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"Absolute breakthrough": New hope in search for Motor Neurone Disease cure

Melbourne researchers are one step closer to finding a cure for Motor Neurone Disease, with the help technology and stem cell research. Scientists at The Florey Institute of Neuroscience and Mental Health have developed a world-first technology that will speed up the drug testing process to help find an effective treatment and maybe even a cure for the disease. New machines at the institute can now help determine whether drugs on the market could be used to treat MND in just weeks, a process which previously took decades. "This is an absolute breakthrough, it's at the cutting edge of technology," Florey MND researcher Professor Brad Turner said. Animal cells were previously used to test the efficacy of MND drugs, but now thanks to more than 100 MND patients who donated their skin cells to the institute, researchers have a library of stem cells to work with. The human stem cells can provide scientists with the full scope of the disease, something that they were previously unable to do with just animal cells. "This is really a game-changer in that we can use their own cells, and we can test drugs directly on their own cells," Florey MND researcher and neurologist Dr Thanuja Dharmadasa said. Large scale screening will commence thanks to a $5 million grant from the Australian Medical Research Future Fund. The research is expected to help people like Phil Camden who has been living with the disease for 10 years. "That's the key to all of us living with MND... we want to do what we can while we can," Camden said. "We know we're not doing it to find a cure for us. We're doing it for those in the future, my grandkids and their children." Scientists believe that medication or a cocktail of drugs tailored specifically to a patient is the way forward when it comes to treating the disease. "Therefore your drug treatments are tailed back to the clinical makeup in the dish and we call that personalised medical treatment," Turner said. Image: Nine News

Caring

How long does back pain last? And how can learning about pain increase the chance of recovery?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>. Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>. If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups: <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain. Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access. <h2>More pain doesn’t mean a more serious injury</h2> Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease. There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine. Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system. The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement. The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain. <h2>Reduce your chance of lasting pain</h2> Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain: <ul> <li> understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want. These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover. But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure. When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>. Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community. But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<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/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</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-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>. </div>

Body

Millions warned as dangerous disease spreads in Melbourne

Health authorities have issued an urgent warning to Victorians after multiple people have been admitted to hospital with severe symptoms. Victoria's Department of Health has revealed it is investigating an outbreak of Legionnaires disease after a "significant increase" in cases across Melbourne since Friday. Over just three days, 22 cases of the disease have been confirmed with another six cases suspected. Most of the cases are in adults aged over 40, with many of them requiring hospitalisation and intensive care for severe pneumonia. Health authorities are now searching for the source of the outbreak, as the health department said in a statement, "Legionnaires' disease can cause a chest infection with symptoms of fever, chills, cough, headache and muscle aches and pains. Other atypical symptoms may include nausea, vomiting, diarrhoea and confusion." "All cases have visited or reside in metropolitan Melbourne. Those most at risk are adults aged over 40 years, especially people with other medical conditions or immune compromise, or who smoke." The source of the outbreak is not yet known but investigations are underway to determine where it has come from. Legionnaires' disease is spread by breathing in fine droplets of water that contain legionella bacteria, and is not commonly spread from person-to-person or by drinking contaminated water. The <a href="https://www.health.vic.gov.au/health-alerts/outbreak-of-legionnaires-disease-in-metropolitan-melbourne" target="_blank" rel="noopener">Department of Health</a> is urging anyone who lives in, works in or has visited metropolitan Melbourne and surrounding areas to seek urgent medical care if they develop symptoms. Image credits: Shutterstock

Caring

Mysterious leg pain that’s quietly killing older Australians

Peripheral Artery Disease (PAD) has long been overshadowed by its more widely recognised counterparts, such as heart attacks and strokes. Often referred to as the “poor cousin” or “Cinderella” of cardiovascular diseases, PAD affects one in five older Australians, yet it remains largely under-diagnosed and misunderstood. However, a wave of optimism is sweeping through the medical community with the launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a>, an Australian-first facility dedicated to pioneering research and improving patient outcomes. Spearheaded by the Heart Research Institute, the Centre for Peripheral Artery Disease, marks a significant step forward in addressing the challenges posed by PAD. The centre aims to fill critical gaps in our understanding of the disease, which is responsible for a limb amputation in Australia every two hours. This initiative promises to enhance diagnosis, transform patient care, and raise awareness about PAD. Associate Professor Mary Kavurma, the Centre Lead, is at the forefront of this ground-breaking effort. “We’re supercharging research into PAD because there are still many unknowns about the disease’s biology that could unlock new methods for early detection and better management,” she explains. This research is particularly urgent given the prevalence of PAD among women and First Nations Australians, groups that remain disproportionately affected by this condition. The centre’s mission is to develop a simple blood test for early diagnosis and explore novel therapies that could reduce the need for limb amputations and significantly improve patients’ quality of life. Unlike current treatments that primarily focus on symptom management, this new approach seeks to prevent the disease from progressing. One of the most inspiring aspects of the centre is its commitment to involving patients and their families in the research process. At the inaugural consumer meeting, nearly 20 patients and their carers shared their personal experiences with PAD. Take the story of Simon Josephson, a renowned advertising guru – who famously designed the Solo logo. PAD almost cost him his life after taking more than five years to diagnose. He woke up one morning with a sore leg, thinking he’d overdone it exercising but the 73-year-old – who was otherwise healthy and active – unknowingly had Peripheral Artery Disease, caused by a build-up of plaque in his arteries causing them to narrow and stiffen. It wasn’t until a trip to the hospital emergency department years later that doctors would discover his aorta had expanded to more than twice the usual size and was at risk of rupturing. He immediately underwent open heart surgery and has faced a lengthy recovery. The launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a> heralds a new era of hope and progress in the fight against PAD. Through world-leading research, community engagement, and a commitment to patient-centred care, the CPAD is poised to make a profound impact on the lives of many Australians. As Assoc Prof Kavurma aptly put it, “By understanding more about this debilitating condition, we are paving the way for better health outcomes and a brighter future for all those affected by PAD.” Images: CPAD

Caring

Is it really possible to have Alzheimer’s yet no symptoms?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a> Some people seem to be more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003087/#:%7E:text=Some%20individuals%20are%20able%20to,into%20a%20widely%20debated%20concept.">resilient</a> to developing Alzheimer’s diseases, despite having the biological hallmarks of the devastating disease. For obvious reasons, scientists are very interested in studying this special group of people. Alzheimer’s disease, the most common form of dementia, is thought to start because of a build-up of two proteins in the brain: amyloid and tau. Once these proteins accumulate, for yet-to-be-determined reasons, they become toxic to brain cells (neurons) and these cells start dying. As a result, people develop symptoms such as memory loss because the brain can’t function properly with all these dead neurons. This cascade of events has been known for many years and is how the disease progresses in most people with Alzheimer’s. Most people, except a special group who are more resilient. But why are they resilient? A recent study in the journal <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-024-01760-9">Acta Neuropathologica Communications</a> investigated whether our genes might influence how resilient we are against Alzheimer’s disease symptoms when there are high levels of amyloid in our brain. The scientists conducted a study on the brains of three groups of people. The first group comprised people who had died with Alzheimer’s disease. The second were healthy people who died of natural causes. And the third comprised people who had high levels of Alzheimer’s proteins in the brain but never developed symptoms of the disease during their lifetime – or at least never had a diagnosis of Alzheimer’s disease. The last group, they considered as being resilient to Alzheimer’s disease since they had the proteins in their brains but did not have the symptoms or a diagnosis of Alzheimer’s disease during their lifetime. The scientists found that genes related to the activity of the immune system seem to have been more active in the Alzheimer’s resilient group. This would make sense as it is well established that the immune system helps clear the excess proteins from the brain, so genes that help this process might make us more resilient to developing symptoms of the disease. <h2>How to become resilient – even if you don’t have the genes</h2> This is great if you have inherited these genes from your parents, but what does it mean for the rest of us who do not have those genes? Is there a way we can make ourselves more resilient to developing Alzheimer’s disease regardless of our genes? “Yes” is the short answer. There is now good scientific evidence that <a href="https://theconversation.com/can-alzheimers-really-be-reversed-as-a-new-documentary-claims-230705">lifestyle changes</a> and drugs allow us to reduce our risk of developing Alzheimer’s disease in the future. In particular, physical activity has been shown to reduce our risk of developing Alzheimer’s, probably because it has a well-known beneficial effect on our immune system and hence helps clear those rogue proteins accumulating in our brains. This means that being more physically active might have the same effect on our Alzheimer’s resilience as those lucky people who have the “right” genes. Interestingly, we do not know how physically active the resilient people in the study were and how this might have influenced their resilience to Alzheimer’s disease. As so often in science, it is not clear whether nature (genes) or nurture (lifestyle) contributed to their resilience. The other interesting aspect is that the resilient people in the study died of another cause than Alzheimer’s disease, but they might have developed Alzheimer’s disease eventually if they had lived longer.<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/230334/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, Professor of Applied Dementia Research, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</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/is-it-really-possible-to-have-alzheimers-yet-no-symptoms-230334">original article</a>. </div>

Mind

"Rest in love": All Blacks legend and Dancing with the Stars winner dies at 55

The sports and entertainment communities are mourning the loss of former All Blacks hooker and Dancing with the Stars winner Norm Hewitt, who has passed away at the age of 55. Hewitt, a beloved figure both on and off the rugby field, succumbed to a lengthy battle with motor neurone disease, as confirmed by his family in a heartfelt statement. "Although rugby dominated his early life, he established a thriving human relations consultancy after retirement, and his services were much in demand both nationally and internationally," his family shared. "He walked confidently in both Māori and Pākehā worlds and was a particular role model for troubled youth, citing his own background, and offering inspirational teachings that one’s present life need not be one’s future." Hewitt leaves behind his wife Arlene and their two children, Elizabeth and Alexander. Born and raised in Pōrangahau, southern Hawke’s Bay, Hewitt's rugby career was nothing short of illustrious. Over 13 seasons, he played 296 representative matches for Hawke’s Bay, Southland and Wellington, earning 23 caps for the All Blacks. Hewitt was also a pivotal member of the Hurricanes during the formative years of Super Rugby, missing only one match in the first five years. The rugby community has been profoundly affected by Hewitt's passing. Former teammate Ofisa Tonu’u posted a touching tribute on Facebook: "I’m just devastated finding out the news today. I will never forget how you always stuck up for me during the Black Tracker days when no one else would, you always look after all the players and we always followed you into battle. No more pain, brother, you can now rest in Love. Fa’afetai tele lava my uso for having my back as I did yours. I know the other boys will be welcoming you with open arms at the gates. Rest in Love, Normy." Beyond his rugby career, Hewitt transitioned into a public speaker and mentor, focusing heavily on violence prevention programmes and advocacy. He worked with the SPCA as an animal cruelty and anti-violence publicity officer, visiting schools to spread his message. In 2005, Hewitt showcased his versatility by winning the first season of Dancing with the Stars alongside professional dancer Carol-Ann Hickmore. Hewitt's life was not without its struggles. In 1999, he made a public apology for a drunken incident in Queenstown, marking a turning point as he renounced alcohol and dedicated himself to helping others facing similar challenges. The outpouring of tributes was immediate, with The All Blacks expressing their sorrow: “We are saddened by the loss of All Black #938 Norm Hewitt who passed away yesterday in Wellington. Hewitt played 9 Tests and 14 Games between 1993 and 1998. Our thoughts are with Norm’s family and loved ones at this time.” Podcaster Martin Devlin shared his personal experience: “RIP Norm Hewitt. Not a lot of people know how kind & generous this man was. A truly wonderful person. Reached out to me and helped me considerably a long time ago when things were very rough. Love & respect.” Richard Hills echoed the sentiments of many: “This is bloody sad. A sad way to lose a kiwi icon so young. He had a really rough childhood and upbringing and faced it and turned his life around to become not only a rugby legend but also helped others who’d been through similar issues.” Norm Hewitt’s legacy will endure through the lives he touched and the positive change he inspired. His story is a testament to the strength of the human spirit and the profound impact one individual can have on the world. Image: Radio New Zealand

Caring

1 in 5 deaths are caused by heart disease, but what else are Australians dying from?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/garry-jennings-5307">Garry Jennings</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Nobody dies in good health, at least in their final moments. But to think the causes of death are easy to count or that there is generally a single reason somebody passes is an oversimplification. In fact, in 2022, four out of five Australians had multiple conditions at the time of death listed on their death certificate, and almost one-quarter had five or more recorded. This is one of many key findings from a <a href="https://pp.aihw.gov.au/reports/life-expectancy-deaths/what-do-australians-die-from/contents/about">new report</a> from the Australian Institute of Health and Welfare (AIHW). The report distinguishes between three types of causes of death – underlying, direct, and contributory. An underlying cause is the condition that initiates the chain of events leading to death, such as having coronary heart disease. The direct cause of death is what the person died from (rather than with), like a heart attack. Contributory causes are things that significantly contributed to the chain of events leading to death but are not directly involved, like having high blood pressure. The report also tracks how these three types of causes can overlap in deaths involving multiple causes. In 2022 the top five conditions involved in deaths in Australia were coronary heart disease (20% of deaths), dementia (18%), hypertension, or high blood pressure (12%), cerebrovascular disease such as stroke (11.5%), and diabetes (11.4%). <hr /> <iframe id="MzQHA" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/MzQHA/" width="100%" height="400px" frameborder="0"></iframe> <hr /> When the underlying cause of death was examined, the list was similar (coronary heart disease 10%, dementia 9%, cerebrovascular disease 5%, followed by COVID and lung cancer, each 5%). This means coronary heart disease was not just lurking at the time of death but also the major underlying cause. The direct cause of death however was most often a lower respiratory condition (8%), cardiac or respiratory arrest (6.5%), sepsis (6%), pneumonitis, or lung inflammation (4%) or hypertension (4%). <h2>Why is this important?</h2> Without looking at all the contributing causes of death, the role of important factors such as coronary heart disease, sepsis, depression, high blood pressure and alcohol use can be underestimated. Even more importantly, the various causes draw attention to the areas where we should be focusing public health prevention. The report also helps us understand which groups to focus on for prevention and health care. For example, the number one cause of death in women was dementia, whereas in men it was coronary heart disease. <hr /> <iframe id="NosVz" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/NosVz/" width="100%" height="400px" frameborder="0"></iframe> <hr /> People aged under 55 tended to die from external events such as accidents and violence, whereas older people died against a background of chronic disease. <hr /> <iframe id="1l3OS" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/1l3OS/" width="100%" height="400px" frameborder="0"></iframe> <hr /> We cannot prevent death, but we can prevent many diseases and injuries. And this report highlights that many of these causes of death, both for younger Australians and older, are preventable. The top five conditions involved in death (coronary heart disease, dementia, hypertension, cerebrovascular disease and diabetes) all share common risk factors such as tobacco use, high cholesterol, poor nutrition, physical inactivity, or are risk factors themselves, like hypertension or diabetes. <hr /> <iframe id="7Eb8O" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/7Eb8O/" width="100%" height="400px" frameborder="0"></iframe> <hr /> Tobacco use, high blood pressure, being overweight or obese and poor diet were attributable to a combined 44% of all deaths in this report. This suggests a comprehensive approach to health promotion, disease prevention and management is needed. <hr /> <iframe id="2MmGg" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/2MmGg/" width="100%" height="400px" frameborder="0"></iframe> <hr /> This should include strategies and programs encouraging eating a healthy diet, participating in regular physical activity, limiting or eliminating alcohol consumption, quitting smoking, and seeing a doctor for regular health screenings, such as the Medicare-funded <a href="https://www.heartfoundation.org.au/your-heart/heart-health-checks">Heart Health Checks</a>. Programs directed at accident prevention, mental health and violence, especially gender-related violence, will address untimely deaths in the young.<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/231598/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/garry-jennings-5307">Garry Jennings</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of 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/1-in-5-deaths-are-caused-by-heart-disease-but-what-else-are-australians-dying-from-231598">original article</a>. </div>

Body

"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

An emotional final message from rugby legend Rob Burrow has been released in the days after his death. The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled There's Only One Burrow, only agreeing to appear in the program on the condition it only be used after his death. In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research. "I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video. "In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league." <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/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a> </div> </blockquote> His pre-recorded final words were shown to his friends and family on screen, reacting to his words. "I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said. "I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home." Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them." In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease. "I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled. When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." "I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them." Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this." "I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration." "My final message to you is whatever your personal battle to be brave and face it." "Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out." Image credits: BBC

Caring

Rugby League hero dies at just 41

Rugby League legend Rob Burrow has passed away at the age of 41 after a lengthy battle with motor neurone disease. The British footballer spent his career with the Leeds Rhinos and helped them win eight Super League titles, and while he never played in Australia, he won the World Club Challenge over NRL opponents three times. Just two years after his retirement in 2017, Burrows was diagnosed with MND. Despite his rapidly progressing condition, Burrows stayed in the public eye to raise money and awareness for MND, and soon became the face of the fight against the disease in the UK. He worked with former teammate Kevin Sinfield to raise millions for a new care centre for MND patients, as the pair competed in <a href="https://oversixty.com.au/health/caring/terminally-ill-rugby-player-carried-across-marathon-finish-line-by-his-best-mate" target="_blank" rel="noopener">marathons</a> today, with Sinfield often pushing Burrow the entire way. His former football club announced Burrow’s death on Sunday, just one day before the groundbreaking of the new Rob Burrow Centre for MND at Seacroft Hospital, which will go ahead at his request. “It is with deep sadness that we announce the death of our beloved son, husband, father, brother and friend,” the club said. “Rob has always been a true inspiration throughout his life whether that was on the rugby league field or during his battle with MND. He never allowed others to define what he could achieve and believed in his own ability to do more." “The outpouring of love and support that Rob and the whole Burrow family have received over the last four and a half years meant so much to Rob." “For those who knew Rob throughout his life, his determination and spirit in the face of MND over the last four and a half years came as no surprise. Rob never accepted that he couldn’t do something. He just found his way of doing it better than anyone else." “He will continue to inspire us all every day. In a world full of adversity. We must dare to dream.” Prince William, who awarded Burrow with a Commander of the British Empire (CBE) honour in January 2024, was among those to mourn his death on social media. “A legend of rugby league, Rob Burrow had a huge heart,” he wrote. “He taught us ‘in a world full of adversity, we must dare to dream’. Catherine and I send our love." Burrow is survived by wife Lindsey and their three children Macy, Maya and Jackson. Image credits: SplashNews.com/Matt West/BPI/Phil Noble-Reuters/POOL supplied by Splash News/Shutterstock Editorial

Caring

Major TV star's 7-year-old undergoes third open heart surgery

Jimmy Kimmel's seven-year-old son has undergone his third, and hopefully final open heart surgery after being born with congenital heart disease. In 2017, Jimmy <a href="https://www.youtube.com/watch?v=MmWWoMcGmo0" target="_blank" rel="noopener">revealed</a> that Billy was only three days old when had to undergo his first open heart surgery, after doctors found “a hole in the wall of the left and right side of his heart” that was preventing enough oxygen from reaching his blood. Billy was only seven months old when he had to undergo his second open heart surgery, and over the weekend he had to undergo his third major surgery at the Children's Hospital Los Angeles. A few days later, the TV host took to Instagram to share an update following his son's successful surgery. "We went into this experience with a lot of optimism and nearly as much fear and came out with a new valve inside a happy, healthy kid," Kimmel wrote, alongside a picture of his youngest son smiling in a hospital bed. He then thanked all the surgeons, doctors and other medical staff who "came through for us with immeasurable kindness and expertise." "Walking around this hospital, meeting parents at their most vulnerable, children in pain and the miracle workers who do everything in their considerable power to save them is a humbling experience," Kimmel continued. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7fE-p4S7YN/?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/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Kimmel (@jimmykimmel)</a> </div> </blockquote> He then highlighted the hospital's dedication to providing help to families "regardless of their ability to pay". Jimmy then extended his thanks to his family and friends and the "loving strangers who took time to pray for and send positive energy to our baby". He gave a special shout out to his wife Molly – for "being stronger than is reasonable for any Mum to be". The pair also share daughter Jane, nine. The late night TV host then praised his son for being "the toughest (and funniest) 7 year-old we know." "There are so many parents and children who aren't fortunate enough to go home after five days," he added and encouraged his followers to send their thoughts and prayers to these families. Image: Instagram/ X

Caring

Amanda Keller's emotional family update

Amanda Keller has shared an emotional family update while live on-air on the Jonesy and Amanda show on Monday. The radio star has shared an update on how her husband's battle with Parkinson's disease has affected them, as they try to plan their son's 21st birthday party. “It was a hard week for me leading up to it because I wanted to put a slide show together to play throughout the night,” she told her co-host Jonesy. “And normally that is Harley’s domain. He has been the guy who will make the kid’s birthday invitations. He’s very creative. He will work on the computer to do this funky stuff. Normally, he would have done all of that. And with the way things are with Harley at the moment, he’s got Parkinson’s disease and things are just hard.” Keller, who has been married to her husband since 1989, revealed that he had been <a href="https://www.oversixty.com.au/health/caring/amanda-keller-shares-heartbreaking-family-news" target="_blank" rel="noopener">privately battling</a> with the disease for seven years, on October 2023. She then went on to share how the disease has affected her husband's ability to perform tasks that he was once good at. “So that kind of skill set isn’t with him anymore. He doesn’t have dementia or any of that stuff, but that stuff’s hard for him to do now. "And so I was going through a whole lot of photos on my phone and seeing photos of when he was well, and it was a very emotional week leading up to the 21st.” She then went on to confess that the situation had made her feel “lonely” and that her heart broke for her husband, who she thought couldn't attend the birthday party. “Leaving the house to go to Jack’s party, I thought, you know, it’s not right that Harley can’t come. Yeah, I really felt lonely thinking it’s our son’s 21st, but how hard it is for Harley and how much he would have loved to have been there,” she continued. But her husband surprised her, and managed to attend the event despite his ill health. “So there we are, having a great time. The speeches are about to start and my friend Kate said to me, There’s Harley. And I looked over. And I know what it cost him to be there. "He and our friend Pam and our driver friend Cole had conspired to get Harley there for the speeches. And it was so moving.” Keller, who was tearing up at this moment, proudly added: “And a lot of people were shocked because they hadn’t seen Harley for a while. But I know what it cost him to get there. And he said to me, how could I not be here?” Image: Jonesy and Amanda show/ news.com.au

Caring

Longer appointments are just the start of tackling the gender pain gap. Here are 4 more things we can do

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Ahead of the federal budget, health minister Mark Butler <a href="https://www.abc.net.au/news/2024-05-10/endometriosis-australia-welcomes-govt-funding-for-endometriosis/103830392">last week announced</a> an investment of A$49.1 million to help women with endometriosis and complex gynaecological conditions such as chronic pelvic pain and polycystic ovary syndrome (PCOS). From July 1 2025 <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/historic-medicare-changes-for-women-battling-endometriosis">two new items</a> will be added to the Medicare Benefits Schedule providing extended consultation times and higher rebates for specialist gynaecological care. The Medicare changes <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">will subsidise</a> $168.60 for a minimum of 45 minutes during a longer initial gynaecologist consultation, compared to the standard rate of $95.60. For follow-up consultations, Medicare will cover $84.35 for a minimum of 45 minutes, compared to the standard rate of $48.05. Currently, there’s <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=104&qt=item&criteria=104">no specified time</a> for these initial or subsequent consultations. But while reductions to out-of-pocket medical expenses and extended specialist consultation times are welcome news, they’re only a first step in closing the gender pain gap. <h2>Chronic pain affects more women</h2> Globally, research has shown chronic pain (generally defined as pain that persists for <a href="https://www.healthdirect.gov.au/chronic-pain">more than three months</a>) disproportionately affects <a href="https://academic.oup.com/bja/article/111/1/52/331232?login=false">women</a>. Multiple biological and psychosocial processes likely contribute to this disparity, often called the gender pain gap. For example, chronic pain is frequently associated with conditions influenced by <a href="https://www.sciencedirect.com/science/article/abs/pii/S0304395914003868">hormones</a>, among other factors, such as endometriosis and <a href="https://theconversation.com/adenomyosis-causes-pain-heavy-periods-and-infertility-but-youve-probably-never-heard-of-it-104412">adenomyosis</a>. Chronic pelvic pain in women, regardless of the cause, can be debilitating and <a href="https://www.nature.com/articles/s41598-020-73389-2">negatively affect</a> every facet of life from social activities, to work and finances, to mental health and relationships. The gender pain gap is both rooted in and compounded by gender bias in medical research, treatment and social norms. The science that informs medicine – including the prevention, diagnosis, and treatment of disease – has traditionally focused on men, thereby <a href="https://www.theguardian.com/lifeandstyle/2015/apr/30/fda-clinical-trials-gender-gap-epa-nih-institute-of-medicine-cardiovascular-disease">failing to consider</a> the crucial impact of sex (biological) and gender (social) factors. When medical research adopts a “male as default” approach, this limits our understanding of pain conditions that predominantly affect women or how certain conditions affect men and women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921746/">differently</a>. It also means intersex, trans and gender-diverse people are <a href="https://www.deakin.edu.au/about-deakin/news-and-media-releases/articles/world-class-centre-tackles-sex-and-gender-inequities-in-health-and-medicine">commonly excluded</a> from medical research and health care. Minimisation or dismissal of pain along with the <a href="https://www.hindawi.com/journals/ecam/2016/3467067/">normalisation of menstrual pain</a> as just “part of being a woman” contribute to significant delays and misdiagnosis of women’s gynaecological and other health issues. Feeling dismissed, along with perceptions of stigma, can make women less likely <a href="https://link.springer.com/article/10.1186/s12905-024-03063-6">to seek help</a> in the future. <h2>Inadequate medical care</h2> Unfortunately, even when women with endometriosis do seek care, many <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.15494?saml_referrer">aren’t satisfied</a>. This is understandable when medical advice includes being told to become pregnant to treat their <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02794-2">endometriosis</a>, despite <a href="https://academic.oup.com/humupd/article/24/3/290/4859612?login=false">no evidence</a> pregnancy reduces symptoms. Pregnancy should be an autonomous choice, not a treatment option. It’s unsurprising people look for information from other, often <a href="https://www.mdpi.com/2227-9032/12/1/121">uncredentialed</a>, sources. While online platforms including patient-led groups have provided women with new avenues of support, these forums should complement, rather than replace, <a href="https://journals.sagepub.com/doi/full/10.1177/1460458215602939">information from a doctor</a>. Longer Medicare-subsidised appointments are an important acknowledgement of women and their individual health needs. At present, many women feel their consultations with a gynaecologist are <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">rushed</a>. These conversations, which often include coming to terms with a diagnosis and management plan, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/">take time</a>. <h2>A path toward less pain</h2> While extended consultation time and reduced out-of-pocket costs are a step in the right direction, they are only one part of a complex pain puzzle. If women are not listened to, their symptoms not recognised, and effective treatment options not adequately discussed and provided, longer gynaecological consultations may not help patients. So what else do we need to do? 1. Physician knowledge Doctors’ knowledge of women’s pain requires development through both practitioner <a href="https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00815-4/tables/2">education and guidelines</a>. This knowledge should also include dedicated efforts toward understanding the <a href="https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain">neuroscience of pain</a>. Diagnostic processes should be tailored to consider gender-specific symptoms and responses to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00137-8/fulltext">pain</a>. 2. Research and collaboration Medical decisions should be based on the best and most inclusive evidence. Understanding the complexities of pain in women is essential for managing their pain. Collaboration between health-care experts from different disciplines can facilitate comprehensive and holistic pain research and management strategies. 3. Further care and service improvements Women’s health requires multidisciplinary treatment and care which extends beyond their GP or specialist. For example, conditions like endometriosis often see people presenting to emergency departments in <a href="https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia/contents/treatment-management/ed-presentations">acute pain</a>, so practitioners in these settings need to have the right knowledge and be able to provide support. Meanwhile, pelvic ultrasounds, especially the kind that have the potential to visualise endometriosis, take longer to perform and require a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0015028223020757/">specialist sonographer</a>. Current rebates do not reflect the time and expertise needed for these imaging procedures. 4. Adjusting the parameters of ‘women’s pain’ Conditions like PCOS and endometriosis don’t just affect women – they also impact people who are gender-diverse. Improving how people in this group are treated is just as salient as addressing how we treat women. Similarly, the gynaecological health-care needs of culturally and linguistically diverse and Aboriginal and Torres Strait islander women may be even <a href="https://www.mdpi.com/1660-4601/20/13/6321">less likely to be met</a> than those of women in the general population. <h2>Challenging gender norms</h2> Research suggests one of the keys to reducing the gender pain gap is challenging deeply embedded <a href="https://pubmed.ncbi.nlm.nih.gov/29682130/">gendered norms</a> in clinical practice and research. We are hearing women’s suffering. Let’s make sure we are also listening and responding in ways that close the gender pain gap.<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/229802/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, Senior Lecturer, School of Business, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, PhD candidate, health communication and health sociology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, Affiliate Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, Associate Professor at NICM Health Research Institute, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney 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/longer-appointments-are-just-the-start-of-tackling-the-gender-pain-gap-here-are-4-more-things-we-can-do-229802">original article</a>. </div>

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Why this iconic view of Mt Fuji is set to be obstructed

One small town in Japan is fed up with disrespectful tourists, and is set to take drastic measures to block an iconic view of My Fuji to deter travellers. Fujikawaguchiko, at the foot of the Yoshida Trail to Mount Fuji, has long been overrun with tourists who are hellbent on getting the perfect picture of the Japanese mountain. Tourists specifically flock to the Lawson convenience store to take their pictures, with the contrast between the busy neon-lit shop and the peaceful mountain behind it making for the perfect holiday snap. However, in recent years since Japan reopened its borders to international tourists after harsh Covid lockdowns, these tourists have had the run of the town, and locals have had enough. To combat the over tourism of the area and deter travellers, local officials of the town are set to erect a giant mesh barrier atop the store, blocking the picture perfect view. One town official said that there have been ongoing problems with tourists leaving trash and not following traffic rules, despite signs and security guards being posted to warn them. "It is regrettable that we had to take such measures," the official said. The net, which measures 2.5 meters high and 20 meters long, will be erected early next week. The crowds plaguing the small town, which is in Yamanashi prefecture, to the north of Fuji and about 100 kilometres west of Tokyo, is just one part of a larger over tourism issue in the whole of Japan. "Overtourism – and all the subsequent consequences like rubbish, rising CO2 emissions and reckless hikers – is the biggest problem facing Mount Fuji," Masatake Izumi, a Yamanashi prefectural government official, <a href="https://www.cnn.com/travel/mount-fuji-overtourism-intl-hnk/index.html">told CNN Travel</a> in 2023. Some locals had even nicknamed the 3,776-meter (12,388-foot) mountain, called Fuji-san in Japanese, "trash mountain." Image credits: Getty Images

International Travel

Surgery won’t fix my chronic back pain, so what will?

<a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> This week’s ABC Four Corners episode <a href="https://www.abc.net.au/news/2024-04-08/pain-factory/103683180">Pain Factory</a> highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain. The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain. <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">One in five</a> Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">A$139 billion a year</a>, including $12 billion in direct health-care costs. The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work? <h2>Opioids and invasive procedures</h2> Treatments offered to people with chronic pain include strong pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/30561481/">opioids</a> and invasive procedures such as <a href="https://pubmed.ncbi.nlm.nih.gov/36878313/">spinal cord stimulators</a> or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120">spinal fusion surgery</a>. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm. <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8">Spinal fusion surgery</a> and <a href="https://privatehealthcareaustralia.org.au/consumers-urged-to-be-cautious-about-spinal-cord-stimulators-for-pain/#:%7E:text=Australian%20health%20insurance%20data%20shows,of%20the%20procedure%20is%20%2458%2C377.">spinal cord stimulators</a> are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual. <h2>Addressing the contributors to pain</h2> Recommendations from the latest <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard">Australian</a> and <a href="https://www.who.int/publications/i/item/9789240081789">World Health Organization</a> clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as: <ul> <li>education</li> <li>advice</li> <li>structured exercise programs</li> <li>physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.</li> </ul> Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain. The interventions have minimal side effects and are cost-effective. In the <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">RESOLVE</a> trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move. In the <a href="https://pubmed.ncbi.nlm.nih.gov/37146623/">RESTORE</a> trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it. <h2>Why isn’t everyone with chronic pain getting this care?</h2> While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session <a href="https://www.sira.nsw.gov.au/__data/assets/pdf_file/0005/1122674/Physiotherapy-chiropractic-and-osteopathy-fees-practice-requirements-effective-1-February-2023.pdf">can cost</a> $90–$150. In contrast, <a href="https://www.servicesaustralia.gov.au/chronic-disease-individual-allied-health-services-medicare-items">Medicare</a> provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions. Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs. Access to trained clinicians is another barrier. This problem is particularly evident in <a href="https://www.ruralhealth.org.au/15nrhc/sites/default/files/B2-1_Bennett.pdf">regional and rural Australia</a>, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited. Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/data-file-57-opioid-medicines-dispensing-2016-17-third-atlas-healthcare-variation-2018">rate of opioid use</a>, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas. <h2>So what can we do about it?</h2> We need to reform Australia’s health system, private and <a href="https://www.health.gov.au/sites/default/files/documents/2020/12/taskforce-final-report-pain-management-mbs-items-final-report-on-the-review-of-pain-management-mbs-items.docx">public</a>, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments. Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian <a href="https://pubmed.ncbi.nlm.nih.gov/38461844/">trial</a>, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain. Advocacy and <a href="https://pubmed.ncbi.nlm.nih.gov/37918470/">improving the public’s understanding</a> of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.<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/227450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <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> 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/surgery-wont-fix-my-chronic-back-pain-so-what-will-227450">original article</a>.

Body

Allan Border's desperate plea to PM

Allan Border has joined Parkinson’s Australia chief executive Olivia Nassaris in a plea for the Federal Government to provide more funding and research into the condition. The 68-year-old cricket legend is one of over 150,000 Australians living with Parkinson’s, after being diagnosed with the neurodegenerative disorder back in 2016. A new report from the organisation revealed that there are 19,500 new cases every year, with one Australian diagnosed with the condition every 27 minutes. “A lot of people know the disease but they don’t know the impact that it has — 150,000 people in Australia have the disease, it does present in different ways,” Border said. “When I was told I was suffering, my first image was of (boxer) Muhammad Ali and the Olympic torch, I just thought people suffered from a tremor. “But there’s about 100,000 different ways of it presenting.” Border joined the Parkinson’s Australia chief executive on April 11 to raise awareness for World Parkinson’s Day. Nassaris estimated that the number of Australians impacted by Parkinson’s would almost triple by 2050. “At the moment we don’t have a cause or cure, so it is frightening that a disease like this is going to almost triple in numbers,” she said. Responding to the cricketer’s plea, the Prime Minister described Border as a “great Australian” and hinted at a potential boost to government support in providing more resources into the condition. “Our heart goes out to him,” the PM said on Thursday. “I will have a word with the Health Minister about what more we can do. We have contributed over $100m to research into Parkinson’s. “There’s also a pilot program for nurses about people suffering from Parkinson’s at the moment. There’s some $6.5m being used for that pilot program. We want to wait and see what the assessment of that is.” Images: Getty

Caring

Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January. Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”. The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate. <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”. Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively. <h2>What is cancer?</h2> Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one. We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide. However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced. In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell. <h2>What exactly are mutations?</h2> Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix. <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions. These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>. Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required. <h2>How is cancer treated?</h2> Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy. Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically. <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence). Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally. Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients. Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history. <h2>What you should do</h2> Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to: <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<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/226456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin 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/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.

Caring

Victorian man rides lawn mower for 800km to speak to the PM

You know the saying: mow big or mow home. And one man risked it all in hopes of scoring a meeting with Prime Minister Anthony Albanese. In an incredible 11-day journey Warren "Woz" Acott made the 800km journey from Central Victoria to Canberra to try and speak with the Prime Minister about motor neurone disease (MND). He left his home in Toolleen in Central Victoria on March 11, with no guarantee that anyone was going to meet him at the end of his journey. But his efforts have been fruitful, because by the time he arrived in Canberra this morning, he had a booking with the PM. "I've shuffled my schedule around to fit him in. I'd better go see him," Woz joked when he was told he had a meeting with the PM Albanese met met Woz in the Prime Minister's courtyard, and a crowd of families affected by MND were also waiting outside parliament to welcome Woz. "I'm overwhelmed. But it's not about me. It's about MND and the families and the carers and everybody else," Woz told A Current Affair. Woz, who lives with MND, wants the condition to be added to the National Notifiable Disease Surveillance System (NNDSS). This is because NNDSS conditions "a threat to public health in Australia" and are given additional funding for research." "We'll give consideration to all these things. You're a champion, mate," Albanese said. "It's all over my head. I mean, I'm a truck driver at the end of the day. But I know that if (MND is added to the NNDSS), it's more trackable, more funding, and everything else," Woz said. Robyn Sneddon, who lost her husband Ian to MND, praised Woz for his effort. "The effort he has made has been incredible. He is just a champion," she told A Current Affair. "I'm very proud of him," Snedden added. Images: A Current Affair

Caring

Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial. UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom. Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year. They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area. Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments. <h2>Why are chronic UTIs so hard to treat?</h2> Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach. The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments. This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective. Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted. But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead. Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria. Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions. The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence. For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur. Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role. Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>. <h2>What treatments might we see in the future?</h2> Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu. Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus. Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves. Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response. Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<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/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond 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-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.

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"What a legend": Michael J Fox receives emotional standing ovation

Michael J Fox, who has Parkinson's disease, made a surprise appearance at the BAFTA Awards in London. The Back to the Future actor came onstage in a wheelchair, but he insisted on standing up at the podium to present the Best Film award. The star-studded audience all rose to their feet and gave the actor a standing ovation. When presenting the award, Fox described cinema as "magic" which can "change your life". "Five films were nominated in this category tonight and all five have something in common. They are the best of what we do," he said. He added that films can bring people together "no matter who you are or where you're from". "There's a reason why they say movies are magic because movies can change your day. "It can change your outlook. Sometimes it can change your life." Fox, who was diagnosed with Parkinson's in the 1990s, rarely makes public appearances. Many fans were pleasantly surprised at his appearance as he presented the night’s biggest award, Best Film, to Oppenheimer. "I was in tears the moment Michael J Fox came on the stage," one fan wrote on X, formerly known as Twitter. "THE MAN IS A LEGEND" <blockquote class="twitter-tweet"> i was in tears the moment Michael J Fox came on the stage 😥😥😥 THE MAN IS A LEGEND <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://twitter.com/hashtag/BAFTA2024?src=hash&ref_src=twsrc%5Etfw">#BAFTA2024</a> <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> <a href="https://t.co/Uud368S9gb">pic.twitter.com/Uud368S9gb</a> — RanaJi🏹 (@RanaTells) <a href="https://twitter.com/RanaTells/status/1759323180060299726?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "Michael J Fox. Absolute hero. What a legend," wrote another. <blockquote class="twitter-tweet"> Michael J Fox. Absolute hero. What a legend. <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://t.co/62lxpCy3mn">pic.twitter.com/62lxpCy3mn</a> — Jules 🌼 (@JulesItsjules) <a href="https://twitter.com/JulesItsjules/status/1759320058583568638?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend," added a third. <blockquote class="twitter-tweet"> All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend. <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> — Declan Cashin (@Tweet_Dec) <a href="https://twitter.com/Tweet_Dec/status/1759319831696855281?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "He's a total legend and wonderful human," wrote a fourth. The actor has spoken <a href="https://www.oversixty.com.au/health/caring/i-m-not-gonna-be-80-michael-j-fox-s-tragic-admission" target="_blank" rel="noopener">candidly</a> about his experience with Parkinson's over the years, and has said that he has made peace with the degenerative nature of the disease. In a previous interview with AARP magazine profile, the actor admitted that he did not fear death. “I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all," he told the publication. Images: Getty

"One step forward, two steps back": Joh Griggs reveals debilitating health battle

Johanna Griggs has revealed how she overcame a debilitating health struggle that threatened to derail her career as a teenager. The former swimming champion won her first medal at the Commonwealth Games in 1990 at 16 years of age, but just one year later, her world changed forever. In a new interview with Prevention magazine, the Better Homes & Gardens host admitted that being diagnosed with chronic fatigue syndrome at the young age of 17 was a blow, but one she ultimately felt “thankful” for. “You learn more about yourself during a tough period than you do during a great one,” she said. “One of the most important things that it taught me was to be able to be by myself and to be comfortable in my own skin.” With her swimming career on pause, Joh shared that the next few years were “one step forward, two steps back”. As a teenager, she learned the power of positive self-belief while learning what was best for her body as she worked her way back to physical and emotional strength. “It’s asking yourself, ‘Can you put your head on the pillow and know in your heart of hearts you’ve done everything within your power that day to get better?’,” she said of that time in her life. “But also, not beating yourself up on it, just working out what was working (and) what wasn’t working.” Over the next two and a half years, Johanna was on a highly restricted diet to combat her health issues, one that was “wheat-free, yeast-free, egg-free, malt-free, sugar-free, dairy-free, herb-free, spice-free, caffeine-free”. Eventually she was able to return to the pool, although she faced further setbacks, including a bout of pleurisy that landed her in hospital. By 1993, she was back at the top of her game, taking out the win for the 50m backstroke at the Australian Swimming Championships. Riding this high, Johanna decided her swimming career was over. “For me, it was a massive milestone to get to say I could be the best, but I also knew when I hit that (pool) wall, I did not want to keep living like that,” she said. “I told my mum I was retiring that night and remember her voice going up a couple of octaves higher than normal.” Image credits: Getty Images / Instagram

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