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Bunnings announce game-changing venture

Everyone is well-acquainted with multiple trips to Bunnings for forgotten items, but now the retail giant's new venture with Uber could make life just a little easier before Christmas. The retail giant is teaming up with the rideshare and courier service to equip over 100 regional and metropolitan stores with same day parcel delivery. So shoppers looking for a last minute Christmas gift can get same day parcel delivery for orders placed by 2pm right up until December 23rd. The packages will be delivered by 7pm that day. With Australia Post Christmas delivery cut-offs set to take effect from December 20, the retail giants same-day delivery service with Uber makes it much easier for shoppers over the holiday season. The service will operate via the Bunnings website, at a flat fee of $15 for any purchases. The only condition is that for some regional outlets, the same-day delivery guarantee is subject to geographical limits, a radius of 15 kilometres from any store. “We’re committed to offering our customers the best experience, widest range and lowest prices, and same day parcel delivery across regional Australia is another way we can improve this offering”, Bunnings Chief Operating Officer, Ryan Baker said. “This builds on our current same day parcel delivery offering across metro Australia, bringing more convenience to our regional customers, and hopefully helping to ease some of the stress this time of year can bring.” Baker also emphasised that this service would not replace the in-store experience Aussies love. “Some customers value coming into the store to browse, talk to the team and enjoy the Bunnings experience such as a coffee in the cafe or the sausage sizzle hosted by a local community group. But for others, the convenience of delivery is preferred,” he said. Image: haireena / Shutterstock.com

Home & Garden

Australians are embracing chatbots this Christmas, but what does it mean for retailers and consumers?

<div> By Richard Valente, Executive Vice President of Business Solutions at<a title="https://www.teleperformance.com/" href="https://www.teleperformance.com/" target="_blank" rel="noopener" data-outlook-id="b381e4a3-fd96-44ea-ac4f-2162ce2e7cfe"> </a><a title="https://www.teleperformance.com/" href="https://www.teleperformance.com/" target="_blank" rel="noopener" data-outlook-id="6a609d2f-3bfa-4e4d-b9b1-9936ebdc3ade">Teleperformance</a> (TP) </div> The festive season is upon us and Australians are turning to technology to make their Christmas shopping easier. A new study reveals that nearly one-third of Australian shoppers are more open to using AI chatbots this year than last, a significant shift in consumer behaviour. Surprisingly, it’s not just the younger generations leading the charge. Australians aged 55 and over are also showing a growing willingness to embrace chatbots for finding the best deals and simplifying their holiday shopping. But what does this mean for retailers, and how are consumers balancing convenience with the desire for personalised service? AI chatbots are revolutionising how we shop. From generating tailored gift recommendations to answering product questions in real-time, chatbots are no longer just a novelty, they’re a powerful tool in the modern retail landscape. Retail giants like Amazon have adopted these advancements, offering AI-powered buying guides that help consumers navigate complex purchasing decisions. Whether you’re looking for the latest tech gadget or the perfect pair of shoes, these tools streamline the shopping experience, saving time and effort during the busy Christmas rush. Older Australians are joining the AI revolution and the adoption of over 55s highlights a fascinating trend - older consumers are increasingly willing to experiment with technology. Their openness to chatbots suggests a broader acceptance of AI in everyday life, driven by its ability to simplify tasks and provide instant support. However, this rapid technological adoption doesn’t come without concerns. Many Australian consumers are apprehensive about the fast changing shopping experience. They fear losing the personal touch that has traditionally defined retail interactions. But the reality is that these advancements can enhance the shopping journey by freeing up staff to engage in more meaningful ways with customers. Here at TP, we feel the key to maintaining customer trust lies in using AI to complement human assistance, not replace it. Automating repetitive tasks, answering questions and providing tailored recommendations. For retailers the messaging is clear, innovation must go hand-in-hand with empathy. Businesses that invest in both AI technology and high quality customer service teams will be positioned to meet evolving customer expectations. AI isn’t just transforming the customer experience, it’s also delivering cost efficiency for retailers. Automated systems reduce the burden on support staff enabling faster responses to customer enquiries while lowering operational costs. This dual benefit is why brands are rushing to integrate AI-powered solutions like customer relationship management (CRM) systems, omnichannel tracking and loyalty programs. It’s important retailers find balance and use AI to enhance the customer journey and not overshadow it. Self-service options and chatbots are invaluable but they should be backed by a strong human support team for more complex queries. For customers, the rise of chatbots means faster service, better deals and smoother shopping journeys. But it also highlights the growing importance of choosing brands that value customer care. TP’s research shows that half of consumers now prioritise companies with excellent service, a trend likely to shape the future of retail. As Australians embrace AI this Christmas, the message is clear, technology is not the enemy of personalisation. Instead, it’s a tool that when used thoughtfully, can make holiday shopping less stressful and more enjoyable for everyone. This holiday season, chatbots are proving to be the ultimate shopping assistant but only for brands willing to blend innovation with a human touch. As we look ahead, one thing is certain, the future of retail will be shaped by how well technology and empathy can co-exist. Image credits: Shutterstock

Technology

Does menopause hormone therapy increase or decrease your risk of dementia?

<div class="theconversation-article-body"> <figure>By <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://theconversation.com/profiles/caroline-gurvich-473295">Caroline Gurvich</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://theconversation.com/profiles/rachel-furey-2274695">Rachel Furey</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://theconversation.com/profiles/samantha-loi-2274698">Samantha Loi</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></figure> By 2050, <a href="https://www.alzint.org/u/2020/08/GlobalImpactDementia2013.pdf">around 135 million people</a> worldwide will be living with dementia. The most common cause of dementia is Alzheimer’s disease. Women are more likely than men to develop Alzheimer’s disease, even after accounting for women living longer. The symptoms of Alzheimer’s disease most commonly occur after the age of 65. However, changes in the brain begin decades before symptoms start. For women, this typically coincides with their transition to menopause. Menopause results from the body decreasing production of two hormones made by the ovaries: oestrogen and progesterone. These hormonal changes are associated with a wide range of symptoms, including hot flushes, night sweats, difficulties sleeping, reduced libido, mood changes and brain fog. Menopause hormonal therapy (also called hormone replacement therapy or HRT), including oestrogen alone or oestrogen combined with a progesterone, has been prescribed to help with menopausal symptoms for decades. But how does menopause hormone therapy affect the risk of dementia? And why do some studies say the therapy increases the risk, while others say it reduces it? <h2>Hormones and the brain</h2> A large body of pre-clinical (animal based) research shows oestrogen helps protect the brain. It reduces any damage to nerve cells and supports overall brain health. Receptors that respond to oestrogen are in areas of the brain related to reproductive functions. But they’re also in <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4491541/">areas of the brain</a> important for learning, memory and higher-order cognitive abilities such as planning, organisation and decision making. <figure class="align-right "><figcaption></figcaption></figure> The loss of the “neuroprotective” effects of oestrogen after menopause is thought to contribute to more cases of Alzheimer’s disease in women than men. <a href="https://pubmed.ncbi.nlm.nih.gov/30928686/">Clinical studies</a> have also shown women who have a medical or surgical menopause before the age of natural menopause have a higher lifelong risk of dementia and cognitive impairment. This risk <a href="https://pubmed.ncbi.nlm.nih.gov/17761551/">appears to be reduced</a> in women who take oestrogen therapy after their surgery. This has led researchers to hypothesise that adding oestrogen back – via menopause hormone therapy – might protect and maintain women’s cognitive health. However, the research findings have not been consistent. <h2>Could menopause hormone therapy impact dementia risk?</h2> Concern about dementia risk and menopause hormone therapy have been partially driven by the unexpected findings from a landmark study conducted more than two decades ago. The <a href="https://jamanetwork.com/journals/jama/fullarticle/198994">findings showed</a> hormone therapy use in post-menopausal women, 65 years and older, was associated with an increased risk for dementia. However, these studies have some key limitations: 1) most of the women were aged over 65 and more than ten years post-menopause 2) the type of oestrogen and progestogen (a synthetic form of progesterone) used may have less benefit on brain health. The most recently published <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10625913/">systematic review and meta-analysis</a> of scientific data linking hormone therapy to the risk of Alzheimer’s disease included findings from 51 different reports that were published up to 2023. The results showed if hormone therapy was initiated in midlife, or more generally within ten years of the final menstrual period, there was a decreased risk of later-life Alzheimer’s disease compared to women not using any hormone therapy. The greatest reduction in risk was associated with oestrogen-only hormone therapy. In contrast, when considering using hormone therapy in late-life, or more than ten years after menopause, oestrogen-only therapy had a neutral effects on Alzheimer’s disease risk. However, oestrogen-progestogen therapy was associated with a risk increase. Only <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004435">one clinical trial</a> has been published since this meta-analysis. This study examined the long-term effects of menopause hormone therapy use initiated in early menopause. Women were on average aged 52.8 years and 1.5 years post-menopause when they entered this trial. They were randomly assigned to an oestrogen (with or without progestogen) or placebo for four years. Researchers followed 275 women up ten years later. They found no cognitive effects (no harm nor any benefit) based on whether women were exposed to 48 months of hormone therapy or a placebo. <h2>What affects your risk?</h2> It appears the effects of menopause hormone therapy on dementia risk are influenced by several factors. These include when someone starts taking it, how long they take it for, the type of hormones used, and the person’s genetic and health background. 1. When therapy starts: the critical window hypothesis One key factor in determining the effect of menopause hormone therapy on cognitive function and the risk of dementia appears to be when therapy starts relative to menopause. This is called the “critical window hypothesis”. According to this hypothesis, oestrogen may help protect neurons in the brain only if started early in the menopause transition, particularly within a few years of menopause, when the brain may still be more responsive to hormones. 2. Type of menopause hormone therapy and the role of progesterone The type of hormones included in hormone therapy can <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9964432/#sec6-ijms-24-03205">vary widely</a> in their molecular structure as well as their physiological actions. Different types of oestrogens (such as estradiol or conjugated oestrogen) and the inclusion of a progestogen (needed for women who have not undergone a hysterectomy) may have different impacts on brain health and dementia risk. <a href="https://www.sciencedirect.com/science/article/pii/S0091302224000402#s0055">Some studies</a> suggest adding a progestogen to oestrogen therapy could counteract some of the cognitive benefits of oestrogen alone, possibly by blocking oestrogen receptors in the brain. 3. The role of vasomotor symptoms Vasomotor symptoms, such as hot flushes and night sweats, are the hallmark of menopause. Experiencing more vasomotor symptoms has been <a href="https://journals.lww.com/menopausejournal/abstract/2008/15050/objective_hot_flashes_are_negatively_related_to.9.aspx">linked to poorer memory</a> as well as an <a href="https://pubmed.ncbi.nlm.nih.gov/37577812/">increase in biological markers</a> associated with dementia risk. Therefore, one possible pathway by which menopause hormone therapy may moderate Alzheimer’s disease risk is via their effects on reducing vasomotor symptoms. 4. An person’s genetic and health background The greatest genetic risk factor for older-onset Alzheimer’s disease is carrying one or more copies of a specific version of the APOE gene, called APOE e4. There is an <a href="https://pubmed.ncbi.nlm.nih.gov/36218064/">emerging hypothesis</a> that women who have this genetic risk for Alzheimer’s disease may show the greatest benefit from using hormone therapy. <h2>What does this mean for you?</h2> The clinical and scientific community are still debating whether menopause hormone therapy may play a role in Alzheimer’s disease risk. Overall, the decision to use hormone therapy should be individualised, taking into account your age and timing of menopause, health status and specific menopause symptoms. We need more research before we can make clear decisions about the role of hormone therapy and dementia risk, but based on the current evidence, hormone therapy may be beneficial if started early in the menopause transition, particularly for women at genetic risk of Alzheimer’s disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/242111/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-gurvich-473295">Caroline Gurvich</a>, Associate Professor and Clinical Neuropsychologist, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/rachel-furey-2274695">Rachel Furey</a>, Teaching Associate, Neuropsychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/samantha-loi-2274698">Samantha Loi</a>, Associate Professor and Neuropsychiatrist, Department of Psychiatry and Royal Melbourne Hospital, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-menopause-hormone-therapy-increase-or-decrease-your-risk-of-dementia-heres-the-science-242111">original article</a>. Image: Shutterstock </div>

Caring

What is ‘doll therapy’ for people with dementia? And is it backed by science?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> The way people living with dementia <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-changes-perception">experience the world</a> can change as the disease progresses. Their sense of reality or place in time can become distorted, which can cause <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/restlessness">agitation and distress</a>. One of the best ways to support people experiencing changes in perception and behaviour is to <a href="https://www.dementia.org.au/professionals/designing-dementia-friendly-care-environments">manage their environment</a>. This can have profound benefits including <a href="https://www.agedcarequality.gov.au/resource-library/reducing-use-sedatives-aged-care-video">reducing the need for sedatives</a>. One such strategy is the use of dolls as comfort aids. <h2>What is ‘doll therapy’?</h2> More appropriately referred to as “<a href="https://www.dementia.com.au/resource-hub/the-use-of-dolls-in-dementia-care">child representation</a>”, lifelike dolls (also known as empathy dolls) can provide comfort for some people with dementia. Memories from the <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/memory-loss#:%7E:text=Older%20memories%20%E2%80%93%20which%20have%20been,detailed%20memories%20from%20earlier%20life.">distant past</a> are often more salient than more recent events in dementia. This means that past experiences of parenthood and caring for young children may feel more “real” to a person with dementia than where they are now. <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/hallucinations#:%7E:text=Visual%20hallucinations%20are%20more%20common,hallucinating%20and%20how%20others%20respond.">Hallucinations or delusions</a> may also occur, where a person hears a baby crying or fears they have lost their baby. Providing a doll can be a tangible way of reducing distress without invalidating the experience of the person with dementia. <h2>Some people believe the doll is real</h2> A recent case involving <a href="https://www.theguardian.com/australia-news/2024/nov/06/deplorable-nurse-slammed-therapy-doll-dementia-patient-believed-was-real-baby-on-table-nsw-tribunal-hears">an aged care nurse mistreating a dementia patient’s therapy doll</a> highlights the importance of appropriate training and support for care workers in this area. For those who do become attached to a therapeutic doll, they will treat the doll as a real baby needing care and may therefore have a profound emotional response if the doll is mishandled. It’s important to be guided by the person with dementia and only act as if it’s a real baby if the person themselves believes that is the case. <h2>What does the evidence say about their use?</h2> Evidence shows the use of empathy dolls may help <a href="https://www.sciencedirect.com/science/article/pii/S0197457223002677">reduce agitation and anxiety</a> and <a href="https://www.mdpi.com/2039-4403/14/4/200">improve overall quality of life</a> in people living with dementia. Child representation therapy falls under the banner of <a href="https://www.sciencedirect.com/science/article/pii/S0149763423004761">non-pharmacological approaches to dementia care</a>. More specifically, the attachment to the doll may act as a form of <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6494367/">reminiscence therapy</a>, which involves using prompts to reconnect with past experiences. Interacting with the dolls may also act as a form of <a href="https://www.health.vic.gov.au/dementia-friendly-environments/sensory-stimulation">sensory stimulation</a>, where the person with dementia may gain comfort from touching and holding the doll. Sensory stimulation may <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.13169?casa_token=ro96fxe2VPoAAAAA%3AKOS10VkTdcrf0yTI_F9p6cI5Kpbj85ZTFq13PQ56YHxi0i3-5BOnFQfW1WFWqiCZ8-mk5sp_EGkGtKM">support emotional well-being and aid commnication</a>. However, not all people living with dementia will respond to an empathy doll. The <a href="https://www.alzheimerswa.org.au/wp-content/uploads/2017/07/2.00-Guidlines-for-Use-of-Dolls-and-Mechanized-Pets-as-a-Therapeutic-Tool-4-pages.pdf">introduction of a therapeutic doll</a> needs to be done in conjunction with careful observation and consideration of the person’s background. Empathy dolls may be inappropriate or less effective for those who have not previously cared for children or who may have experienced past birth trauma or the loss of a child. Be guided by the person with dementia and how they respond to the doll. <h2>Are there downsides?</h2> The approach has <a href="https://pubmed.ncbi.nlm.nih.gov/33125455/">attracted some controversy</a>. It has been suggested that child representation therapy “infantilises” people living with dementia and may increase negative stigma. Further, the attachment may become so strong that the person with dementia will <a href="https://www.dementiauk.org/information-and-support/living-with-dementia/doll-therapy/">become upset if someone else picks the doll up</a>. This may create some difficulties in the presence of grandchildren or when cleaning the doll. The introduction of child representation therapy may also require additional staff training and time. Non-pharmacological interventions such as child representation, however, have been shown to be <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10180718/">cost-effective</a>. <h2>Could robots be the future?</h2> The use of more <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8247474/#:%7E:text=Therefore%2C%20an%20interactive%20baby%20robot,mental%20support%20for%20older%20adults.">interactive empathy dolls</a> and <a href="https://journals.sagepub.com/doi/full/10.1177/14713012231155985">pet-like robots</a> is also gaining popularity. While robots have been shown to be <a href="https://www.sciencedirect.com/science/article/pii/S1568163722000757">feasible and acceptable in dementia care</a>, there remains some contention about their benefits. While some studies have shown <a href="https://academic.oup.com/innovateage/article/5/2/igab013/6249558?login=false">positive outcomes</a>, including reduced agitation, others show <a href="https://www.sciencedirect.com/science/article/pii/S1568163722000757">no improvement</a> in cognition, behaviour or quality of life among people with dementia. Advances in artificial intelligence are also being used to help support people living with dementia and <a href="https://journals.sagepub.com/doi/full/10.1177/1471301221998888">inform</a> the community. <a href="https://feel-lab.org/research_projects/ai-viv-and-friends/">Viv and Friends</a>, for example, are AI companions who appear on a screen and can interact with the person with dementia in real time. The AI character Viv has dementia and was co-created with women living with dementia using verbatim scripts of their words, insights and experiences. While Viv can share her experience of living with dementia, she can also be programmed to talk about common interests, such as gardening. These companions are currently being trialled in some residential aged care facilities and to help educate people on the lived experience of dementia. <h2>How should you respond to your loved one’s empathy doll?</h2> While child representation can be a useful adjunct in dementia care, it requires sensitivity and appropriate consideration of the person’s needs. People living with dementia <a href="https://pubmed.ncbi.nlm.nih.gov/38325063/">may not perceive the social world the same way</a> as a person without dementia. But a person living with dementia is not a child and should never be treated as one. Ensure all family, friends and care workers are <a href="https://www.alzheimerswa.org.au/wp-content/uploads/2017/07/2.00-Guidlines-for-Use-of-Dolls-and-Mechanized-Pets-as-a-Therapeutic-Tool-4-pages.pdf">informed about the attachment to the empathy doll</a> to help avoid unintentionally causing distress from inappropriate handling of the doll. If using an interactive doll, ensure spare batteries are on hand. Finally, it is important to reassess the attachment over time as the person’s response to the empathy doll may change.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/243589/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-doll-therapy-for-people-with-dementia-and-is-it-backed-by-science-243589">original article</a>. </div>

Mind

Doctor defies terminal cancer diagnosis with breakthrough therapy

Dr Tina Willits was told she had just 24 months to live after being diagnosed with breast cancer, but against all odds she is now in remission. The mother-of-five's disease was "everywhere" with three golf-ball sized tumors in her breast and cancerous masses in her ribs, spine, lymph nodes and legs. "When my cancer was detected, it was pretty past a stage four diagnosis and I was too far gone for a mastectomy," she told the Daily Mail. She was placed on end-of-care chemotherapy and was told to "enjoy the time you have left". That was nearly three years ago. Now, the 53-year-old US mum is in remission thanks to a breakthrough cancer therapy that uses cold gases and the body's own cells to freeze and fight tumors. "I was devastated, but I was also like no, I was not ok with that diagnosis. I felt I had to do something," she recalled. "I was just really determined that I did not want to live my life with this cancer, even if they could stop it progressing, I didn't want that, I just wanted it gone." Dr Willits' cancer was HER2 positive, which account for about 20 percent of all diagnoses, and she had no family history of the disease. She underwent four rounds of chemotherapy before she sought alternative treatment at the Williams Cancer Institute. The institute sent her a list of supplements to begin taking and advised her to avoid sugar, which some researchers believe can help reduce inflammation and slow down the growth of cancer cells. She then underwent a treatment regimen that is not yet fully approved in the US, with cryoablation as the first step. Cryoablation is the process where doctors insert a small metal probe through the skin and into the tumor, extremely cold gasses are then released directly into the mass to kill its cells. In the second phase of her treatment, she received immunotherapy, where eight drugs were administered directly into her tumor, which doctors say can prompt the immune system to recognise cancer cells as a threat and trigger an immune response. Dr Willits told the Dailymail that she was shocked when she got the results from her six-week scan after the treatment. "There were none, no tumors. They were just completely gone," she said. "All the metastasis (cancerous growths outside the breast) had completely healed, and the cancer in my lymph nodes was no longer there." After the treatment she had another four rounds of chemotherapy, and still undergoes PET scans every six months. So far the cancer has not been detected in her body since the treatment, and will need to wait for five years of clear results before she can be declared cancer free. Dr Williams, the founder of the institute, developed the treatment regimen over several years, and believes it could offer a better way to treat cancer. He is currently running a trial of the treatment in hard-to-treat prostate cancer patients, although he did not reveal how long the study had been going on for or how many rounds of treatment the patients had received. Since going into remission Dr Willits has travelled to Honduras and Colorado, tried mountain biking and is training for a 5k marathon for breast cancer awareness. "I wouldn't appreciate life like this if I had not gone through the cancer," she said. "No one on their deathbed says I wish I had worked more or got that job, you all say I wish I had spent more time with my parents and kids or gone to that place I had always wanted to." Images: DailyMail

Caring

How to know when it’s time to start therapy

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/simon-sherry-557487">Simon Sherry</a>, <a href="https://theconversation.com/institutions/dalhousie-university-1329">Dalhousie University</a> People go to therapy for many reasons. A challenging life event, trauma, volatile emotions, relationship problems, poor mental health: all can prompt someone to seek it out. Whatever the reason, it can be difficult to decide when and if therapy is right for you. If you’re reading this, now’s probably the right time. If you’re considering therapy, something is likely bothering you and you want help. Consider this your sign to reach out. If you’re still unsure, keep reading. <h2>Why therapy?</h2> Sometimes, our minds work against us. Therapy can help you understand why you think, feel, or act how you do and give you the skills you need to think, feel, or act in healthier ways. This includes helping you: <ul> <li> identify, understand, and overcome internal obstacles </li> <li> identify and challenge thought patterns and beliefs that are holding you back </li> <li> improve your mental health </li> <li> cope with mental illness </li> <li> and create lasting changes to your thoughts and behaviour that can improve all areas of your life. </li> </ul> <h2>When your mental health is suffering</h2> Everyone experiences negative emotions in difficult situations — like sadness after a breakup or anxiety before a big life event. But when do these feelings become problematic? When you have <a href="https://www.canada.ca/en/public-health/services/about-mental-health.html">poor mental health</a>. Mental health and mental illness <a href="https://cmha.ca/news/mental-health-what-is-it-really/">are distinct</a>, but related, concepts. <a href="https://dictionary.apa.org/mental-health">Mental health</a> refers to the inner resources you have to handle life’s ups and downs. You have good mental health if you enjoy life; feel connected to others; cope well with stress; and have a sense of purpose, a sense of self and strong relationships. If you have poor mental health, it can be hard to adapt to changes like a breakup, move, loss or parenthood. Therapy can help you improve your mental health, develop resilience and maintain a state of well-being. <a href="https://www.canada.ca/en/public-health/services/about-mental-illness.html">Mental illness</a> refers to distressing disturbances in thoughts, feelings and perceptions that interfere with daily life. There are <a href="https://cmha.ca/brochure/mental-illnesses/">different kinds</a> of mental illness, each characterized by different thoughts, feelings and behaviours. Mental illness may feel like: <ul> <li> Hopelessness — feeling stuck, unmotivated or helpless. </li> <li> Apathy — feeling uninterested in things that used to give you satisfaction or pleasure. </li> <li> Anger — feeling rage or resentment, especially frequently or disproportionately. </li> <li> Stress — feeling overwhelmed, unable to cope, unwilling to rest or like everything is hard (even if you know it shouldn’t be). </li> <li> Guilt — feeling ashamed, undeserving of good things or deserving of bad things. </li> <li> Anxiety — worrying about what has or might happen or having disturbing intrusive thoughts. </li> <li> Exhaustion — sleeping more than usual, having difficulty getting out of bed or lacking energy during the day. </li> <li> <a href="https://doi.org/10.1016/S2215-0366(20)30136-X">Insomnia</a> — having difficulty falling or staying asleep. </li> </ul> Both poor mental health and mental illness are equally good reasons to seek therapy. Ask yourself: Am I having trouble dealing with life challenges? If the answer is yes, therapy might be for you. People often cope with the feelings listed above in different ways. <a href="https://www.nami.org/wp-content/uploads/2023/11/NAMI-Warning-Signs-FINAL.pdf">Some gain or lose a lot of weight</a>. Others might seek out or do things that are unhealthy for them, like entering a toxic relationship, engaging in dangerous activities, developing an unhealthy habit or procrastinating. Others might isolate themselves from friends and family, or catastrophize and <a href="https://pubmed.ncbi.nlm.nih.gov/22468242">ruminate on negative experiences</a>. However it manifests, <a href="https://namica.org/what-is-mental-illness/">mental illness often gets worse if left untreated</a>. It can have very real impacts on your life, potentially leading to unemployment, broken relationships, poor physical health, substance abuse, homelessness, incarceration or even suicide. Ask yourself: Is mental illness negatively affecting my functioning or well-being? If the answer is yes, therapy might be for you. <h2>What if therapy didn’t work before?</h2> Many people put off going to therapy because they don’t think their problems are serious enough, but you don’t need a big, deep reason to start therapy. Some people go to therapy to learn more about themselves. Some, to improve their skills, relationships or productivity. Others go for help reaching their goals or because they aren’t happy and don’t know why. Any of these are good reasons to start therapy, even if they don’t seem like “problems” in a traditional sense. You can go to therapy just because there’s something about yourself or your life you’d like to explore. Therapy is a process. Whether psychotherapy works for you depends on many factors, such as time, effort and your psychologist. There’s no quick fix for mental health. Symptoms can take weeks, months or even years to improve. Although this can be frustrating or disheartening, for therapy to work, you have to give it time. Sometimes people go to therapy, but are skeptical or resistant. Therapy won’t work if you aren’t invested in it. For therapy to work, you have to put in the work. Therapy is a vulnerable process, so finding a psychologist you trust and relate well with is crucial. Psychologists also have different specialities and approaches. For therapy to work, you have to find the right therapist for you. <h2>What if I’m not ready?</h2> There are several reasons why now might not be the right time for you to start therapy. Maybe therapy isn’t in the budget. Maybe you have other priorities. Maybe you’re scared to relive trauma. That’s okay. Therapy can be expensive and difficult, but also rewarding. Just because now isn’t a good time, doesn’t mean there will never be a good time. If you don’t want to start therapy, don’t. However, it can be helpful to determine why you don’t want to. Maybe you don’t want to go to therapy because you’re worried what others might think. If so, remember that people are often <a href="https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics">more understanding</a> than we anticipate, and there is nothing wrong with investing in your health or happiness. If you’re struggling with your mental health, know that you’re not alone. Mental health issues are common. Having them or attending therapy does not mean there is something “wrong” with you. Mental illness affects <a href="https://www.who.int/news-room/fact-sheets/detail/mental-disorders">970 million people</a> and is the leading cause of disability worldwide. <a href="https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics">One in five</a> <a href="https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/">adults</a> and more than <a href="https://doi.org/10.1001/jamapsychiatry.2023.5051">one in 10 children and youths</a> have mental illness. About <a href="https://health-infobase.canada.ca/datalab/mental-illness-blog.html">15 per cent of Canadians</a> use mental health services each year. Don’t let stigma keep you from bettering your life and well-being. Everyone deserves to live a healthy, fulfilling life. Therapy can help you get there.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234078/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/simon-sherry-557487">Simon Sherry</a>, Clinical Psychologist and Professor in the Department of Psychology and Neuroscience, <a href="https://theconversation.com/institutions/dalhousie-university-1329">Dalhousie University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-know-when-its-time-to-start-therapy-234078">original article</a>. </div>

Mind

Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> With so many high-profile people <a href="https://www.theguardian.com/uk-news/2024/mar/23/cancer-charities-princess-of-wales-speaking-about-diagnosis">diagnosed with cancer</a> we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are <a href="https://www.cancer.org/research/acs-research-news/facts-and-figures-2024.html">increasing among younger people</a> in their 30s and 40s. On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are <a href="https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21763">improving greatly</a> and some cancers are now being managed more as <a href="https://www.cancer.org/cancer/survivorship/long-term-health-concerns/cancer-as-a-chronic-illness.html">long-term chronic diseases</a> rather than illnesses that will rapidly claim a patient’s life. The <a href="https://www.cancer.org/cancer/managing-cancer/treatment-types.html">mainstays of cancer treatment</a> remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment. <h2>Keep moving if you can</h2> Physical exercise is now recognised as a <a href="https://www.exerciseismedicine.org/">medicine</a>. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where <a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.884">cancer is less likely to flourish</a>. It does this in a number of ways. Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue <a href="https://jitc.bmj.com/content/9/7/e001872">to identify and kill cancer cells</a>. Our skeletal muscles (those attached to bone for movement) release signalling molecules called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288608/">myokines</a>. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells <a href="https://www.sciencedirect.com/science/article/pii/S2095254623001175">slowing their growth and causing cell death</a>. Exercise can also greatly <a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.884">reduce the side effects of cancer treatment</a> such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of <a href="https://doi.org/10.2337/diacare.27.7.1812">developing other chronic diseases</a> such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health <a href="https://www.hindawi.com/journals/tbj/2022/9921575/">for patients with cancer</a>. Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as <a href="https://aacrjournals.org/cancerres/article/81/19/4889/670308/Effects-of-Exercise-on-Cancer-Treatment-Efficacy-A">chemotherapy</a> and <a href="https://www.nature.com/articles/s41391-020-0245-z">radiation therapy</a>. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then <a href="https://www.jsams.org/article/S1440-2440(18)31270-2/fulltext">rehabilitating them after surgery</a>. These mechanisms explain why cancer patients who are physically active have much <a href="https://journals.lww.com/acsm-msse/fulltext/2019/06000/physical_activity_in_cancer_prevention_and.20.aspx">better survival outcomes</a> with the relative risk of death from cancer <a href="https://journals.lww.com/acsm-msse/fulltext/2019/06000/physical_activity_in_cancer_prevention_and.20.aspx">reduced by as much as 40–50%</a>. <h2>Mental health helps</h2> The second “tool” which has a major role in cancer management is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016045/">psycho-oncology</a>. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships. Supporting quality of life and happiness is important on their own, but these barometers <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1349880/full">can also impact</a> a patient’s physical health, response to exercise medicine, resilience to disease and to treatments. If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression <a href="https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet">through hormonal and inflammatory mechanisms</a>. So it’s essential their mental health is supported. <h2>Putting the good things in: diet</h2> A third therapy in the supportive cancer care toolbox is diet. A healthy diet <a href="https://www.cancer.org/cancer/survivorship/coping/nutrition/benefits.html">can support the body</a> to fight cancer and help it tolerate and recover from medical or surgical treatments. Inflammation provides a more fertile environment <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2022/reducing-inflammation-to-treat-cancer">for cancer cells</a>. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This <a href="https://www.frontiersin.org/articles/10.3389/fnut.2021.709435/full">generally means</a> avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based. Muscle loss is <a href="https://onlinelibrary.wiley.com/doi/10.1002/rco2.56">a side effect of all cancer treatments</a>. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so <a href="https://www.sciencedirect.com/science/article/pii/S0261561421005422">supplementation may be indicated</a>. Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233663/">cachexia and needs careful management</a>. Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes). <h2>Working as a team</h2> These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients. If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support. For exercise medicine support it is best to consult with an <a href="https://www.essa.org.au/Public/Public/Consumer_Information/What_is_an_Accredited_Exercise_Physiologist_.aspx">accredited exercise physiologist</a>, for diet therapy an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a> and mental health support with a <a href="https://psychology.org.au/psychology/about-psychology/what-is-psychology">registered psychologist</a>. Some of these services are supported through Medicare on referral from a general practitioner. <hr /> For free and confidential cancer support call the <a href="https://www.cancer.org.au/support-and-services/cancer-council-13-11-20">Cancer Council</a> on 13 11 20.<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/226720/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, Professor of Exercise Medicine, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/exercise-therapy-and-diet-can-all-improve-life-during-cancer-treatment-and-boost-survival-heres-how-226720">original article</a>. </div>

Caring

5 reasons art therapy is great for your mental health as you age

We know how important it is to look after our <a style="color: blue;" href="https://www.betterhealth.vic.gov.au/health/servicesandsupport/healthy-and-active-ageing">physical health</a> as we age, but our mental health is equally important. <a style="color: blue;" href="https://aifs.gov.au/resources/short-articles/normalising-mental-illness-older-adults-barrier-care">Studies have shown</a> that besides the immediate impact on wellbeing, older people with untreated mental ill health are at risk of poorer overall health, increased hospital admissions, and an earlier transition into aged care. Art therapy is an excellent way to boost our mental wellbeing. In a nutshell, this type of therapy is when visual art, such as drawing, sculpting, or collage, is used in a <a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/">therapeutic context</a>. And don’t be put off if you haven’t picked up a paintbrush since you were a kid. Art therapy is not about creating works of beauty but about the process. It’s a completely <a style="color: blue;" href="https://cata.org.au/faqs-myth-busters/#:~:text=The%20focus%20of%20Creative%20Art,%2C%20growth%20and%20self%2Dawareness.&text=Reality%3A%20Creative%20Art%20Therapy%20does,to%20affect%20change%20and%20growth.">judgement free zone</a>! Emotional release: Growing up, many of us were never taught that it was okay to express how we’re feeling, especially emotions like anger and sadness. In that way, art therapy can be ideal us older folks who often feel stuck when it comes to expressing ourselves. Art therapy provides the opportunity to express our <a style="color: blue;" href="https://creativityintherapy.com/2017/06/expressing-emotions-creativity-6-step-art-process/">inner experiences</a> in a visual way. Through the act of creation, we can release pent-up feelings, reduce stress, and experience emotional release. Another challenging emotion that art therapy can help with is grief. As we age, we are more likely to experience the <a style="color: blue;" href="https://www.nari.net.au/the-impact-of-prolonged-grief-in-older-people">loss of a loved one</a> and we don’t get ‘used to it’. The hole it leaves in our hearts is just as dark. Through <a style="color: blue;" href="https://www.vivianpaans.com.au/blog/healing-through-art-how-art-therapy-can-help-with-grief-and-wellbeing">creating art</a> we can explore the feelings of grief and sadness in a safe, judgement-free space. It can also foster a sense of self-compassion and when we have more compassion for ourselves, it becomes easier to accept our emotions. Stress relief: <a style="color: blue;" href="https://www.sane.org/information-and-resources/facts-and-guides/facts-mental-health-issues">Anxiety, depression, and past traumas</a> can heavily impact on our daily lives. Risk factors over our lifespans may change but they don’t magically disappear once we hit a certain age. Illness, grief, financial stress, social isolation, and life transitions such as menopause can all be <a style="color: blue;" href="https://www.healthdirect.gov.au/older-people-and-mental-health">contributing factors</a> of poor mental health for older adults. Creating art can ease symptoms as we refocus on what we’re creating and move thoughts away from overthinking and worry. Creating art releases <a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/">dopamine,</a> the chemical responsible for allowing us to feel pleasure and satisfaction. This further reduces bothersome symptoms of anxiety and depression. Also, participating in art therapy leads to a more creative brain. A creative brain is better equipped to create stress-relieving techniques for other areas of our lives. Through creating art, we draw the fears that are inside our minds. This takes them out of our heads and places them away from us, helping us feel more in control. Recovering from <a style="color: blue;" href="https://www.interrelate.org.au/news-media/blogs/november-2021/how-art-can-heal-trauma">trauma</a> can be a lifelong process for many, and it’s important for someone dealing with it to find tools that will help this process. Art therapy can be one of those as it can give a sense of agency and self-understanding through the ability to express feelings symbolically. This can give <a style="color: blue;" href="https://anzacata.org/About-CAT">new perspectives</a> of ourselves and our worldview which is essential in the recovery process. It can also help connect with deeply stored emotions and help process them. Self-discovery: When we are younger we are often so busy working, socialising, and raising a family many of us never get a chance to take the time out for <a style="color: blue;" href="https://www.visionpsychology.com/starting-the-process-of-self-discovery/">self-discovery</a>. Self-discovery is important in our lives as it gives us a clearer sense of purpose and direction in life. In turn, this leads to making better decisions that lead to our overall happiness. Some of us see our kids leave home and suddenly we’re left wondering, who am I when I don’t have a family to care for? Creating art can help us acknowledge and recognise feelings that have been suppressed in our subconscious. Through learning to use different techniques of art our minds open up to thinking more freely. Self-discovery comes from both the finished product we create as well as the process of making it. Self-esteem: As we age, it’s easy to look in the mirror and struggle to recognise the person we see. Our bodies are changing, and it can often feel like society doesn’t value us as much as when we were young. It can be a major shift in the way we view ourselves and lead to poor self-esteem. Art therapy teaches us how to use a variety of media to create something new. We can develop talents and see strengths as we master new materials and see the completion of projects. This sense of accomplishment can be a big leg up to our <a style="color: blue;" href="https://artbusinessnews.com/2022/01/benefits-of-art-therapy/">self-esteem.</a> A sense of community: <a style="color: blue;" href="https://likefamily.com.au/blog/what-is-loneliness-and-how-does-it-affect-someone/">Loneliness</a> is a big contributor to poor mental health. <a style="color: blue;" href="https://www.psychiatrist.com/news/study-why-older-people-feel-so-lonely/">Studies</a> show two groups of people are most at risk: young adults and older people. With factors at our age such as children leaving home, not working as much or at all, living alone, and chronic illness, it’s easy to see how loneliness can creep into our lives. Group art therapy is a wonderful way to connect with others. We share a space with those who have similar interests, and it gives us a sense of belonging. For those who can't make a session in person due to distance or illness, some therapists offer <a style="color: blue;" href="https://www.artandplaytherapytraining.com.au/art_therapy">online group art therapy</a>. You don’t need to see an art therapist to get the mental health benefits of creating art. But the advantage of that is they have the skills to work out what best suits your needs. They’ll also work with you through any tough emotions that may arise from your art therapy. So maybe it’s time to hide those new coloured pencils from the little ones, crack them open, and enjoy them yourself! If you’d like to find out more about art therapy sessions, the links below are helpful. They offer online, in person and group sessions. <a style="color: blue;" href="https://www.zevaarttherapy.com/" target="_blank" rel="noopener">https://www.zevaarttherapy.com/</a> <a style="color: blue;" href="https://www.alliedarttherapy.com.au/" target="_blank" rel="noopener">https://www.alliedarttherapy.com.au/</a> <a style="color: blue;" href="https://www.solacecreativetherapies.com.au/" target="_blank" rel="noopener">https://www.solacecreativetherapies.com.au/</a> <a style="color: blue;" href="https://cata.org.au/programs-ndis/online-creative-art-therapy/" target="_blank" rel="noopener">https://cata.org.au/programs-ndis/online-creative-art-therapy/</a> And for some more ideas on dabbling in art therapy on your own (or with a friend), check out Shelley Klammer’s amazing resources. She is US-based but has some online workshops that are also amazing: <a style="color: blue;" href="https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/" target="_blank" rel="noopener">https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/</a> Article written by Kylie Carberry Image: Shutterstock

Mind

What are the most common symptoms of menopause? And which can hormone therapy treat?

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers. Adding to the uncertainty, a recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">series in the Lancet</a> medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate. So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says. <h2>Remind me, what exactly is menopause?</h2> Menopause, simply put, is complete loss of female fertility. Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause). Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months. Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder). <h2>What are the most common symptoms of menopause?</h2> <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">Our study</a> of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are: <ul> <li>hot flushes and night sweats (known as vasomotor symptoms)</li> <li>disturbed sleep</li> <li>musculoskeletal pain</li> <li>decreased sexual function or desire</li> <li>vaginal dryness and irritation</li> <li>mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.</li> </ul> However, none of these symptoms are menopause-specific, meaning they could have other causes. In <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">our study of Australian women</a>, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats. But the severity of these symptoms <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">varies greatly</a>. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55. So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are <a href="https://journals.lww.com/menopausejournal/fulltext/2022/05000/prevalence,_severity,_and_associated_factors_in.9.aspx">similarly affected</a>. Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span. The <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">most robust guidelines</a> do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of <a href="https://www.cell.com/cell/abstract/S0092-8674(23)00905-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867423009054%3Fshowall%3Dtrue">menopausal hormonal changes</a>. The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">Some studies</a> suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">have not been shown to change</a>. <h2>Who might benefit from hormone therapy?</h2> The Lancet papers <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">suggest</a> menopause hormone therapy <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02799-X/fulltext">alleviates</a> hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats). In contrast, the highest quality <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">clinical guidelines</a> consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy. Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency). However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”. Despite musculoskeletal pain being the most common menopausal symptom in <a href="https://journals.lww.com/menopausejournal/abstract/2016/07000/prevalence_and_severity_of_vasomotor_symptoms_and.6.aspx">some populations</a>, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied. Some guidelines, such as an <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Australian endorsed guideline</a>, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease. <h2>What are the risks?</h2> The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot. Oestrogen-only menopause hormone therapy is <a href="https://www.nice.org.uk/guidance/ng23">consistently considered</a> to cause little or no change in breast cancer risk. Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, <a href="https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Women%20Health/CPG_Management_of_Menopause_2022_e-version-1.pdf">has been associated with a small increase</a> in the risk of breast cancer, although any <a href="https://www.bmj.com/content/bmj/371/bmj.m3873.full.pdf">risk appears to vary</a> according to the type of therapy used, the dose and duration of use. Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels <a href="https://www.bmj.com/content/bmj/364/bmj.k4810.full.pdf">prescribed at standard doses</a> <h2>What if I don’t want hormone therapy?</h2> If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats. In Australia, most of these options are “off-label”, although the new medication <a href="https://australianprescriber.tg.org.au/articles/management-of-menopause.html">fezolinetant</a> has just been <a href="https://www.tga.gov.au/resources/artg/401401">approved</a> in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat). Unfortunately, most over-the-counter treatments promoted for menopause are either <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">ineffective or unproven</a>. However, cognitive behaviour therapy and hypnosis <a href="https://journals.lww.com/menopausejournal/abstract/2023/06000/the_2023_nonhormone_therapy_position_statement_of.4.aspx">may provide symptom relief</a>. The Australasian Menopause Society has useful <a href="https://www.menopause.org.au/health-info/fact-sheets">menopause fact sheets</a> and a <a href="https://www.menopause.org.au/health-info/find-an-ams-doctor">find-a-doctor</a> page. The <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Practitioner Toolkit for Managing Menopause</a> is also freely available.<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/225174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images 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-are-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">original article</a>.

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Why prices are so high – 8 ways retail pricing algorithms gouge consumers

<a href="https://theconversation.com/profiles/david-tuffley-13731">David Tuffley</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> The just-released report of the inquiry into <a href="https://pricegouginginquiry.actu.org.au/">price gouging and unfair pricing</a> conducted by Allan Fels for the Australian Council of Trades Unions does more than identify the likely offenders. It finds the biggest are supermarkets, banks, airlines and electricity companies. It’s not enough to know their tricks. Fels wants to give the Australian Competition and Consumer Commission more power to investigate and more power to prohibit mergers. But it helps to know how they try to trick us, and how technology has enabled them to get better at it. After reading the report, I’ve identified eight key maneuvers. <h2>1. Asymmetric price movements</h2> Otherwise known as <a href="https://www.jstor.org/stable/25593733">Rocket and Feather</a>, this is where businesses push up prices quickly when costs rise, but cut them slowly or late after costs fall. It seems to happen for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0140988323002074">petrol</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S105905601730240X">mortgage rates</a>, and the Fels inquiry was presented with evidence suggesting it happens in supermarkets. Brendan O’Keeffe from NSW Farmers told the inquiry wholesale lamb prices had been falling for six months before six Woolworths announced a cut in the prices of lamb it was selling as a “<a href="https://pricegouginginquiry.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web.pdf">Christmas gift</a>”. <h2>2. Punishment for loyal customers</h2> A <a href="https://theconversation.com/simple-fixes-could-help-save-australian-consumers-from-up-to-3-6-billion-in-loyalty-taxes-119978">loyalty tax</a> is what happens when a business imposes higher charges on customers who have been with it for a long time, on the assumption that they won’t move. The Australian Securities and Investments Commission has alleged a big <a href="https://theconversation.com/how-qantas-might-have-done-all-australians-a-favour-by-making-refunds-so-hard-to-get-213346">insurer</a> does it, setting premiums not only on the basis of risk, but also on the basis of what a computer model tells them about the likelihood of each customer tolerating a price hike. The insurer disputes the claim. It’s often done by offering discounts or new products to new customers and leaving existing customers on old or discontinued products. It happens a lot in the <a href="https://www.finder.com.au/utilities-loyalty-costing-australians-billions-2024">electricity industry</a>. The plans look good at first, and then less good as providers bank on customers not making the effort to shop around. Loyalty taxes appear to be less common among mobile phone providers. Australian laws make it easy to switch <a href="https://www.reviews.org/au/mobile/how-to-switch-mobile-carriers-and-keep-your-number/">and keep your number</a>. <h2>3. Loyalty schemes that provide little value</h2> Fels says loyalty schemes can be a “low-cost means of retaining and exploiting consumers by providing them with low-value rewards of dubious benefit”. Their purpose is to lock in (or at least bias) customers to choices already made. Examples include airline frequent flyer points, cafe cards that give you your tenth coffee free, and supermarket points programs. The purpose is to lock in (or at least bias) consumers to products already chosen. The <a href="https://www.accc.gov.au/consumers/advertising-and-promotions/customer-loyalty-schemes">Australian Competition and Consumer Commission</a> has found many require users to spend a lot of money or time to earn enough points for a reward. Others allow points to expire or rules to change without notice or offer rewards that are not worth the effort to redeem. They also enable businesses to collect data on spending habits, preferences, locations, and personal information that can be used to construct customer profiles that allow them to target advertising and offers and high prices to some customers and not others. <h2>4. Drip pricing that hides true costs</h2> The Competition and Consumer Commission describes <a href="https://pricegouginginquiry.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web.pdf">drip pricing</a> as “when a price is advertised at the beginning of an online purchase, but then extra fees and charges (such as booking and service fees) are gradually added during the purchase process”. The extras can add up quickly and make final bills much higher than expected. Airlines are among the best-known users of the strategy. They often offer initially attractive base fares, but then add charges for baggage, seat selection, in-flight meals and other extras. <h2>5. Confusion pricing</h2> Related to drip pricing is <a href="https://www.x-mol.net/paper/article/1402386414932836352">confusion pricing</a> where a provider offers a range of plans, discounts and fees so complex they are overwhelming. Financial products like insurance have convoluted fee structures, as do electricity providers. Supermarkets do it by bombarding shoppers with “specials” and “sales”. When prices change frequently and without notice, it adds to the confusion. <h2>6. Algorithmic pricing</h2> <a href="https://pricegouginginquiry.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web.pdf">Algorithmic pricing</a> is the practice of using algorithms to set prices automatically taking into account competitor responses, which is something akin to computers talking to each other. When computers get together in this way they can <a href="https://www.x-mol.net/paper/article/1402386414932836352">act as it they are colluding</a> even if the humans involved in running the businesses never talk to each other. It can act even more this way when multiple competitors use the same third-party pricing algorithm, effectively allowing a single company to influence prices. <h2>7. Price discrimination</h2> Price discrimination involves charging different customers different prices for the same product, setting each price in accordance with how much each customer is prepared to pay. Banks do it when they offer better rates to customers likely to leave them, electricity companies do it when they offer better prices for business customers than households, and medical specialists do it when they offer vastly different prices for the same service to consumers with different incomes. It is made easier by digital technology and data collection. While it can make prices lower for some customers, it can make prices much more expensive to customers in a hurry or in urgent need of something. <h2>8. Excuse-flation</h2> <a href="https://www.bloomberg.com/news/articles/2023-03-09/how-excuseflation-is-keeping-prices-and-corporate-profits-high">Excuse-flation</a> is where general inflation provides “cover” for businesses to raise prices without justification, blaming nothing other than general inflation. It means that in times of general high inflation businesses can increase their prices even if their costs haven’t increased by as much. On Thursday Reserve Bank Governor <a href="https://www.afr.com/policy/economy/inflation-is-cover-for-pricing-gouging-rba-boss-says-20240215-p5f58d">Michele Bullock</a> seemed to confirm that she though some firms were doing this saying that when inflation had been brought back to the Bank’s target, it would be "much more difficult, I think, for firms to use high inflation as cover for this sort of putting up their prices." <h2>A political solution is needed</h2> Ultimately, our own vigilance won’t be enough. We will need political help. The government’s recently announced <a href="https://treasury.gov.au/review/competition-review-2023">competition review</a> might be a step in this direction. The legislative changes should police business practices and prioritise fairness. Only then can we create a marketplace where ethics and competition align, ensuring both business prosperity and consumer wellbeing. This isn’t just about economics, it’s about building a fairer, more sustainable Australia.<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/223310/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/david-tuffley-13731">David Tuffley</a>, Senior Lecturer in Applied Ethics & CyberSecurity, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Getty Images 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-prices-are-so-high-8-ways-retail-pricing-algorithms-gouge-consumers-223310">original article</a>.

Money & Banking

Retailer pulls "creepy" and "disturbing" ad for school uniforms

H&M has removed a school uniform ad in Australia after social media users slammed the retailer for sexualising children. The ad, which a few social media users have screenshot before it was removed, features two young girls in school uniform looking back at the camera with the caption: "Make those heads turn in H&M's Back to School fashion." Users on X, formerly known as Twitter, slammed the ad calling it it "creepy" and "disturbing", and sharing their own stories about "being ogled" at school. "What is your intention with this sponsored Facebook ad?" Australian writer Melinda Tankard Reist, whose work addresses sexualization and the harms of pornography, shared on X. "Little schoolgirls generally don't want to 'turn heads.' The large numbers I engage with in schools want to be left alone to learn and have fun and not draw unwanted attention to their appearance." "The little girls parents generally prefer heads don't 'turn' when others see their daughters walking to school, on a bus or in class," she continued. "Why would you want to fuel the idea that little girls should draw attention to their looks, bodies and 'style'?" <blockquote class="twitter-tweet"> <a href="https://twitter.com/hm?ref_src=twsrc%5Etfw">@hm</a> <a href="https://twitter.com/hmaustralia?ref_src=twsrc%5Etfw">@hmaustralia</a> what is your intention with this sponsored Facebook ad? Little schoolgirls generally don’t want to “turn heads”. The large numbers I engage with in schools want to be left alone to learn and have fun and not draw unwanted attention to their appearance 1/ <a href="https://t.co/DDwv42GeNz">pic.twitter.com/DDwv42GeNz</a> — Melinda TankardReist (@MelTankardReist) <a href="https://twitter.com/MelTankardReist/status/1747866459836158415?ref_src=twsrc%5Etfw">January 18, 2024</a></blockquote> Another user wrote: "This is really disturbing. "I remember being cat called whilst waiting for the bus in my school uniform. It made me feel unsafe." "Girls go to school to get an education, not to be jeered at by onlookers," they concluded. The Swedish fashion giant has since removed the ad and apologised for the campaign. "We have removed this ad," they told CNN. "We are deeply sorry for the offence this has caused and we are looking into how we present campaigns going forward." Images: Getty

Legal

Senior wins $38,000 a year for life because of retailer's mistake

A man in the US is set for life after a retailer's blunder led him to win the lotto. Michael Sopejstal, 60, who lives in Illinois, won the Lucky for Life lotto after a retailer at a GoLo gas station accidentally printed a ticket with 10 lines for a single draw. Buying the Lucky for Life ticket has been part of Sopejstal's routine, as he travels from Illinois to Michigan every few weeks to eat at his favourite restaurant, and this time he got lucky. “I checked my ticket one morning and saw that I had won $US25,000 ($A38,000) a year for life,” he told Michigan Lottery officials. “I immediately started thinking about all the things I could do with the money and whether I wanted to take the lump sum or annuity option. “It was an amazing feeling!” Sopejstal chances of winning were one in more than 1.8 million. According to the lottery, Sopejstal recently visited their headquarters to claim his prize. They said he opted for a lump sum payment of $US390,000 ($A590,000) instead of the annual payment. Sopejstal also told them that he plans to use his prize money to travel and save whatever is left. Images: Getty

Money & Banking

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months). There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles. We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>. But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again. <h2>People are often given the wrong advice</h2> People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis. But these findings are very common in people without low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain. Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain. In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress. It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves. <h2>So how should low back pain be treated?</h2> A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety. Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice. <a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language. They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities. An example of this type of care is cognitive functional therapy. <h2>What is cognitive functional therapy?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out. The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it. It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>. Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required. <h2>What’s the evidence for this type of therapy?</h2> Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments. We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”. We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care. The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>. People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group. The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work. <h2>What does this mean for you?</h2> This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success. <a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up. The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <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/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.

Body

Kmart and Target join forces to create mega discount stores

Two of Australia’s favourite retail giants are about to get better in a huge merger creating a $10 billion discount giant. Wesfarmers is set to fold Target into Kmart with hopes that it will improve sales, provide better value for customers, and allow both stores to share backend technology. Ian Bailey the Managing Director of Kmart Group has said that there will be “no impact” to stores, and that the move was an "internal reorganisation". "With customers now demanding value more than ever, this new operating model will unlock a new level of scale and productivity across both brands, so we can deliver even greater value to our customers in the future," he said in a statement. "For store networks and 50,000 store team members – it's business as usual – as we continue to focus on providing the best value products to the thousands of customers in Australia and New Zealand who choose to shop at Kmart or Target every day." The move comes as the cost of living crisis is forcing more and more Aussies to be mindful of their spending habits. In a statement to the The Australian Financial Review, Bailey said that there would likely be “a handful of redundancies" but more jobs overall by next year. He added that one of the benefits of tighter integration and better technology is the ease in which the prices of products can be reduced. He said that the price drop on 1000 Kmart products this month was assisted by merchandise planning tools and a self-navigating inventory scanning robot. "Kmart and Target are both strong businesses. I don't see us doing this from a position of weakness. It's quite the opposite,” he told the publication. “I'd say we're strong, but I think there's an opportunity to really capitalise on this time and find ways to continue to deliver better value for customers." "What we found was that running two businesses it was very, very difficult to get the tech into Target, and to get those benefits. This is really why we decided to push the two businesses into one." Images: Getty

Money & Banking

Fun ways to boost memory in seniors

Memory issues can seriously deteriorate the quality of life for seniors. To reverse the typically progressive process of memory loss, many solutions have been put forward. These include creative leisure activities aimed to work on the senior’s brain while providing relaxation. To work on a senior’s memory, it’s optimal to have them work on a project, focusing and seeing the work being done. There are plenty of games and activities available to help memory. Paint by Numbers Paint by Numbers is a creative art form that involves painting a pre-drawn sketch on a linen canvas with reference numbers. It helps stimulate the intellect and senses. They’re available in colour books as well, you can find them at your local Kmart and select supermarkets. Diamond painting Diamond painting is a manual activity where the senior creates beautiful pictures using rhinestones to stick onto a self-adhesive canvas. It calls for concentration, reflection, memorisation, and patience from the practitioner, which is beneficial for working on memory. Scratch painting Scratch painting is a fun activity that involves scratching a picture with a coin or stylus, like a lottery scratch-off. It requires interest and concentration from the individual, who will enjoy the final picture and benefit their memory. Music therapy Music therapy is used to treat and alleviate disorders, such as relational, behavioural, and communication difficulties. It also has benefits for seniors with memory problems, as it allows them to mobilise concentration, emotions, and memory in a playful way. Image credit: Shutterstock

Mind

Aussie patient given new drug worth $5 million per dose

A potential cure for a rare genetic disease is being trialled, and it comes with a hefty price tag. Sydney’s Royal Prince Alfred Hospital is part of a groundbreaking new trial aimed at potentially curing haemophilia B – a hereditary bleeding disorder. Patients with haemophilia B have a mutation on the F9 gene, which causes excessive bleeding and damage to joins as they lack the protein that helps blood to clot. A mere 40 patients worldwide will be infused with the gene therapy, with each dose the equivalent of $5 million, or over $1,000 a drop. A safe virus carrying the F9 gene is infused into the body, sending it to the liver cells, where doctors hope the protein is made for the rest of the patient’s life. Professor John Rasko, Head of Cell and Molecular Therapies at RPA, said the process is a “thrilling moment in the history of gene therapy” "We are pushing the boundaries of medical technology hoping to bring cures to individuals," he said. "It's a massive international effort that takes time and money and ultimately the manufacturing alone costs millions and millions of dollars." Haemophilia B patients currently require three injections a week. This revolutionary treatment could mean just one infusion in a lifetime. The infusion on May 22 was the culmination of more than two decades of work. Image credit: Shutterstock

Caring

Ed Sheeran shoots for the stars with daughter’s name reveal

When Ed Sheeran and his wife Cherry Seaborn announced the birth of their second child in May 2022, they kept things simple. In a post to social media, Sheeran shared a picture of socks on a crochet blanket, with a caption reading “Want to let you all know we’ve had another beautiful baby girl. We are both so in love with her, and over the moon to be a family of 4”. The couple shared no ‘face reveal’ - opting to keep their children far removed from the public eye - and did not share their youngest daughter’s name with Sheeran’s 42.8m followers. But in a March interview with Rolling Stone, the 32-year-old singer-songwriter took everyone by surprise, opening up about his family life, and revealing the out-of-this-world moniker bestowed upon their youngest, Jupiter. “Me and Cherry were talking earlier about how it’s so lovely,” he told the publication, opening up about the little things in life that he and his family cherish the most. “We had an entire day. We did nothing but this. It’s so nice and wholesome having family on tour. “On the last tour, I’d party till 7 am, sleep till 4 pm, get up, and do the gig. But I was like, 26. It’s very different.” Jupiter’s birth, and establishing their new “lovely” life, were no easy feats for the couple. In February 2022 - a month that was already proving determined to knock Sheeran down - when Cherry was six months along in her pregnancy, she was diagnosed with a tumour. Surgery was required, but couldn’t be performed until she had given birth. As Sheeran wrote in a post outlining plans for his album Subtract, “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. My best friend Jamal, a brother to me, died suddenly, and I found myself standing in court defending my integrity and career as a songwriter. “I was spiralling through fear, depression and anxiety. I felt like I was drowning, head below the surface, looking up but not being able to break through for air.” “There’s nothing you can do about it,” he confessed to Rolling Stone. “You feel so powerless.” Over the course of his interview, Sheeran toyed with a chain bracelet - one gifted to him by his wife, with their daughters’ name engraved. “It felt symbolic,” he said of the swap to the silver from the rubber bands that had previously adorned his wrist, “to take off those bracelets and put on one for my family.” After the slew of tragedies to hit Sheeran in such a short span of time, it was Cherry who realised that he was in need of professional help, leading to the singer seeking out a therapist. “No one really talks about their feelings where I come from,” he said. “People think it’s weird getting a therapist in England … I think it’s very helpful to be able to speak with someone and just vent and not feel guilty about venting. Obviously, like, I’ve lived a very privileged life. So my friends would always look at me like, ‘Oh, it’s not that bad.’ ” “The help isn’t a button that is pressed, where you’re automatically okay,” he added. “It is something that will always be there and just has to be managed.” And as Sheeran himself <a href="https://www.oversixty.com.au/health/caring/writing-songs-is-my-therapy-ed-sheeran-reveals-further-heartbreak">wrote in his Subtract post</a>, “Writing songs is my therapy. It helps me make sense of my feelings … in just over a week I replaced a decade’s worth of work with my deepest darkest thoughts.” Images: Getty

Family & Pets

"Writing songs is my therapy": Ed Sheeran reveals further heartbreak

In the wake of the tragic news of the <a href="https://www.oversixty.com.au/news/news/tragedy-strikes-ed-sheeran-tour" target="_blank" rel="noopener">heartbreaking loss</a> suffered by his co-writer and touring partner, Ed Sheeran has taken to Instagram to share his struggle following a series of life-changing events – and how this has altered the course of his new album, Subtract. The singer shared how he “spiralled” into depression last year after his wife, Cherry, was diagnosed with a tumour during her second pregnancy, which couldn’t be treated until after she gave birth. The star explained that he was "trying to sculpt the perfect acoustic album" for almost a decade, when the series of events changed everything. “Writing songs is my therapy. It helps me make sense of my feelings. I wrote without thought of what the songs would be, I just wrote whatever tumbled out. “And in just over a week, I replaced a decade’s worth of work with my deepest darkest thoughts," he captioned. “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. “My best friend Jamal [Edwards], a brother to me, died suddenly and I found myself standing in court defending my integrity and career as a songwriter. I was spiralling through fear, depression and anxiety. “I felt like I was drowning, head below the surface, looking up but not being able to break through for air". <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/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ed Sheeran (@teddysphotos)</a> </div> </blockquote> The four-time Grammy award winner shared that this album was a "trapdoor" into his soul, and a way for him to make sense of everything he's been through. Sheeran announced the birth of his second daughter, Jupiter, in May of last year. Subtract will be released on the 5th of May 2023, through Asylum/Atlantic. Image: Getty

Caring

Hugh Jackman reveals why he is now in therapy

Hugh Jackman has revealed he is undergoing therapy to help him come to terms with the trauma he experienced as a child. The Aussie actor opened up about his healing process in a new interview with Who magazine, telling the publication he recently began treatment. "I just started it recently. It's helped me a lot," he said. "We all need a village." "You need a friend you can unload everything – having someone really smart, who's a little a bit removed from your world can be really helpful." In his sessions, Jackman discussed his longstanding pain from being abandoned by his mother, Grace, and sisters Zoe and Sonya, who left Australia for the UK when he was just eight. Jackman remained in Sydney with his father, Christopher, and brothers Ian and Ralph. It wasn't until he was about 12 years old that he realised she was not coming home. However, therapy has allowed Jackman to accept the past and make peace with loved ones. "Understanding my past and how it's informing my thinking unconsciously – getting to really understand some of the patterns that I was unconsciously just repeating," he said. However, Jackman has been fortunate enough to reconnect with his mother over the years, previously telling The Sun: "As I grew older I gained an understanding of why Mum did leave … and we have definitely made our peace, which is important. I was always quite connected with my mum. I have a good relationship with her." Sadly, Jackman's father passed away in September last year, on Father's Day in Australia. Images: Instagram

Mind

"An arts engagement that’s changed their life": the magic of arts and health

In 2007, a life-changing encounter at South Australia’s Flinders Medical Centre became the catalyst and symbol for a national arts and health movement. A young woman, Becky Corlett, was being transported through the hospital where an artist-in-residence, Rebecca Cambrell, was painting a mural. Becky had suffered a stroke and cardiac failure. She had stopped eating and was non-responsive even to family. When Becky passed the mural, however, she made a noise of interest. Cambrell instinctively drew Becky closer and gave her a paint brush. To everyone’s surprise, Becky started adding dabs of paint to the canvas, and then she smiled. The wonder of this moment only dawned on Cambrell when she turned around. “Her parents were convinced that the moment she touched that paintbrush, something was triggered inside Becky that made her want to live”, remembers Cambrell. Becky’s story is just one of many collected in our new report <a href="https://apo.org.au/node/321047">Telling the Story of Arts in Health in South Australia</a>. <h2>What is ‘arts and health’?</h2> Arts and health is broadly defined as using arts practice to deliver health outcomes, be they specifically targeted interventions or general wellbeing benefits. Arts and health work comes in many forms. It can be <a href="https://statetheatrecompany.com.au/shows/euphoria/">play</a> about mental health issues in rural areas. It can be a <a href="https://www.visualisingmentalhealth.com/">university competition</a> to design solutions to community wellbeing challenges. It can be the <a href="https://celsus.net.au/a-hospital-within-a-park/">integration</a> of art throughout an entire hospital to create a calming environment. In an interview with us, design researcher Jane Andrew said the breadth of arts and health work means participant involvement can range “from passively viewing to making to being in the environment”. The benefits are diverse. A <a href="https://www.who.int/europe/publications/i/item/9789289054553">2019 World Health Organisation study</a> looking at over 900 peer-reviewed publications found arts and health can do everything from encouraging health-promoting behaviours to supporting end-of-life care. The diversity of the arts and health field is represented by the perspectives of our report’s 47 interviewees. We spoke to arts therapists, managers of hospital-based arts and health programs, government arts agency staff, CEOs of local health networks and former ministers. We asked them about their past experiences with arts and health, the present challenges and opportunities for the field, and how best to advance this work in the future. <h2>Art and health in Australia</h2> Although benefits of the arts to health have been recognised <a href="https://academic.oup.com/book/9415/chapter/156246455">for millennia</a>, the formal field of arts and health work <a href="https://www.tandfonline.com/doi/abs/10.1080/17533010903421484">first emerged</a> across South Australia and the rest of the nation through the community arts movement of the 1970s and the rise of health promotion in the 1980s. The establishment of the Flinders Medical Centre’s Arts in Health program in the late 1990s provided a major step for the field into health settings, and the program remains an <a href="https://anmj.org.au/the-art-of-healing-inside-flinders-medical-centres-pioneering-arts-in-health-program/">innovative leader today</a>. The former director of the program, Sally Francis, recalled how, “on a regular basis” the program would have “three, four, five stories of someone who has been critically ill and had an arts engagement that’s changed their life.” But Becky Corlett’s story had, as Francis describes it, a “huge and far-reaching effect” on arts and health in Australia. Days after Becky’s first painting experience, former South Australian Minister of Health and Assistant Arts Minister, John Hill, visited the hospital "I was just walking along, and I saw the painting going on and there was this little girl busily doing art. […] Her parents came up to me and had tears in their eyes. […] She was reconnected with life." Inspired by this encounter, Hill and Francis led a push to have arts and health formally recognised by the state and then federal government. The <a href="https://www.arts.qld.gov.au/images/documents/artsqld/Research/National-Arts-and-Health-Framework-May-2014.pdf">National Arts and Health Framework</a> was officially endorsed in 2014. This historic statement declared the Australian federal, state and territory governments’ recognition of and support for the field. The framework aimed to raise awareness of arts and health, and to encourage government departments and agencies across the country to integrate arts and health work into their services. However, it did not make any funding or legislative requests, meaning no permanent arts and health policy followed its endorsement. <h2>What next for arts and health?</h2> Next year marks ten years since the framework’s endorsement. While there is continuing good work in this space across the country, our interviewees believe arts and health remains underutilised. Community artist Lisa Philip-Harbutt told us there is a lack of “connection between all the various things that people are doing” – different arts and health projects often aren’t speaking to each other. To regain momentum for the field, interviewees recommend developing educational pathways for prospective arts and health workers, conducting a review and update of the National Arts and Health Framework to embed it in policy, and establishing research partnerships between universities and arts and health programs. The hope is that the next generation of leaders will be inspired by witnessing arts and health’s life-changing power. According to Deborah Mills, a key driver of the National Arts and Health Framework, "If you want passionate advocates, they have to have a visceral understanding of what creative activity does." Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/an-arts-engagement-thats-changed-their-life-the-magic-of-arts-and-health-196212" target="_blank" rel="noopener">The Conversation</a>.

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"An arts engagement that’s changed their life": the magic of arts and health

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