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Been drinking and your heart’s fluttering? You may have ‘holiday heart’

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/sabine-allida-2236436">Sabine Allida</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>It’s the time of year for workplace Christmas parties, and gatherings with family and friends. Maybe you’ll drink a lot in one go.</p> <p>Then you feel your heart beating fast or irregularly. Maybe there’s a flutter in your chest or neck. Maybe you feel dizzy or short of breath. You may feel so concerned you go to the emergency department.</p> <p>After a few tests, you’re told you have “alcohol-induced atrial arrhythmia”. In plain English, that’s an irregular heartbeat brought on by excessive, or binge drinking.</p> <p>The condition is common at this time of year. That’s why it’s also called “<a href="https://www.sciencedirect.com/science/article/abs/pii/000287037890296X">holiday heart</a>”.</p> <h2>What is holiday heart?</h2> <p>Every festive season, emergency departments see more people with <a href="https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/impact-of-alcoholrelated-presentations-to-emergency-departments-on-days-with-a-public-holiday-or-sporting-event-a-retrospective-cohort-study/174603C0385FE6FCEBBAEA1A10DB25BD">alcohol-related issues</a> and <a href="https://www.heartlungcirc.org/article/S1443-9506(16)30583-2/pdf">irregular heart rhythms</a>.</p> <p>People often present with a fast or irregular heartbeats associated with binge drinking, overeating, dehydration and increased stress over the silly season – all contributing factors.</p> <p>We’ve known about holiday heart (or holiday heart syndrome) for <a href="https://www.sciencedirect.com/science/article/abs/pii/000287037890296X">almost 50 years</a>. Back in the 1970s, it was described as an abnormal heart rhythm (or arrythmia) in healthy people without heart disease after binge drinking alcohol. Doctors often saw this after weekends and public holidays, including the festive season.</p> <p>But an abnormal heart rhythm related to alcohol <a href="https://www.sciencedirect.com/science/article/pii/S2405500X22009379#bib2">isn’t limited</a> to the holidays and weekends. We also see it in people who binge drink at any time of year, or in people who drink heavily over many years.</p> <h2>What causes it? How is it diagnosed?</h2> <p>Alcohol affects your <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5513687/">heart, blood vessels, blood</a> and nervous system in many ways.</p> <p>For instance, when alcohol disrupts your nervous system, it can lead to dehydration and inflammation. In turn, this can cause disruption to the heart’s electrical system, which can lead to an <a href="https://pubmed.ncbi.nlm.nih.gov/28867013/">irregular heartbeat</a>.</p> <p>People may go to hospital with heart flutters, chest pain, fainting or passing out (syncope) and shortness of breath (dyspnoea). But an irregular heartbeat can also occur without symptoms, and may only be discovered when investigating other health issues.</p> <p>If you have symptoms, go to your emergency department or GP. Health professionals will likely run some tests to diagnose heart-related rhythm problems.</p> <p>These include monitoring the heart’s rhythm using an ECG or electrocardiogram. This simple and non-invasive test involves attaching some electrodes to your chest, arms and legs to produce a graph of electrical signals from the heart. Clinicians are often interested in the “p wave”, which represents the electrical activation of the upper chambers of the heart.</p> <p>You may also have a blood test to look at your electrolyte levels (essential minerals in your blood). A blood test may also test for markers of clotting and inflammation, as well as kidney and liver function.</p> <h2>Why are we concerned about it?</h2> <p>The vast majority of people diagnosed with holiday heart will recover, especially if treated early or if they stop or limit drinking alcohol.</p> <p>However, some people will be diagnosed with <a href="https://theconversation.com/getting-to-the-heart-of-the-matter-on-stroke-7180">atrial fibrillation</a> – the <a href="https://www.heartlungcirc.org/article/S1443-9506(18)31778-5/fulltext">most common</a> heart rhythm disorder in Australian adults, affecting <a href="https://www.sciencedirect.com/science/article/pii/S1443950617304845">1.4-5.5%</a> of the population.</p> <p>If so, this may require medicines to restore a regular heartbeat (known as <a href="https://www.svhhearthealth.com.au/procedures/procedures-treatments/cardioversion">cardioversion</a>), electrical cardioversion (using a defibrillator to apply an electric shock to the heart) or a procedure called <a href="https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/ablation-for-arrhythmias">cardiac ablation</a>.</p> <p>If atrial fibrillation is left untreated, there’s an increased risk of blood clots, stroke and a heart attack.</p> <h2>How can you prevent it?</h2> <p>There is no definitive number of drinks known to trigger holiday heart. So our best advice to prevent it is to avoid binge drinking. Australian <a href="https://www.nhmrc.gov.au/health-advice/alcohol">guidelines</a> recommend women and men limit alcohol to no more than ten standard drinks a week and no more than four standard drinks on any one day.</p> <p>We’d also recommend drinking water between alcoholic drinks. This can help reduce the dehydrating effects of alcohol and reduce the risk of alcohol-induced heart rhythm complications.</p> <p>Then do your best to <a href="https://journals.sagepub.com/doi/full/10.1177/2156587214543143">reduce stress</a>, keep up with exercise and eat a diet that’s <a href="https://www.heartfoundation.org.au/healthy-living/healthy-eating/heart-healthy-eating-pattern">good for your heart</a> – all general advice for looking after your heart, whether or not you’re drinking alcohol.</p> <p>Taking these steps will help reduce your risk of holiday heart and keep your heart healthy this festive season.</p> <hr /> <p><em>Information about alcohol and the heart is available from the <a href="https://www.heartfoundation.org.au/blog/alcohol-and-heart-health">Heart Foundation</a>. If your GP is closed over the holidays and you need health advice, call <a href="https://www.healthdirect.gov.au/">healthdirect</a> on 1800 022 222, <a href="https://www.health.vic.gov.au/primary-care/nurse-on-call">NURSE-ON-CALL</a> in Victoria on 1300 60 60 24 or <a href="https://www.qld.gov.au/health/contacts/advice/13health">13HEALTH</a> in Queensland on 13 43 25 84. In an emergency in Australia, call 000.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/241469/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/caleb-ferguson-72"><em>Caleb Ferguson</em></a><em>, Professor of Nursing and Director of Health Innovations, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/sabine-allida-2236436">Sabine Allida</a>, Research Fellow (Implementation Science), <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/been-drinking-and-your-hearts-fluttering-you-may-have-holiday-heart-241469">original article</a>.</em></p> </div>

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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels.</p> <p>However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>.</p> <p>Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes.</p> <p>Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?</p> <h2>Osteoarthritis and obesity</h2> <p>Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis.</p> <p>Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation.</p> <p>For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>.</p> <p>Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help.</p> <p>But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.</p> <p>Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.</p> <h2>Semaglutide for osteoarthritis?</h2> <p>The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.</p> <p>They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.</p> <p>As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.</p> <p>The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.</p> <p>This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.</p> <p>The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>.</p> <p>Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.</p> <h2>How could semaglutide reduce knee pain?</h2> <p>It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.</p> <p>But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>.</p> <p>While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.</p> <p>The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.</p> <p>It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue.</p> <p>There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this.</p> <p>Further, it can be difficult to access.</p> <h2>I have knee osteoarthritis, what should I do?</h2> <p>Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstocl</em></p> <p><em>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/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>.</em></p> </div>

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Having the ‘right’ friends may hold the secret to building wealth, according to new study on socioeconomic ties

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/brad-cannon-2216202">Brad Cannon</a>, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a></em></p> <p>Having wealthy people in your social network significantly boosts the likelihood that you’ll participate in stock markets and savings plans, according to a new working paper I co-authored.</p> <p>My colleagues and I <a href="https://www.nber.org/system/files/working_papers/w32186/w32186.pdf">recently conducted research</a> on social finance to understand the ways in which social networks affect stock market participation and savings behavior. This is important because a substantial fraction of households in the U.S., particularly <a href="https://www.axios.com/2023/10/18/percentage-americans-own-stock-market-investing">lower-income families, do not own stocks</a>.</p> <p>Given that the total return to the U.S. stock market from 1980 through September 2024 has been over 12,000% – for example, US$1,000 <a href="https://ofdollarsanddata.com/sp500-calculator/">invested in the S&amp;P 500</a> in 1980 would be worth $121,350 today – this creates a disparity in wealth for those who participate relative to those who do not. Understanding why some people invest and others don’t is important for addressing social concerns such as rising inequality.</p> <p>In our study, we looked at <a href="https://academic.oup.com/ej/advance-article/doi/10.1093/ej/ueae074/7720537">social capital</a>, which is a measure of the value that comes from being in a group or having dense social networks. Researchers have found that social capital can have positive impacts on individuals and communities, spurring innovation, <a href="https://www.nature.com/articles/s41586-022-04996-4">economic prosperity</a> and better health outcomes. We used friendship data from Facebook to measure different aspects of social networks by county in the U.S. We combined this data with tax information from the Internal Revenue Service about investments and savings.</p> <p>We found that in counties where friendships with prosperous individuals are more common, investment and savings tend to be higher. Moreover, we found that having these friendships with wealthy individuals plays a more important role in shaping financial behaviors than two other aspects of social capital we looked at in our study: having a tight group of friends and living in a community with strong civic engagement.</p> <p>Of course, making wealthy friends alone does not guarantee you’ll invest or save more. But perhaps knowing people who invest makes it less daunting and fraught, particularly if those friends can serve as a resource and sounding board.</p> <p><em>“Friends with Benefits: Social Capital and Household Financial Behavior” was co-authored by <a href="https://www.marshall.usc.edu/personnel/david-hirshleifer">David Hirshleifer</a> and <a href="https://hankamer.baylor.edu/person/joshua-thornton">Joshua Thornton</a>.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/239370/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/brad-cannon-2216202">Brad Cannon</a>, Assistant Professor of Finance, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/having-the-right-friends-may-hold-the-secret-to-building-wealth-according-to-new-study-on-socioeconomic-ties-239370">original article</a>.</em></p> </div>

Money & Banking

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Humans evolved to share beds – how your sleeping companions may affect you now

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/goffredina-spano-2240566">Goffredina Spanò</a>, <a href="https://theconversation.com/institutions/kingston-university-949">Kingston University</a> and <a href="https://theconversation.com/profiles/gina-mason-2240569">Gina Mason</a>, <a href="https://theconversation.com/institutions/brown-university-1276">Brown University</a></em></p> <p><a href="https://www.cell.com/trends/ecology-evolution/fulltext/S0169-5347(24)00176-9">Recent research</a> on animal sleep behaviour has revealed that sleep is influenced by the animals around them. Olive baboons, for instance, sleep less as group sizes increase, while mice can synchronise their rapid eye movement (REM) cycles.</p> <p>In western society, many people expect to sleep alone, if not with a romantic partner. But as with other group-living animals, human co-sleeping is common, despite some <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945710000377">cultural</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S2352721820303053?via%3Dihub">age-related variation</a>. And in many cultures, bedsharing with a relative is considered typical.</p> <p>Apart from <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945710000377">western countries</a>, caregiver-infant co-sleeping is common, with rates as high as <a href="https://www.sciencedirect.com/science/article/abs/pii/S1087079216000265">60-100%</a> in parts of South America, Asia and Africa.</p> <p>Despite its prevalence, infant co-sleeping is controversial. Some western perspectives, that value self-reliance, argue that sleeping alone promotes self-soothing when the baby wakes in the night. But <a href="https://www.tandfonline.com/doi/abs/10.1080/00221325.2021.1905599">evolutionary scientists argue</a> that co-sleeping has been important to help keep infants warm and safe throughout human existence.</p> <p><a href="https://www.sleephealthjournal.org/article/S2352-7218(22)00077-8/abstract">Many cultures</a> do not expect babies to self-soothe when they wake in the night and see night wakings as a normal part of breastfeeding <a href="https://www.sciencedirect.com/science/article/pii/S1389945713002220?via%3Dihub">and development</a>.</p> <p>Concerns about Sudden Infant Death Syndrome (Sids) have often led paediatricians to discourage bed-sharing. However, when studies control for <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0107799">other Sids risk factors</a> including unsafe sleeping surfaces, Sids risk does not seem to differ statistically between co-sleeping and solitary sleeping infants.</p> <p>This may be one reason why agencies such as the <a href="https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022?autologincheck=redirected">American Academy of Pediatrics</a>, the <a href="https://www.nice.org.uk/guidance/qs37/chapter/Quality-statement-5-Safer-practices-for-bed-sharing">National Institute for Health and Care Excellence</a> and the <a href="https://www.nhs.uk/conditions/baby/caring-for-a-newborn/reduce-the-risk-of-sudden-infant-death-syndrome/">NHS</a> either <a href="https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022">recommend that</a> infants “sleep in the parents’ room, close to the parents’ bed, but on a separate surface,” or, if bedsharing, to make sure that the infant <a href="https://www.nice.org.uk/guidance/qs37/chapter/Quality-statement-5-Safer-practices-for-bed-sharing">“sleeps on a firm, flat mattress”</a> without pillows and duvets, rather than discouraging co-sleeping altogether.</p> <p>Researchers don’t yet know whether co-sleeping causes differences in sleep or, whether co-sleeping happens because of these differences. However, experiments in the 1990s suggested that co-sleeping can <a href="https://onlinelibrary.wiley.com/doi/10.1002/ajpa.20736">encourage more sustained and frequent bouts of breastfeeding</a>. Using sensors to measure brain activity, this research also suggested that infants’ and caregivers’ sleep may be lighter during co-sleeping. But researchers speculated that this lighter sleep may actually <a href="https://www.tandfonline.com/doi/full/10.1080/00221325.2021.1905599">help protect against Sids</a> by providing infants more opportunities to rouse from sleep and develop better control over their respiratory system.</p> <p>Other advocates believe that co-sleeping <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163638319301237">benefits infants’ emotional and mental health</a> by promoting parent-child bonding and aiding infants’ <a href="https://www.tandfonline.com/doi/full/10.3109/10253890.2012.742057">stress hormone regulation</a>. However, current data is inconclusive, with most studies showing <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163638319301249?via%3Dihub">mixed findings</a> or <a href="https://www.tandfonline.com/doi/full/10.1080/14616734.2024.2380427">no differences</a> between co-sleepers and solitary sleepers with respect to short and long-term mental health.</p> <h2>Co-sleeping in childhood</h2> <p>Childhood co-sleeping past infancy is also fairly common according to <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945713011076?via%3Dihub">worldwide surveys</a>. A <a href="https://publications.aap.org/pediatrics/article-abstract/126/5/e1119/65347/Relationship-Between-Bed-Sharing-and-Breastfeeding">2010 survey</a> of over 7,000 UK families found 6% of children were constant bedsharers up to at least four years old.</p> <p>Some families adopt co-sleeping <a href="https://capmh.biomedcentral.com/articles/10.1186/s13034-023-00607-w">in response to</a> their child having trouble sleeping. But child-parent bedsharing in many countries, including some western countries <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1471-6712.2005.00358.x">like Sweden</a> where children often co-sleep with parents until school age, is viewed culturally as part of a nurturing environment.</p> <p>It is also common for siblings to share a room or even a bed. A <a href="https://www.tandfonline.com/doi/full/10.1080/00221325.2021.1916732">2021 US study</a> found that over 36% of young children aged three to five years bedshared in some form overnight, whether with caregivers, siblings, pets or some combination. Co-sleeping decreases but is still present among older children, with up to <a href="https://onlinelibrary.wiley.com/doi/10.1111/fare.12955">13.8% of co-sleeping parents</a> in Australia, the UK and other countries reporting that their child was between five and 12 years old when they engaged in co-sleeping.</p> <p>Two recent US studies using wrist-worn actigraphs (motion sensors) to track sleep indicated that kids who bedshare may have <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.11352">shorter sleep durations</a> than children who sleep alone. But this shorter sleep duration <a href="https://www.tandfonline.com/doi/full/10.1080/00221325.2021.1916732">is not explained by</a> greater disruption during sleep. Instead, bedsharing children may lose sleep by <a href="https://www.tandfonline.com/doi/full/10.1080/00221325.2021.1916732">going to bed later than</a> solitary sleepers.</p> <p>The benefits and downsides of co-sleeping may also differ in children with conditions such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945717303842">autism spectrum disorder</a>, <a href="https://link.springer.com/article/10.1007/s10802-017-0387-1">mental health disorders</a> and <a href="https://onlinelibrary.wiley.com/doi/10.1111/dmcn.13300">chronic illnesses</a>. These children may experience heightened anxiety, sensory sensitivities and physical discomfort that make falling and staying asleep difficult. For them, co-sleeping can provide <a href="https://link.springer.com/article/10.1007/s11325-018-1710-y">reassurance</a>.</p> <h2>Adults sharing beds</h2> <p>According to <a href="https://www.sleepfoundation.org/wp-content/uploads/2018/10/NSF_Bedroom_Poll_Report_1.pdf">a 2018 survey</a> from the US National Sleep Foundation, 80-89% of adults who live with their significant other share a bed with them. Adult bedsharing has shifted over time from pre-industrial <a href="https://academic.oup.com/ahr/article-abstract/106/2/343/64370?redirectedFrom=fulltext">communal arrangements</a>, including whole families and other household guests, to <a href="https://academic.oup.com/jdh/article-abstract/23/3/275/359439?redirectedFrom=fulltext">solo sleeping</a> in response to hygiene concerns as germ theory became accepted.</p> <p>Many couples find that bedsharing boosts their <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC1978364/">sense of closeness</a>. Research shows that bedsharing with your partner can lead to <a href="https://onlinelibrary.wiley.com/doi/10.1155/2017/8140672">longer sleep times</a> and a <a href="https://academic.oup.com/sleep/article-abstract/17/4/308/2753131">feeling of better sleep</a> overall.</p> <p>Bedsharing couples also often <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.00583/full">get into sync</a> with each other’s sleep stages, which can enhance that feeling of intimacy. However, it’s not all rosy. Some studies indicate that females in heterosexual relationships may struggle more with sleep quality when bedsharing, as they can be <a href="https://link.springer.com/article/10.1111/j.1479-8425.2007.00320.x">more easily disturbed</a> by their male partner’s movements. Also, bedsharers can have less <a href="https://pubmed.ncbi.nlm.nih.gov/27624285/">deep sleep</a> than when sleeping alone, even though they feel like their sleep is better together.</p> <p>Many questions about co-sleeping remain unanswered. For instance, we don’t fully understand the developmental effects of co-sleeping on children, or the benefits of co-sleeping for adults beyond female-male romantic partners. But, some work suggests that co-sleeping can <a href="https://link.springer.com/article/10.1007/s11325-018-1710-y">comfort us</a>, similar to other <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.14174">forms of social contact</a>, and help to enhance <a href="https://onlinelibrary.wiley.com/doi/10.1002/ajpa.20736">physical synchrony</a> between parents and children.</p> <p>Co-sleeping doesn’t have a one-size-fits-all answer. But remember that western norms aren’t necessarily the ones we have evolved with. So consider factors such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945716301265">sleep disorders</a>, health and age in your decision to co-sleep, rather than what everyone else is doing.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/241803/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/goffredina-spano-2240566">Goffredina Spanò</a>, Lecturer in Developmental Cognitive Neuroscience, <a href="https://theconversation.com/institutions/kingston-university-949">Kingston University</a> and <a href="https://theconversation.com/profiles/gina-mason-2240569">Gina Mason</a>, Postdoctoral Research Fellow in Psychiatry and Human Behaviour, <a href="https://theconversation.com/institutions/brown-university-1276">Brown University</a></em></p> <p><em>Image </em><em>credits: Shutterstock </em></p> <p><em>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/humans-evolved-to-share-beds-how-your-sleeping-companions-may-affect-you-now-241803">original article</a>.</em></p> </div>

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Mick Jagger welcomes new grandchild

<p>Mick Jagger has become a grandpa again as his 32-year-old daughter, Georgia May, welcomed her first baby with boyfriend Cambryan Sedlick. </p> <p>"Our Son Dean Lee Jagger Sedlick was born September 30th," she announced on Instagram with a series of polaroid photos of the pair and their bub. </p> <p>"We are so in Love and happy and can't stop staring at him."</p> <p>Georgia first announced she was pregnant in June, sharing photos of her baby bump to Instagram.</p> <p>She also thanked her boyfriend for "being so incredible through everything and taking such good care of us".</p> <p>The photo was flooded with congratulatory messages from fellow celebrities including from <em>Daisy Jones & The Six</em> actress Suki Waterhouse and Meadow Walker, daughter of the late <em>Fast and Furious</em> actor Paul Walker.</p> <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-captioned="" data-instgrm-permalink="https://www.instagram.com/p/DA8YB_MiiJ-/?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/p/DA8YB_MiiJ-/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Georgia May Jagger (@georgiamayjagger)</a></p> </div> </blockquote> <p>"Cutest parents ever ❤️" Suki wrote. </p> <p>In one of the photos, Jerry Hall had her arms around her daughter as she smiled for the photo with her new grandchild. </p> <p>Jerry and Mick were together from 1977 to 1999 and share four children together, Elizabeth, 40, Georgia May, James, 39, and Gabriel, 26. </p> <p>The Rolling Stones frontman is also father to daughter Karis, 53, whom he welcomed with ex Marsha Hunt, daughter Jade, 53, whom he shares with ex-wife Bianca Jagger, son Lucas, 25, whom he welcomed with ex Luciana Gimenez.</p> <p>He also shares a seven-year-old son with his current partner Melanie Hamrick.</p> <p><em>Images: Instagram</em></p> <p> </p>

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High-speed rail plans may finally end Australia’s 40-year wait to get on board

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/philip-laird-3503">Philip Laird</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>Australia has debated and studied high-speed rail for four decades. The High Speed Rail Authority has begun <a href="https://www.hsra.gov.au/project">work on a project</a> that could finally deliver some high-speed rail in the 2030s.</p> <p>The Albanese government set up the authority in 2022. It also committed A$500 million to plan and protect a high-speed rail corridor between Sydney and Newcastle. This corridor was prioritised due to significant capacity constraints on the existing line, among other reasons.</p> <p>The ultimate plan is for a high-speed rail network to connect Brisbane, Sydney, Canberra, Melbourne and regional communities across the east coast. The network would help Australia in its urgent task to reduce greenhouse gas emissions from transport. These <a href="https://www.infrastructure.gov.au/infrastructure-transport-vehicles/towards-net-zero-transport-and-infrastructure">continue to increase</a> even as emissions from other sectors fall.</p> <p>The authority has now publicly outlined plans for the first stage of this east coast network. After a history of failed proposals dating back to 1984, the new plans provide some cause for optimism that Australia could have some high-speed rail by 2037.</p> <h2>What is high-speed rail and why do we need it?</h2> <p>The International Rail Union of Railways <a href="https://uic.org/passenger/highspeed">defines high-speed rail</a> as new lines designed for speeds of 250km/h or more and upgraded lines for speeds of at least 200km/h.</p> <p>High-speed rail could greatly reduce transport emissions by replacing <a href="https://theconversation.com/wondering-how-to-get-from-brisbane-to-melbourne-without-wrecking-the-climate-our-transport-choices-make-a-huge-difference-237396">air travel in particular</a>.</p> <p>For example, the <a href="https://www.bitre.gov.au/publications/ongoing/domestic_airline_activity-monthly_publications">7.92 million passengers</a> flying between Melbourne and Sydney in 2023-24 produced about 1.5 million tonnes of emissions. Including <a href="https://theconversation.com/how-air-travellers-can-cut-their-door-to-door-emissions-right-now-by-as-much-as-13-on-the-sydney-melbourne-route-211099">travel to and from airports</a> and other flight routes along the corridor (Sydney or Melbourne to Canberra, Albury etc), this adds up to about 2% of <a href="https://www.dcceew.gov.au/climate-change/strategies/annual-climate-change-statement-2023">annual domestic transport emissions</a>.</p> <p>A Sydney–Melbourne high-speed rail link could cut emissions to a fraction of those from <a href="https://theconversation.com/wondering-how-to-get-from-brisbane-to-melbourne-without-wrecking-the-climate-our-transport-choices-make-a-huge-difference-237396">air</a> and <a href="https://theconversation.com/we-compared-land-transport-options-for-getting-to-net-zero-hands-down-electric-rail-is-the-best-234092">road</a> transport. If Australia is to achieve <a href="https://www.dcceew.gov.au/climate-change/emissions-reduction/net-zero">net zero by 2050</a>, a <a href="https://theconversation.com/we-compared-land-transport-options-for-getting-to-net-zero-hands-down-electric-rail-is-the-best-234092">shift to rail will be essential</a>.</p> <p>High-speed city-to-city rail services will be needed to become an attractive alternative to air travel.</p> <h2>What is the authority working on?</h2> <p>Early this year the High Speed Rail Authority gained a new CEO, Tim Parker, with extensive experience in delivering mega-projects. In late August, the authority outlined its plans at an industry briefing in Newcastle.</p> <p>The authority has commissioned eight studies, including a business case for a Sydney–Newcastle line. Significantly, it will include the cost of future highway upgrades if high-speed rail does not proceed. This study, along with a report on how high-speed rail will proceed along Australia’s east coast, is due by the end of this year.</p> <p>Also under way is a <a href="https://minister.infrastructure.gov.au/c-king/media-release/all-aboard-high-speed-rail-accelerates-first-investigation-works">geotechnical study</a> that includes drilling 27 boreholes. It will help determine the proposed depths of two long rail tunnels and guide decisions on crossing the Hawkesbury River and the route to the Central Coast and on to Newcastle.</p> <p>All going well, including land acquisition and agreements with the New South Wales government (which could include funding), work could <a href="https://www.newcastleherald.com.au/story/8743698/newcastle-high-speed-rail-possible-by-2037-as-tunnel-plan-emerges">start in 2027 and be completed by 2037</a>.</p> <h2>Many questions remain</h2> <p>Given the time and money required to deliver a Sydney–Newcastle line, bipartisan support will be needed. However, the federal opposition is yet to make a clear commitment to high-speed rail.</p> <p>There are other uncertainties too. Will the trains be operated by the public or private sector? The latter was the intention for projects that were scrapped decades ago, such as the CSIRO-proposed Very Fast Train (<a href="http://www.repositoryofideas.com/VFT_information.html">VFT</a>) linking Sydney, Canberra and Melbourne, and the Sydney–Canberra <a href="https://trid.trb.org/View/1203853">Speedrail</a>.</p> <p>And how will the engineering projects be delivered? The new authority must learn from the project management <a href="https://www.infrastructure.gov.au/department/media/news/independent-review-inland-rail-released">problems in delivering the Inland Rail</a> freight line. The project is running late and costs have blown out.</p> <p>Some major federally funded government projects have worked well. These include upgrades of the national highway system (by state road authorities and contractors) and the new <a href="https://www.westernsydneyairport.gov.au/">Western Sydney International Airport</a>, which is nearing completion.</p> <h2>And what about a full Sydney–Melbourne line?</h2> <p>The big question is when work will start on a Sydney–Melbourne high-speed rail service. In 2019, International High-Speed Rail Association chairman <a href="https://ara.net.au/media-release/ausrailplus-2019-conference-exhibition-3-5-december-2019-in-sydney/">Masafumi Shukuri estimated</a> building this line could take 20 years.</p> <p>The present line is 60km longer than it should be as the route dates back to the steam age. It also has far too many tight curves. This means train travel on this line is slower than cars and trucks.</p> <p>As former NSW State Rail chief Len Harper <a href="https://theconversation.com/more-than-ever-its-time-to-upgrade-the-sydney-melbourne-railway-187169">said</a> in 1995, this railway was already “inadequate for current and future needs” even back then.</p> <p>When the VFT was proposed in 1984, questions were raised as to whether our population was big enough for such a project. Now, more than 15.5 million people live in NSW, Victoria and the Australian Capital Territory. Melbourne–Sydney is the <a href="https://www.smh.com.au/traveller/travel-news/the-world-s-busiest-flight-routes-and-airports-revealed-20231222-p5et7n.html">world’s fifth-busiest flight route</a>.</p> <p>Advocacy group Fastrack Australia <a href="https://www.fastrackaustralia.net/hsr-implementation-plan">has called</a> for a Sydney–Melbourne track built to high-speed standards and able to carry freight. The estimated travel time is four hours.</p> <p>This group and the <a href="https://www.railfutures.org.au/category/submissions/%20July%202024%20reducing%20emissions%20in%20freight">Rail Futures Institute</a> propose the line be built in stages, with priority given to the section from near Macarthur to Mittagong in NSW. This would reduce the current line’s length by about 18km and allow for better Sydney–Canberra train services.</p> <p>Urgent action is needed to protect the rail corridor from encroaching urban development.</p> <h2>Australia needs to catch up</h2> <p>In June 2023, when the new authority started work, I <a href="https://theconversation.com/can-the-new-high-speed-rail-authority-deliver-after-4-decades-of-costly-studies-206287">observed</a> that Australia must surely hold the world record for studies into high-speed rail with no construction.</p> <p>In stark contrast, this October marks the 60th anniversary of the world’s first dedicated high-speed rail line, the Tokaido Shinkansen in Japan linking Tokyo to Shin-Osaka. The network has since grown in stages to about 3,000km of lines.</p> <p>Today, high-speed rail <a href="https://uic.org/passenger/highspeed/article/high-speed-data-and-atlas">operates in 21 countries</a> over about 60,000km of lines – China has about 40,000km. Indonesia’s high-speed rail service between Jakarta and Bandung started running last year. India and Thailand are in the advanced stages of delivering high-speed rail. It’s also under construction in another 11 countries.</p> <p>Australia could finally join them in the next few years if it starts building the Sydney–Newcastle line.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/238232/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/philip-laird-3503">Philip Laird</a>, Honorary Principal Fellow, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/high-speed-rail-plans-may-finally-end-australias-40-year-wait-to-get-on-board-238232">original article</a>.</em></p> </div>

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Offering end of life support as part of home care is important – but may face some challenges

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Earlier this month, the government announced <a href="https://theconversation.com/the-government-has-a-new-plan-for-residential-aged-care-heres-whats-changing-238765">major changes</a> to aged care in Australia, including a A$4.3 billion <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">investment in home care</a>.</p> <p>Alongside a shake up of home care packages, the Support at Home program will include an important addition – an <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">end of life pathway</a> for older Australians.</p> <p>This pathway will allow access to a <a href="https://www.health.gov.au/our-work/support-at-home/features">higher level</a> of in-home aged care services to help Australians stay at home as they come to the end of their life. Specifically, it will provide an extra A$25,000 for palliative support when a person has three months or less left to live.</p> <p>This is a positive change. But there may be some challenges to implementing it.</p> <h2>Why is this important?</h2> <p>Older people have made clear their preference to remain in their homes as they age. For <a href="https://journals.sagepub.com/doi/10.1177/0269216313487940">most people</a>, home is where they would like to be during their last months of life. The space is personal, familiar and comforting.</p> <p>However, data from the <a href="https://www.abs.gov.au/statistics/research/classifying-place-death-australian-mortality-statistics">Australian Bureau of Statistics</a> shows most people who die between the ages of 65 and 84 die in hospital, while most people aged 85 and older die in residential aged care.</p> <p>This apparent gap may reflect a lack of appropriate services. Both palliative care services and GPs have an important role in providing medical care to people living at home with a terminal illness. However, being able to <a href="https://grattan.edu.au/wp-content/uploads/2014/09/815-dying-well.pdf">die at home</a> relies on the availability of ongoing support including hands-on care and assistance with daily living.</p> <p>Family members and friends often provide this support, but this is not always possible. Even when it is, carers may <a href="https://pubmed.ncbi.nlm.nih.gov/38533612/">lack confidence and skills</a> to provide the necessary care, and may not have enough support for and respite from their carer role.</p> <p>The palliative care funding offered within Support at Home should help an older person to remain at home and die at home, if that is their preference.</p> <p>Unless someone dies suddenly, care needs are likely to increase at the end of a person’s life. Supports at home may involve help with showering and toileting, assessing and addressing symptoms, developing care plans, managing medications, wound dressing, domestic tasks, preparing meals, and communicating with the person’s family.</p> <p>Occupational therapists and physiotherapists can assist with equipment requirements and suggest home modifications.</p> <p>End of life supports may also involve clarifying goals of care, contacting services such as pharmacists for medications or equipment, liaising with organisations about financial matters, respite care or funeral planning, as well as acknowledging grief and offering spiritual care.</p> <p>But we don’t know yet exactly what services the $25,000 will go towards.</p> <h2>What do we know about the scheme so far?</h2> <p>The Support at Home program, including the end of life pathway, is scheduled to start from <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">July 1 2025</a>.</p> <p>We know the funding is linked to a prognosis of three months or less to live, which will be determined <a href="https://www.abc.net.au/news/2024-09-15/new-payment-aims-to-make-it-easier-for-people-to-die-at-home/104347984">by a doctor</a>.</p> <p>Further information has indicated that an older person can be referred to a <a href="https://www.health.gov.au/our-work/support-at-home/features">high-priority assessment</a> to access the end of life pathway. We don’t know yet what this means, however they don’t need to be an existing Support at Home participant to be eligible.</p> <p>The pathway will allow 16 weeks to use the funds, possibly to provide some leeway around the three-month timeline.</p> <p>Although more details are coming to light, there are still some things which remain unclear.</p> <p>Home care providers will be looking for details on what can be covered by this funding and how they will work alongside primary care providers and health-care services.</p> <p>Older people and their families will want to know the processes to apply for this funding and how long applications will take to be reviewed.</p> <p>Everyone will want to know what happens if the person doesn’t die within three months.</p> <h2>Some challenges</h2> <p>Ready availability of appropriate supports and services will be crucial for older people accessing this pathway. Home care providers will therefore need to assess how an end of life pathway fits into their operational activities and how they can build the necessary skills and capacity.</p> <p>Demand for nurses with palliative care skills and allied health professionals is likely to increase. Providing end of life care can be <a href="https://pubmed.ncbi.nlm.nih.gov/33096682/">especially taxing</a> so strategies will be needed to prevent staff burnout and encourage self-care.</p> <p>How pathways are implemented in rural and remote areas and in different cultural and community groups will need to be monitored to ensure all older people benefit.</p> <p>Effective coordination and communication between home care, primary care and specialist palliative providers care will be key. Digital health systems that connect the sectors could be helpful. Family engagement will also be very important.</p> <p>Escalation pathways and referral pathways should be established to enable appropriate responses to emergencies, unexpected deterioration, and family distress.</p> <p>Finally, <a href="https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-023-01155-y">accurately determining</a> when someone will die can be difficult. Knowing when the last three months of life starts may not be easy, particularly where frailty, cognitive issues and multiple health concerns may be present.</p> <p>This might mean some people are not seen as being ready for this pathway. Others may not be willing to accept this prognosis. An older person may also be expected to live with a terminal illness for many months or years. Their palliative care needs would not be met under this pathway.</p> <p>Despite these challenges, the announcement of an end of life pathway within the home care program is timely and welcome. As a population we are living longer and dying older. More details will help us be better prepared to implement this scheme.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/239296/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, Matthew Flinders Professor and Director of the Research Centre for Palliative Care, Death and Dying, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/offering-end-of-life-support-as-part-of-home-care-is-important-but-may-face-some-challenges-239296">original article</a>.</em></p> </div>

Retirement Life

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"This is horrific": Queen icon calls out convincing scam

<p>Brian May has spoken out after becoming the target of a dangerous scam, urging people to be careful online. </p> <p>The guitarist of iconic rock band Queen was made aware of the scam by a fan, who sent him the TikTok of what seems to be May himself offering concert tickets at a discount. </p> <p>The video, which is actually AI-generated and has nothing to do with May or with Queen, shows the rockstar offering music fans the chance to see a concert from backstage. </p> <p>“I hope you’re all well out there,” says the fake Brian May in the video. “Some good news. Backstage tickets for my next show in your cities are now going for only $800, which were previously $2000. I’m only selecting 10 people in the comments, so if you’re ready to make payment, comment, ‘ready’.”</p> <p>May responded to the post publicly, sharing his horror and anger with fans over the “creepy” video, saying, “My God. This is horrific.”</p> <p>“I suppose this is now so easy to do – and there are always people who will sink to any depths to try to make a quick buck. Disgusting.”</p> <p>He continued, “Thanks for the alert dear (TikTok username) stereojazz. I’ve alerted our team and hopefully we can squash this.”</p> <p>Fans were quick to comment that they had almost been fooled by the convincing video. </p> <p>“That they abuse your beautiful personality for this scam hurts even more and is really scary. I hate it,” commented one. </p> <p>“It is insanely terrifying what AI can do these days,” wrote another.</p> <p><em>Image credits: TikTok</em></p>

Legal

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Boeing Starliner astronauts: what six months stuck in space may do to their perception of time

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ruth-ogden-1182467">Ruth Ogden</a>, <a href="https://theconversation.com/institutions/liverpool-john-moores-university-1319">Liverpool John Moores University</a> and <a href="https://theconversation.com/profiles/daniel-eduardo-vigo-1631723">Daniel Eduardo Vigo</a>, <a href="https://theconversation.com/institutions/pontificia-universidad-catolica-de-argentina-5531">Pontificia Universidad Católica de Argentina</a></p> <p>Two astronauts marooned in space may sound like the plot of a Hollywood blockbuster, but for two <a href="https://www.nasa.gov/">Nasa</a> crew members, it is now a reality. Commander Barry Wilmore and pilot Sunita Williams are currently in limbo on the International Space Station (ISS).</p> <p>They arrived in the Boeing Starliner spacecraft – the first test of the spaceship with astronauts. Wilmore and Williams were supposed to stay on the ISS for around eight days and return on the same spacecraft. But there is now debate about the safety of Starliner after it experienced <a href="https://www.bbc.co.uk/news/articles/c6pp29gdwe6o">helium leaks and thruster problems</a> on its way to the ISS.</p> <p>In coming days, Nasa and Boeing may decide to clear Starliner to carry the astronauts back to Earth. This means their stay might not last too much longer. But if officials decide against Starliner, the astronauts face waiting an <a href="https://www.nasa.gov/news-release/update-nasa-boeing-to-stream-flight-test-mission-briefing-on-nasa/">additional six months in orbit</a> before returning. So how do astronauts cope with a potential six-month wait for a lift home?</p> <p><a href="https://www.sciencedirect.com/science/article/abs/pii/0022249685900203">Waiting for things is difficult</a> at the best of times. Under normal circumstances, it is <a href="https://journals.sagepub.com/doi/full/10.1177/2043808718778982">frustrating, stressful and anxiety-provoking</a>. But in extreme situations, with high stakes, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2648.2011.05638.x?casa_token=jC_hT4wqbuIAAAAA%3AGTrJPmd496aDTdirdwYi7CvLK8Q1g_oR-Em2E3EpDP0AwRCs2ko13Jpqui15BlkPiAx7MMRqA0MC">waiting can be purgatory</a>.</p> <p>Part of the reason that waiting is difficult is that it distorts our sense of time. Think of last time you were waiting for a delayed train, test results or a text from a potential new partner. Did it fly by or drag? For most people, time spent waiting crawls at a glacial pace. As a result, delays and periods of anticipation often feel much longer than they actually are.</p> <p>Waiting slows our perception of time, because it changes the amount of time that we spend <a href="https://www.jstor.org/stable/23324610?casa_token=KmtJWWmtHwQAAAAA%3AN_CUdtNakK46j4ItZaH_f__QcIGOjMnasX1NeMTRFH5YPpcmYx1JpigTfTb1bPYi5Fcus-IhtzDX0Jsz3xpqZRMDUxg0RWYhSr87V-zXz_pqS0zM&amp;seq=2">thinking about time</a>. During normal daily life we often ignore time; our brains have a limited capacity. If time isn’t important, we simply don’t think about it, and this helps it to pass quickly.</p> <p>When we are waiting, our desire to know when the wait is over increases how much we think about time. This “clock watching” can make the minutes and hours feel like they are <a href="https://doi.org/10.1016/0278-2626(90)90026-K">passing at a snail’s pace</a>. Stress, discomfort and pain exacerbate this effect, meaning that waiting in difficult situations <a href="https://doi.org/10.1002/ejp.2211">can seem even longer</a>.</p> <p>Waiting also slows our perception of time because it what we do and how we feel. Normal life is busy and full of ever-changing activities and interactions. The sudden need to wait halts the flow of life, often leaving us with nothing else to do, thus increasing levels of boredom and frustration.</p> <p>In general, time filled with activity <a href="https://doi.org/10.1016/0278-2626(90)90026-K">passes more quickly</a>. We all got a taste of this during <a href="https://doi.org/10.1371/journal.pone.0235871">COVID lockdowns</a>. When we were stuck inside unable to see friends and engage in normal daily activities, the loss of routine and distractions caused time to drag for many.</p> <p>For the astronauts stuck on the ISS, anxiety about when they will return, limited opportunities for activities and fewer opportunities to contact friends and families combine to make their wait to return home feel significantly longer than six months – if it should come to that.</p> <p>However, as academics who research the effects of time on human psychology and biology, our ongoing work with crew members at research stations in Antarctica aims to shed light on whether waiting in extreme environments is different to waiting during normal daily life.</p> <h2>A year in Antarctica</h2> <p>While being stuck for six months on the ISS may sound like many people’s worst nightmare, it is not uncommon for scientists to spend long periods isolated and confined in extreme environments. Every year, organisations such as the Instituto Antártico Argentino (which uses the Belgrano II Antarctic station), the French Polar Institute and the Italian Antarctic Programme, in cooperation with the European Space Agency (which all use Antarctica’s Concordia station), send crews of people for up to 16 months to conduct research on the frozen continent.</p> <p>During the March to October <a href="https://www.bas.ac.uk/">polar winter</a>, teams spend six months in near darkness – and from May to August, in complete darkness – facing outside temperatures of up to -60C, wind speeds of 160 km/h (100 mph) and storms which prevent almost all outdoor activity. Limited internet coverage can also prevent constant communication with the outside world.</p> <p>For the last year, we have researched how life in Antarctica influences people’s experience of time. Each month, we asked crew members how time felt like it was passing in comparison to before their mission. Trapped on base, with limited contact with the outside world, you might expect time to drag. However, our results suggest the opposite may be true.</p> <p>Analysis of crew members’ experiences indicated that being constantly busy with complex tasks such as scientific research helped time to pass swiftly, according to 80% of crew responses. Only 3% of responses indicated that time actually dragged, and these reports occurred when nights were long and there was little to do.</p> <p>These experiences may provide hope for those stuck on the ISS. Like life on an Antarctic station, these Nasa astronauts have a busy and mentally demanding existence. These factors may help time to pass quickly.</p> <p>However, a key factor of their wait may be their ability to <a href="https://journals.sagepub.com/doi/10.1177/2043808718778982">tolerate the uncertainty</a> of when they will return. Wilmore and Williams will spend their time in a space equivalent to the <a href="https://www.nasa.gov/international-space-station/space-station-facts-and-figures/">inside a Boeing 747</a> plane. But better information about “when” things will happen and “why” delays are being incurred can help people to tolerate waiting and reduce its impact on their wellbeing.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/236546/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ruth-ogden-1182467">Ruth Ogden</a>, Professor of the Psychology of Time, <a href="https://theconversation.com/institutions/liverpool-john-moores-university-1319">Liverpool John Moores University</a> and <a href="https://theconversation.com/profiles/daniel-eduardo-vigo-1631723">Daniel Eduardo Vigo</a>, Senior Researcher in Chronobiology, <a href="https://theconversation.com/institutions/pontificia-universidad-catolica-de-argentina-5531">Pontificia Universidad Católica de Argentina</a></em></p> <p><em>Image credits: NASA</em></p> <p><em>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/boeing-starliner-astronauts-what-six-months-stuck-in-space-may-do-to-their-perception-of-time-236546">original article</a>.</em></p> </div>

Mind

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It’s hard to reach out to old friends, but doing so may help alleviate loneliness

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>Millions of <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=4510004801">Canadians are lonely</a>. This is worrisome because loneliness, defined by the World Health Organization as “<a href="https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection">the social pain of not feeling connected</a>,” predicts both lower mental and physical health. Research shows that lacking a sense of social connection can pose an <a href="https://doi.org/10.1177/1745691614568352">equivalent health risk to smoking 15 cigarettes per day</a>.</p> <p>To combat loneliness, people are commonly advised to seek out social connection. For many, this guidance brings to mind spending time with loved ones, such as close friends, family and romantic partners. But are there other people we can reach out to?</p> <p>In our research, recently published in <em>Communications Psychology</em>, we examined whether people have “old friends” — individuals that they care about but with whom they have lost touch — and <a href="https://doi.org/10.1038/s44271-024-00075-8">how easily these relationships can be rekindled</a>.</p> <p>We found that certain strategies can help people reconnect — and, in new research, we are getting a sense that certain values and personality traits may make it easier for people to stay in touch far into the future.</p> <h2>Reconnecting with old friends</h2> <p>Across a series of seven studies, we found the majority of people reported having an old friend. Yet, when we asked over 400 participants how willing they would be to reach out to an old friend right now, most said they were neutral or unwilling. In fact, in one study, people reported being no more willing to reach out to an old friend than they were to talk to a stranger or pick up trash.</p> <p>This reluctance was observable in behaviour too. We conducted two experiments in which more than 1,000 people were given several minutes to draft and send a message to an old friend. Only 30 per cent sent the message to their old friend.</p> <p>Given that reaching out to an old friend could boost <a href="https://www.forbes.com/sites/nextavenue/2018/08/19/the-power-and-joy-of-reconnecting-with-old-friends/">feelings of social connection and happiness</a>, we tried designing interventions to encourage reaching out. For instance, we reminded participants that reaching out to an old friend was an act of kindness and that the recipient would appreciate it more than they realize. We also tried telling participants not to overthink it — to just send their message. Unfortunately, neither prompt was effective at encouraging more people to reach out.</p> <h2>Reluctance to reconnect</h2> <p>Why are people reluctant to reach out to old friends? There may be a number of reasons, including the possibility that old friends feel like strangers after time has passed. In one study with over 500 participants we asked people to list between three to five old friends, and tell us how close each one felt to them right now. The more unfamiliar an old friend felt, the less willing people were to reach out.</p> <p>Research has found that when people <a href="https://doi.org/10.1016/j.jesp.2022.104356">practise talking to strangers for a week</a>, they become less anxious about it. If old friends can feel like strangers, might a similar strategy encourage people to reach out to old friends?</p> <p>To find out, we conducted an experiment in which we randomly assigned some people to complete a three-minute warm-up activity in which they messaged current family or friends. Other participants were randomly assigned to a control condition in which they simply browsed social media for three minutes instead.</p> <p>Afterward, all participants were given an opportunity to write and send a message to an old friend. While only 30 per cent of participants sent their message in the control condition, over 50 per cent did so after warming-up, suggesting that practising the behaviour that underlies reaching out may make this act easier.</p> <h2>Personality traits</h2> <p>We are extending this research in a number of new directions. For instance, in some newly conducted and unpublished research, we are examining whether people with certain personality traits or beliefs are more likely to send a message to an old friend.</p> <p>Responses from over 300 people suggest that people who are open to new experiences — <a href="https://www.psychologytoday.com/ca/basics/big-5-personality-traits">one of the five key personality traits studied by psychologists</a> — say they are willing to reach out to an old friend. Despite this inclination, our research found that highly open people do not necessarily communicate with old friends when given the chance.</p> <p>On the other hand, people’s values and beliefs may be important determinants of whether they stay in touch. Our preliminary work shows that people who see friendship as a bond that does not easily break may be more likely to reach out than others.</p> <p>We hope this work helps normalize the fact that friendships can fade and be hard to rekindle. That said, with some practice, people can overcome this reluctance and hit “send” to potentially open a path to connection and less loneliness.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/234895/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, Distinguished Professor of Social Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, Senior Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, Master's Student, Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/its-hard-to-reach-out-to-old-friends-but-doing-so-may-help-alleviate-loneliness-234895">original article</a>.</em></p> </div>

Relationships

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How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>A growing number of complaints against older doctors has prompted the Medical Board of Australia to <a href="https://www.medicalboard.gov.au/News/2024-08-07-Medical-Board-consults-on-new-approach-to-keep-late-career-doctors-in-safe-practice.aspx">announce</a> today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table.</p> <p>The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine.</p> <p>The second would require only general health checks for doctors over 70.</p> <p>A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their <a href="https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx">professional code of conduct</a>, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo.</p> <h2>Haven’t we moved on from set retirement ages?</h2> <p>It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “<a href="https://law.unimelb.edu.au/__data/assets/pdf_file/0019/2061019/02-Blackham.pdf">still valid in a modern society</a>”.</p> <p>However, unlike judges, doctors are already <a href="https://www.medicalboard.gov.au/Registration/Registration-Renewal.aspx">required to renew their registration</a> annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct <a href="https://www.ahpra.gov.au/Notifications/Further-information/Guides-and-fact-sheets/Performance-assessments.aspx">performance assessments</a> if and when they are needed.</p> <h2>What has prompted these proposals?</h2> <p>This latest <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD24%2f33840&amp;dbid=AP&amp;chksum=vCEdxXaBs0%2bMeMZFxSb7SQ%3d%3d&amp;_gl=1*3ol06k*_ga*MzU1NjAzMTc1LjE3MjMwMDA1Nzc.*_ga_F1G6LRCHZB*MTcyMzAwMDU3Ny4xLjEuMTcyMzAwMDU4My4wLjAuMA..">proposal</a> identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years.</p> <p>Studies of medical competence in ageing doctors show <a href="https://qualitysafety.bmj.com/content/29/2/113">variable results</a>. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour.</p> <p>The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors.</p> <p>In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.</p> <p>In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015.</p> <p>While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate.</p> <p>It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients.</p> <h2>So what distinguishes the two new proposed options?</h2> <p>The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80.</p> <p>Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions.</p> <p>Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia.</p> <p>The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia.</p> <p>In practice, both of these proposals appear to allow doctors to manage their own general health confidentially.</p> <h2>The law tends to prioritise patient safety</h2> <p>All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/act/consol_act/hprnl428/s3a.html">That provision</a> basically says patient safety is paramount and trumps all other considerations.</p> <figure class="align-center zoomable"><figcaption></figcaption></figure> <p>As with legal <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2010-104a#sec.3">regimes regulating childcare</a>, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional.</p> <p>Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3383892">punished</a>” for errors in practice.</p> <p>All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care.</p> <h2>Could these proposals amount to age discrimination?</h2> <p>It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws.</p> <p>For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/ada2004174/s22.html?context=1;query=inherent;mask_path=au/legis/cth/consol_act/ada2004174">who are</a> “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”.</p> <p>In broader terms, a licence to practise medicine is often compared to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797044/">licence to drive</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236877/">pilot an aircraft</a>. Despite <a href="https://www.smh.com.au/national/nsw/mandatory-test-older-drivers-facing-discrimination-says-pensioner-group-20170607-gwm45u.html">claims of discrimination</a>, New South Wales law requires older drivers to undergo a medical assessment <a href="https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/older-drivers-and-riders/assessments">every year</a>; and similar requirements affect older <a href="https://www.google.com/url?sa=t&amp;source=web&amp;rct=j&amp;opi=89978449&amp;url=https://www.casa.gov.au/guidelines-medical-assessment-aviation&amp;ved=2ahUKEwil-9GXlOKHAxUdslYBHdN_EboQFnoECBkQAQ&amp;usg=AOvVaw0SgpoCCKjNriMN20fs16rq">pilots and air traffic controllers</a>.</p> <h2>Where to from here?</h2> <p>When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different.</p> <p>How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, <a href="https://www1.racgp.org.au/newsgp/professional/ahpra-eyes-mandatory-health-checks-for-older-gps">others have suggested</a> this would only exacerbate shortages in the health-care workforce.</p> <p>The proposals are open for <a href="https://www.medicalboard.gov.au/News/Current-Consultations.aspx">public comment</a> until October 4.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/236305/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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-olds-too-old-to-be-a-doctor-why-gps-and-surgeons-over-70-may-need-a-health-check-to-practise-236305">original article</a>.</em></p> </div>

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Snug but unsafe: your heater may be harming your health. What are your safest choices?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/christine-cowie-191638">Christine Cowie</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/bill-dodd-1280161">Bill Dodd</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888"><em>University of Tasmania</em></a></em></p> <p>We now have a dizzying array of heating technologies to consider, besides the fire that warmed our ancestors.</p> <p>Salespeople will highlight any number of features and minor conveniences. You will be made aware of limited-offer discounts, product warranties, trends in certain Nordic countries, or their low cost (at least in the short-term). What you are less likely to read on the box is, well, the stuff that really matters: the long-term effects on your health and the health of your family, your neighbours and the environment.</p> <p>Yes, a heater should keep you warm affordably. After all, a warm home is vital for your health. But would you run a heater that you knew was increasing the likelihood of your child developing asthma, your partner developing lung cancer, and your neighbour or your grandparent suffering a stroke or heart attack?</p> <p>Many <a href="https://doi.org/10.1016/j.envint.2019.105429">peer-reviewed studies</a> have found domestic heating to be a major source of air pollution and of ill health in Australia. So which heaters are high-risk and which are low-risk? Let’s consider, firstly, the most dangerous heaters.</p> <h2>Extreme-risk heaters</h2> <p>Two rules reduce the risks:</p> <ol> <li> <p>never burn anything (wood, gas or other fuel) in your home without adequate ventilation such as a chimney, exhaust or flue</p> </li> <li> <p>never use an outdoor appliance (heater, cooker, barbecue) inside.</p> </li> </ol> <p>Concerningly, a 2022 <a href="https://asthma.org.au/wp-content/uploads/2022/11/AA2022_Housing-Survey-Report_full_v4.pdf">Asthma Australia survey</a> found 7% of Australians used an unflued gas heater.</p> <p>When gas or other fuel is burnt indoors it releases a range of <a href="https://search.informit.org/doi/abs/10.3316/informit.786585213635569">particles and toxic gases</a>. Most dangerous of all is <a href="https://www.dcceew.gov.au/environment/protection/npi/substances/fact-sheets/carbon-monoxide-0">carbon monoxide</a> (CO). This colourless, odourless gas can build up in unventilated homes, resulting in serious poisoning and death.</p> <p>A recent <a href="https://www.abc.net.au/news/2024-06-29/sydney-family-use-bbq-as-indoor-heater-inhale-carbon-monoxide/104039702">case of carbon monoxide intoxication</a> left three people unconscious in a Sydney home after an outdoor barbecue was used inside as a heater. Outdoor heaters, cookers and barbecues are especially potent sources of carbon monoxide and should never be brought inside.</p> <p>If you have a gas appliance in your home, even if it is ventilated, install a <a href="https://www.energysafe.vic.gov.au/industry-guidance/gas/gas-information-sheets/gis-36-carbon-monoxide-alarms-domestic-use">carbon monoxide alarm</a> for as little as $30.</p> <h2>High-risk heaters</h2> <p><a href="https://www.sciencedirect.com/science/article/pii/S0048969724012087">The evidence</a> is now very clear: wood heater smoke is a potent source of air pollution and significant cause of ill-health in Australia.</p> <p>The more often you burn, the greater the risk. One <a href="https://doi.org/10.1016/j.envint.2023.108128">large population study</a> found even infrequent wood heater use (30 days or more each year) increases the risk of lung cancer by 68%.</p> <p>Wood heaters spill smoke into the home when refuelling. They also suck smoke from outside back into the home as air is drawn up the chimney.</p> <p>If you can smell your wood heater, it is harming your health and exposing you to a toxic mix of particles and gases.</p> <p>For the wider community, the cumulative health impacts of wood heaters are significant.</p> <p>Less than <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Previousproducts/4602.0.55.001Main%20Features5Mar%202011?opendocument&amp;tabname=Summary&amp;prodno=4602.0.55.001&amp;issue=Mar%202011&amp;num=&amp;view=">10% of Australian households</a> use a wood heater. Yet they are the largest source of particulate air pollution in most Australian cities and towns, including <a href="https://www.environment.nsw.gov.au/-/media/OEH/Corporate-Site/Documents/Air/sydney-air-quality-study-stage-2-program-report-220644.pdf">Sydney</a>, <a href="http://www.doi.org/10.1016/j.scitotenv.2024.171069">Melbourne</a>, <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.52176">Canberra</a>, <a href="http://www.doi.org/10.1016/j.scitotenv.2024.171069">Adelaide</a> and <a href="http://www.doi.org/10.3390/ijerph17093264">Hobart</a>. Even in temperate Sydney, wood heaters emit <a href="https://www.environment.nsw.gov.au/-/media/OEH/Corporate-Site/Documents/Air/sydney-air-quality-study-stage-2-program-report-220644.pdf">more of this pollution</a> than all the cars, trucks, boats and buses combined, and more than coal-fired power stations and industry.</p> <p><a href="https://safeair.org.au/">Centre for Safe Air</a> researchers <a href="https://doi.org/10.1016/j.scitotenv.2024.171069">estimate</a> wood heaters cause between 558 and 1,555 excess deaths a year in Australia. That’s roughly equivalent to the <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">annual road toll</a>.</p> <p>Fine particles (2.5 microns or less in diameter – also known as PM2.5) are a major component of wood smoke. PM2.5 increases <a href="https://www.epa.gov/air-research/air-pollution-and-cardiovascular-disease-basics">rates of heart disease and stroke</a>, <a href="https://doi.org/10.3978%2Fj.issn.2072-1439.2016.01.19">lung disease</a>, <a href="https://doi.org/10.1016/j.scitotenv.2018.11.218">dementia and other neurological conditions</a> and <a href="https://asthma.org.au/about-us/advocacy/air-quality">asthma attacks</a>. Risks of <a href="https://doi.org/10.1371/journal.pmed.1003718">adverse pregnancy outcomes</a> and <a href="https://www.eea.europa.eu/publications/air-pollution-and-childrens-health">poorer learning outcomes in children</a> are also increased.</p> <h2>Low-risk heaters</h2> <p>Evidence suggests there is no “safe” level of air pollution, with health effects <a href="https://doi.org/10.1016/j.envint.2019.02.044">seen at very low levels</a>.</p> <p>Even ducted gas heating, where most of the toxins are ventilated, <a href="https://search.informit.org/doi/abs/10.3316/informit.786585213635569">can expose residents to low levels</a> of PM2.5, nitrogen dioxide (NO2), carbon monoxide and formaldehyde. Over time, this can have a range of <a href="https://safeair.org.au/the-health-impacts-of-gas-use-extraction/#gf_1">health impacts</a>, including worsening asthma and respiratory symptoms.</p> <p>Burning gas for heating also adds to greenhouse gas emissions.</p> <p>As Australia transitions to a zero-carbon society, some states and territories are phasing out installation of new wood heaters, such as <a href="https://www.abc.net.au/news/2023-08-24/canberra-to-phase-out-wood-heaters-by-2045/102769162">in the ACT</a>, and gas connections, such as <a href="https://www.planning.vic.gov.au/guides-and-resources/strategies-and-initiatives/victorias-gas-substitution-roadmap">in Victoria</a>. Subsidies to help people replace unhealthy heaters are excellent investments in the environment, public health and health equity.</p> <h2>Healthy heaters</h2> <p>Ultimately, heaters that do not rely on burning fuel inside the home are the safest, and often more affordable, heating option.</p> <p>A <a href="https://www.abc.net.au/news/2023-07-17/cleaning-filters-in-reverse-cycle-air-conditioner-to-save/102594652">well-maintained</a> reverse-cycle air conditioner, sometimes called a heat pump, actually cleans the air inside your home.</p> <p>These air conditioners have the additional benefit of cooling your home in summer. As heatwaves become more severe and frequent, efficient cooling is <a href="https://www.sciencedirect.com/science/article/pii/S0378778823004152">increasingly important for health</a>.</p> <p>As for affordability, an efficient reverse-cycle air conditioner can be up to <a href="https://www.climatechoices.act.gov.au/__data/assets/pdf_file/0005/1862663/Sustainable-Household-Scheme-A-guide-to-reverse-cycle-systems.pdf">seven times as efficient</a> as a gas wall heater in the energy it uses for a given amount of heat.</p> <p>There are many other <a href="https://www.choice.com.au/home-and-living/heating/electric-heaters/articles/which-electric-heater-type-is-best">electric heating technologies</a> – such as fan heaters, oil column heaters, panel heaters, or infrared heaters – that do not release toxins into the home.</p> <p>Heater manufacturers are often reluctant to talk about the health impacts of their products, and regulators are slow to catch up with the science.</p> <p>By thinking about heating in terms of health, you can make your home safer for yourself and the people around you.</p> <p>After all, there’s nothing cosier than a healthy home.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/235102/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/christine-cowie-191638"><em>Christine Cowie</em></a><em>, Senior Research Fellow, Centre for Air Quality and Health Research and Evaluation, Woolcock Institute of Medical Research, University of Sydney; Senior Research Fellow, South West Sydney Clinical School, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/bill-dodd-1280161">Bill Dodd</a>, Knowledge Broker, Centre for Safe Air (NHMRC CRE), and Adjunct Researcher, Media School, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a></em></p> <p><em>Image </em><em>credits: Shutterstock </em></p> <p><em>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/snug-but-unsafe-your-heater-may-be-harming-your-health-what-are-your-safest-choices-235102">original article</a>.</em></p> </div>

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It may be macabre, but dark tourism helps us learn from the worst of human history

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/dr-neil-robinson-1312179">Dr Neil Robinson</a>, <a href="https://theconversation.com/institutions/university-of-salford-878">University of Salford</a></em></p> <p>Dark tourism has become a much more well-covered pasttime in recent years, in which a macabre fascination lead tourists to travel to various places not served by Thomas Cook: the sites of battles and genocides, war cemeteries, prisons, and even <a href="http://www.theatlantic.com/international/archive/2014/07/the-rise-of-dark-tourism/374432/">current warzones such as Syria</a>.</p> <p>The 20th century alone has provided such a <a href="http://www.therichest.com/expensive-lifestyle/location/10-great-places-to-visit-for-dark-tourism/">long list of places</a> at which catastrophes or great loss of life and suffering has occurred. Sites visited range from the spot from which JFK was assassinated, to prisons such as Alcatraz in San Francisco, through to battlefields of the World Wars, or the vestiges of genocides such at Auschwitz in Poland or Tuol Sleng in Phnom Penh, Cambodia. It’s not everybody’s cup of tea, but we shouldn’t condemn those for whom this is an interest.</p> <p>Dark tourism appears to be a manifestation of our media-rich society through which information found online may persuade us to see historical sites in person. But its origins can be traced back much further than the fascination with death and disasters of the 19th and 20th century. In the 11th century, people and pilgrims often visited places with religious significance such as Jerusalem, where the location of Christ’s crucifixion is a popular attraction; tourists visited Gettysburg, the site of the bloodiest battle of the American Civil War in 1863; and in more recent centuries, the Grand Tour offered an opportunity for the wealthy to experience Europe, with sites such as the classical ruins of the Colosseum in Rome – which in the name of entertainment saw execution, torture and death – one of the must-see attractions.</p> <p>Today, in parallel with the growth in popularity of dark tourism is the enormous growth of social media and the 24-hour news economy. The ease of access to such blanket coverage through the web, Facebook and Twitter has increased people’s awareness of, and fascination for, these historical sites of war, conflict and catastrophe. For example, the last decade has brought a surge in visitor numbers to <a href="https://theconversation.com/from-fiction-to-gallows-humour-how-chernobyl-survivors-are-still-coping-with-trauma-57923">Chernobyl</a>, where guides take visitors around the abandoned city of Pripyat (radiation levels permitting) which has been deserted since the nuclear power plant explosion on April 26, 1986. The 30th anniversary this year has in itself <a href="http://www.dailymail.co.uk/travel/travel_news/article-3526271/Chernobyl-tourists-pose-photos-eerie-sites.html">added to interest in visiting</a> the overgrown and crumbling city.</p> <p>As with tourism of any kind, this greater footfall brings benefits. In this case, not just the economic boost but also as a tool of education and even conflict resolution. For example, the <a href="http://www.belfasttours.com/package/belfast-political-mural-tour">taxi tours of Belfast’s murals</a>, which document Northern Ireland’s Troubles, offer visitors a way to understand the history and provide the communities involved a means to reflect and move on from the conflict. This model is <a href="http://www.h-net.org/reviews/showpdf.php?id=25852">viewed with interest</a> and hope by moderates on both sides of the Arab-Israeli divide searching for a peaceful solution for the long term.</p> <p>The tours of <a href="http://whc.unesco.org/en/list/916">Robin Island prison</a> in South Africa, where Nelson Mandela spent 18 years incarcerated among many others, starkly present how those imprisoned by a corrupt and discriminatory political regime can later engage in peace and reconciliation. The <a href="http://www.bruisedpassports.com/africa/5-reasons-you-must-go-for-a-township-tour-in-south-africa">Soweto township tours</a> in Johannesburg have acted in part as a means through which generations of South Africans can better understand their country’s dark past and help to establish truth and reconciliation for the future.</p> <p>Dark tourism should not in my opinion by viewed as unethical, repugnant or even a self-indulgent activity. Certainly some dark tourists may engage in their pursuits for all the wrong reasons, seeing death and destruction as a commodity to be consumed with little thought for those who caught up in its wake. But others visit such sites to pay their respects, to better understand the magnitude of death and destruction, and to inform the outside world of the details of terrible events – even in some case offering to help. These are positive effects that may come from so much pain and suffering.</p> <p>We should strive to better understand the origins of the terrible events of human history to be more able to prevent us repeating them. In this regard, that more people visit sites associated with dark tourism and learn about them should be seen as a positive.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/60966/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/dr-neil-robinson-1312179">Dr Neil Robinson</a>, Lecturer in Business, <a href="https://theconversation.com/institutions/university-of-salford-878">University of Salford</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/it-may-be-macabre-but-dark-tourism-helps-us-learn-from-the-worst-of-human-history-60966">original article</a>.</em></p> </div>

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Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>Many people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">drinking less</a> sugary soft drink than in the past. This is a great win for public health, given the <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2749350">recognised risks</a> of diets high in sugar-sweetened drinks.</p> <p>But over time, intake of diet soft drinks has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">grown</a>. In fact, it’s so high that these products are now regularly <a href="https://www.sciencedirect.com/science/article/pii/S0160412020319188">detected in wastewater</a>.</p> <p>So what does the research say about how your health is affected in the long term if you drink them often?</p> <h2>What makes diet soft drinks sweet?</h2> <p>The World Health Organization (WHO) <a href="https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children">advises</a> people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.”</p> <p>But most regular soft drinks contain <a href="https://www.actiononsugar.org/surveys/2014/sugar-sweetened-beverages/">a lot of sugar</a>. A regular 335 millilitre can of original Coca-Cola contains at least <a href="https://www.coca-cola.com/ng/en/about-us/faq/how-much-sugar-is-in-cocacola-original-taste">seven</a> teaspoons of added sugar.</p> <p>Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources.</p> <p>Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness.</p> <p>Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight.</p> <p>But while surveys of Australian <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551593/">adults</a> and <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/adolescents-knowledge-and-beliefs-regarding-health-risks-of-soda-and-diet-soda-consumption/32F3E0FD6727F18F04C63F0390595131">adolescents</a> show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly.</p> <h2>What does the research say about aspartame?</h2> <p>The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the <a href="https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food">US</a> and <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame">Australia</a>. However, some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/">researchers</a> have raised concern about the long-term risks of consumption.</p> <p>People who drink diet soft drinks regularly and often are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446768/">more likely</a> to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks.</p> <p>The link was found even after accounting for other dietary and lifestyle factors (such as physical activity).</p> <p>In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “<a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">possibly carcinogenic to humans</a>” (carcinogenic means cancer-causing).</p> <p>Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally.</p> <h2>Will diet soft drinks help manage weight?</h2> <p>Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management.</p> <p>In 2022, the WHO conducted a <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">systematic review</a> (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management.</p> <p>Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners.</p> <p>But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity.</p> <p>In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">advising</a> artificial sweeteners should not be used to manage weight.</p> <p><a href="http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30296-0">Studies</a> in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven.</p> <h2>What about inflammation and dental issues?</h2> <p>There is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10817473/">some early evidence</a> artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed.</p> <p>High amounts of diet soft drinks have <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17223-0">also been</a> linked with liver disease, which is based on inflammation.</p> <p>The consumption of diet soft drinks is also <a href="https://link.springer.com/article/10.1007/s40368-019-00458-0#:%7E:text=Diet%20soft%20drinks%20often%20have,2006">associated</a> with dental erosion.</p> <p>Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion.</p> <h2>Moderation is key</h2> <p>As with many aspects of nutrition, moderation is key with diet soft drinks.</p> <p>Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term.</p> <p>Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/233438/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/cheeky-diet-soft-drink-getting-you-through-the-work-day-heres-what-that-may-mean-for-your-health-233438">original article</a>.</em></p> </div>

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What’s the difference between ‘man flu’ and flu? Hint: men may not be exaggerating

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>The term “man flu” takes a <a href="https://www.oxfordlearnersdictionaries.com/definition/english/man-flu">humorous poke</a> at men with minor respiratory infections, such as colds, who supposedly exaggerate their symptoms.</p> <p>According to the stereotype, a man lies on the sofa with a box of tissues. Meanwhile his female partner, also with a snotty nose, carries on working from home, doing the chores and looking after him.</p> <p>But is man flu real? Is there a valid biological reason behind men’s symptoms or are men just malingering? And how does man flu differ from flu?</p> <h2>What are the similarities?</h2> <p>Man flu could refer to a number of respiratory infections – a cold, flu, even a mild case of COVID. So it’s difficult to compare man flu with flu.</p> <p>But for simplicity, let’s say man flu is actually a cold. If that’s the case, man flu and flu have some similar features.</p> <p>Both are caused by viruses (but different ones). Both are improved with rest, fluids, and if needed painkillers, throat lozenges or decongestants to <a href="https://activities.nps.org.au/nps-order-form/Resources/NPS-Cold-and-Flu-Brochure-May-2014.pdf">manage symptoms</a>.</p> <p>Both <a href="https://www.cdc.gov/flu/symptoms/coldflu.htm">can share</a> similar symptoms. Typically, more severe symptoms such as fever, body aches, violent shivering and headaches are more common in flu (but sometimes occur in colds). Meanwhile sore throats, runny noses, congestion and sneezing are more common in colds. A cough is common in both.</p> <h2>What are the differences?</h2> <p><a href="https://www.cdc.gov/flu/about/keyfacts.htm">Flu</a> is a more serious and sometimes fatal respiratory infection caused by the influenza virus. Colds are caused by various viruses such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553670/">rhinoviruses</a>, <a href="https://www.cdc.gov/adenovirus/about/?CDC_AAref_Val=https://www.cdc.gov/adenovirus/symptoms.html">adenoviruses</a>, and common cold <a href="https://journals.lww.com/pidj/citation/2022/03000/proving_etiologic_relationships_to_disease_.18.aspx">coronaviruses</a>, and are rarely serious.<br />Colds tend to <a href="https://www.cdc.gov/flu/symptoms/coldflu.htm">start gradually</a> while flu tends to start abruptly.</p> <p>Flu can be <a href="https://www.cdc.gov/flu/professionals/diagnosis/overview-testing-methods.htm">detected</a> with laboratory or at-home tests. Man flu is not an official diagnosis.</p> <p>Severe flu symptoms may be prevented with <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm">a vaccine</a>, while cold symptoms cannot.</p> <p>Serious flu infections may also be <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/racf-antiviral-treatments-and-prophylaxis.aspx">prevented or treated</a> with antiviral drugs such as Tamiflu. There are no antivirals for colds.</p> <h2>OK, but is man flu real?</h2> <p>Again, let’s assume man flu is a cold. Do men really have worse colds than women? The picture is complicated.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0022399922003324?via%3Dihub">One study</a>, with the title “Man flu is not a thing”, did in fact show there <em>were</em> differences in men’s and women’s symptoms.</p> <p>This study looked at symptoms of acute rhinosinusitis. That’s inflammation of the nasal passages and sinuses, which would explain a runny or stuffy nose, a sinus headache or face pain.</p> <p>When researchers assessed participants at the start of the study, men and women had similar symptoms. But by days five and eight of the study, women had fewer or less-severe symptoms. In other words, women had recovered faster.</p> <p>But when participants rated their own symptoms, we saw a somewhat different picture. Women rated their symptoms worse than how the researchers rated them at the start, but said they recovered more quickly.</p> <p>All this suggests men were not exaggerating their symptoms and did indeed recover more slowly. It also suggests women feel their symptoms more strongly at the start.</p> <h2>Why is this happening?</h2> <p>It’s not straightforward to tease out what’s going on biologically.</p> <p>There are <a href="https://www.nature.com/articles/nri.2016.90">differences</a> in immune responses between men and women that provide a plausible reason for worse symptoms in men.</p> <p>For instance, women generally produce antibodies more efficiently, so they <a href="https://www.nature.com/articles/nri.2016.90">respond more effectively</a> to vaccination. Other aspects of women’s immune system also appear to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735332/">work more strongly</a>.</p> <p>So why do women tend to have <a href="https://www.nature.com/articles/nri.2016.90">stronger immune responses</a> overall? That’s probably partly because women have two X chromosomes while men have one. X chromosomes carry important <a href="https://www.nature.com/articles/nri.2016.90#Tab3">immune function genes</a>. This gives women the benefit of immune-related genes from two different chromosomes.</p> <p>Oestrogen (the female sex hormone) also seems to <a href="https://www.nature.com/articles/nri.2016.90">strengthen</a> the immune response, and as levels vary throughout the lifespan, so does <a href="https://www.science.org/doi/10.1126/sciimmunol.aan2946">the strength</a> of women’s immune systems.</p> <p>Men are certainly more likely to die from some infectious diseases, such as <a href="https://www.aihw.gov.au/reports/life-expectancy-deaths/deaths-in-australia/contents/covid-10-deaths">COVID</a>. But the picture is less clear with other infections such as the flu, where the incidence and mortality between men and women <a href="https://iris.who.int/bitstream/handle/10665/44401/9789241500111_eng.pdf?sequence=1&amp;isAllowed=y">varies widely</a> between countries and particular flu subtypes and outbreaks.</p> <p>Infection rates and outcomes in men and women can also depend on the way a virus is <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.712688/full">transmitted</a>, the person’s age, and social and behavioural factors.</p> <p>For instance, women seem to be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077589/#R20">practice protective behaviours</a> such as washing their hands, wearing masks or avoiding crowded indoor spaces. Women are also <a href="https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-016-0440-0">more likely</a> to seek medical care when ill.</p> <h2>So men aren’t faking it?</h2> <p>Some evidence suggests men are not over-reporting symptoms, and may take longer to clear an infection. So they may experience man flu more harshly than women with a cold.</p> <p>So cut the men in your life some slack. If they are sick, gender stereotyping is unhelpful, and may discourage men from seeking medical advice.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/231161/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, Professor, Nursing, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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-the-difference-between-man-flu-and-flu-hint-men-may-not-be-exaggerating-231161">original article</a>.</em></p> </div>

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Breast cancer screening in Australia may change. Here’s what we know so far

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The way women are screened for breast cancer in Australia may <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/early-detection/breast-cancer/rosa/key-findings">change</a>.</p> <p>There’s international debate on the <a href="https://www.bmj.com/content/385/bmj.q1353">age</a> women should be invited for screening. But an even larger change being considered worldwide is whether to screen women at <a href="https://www.nature.com/articles/s41416-021-01550-3">high and low risk</a> of breast cancer differently.</p> <p>But what such a “risk-based” approach to screening might look like in Australia is not yet clear.</p> <p>Here’s why researchers and public health officials are floating a change to breast cancer screening in Australia, and what any changes might mean.</p> <h2>Why breast cancer screening may need to change</h2> <p>Mass screening (known as population-based screening) for breast cancer was introduced in Australia and many other developed countries in the 1980s and 90s.</p> <p>This was based on <a href="https://pubmed.ncbi.nlm.nih.gov/26756588/">robust research</a> that found early detection and treatment of cancers before there were symptoms prevented some women from dying from breast cancer.</p> <p>These programs offer regular breast cancer screening to women within a specific age group. For example, <a href="https://www.aihw.gov.au/reports/cancer-screening/national-cancer-screening-programs-participation/contents/breastscreen-australia">in Australia</a>, women aged 40-74 years can have free mammograms (x-rays of the breasts) every two years. The BreastScreen program sends invitations for screening to those aged 50-74.</p> <p>However, evidence has been mounting that mammography screening could be inadvertently causing <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61611-0/abstract">harm</a> for some women.</p> <p>For some, screening causes a false alarm that may cause anxiety, and unnecessary tests and procedures. Even though these tests rule out cancer, these women may remain anxious and perceive something is wrong <a href="https://bmjopen.bmj.com/content/13/4/e072188">for many years</a>.</p> <p>A more insidious harm is <a href="https://theconversation.com/five-warning-signs-of-overdiagnosis-110895">overdiagnosis</a>, where screening detects a non-growing or slow-growing lesion that looks like “cancer” under the microscope, but would not have progressed or caused harm if it had been left alone. This means some women are having unnecessary surgery, radiotherapy and hormone therapy that will not benefit them, but may harm.</p> <p>Although trials have shown screening reduces the risk of dying from breast cancer, questions are being raised about how much it <a href="https://www.bmj.com/content/352/bmj.h6080.abstract">saves lives overall</a>. That is, it’s uncertain how much the reduced risk of dying from breast cancer translates into improvements in a woman’s overall survival.</p> <h2>How about better targeting women?</h2> <p>One idea is to target screening to those most likely to benefit. Under such a “<a href="https://www.nature.com/articles/s41416-021-01550-3">risk-based</a>” approach, a women’s personal risk of breast cancer is estimated. This may be based on her age and many other factors that may include breast density, family history of breast cancer, body-mass index, genetics, age she started and stopped her periods, and the number of children she’s had.</p> <p>Women who are at higher risk would be recommended to start screening at a younger age and to screen more frequently or to use different, more sensitive, imaging tests. Women at lower risk would be recommended to start later and to screen less often.</p> <p>The idea of this more “precise” approach to screening is to direct efforts and resources towards the smaller number of women most likely to benefit from screening via the early detection of cancer.</p> <p>At the same time, this approach would reduce the risk of harm from false positives (detection of an anomaly but no cancer is present) and overdiagnosis (detection of a non-growing or slow-growing cancer) for the larger number of women who are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230256/">unlikely to benefit</a>.</p> <p>On face value this sounds like a good idea, and could be a favourable change for breast cancer screening.</p> <h2>But there’s much we don’t know</h2> <p>However, it’s uncertain how this would play out in practice. For one thing, someone’s future risk of a cancer diagnosis includes the risk of detecting both <a href="https://www.acpjournals.org/doi/10.7326/m17-2792">overdiagnosed cancers</a> as well as potentially lethal ones. This is proving to be a problem in risk-based screening for <a href="https://www.nature.com/articles/s41698-022-00266-8">prostate cancer</a>, another cancer prone to overdiagnosis.</p> <p>Ideally, we’d want to predict someone’s risk of <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00113-9/fulltext">potentially lethal cancers</a> as these are the ones we want to catch early.</p> <p>It is also still uncertain how many women found to be at <a href="https://pubmed.ncbi.nlm.nih.gov/31701797/">low risk</a> will accept a recommendation for <a href="https://pubmed.ncbi.nlm.nih.gov/23092125/">less screening</a>.</p> <p>These uncertainties mean we need robust evidence the benefits outweigh the harms for Australian women before we make changes to the breast cancer screening program.</p> <p>There are several international <a href="https://www.nature.com/articles/s41416-021-01550-3">randomised controlled trials</a> (the gold standard for research) under way to evaluate the effectiveness of risk-based screening compared to current practice. So it may be prudent to wait for their findings before making changes to policy or practice.</p> <p>Even if such trials did give us robust evidence, there are still a number of issues to address before implementing a risk-based approach.</p> <p>One key issue is having enough staff to run the program, including people with the skills and time to discuss with women any concerns they have about their calculated risk.</p> <h2>How about breast density?</h2> <p>Women with dense breasts are at <a href="https://www.sciencedirect.com/science/article/pii/S0960977622001618#:%7E:text=Mammographic%20density%20is%20a%20well,increased%20risk%20of%20breast%20cancer.">higher risk of breast cancer</a>. So notifying women about their breast density has been proposed as a “first step” on the pathway to risk-based screening. However, this ignores the many other factors that determine a woman’s risk of breast cancer.</p> <p>Legislation in the <a href="https://www.fda.gov/radiation-emitting-products/mammography-quality-standards-act-and-program">United States</a> and changes in some <a href="https://australianbreastcancer.org.au/news-stories/latest-news/breast-density-reporting-at-all-sa-clinics/">Australian states</a> mean some women are already being notified about their breast density. The idea is to enhance their knowledge about their breast cancer risk so they can make informed decisions about future screening.</p> <p>But this has happened before we know what the best options are for such women. An <a href="https://www.mja.com.au/journal/2023/219/9/psychosocial-outcomes-and-health-service-use-after-notifying-women-participating">ongoing Australian trial</a> is investigating the effects that breast density notification has on individual women and the health system.</p> <h2>What next?</h2> <p>Robust evidence and careful planning are needed before risk-based screening or other changes are made to Australia’s breast cancer screening program.</p> <p>Where changes are made, there needs to be early evaluation of both the <a href="https://www.bmj.com/content/350/bmj.h1566.abstract">benefits and harms</a>. Programs also need <a href="https://www.bmj.com/content/374/bmj.n2049.long">independent, regular re-evaluation</a> in the longer term.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/231917/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, NHMRC Emerging Leader Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, Professor in Clinical Epidemiology, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/breast-cancer-screening-in-australia-may-change-heres-what-we-know-so-far-231917">original article</a>.</em></p> </div>

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How you experience the menopause may have a lot to do with your family

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pubmed/30346539">menopause</a> happens around the age of 50, and for many women, the end of their fertile life is accompanied by uncomfortable symptoms, such as hot flashes, night sweats and anxiety. In the West, it is generally taken as read that these symptoms are a normal part of the menopause. But <a href="https://www.ncbi.nlm.nih.gov/pubmed/11330770">cross-cultural research</a> suggests that menopause symptoms are not necessarily inevitable.</p> <p>For example, <a href="https://www.ncbi.nlm.nih.gov/pubmed/18521049">Japanese women</a> rarely report hot flashes, whereas for European women they are a common complaint. As a result, scientists have begun to focus on what causes this difference in experience and the potential impact that behavioural and lifestyle factors, such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/16735636">smoking</a>, might have.</p> <p>Our latest <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ece3.5705">study</a> adds to this knowledge. We found that living away from your genetic family may worsen the menopause.</p> <h2>Family matters?</h2> <p>Where people live once they’re married varies across cultures. To investigate whether these different living arrangements affect menopause symptoms, we travelled to south-west China to collect data.</p> <p>In this region, there are groups with distinct living arrangements. First, the Han and the Yi, in which women typically leave their family after they’ve got married and live with their husband’s family. Second, the Mosuo and Zhaba, who engage in the practice of <em>zou hun</em> (“<a href="https://www.ncbi.nlm.nih.gov/pubmed/23486437">walking marriage</a>”), where the husband and wife live separately with their own related families, and only visit each other at night.</p> <p>We found that women who remained living with their own family following marriage had significantly less severe menopause symptoms than those who went to live with their husband’s family.</p> <h2>In-law conflict</h2> <p>Many anthropologists are interested in how different levels of relatedness within households can have behavioural and physiological implications. For the menopause, we think the difference in symptom severity between the groups may be the result of the different levels of conflict that result from being more or less related to other members of your household.</p> <p>If a woman lives with her husband’s family, then until she has children, she is unrelated to anyone in the household. This lack of relatedness can cause <a href="https://link.springer.com/article/10.1007/s40806-017-0114-8">tension</a> between the new wife and her husband’s relatives as they have little direct genetic interest in her.</p> <p>As well as conflict with non-related household members, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/evan.20226">earlier research</a> has shown that women who live with their husband’s family tend to argue with their partners more and are also more likely to get divorced. Additionally, rates of domestic violence are <a href="https://www.ncbi.nlm.nih.gov/pubmed/27279077">higher</a> when women live away from their genetic family.</p> <p>But how does this relate to the severity of menopause symptoms? We think that increased levels of household conflict would result in the woman being more stressed. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795524/">Stress</a> is known to worsen pain perception and so could aggravate menopause symptoms.</p> <p>In contrast to women who leave their kin group, women who live with their own family once they’re married also tend to have higher levels of <a href="https://scholar.harvard.edu/slowes/publications/matrilineal-spousal-cooperation">social support</a>. There are more people to help with childcare and more shoulders to cry on. This can help to lower stress and thus soften the mental and physical burden of the menopause.</p> <h2>Global perspectives</h2> <p>While our research was conducted in China, globally, we see a wide range of living arrangements, which themselves can bring different levels of conflict and social support. In the West, many women live away from their families, which may mean that they lack social support, perhaps contributing to more turbulent menopause symptoms. Distance from one’s own family can also be seen to increase <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1741-3737.2005.00155.x">conflict</a> within the household – be it between a husband and wife, or wife and in-laws.</p> <p>These results aren’t an excuse to visit your in-laws less, but they show that menopause symptoms are not only about hormonal irregularities. They may also be a product of your social environment, which should be worth bearing in mind when approaching and going through the menopause.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/123621/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, PhD Candidate, Evolutionary Anthropology and Behavioural Ecology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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-you-experience-the-menopause-may-have-a-lot-to-do-with-your-family-123621">original article</a>.</em></p> </div>

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Drinking lots of water may seem like a healthy habit – here’s when and why it can prove toxic

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>In late 2023, actor <a href="https://www.glamour.com/story/brooke-shields-recently-experienced-a-full-blown-seizure-and-bradley-cooper-came-running?utm_source=instagram&amp;utm_medium=social&amp;utm_content=instagram-bio-link&amp;client_service_id=31196&amp;client_service_name=glamour&amp;service_user_id=1.78e+16&amp;supported_service_name=instagram_publishing&amp;utm_brand=glm&amp;utm_social_type=owned">Brooke Shields</a> suffered a seizure after “flooding” her body with water. Shields became dangerously low on sodium while preparing for her show by drinking loads of water. “I flooded my system and I drowned myself,” she would later explain. “And if you don’t have enough sodium in your blood or urine or your body, you can have a seizure.”</p> <p>Shields said she found herself walking around outside for “no reason at all”, wondering: “Why am I out here?”</p> <blockquote> <p>Then I walk into the restaurant and go to the sommelier who had just taken an hour to watch my run through. That’s when everything went black. Then my hands drop to my side and I go headfirst into the wall.</p> </blockquote> <p>Shields added that she was “frothing at the mouth, totally blue, trying to swallow my tongue”.</p> <p>Like Shields, many people may be unaware of the dangers of drinking excessive amounts of water – especially because hydration is so often associated with health benefits. Models and celebrities <a href="https://www.teenvogue.com/story/drinking-water-flawless-skin#:%7E:text=If%20you're%20reading%20a,long%20hours%20at%20a%20time.">often advocate</a> drinking lots of water to help maintain clear, smooth skin. Some <a href="https://www.independent.co.uk/life-style/75-hard-challenge-before-and-after-tiktok-b2382706.html">social media influencers</a> have promoted drinking a gallon of water daily for weight loss.</p> <p>But excessive water consumption can cause <a href="https://patient.info/treatment-medication/hyponatraemia-leaflet">hyponatraemia</a> – a potentially fatal condition of low sodium in the blood.</p> <h2>Worried about hydration levels? Check your urine</h2> <p>The body strictly regulates its water content to maintain the optimum level of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323003/">total body water</a> and “osmolality” – the concentration of dissolved particles in your blood. Osmolality increases when you are dehydrated and decreases when you have too much fluid in your blood.</p> <p>Osmolality is monitored by <a href="https://pubmed.ncbi.nlm.nih.gov/9074779/">osmoreceptors</a> that regulate sodium and water balance in the hypothalamus – the part of the brain that controls numerous hormones. These osmoreceptors signal the release of antidiuretic hormone (ADH), which acts on blood vessels and the kidneys to control the amount of water and salt in the body.</p> <figure><iframe src="https://www.youtube.com/embed/Qghf7Y9ILAs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>In healthy people, the body releases ADH when osmolality becomes high. ADH tells the kidneys to reabsorb water, which makes urine more concentrated. The reabsorbed water dilutes the blood, bringing osmolality back to normal levels.</p> <p>Low blood osmolality suppresses the release of ADH, reducing how much water the kidneys reabsorb. This dilutes your urine, which the body then passes to rid itself of the excess water.</p> <p>Healthy urine should be clear and odourless. Darker, yellower urine with a noticeable odour can indicate dehydration – although medications and certain foods, including <a href="https://pubmed.ncbi.nlm.nih.gov/3433805/">asparagus</a>, can affect urine colour and odour, too.</p> <h2>How much is too much?</h2> <p>Adults should consume <a href="https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/water-drinks-nutrition/">two-to-three litres per day</a>, of which around 20% comes from food. However, we can lose <a href="https://www.ncbi.nlm.nih.gov/books/NBK236237/">up to ten litres</a> of water through perspiration – so sweating during exercise or in hot weather increases the amount of water we need to replace through drinking.</p> <p>Some medical conditions can cause overhydration. Approximately <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616165/">one in five</a> schizophrenia patients drink water compulsively, a dangerous condition known as <a href="https://www.theguardian.com/uk-news/2024/apr/15/woman-died-mental-hospital-excessive-water-drinking-inquest#:%7E:text=Woman%20died%20at%20mental%20hospital%20after%20excessive%20water%20drinking%2C%20inquest%20told,-Parents%20of%20Lillian&amp;text=A%20woman%20collapsed%20and%20died,water%2C%20an%20inquest%20has%20heard.">psychogenic polydipsia</a>. One long-term study found that patients with psychogenic polydipsia have a <a href="https://pubmed.ncbi.nlm.nih.gov/18984069/">“74% greater chance</a> of dying before a non-polydipsic patient”.</p> <p>In <a href="https://pubmed.ncbi.nlm.nih.gov/22306188/">some cases</a>, people with <a href="https://psychiatry-psychopharmacology.com/en/childhood-and-adolescence-disorders-psychogenic-polydipsia-in-an-adolescent-with-eating-disorder-a-case-report-132438">anorexia nervosa</a> can also suffer from compulsive water drinking.</p> <figure><iframe src="https://www.youtube.com/embed/ReQew2zcN7c?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For those suffering from polydipsia, treatment is focused on medication to reduce the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675986/">urge to drink</a>, as well as <a href="https://www.uptodate.com/contents/overview-of-the-treatment-of-hyponatremia-in-adults/print">increasing sodium levels</a>. This should be done gradually to avoid causing <a href="https://www.ncbi.nlm.nih.gov/books/NBK562251/">myelinolysis</a> – <a href="https://www.ncbi.nlm.nih.gov/books/NBK551697/">neurological damage</a> caused by rapid changes in sodium levels in nerve cells.</p> <p>In rare but often highly publicised cases such as that of <a href="http://news.bbc.co.uk/onthisday/hi/dates/stories/november/13/newsid_2516000/2516593.stm">Leah Betts</a> in 1995, some users of the illegal drug MDMA (also known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119400/">ecstasy)</a> have <a href="https://pubmed.ncbi.nlm.nih.gov/11265566/">died</a> after drinking copious amounts of water to rehydrate after dancing and sweating.</p> <p>The drug <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">increases body temperature</a>, so users drink water to avoid overheating. Unfortunately, MDMA also triggers the <a href="https://pubmed.ncbi.nlm.nih.gov/12105115/">unnecessary release of ADH</a>, causing water retention. The body becomes unable to rid itself of excess water, which affects its electrolyte levels – causing cells to swell with water.</p> <p>Symptoms of water intoxication start with nausea, vomiting, blurred vision and dizziness. As the condition progresses, sufferers can often display symptoms of <a href="https://www.nhs.uk/mental-health/conditions/psychosis/symptoms/">psychosis</a>, such as inappropriate behaviour, confusion, delusions, disorientation and hallucinations.</p> <p>These symptoms are caused by <a href="https://www.ncbi.nlm.nih.gov/books/NBK470386/">hyponatraemia</a>, where sodium levels are diluted or depleted in blood and the subsequent imbalance of electrolytes affects the nervous system. Water begins to move into the brain causing <a href="https://www.sciencedirect.com/science/article/pii/S1572349604000149">a cerebral oedema</a> – brain swelling because of excessive fluid buildup, which is usually fatal if not treated.</p> <p>A healthy body will tell you when it needs water. If you’re thirsty and your urine is dark with a noticeable odour, then you need to drink more. If you aren’t thirsty and your urine is clear or the colour of light straw, then you’re already doing a good job of hydrating yourself.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/228715/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/adam-taylor-283950"><em>Adam Taylor</em></a><em>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/drinking-lots-of-water-may-seem-like-a-healthy-habit-heres-when-and-why-it-can-prove-toxic-228715">original article</a>.</em></p> </div>

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The voice in your head may help you recall and process words. But what if you don’t have one?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/derek-arnold-106381">Derek Arnold</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Can you imagine hearing yourself speak? A voice inside your head – perhaps reciting a shopping list or a phone number? What would life be like if you couldn’t?</p> <p>Some people, including me, cannot have imagined visual experiences. We cannot close our eyes and conjure an experience of seeing a loved one’s face, or imagine our lounge room layout – to consider if a new piece of furniture might fit in it. This is called “<a href="https://theconversation.com/a-blind-and-deaf-mind-what-its-like-to-have-no-visual-imagination-or-inner-voice-226134">aphantasia</a>”, from a Greek phrase where the “a” means without, and “phantasia” refers to an image. Colloquially, people like myself are often referred to as having a “blind mind”.</p> <p>While most attention has been given to the inability to have imagined visual sensations, aphantasics can lack other imagined experiences. We might be unable to experience imagined tastes or smells. Some people cannot imagine hearing themselves speak.</p> <p>A <a href="https://www.sciencealert.com/we-used-to-think-everybody-heard-a-voice-inside-their-heads-but-we-were-wrong">recent study</a> has advanced our understanding of people who cannot imagine hearing their own internal monologue. Importantly, the authors have identified some tasks that such people are more likely to find challenging.</p> <h2>What the study found</h2> <p>Researchers at the University of Copenhagen in Denmark and at the University of Wisconsin-Madison in the United States <a href="https://journals.sagepub.com/doi/10.1177/09567976241243004">recruited 93 volunteers</a>. They included 46 adults who reported low levels of inner speech and 47 who reported high levels.</p> <p>Both groups were given challenging tasks: judging if the names of objects they had seen would rhyme and recalling words. The group without an inner monologue performed worse. But differences disappeared when everyone could say words aloud.</p> <p>Importantly, people who reported less inner speech were not worse at all tasks. They could recall similar numbers of words when the words had a different appearance to one another. This negates any suggestion that aphants (people with aphantasia) simply weren’t trying or were less capable.</p> <h2>A welcome validation</h2> <p>The study provides some welcome evidence for the lived experiences of some aphants, who are still often told their experiences are not different, but rather that they cannot describe their imagined experiences. Some people feel anxiety when they realise other people can have imagined experiences that they cannot. These feelings may be deepened when others assert they are merely confused or inarticulate.</p> <p>In my own <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1374349/full">aphantasia research</a> I have often quizzed crowds of people on their capacity to have imagined experiences.</p> <p>Questions about the capacity to have imagined visual or audio sensations tend to be excitedly endorsed by a vast majority, but questions about imagined experiences of taste or smell seem to cause more confusion. Some people are adamant they can do this, including a colleague who says he can imagine what combinations of ingredients will taste like when cooked together. But other responses suggest subtypes of aphantasia may prove to be more common than we realise.</p> <p>The authors of the recent study suggest the inability to imagine hearing yourself speak should be referred to as “anendophasia”, meaning without inner speech. Other authors had suggested <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551557/">anauralia</a> (meaning without auditory imagery). Still other researchers have referred to all types of imagined sensation as being different types of “imagery”.</p> <p>Having <a href="https://www.sciencedirect.com/science/article/abs/pii/S0010945222000417">consistent names</a> is important. It can help scientists “talk” to one another to compare findings. If different authors use different names, important evidence can be missed.</p> <h2>We have more than 5 senses</h2> <p>Debate continues about how many senses humans have, but some scientists reasonably argue for a <a href="https://www.sensorytrust.org.uk/blog/how-many-senses-do-we-have#:%7E:text=Because%20there%20is%20some%20overlap,sensation%20of%20hunger%20or%20thirst.">number greater than 20</a>.</p> <p>In addition to the five senses of sight, smell, taste, touch and hearing, lesser known senses include thermoception (our sense of heat) and proprioception (awareness of the positions of our body parts). Thanks to proprioception, most of us can close our eyes and touch the tip of our index finger to our nose. Thanks to our vestibular sense, we typically have a good idea of which way is up and can maintain balance.</p> <p>It may be tempting to give a new name to each inability to have a given type of imagined sensation. But this could lead to confusion. Another approach would be to adapt phrases that are already widely used. People who are unable to have imagined sensations commonly refer to ourselves as “aphants”. This could be adapted with a prefix, such as “audio aphant”. Time will tell which approach is adopted by most researchers.</p> <h2>Why we should keep investigating</h2> <p>Regardless of the names we use, the study of multiple types of inability to have an imagined sensation is important. These investigations could reveal the essential processes in human brains that bring about a conscious experience of an imagined sensation.</p> <p>In time, this will not only lead to a better understanding of the diversity of humans, but may help uncover how human brains can create any conscious sensation. This question – how and where our conscious feelings are generated – remains one of the great mysteries of science.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/230973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/derek-arnold-106381">Derek Arnold</a>, Professor, School of Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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-voice-in-your-head-may-help-you-recall-and-process-words-but-what-if-you-dont-have-one-230973">original article</a>.</em></p> </div>

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Laura Tingle shares "regret" over racism comments

<p>Laura Tingle has shared her "regret" over her <a href="https://oversixty.com.au/finance/legal/laura-tingle-under-fire-after-declaring-australia-a-racist-country" target="_blank" rel="noopener">comments</a> that Australia is "a racist country", as the ABC Director of News responded to her claims. </p> <p>Tingle caused outrage after she made the claims about Australia being inherently racist during a panel on Sunday as part of the Sydney Writer's Festival. </p> <p>Now, ABC News director Justin Stevens says her comments did not meet the organisation's editorial standards.</p> <p>“Although the remarks were conversational, and not made in her work capacity, the ABC and its employees have unique obligations in the Australian media,’’ he said in a <a href="https://www.abc.net.au/about/media-centre/statements-and-responses/justin-stevens-statement-on-laura-tingle/103909056" target="_blank" rel="noopener">statement</a>. </p> <p>“Today she has explained her remarks in more detail to ensure there is a factual record of the relevant context and detail."</p> <p>“The ABC’s editorial standards serve a vital role. Laura has been reminded of their application at external events as well as in her work and I have counselled her over the remarks."</p> <p>In response to much nation-wide backlash over her comments, Tingle issued a lengthy statement clarifying her remarks and also sharing her "regret". </p> <p>“I did indeed make the observation on Sunday that we are a racist country, in the context of a discussion about the political prospects ahead,’’ Tingle said.</p> <p>“I wasn’t saying every Australian is a racist. But we clearly have an issue with racism. Without even going into the historic record, there is also ample evidence that racism remains a particular problem in our legal and policing systems."</p> <p>“In my commentary at the ABC, and at the Sydney Writers’ Festival, I expressed my concern at the risks involved in Peter Dutton pressing the hot button of housing and linking it to migration for these reasons," she continued. </p> <p>“Political leaders, by their comments, give licence to others to express opinions they may not otherwise express. That does not make them racist, but it has real world implications for many Australians.”</p> <p>She went on to add a statement of "regret", saying, “I regret that when I was making these observations at the Writers’ Festival the nature of the free-flowing panel discussion means they were not surrounded by every quote substantiating them which would have – and had – been included in what I had said earlier on the ABC."</p> <p>“This has created the opportunity for yet another anti-ABC pile-on. This is not helpful to me or to the ABC. Or to the national debate. I am proud of my work as a journalist at the ABC, on all its platforms, and I let that work speak for itself.”</p> <p>ABC News boss Justin Stevens confirmed on Thursday that Tingle had been “counselled over her remarks” and "reminded of their application at external events as well as in her work."</p> <p><em>Image credits: ABC News / DANNY CASEY/EPA-EFE / Shutterstock Editorial </em></p> <p> </p>

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