How did we get here? And can we claw our way back? <h2>Commercial interests rule</h2> One major factor contributing to the current state of the internet is its over-commercialisation: financial motives drive much of the content. This has arguably led to the prevalence of sensationalism, prioritising virality over information quality. Covert and deceptive advertising is widespread, blurring the line between commercial and non-commercial content to attract more attention and engagement. Another driving force is the dominance of tech giants like Google, Meta and Amazon. They reach billions worldwide and wield immense power over the content we consume. Their platforms use advanced tracking technologies and opaque algorithms to generate hyper-targeted media content, powered by extensive user data. This creates <a href="https://www.campaignasia.com/article/the-echo-chamber-effect-how-algorithms-shape-our-worldview/491762">filter bubbles</a>, where users are exposed to limited content that reinforces their existing beliefs and biases, and <a href="https://philarchive.org/archive/NGUECA">echo chambers</a> where other viewpoints are actively discredited. Bad actors like <a href="https://abcnews.go.com/Technology/ai-fuel-financial-scams-online-industry-experts/story?id=103732051">cyber criminals and scammers</a> have been an enduring problem online. However, evolving technology like generative AI has further empowered them, enabling them to create highly realistic fake images, deepfake videos and <a href="https://www.newyorker.com/science/annals-of-artificial-intelligence/the-terrifying-ai-scam-that-uses-your-loved-ones-voice">voice cloning</a>. AI’s ability to automate content creation has also flooded the internet with low-quality, misleading and harmful material at an unprecedented scale. In sum, the accelerated commercialisation of the internet, the dominance of media tech giants and the presence of bad actors have infiltrated content on the internet. The rise of AI further intensifies this, making the internet more chaotic than ever. <h2>Some of the ‘good’ internet remains</h2> So, what was the “good internet” some of us long for with nostalgia? At the outset, the internet was meant to be a free egalitarian space people were meant to “surf” and “browse”. Knowledge was meant to be shared: sites such as Wikipedia and The Internet Archive are continuing bastions of knowledge. Before the advent of filter bubbles, the internet was a creative playground where people explored different ideas, discussed varying perspectives, and collaborated with individuals from “outgroups” – those outside their social circles who may hold opposing views. Early social media platforms were built on the ethos of reconnecting with long-lost classmates and family members. Many of us have community groups, acquaintances and family we reach out to via the internet. The “connection” aspect of the internet remains as important as ever – as we all saw during the COVID pandemic. What else do we want to preserve? Privacy. A New Yorker cartoon joke in 1993 stated that “<a href="https://web.archive.org/web/20051029045942/http://www.unc.edu/depts/jomc/academics/dri/idog.html">on the internet, nobody knows you’re a dog</a>”. Now everyone – especially advertisers – wants to know who you are. To quote the <a href="https://www.oaic.gov.au/privacy/your-privacy-rights/your-personal-information/what-is-privacy">Office of the Australian Information Commissioner</a>, one of the tenets of privacy is “to be able to control who can see or use information about you”. At the very least, we want to control what big tech knows about us, especially if they could stand to profit from it. <h2>Can we ever go back?</h2> We can’t control “a changin’” times, but we can keep as much of the good parts as we can. For starters, we can vote with our feet. Users can enact change and bring awareness to problems on existing platforms. In recent times, we have seen this with the <a href="https://theconversation.com/thinking-of-breaking-up-with-twitter-heres-the-right-way-to-do-it-195002">exodus of users</a> from X (formerly Twitter) to other platforms, and the <a href="https://www.economist.com/the-economist-explains/2023/06/26/why-reddit-users-are-protesting-against-the-sites-leadership">platform-wide protest against Reddit</a> for changing its third-party data access policies. However, voting with our feet is only possible when there’s competition. In the case of X, various other platforms – from Mastodon to Threads to Bluesky – enable users to pick one that aligns with their preferences, values and social circles. Search engines have alternatives, too, such as DuckDuckGo or Ecosia. But competition can only be created by moving to decentralised systems and removing monopolies. This actually happened in the early days of the internet during the 1990s “<a href="https://thehistoryoftheweb.com/browser-wars/">browser wars</a>”, when Microsoft was eventually accused of illegally monopolising the web browser market in <a href="https://en.wikipedia.org/wiki/United_States_v._Microsoft_Corp.">a landmark court case</a>. As users of technology, all of us must remain vigilant about threats to our privacy and knowledge. With cheap and ubiquitous generative AI, misleading content and scams are more realistic as ever. We must exercise healthy scepticism and ensure those most at risk from online threats – such as children and older people – are educated about potential harms. Remember, the internet is not optimised for your best interests. It’s up to you to decide how much power you give to the tech giants who are fuelling theirs.<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/236513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, Senior Lecturer of Information Systems, School of Computing and Information Systems; and (Honorary) Senior Fellow, Melbourne Law School, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, Associate Professor in Media and Communications, <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/the-internet-is-worse-than-it-used-to-be-how-did-we-get-here-and-can-we-go-back-236513">original article</a>. </div>

Technology

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

Readers response: How do you feel about online shopping compared to traditional in-store shopping?

When it comes to shopping for things we want and need, many people have a preference over whether they shop in a physical store or online. We asked our readers which they prefer when shopping for food, clothes or anything else their hearts desire, and the response was overwhelming. Here's what they said. Ellen Polsen - Why would one buy online? I like to feel and see the things I purchase, particularly garments, as fabrics today are mostly rubbish. Jennie Craven - I do a little of each. But usually use stores that I know or brands where the sizing is correct for me. I always use a payment system that I understand. Gail Ladds - I love online shopping! I often forget that I’ve bought something then get a nice surprise when it arrives lol. Debra Coats - Online is okay when you cant go to the store. I did online shopping for about 8 months after open heart surgery but when i was given the all clear to shop and drive, I was in my element as its a moment of getting out of the house and seeing others around me. Karen Peardon - I have done some online shopping (mainly craft supplies) only because I have been very ill for months but I love in-store shopping more. Retail therapy!! Christine Whyte - Have not and will not ever do it, very old school and too wary of the dangers out there, besides I like getting out and choosing for myself. Helga Bonello - I like to see feel and touch products before I buy. Online scammers are a worry, besides we need a reason to go out and be sociable. Olimpia Palumbo - My family does on line shopping and usually end up with the worst fruit and sometimes the wrong items. Image credits: Shutterstock

Money & Banking

What’s a recession – and how can we tell if we’re in one?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/leonora-risse-405312">Leonora Risse</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Today’s <a href="https://www.abs.gov.au/statistics/economy/national-accounts/australian-national-accounts-national-income-expenditure-and-product/latest-release">economic data</a> shows that, outside of the pandemic, the Australian economy has slowed down to its lowest annual rate of growth since the early-1990s recession. That’s prompting the dreaded question: are we headed for another one? Any mention of the “R” word can trigger anxiety. Recessions bring job losses and financial strain, and put serious pressure on people’s mental health. These impacts can be especially severe for people who are already experiencing disadvantage and vulnerabilities. But what exactly does it mean to be in a recession? What are the different ways we define them? And are these current approaches the best way to measure people’s economic pain? <h2>What’s a recession?</h2> A bit like the waves of the ocean, our economy is characterised by ebbs and flows in overall activity. Spending and business growth can swell during times of confidence, but slow down when optimism deflates or the economy is hit by an unexpected shock such as a pandemic or climate disaster. This pattern is what economists describe as “the business cycle”. Most of the time, our economy is constantly growing, even if the pace varies. Conventionally, we measure this pace by tracking changes in the level of <a href="https://www.rba.gov.au/education/resources/explainers/economic-growth.html">gross domestic product</a> (GDP) – the overall volume of items and services being produced, bought and sold in the economy. The <a href="https://www.abs.gov.au/statistics/economy/national-accounts/australian-national-accounts-national-income-expenditure-and-product/jun-2024">latest economic growth rates</a> of 0.2% for the June quarter, and 1% over the past year, tell us that the Australian economy is still growing, even if at a slower pace than previous years. Occasionally, the economy slows down to such a grind that economic activity, from one quarter to the next, shrinks. When this happens, the GDP measurements come out negative. When we have two negative measurements of GDP in a row, this is defined as a <a href="https://www.rba.gov.au/education/resources/explainers/recession.html">technical recession</a>. This is what happened to most countries around the globe during the COVID-19 pandemic. Prior to the pandemic, Australia hadn’t experienced a technical recession since 1991. The latest figures tell us Australia is staying afloat for now. But that doesn’t mean it doesn’t feel like a recession to many people. Some other metrics show why. <h2>Other measures of recession</h2> Growth in economic activity is fuelled, in part, by a growing population. Dividing total economic output by the population size, GDP per capita can offer a more accurate picture of people’s economic reality. This population-adjusted measure of economic growth has long fallen into negative territory. Today’s figures tell us that Australia’s GDP per person has been shrinking for 18 months. Our annual per capita growth rate is now -1.5%. <figure class="align-right zoomable"></figure> In the United States, recessions are measured differently again. Recessions are officially declared by the National Bureau of Economic Research (<a href="https://www.nber.org/research/business-cycle-dating">NBER</a>). Unlike technical recessions, these aren’t based on a simple rule. NBER considers a range of measures beyond GDP – including personal income, employment, personal consumption, wholesale and retail sales, and industrial production across multiple sectors – when deciding whether to declare a US recession. <h2>Is Australia heading for a recession?</h2> This is a challenging question to answer because the GDP figures economists conventionally use to diagnose the situation only come to light after a recession hits. Today’s economic figures from the ABS are for the June 2024 quarter – now more than two months old. Measurements of the current economic climate won’t come through in official statistics for some time. If it occurs, by the time a recession is officially diagnosed, we’re usually well and truly in it. A similar limitation applies to the retrospective approach of the <a href="https://www.nber.org/research/business-cycle-dating">NBER</a>, which “waits until it is confident that a recession has occurred”. It’s like a weather forecaster declaring a cyclone has hit only after the wind gusts have blown your roof away. But we can use other metrics to alert ourselves to recession risks before the eye of the storm hits. <h2>Using jobs numbers as a recession alert</h2> One approach is the <a href="https://fred.stlouisfed.org/series/SAHMCURRENT">Sahm Rule</a>, named after its creator, US economist Claudia Sahm. By analysing patterns in the monthly unemployment data that preceded past recessions, Sahm devised a <a href="https://stayathomemacro.substack.com/p/the-sahm-rule-step-by-step">formula</a> to detect when increases in the current unemployment rate were rapid enough to pose a recession risk. The advantage of this approach is that unemployment statistics come out more quickly and frequently than GDP numbers. Many would also argue that monitoring unemployment, rather than GDP, is a more meaningful metric to reflect people’s everyday experiences of the economy and wellbeing. The Sahm approach tracks how quickly the national unemployment rate is currently rising compared to the past year. It’s calculated by comparing the current three-month moving average of the national unemployment rate to this figure’s lowest value in the previous 12 months. This “moving average” approach smooths out the bumpiness of monthly figures. A jump of 0.5% or more signals the economy’s current pattern is on the cusp of recession. While the Sahm formula was developed for the US economy, it does a fairly good job of waving a red flag where recessions previously occurred in the Australian economy, too. Australia’s latest unemployment rate – inching up to 4.2% in July 2024 – pushed the Sahm value up to 0.5%. <iframe id="3d239" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/3d239/5/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> This indicator doesn’t necessarily mean that a recession will occur. But it suggests policymakers should be on high alert. The Sahm indicator also validates the experiences of job seekers who – despite official definitions that the economy is not in recession – are personally feeling the pressures of a slowing economy and shrinking job opportunities. As our approaches to measuring and managing the ups and downs of the economy continue to evolve, these people-centred metrics are an increasingly important part of our toolkit.<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/238199/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leonora-risse-405312">Leonora Risse</a>, Associate Professor in Economics, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/whats-a-recession-and-how-can-we-tell-if-were-in-one-238199">original article</a>. </div>

Money & Banking

The hidden epidemic: How ageism affects Australians over 60

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

Retirement Life

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <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/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

Body

Revealed: How much regular sex each generation is having

While it's often seen as a taboo subject, researchers from Kinsey Institute at Indiana University, have just revealed their report on the sex lives of thousands of people around the world and across different generations. The report, titled The State of Dating: How Gen Z is Redefining Sexuality and Relationships is based on data from over 3,310 people of the dating app, Feeld. The participants, who came from 71 different countries and between 18-75 years old, were surveyed about their sex lives and results are not what you'd expect. Gen Z is having less sex, fewer partners and fewer relationships than other generations, reporting that on average they had had sex three times in the last month. "Gen Z and Boomers exhibited nearly identical sexual frequencies, suggesting that both the youngest and oldest adults are having the least sex," the researchers, led by Dr Justin Lehmiller, wrote in the report. Millennials and Gen X reported slightly higher figures, with both groups having sex five times in the last month. "Also, nearly half of Gen Z reported that they were single, compared to only one-ﬁfth of Millennials, Gen X, and Boomers." Despite having the least sex, Gen Z appears to be the most adventurous group in the bedroom, with 55 per cent of them saying they'd discovered a new kink since joining the app compared to 49 per cent of Millennials, 39 per cent of Gen X, and 33 per cent of Boomers. Researchers said there are two possible explanations for this. "One is simply that older adults have had more time to learn and discover what they enjoy about sex, so they may have already uncovered their kinks. "However, the other is that it also appears to be the case that younger adults today have a greater overall interest in kink than older adults, which may create greater openness to exploring and learning about one's kinks." The researchers hope that their findings will help shed new light on the evolution of sex, gender, sexuality and relationships. "Despite the longstanding tendency of humans to narrowly categorize sexuality and relationships, they have always existed on a continuum, and that continuum will only evolve and expand further as Gen Z and future generations continue their pursuit of sexual and relational self-discovery," they wrote. "The more that we can understand and embrace this simple fact of human life, the better suited we will all be to pursuing pleasure and happiness." Images: Shutterstock

Relationships

How much money is actually thrown into the Trevi Fountain

Around 21 million tourists visit Rome each year, with most of them making a pit stop at the Trevi fountain, one of the most popular and Instagrammable tourist spots in the world. Many take part in the special tradition that has been going on for hundreds of years, that is tossing a coin into the fountain in hopes that their wishes come true. The money is collected twice a week, with signs around the fountain explaining that the change will go to the local not-for-profit organisation Caritas, which is run by the Catholic Church. The money is then used to fund a food bank, soup kitchen and welfare projects in Rome. “The collection and cleaning operations are carried out as quickly as possible to try to reduce the downtime of the fountain,” Francesco Prisco, a manager at regional utility ACEA said. The coins are collected by ACEA workers using long brooms and suction hoses, and according to a 2022 report by Reuters, the church collected 1.4 million euros – about $A2.2 million — from the fountain, with more believed to have been gathered in 2023. The iconic tourist attraction was completed in 1762 and covers one side of Palazzo Poli in central Rome with its statues of Tritons guiding the shell chariot of the god Oceanus. It has since attracted millions of visitors. Image: Shutterstock

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I’m iron deficient. Which supplements will work best for me and how should I take them?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant. The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration. If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day? Here are some tips to help you work out how, when and what iron supplement to take. <h2>How do I pick the right iron supplement?</h2> The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need. The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain. In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%). These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost. Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency. <h2>Should I take tablets or liquid formulas?</h2> Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference. The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term. <h2>What should I eat with my iron supplement?</h2> Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone. If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it. Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>. On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement. <h2>Should I take my supplement in the morning or evening?</h2> The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest. Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop. <a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes). <h2>My supplements are upsetting my stomach. What should I do?</h2> If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily. Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects. Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success. It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it. If you think you may be low on iron, talk to your GP to find out your best options.<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/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic 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/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>. </div>

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