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Readers response: What’s your best advice for managing medications while travelling?

<p>When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. </p> <p>We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said.</p> <p><strong>Kristeen Bon</strong> - I put each days tablet into small ziplock bags and staple them at one corner. All that goes into one larger ziplock bag and into my toilet bag. I store all the outer packs flat into another ziplock bag and that stays in the zip pack with my first aid kit in the main suitcase. I travel long haul up to six times a year and this is the most manageable way I have found.</p> <p><strong>Diane Green</strong> - Firstly, take sufficient  supply of all meds to last the time I'm away. I separate morning medications and evening medications. Then it depends on how long I'm away. I have one that needs to be refrigerated. Depending on where I travel, this can entail arranging overnight in the establishment fridge while taking a freezer pack for daytime travel.</p> <p><strong>Irene Varis</strong> - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble!</p> <p><strong>Helen Lunn</strong> - Just get the chemist to pack into Medipacks. I usually take an extra week. I alway put some of the packs in my partners baggage incase my bag goes missing and a pack and a doctor’s letter in my hand luggage.</p> <p><strong>Jancye Winter</strong> - Always pack in your carry on with prescriptions.</p> <p><strong>Jenny Gordon</strong> - Carry a letter from doc with all medications, leave in original packaging. Double check that it isn’t illegal to carry your medication as some countries have strict regulations for things like Codeine. Always carry in carry on as you don’t want them to get lost.</p> <p><strong>Nina Thomas Rogers</strong> - Be organised with all your medicines before you leave.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Tips

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More Australians are using their superannuation for medical procedures. But that might put their financial health at risk

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member.</p> <p>Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%.</p> <p>Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed.</p> <h2>What are compassionate grounds?</h2> <p>Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds.</p> <p><a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are:</p> <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> <p>The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness.</p> <p>The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded.</p> <p>You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan.</p> <p>People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible.</p> <h2>Why are people using this scheme more?</h2> <p>The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures.</p> <p>But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues.</p> <p>There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system.</p> <p>Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system.</p> <p>While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated.</p> <h2>Lack of clarity</h2> <p>As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation.</p> <p>For example, the meaning of “mental disturbance” is not defined.</p> <p>You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early.</p> <p>People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues.</p> <p>Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications.</p> <p>In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment.</p> <h2>A closed-loop system</h2> <p>Conflict of interest is another major issue.</p> <p>There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment.</p> <p>Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments.</p> <p>This raises important questions about the independence of the process, as well as professional ethics.</p> <p>Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds.</p> <p>Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight.</p> <h2>What is needed?</h2> <p><strong>1. Mandatory financial counselling</strong></p> <p>The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications.</p> <p><strong>2. Tightening of the criteria</strong></p> <p>Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited.</p> <p><strong>3. Better oversight</strong></p> <p>Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest.</p> <p>Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<!-- 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/239588/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/neera-bhatia-15189"><em>Neera Bhatia</em></a><em>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin 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/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>.</em></p> </div>

Money & Banking

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John Boland’s battle against prostate cancer and the urgent need for reform

<p>John Boland, a 74-year-old retired Navy Reserve Lieutenant Commander, found himself at a crossroads – a place where hope and despair often meet in the lives of those battling life-threatening illnesses like prostate cancer. </p> <p>Diagnosed five years ago, John’s journey has been a relentless fight against a disease that, despite medical advancements, still claims the lives of 10 men in Australia every day.</p> <p>After undergoing surgery and 37 rounds of radiation therapy, John’s battle was far from over. His PSA (Prostate-Specific Antigen) levels, an indicator of prostate cancer activity, were not dropping sufficiently, signalling that the fight was only getting tougher. It was then that John was introduced to a groundbreaking treatment: Lutetium-177 PSMA therapy (LuPSMA), a targeted radionuclide therapy with pinpoint accuracy to attack cancer cells.</p> <p>This innovative treatment offered a glimmer of hope, a chance to strike at the heart of the disease that had disrupted his life. But there was a catch – the cost. Each round of LuPSMA treatment costs $10,000, and while some patients may require up to eight rounds, John’s doctors recommended two based on his response. Even so, the financial burden was immense, forcing John to dip into his superannuation, ultimately spending $60,000 on the treatment that was not covered by insurance.</p> <p>Despite the financial strain, the results were nothing short of miraculous. After just the first round, John’s PSA levels dropped by a staggering 95%. After the second, they fell to nearly zero. The treatment had not only attacked the cancer but had also restored his quality of life, allowing him to once again enjoy the simple pleasures – time with family, daily activities and even golf. It was a victory that brought renewed hope and confidence for the future, a victory that made the $60,000 investment worth every cent.</p> <p>“My case was remarkably successful after the second treatment, which are eight weeks apart, after the scan had no cancer, and my PSA was effective to zero. So it was a reliable result for me and a huge boost, but unfortunately, they're $10,000 a time, and you can require up to eight treatments,” says John. “Fortunately we were able to fund it from our superannuation pension account, the $20,000, but I imagine that a lot of people, they can’t find that $20,000.”</p> <p>But John’s story, while inspiring, also highlights a grim reality: many Australians are not as fortunate. The LuPSMA treatment that worked so well for John remains out of reach for many others due to its prohibitive cost. And this isn’t just an isolated issue; it’s a systemic problem affecting thousands of men across the country.</p> <p>A new report, the <a href="https://www.pcfa.org.au/media/nbennwom/aus-np-1123-80001-amgen-access-gap-report_april-2024-data-final-approved.pdf" target="_blank" rel="noopener">Australian Patient Access Gap Report</a>, has shed light on the alarming delay in the public availability of new medicines in Australia. The report reveals that Australians with life-threatening illnesses are waiting an average of 591 days – more than 18 months – for access to new, potentially life-saving medicines. For some, the wait can be as long as three years. These delays are not just statistics; they represent real people, real lives hanging in the balance.</p> <p>The Prostate Cancer Foundation of Australia (PCFA), the country’s leading organisation in the fight against prostate cancer, is calling for urgent reform. They argue that the current system, which often requires multiple rounds of review before new treatments are approved for public use, is failing Australians. </p> <p>PCFA CEO Anne Savage points out that while 10 men die from prostate cancer every day, the approval process for new treatments drags on, leaving patients like John Boland to fend for themselves – often at great financial and emotional cost. “In almost every instance, Australians are being denied access to new medicines that can extend and save their lives, simply because our approval systems have not kept up with the pace of change,” she says. </p> <p>“In relation to prostate cancer, applications typically undergo two or three rounds of review before achieving a positive recommendation, while 10 men die a day from the disease. It’s simply not good enough.”</p> <p>John’s story serves as a strong call to action. His successful treatment with LuPSMA is a testament to the power of modern medicine, but it also underscores the urgent need for change. No one should have to choose between their life savings and their life; it’s time for Australia to modernise its pharmaceutical benefits scheme, ensuring that all Australians, regardless of their financial situation, have access to the treatments they need.</p> <p>As we move forward, the PCFA is urging Australians to take part in initiatives like <a href="https://www.thelongrun.org.au/" target="_blank" rel="noopener">The Long Run</a> during Prostate Cancer Awareness Month in September, raising awareness and funds to support the fight against this devastating disease. </p> <p>For John Boland, and for the thousands of others who share his struggle, we must work towards a future where no one is left behind in the fight against cancer.</p> <p><em>Image: Courtesy of John Boland.</em></p>

Caring

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What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<!-- 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/227559/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/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <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/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

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Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p>When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact?</p> <p>The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines).</p> <p>I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65.</p> <h2>Polypharmacy among older adults</h2> <p>Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics.</p> <p>Is it a good idea to take so many drugs?</p> <p>According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability.</p> <p>In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic.</p> <h2>The risks of polypharmacy: 5 points to consider</h2> <p>When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken.</p> <ol> <li> <p>Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments.</p> </li> <li> <p>A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses?</p> </li> <li> <p>The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences.</p> </li> <li> <p>The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death.</p> </li> <li> <p>Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks.</p> </li> </ol> <p>Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements.</p> <p>Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health.</p> <h2>3 tips to avoid the risks associated with polypharmacy</h2> <p>What can we do as a patient, or as a caregiver?</p> <ol> <li> <p>Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ?</p> </li> <li> <p>Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced?</p> </li> <li> <p>Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter.</p> </li> </ol> <h2>Benefits should outweigh the risks</h2> <p>Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion.</p> <p>Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<!-- 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/230612/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/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>.</em></p> </div>

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Almost half the men surveyed think they could land a passenger plane. Experts disagree

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/guido-carim-junior-1379129">Guido Carim Junior</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/chris-campbell-1414564">Chris Campbell</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/elvira-marques-1362476">Elvira Marques</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/nnenna-ike-1490692">Nnenna Ike</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/tim-ryley-1253269">Tim Ryley</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Picture this: you’re nestled comfortably in your seat cruising towards your holiday destination when a flight attendant’s voice breaks through the silence:</p> <blockquote> <p>Ladies and gentlemen, both pilots are incapacitated. Are there any passengers who could land this plane with assistance from air traffic control?</p> </blockquote> <p>If you think you could manage it, you’re not alone. <a href="https://today.yougov.com/topics/politics/survey-results/daily/2023/01/02/fd798/3">Survey results</a> published in January indicate about one-third of adult Americans think they could safely land a passenger aircraft with air traffic control’s guidance. Among male respondents, the confidence level rose to nearly 50%.</p> <p>Can a person with no prior training simply guide everyone to a smooth touchdown?</p> <p>We’ve all heard stories of passengers who saved the day when the pilot became unresponsive. For instance, last year <a href="https://www.youtube.com/watch?v=qbMoyWukjbs">Darren Harrison</a> managed to land a twin-engine aircraft in Florida – after the pilot passed out – with the guidance of an air traffic controller who also happened to be a flight instructor.</p> <p>However, such incidents tend to take place in small, simple aircraft. Flying a much bigger and heavier commercial jet is a completely different game.</p> <h2>You can’t always rely on autopilot</h2> <p>A pilot spends about 90% of their time monitoring autopilot systems and making sure everything is working as intended. The other 10% is spent managing problems, taxiing, taking off and landing.</p> <p>Takeoffs and landings are arguably the most difficult tasks pilots perform, and are always performed manually. Only on very few occasions, and in a handful of aircraft models, can a pilot use autopilot to land the aircraft for them. This is the exception, and not the rule.</p> <p>For takeoff, the aircraft must build up speed until the wings can generate enough lift to pull it into the air. The pilot must <a href="https://youtu.be/16XTAK-4Xbk?si=66yDo5g5I086Q2y2&amp;t=65">pay close attention</a> to multiple instruments and external cues, while keeping the aircraft centred on the runway until it reaches lift-off speed.</p> <p>Once airborne, they must coordinate with air traffic control, follow a particular path, retract the landing gear and maintain a precise speed and direction while trying to climb.</p> <p>Landing is even more complicated, and requires having precise control of the aircraft’s direction and descent rate.</p> <p><a href="https://youtu.be/u_it9OiTnSM?si=xNZrLB9ZH870LEa3&amp;t=360">To land successfully</a>, a pilot must keep an appropriate speed while simultaneously managing gear and flap configuration, adhering to air traffic regulations, communicating with air traffic control and completing a number of paper and digital checklists.</p> <p>Once the aircraft comes close to the runway, they must accurately judge its height, reduce power and adjust the rate of descent – ensuring they land on the correct area of the runway.</p> <p>On the ground, they will use the brakes and reverse thrust to bring the aircraft to a complete stop before the runway ends. This all happens within just a few minutes.</p> <figure><iframe src="https://www.youtube.com/embed/Nyx4NyMrvOs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Both takeoff and landing are far too quick, technical and concentration-intensive for an untrained person to pull off. They also require a range of skills that are only gained through extensive training, such as understanding the information presented on different gauges, and being able to coordinate one’s hands and feet in a certain way.</p> <h2>Training a pilot</h2> <p>The journey from student to commercial pilot is a long one. It normally starts with a recreational licence, followed by a private licence, and then a commercial licence (which allows them to fly professionally).</p> <p>Even before stepping into a cockpit, the student must study aerodynamics, air law and flight rules, meteorology, human factors, navigation, aircraft systems, and performance and flight planning. They also need to spend time learning about the specific aircraft they will be flying.</p> <p>Once the fundamentals are grasped, an instructor takes them for training. Most of this training is conducted in small, lightweight aircraft – with a simulator introduced briefly towards the end.</p> <p>During a lesson, each manoeuvre or action is demonstrated by the instructor before the student attempts it. Their attempt may be adjusted, corrected or even terminated early in critical situations.</p> <p>The first ten to fifteen lessons focus on takeoff, landing, basic in-flight control and emergency management. When the students are ready, they’re allowed to “go solo” – wherein they conduct a complete flight on their own. This is a great milestone.</p> <p>After years of experience, they are ready to transition to a commercial aircraft. At this point they might be able to take off and land reasonably well, but they will still undergo extensive training specific to the aircraft they are flying, including hours of advanced theory, dozens of simulator sessions and hundreds of hours of real aircraft training (most of which is done with passengers onboard).</p> <p>So, if you’ve never even learned the basics of flying, your chances of successfully landing a passenger aircraft with air traffic control’s help are close to zero.</p> <h2>Yet, flying is a skill like any other</h2> <p>Aviation training has been democratised by the advent of high-end computers, virtual reality and flight simulation games such as Microsoft’s <a href="https://www.flightsimulator.com/">Flight Simulator</a> and <a href="https://www.x-plane.com/">X-Plane</a>.</p> <p>Anyone can now rig up a desktop flight simulator for a few thousand dollars. Ideally, such a setup should also include the basic physical controls found in a cockpit, such as a control yoke, throttle quadrant and pedals.</p> <p>Flight simulators provide an immersive environment in which professional pilots, students and aviation enthusiasts can develop their skills. So if you really think you could match-up against a professional, consider trying your hand at one.</p> <p>You almost certainly won’t be able to land an actual passenger plane by the end of it – but at least you’ll gain an appreciation for the immense skill pilots possess.<!-- 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/218037/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/guido-carim-junior-1379129"><em>Guido Carim Junior</em></a><em>, Senior Lecturer in Aviation, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/chris-campbell-1414564">Chris Campbell</a>, Adjunct Associate Professor, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/elvira-marques-1362476">Elvira Marques</a>, Aviation PhD candidate, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/nnenna-ike-1490692">Nnenna Ike</a>, Research Assistant, Griffith Aviation, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/tim-ryley-1253269">Tim Ryley</a>, Professor and Head of Griffith Aviation, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: </em><em>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/almost-half-the-men-surveyed-think-they-could-land-a-passenger-plane-experts-disagree-218037">original article</a>.</em></p> </div>

Travel Trouble

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Shannon Noll postpones show due to medical emergency

<p>Shannon Noll has been forced to postpone two of his upcoming shows in Victoria due to a medical emergency.</p> <p>The former <em>Australian Idol </em>winner, 48, took to Instagram to announce that he had to undergo an "emergency procedure" although the exact details of the procedure was kept under wraps.</p> <p>"Hi guys, due to unforeseen circumstances I'm afraid I have to postpone this weekend's shows at Thornbury Theatre and West Gippsland Arts Centre," he began on the post shared on Friday. </p> <p>"I'm so sorry to do this but I had to undergo an emergency procedure yesterday that now prevents me from travelling for the next few days.</p> <p>"Huge apologies again everyone but I look forward to seeing you all at the rescheduled shows soon!" he concluded. </p> <p>Fans took to the comments to wish the star a speedy recovery. </p> <p>"Health comes first, wishing you a speedy recovery," one wrote. </p> <p>"Hope you are back to good health quickly Shannon. All the very best," another added. </p> <p>"Health is the absolute priority - we hope that you’re back fit and fighting very soon!" a third commented. </p> <p>"Get well soon Shannon! Take the time you need to recover," added a fourth. </p> <p>It has been 20 years since the singer rose to fame after becoming a runner-up on the first season of <em>Australian Idol</em>. </p> <p>"To still be a professional musician travelling the country and playing music 20 years later after a singing competition, I'm so thankful and blessed," he told <em>9Honey</em>. </p> <p>"And it's all because of the support the Australian public has given me over the years, during the ups and downs as well."</p> <p>"It's all because of the public. I'm thankful to them and will be forever," he added. </p> <p><em>Image: Getty</em></p>

Caring

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Asking ChatGPT a health-related question? Better keep it simple

<p>It’s tempting to <a href="https://cosmosmagazine.com/news/chatgpt-and-dr-google/">turn to search engines</a> to seek out health information, but with the rise of large language models, like ChatGPT, people are becoming more and more likely to depend on AI for answers too.</p> <div class="copy"> <p>Concerningly, an Australian study has now found that the more evidence given to <a href="https://cosmosmagazine.com/technology/chatgpt-an-intimate-companion/">ChatGPT</a> when asked a health-related question, the less reliable it becomes.</p> <p>Large language models (LLM) and artificial intelligence use in health care is still developing, creating a  a critical gap when providing incorrect answers can have serious consequences for people’s health.</p> <p>To address this, scientists from Australia’s national science agency, CSIRO, and the University of Queensland (UQ) explored a hypothetical scenario: an average person asking ChatGPT if ‘X’ treatment has a positive effect on condition ‘Y’.</p> <p>They presented ChatGPT with 100 questions sourced from the <a href="https://trec-health-misinfo.github.io/" target="_blank" rel="noopener">TREC Health Misinformation track</a> – ranging from ‘Can zinc help treat the common cold?’ to ‘Will drinking vinegar dissolve a stuck fish bone?’</p> <p>Because queries to search engines are typically shorter, while prompts to a LLM can be far longer, they posed the questions in 2 different formats: the first as a simple question and the second as a question biased with supporting or contrary evidence.</p> <p>By comparing ChatGPT’s response to the known correct response based on existing medical knowledge, they found that ChatGPT was 80% accurate at giving accurate answers in a question-only format. However, when given an evidence-biased prompt, this accuracy reduced to 63%, which was reduced again to 28% when an “unsure” answer was allowed. </p> <p>“We’re not sure why this happens,” says CSIRO Principal Research Scientist and Associate Professor at UQ, Dr Bevan Koopman, who is co-author of the paper.</p> <p>“But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.”</p> <p>Study co-author Guido Zuccon, Director of AI for the Queensland Digital Health Centre at UQ says that major search engines are now integrating LLMs and search technologies in a process called Retrieval Augmented Generation.</p> <p>“We demonstrate that the interaction between the LLM and the search component is still poorly understood, resulting in the generation of inaccurate health information,” says Zuccon.</p> <p>Given the widespread popularity of using LLMs online for answers on people’s health, Koopman adds, we need continued research to inform the public about risks and to help them optimise the accuracy of their answers.</p> <p>“While LLMs have the potential to greatly improve the way people access information, we need more research to understand where they are effective and where they are not.”</p> <p><em>Image credits: Getty Images</em></p> <div> <p align="center"><noscript data-spai="1"><em><img decoding="async" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/12/MICROSCOPIC-TO-TELESCOPIC__Embed-graphic-720x360-1.jpg" data-spai-egr="1" width="600" alt="Buy cosmos print magazine" title="asking chatgpt a health-related question? better keep it simple 2"></em></noscript></p> </div> <p><em><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=301406&amp;title=Asking+ChatGPT+a+health-related+question%3F+Better+keep+it+simple" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em><em><a href="https://cosmosmagazine.com/technology/ai/asking-chatgpt-a-health-related-question-better-keep-it-simple/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </em></div>

Caring

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Survey unveils Aussies thoughts on tourism tax

<p>Earlier this year, Bali launched a controversial tourism tax, which meant that every traveller entering the island would have to pay a $15 fee, which the Indonesian province have said will be used for environmental and cultural projects. </p> <p>Now, Aussies have shared their thoughts on introducing a similar system here, and survey results have revealed that many are keen for the tourism tax to be introduced here. </p> <p>Travel provider InsureandGo conducted the survey and found that 60 per cent of Australians would support the government introducing a tax to combat the rising environmental toll of tourism.</p> <p>"Tourist taxes are a relatively new concept, but as travel demand swells, we are seeing more countries adopt the levy," InsureandGo Chief Commercial Officer Jonathan Etkind said. </p> <p>"What's heartening is that only a minority of 37 per cent of respondents don't support tourism taxes, demonstrating just how many Australians support the concept of sustainable travel."</p> <p>The response comes amid increased sustainability concerns on our flora and fauna, which are being threatened by over-tourism. </p> <p>The tax is particularly supported by younger Aussies aged between 18 to 30, with 73 per cent of them saying yes to tourism taxes. </p> <p>Etkind said that this may be because younger Aussies are typically more aware of the environmental impacts of travel compared to the older generation, who may be less accustomed to the tax. </p> <p>Along with Bali, other cities and countries have started introducing similar fees to combat overtourism,  with Venice set to charge day-trippers a fee of 5 Euros ($8.20) per visit. </p> <p>Amsterdam, Netherlands has the highest tourism tax in Europe, with the former 7 per cent hotel tourist levy rising to 12.5 per cent this year. </p> <p>New Zealand also charges international visitors excluding Aussie citizens and permanent residents $25 levy ($32.64 AUD) to address the challenges created by tourism in its conservation areas. </p> <p><em>Image: Getty</em></p>

International Travel

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Embracing healing: The rise of medical cannabis in Australia

<p>In recent years, Australia has made significant strides in healthcare, particularly in the realm of alternative medicine. One such breakthrough gaining widespread recognition is the availability and utilisation of medical cannabis. <a href="https://www.oversixty.com.au/health/body/how-nurses-are-changing-the-conversation-around-medicinal-cannabis" target="_blank" rel="noopener">As attitudes shift and research unfolds</a>, the once-stigmatised plant is emerging as a source of genuine hope and relief for patients across the country.</p> <p>Medical cannabis, derived from the cannabis plant, contains compounds known as cannabinoids, notably THC (tetrahydrocannabinol) and CBD (cannabidiol), which possess therapeutic properties. While recreational use remains a contentious issue, the medicinal potential of cannabis cannot be overlooked.</p> <p>In Australia, its legal status has evolved; in October 2016 the Australian Government changed the law to allow organisations to grow cannabis for research and to make pharmaceutical products, allowing patients to access cannabis-based products under specific conditions.</p> <p>One of the most significant benefits of medical cannabis is its ability to alleviate symptoms and improve the quality of life for patients suffering from various medical conditions. From chronic pain and epilepsy to nausea induced by chemotherapy, medical cannabis offers relief where traditional treatments can fall short or have significant long-term side effects. For people with debilitating illnesses, this alternative therapy can open doors to a life with reduced discomfort and enhanced well-being.</p> <p>Moreover, the availability of medical cannabis fosters a more patient-centric approach to healthcare. By recognising the diverse needs of individuals and offering alternative treatment options, healthcare professionals empower patients to take control of their health journey. This shift towards personalised medicine acknowledges that what works for one person may not work for another, and cannabis-based treatments provide another tool in the arsenal of healthcare interventions.</p> <p>Australia's embrace of medical cannabis also extends to research and innovation. With an increasing number of clinical trials and studies exploring its efficacy and safety, the medical community is uncovering new insights into the potential applications of cannabis-based therapies. This commitment to scientific inquiry ensures that medical cannabis is integrated into healthcare practices responsibly and ethically.</p> <p>Furthermore, the legalisation of medical cannabis opens doors for economic growth and innovation. Australia's burgeoning cannabis industry has the potential to create jobs, stimulate investment and drive technological advancements in cultivation, processing and distribution. By capitalising on this emerging market, Australia can position itself as a global leader in medical cannabis research and production.</p> <p>Take the example of <a href="https://www.montu.com.au/" target="_blank" rel="noopener">Montu</a>, a Melbourne-based medical cannabis company that in November was <a href="https://www.montu.com.au/_files/ugd/0ee6ca_f78badef1cf64ccba22263ed6b5ea5d0.pdf" target="_blank" rel="noopener">named the fastest-growing tech company</a> in the entire country for the second consecutive year. The groundswell of public and investor support for such a company – whose stated mission is to deploy technology to create a better medical cannabis ecosystem for suppliers, practitioners, pharmacies and the patients they serve – is testament to the rapidly growing popularity of medical cannabis as a viable everyday resource for health and wellbeing. </p> <p>Companies like Montu that are streamlining and regulating access to medical cannabis via a growing network of medical practitioners are playing a vital role in getting help for those who need it most. Even though Montu was only formed in 2019, with its first products entering the market in 2020, the evolution of its company ecosystem has been dramatic to say the least. Now with a diverse range of companies under its umbrella, Montu is using innovative solutions to enhance the patient experience – from their "Leafio" dispensing system bridging the gap between suppliers and pharmacies, to their growing variety of products and brands, to their "Alternaleaf" telehealth service that connects patients with expert clinicians, and their high-end "Saged" professional online learning portal for healthcare professionals, this integrated approach is shaping a future where medical cannabis is accessible, efficient and tailored to meet the diverse needs of patients and healthcare providers alike.</p> <p>Perhaps most importantly of all, the availability of medical cannabis promotes harm reduction by offering a safer alternative to potentially addictive pharmaceutical drugs. For patients struggling with opioid dependence or other addictive substances, cannabis-based treatments provide a non-addictive option for managing symptoms, reducing the risk of substance abuse and overdose.</p> <p>The legalisation of medical cannabis in Australia marked a pivotal moment in the nation's healthcare landscape. With growing recognition of the therapeutic potential of cannabis-derived treatments, Australia has taken decisive steps to ensure that patients in need have access to this alternative therapy.</p> <p>Through rigorous regulation and oversight, the legal framework surrounding medical cannabis balances patient safety with the need for compassionate care, allowing individuals suffering from debilitating conditions to explore new avenues of treatment.</p> <p>This landmark decision not only reflected a shift in societal attitudes towards cannabis but also underscored Australia's commitment to evidence-based medicine and the well-being of its citizens.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">As attitudes towards cannabis evolve and its medicinal benefits become more widely recognised, Australia stands at the forefront of a healthcare revolution – one of </span>hope, healing and a future where patients can experience relief and improved quality of life.</p> <p><em>Image: Getty</em></p>

Caring

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Attempts to access Kate Middleton’s medical records are no surprise. Such breaches are all too common

<p><a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <em><a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>The <a href="https://www.abc.net.au/news/2024-03-20/claim-hospital-staff-tried-to-access-kate-middleton-health-info/103608066">alleged</a> data breach involving Catherine, Princess of Wales tells us something about health privacy. If hospital staff can apparently access a future queen’s medical records without authorisation, it can happen to you.</p> <p>Indeed it may have already happened to you, given many breaches of health data go under the radar.</p> <p>Here’s why breaches of health data keep on happening.</p> <h2>What did we learn this week?</h2> <p>Details of the alleged data breaches, by <a href="https://www.mirror.co.uk/news/royals/breaking-kate-middleton-three-london-32401247">up to three staff</a> at The London Clinic, emerged in the UK media this week. These breaches are alleged to have occurred after the princess had abdominal surgery at the private hospital earlier this year.</p> <p>The UK Information Commissioner’s Office <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/03/ico-statement-in-response-to-reports-of-data-breach-at-the-london-clinic/">is investigating</a>. Its report should provide some clarity about what medical data was improperly accessed, in what form and by whom. But it is unlikely to identify whether this data was given to a third party, such as a media organisation.</p> <h2>Health data isn’t always as secure as we’d hope</h2> <p>Medical records are inherently sensitive, providing insights about individuals and often about biological relatives.</p> <p>In an ideal world, only the “right people” would have access to these records. These are people who “need to know” that information and are aware of the responsibility of accessing it.</p> <p>Best practice digital health systems typically try to restrict overall access to databases through hack-resistant firewalls. They also try to limit access to specific types of data through grades of access.</p> <p>This means a hospital accountant, nurse or cleaner does not get to see everything. Such systems also incorporate blocks or alarms where there is potential abuse, such as unauthorised copying.</p> <p>But in practice each health records ecosystem – in GP and specialist suites, pathology labs, research labs, hospitals – is less robust, often with fewer safeguards and weaker supervision.</p> <h2>This has happened before</h2> <p>Large health-care providers and insurers, including major hospitals or chains of hospitals, have a <a href="https://www.theguardian.com/australia-news/2023/dec/22/st-vincents-health-australia-hack-cyberattack-data-stolen-hospital-aged-care-what-to-do">worrying</a> <a href="https://www.afr.com/technology/medical-information-leaked-in-nsw-health-hack-20210608-p57z7k">history</a> of <a href="https://www.innovationaus.com/oaic-takes-pathology-company-to-court-over-data-breach/">digital breaches</a>.</p> <p>Those breaches include hackers accessing the records of millions of people. The <a href="https://www.theguardian.com/world/2022/nov/11/medical-data-hacked-from-10m-australians-begins-to-appear-on-dark-web">Medibank</a> data breach involved more than ten million people. The <a href="https://www.hipaajournal.com/healthcare-data-breach-statistics/">Anthem</a> data breach in the United States involved more than 78 million people.</p> <p>Hospitals and clinics have also had breaches specific to a particular individual. Many of those breaches involved unauthorised sighting (and often copying) of hardcopy or digital files, for example by nurses, clinicians and administrative staff.</p> <p>For instance, this has happened to public figures such as <a href="https://www.latimes.com/archives/la-xpm-2008-mar-15-me-britney15-story.html">singer</a> <a href="https://journals.lww.com/healthcaremanagerjournal/abstract/2009/01000/health_information_privacy__why_trust_matters.11.aspx">Britney Spears</a>, actor <a href="https://www.nytimes.com/2007/10/10/nyregion/10clooney.html">George Clooney</a> and former United Kingdom prime minister <a href="https://www.theguardian.com/uk-news/2024/mar/20/when-fame-and-medical-privacy-clash-kate-and-other-crises-of-confidentiality">Gordon Brown</a>.</p> <p>Indeed, the Princess of Wales has had her medical privacy breached before, in 2012, while in hospital pregnant with her first child. This was no high-tech hacking of health data.</p> <p>Hoax callers from an Australian radio station <a href="https://theconversation.com/did-2day-fm-break-the-law-and-does-it-matter-11250">tricked</a> hospital staff into divulging details over the phone of the then Duchess of Cambridge’s health care.</p> <h2>Tip of the iceberg</h2> <p>Some unauthorised access to medical information goes undetected or is indeed undetectable unless there is an employment dispute or media involvement. Some is identified by colleagues.</p> <p>Records about your health <em>might</em> have been improperly sighted by someone in the health system. But you are rarely in a position to evaluate the data management of a clinic, hospital, health department or pathology lab.</p> <p>So we have to trust people do the right thing.</p> <h2>How could we improve things?</h2> <p>Health professions have long emphasised the need to protect these records. For instance, medical ethics bodies <a href="https://www.bmj.com/content/350/bmj.h2255">condemn</a> medical students who <a href="https://www.abc.net.au/news/2014-04-14/picture-sharing-app-for-doctors-raises-privacy-concerns/5389226">share</a> intimate or otherwise inappropriate images of patients.</p> <p>Different countries have various approaches to protecting who has access to medical records and under what circumstances.</p> <p>In Australia, for instance, we have a mix of complex and inconsistent laws that vary across jurisdictions, some covering privacy in general, others specific to health data. There isn’t one comprehensive law and set of standards <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">vigorously administered</a> by one well-resourced watchdog.</p> <p>In Australia, it’s mandatory to report <a href="https://www.oaic.gov.au/privacy/notifiable-data-breaches">data breaches</a>, including breaches of health data. This reporting system is currently <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">being updated</a>. But this won’t necessarily prevent data breaches.</p> <p>Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data.</p> <p>The best policy <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1475-4932.12693">nudges</a> involve increasing penalties for breaches. This is so organisations act as responsible custodians rather than negligent owners of health data.</p> <p>We also need to step-up enforcement of data breaches and make it easier for victims to sue for breaches of privacy – princesses and tradies alike.<!-- 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/226303/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/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <em><a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></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/attempts-to-access-kate-middletons-medical-records-are-no-surprise-such-breaches-are-all-too-common-226303">original article</a>.</em></p> <p><em>Images: Getty</em></p>

Legal

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Why it’s a bad idea to mix alcohol with some medications

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.</p> <p>But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.</p> <p>When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.</p> <h2>How alcohol and medicines interact</h2> <p>The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to <a href="https://www.medicalnewstoday.com/articles/324330">convulsions</a>. Too much inhibition and you will experience effects like sedation and depression.</p> <p><iframe id="JCh01" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/JCh01/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.</p> <p>With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.</p> <p>Medications can interact with alcohol to <a href="https://awspntest.apa.org/record/2022-33281-033">produce different or increased effects</a>. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those <a href="https://www.drugs.com/article/medications-and-alcohol.html#:%7E:text=Additive%20effects%20of%20alcohol%20and,of%20drug%20in%20the%20bloodstream.">effects can be compounded</a>.</p> <p>Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can <a href="https://www.healthline.com/health/adhd/ritalin-and-alcohol#side-effects">increase the drug’s effect on the heart</a>, increasing your heart rate and the risk of a heart attack.</p> <p>Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.</p> <p>Alcohol can increase the break-down of certain medicines, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763421005121?via%3Dihub">opioids, cannabis, seizures, and even ritalin</a>. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with <a href="https://australianprescriber.tg.org.au/articles/alcohol-and-paracetamol.html">paracetamol</a>.</p> <p>At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.</p> <h2>Who is at most risk?</h2> <p>The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.</p> <p>Older people do not break down medicines as quickly as younger people, and are often on <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over#:%7E:text=is%20this%20important%3F-,Polypharmacy%20is%20when%20people%20are%20using%20five%20or%20more%20medicines,take%20five%20or%20more%20medicines.">more than one medication</a>.</p> <p>Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.</p> <p>Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.</p> <h2>What drugs can’t you mix with alcohol?</h2> <p>You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.</p> <p>The most common <a href="https://adf.org.au/insights/prescription-meds-alcohol/">alcohol-interacting prescription medicines</a> are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.</p> <p>It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.</p> <p>Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.</p> <p>If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.<!-- 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/223293/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/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, Pharmacist and PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, Associate Professor in Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </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/why-its-a-bad-idea-to-mix-alcohol-with-some-medications-223293">original article</a>.</em></p>

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Medical Research Future Fund has $20 billion to spend. Here’s how we prioritise who gets what

<p><em><a href="https://theconversation.com/profiles/adrian-barnett-853">Adrian Barnett</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/philip-clarke-1149967">Philip Clarke</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p>The <a href="https://www.health.gov.au/our-work/medical-research-future-fund">Medical Research Future Fund</a> (MRFF) is a A$20 billion fund to support Australian health and medical research. It was set up in 2015 to deliver practical benefits from medical research and innovation to as many Australians as possible.</p> <p>Unlike the other research funding agencies, such the National Health and Medical Research Council (NHMRC), most of the MRFF funding is priority-driven. It seeks to fund research in particular areas or topics rather than using open calls when researchers propose their own ideas for funding.</p> <p>As the <a href="https://www.smh.com.au/politics/federal/not-how-you-run-a-1b-scheme-science-fund-backers-lead-chorus-for-reform-20230619-p5dhni.html">Nine newspapers</a> outlined this week, researchers have criticised the previous Coalition government’s allocation of MRFF funds. There is widespread consensus the former health minister had <a href="https://www.theage.com.au/politics/federal/a-centre-never-built-and-a-hospital-that-missed-out-the-coalition-s-unusual-20b-research-fund-20230619-p5dhng.html">too much influence</a> in the allocation of funds, and there was limited and sometimes no competition when funding was directly allocated to one research group.</p> <p>The current Health Minister, Mark Butler, has instituted a <a href="https://www.innovationaus.com/billion-dollar-medical-research-grants-process-under-review/">review</a>. So how should the big decisions about how to spend the MRFF be made in the future to maximise its value and achieve its aims?</p> <h2>Assess gaps in evidence</h2> <p>Research priorities for the MRFF are set by the <a href="https://www.health.gov.au/committees-and-groups/australian-medical-research-advisory-board-amrab?language=und">Australian Medical Research Advisory Board</a>, which widely consults with the research sector.</p> <p>However, most researchers and institutions will simply argue more funding is needed for their own research. If the board seeks to satisfy such lobbying, it will produce fragmented funding that aligns poorly with the health needs of Australians.</p> <p>A better approach would be to systematically assemble evidence about what is known and the key evidence gaps. Here, the board would benefit from what is known as a “<a href="https://pubmed.ncbi.nlm.nih.gov/15484602/">value of information</a>” framework for decision-making.</p> <p>This framework systematically attempts to quantify the most valuable information that will reduce the uncertainty for health and medical decision-making. In other words, it would pinpoint which information we need to allow us to better make health and medical decisions.</p> <p>There have been <a href="https://pubmed.ncbi.nlm.nih.gov/30288400/">attempts</a> to use this method in Australia to help inform how we prioritise hospital-based research. However, we now need to apply such an approach more broadly.</p> <h2>Seek public input</h2> <p>A structured framework for engaging with the public is also missing in Australia. The public’s perspective on research prioritisation has often been overlooked, but as the ultimate consumers of research, they need to be heard.</p> <p>Research is a highly complex and specialised endeavour, so we can’t expect the public to create sensible priorities alone.</p> <p>One approach used overseas has been developed by the <a href="https://www.jla.nihr.ac.uk/">James Lind Alliance</a>, a group in the United Kingdom that combines the public’s views with researchers to create agreed-on priorities for research.</p> <p>This is done using an intensive process of question setting and discussion. Priorities are checked for feasibility and novelty, so there is no funding for research that’s impossible or already done.</p> <p>The priorities from the James Lind Alliance process can be surprising. The top priority in the area of <a href="https://www.jla.nihr.ac.uk/priority-setting-partnerships/irritable-bowel-syndrome/top-10-priorities.htm">irritable bowel syndrome</a>, for example, is to discover if it’s one condition or many, while the second priority is to work on bowel urgency (a sudden urgent need to go to the toilet).</p> <p>While such everyday questions can struggle to get funding in traditional systems that often focus on novelty, funding research in these two priority areas could lead to the most benefits for people with irritable bowel syndrome.</p> <h2>Consider our comparative advantages</h2> <p>Australia is a relatively small player globally. To date, the MRFF has allocated around <a href="https://www.health.gov.au/resources/publications/medical-research-future-fund-mrff-grant-recipients?language=und">$2.6 billion</a>, just over 5% of what the United States allocates through the National Institute of Health funding in a <a href="https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/investments-on-grants-for-biomedical-research-by-funder-type-of-grant-health-category-and-recipient">single year</a>.</p> <p>A single research grant, even if it involves a few million dollars of funding, is unlikely to lead to a medical breakthrough. Instead, the MRFF should prioritise areas where Australia has a comparative advantage.</p> <p>This could involve building on past success (such as the research that led to the HPV, or human papillomavirus, vaccine to prevent cervical cancer), or where Australian researchers can play a critical role globally.</p> <p>However, there is an area where Australian researchers have an absolute advantage: using research to improve our own health system.</p> <p>A prime example would be finding ways to improve dental care access in Australia. For example, a randomised trial of different ways of providing insurance and dental services, similar to the <a href="https://www.rand.org/health-care/projects/hie.html">RAND Health Insurance Experiment</a> conducted in the United States in the 1970s.</p> <p>This could provide the evidence needed to design a sustainable dental scheme to complement Medicare. Now that is something the MRFF should consider as a funding priority.<!-- 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/209977/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/adrian-barnett-853">Adrian Barnett</a>, Professor of Statistics, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/philip-clarke-1149967">Philip Clarke</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p><em>Image credits: Getty Images</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/medical-research-future-fund-has-20-billion-to-spend-heres-how-we-prioritise-who-gets-what-209977">original article</a>.</em></p>

Money & Banking

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Survey reveals over a third of us are neglecting our hearing

<p dir="ltr">A survey conducted by hearing healthcare group Audika - and hosted by Decibel Research - has revealed the hard truth that Australians just aren’t keeping on top of their hearing.</p> <p dir="ltr">Research even found that for 88% percent of respondents - 1,020 individuals over the age of 40 - the thought of losing their eyesight was a bigger concern than losing their hearing. </p> <p dir="ltr">People had a whole host of reasons, but most circled back to the stigma that surrounds hearing loss - they feared that hearing aids would make them look older, or that they might be too uncomfortable, or even that they’re simply too expensive for the average person, despite 37% of those surveyed admitting that they would probably benefit from one. </p> <p dir="ltr">34% - roughly one third of the participants - confessed that they probably do have difficulty hearing, but have never undergone testing or sought out any sort of treatment. Meanwhile, 61% admitted that the chances of them partaking in a hearing test in the following 12 months were slim to none. </p> <p dir="ltr">Even more concerning were the 51% - over half of those surveyed - said that they would put off wearing a hearing loss “as long as possible”, even to their own detriment. Their minds wouldn’t change even if they received a hearing loss diagnosis. </p> <p dir="ltr">And this is all despite 69% of those with hearing loss reporting that their lives had been negatively impacted, from 35% citing their personal relationships as the area of concern to 35% noting their social life in general, and 19% looking to their career. </p> <p dir="ltr">Those same respondents shared that they have experienced difficulty communicating and that others don’t always understand them, often withdrawn from various events, and have faced a lack of confidence in navigating social situations. None of which can have been helped by the jokes from loved ones that a quarter of them also reported. </p> <p dir="ltr">It is more important than ever to address these statistics, and to overcome the stigma that surrounds hearing loss, as the World Health Organisation has estimated that by 2050, 1 in every 4 people around the world will experience hearing loss of some degree. On top of this, it’s believed that up to one third of the world’s population may be both undiagnosed and consequently untreated.</p> <p dir="ltr">Luckily for us, preventative measures can be taken, and the first - and arguably most important step - is to take our hearing health seriously, and make the necessary changes that will benefit us in the long run. The importance of taking such measures cannot be stressed enough, from managing symptoms all the way to preventing other “serious health conditions”.</p> <p dir="ltr">As Audika’s Audiologist and Clinical Trainer Lauren McNee put it, “poor hearing, if untreated, is linked to a number of other health conditions including mental health challenges. </p> <p dir="ltr">“The results of the recent survey indicate that Aussies don’t seem to be aware of how common hearing loss can be. They also appear to be unaware of the serious daily impacts that are felt by people that are hard of hearing, and their loved ones.</p> <p dir="ltr">“Unfortunately, stigma surrounding hearing health is still prevalent across our society – yet more than half (51%) of the survey respondents said that they have a loved one that experiences it. </p> <p dir="ltr">“With greater understanding of the impacts of hearing loss and compassion for each other, we can work towards more open conversations around hearing loss and encourage those we care about to be more proactive with their hearing health.”</p> <p dir="ltr">To help Australians on their way towards a better hearing future, Audika are encouraging people over the age of 26 to head out, learn to ‘Love Your Ears’, and visit an Audika clinic for a free hearing check. </p> <p dir="ltr">And for those who’d prefer to do it from the comfort of home, you can head over to <a href="https://www.audika.com.au/online-hearing-test">Audika’s five-minute online hearing check</a>. </p> <p dir="ltr">For more information, visit <a href="https://www.audika.com.au/">Audika’s official website</a>. </p> <p dir="ltr"><em>Images: Getty</em></p>

Body

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Madonna rushed to intensive care

<p dir="ltr">Madonna was rushed to a hospital in New York and admitted into the ICU on Saturday after being found unresponsive. She has since been treated for a serious bacterial infection.</p> <p dir="ltr">The <em>Material Girl </em>was intubated for at least one night but is now reportedly out of the ICU, alert and recovering, according to Page Six.</p> <p dir="ltr">The singer had her daughter, Lourdes Leon, by her side during the entire ordeal.</p> <p dir="ltr">Madonna’s longtime manager, Guy Oseary, has released a statement on Instagram regarding the incident.</p> <p dir="ltr">“On Saturday June 24, Madonna developed a serious bacterial infection which led to a several day stay in the ICU,” he started the post.</p> <p dir="ltr">“Her health is improving, however she is still under medical care. A full recovery is expected,” he added.</p> <p dir="ltr">Oseary also announced that all of the singer’s current commitments including her upcoming world tour have been “paused” due to the medical emergency, however further details will be provided with new dates for the tour “as soon as we have them”.</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/CuC6w1TPH_l/?utm_source=ig_embed&amp;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/CuC6w1TPH_l/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Guy Oseary (@guyoseary)</a></p> </div> </blockquote> <p dir="ltr">The “Celebration” tour highlighting her greatest hits and the 40th anniversary of her breakout single, <em>Holiday</em> was set to kick off on July 15 in Vancouver and wrapped up in Amsterdam on December 1.</p> <p dir="ltr">Fans and celebrities alike have sent their love and report for the recovering star in the comment section of Oseary’s post.</p> <p dir="ltr">“Hope she feels better very soon!” commented <em>New Girl</em> actor Zoey Deschanel.</p> <p dir="ltr">“Sending her so much love from us. ❤️❤️❤️” wrote Aussie actress Isla Fisher.</p> <p dir="ltr">“Omg sending her love and healing light! 🙏” commented Ariana Grande’s brother Frankie.</p> <p dir="ltr">“Please send her my love and support. I’ll be sending prayers for her healing ❤️❤️🙏🙏,” wrote one fan.</p> <p dir="ltr">“Health is everything. Take as much time as needed,” commented another.</p> <p dir="ltr"><em>Images: Getty</em></p>

Caring

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"A night in hospital and a trip to the burns unit later”: Concerned mum's warning against popular fruit

<p><em><strong>Warning: This article contains images that some readers may find distressing.</strong></em></p> <p>A mother has taken to the internet and shared photos of her son’s severe burns that came as a result of him playing with a popular fruit. “A night in hospital and a trip to the burns unit later.” She began in her Facebook post.</p> <p>Her son Otis was playing happily outside with a lime in the sunshine, but the next day horror ensued.</p> <p>“It wasn’t until the next day that we noticed a rash appeared.” The mother said.</p> <p>The parents had assumed the rash must’ve been an allergic reaction to the lime juice, however, the rash quickly developed into a “horrific burn,” she added.</p> <p>The parents took Otis to the hospital where they were informed their son was suffering from a condition called phytophotodermatitis.</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-permalink="https://www.instagram.com/p/Cku5QH2thxE/?utm_source=ig_embed&amp;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/Cku5QH2thxE/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Tiny Hearts (@tinyheartseducation)</a></p> </div> </blockquote> <p>Phytophotodermatitis, more commonly known as margarita burn, is a little-known condition which causes burns to the skin when a chemical called furocoumarin reacts to sunlight.</p> <p>The chemical is found in limes, citrus fruit and some plants.</p> <p>“The small lime he had been innocently playing with - had now burnt his skin horrifically!“ The mum said. “If our story can help raise awareness into phytophotodermatitis at least something good has come out of our horrific experience!”</p> <p>The woman has urged parents to be on the lookout for this little-known skin condition.</p> <p>To minimise the risks of phytophotodermatitis, <a href="https://www.healthline.com/" target="_blank" rel="noopener">Healthline</a> suggests washing hands and other exposed parts of the skin immediately after being outdoors, wearing gloves when gardening, putting on sunscreen before going outdoors and wearing long-sleeved tops and pants in wooded areas.</p> <p><em>Photo credit: Getty</em></p>

Body

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Why does my dog eat grass? And when is it not safe for them?

<p><a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em> and <a href="https://theconversation.com/profiles/joshua-zoanetti-1439474">Joshua Zoanetti</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Have you ever wondered why your dog is eating your beautifully cropped lawn or nibbling at the grass at the dog park?</p> <p>Eating grass is a common behaviour in pet dogs. Some surveys show <a href="http://raw-feeding-prey-model.fr/wp-content/uploads/2019/03/WhydogogsandcatseatgrassGrassVetMed2008-2.pdf">up to 80%</a> of guardians notice their dog regularly snacking on the grass.</p> <p>Grass eating isn’t a new behaviour either, or only done by our new designer dog breeds. Studies in Yellowstone National Park show plant matter (mostly grass) is found in up to <a href="https://academic.oup.com/jn/article/136/7/1923S/4664711">74% of wolf scats</a>, suggesting the behaviour is possibly inherited from the beginning of doggy time.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=390&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=390&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=390&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=490&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=490&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529490/original/file-20230601-21796-wl09tw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=490&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>So why does my dog eat the grass?</h2> <p>A lot of people think dogs eat grass when they have a sore stomach, believing grass causes dogs to vomit. This is probably not the case; a study with <a href="https://www.une.edu.au/__data/assets/pdf_file/0019/32446/bjone-brown-price-grass-eating20patterns-raan-2007.pdf">12 dogs that ate grass daily</a> found there were few vomiting episodes and the ones that did occur came after the dog had eaten a meal.</p> <p>And if a dog has a mild gastrointestinal disturbance because of something they’ve been fed, they are in fact <a href="https://www.sciencedirect.com/science/article/abs/pii/S0168159109003311">less likely</a> to eat grass than if they are fed a normal diet.</p> <p>Other theories include that dogs eat grass because they want a laxative or that it provides roughage in their diet (get that fibre!).</p> <p>Like the vomiting discussed above, there is little to no scientific proof for most of these theories. For example, in the study of <a href="https://www.une.edu.au/__data/assets/pdf_file/0019/32446/bjone-brown-price-grass-eating20patterns-raan-2007.pdf">12 dogs mentioned above</a>, all of them were wormed and had no previous digestive problems. Yet all 12 still happily ate grass (709 times).</p> <p>Their main finding was that when the dog had not yet had their daily meal, they were more likely to eat grass. In short, the hungrier the dog, the more likely they were to eat some grass.</p> <p>The answer to why your dog eats grass may simply be: because they like to. Your dog may be bored, and chewing on grass is something to do.</p> <p>Maybe your dog just enjoys eating grass. Ripping grass from the ground can be satisfying. The texture and taste of grass offers something different to what they usually eat. You may even notice they prefer grass in certain seasons; perhaps fresh spring grass a favourite delicacy.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529491/original/file-20230601-23190-7g4mhp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Is there any reason why you shouldn’t let your dog eat grass?</h2> <p>Well, yes, there are several. Firstly, you may not want your dog eating your neighbour’s immaculately presented fancy Kikuyu lawn.</p> <p>More importantly, though, grass is sometimes treated with herbicides. Grass at the local oval or parkland may have been treated or sprayed. Some local councils use a non-hazardous dye to show where grass has been sprayed with <a href="https://www.yassvalleytimes.com.au/general-news/council-to-use-marker-dye-when-spraying-weeds/">herbicide</a>, which is very helpful.</p> <p>Lawn chemicals are frequently detected in lawn for up to 48 hours after they’re applied, and have also been detected in the urine of dogs with <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969713003100?via%3Dihub">access to grass</a> treated this way.</p> <p>Research has suggested there may be a <a href="https://avmajournals.avma.org/view/journals/javma/224/8/javma.2004.224.1290.xml">link</a> between bladder cancer in dogs and exposure to herbicides.</p> <p>In fact, dogs may even act as sentinels; the same chemical exposures appear in the urine of dogs and people <a href="https://www.cambridge.org/core/journals/journal-of-clinical-and-translational-science/article/environmental-chemical-exposures-in-the-urine-of-dogs-and-people-sharing-the-same-households/C3F9330A4AA7723FE78CE5D492071F55">sharing the same environment</a>.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529492/original/file-20230601-22271-5juhsh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <p>If you are using herbicides on your own grass, remove your dog, their toys, food and water bowls from the area prior to any application.</p> <p>Make sure the pesticide has completely dried out before you allow the dog back in the area, and be certain to check the packaging for the appropriate drying time period.</p> <p>This is particularly the case for granular pesticides or fertilisers that soak into the soil, as these can require up to 24 hours or longer.</p> <p>If you want to reduce the risk even further, hand weeding may be a <a href="https://www.cnet.com/home/kitchen-and-household/is-weed-killer-safe-for-pets-what-to-know/">better option</a>.</p> <p>Apart from grass, many leaves, flowers and berries from common plants can be toxic to your dog. <a href="https://www.aspca.org/pet-care/animal-poison-control/toxic-and-non-toxic-plants/o?&">This includes</a> plants such as oleander and arum lily; even oregano and bay leaves can cause vomiting and diarrhoea in dogs.</p> <p>One of the best things you can do for your dog is take them for a walk. And if they eat some grass along the way, provided it has not been sprayed with herbicide, you have nothing to worry about.</p> <p>Don’t worry if they occasionally vomit. If there is more serious vomiting or diarrhoea, however, please consult your vet.<!-- 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/205658/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>Image credit: Shutterstock</em></p> <p><a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, Associate Professor, School of Animal and Veterinary Science, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em> and <a href="https://theconversation.com/profiles/joshua-zoanetti-1439474">Joshua Zoanetti</a>, PhD candidate in Veterinary Bioscience, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-dog-eat-grass-and-when-is-it-not-safe-for-them-205658">original article</a>.</p>

Family & Pets

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People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<!-- 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/203744/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/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics &amp; Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Getty Images</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/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

Caring

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9 medical reasons your short-term memory is getting worse

<p><strong>What is short-term memory?</strong></p> <p>Short-term memory is the type of memory you need to accomplish your immediate goals, explains Dr Patrick Lyden, chair of the department of neurology at Cedars-Sinai Hospital. That may be working your way through tasks during the workday, remembering someone’s name, email, or phone number, or recalling where you tossed your keys when you got home.</p> <p><strong>Where is it located in the brain?</strong></p> <p>When someone rattles off their phone number, you file it away in brain circuits that include the hippocampus (your memory centre) and the amygdala (your emotional hub). Depending on how important the short-term memory item may be (your address, someone you call all the time), it can be converted into long-term memory, says Dr Lyden.</p> <p><strong>How does short-term memory work?</strong></p> <p>Short-term memory isn’t just about being able to quickly recall new info; there are three phases. “You have to register the information, store the information, and retrieve the information,” says Dr Lyden. Registering means that you’re paying attention in the first place. Storing the info means you’ve filed it away in your brain. Retrieval is the ability to access the memory again. Any of these steps can break down, he says.</p> <p><strong>Is your memory okay?</strong></p> <p>Many people assume they have a memory problem when the explanation is something else entirely, says Dr Lyden. Maybe you’re not paying attention because you’re gazing at your phone or texting, for example. The first step to figuring out if something is going on is to “pay closer attention,” he says. Repeat the new information three times to commit it to memory.</p> <p><strong>When it may be time to worry</strong></p> <p>If you can’t pass the “pay attention test” despite repeating the information, your next step, advises Dr Lyden, is to determine if your problem is storing new memories or retrieving them. If you’re having a problem remembering a new acquaintance’s name, ask them to give you three choices – like Carrie, Lauren, or Janet. If your problem is storing new memories, you won’t be able to remember. But if your problem is retrieval, you’ll remember that her name is Janet once you hear the correct name.</p> <p>Having trouble with retrieving a short-term memory isn’t as serious as being unable to store them. “The storage problem is a serious problem, and you should see a neurologist,” he says.</p> <p><strong>Inactivity</strong></p> <p>Blood flow is good for your brain – it keeps it young. “Exercising boosts blood flow to your brain. If you stay active, you’ll have a better memory,” says Dr Daniel G. Amen, author of <em>Memory Rescue: Supercharge Your Brain, Reverse Memory Loss, and Remember What Matters Most</em>. Dr Lyden suggests daily exercise and it doesn’t have to be intense. “A one-kilometre run daily is better than a 10-kilometre run one day a week,” he says.</p> <p><strong>Substance abuse</strong></p> <p>According to Dr Amen, marijuana a toxin that impairs memory. “Marijuana lowers every area of the brain and ages it. On average, pot smokers have brains three years older than non-smokers,” he says. Alcohol abuse can also harm your memory.</p> <p><strong>Mental health conditions</strong></p> <p>People tend to miss their own depression. But if you’re suffering from depression, anxiety, or chronic stress, get help or your memory can also pay the price. “These conditions may all hurt the brain,” says Dr Amen. Getting relief will not only improve your life and outlook but save your brain.</p> <p><strong>Lack of sleep</strong></p> <p>When considering short-term memory loss causes, poor sleep is a big one. “If you don’t sleep seven hours a night or more, you’ll be in trouble. Your brain cleans itself at night. When you don’t get enough, it’s like the garbage collectors didn’t come to clean up,” says Dr Amen.</p> <p><strong>Dementia</strong></p> <p>Before you panic, there’s some good news: “The vast majority of people who are healthy will not have a degenerative neurological condition causing short-term memory loss,” says Dr Lyden. But dementia or Alzheimer’s is a possibility in some groups. If you’re over 60 and have risk factors like diabetes, high blood pressure, or obesity, then you may be more prone to problems and need to be evaluated, he says.</p> <p><strong>Medication</strong></p> <p>If you lead a healthy lifestyle, eat right, exercise, and go easy on alcohol and other substances that can harm memory, yet you still feel like your memory if failing, talk to your doctor about your medications – prescription and over-the-counter, advises Dr Lyden. Cholesterol drugs, painkillers, high blood pressure pills, and sleeping pills are among the drugs that can trigger memory issues.</p> <p><strong>Hypothyroidism</strong></p> <p>When you have an under-active thyroid, everything in your body runs slower. Your digestion will slow and you can become constipated; cell growth slows and can lead to hair loss; your metabolism becomes sluggish, triggering weight gain. And you may be plagued by muddied thinking or forgetfulness. Often, medication to restore thyroid hormones can help alleviate symptoms and help you feel better all over.</p> <p><strong>A poor diet</strong></p> <p>Inflammation is bad for your body and your brain. “The higher the inflammation levels in your body, the worse your memory will be,” says Dr Amen. Eating an anti-inflammatory diet, like the Mediterranean diet, and avoiding foods that increase it (highly processed foods, loads of sugar) is key. He also recommends taking fish oil and probiotics.</p> <p><strong>Lyme disease</strong></p> <p>Lyme disease is transmitted through a tick bite, and causes early symptoms like fever, chills, headache, and fatigue, according to the Centers for Disease Control and Prevention (CDC). Later on, without treatment, some people also may notice short-term memory problems. Dr Amen points out this may include trouble with attention, focus, and organisation. Keep in mind that the types of tick that carry the bacteria are not native to Australia and it’s not likely you can catch Lyme disease in Australia.</p> <p><strong>When to seek help</strong></p> <p>Along with the self-test mentioned earlier, think about how you perceive your short-term memory. Ask yourself: Is it getting progressively worse? Is it worse than 10 years ago? Are other people noticing a problem? “Those are things you should take seriously,” says Dr Amen.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/9-medical-reasons-your-short-term-memory-is-getting-worse-2?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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