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Ambulance ramping is getting worse in Australia. Here’s why – and what we can do about it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jonathan-karnon-290">Jonathan Karnon</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/andrew-partington-93821">Andrew Partington</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> We’ve seen countless <a href="https://www.heraldsun.com.au/leader/ballarat/ambulance-ramping-leaves-paramedics-unable-to-respond-to-emergencies-says-union/news-story/54b6fee380eb7b7f1c9b2784edf3d2cd">media reports</a> in recent days, weeks and months about the <a href="https://www.couriermail.com.au/news/queensland/qld-politics/worst-cases-of-ambulance-ramping-at-queensland-hospitals-revealed/news-story/bcf4833b5197774329cf983029d77cb4">ramping of ambulances</a> at <a href="https://thewest.com.au/news/health/ambulance-ramping-reaches-record-levels-in-june-as-hospitals-struggle-with-surging-winter-demand-c-15192504">hospital emergency departments</a> (EDs) around Australia. Ambulance ramping occurs when paramedics are made to wait at the hospital’s entrance and are unable to transfer their patient into the emergency department within an appropriate time frame – defined as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/our+performance/ambulance+waiting+times">30 minutes</a> in South Australia. Ramping is an indicator of hospital stress. It means patients are waiting longer to receive care in the emergency department, and patients requiring inpatient care are waiting longer to access a hospital bed. Research suggests <a href="https://www.mja.com.au/journal/2022/217/5/influence-ambulance-offload-time-30-day-risks-death-and-re-presentation-patients">ambulance ramping</a> and <a href="https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.13699">having to wait longer</a> for a hospital bed are associated with a greater risk of patients dying up to 30 days after their initial presentation. So why is ambulance ramping still a problem? And what can we do to fix it? <h2>Ramping is getting worse</h2> Available data indicate the problem has become worse over time. In <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/our+performance/ambulance+waiting+times">South Australia</a>, for example, ramping has been steadily increasing since 2017, from around 500 hours “ramped” per month to around 4,000 hours per month in 2024. This is the sum of the time ambulances spend waiting beyond 30 minutes after arriving at the hospital. In <a href="https://www.bhi.nsw.gov.au/data-portal">New South Wales</a>, we calculate the numbers of patients being ramped increased from around 44,000 patients per month in early 2022 to more than 50,000 in early 2024. <h2>What’s driving the increase in ramping?</h2> The ambulance ramping bottleneck reflects an imbalance between the number of people presenting at emergency departments and the capacity to treat patients and transfer those requiring inpatient care to a ward. Potential drivers of this imbalance are increased emergency department presentations and reduced availability of inpatient beds. The latter may reflect increased demand for beds, including longer hospital stays. Between the financial years 2018–19 and 2022–23 (the latest period for which figures are available), Australian Institute of Health and Welfare data show the numbers of more serious presentations (triage categories 1 to 3) increased by <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/emergency-department-care">almost 700,000</a> across Australia. Some 100,000 fewer patients who presented to an emergency department were <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">admitted as inpatients</a> during this period, but the additional presentations will nonetheless have contributed to more ramping. In the same period, admissions to inpatient beds that did not come through an emergency department increased by <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">almost 400,000</a> across the country. These include admissions for the management of chronic conditions (such as diabetes, heart disease, asthma and so on) and infections and viruses (COVID, flu, RSV and others). Further, COVID and other viruses are likely to have contributed to increased hospital stress via <a href="https://www.aihw.gov.au/reports/workforce/health-workforce">workforce shortages</a>. This has possibly led to delays in seeing patients in the emergency department and in discharging patients from hospital. There has not been a significant increase in <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">patients’ time in hospital</a> receiving required care, but there appear to be increasing numbers of patients waiting for placement in an aged care facility or for home care services after their treatment <a href="https://www.ama.com.au/sites/default/files/2023-02/Hospital%20exit%20block%20-%20a%20symptom%20of%20a%20sick%20health%20system_Final.pdf">has finished</a>. <h2>Many admissions may be preventable</h2> Increased vaccination rates could reduce the impact of viruses. For example, only <a href="https://www.aihw.gov.au/reports/australias-health/immunisation-and-vaccination">21% of Australians</a> aged 65 to 74 received the 2023 COVID booster recommended for their age group. We know there were significant increases in people delaying or avoiding seeing a GP <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">due to cost</a> in 2022–23, which can put extra pressure on hospitals. The government is trying to address this issue by increasing <a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments">incentives to GPs</a> to reduce costs to patients. Meanwhile, government health departments may not have been provided with enough funding to meet increasing demand for health care. Year on year the gap between supply and demand grows. <a href="https://www.theguardian.com/australia-news/article/2024/jun/27/victoria-hospitals-recruitment-freeze-cost-cuts-premier-jacinta-allan">Victorian hospitals</a> are reportedly scrambling to reduce spending in light of proposed budget cuts. <h2>What are the solutions?</h2> The creation of new hospital beds is not the only option for increasing capacity. Governments should design, implement and scale up services that free up hospital capacity by providing appropriate and cost-effective out-of-hospital care. For example, there is further scope to care for patients admitted to hospital in their own homes with the support of digital technologies. Programs such as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/services/hospitals/my+home+hospital/my+home+hospital">My Home Hospital</a> in South Australia aim to provide an alternative to inpatient care. Across Australia, such “hospital in the home” care was provided 150,000 times in 2022–23, compared to <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">6.8 million episodes of care</a> in public hospitals. Virtual ED services are a growing phenomenon across Australia, using <a href="https://theconversation.com/what-is-a-virtual-emergency-department-and-when-should-you-visit-one-228098">virtual consultations</a> to identify patients for whom urgent care can be provided outside hospital. The Victorian virtual ED service is targeting a capacity of <a href="https://www.afr.com/policy/health-and-education/meet-the-two-doctors-revolutionising-emergency-healthcare-20240415-p5fjud">1,000 consults</a> per day. Longer-term solutions require co-operation between state and territory governments and the federal government to prevent and better manage chronic conditions, such as diabetes and heart disease, outside hospital. This includes boosting access to GPs and improving communication between GPs and hospitals. Greater investment in well-designed policies and programs to support healthy ageing would also likely help, as well as improving access to required out-of-hospital aged care and disability services for patients waiting to leave hospital. All these measures could ease the pressure on hospitals and reduce the likelihood of patients waiting in an ambulance, unable to get inside and receive the care they need.<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/232720/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jonathan-karnon-290">Jonathan Karnon</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/andrew-partington-93821">Andrew Partington</a>, Research Fellow (Health Economics), <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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/ambulance-ramping-is-getting-worse-in-australia-heres-why-and-what-we-can-do-about-it-232720">original article</a>. </div>

Caring

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> The <a href="https://www.ncbi.nlm.nih.gov/pubmed/30346539">menopause</a> happens around the age of 50, and for many women, the end of their fertile life is accompanied by uncomfortable symptoms, such as hot flashes, night sweats and anxiety. In the West, it is generally taken as read that these symptoms are a normal part of the menopause. But <a href="https://www.ncbi.nlm.nih.gov/pubmed/11330770">cross-cultural research</a> suggests that menopause symptoms are not necessarily inevitable. For example, <a href="https://www.ncbi.nlm.nih.gov/pubmed/18521049">Japanese women</a> rarely report hot flashes, whereas for European women they are a common complaint. As a result, scientists have begun to focus on what causes this difference in experience and the potential impact that behavioural and lifestyle factors, such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/16735636">smoking</a>, might have. Our latest <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ece3.5705">study</a> adds to this knowledge. We found that living away from your genetic family may worsen the menopause. <h2>Family matters?</h2> Where people live once they’re married varies across cultures. To investigate whether these different living arrangements affect menopause symptoms, we travelled to south-west China to collect data. In this region, there are groups with distinct living arrangements. First, the Han and the Yi, in which women typically leave their family after they’ve got married and live with their husband’s family. Second, the Mosuo and Zhaba, who engage in the practice of zou hun (“<a href="https://www.ncbi.nlm.nih.gov/pubmed/23486437">walking marriage</a>”), where the husband and wife live separately with their own related families, and only visit each other at night. We found that women who remained living with their own family following marriage had significantly less severe menopause symptoms than those who went to live with their husband’s family. <h2>In-law conflict</h2> Many anthropologists are interested in how different levels of relatedness within households can have behavioural and physiological implications. For the menopause, we think the difference in symptom severity between the groups may be the result of the different levels of conflict that result from being more or less related to other members of your household. If a woman lives with her husband’s family, then until she has children, she is unrelated to anyone in the household. This lack of relatedness can cause <a href="https://link.springer.com/article/10.1007/s40806-017-0114-8">tension</a> between the new wife and her husband’s relatives as they have little direct genetic interest in her. As well as conflict with non-related household members, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/evan.20226">earlier research</a> has shown that women who live with their husband’s family tend to argue with their partners more and are also more likely to get divorced. Additionally, rates of domestic violence are <a href="https://www.ncbi.nlm.nih.gov/pubmed/27279077">higher</a> when women live away from their genetic family. But how does this relate to the severity of menopause symptoms? We think that increased levels of household conflict would result in the woman being more stressed. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795524/">Stress</a> is known to worsen pain perception and so could aggravate menopause symptoms. In contrast to women who leave their kin group, women who live with their own family once they’re married also tend to have higher levels of <a href="https://scholar.harvard.edu/slowes/publications/matrilineal-spousal-cooperation">social support</a>. There are more people to help with childcare and more shoulders to cry on. This can help to lower stress and thus soften the mental and physical burden of the menopause. <h2>Global perspectives</h2> While our research was conducted in China, globally, we see a wide range of living arrangements, which themselves can bring different levels of conflict and social support. In the West, many women live away from their families, which may mean that they lack social support, perhaps contributing to more turbulent menopause symptoms. Distance from one’s own family can also be seen to increase <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1741-3737.2005.00155.x">conflict</a> within the household – be it between a husband and wife, or wife and in-laws. These results aren’t an excuse to visit your in-laws less, but they show that menopause symptoms are not only about hormonal irregularities. They may also be a product of your social environment, which should be worth bearing in mind when approaching and going through the menopause.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/123621/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, PhD Candidate, Evolutionary Anthropology and Behavioural Ecology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> 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-you-experience-the-menopause-may-have-a-lot-to-do-with-your-family-123621">original article</a>. </div>

Body

I’ve been diagnosed with cancer. How do I tell my children?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/cassy-dittman-1380541">Cassy Dittman</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/govind-krishnamoorthy-1467986">Govind Krishnamoorthy</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a>, and <a href="https://theconversation.com/profiles/marg-rogers-867368">Marg Rogers</a>, <a href="https://theconversation.com/institutions/university-of-new-england-919">University of New England</a> With around <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/cancer/2022">one in 50 adults</a> diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most <a href="https://www.sciencedirect.com/science/article/pii/S1462388914000994">worried about</a> telling their children. It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33202-1/fulltext">blame themselves</a>. Over time, supportive family relationships and open communication <a href="https://link.springer.com/article/10.1007/s00520-016-3214-2">help children adjust</a> to their parent’s diagnosis and treatment. It’s natural to feel you don’t have the <a href="https://onlinelibrary.wiley.com/doi/10.1111/ecc.12018">skills or knowledge</a> to talk with your children about cancer. But preparing for the conversation can improve your confidence. <h2>Preparing for the conversation</h2> Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones. For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk. Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you. Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax. Also consider what you might need to support yourself. <h2>Preparing the words</h2> Parents might be worried about the <a href="https://www.bmj.com/content/321/7259/479.full.pdf+html">best words or language</a> to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track. The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud. Ask family and friends for their feedback on what you want to say. <a href="https://www.cancer.org.au/cancer-information/types-of-cancer/childhood-cancers/talking-to-kids-about-cancer">Make use of guides</a> by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”. <h2>Having the conversation</h2> Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The <a href="https://www.sciencedirect.com/science/article/pii/S1462388914000994">amount and type</a> of information you give will be based on their age and previous experiences with illness. Remember, if things don’t go as planned, you can always try again later. Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment. Let them know what to expect in the coming weeks and months. Balance hope with reality. For example: <blockquote> The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick. </blockquote> Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a <a href="https://journals.sagepub.com/doi/epdf/10.1177/0165025408093663">serious illness</a>. Young children may worry about becoming unwell themselves, or other loved ones becoming sick. Older children and teenagers may have experiences with cancer through other family members, friends at school or social media. This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault. Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example: <blockquote> You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment. </blockquote> If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”. Finally, tell children you love them and offer them comfort. <h2>How might they respond?</h2> Be prepared for a range of <a href="https://link.springer.com/article/10.1007/s00520-016-3214-2">different responses</a>. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you. Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable. Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family. <h2>What’s next?</h2> Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions. Resources might also help; for example, The Cancer Council’s <a href="https://www.campquality.org.au/kids-guide-to-cancer/">app for children and teenagers</a> and Redkite’s <a href="https://www.redkite.org.au/service/book-club/">library of free books</a> for families affected by cancer. If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.<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/228012/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cassy-dittman-1380541">Cassy Dittman</a>, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/govind-krishnamoorthy-1467986">Govind Krishnamoorthy</a>, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a>, and <a href="https://theconversation.com/profiles/marg-rogers-867368">Marg Rogers</a>, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, <a href="https://theconversation.com/institutions/university-of-new-england-919">University of New England</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/ive-been-diagnosed-with-cancer-how-do-i-tell-my-children-228012">original article</a>. </div>

Family & Pets

What is ‘breathwork’? And do I need to do it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/judy-pickard-831093">Judy Pickard</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> From “breathwork recipes” to breathing techniques, many <a href="https://www.instagram.com/p/C5WpkWxNrDI/">social media</a> and <a href="https://www.healthline.com/health/breathing-exercise">health websites</a> are recommending breathwork to reduce stress. But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336946/">Pranayama</a> from India and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312231/#:%7E:text=Qigong%2C%20on%20the%20other%20hand,one%20or%20two%20balancing%20poses.">qigong</a> from China. Such practices have been used for thousands of years to promote a healthy mind and body. The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer? So, what’s the difference between the breathing we do to keep us alive and breathwork? <h2>Breathwork is about control</h2> Breathwork is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873947/#bib3">not the same</a> as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">other mindfulness practices</a>. While the latter focus on observing the breath, breathwork is about <a href="https://www.nature.com/articles/s41598-022-27247-y">controlling inhalation and exhalation</a>. Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth. <a href="https://www.medicalnewstoday.com/articles/diaphragmatic-breathing">The diaphragm</a> is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs. Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from <a href="https://www.healthline.com/health/breath-of-fire-yoga">fire breathing</a> to the <a href="https://www.headspace.com/content/meditation/humming-bee-breath/9422">humming bee breath</a>. <h2>Breathwork can calm or excite</h2> Even small bits of breathwork can have physical and mental health benefits and <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">complete the stress cycle</a> to avoid burnout. Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale. In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower. You can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681046/">slow the breath</a> by doing: <ul> <li> <a href="https://www.medicalnewstoday.com/articles/321805">box breathing</a> (count to four for each of four steps: breathe in, hold, breathe out, hold), or </li> <li> <a href="https://pubmed.ncbi.nlm.nih.gov/38092805/">coherent breathing</a> (controlled slow breathing of five or six breaths per minute), or </li> <li> <a href="https://www.healthline.com/health/alternate-nostril-breathing#benefits">alternate nostril breathing</a> (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way). </li> </ul> You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out. In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, <a href="https://www.webmd.com/balance/what-is-breath-of-fire-yoga">fire breathing</a> (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and <a href="https://www.healthline.com/health/breathing-exercise#breath-focus">Lion’s breath</a> (breathe out through your mouth, stick your tongue out and make a strong “haa” sound). <h2>What is happening in the body?</h2> Deep and slow breathing, especially with a long exhale, is the best way to <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">stimulate the vagus nerves</a>. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system. Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/">cortisol</a> and helps to regulate emotions and responses. It also promotes more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/">coordinated brain activity</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">improves immune function and reduces inflammation</a>. Taking deep, diaphragmatic breaths also has <a href="https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing">physical benefits</a>. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm. <a href="https://link.springer.com/article/10.1007/s12671-023-02294-2#:%7E:text=Accumulating%20evidence%20supports%20the%20efficacy,et%20al.%2C%202001">Slow breathing</a> reduces heart rate and blood pressure and increases heart rate variability (normal variation in <a href="https://www.health.harvard.edu/blog/heart-rate-variability-new-way-track-well-2017112212789">time between heart beats</a>). These are linked to better heart health. Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and <a href="https://pubmed.ncbi.nlm.nih.gov/36624160/">develops resilience to stress</a>. <h2>Breathing in through the nose</h2> We are designed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986941/">inhale through our nose</a>, not our mouth. Inside our nose are lots of <a href="https://www.ncbi.nlm.nih.gov/books/NBK544232/">blood vessels, mucous glands and tiny hairs called cilia</a>. These warm and humidify the air we breathe and filter out germs and toxins. We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body. <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00148.2023?utm_source=AJPRegu&utm_medium=PressRelease&utm_campaign=1.17.2024">Nasal breathing</a> increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure. Consistently breathing through our mouth <a href="https://www.sciencefocus.com/the-human-body/mouth-breathing">is not healthy</a>. It can lead to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455204/">pollutants</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967998/#:%7E:text=Hence%2C%20we%20sought%20to%20synthesize,barriers%20to%20long%2Dterm%20enjoyment.">infections</a> reaching the lungs, snoring, sleep apnoea, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986941/">dental issues</a> including cavities and jaw joint problems. <h2>A free workout</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/">Slow breathing</a> – even short sessions at home – can reduce stress, anxiety and depression in the general population and among those with clinical depression or anxiety. Research on breathwork in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309518/">helping post-traumatic stress disorder</a> (PTSD) is also promising. Diaphragmatic breathing to improve lung function and strengthen the diaphragm can improve breathing and exercise intolerance in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9690833/">chronic heart failure</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/33076360/">chronic obstructive pulmonary disease</a> and <a href="https://www.medicalnewstoday.com/articles/diaphragmatic-breathing#conditions-it-can-help-with">asthma</a>. It can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967998/#:%7E:text=Hence%2C%20we%20sought%20to%20synthesize,barriers%20to%20long%2Dterm%20enjoyment.">improve exercise performance</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/19875429/">reduce oxidative stress</a> (an imbalance of more free radicals and/or less antioxidants, which can damage cells) after exercise. <h2>A mind-body connection you can access any time</h2> If you feel stressed or anxious, you might subconsciously <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/breathing-to-reduce-stress">take shallow, quick breaths</a>, but this can make you feel more anxious. Deep diaphragmatic breaths through your nose and focusing on strong exhalations can help break this cycle and bring calm and mental clarity. Just <a href="https://www.nature.com/articles/s41598-022-27247-y">a few minutes a day</a> of breathwork can improve your physical and mental health and wellbeing. Daily deep breathing exercises <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1040091/full">in the workplace</a> reduce blood pressure and stress, which is important since <a href="https://theconversation.com/what-is-burnout-and-how-to-prevent-it-in-the-workplace-insights-from-a-clinical-psychologist-196578">burnout rates are high</a>. Bottom line: any conscious control of your breath throughout the day is positive. So, next time you are waiting in a line, at traffic lights or for the kettle to boil, take a moment to focus on your breath. Breathe deeply into your belly through your nose, exhale slowly, and enjoy the benefits.<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/231192/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/judy-pickard-831093">Judy Pickard</a>, Senior Lecturer, Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">original article</a>. </div>

Body

Do you have a mental illness? Why some people answer ‘yes’, even if they haven’t been diagnosed

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jesse-tse-1429151">Jesse Tse</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nick-haslam-10182">Nick Haslam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Mental illnesses such as depression and anxiety disorders have become more prevalent, especially among <a href="https://www.aihw.gov.au/mental-health/overview/prevalence-and-impact-of-mental-illness#changeovertime">young people</a>. Demand for treatment is surging and prescriptions of some <a href="https://pubmed.ncbi.nlm.nih.gov/35176912/">psychiatric medications</a> have climbed. These upswinging prevalence trends are paralleled by rising public attention to mental illness. Mental health messages saturate traditional and social media. Organisations and governments are developing awareness, prevention and treatment initiatives with growing urgency. The mounting cultural focus on mental health has obvious benefits. It increases awareness, reduces stigma and promotes help-seeking. However, it may also have costs. Critics worry <a href="https://www.bacp.co.uk/bacp-journals/therapy-today/2023/april-2023/the-big-issue/">social media</a> sites are incubating mental illness and that ordinary unhappiness is being pathologised by the overuse of diagnostic concepts and “<a href="https://www.bustle.com/wellness/is-therapy-speak-making-us-selfish">therapy speak</a>”. British psychologist <a href="https://www.psych.ox.ac.uk/team/lucy-foulkes">Lucy Foulkes</a> argues the trends for rising attention and prevalence are linked. Her “<a href="https://www.sciencedirect.com/science/article/pii/S0732118X2300003X">prevalence inflation hypothesis</a>” proposes that increasing awareness of mental illness may lead some people to diagnose themselves inaccurately when they are experiencing relatively mild or transient problems. Foulkes’ hypothesis implies that some people develop overly broad concepts of mental illness. Our research supports this view. In a new study, <a href="https://www.sciencedirect.com/science/article/pii/S2666560324000318?via%3Dihub">we show</a> that concepts of mental illness have broadened in recent years – a phenomenon we call “<a href="https://www.tandfonline.com/doi/full/10.1080/1047840X.2016.1082418">concept creep</a>” – and that <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05152-6">people differ</a> in the breadth of their concepts of mental illness. <h2>Why do people self-diagnose mental illnesses?</h2> In our new <a href="https://doi.org/10.1016/j.ssmmh.2024.100326">study</a>, we examined whether people with broad concepts of mental illness are, in fact, more likely to self-diagnose. We defined self-diagnosis as a person’s belief they have an illness, whether or not they have received the diagnosis from a professional. We assessed people as having a “broad concept of mental illness” if they judged a wide variety of experiences and behaviours to be disorders, including relatively mild conditions. We asked a nationally representative sample of 474 American adults if they believed they had a mental disorder and if they had received a diagnosis from a health professional. We also asked about other possible contributing factors and demographics. Mental illness was common in our sample: 42% reported they had a current self-diagnosed condition, a majority of whom had received it from a health professional. Unsurprisingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress. The second most important factor after distress was having a broad concept of mental illness. When their levels of distress were the same, people with broad concepts were substantially more likely to report a current diagnosis. The graph below illustrates this effect. It divides the sample by levels of distress and shows the proportion of people at each level who report a current diagnosis. People with broad concepts of mental illness (the highest quarter of the sample) are represented by the dark blue line. People with narrow concepts of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with broad concepts were much more likely to report having a mental illness, especially when their distress was relatively high. People with greater mental health literacy and less stigmatising attitudes were also more likely to report a diagnosis. Two interesting further findings emerged from our study. People who self-diagnosed but had not received a professional diagnosis tended to have broader illness concepts than those who had. In addition, younger and politically progressive people were more likely to report a diagnosis, consistent with some <a href="https://www.sciencedirect.com/science/article/pii/S2666560321000438">previous research</a>, and held broader concepts of mental illness. Their tendency to hold these more expansive concepts partially explained their higher rates of diagnosis. <h2>Why does it matter?</h2> Our findings support the idea that expansive concepts of mental illness promote self-diagnosis and may thereby increase the apparent prevalence of mental ill health. People who have a lower threshold for defining distress as a disorder are more likely to identify themselves as having a mental illness. Our findings do not directly show that people with broad concepts over-diagnose or those with narrow concepts under-diagnose. Nor do they prove that having broad concepts causes self-diagnosis or results in actual increases in mental illness. Nevertheless, the findings raise important concerns. First, they suggest that rising mental health awareness may <a href="https://www.newscientist.com/article/mg25934573-900-why-being-more-open-about-mental-health-could-be-making-us-feel-worse/">come at a cost</a>. In addition to boosting mental health literacy it may increase the likelihood of people incorrectly identifying their problems as pathologies. Inappropriate self-diagnosis can have adverse effects. Diagnostic labels may become identity-defining and self-limiting, as people come to believe their problems are enduring, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032724002489?via%3Dihub">hard-to-control</a> aspects of who they are. Second, unwarranted self-diagnosis may lead people experiencing relatively mild levels of distress to seek help that is unnecessary, inappropriate and ineffective. Recent <a href="https://pubmed.ncbi.nlm.nih.gov/37844607/">Australian research</a> found people with relatively mild distress who received psychotherapy worsened more often than they improved. Third, these effects may be particularly problematic for young people. They are most liable to hold broad concepts of mental illness, in part due to <a href="https://www.sciencedirect.com/science/article/pii/S0010440X22000682?via%3Dihub">social media</a> <a href="https://www.tandfonline.com/doi/full/10.1080/10810730.2023.2235563">consumption</a>, and they experience mental ill health at relatively high and rising rates. Whether expansive concepts of illness play a role in the youth mental health crisis remains to be seen. Ongoing cultural shifts are fostering increasingly expansive definitions of mental illness. These shifts are likely to have mixed blessings. By normalising mental illness they may help to remove its stigma. However, by pathologising some forms of everyday distress, they may have an unintended downside. As we wrestle with the mental health crisis, it is crucial we find ways to increase awareness of mental ill health without inadvertently inflating it.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231687/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jesse-tse-1429151">Jesse Tse</a>, PhD Candidate at Melbourne School of Psychological Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nick-haslam-10182">Nick Haslam</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-a-mental-illness-why-some-people-answer-yes-even-if-they-havent-been-diagnosed-231687">original article</a>. </div>

Mind

I’ve been given opioids after surgery to take at home. What do I need to know?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a> Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home. These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence. However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery. <h2>Which types of opioids are most common?</h2> The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia). In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit. <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain. Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels. Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box. Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery. Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots. Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover. <h2>But there are also risks</h2> As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over. Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use. But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids. Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect. Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer. Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed. This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision. <h2>How to mimimise the risks</h2> Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac). These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed. Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most. However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>: <ul> <li> ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects </li> <li> do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing </li> <li> as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen </li> <li> before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time. </li> </ul> <h2>If you’re concerned about side effects</h2> If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include: <ul> <li> <a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives </li> <li> drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor </li> <li> weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately. </li> </ul> <h2>If you’re having trouble stopping opioids</h2> Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose. You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these. <h2>How about leftover opioids?</h2> After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge. Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children. <hr /> For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.<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/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</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/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>. </div>

Body

Why do I poo in the morning? A gut expert explains

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this. But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper? To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast. Here’s what the science says. <h2>So morning poos are real?</h2> In a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/">UK study</a> from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits. The most common time to poo was in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/pdf/gut00573-0122.pdf">early morning</a>. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work. About a decade later, <a href="https://pubmed.ncbi.nlm.nih.gov/16200717/">a Chinese study</a> found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning. <h2>But why the morning?</h2> There are a few reasons. The first involves our <a href="https://theconversation.com/circadian-rhythm-nobel-what-they-discovered-and-why-it-matters-85072">circadian rhythm</a> – our 24-hour internal clock that helps regulate bodily processes, such as digestion. For healthy people, our internal clock means the muscular contractions in our colon follow <a href="https://pubmed.ncbi.nlm.nih.gov/19926812/">a distinct rhythm</a>. There’s minimal activity in the night. The deeper and more restful our sleep, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677652">fewer</a> of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=565&fit=crop&dpr=3 2262w" alt="Diagram of digestive system including colon and rectum" /></a><figcaption>Your lower gut is a muscular tube that contracts more strongly at certain times of day. <a class="source" href="https://www.shutterstock.com/image-vector/illustration-healthcare-medical-education-drawing-chart-1984316789">Vectomart/Shutterstock</a></figcaption></figure> But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal. One particular type of colon contraction partly controlled by our internal clock are known as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1411356/">mass movements</a>”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals. Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “<a href="https://www.ncbi.nlm.nih.gov/books/NBK549888/">gastrocolic reflex</a>”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion. Then there’s our morning coffee. This is a very <a href="https://pubmed.ncbi.nlm.nih.gov/2338272/">powerful stimulant</a> of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion. <h2>How important are morning poos?</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1846921/pdf/brmedj02601-0041.pdf">Large international</a> <a href="https://pubmed.ncbi.nlm.nih.gov/20205503/">surveys</a> show the vast majority of people will poo between three times a day and three times a week. This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning. So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning. Morning poos are also not a good thing for everyone. <a href="https://gut.bmj.com/content/61/Suppl_2/A318.1">Some people</a> with <a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">irritable bowel syndrome</a> feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning. <h2>Can you train yourself to be regular?</h2> Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast <a href="https://www.ncbi.nlm.nih.gov/books/NBK549888/">to relieve symptoms</a>. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning. A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147411/">evenings</a>. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine. Regular physical activity and avoiding <a href="https://pubmed.ncbi.nlm.nih.gov/2787735/">sitting down a lot</a> are also important in <a href="https://pubmed.ncbi.nlm.nih.gov/16028436/">stimulating bowel movements</a>, particularly in people with constipation. We know <a href="https://theconversation.com/nervous-tummy-why-you-might-get-the-runs-before-a-first-date-106925">stress</a> can contribute to irregular bowel habits. So minimising stress and focusing on relaxation <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193306/">can help</a> bowel habits become more regular. Fibre from fruits and vegetables also <a href="https://pubmed.ncbi.nlm.nih.gov/665565/">helps</a> make bowel motions more regular. Finally, ensuring <a href="https://theconversation.com/health-check-what-causes-constipation-114290">adequate hydration</a> helps minimise the chance of developing constipation, and helps make bowel motions more regular. <h2>Monitoring your bowel habits</h2> Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you. If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication. But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.<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/229624/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <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/why-do-i-poo-in-the-morning-a-gut-expert-explains-229624">original article</a>. </div>

Body

To-do list got you down? Understanding the psychology of goals can help tick things off – and keep you on track

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> It feels like we are living in busy times. According to the <a href="https://www.oecdbetterlifeindex.org/topics/work-life-balance/">OECD Better Life Index</a>, 12.5% of Australians report working at least 50 hours a week, higher than the OECD average. Many Australians are also <a href="https://www.abc.net.au/news/2023-08-03/multiple-job-holders-hit-record-high-abs/102679190">working more than one job to buffer against cost-of-living pressures</a>. Psychology has long been interested in our goals – our mental representations of desirable outcomes. Much of this research is on how we form, pursue and attain goals, plus how goals make us feel. Across studies, we see a consistent pattern of <a href="https://link.springer.com/article/10.1007/s10902-013-9493-0#Sec34">successful goal pursuit and wellbeing</a>. So, having time to work toward our goals is important. With this in mind, what is the best way to get things done – and how can we get better at achieving our goals, especially when we feel time poor? <h2>Make a list</h2> Most of us approach multiple goals with the age-old “to-do” list. First, you write down everything you need to do. Then you “check” or tick things off as you do them. One reason to-do lists are useful is because we are more likely to remember things we haven’t completed, rather than things we have. This is known as the <a href="https://www.youtube.com/watch?v=E-F1U4bV2m8">Zeigarnik effect</a>. While to-do lists are easy to write, they don’t always work. There are however <a href="https://hbr.org/2021/01/i-tried-4-to-do-list-methods-heres-what-worked">various approaches for to-do lists</a> that may improve their effectiveness. Another thing to consider is the wide range of apps, tools and platforms that can make tasks more fun and outsource mental load. Adding elements of game play like point scoring or competition – called “<a href="https://theconversation.com/how-gamification-could-revolutionise-creative-thinking-in-the-workplace-122852">gamification</a>” – can <a href="https://www.sciencedirect.com/science/article/pii/S0747563221002867">help people work toward goals in educational and work settings</a>. Similarly, app-based reminders can help people reach <a href="https://doi.org/10.1177/2047487320905717">physical rehabilitation goals and form good exercise habits</a>. <h2>Finding your why</h2> Researchers have focused a lot on the psychology of why people pursue goals – and how this affects their approach to tasks. For example, some people want to complete a university degree because they want to get a job. Others may be more interested in developing skills or knowledge. In both cases, there is a desired outcome – albeit with differing reasons. Our goals can be differentiated by who or what is driving them. Goals that feel like our own, and for which we experience a sense of intrinsic motivation, are known as “self-concordant”. These goals represent enduring personal interests, are aligned with values and are positively <a href="https://link.springer.com/article/10.1007/s12144-020-01156-7">linked to wellbeing</a>. <a href="https://link.springer.com/article/10.1007/s10648-006-9012-5">Goal orientation theory</a> offers a similar perspective. Using the same example, you may study so you score well on a test (a performance goal) or because you want to be sure you develop your knowledge (a mastery goal). Mastery goals tend to lead to <a href="https://link.springer.com/article/10.1007/s10869-010-9201-6">better results and self-regulation</a>. <h2>Juggling goals – 4 to-do tips</h2> So, what happens when we have multiple – perhaps even competing – goals, or goals that aren’t so enjoyable? We might want to finish writing a report or assignment, then read a few chapters of a textbook – but also go to the gym and binge a few episodes of our favourite TV show. In such scenarios, psychological science offers some insights into how we might stay task-focused, and on track to tick more items off our to-do list. 1. Beware the <a href="https://www.pwc.pl/en/articles/planning-fallacy-part-I-cognitive-traps.html">planning fallacy</a>. This happens when we underestimate the amount of resources (such as time) it will take to reach a goal. As writer and religious thinker William Penn put it: “Time is what we want most, but what we use worst”. Think through the all the steps and time required to complete your goal. 2. Monitor your progress. <a href="https://eprints.whiterose.ac.uk/91437/8/3_PDFsam_Does%20monitoring%20goal.pdf">Incorporating goal monitoring</a> into an activity can boost progress. And reviewing your estimations and expectations against your actual times and achievements can be used to calculate a “<a href="https://www.indeed.com/career-advice/career-development/estimating-time-for-tasks">fudge ratio</a>” to aid future planning. For instance, you could multiply your expected time on tasks by 1.5 to help buffer against the planning fallacy. 3. Focus on mastery. Self-concordant goals and tasks feel easier, and their underlying tasks may be <a href="https://journals.sagepub.com/doi/full/10.1177/0146167215575730">less subject to forgetting</a>. Tedious but necessary goals (such as doing the dishes or filling out forms) are less intrinsically motivating. This means <a href="https://www.emerald.com/insight/content/doi/10.1108/EBHRM-04-2014-0013/full/html#idm45933122746592">planning, reminders and support become more important to goal progress</a>. 4. Plan for derailments. People vary in their ability to plan and might forget to take a goal-directed action at an appropriate time (this could be one reason the <a href="https://www.sbs.com.au/news/article/the-streaming-services-winning-the-battle-for-attention-and-the-feature-australians-want/9crrpafgd">average Australian streams 27 hours of video each week</a>). <a href="https://www.tandfonline.com/doi/full/10.1080/10463283.2024.2334563">Implementation intentions</a> bring our attention back toward our goals by linking them to an environmental marker. These simple “if-then” plans are shown to <a href="https://cancercontrol.cancer.gov/brp/research/constructs/implementation-intentions#:%7E:text=Implementation%20intentions%20are%20formed%20for,might%20otherwise%20undermine%20goal%20striving.">help overcome issues with self-regulation</a>. Such a statement might be “if I see the ‘next episode’ icon appear, I will get up and turn off the TV so I can read a chapter of my textbook”. With time being frustratingly finite, it is inevitable we will run out of time to do all of the things on our to-do list. Finding an approach that works for us will take time and effort. But it’s probably a worthy goal in itself.<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/230399/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, Senior Lecturer - Psychology | Chair, Researchers in Behavioural Addictions, Alcohol and Drugs (BAAD), <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin 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/to-do-list-got-you-down-understanding-the-psychology-of-goals-can-help-tick-things-off-and-keep-you-on-track-230399">original article</a>. </div>

Mind

"Do not cry for me": Teacher announces own death

A teacher and mum-of-two who chronicled her breast cancer journey online has announced her own death, through a social media post written before her passing. "If you're reading this, it means I have died," Kate Rackham, 45, shared on her Teacher With Cancer X account. "But do not cry for me. I have lived my life on my own terms, the way I have wanted to." The mum told her followers that she joined X, formerly Twitter, as she "needed an outlet", but "what I got was so much more". "You made me feel validated in my feelings and much less alone. Thank you." <blockquote class="twitter-tweet"> If you’re reading this, it means I have died. But do not cry for me. I have lived my life on my own terms, the way I have wanted to. I joined X because I needed an outlet, what I got was so much more. You made me feel validated in my feelings and much less alone. Thank you ❤️ — Teacher with Cancer (@kate_rackham) <a href="https://twitter.com/kate_rackham/status/1801137648146243756?ref_src=twsrc%5Etfw">June 13, 2024</a></blockquote> The British mum was only 39 when she was diagnosed with incurable oestrogen-receptive breast cancer and spent the past six years fighting the disease. She began documenting her journey online, and explained that she had no obvious risk factors leading to the disease. Just before her passing, she was admitted into hospital and was told by doctors that "there is nothing more we can do" and that she "needed a bit of time" to process the news. "I'm now home, where I want to be. With Mark and the girls. Surrounded by love, family and friends," she shared at the time. "Everyone is rallying around and I have so much support. Despite everything I feel blessed." Many have shared their condolences, including friends and those who are also battling breast cancer. "When my time comes, I can but hope I display the dignity and strength of character you did. Much love and condolences to your family and friends," one wrote. "I hope you are free from the pain. You still live in your children your husband. Your legacy," another said. "Thank you for sharing your journey with grace and dignity," a third added. "I hope wherever you are you are no longer in pain. Sending love and thoughts to your family." Rackham is survived by her husband Mark and their two daughters Ruby and Nancy. Images: X/ Nine

Caring

Super funds are using ‘nudges’ to help you make financial decisions. How do they work?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/fernanda-mata-1533222">Fernanda Mata</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/breanna-wright-267597">Breanna Wright</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/liam-smith-5152">Liam Smith</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Late last year the federal government announced <a href="https://ministers.treasury.gov.au/ministers/stephen-jones-2022/media-releases/government-unveils-comprehensive-financial-advice">measures</a> to make it easier for Australians to access financial advice. As part of this, the government wants super funds to use “nudges” to get members to engage more with their retirement investments and superannuation, especially when they’re starting work and approaching retirement. While the legislation containing the changes is still in the consultation phase, super funds are <a href="https://www.afr.com/companies/financial-services/super-funds-spend-big-ahead-of-advice-reforms-20240418-p5fkx6">upskilling staff</a> and making other changes to improve customer service or risk a government crackdown. Telling funds to use <a href="https://www.behaviourworksaustralia.org/blog/nudging-what-is-it-and-how-can-we-use-it-forgood">nudge theory</a> to advise on super comes as more than five million Australians are heading towards retirement. <h2>What is nudge theory?</h2> Nudging is used to encourage people to pick the “better” option, without taking away their freedom to choose differently. For example, sending regular reminders to members about the benefits of voluntary contributions can get them to increase the amount they put in. This nudge makes it easier for them to contribute more – the better option – while still allowing them to choose not to. Assistant Treasurer Stephen Jones <a href="https://ministers.treasury.gov.au/ministers/stephen-jones-2022/media-releases/government-unveils-comprehensive-financial-advice">explained</a> the government’s changes were needed because so-called “fin-fluencers” were providing unregulated financial advice on social media platforms to Australians unable to pay an adviser. <h2>Helping people protect their interests</h2> There are three ways, supported by research, nudges can help Australians engage with their super. 1. Future self visualisation This involves getting young people to think about their <a href="https://www.halhershfield.com/considering-the-future-self">future selves</a> and visualise their life in retirement. This can help them to recognise the long-term benefits of getting actively involved with their super. Showing fund members how they might look when older by using an ageing filter software, for example, can make this visualisation more real for them and <a href="https://journals.sagepub.com/doi/full/10.1177/23794607231190607">enhance understanding of their future selves, leading to higher engagement</a>. 2. Simplification We all know financial products and superannuation can be complicated. The information and choices presented can lead to <a href="https://thedecisionlab.com/biases/choice-overload-bias">decision paralysis</a>, causing people to delay or opt out of making a decision. By simplifying the process, funds can motivate people to get more engaged with their super. To get people to make voluntary contributions, for example, it might be more effective for funds to recommend <a href="https://siepr.stanford.edu/news/how-simple-nudge-can-motivate-workers-save-retirement">a specific percentage of their salary</a> rather than offering several options. Deciding whether to boost contributions by an extra 3%, 4% or 5% can be overwhelming, especially for people with poor <a href="https://theconversation.com/are-you-financially-literate-here-are-7-signs-youre-on-the-right-track-202331">financial literacy</a>. 3. Language and framing The way options are framed and the language super funds use can significantly impact member engagement. Australians may be more likely to make higher voluntary contributions if they are asked how much they want <a href="https://www.bi.team/press-releases/the-small-nudges-that-could-make-young-people-142000-better-off-in-retirement/">to “invest” in their super </a> instead of how much they want to “contribute” or “add”. The word “invest” encourages people to think about future benefits, motivating them to make higher contributions. How options are labelled can also have an impact on <a href="https://www.bi.team/press-releases/the-small-nudges-that-could-make-young-people-142000-better-off-in-retirement/">member engagement</a> and decision making. For example, highlighting concrete benefits of different voluntary payments, such as “a 4% contribution keeps you above the poverty line”, and “a 10% contribution allows for a comfortable retirement according to Australian standards” can increase how much people are willing to contribute. <h2>Ethical use of nudges</h2> The <a href="https://www.superreview.com.au/news/superannuation/industry-body-backs-super-fund-nudges-though-parameters-need-be-set">Financial Services Council</a> backs the government on getting super funds to nudge members about contributions and investments but says there are limits. Parameters around nudging should be set […] to ensure that the language is appropriate and does not ultimately amount to defaulting. For example, letting a customer know that as they approach retirement, they need to make a decision about what retirement product they wish to utilise would be an acceptable nudge, while contacting a customer to let them know that they will be placed in a product when they retire, would not necessarily be acceptable. The council emphasises the importance of super funds recognising <a href="https://www.superreview.com.au/news/superannuation/industry-body-backs-super-fund-nudges-though-parameters-need-be-set">people’s autonomy</a> when delivering a “soft” or “hard” nudge. Soft nudges are gentle prompts and reminders designed to guide people to make good choices without pressuring them, such as sending an email reminder to review their investment options. Hard nudges are more direct in their guidance. These might include recommending specific investment options. Despite these differences, <a href="https://www.behaviourworksaustralia.org/blog/can-we-have-a-quiet-word-about-behavioural-science">ethical use of nudges</a> should encourage engagement while respecting people’s autonomy by making it easy for them to opt out. The use of nudges presents a valuable opportunity to increase superannuation fund members’ engagement. Whether through future self visualisation, simplification or language framing, ethical nudges can motivate members to take action, leading to greater confidence in navigating the retirement transition and achieving retirement goals.<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/230404/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/fernanda-mata-1533222">Fernanda Mata</a>, Research Fellow, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/breanna-wright-267597">Breanna Wright</a>, Research fellow, BehaviourWorks Australia, Monash Sustainable Development Institute, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/liam-smith-5152">Liam Smith</a>, Director, BehaviourWorks, Monash Sustainable Development Institute, <a href="https://theconversation.com/institutions/monash-university-1065">Monash 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/super-funds-are-using-nudges-to-help-you-make-financial-decisions-how-do-they-work-230404">original article</a>. </div>

Money & Banking

Why do we love to see unlikely animal friendships? A psychology expert explains

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/shane-rogers-575838">Shane Rogers</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> The internet is awash with stories and videos of unlikely animal friendships, often with many millions of views. This content typically shows animals from different species showing affection to one another, signifying a bond or even a “friendship”. These relationships have been captured in people’s homes, such as with <a href="https://www.abc.net.au/news/2021-09-10/meet-unlikely-friends-peggy-the-dog-and-molly-the-magpie/100447022">Molly the magpie and Peggy the dog</a>, in zoos, <a href="https://www.abc.net.au/news/2016-03-04/bear-lion-and-tiger-make-an-affectionate,-gentle-family/7222462">such as with</a> Baloo the bear, Leo the lion and Shere Khan the tiger, and even <a href="https://www.youtube.com/watch?v=_BvB0182xag&t=2300s">in the wild</a>, such as one case of <a href="https://www.huffpost.com/entry/fox-cat-friendship_n_4268629">a fox and cat living together</a> in Turkey. <figure><iframe src="https://www.youtube.com/embed/fdxU6CpvUgg?wmode=transparent&start=19" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> A plethora of research on <a href="https://www.nature.com/articles/s41598-020-66407-w.pdf">primates</a>, <a href="https://blog.mybirdbuddy.com/post/can-birds-form-friendships">birds</a>, <a href="https://theconversation.com/the-social-lives-of-kangaroos-are-more-complex-than-we-thought-213770">kangaroos</a>, <a href="https://theconversation.com/male-dolphins-use-their-individual-names-to-build-a-complex-social-network-97780">dolphins</a>, <a href="https://www.mdpi.com/2076-2615/8/11/191">horses</a>, <a href="https://www.mdpi.com/2076-2615/12/1/126">cats</a> and <a href="https://www.nature.com/articles/s41598-022-05669-y">dogs</a> has shown many non-human animals can develop deep social bonds with their own kind. And while inter-species bonding hasn’t been studied to the same extent, videos like those mentioned above show animals from different species displaying the same affection to each other as they would to their own, such as through cuddling, playing and grooming. Why do we, as people, find these stories so enjoyable? Answering this question requires us to consider some of the nicer aspects of our own nature. <h2>When animals reflect us</h2> Witnessing animals get along well together isn’t just cute, it can also make us feel like we have things in common with other species, and feel more connected with the other life on the planet. <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00976/full">Decades of research</a> reveals how feeling connected to nature fosters happiness in humans. <figure><iframe src="https://www.youtube.com/embed/PrJi-P61aLY?wmode=transparent&start=7" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> While the mechanisms behind inter-species bonding are not fully understood, <a href="https://www.frontiersin.org/articles/10.3389/fnbeh.2022.994504/full">one 2022 research review</a> suggests the mechanisms that operate in other animals’ brains during social interactions with their own are similar to those that operate in human brains. The researchers suggest that, due to the evolution of common brain mechanisms, animals engaged in social interaction may experience similar emotions to humans who engage with their own friends or loved ones. So while it’s very hard to know what this subjective social experience is like for other animals – after all, they can’t report it on a questionnaire – there’s no reason to think it isn’t similar to our own. <figure><iframe src="https://www.youtube.com/embed/ZVMsdz7aZpk?wmode=transparent&start=102" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Humans like co-operation and pleasant surprises</h2> Humans have <a href="https://royalsocietypublishing.org/doi/10.1098/rspb.2022.0128">evolved to enjoy co-operation</a>, which might also help explain why we enjoy seeing co-operation between different animal species. <a href="https://www.abc.net.au/listen/programs/lifematters/competition-versus-cooperation:-which-human-instinct-is-stronge/10291360">Some scholars</a> suggest the human instinct for co-operation is even stronger than our instinct for competition. Another reason we may be drawn to unlikely animal friendships is that they are, in fact, so unlikely. These interactions are surprising, and research shows humans <a href="https://www.scientificamerican.com/article/neuroscientists-learn-why/">enjoy being surprised</a>. Our brain has <a href="https://www.imperial.ac.uk/news/239331/study-reveals-human-brains-have-evolved/">evolved to be incredibly efficient</a> at categorising, solving problems and learning. Part of the reason we’re so efficient is because we are motivated to seek new knowledge and question what we think we know. In other words, we’re motivated to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635443/">curious</a>. Inter-species friendships are indeed a very curious thing. They contradict the more common assumption and observation that different species stick with their own kind. We might think “cats eat birds, so they must not like each other”. So when we see <a href="https://www.youtube.com/watch?v=bGsN7jzp5DE">a cat and a bird</a> getting along like old pals, this challenges our concept of how the natural world works. <figure><iframe src="https://www.youtube.com/embed/bGsN7jzp5DE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Neuroscientists have documented that, when surprised, humans experience a release of brain chemicals responsible for making us <a href="https://www.scientificamerican.com/article/unexpected-brain-chemistry-is-behind-the-element-of-surprise/">more alert</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0896627320308539">sensitive to reward</a>. It is this neurochemical reaction that produces the “pleasantness” in the feeling of being pleasantly surprised. <h2>A desire for peace and harmony</h2> Perhaps another explanation for why humans are so intrigued by inter-species friendships is because they feed a human desire for peace and harmony. These connections may be symbolic of what many people yearn for: a world where differences can be put aside in favour of a peaceful co-existence. These friendships might even prompt us to imagine, consciously or subconsciously, a future in which we become more enlightened as a species. One could argue a key reason behind the success of the TV series <a href="https://www.youtube.com/watch?v=ANnFNfVuZeM">Star Trek</a> is its <a href="https://jacobin.com/2023/08/star-trek-solidarity-utopianism-technology-postcapitalism">optimistic take on the future of humanity</a>. Inter-species co-operation is a central theme of the show. Inter-species friendships may serve as a concrete example of breaking free of the “natural” way of being for a more peaceful way of being. And while it might only be a dream, it’s nice to watch cute animal videos that help us feel like this dream might be possible.<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/230548/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/_BvB0182xag?wmode=transparent&start=1880" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <a href="https://theconversation.com/profiles/shane-rogers-575838">Shane Rogers</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-we-love-to-see-unlikely-animal-friendships-a-psychology-expert-explains-230548">original article</a>. </div>

Family & Pets

Millions of older people don’t get enough nutrients – how to spot it and what to do about it

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a> By 2050, approximately a quarter of the UK population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/january2021">expected to be over the age of 65</a>. With this in mind, the World Health Organization (WHO) has put “<a href="https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_28">healthy ageing</a>” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years. Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat. Older adults are <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/research-report-2019--one-step-at-a-time.pdf">generally less physically active</a> than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older. This means we need to get more nutrients into less energy which can be tricky as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/#:%7E:text=The%20physiological%20changes%20that%20occur,can%20contribute%20to%20declining%20appetite.">older adults often have lower appetites</a>. This is why <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">scientists suggest</a> that it may be necessary to enrich the food of older people to maintain the nutrient intake. <h2>How to spot when someone isn’t eating enough?</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399049/">Several studies have shown</a> that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital. Being overweight, even obese, <a href="https://link.springer.com/article/10.1007/s40520-023-02650-1">does not protect</a> against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.892675/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Nutrition&id=892675">abilities to do daily tasks</a>. Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness <a href="https://www.sciencedirect.com/science/article/pii/S0195666319307603?casa_token=iU5UIdNwGDgAAAAA:I81EKDJ2T0oBsOsZunpPBk6uI-TcgiCr-5gPJE1tz4-Tq3w8pK4Yi_mv22AhVHHpRpiv1Bvz0RI">with good health</a>. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment. Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition. <h2>Getting more nutrients into less food</h2> If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK. Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy. <figure><iframe src="https://www.youtube.com/embed/kNu8auu3fuU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For older adults in particular, protein is a very important nutrient, because of muscle loss (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/#:%7E:text=Sarcopenia%20has%20been%20defined%20as,decade%20of%20life%20%5B1%5D.">sarcopenia)</a> which is a natural part of ageing. This could be slowed down or even reversed by <a href="https://www.medicalnewstoday.com/articles/could-a-higher-protein-intake-lead-to-healthier-eating">eating enough protein</a> at regular intervals throughout the day. A few ways to increase protein include: • Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato. • Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies). • Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals. • Look in the sports section of supermarkets to find <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/whey-powder#:%7E:text=Whey%20powders%20are%20characterized%20as,of%20products%20obtained%20from%20milk.">whey protein</a> powders. These are marketed to gym enthusiasts, but actually whey is one of the <a href="https://www.mdpi.com/2072-6643/15/15/3424">best proteins to stimulate muscle growth</a>. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking. <h2>Importance of physical activity and strength exercises</h2> Physical activity and nutrition go hand-in-hand – both are equally important. As we age, being physically active becomes <a href="https://link.springer.com/article/10.1007/s12603-021-1665-8?fbclid=IwAR3dJkeHjgcSrR9Xq5kBfN-HLrbpli8WcAnz7AeY5Nu9XcGCHEB07Sd2z1w">even more essential</a> as it helps to prevent disease, maintains independence, decreases risk of falls, improves cognitive function, mental health and sleep. Exercise can also <a href="https://academic.oup.com/ageing/article/48/4/476/5423796?login=false">combat isolation and loneliness</a> which has also been <a href="https://www.bda.uk.com/resource/loneliness-and-malnutrition.html">linked to decreased appetite</a> in older adults. Often strength training gets ignored when we think of being active but to keep independence and prevent falls, older adults should do varied physical activity that emphasises balance and strength training at moderate or greater intensity on three or more days a week. Ultimately, it’s essential to contact a doctor or dietician with any worries or concerns about malnutrition or unintentional weight loss. There are, however, <a href="https://www.futurelearn.com/courses/ageing-well-nutrition-and-exercise-for-older-adults">some excellent resources</a> to learn more about ageing healthily and maintaining a good quality of life in later years.<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/221380/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, Senior Lecturer in Human Nutrition, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, Sensory and Consumer Scientist, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</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/millions-of-older-people-dont-get-enough-nutrients-how-to-spot-it-and-what-to-do-about-it-221380">original article</a>. </div>

Body

How do airplanes fly? An aerospace engineer explains the physics of flight

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/craig-merrett-1509278">Craig Merrett</a>, <a href="https://theconversation.com/institutions/clarkson-university-4276">Clarkson University</a> Airplane flight is one of the most significant technological achievements of the 20th century. The <a href="https://airandspace.si.edu/explore/stories/wright-brothers">invention of the airplane</a> allows people to travel from one side of the planet to the other in less than a day, compared with weeks of travel by boat and train. Understanding precisely why airplanes fly is an ongoing challenge for <a href="https://www.clarkson.edu/people/craig-merrett">aerospace engineers, like me</a>, who study and design airplanes, rockets, satellites, helicopters and space capsules. Our job is to make sure that flying through the air or in space is safe and reliable, by using tools and ideas from science and mathematics, like computer simulations and experiments. Because of that work, flying in an airplane is <a href="https://usafacts.org/articles/is-flying-safer-than-driving/">the safest way to travel</a> – safer than cars, buses, trains or boats. But although aerospace engineers design aircraft that are stunningly sophisticated, you might be surprised to learn there are still some details about the physics of flight that we don’t fully understand. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=381&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=381&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=381&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=479&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=479&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577439/original/file-20240222-28-v3tjb4.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=479&fit=crop&dpr=3 2262w" alt="A diagram of an airplane that shows the four forces of flight." /></a><figcaption>The forces of weight, thrust, drag and lift act on a plane to keep it aloft and moving. <a class="source" href="https://www1.grc.nasa.gov/beginners-guide-to-aeronautics/airplane-cruise-balanced-forces/">NASA</a></figcaption></figure> <h2>May the force(s) be with you</h2> There are <a href="https://www.nasa.gov/stem-content/four-forces-of-flight/#:%7E">four forces</a> that aerospace engineers consider when designing an airplane: weight, thrust, drag and lift. Engineers use these forces to help design the shape of the airplane, the size of the wings, and figure out how many passengers the airplane can carry. For example, when an airplane takes off, the thrust must be greater than the drag, and the lift must be greater than the weight. If you watch an airplane take off, you’ll see the wings change shape using flaps from the back of the wings. The flaps help make more lift, but they also make more drag, so a powerful engine is necessary to create more thrust. When the airplane is high enough and is cruising to your destination, lift needs to balance the weight, and the thrust needs to balance the drag. So the pilot pulls the flaps in and can set the engine to produce less power. That said, let’s define what force means. According to <a href="https://ca.pbslearningmedia.org/resource/4079abf0-7a4b-4f49-80ad-c69cd06a80f9/newtons-second-law-of-motion/">Newton’s Second Law</a>, a force is a mass multiplied by an acceleration, or F = ma. A force that everyone encounters every day is <a href="https://spaceplace.nasa.gov/what-is-gravity/en/#:%7E">the force of gravity</a>, which keeps us on the ground. When you get weighed at the doctor’s office, they’re actually measuring the amount of force that your body applies to the scale. When your weight is given in pounds, that is a measure of force. While an airplane is flying, gravity is pulling the airplane down. That force is the weight of the airplane. But its engines push the airplane forward because they create <a href="https://www1.grc.nasa.gov/beginners-guide-to-aeronautics/what-is-thrust/">a force called thrust</a>. The engines pull in air, which has mass, and quickly push that air out of the back of the engine – so there’s a mass multiplied by an acceleration. According to <a href="https://www.youtube.com/watch?v=a-wh3fJRdjo">Newton’s Third Law</a>, for every action there’s an equal and opposite reaction. When the air rushes out the back of the engines, there is a reaction force that pushes the airplane forward – that’s called thrust. As the airplane flies through the air, the shape of the airplane pushes air out of the way. Again, by Newton’s Third Law, this air pushes back, <a href="https://www1.grc.nasa.gov/beginners-guide-to-aeronautics/what-is-drag/#:%7E">which leads to drag</a>. You can experience something similar to drag when swimming. Paddle through a pool, and your arms and feet provide thrust. Stop paddling, and you will keep moving forward because you have mass, but you will slow down. The reason that you slow down is that the water is pushing back on you – that’s drag. <h2>Understanding lift</h2> <a href="https://www1.grc.nasa.gov/beginners-guide-to-aeronautics/what-is-lift/">Lift</a> is more complicated than the other forces of weight, thrust and drag. It’s created by the wings of an airplane, and the shape of the wing is critical; that shape is <a href="https://howthingsfly.si.edu/media/airfoil#:%7E">known as an airfoil</a>. Basically it means the top and bottom of the wing are curved, although the shapes of the curves can be different from each other. As air flows around the airfoil, <a href="https://www.youtube.com/watch?v=UO75jDwGCdQ">it creates pressure</a> – a force spread out over a large area. Lower pressure is created on the top of the airfoil compared to the pressure on the bottom. Or to look at it another way, air travels faster over the top of the airfoil than beneath. Understanding why the pressure and speeds are different on the top and the bottom is <a href="https://airandspace.si.edu/multimedia-gallery/lift-and-copjpg">critical to understand lift</a>. By improving our understanding of lift, engineers can design more fuel-efficient airplanes and give passengers more comfortable flights. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=385&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=385&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=385&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=484&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=484&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579698/original/file-20240304-24-6df49v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=484&fit=crop&dpr=3 2262w" alt="A diagram that shows how the airfoil of a plane works." /></a><figcaption>Note the airfoil, which is a specific wing shape that helps keep a plane in the air. <a class="source" href="https://www.gettyimages.com/detail/illustration/how-airplanes-fly-royalty-free-illustration/1401215523?phrase=airfoil+diagram&adppopup=true">Dimitrios Karamitros/iStock via Getty Images Plus</a></figcaption></figure> <h2>The conundrum</h2> The reason why air moves at different speeds around an airfoil remains mysterious, and <a href="https://www.scientificamerican.com/video/no-one-can-explain-why-planes-stay-in-the-air/">scientists are still investigating</a> this question. Aerospace engineers have measured these pressures on a wing in both wind tunnel experiments and during flight. We can create models of different wings to predict if they will fly well. We can also change lift by changing a wing’s shape to create airplanes that fly for long distances or fly very fast. Even though we still don’t fully know why lift happens, aerospace engineers work with mathematical equations that recreate the different speeds on the top and bottom of the airfoil. Those equations describe a process <a href="https://howthingsfly.si.edu/media/circulation-theory-lift">known as circulation</a>. Circulation provides aerospace engineers with a way to model what happens around a wing even if we do not completely understand why it happens. In other words, through the use of math and science, we are able to build airplanes that are safe and efficient, even if we don’t completely understand the process behind why it works. Ultimately, if aerospace engineers can figure out why the air flows at different speeds depending on which side of the wing it’s on, we can design airplanes that use less fuel and pollute less.  <a href="https://theconversation.com/profiles/craig-merrett-1509278">Craig Merrett</a>, Professor of Mechanical and Aerospace Engineering, <a href="https://theconversation.com/institutions/clarkson-university-4276">Clarkson University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-airplanes-fly-an-aerospace-engineer-explains-the-physics-of-flight-222847">original article</a>. </div>

Travel Tips

How do I keep my fruit, veggies and herbs fresh longer? Are there any ‘hacks’?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/senaka-ranadheera-199225">Senaka Ranadheera</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> We all know <a href="https://theconversation.com/frozen-canned-or-fermented-when-you-cant-shop-often-for-fresh-vegetables-what-are-the-best-alternatives-131678">fresh produce is good for us</a>, but fruit, vegetables and herbs have a tendency to perish quickly if left uneaten. This is because <a href="https://www.sciencedirect.com/science/article/abs/pii/S2212429219305188">even after harvesting</a>, produce from living plants tends to continue its biological processes. This includes respiration: producing energy from stored carbohydrates, proteins and fats while releasing carbon dioxide and water vapour. (Ever found a sprouting potato in your pantry?) On top of that, fresh produce also <a href="https://www.mdpi.com/journal/agriculture/special_issues/quality_safety_fresh_produce">spoils easily thanks to various microbes</a> – both harmless and ones that can cause disease, called pathogens. Simply chucking things in the fridge won’t solve the problem, as different types of plants will react differently to how they’re stored. So, how can you combat food waste and keep produce fresh for longer? Fortunately, there are some helpful tips. <h2>Freshness and quality begin at the farm</h2> Farmers always aim to harvest produce when it’s at an optimal condition, but both pre-harvest and post-harvest factors will affect freshness and quality even before you buy it. Pre-harvest factors are agricultural, such as climatic conditions, soil type and water availability. <a href="https://www.sciencedirect.com/science/article/abs/pii/S2212429219305188">Post-harvest factors</a> include washing and cleaning after harvesting, transportation and distribution, processing and packaging, and storage. As consumers we can’t directly control these factors – sometimes the veggies we buy just won’t be as good. But we can look out for things that will affect the produce once we bring it home. One major thing to look out for is bruised, wounded or damaged produce. This can happen at any stage of post-harvest handling, and can really speed up the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0308814609001411">decay of your veggies and fruit</a>. Moisture loss through damaged skin speeds up deterioration and nutrient loss. The damage also makes it easier for <a href="https://www.sciencedirect.com/science/article/pii/S2468014119301943">spoilage microbes</a> to get in. <h2>To wash or not to wash?</h2> You don’t need to wash your produce before storing it. A lot of what we buy has already been washed commercially. In fact, if you wash your produce and can’t get it completely dry, the added moisture could speed up decay in the fridge. But washing produce <a href="https://theconversation.com/do-we-really-have-to-wash-fruit-and-vegetables-53039">just before you use it</a> is important to remove dirt and pathogenic bugs. Don’t use vinegar in your washing water despite what you see on social media. Studies indicate <a href="https://pubmed.ncbi.nlm.nih.gov/16496573/">vinegar has no effect</a> on lowering microbial loads on fresh produce. Similarly, don’t use baking soda. Even though there’s some evidence baking soda <a href="https://pubs.acs.org/doi/10.1021/acs.jafc.7b03118">can remove pesticide residues</a> from the surface of some produce, it’s not advisable at home. Just use plain tap water. <h2>Location, location, location</h2> The main thing you need is the correct type of packaging and the correct location – you want to manage moisture loss, decay and ripening. The three main storage options are on the counter, in the fridge, or in a “cool, dry and dark place”, such as the pantry. Here are some common examples of produce and where best to put them. Bananas, onion, garlic, potatoes, sweet potato and whole pumpkin will do better in a dark pantry or cupboard. Don’t store potatoes and onions together: onions produce a gas called ethylene that makes potatoes spoil quicker, while the high moisture in potatoes spoils onions. In fact, don’t store fruits such as apples, pears, avocado and bananas together, because these fruits <a href="https://www.tandfonline.com/doi/full/10.1080/15538362.2013.748378#:%7E:text=%27Malindi%27%20had%20higher%20respiration%20rates,retention%20in%20fruit%20during%20ripening">release ethylene gas</a> as they ripen, making nearby fruits ripen (and potentially spoil) much faster. That is, unless you do want to ripen your fruits fast. All leafy greens, carrots, cucumbers, cauliflower and broccoli will do best in the low-humidity drawer (crisper) in the fridge. You can put them in perforated plastic bags to retain moisture but maintain air flow. But don’t put them in completely sealed bags because this can slow down ripening while <a href="https://ucanr.edu/sites/hdnmastergardeners/files/338860.pdf">trapping carbon dioxide</a>, leading to decay and bad smells. Some fruits will also do best in the fridge. For example, apples and citrus fruits such as oranges can keep fresh longer in the fridge (crisper drawer), although they can stay at room temperature for short periods. However, don’t store watermelon in the fridge for too long, as it will lose its flavour and deep red colour if kept refrigerated <a href="https://ucanr.edu/sites/hdnmastergardeners/files/338860.pdf">for longer than three days</a>. Most herbs and some leafy vegetables – like celery, spring onions and asparagus – can be kept with stems in water to keep them crisp. Keep them in a well-ventilated area and away from direct sunlight, so they don’t get too warm and wilt. <figure><iframe src="https://www.youtube.com/embed/cHu10C1DAds?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Experimenting at home is a good way to find the best ways to store your produce.</figcaption></figure> <h2>Fight food waste and experiment</h2> Don’t buy too much. Whenever possible, buy only small amounts so that you don’t need to worry about keeping them fresh. Never buy bruised, wounded or damaged produce if you plan to keep it around for more than a day. “Process” your veggies for storage. If you do buy a large quantity – maybe a bulk option was on sale – consider turning the produce into something you can keep for longer. For example, banana puree made from really ripe bananas can be <a href="https://www.sciencedirect.com/science/article/abs/pii/S0023643817300853">stored for up to 14 days at 4°C</a>. You can use <a href="https://theconversation.com/frozen-canned-or-fermented-when-you-cant-shop-often-for-fresh-vegetables-what-are-the-best-alternatives-131678">freezing, blanching, fermentation and canning</a> for most vegetables. Consider vacuum sealing. Vacuum packaging of vegetables and berries can keep them fresh longer, as well. For example, vacuum-sealed beans can keep up to 16 months in the fridge, but will last only about <a href="https://www.vacpac.com.au/vacuum-sealed-life-expectancy-how-long-will-my-vacuum-sealed-products-last">four weeks in the fridge unsealed</a>. Keep track. Arrange your fridge so you can see the produce easily and use it all before it loses freshness. Experiment with storage hacks. Social media is full of tips and hacks on how best to store produce. Turn your kitchen into a lab and try out any tips you’re curious about – they might just work. You can even use these experiments as a way to teach your kids about the importance of reducing food waste. Grow some of your own. This isn’t <a href="https://theconversation.com/growing-your-own-food-and-foraging-can-help-tackle-your-ballooning-grocery-bill-heres-how-216264">feasible for all of us</a>, but you can always try having some herbs in pots so you don’t need to worry about keeping them fresh or using up a giant bunch of mint all at once. <a href="https://theconversation.com/health-check-are-microgreens-better-for-you-than-regular-greens-73950">Growing your own microgreens</a> could be handy, too.<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/226763/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/senaka-ranadheera-199225">Senaka Ranadheera</a>, Associate Professor, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-keep-my-fruit-veggies-and-herbs-fresh-longer-are-there-any-hacks-226763">original article</a>. </div>

Food & Wine

4 things you’re likely doing that are damaging your hearing

Your hearing is a precious gift, so it’s important to take good care of your ears. We’ve got some advice on the things to avoid, and what you can do to protect your hearing. Using cotton tips Though they’re commonly used for the job, cotton tips should never be used to clean out your ears. In fact, no solid object should be put inside your ears. Cotton tips account for around four per cent of all ruptured eardrums. These innocuous-looking objects can also cause bleeding, scratch your ear canal, or trigger an infection. So put them down and step away. Instead, use a commercial ear cleaner, or even just a few drops of mineral oil, baby oil, or glycerine to soften the earwax. Don’t wait and see If your hearing in one or both ears suddenly disappears without cause, you need to go and see your doctor as soon as you can. It could be inflammation, infection, or a decrease in blood supply to the area. If you need treatment, you’ll likely need it immediately to have any hope of restoring your hearing. Using eardrops without advice There are many over-the-counter eardrops available to help with things like swimmer’s ear. But in extreme cases, these products can cause deafness. Before you use anything, including a home remedy, get your doctor to check that you don’t have a ruptured eardrum. Some people may be born that way, or have had surgery as a child, or suffered an injury. If the ingredients in these drops make their way inside your eardrum, it can cause a lot of pain, and permanent deafness. Always protect your ears It’s incredibly important to protect your ears from permanent damage. Tiny hairs inside your ears act as hearing receptors, and these can be broken by extremely loud noises. Once they’re gone, they don’t come back. So things like loud music, fireworks, machinery, and artillery are all risky to be around. The best thing you can do is cover up with earmuffs whenever you’re around these things – especially if it’s on a regular basis. For extra safety, use earplugs as well. Image credits: Shutterstock

Body

New study reveals people who do this daily make more money over their lifetimes

You’ve heard that regular exercise can help you live richly. Frequent movement, even in short bursts throughout the day, has been linked to lower all-cause mortality rates and reduced risk of heart disease, type-2 diabetes and other age-related conditions, helping you age healthfully and stay independent. Now, new research suggests frequent exercise might help you live well in another meaningful way; in terms of income. In a recent study published in the journal Clinical Orthopaedics and Related Research, doctors from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), which is part of the National Institute of Health (NIH), investigated whether individuals who stayed active would earn more money as a result of their active lifestyle. The researchers’ findings revealed that staying active not only resulted in higher present earnings, but also predicted increased future income throughout one’s life. In essence, the science was clear: Getting more exercise could make you wealthier. <h2>How exercise predicted future earnings</h2> The researchers set out to explore three key correlations: How mobility affected income, how mobility influenced income over time, and whether exercise could help people maintain their mobility as they aged. The team analysed data from the US-federally-supported Health and Retirement Study (HRS), the largest study tracking changes over time in Americans aged 50 and above. This comprehensive study takes into account various life aspects, including work, socio-economic status, health, psychology and family matters, as individuals age. To assess the impact of current mobility on income, the researchers examined data from over 19,000 respondents to determine how well they could perform simple tasks, such as walking several blocks, climbing multiple flights of stairs, or moving around a room. Each person received a numerical score, with 5 indicating full mobility and 0 indicating difficulties with these tasks. <h2>What earnings over time revealed</h2> The researchers found that for each decrease in the mobility category, individuals lost out on an average of US$3000 in annual income compared to their peers. Those who were active were also significantly more likely to remain working for longer than the other group. It appeared that engaging in exercise enabled individuals to maintain mobility and engage in professional life for a longer period of time than those who were less active. Looking at earnings over time revealed even more substantial benefits for those who remained active throughout their lives. Active individuals showed an overall income level that was US$6500 higher, along with higher rates of employment. For the third part of the study, it’s not surprising that those who engaged in exercise continued to maintain their mobility after the age of 55 and had higher employment rates. Even exercising just one day a week showed improvements in mobility outcomes. <h2>Moving more benefits more than just health</h2> While this study doesn’t definitively prove that leading a healthy lifestyle directly leads to higher earnings, it strongly suggests that staying healthy and mobile brings benefits beyond just lower levels of disease (which is a type of wealth in and of itself). NIAMS Director Lindsey A. Criswell, M.D., M.P.H., underscores this point: “We have long understood that greater mobility is an important indicator of good health … The notion that mobility can have economic rewards further extends the evidence for the benefits of exercise and maintaining an active lifestyle.” If this science inspires you to make a healthy lifestyle change, speak with a licensed healthcare provider to determine the right exercise programme for you. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.com.au/food-home-garden/money/new-study-reveals-people-who-do-this-daily-make-more-money-over-their-lifetimes" target="_blank" rel="noopener">Reader's Digest</a>.

Body

How do I plan for my retirement? Step one – start right away

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/bomikazi-zeka-680577">Bomikazi Zeka</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Planning for retirement is important because it will help you build the nest egg you’ll need to financially sustain your retirement years. Past <a href="https://www.tandfonline.com/doi/epdf/10.1080/03601277.2012.660859?needAccess=true">studies</a> have shown that those who plan for their retirement are more likely to be better off at retirement compared to those don’t. The sooner the planning process gets underway, the better. This gives your money more time to grow by generating investment returns. And the income from your first job is your first opportunity to save for retirement. As the saying goes: “The best time to plant a tree was 20 years ago. The second best time is now.” As people <a href="https://www.statssa.gov.za/?p=15601">can expect to live longer</a>, they must save more for retirement so that they don’t outlive their savings. This is particularly true given that the pensions landscape worldwide has undergone some major changes. In the past, governments and employers provided retirement income for individuals through government social security benefits and employment-based retirement funds. Because of increasing life expectancies, pension plans that guaranteed a retirement benefit to employees are now rare. Employees are now responsible for making contributions towards their own pensions as well as choosing the investments offered by the pension fund. Since employers are no longer responsible for funding their employees’ retirement and governments lack resources to provide a universal state pension, each person is ultimately responsible for ensuring they have enough retirement savings. So it’s very important to know the basics of the retirement planning process. As a researcher, I’m interested in how people use financial products to overcome economic challenges and build wealth. One of the things I investigate is whether planning for retirement leads to better retirement outcomes. For instance, my <a href="https://www.researchgate.net/profile/Bomikazi-Zeka-2/publication/340130176_Retirement_funding_adequacy_in_black_South_African_townships/links/5e8bf3924585150839c6408b/Retirement-funding-adequacy-in-black-South-African-townships.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail&_rtd=e30%3D">research</a> has found that individuals whose financial affairs are in order are more likely to maintain their standard of living at retirement. Given that everyone’s financial situation is unique, it’s always a good idea to speak to a financial planner for tailored financial advice. If you haven’t given retirement planning much thought or don’t know where to start, here are four points to help get the ball rolling. <h2>What are my retirement goals?</h2> Retirement goals make you think about what you want to achieve by the time you retire and what you need to do to achieve it. Some people may have a goal in mind about when they want to retire, or how much wealth they’d like to have by the time they retire. And since wealth has different meanings for different people, others may think about maintaining or improving their standard of living at retirement. Once you’ve thought about your retirement goals, the <a href="https://corporatefinanceinstitute.com/resources/management/smart-goal/">“smart” goals</a> framework is a useful guide. It outlines that goals should be: specific, measurable, attainable, relevant and time-bound. When goals are clear, within reach, achievable, realistic and time-sensitive, they become a blueprint to help you turn them into a reality. <h2>How do I start saving for retirement?</h2> For those who have a job that comes with retirement fund membership, a workplace pension is used to provide for retirement. But there are also other options available to help you save. For instance, retirement annuity funds are voluntary retirement savings. Personal assets such as <a href="https://www.allangray.co.za/what-we-offer/unit-trust-investment/#fund-3">unit trusts</a> or <a href="https://www.gov.za/faq/money-matters/how-can-i-make-tax-free-investment">tax-free investments</a> can also be used as a savings tool. Unit trusts are generally better suited for people willing to take on risk because their value is tied to the movements of financial markets. In other words, they can generate positive returns but they can also lose value. The drawback of tax-free investments in South Africa is that they have a lifetime contribution limit. You can’t use them to save more than R500,000 (US$27,400). Each of these options has its advantages and disadvantages and what works best for one person may not be best for another. But there are several ways to save for retirement depending on your financial situation and retirement goals. Getting professional advice will help you determine what’s best for you. <h2>Will my retirement savings be enough?</h2> Once you’ve set your retirement goals and have a retirement savings plan in place, you can calculate whether you are saving enough to achieve your retirement goals. For example, if your retirement goal is: “I want to retire at the age of 65 years with an income equivalent to R35,000 (US$1,900) per month” then you can use a <a href="https://www.sanlam.co.za/tools/Pages/retirement.aspx">retirement calculator</a> to track your progress and determine whether you need to make adjustments to meet your goals. You might have to increase the monthly amount you’re putting away for retirement or reconsider your retirement age. The retirement calculators are also a useful tool for regular check-ins on your progress should your financial situation change – for example, if you change employers and earn a different salary. <h2>What other issues should I consider?</h2> It’s also important to think about your lifestyle and priorities. For instance: <ul> <li> do you aim to retire with your mortgage settled? </li> <li> are there debts you plan to clear before you retire or children who need financial support at retirement? </li> <li> would you like to renovate your home? </li> <li> would you like to buy a new car when you reach retirement age? </li> </ul> Another important consideration is healthcare costs. Many people assume that they will be able to work indefinitely and overlook the fact that healthcare costs may increase with age. <h2>Starting early matters</h2> Many people plan to work after retirement age, while others don’t plan to retire at all. It may be that they can’t afford to. They may have accessed their retirement benefits too soon, made inconsistent retirement fund contributions, or had to pay high administrative costs that eroded the final value of a retirement payout. So best be prepared. Retirement may seem like a distant event to plan and save for, especially when there are more pressing financial needs. It’s important to think about the financial decisions you make now that may cost you in the future. If you start to plan for your retirement now, your future self will thank you for it.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230553/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bomikazi-zeka-680577">Bomikazi Zeka</a>, Assistant Professor in Finance and Financial Planning, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-plan-for-my-retirement-step-one-start-right-away-230553">original article</a>. </div>

Retirement Income

Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically between 45 and 55. As women approach or experience menopause, common “change of life” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244939/">concerns</a> include hot flushes, sweats and mood swings, brain fog and fatigue. But many women may not be aware of the <a href="https://pubmed.ncbi.nlm.nih.gov/32705886/">long-term effects</a> of menopause on the heart and blood vessels that make up the cardiovascular system. Heart disease accounts for <a href="http://world-heart-federation.org/what-we-do/women-cvd/">35% of deaths</a> in women each year – more than all cancers combined. What should women – and their doctors – know about these risks? <h2>Hormones protect hearts – until they don’t</h2> As early as 1976, the <a href="https://pubmed.ncbi.nlm.nih.gov/970770/">Framingham Heart Study</a> reported more than twice the rates of cardiovascular events in postmenopausal than pre-menopausal women of the same age. Early menopause (younger than age 40) also <a href="https://pubmed.ncbi.nlm.nih.gov/25331207/">increases heart risk</a>. Before menopause, women tend to be protected by their circulating hormones: oestrogen, to a lesser extent progesterone and low levels of testosterone. These sex hormones help to relax and dilate blood vessels, reduce inflammation and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503403/">improve lipid (cholesterol) levels</a>. From the mid-40s, a decline in these hormone levels can <a href="https://pubmed.ncbi.nlm.nih.gov/10362825/">contribute to unfavourable changes</a> in cholesterol levels, blood pressure and weight gain – all risk factors for heart disease. <h2>4 ways hormone changes impact heart risk</h2> 1. Dyslipidaemia– Menopause often involves <a href="https://pubmed.ncbi.nlm.nih.gov/38002671/">atherogenic changes</a> – an unhealthy imbalance of lipids in the blood, with higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL-C), dubbed the “bad” cholesterol. There are also reduced levels of high-density lipoprotein (HDL-C) – the “good” cholesterol that helps remove LDL-C from blood. These changes are a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503403/">major risk factor for heart attack or stroke</a>. 2. Hypertension – Declines in oestrogen and progesterone levels during menopause contribute to narrowing of the large blood vessels on the heart’s surface, arterial stiffness and <a href="https://pubmed.ncbi.nlm.nih.gov/35722103/">raise blood pressure</a>. 3. Weight gain – Females are born with one to two million eggs, which develop in follicles. By the time they <a href="https://www.thewomens.org.au/health-information/fertility-information/getting-pregnant/ovulation-and-conception">stop ovulating</a> in midlife, fewer than 1,000 remain. This depletion progressively changes fat distribution and storage, from the hips to the waist and abdomen. Increased waist circumference (greater than 80–88 cm) has been <a href="https://pubmed.ncbi.nlm.nih.gov/18359190/">reported to contribute to heart risk</a> – though it is <a href="https://theconversation.com/good-news-midlife-health-is-about-more-than-a-waist-measurement-heres-why-226019">not the only factor to consider</a>. 4. Comorbidities – Changes in body composition, sex hormone decline, increased food consumption, weight gain and sedentary lifestyles impair the body’s ability to effectively use insulin. This <a href="https://pubmed.ncbi.nlm.nih.gov/11133069/">increases the risk</a> of developing metabolic syndromes such as type 2 diabetes. While risk factors apply to both genders, hypertension, smoking, obesity and type 2 diabetes confer a greater relative risk for heart disease in women. <h2>So, what can women do?</h2> Every woman has a different level of baseline cardiovascular and metabolic risk pre-menopause. This is based on their genetics and family history, diet, and lifestyle. But all women can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351755/">reduce their post-menopause heart risk with</a>: <ul> <li>regular moderate intensity exercise such as brisk walking, pushing a lawn mower, riding a bike or water aerobics for 30 minutes, four or five times every week</li> <li>a healthy heart diet with smaller portion sizes (try using a smaller plate or bowl) and more low-calorie, nutrient-rich foods such as vegetables, fruit and whole grains</li> <li>plant sterols (unrefined vegetable oil spreads, nuts, seeds and grains) each day. A review of 14 clinical trials found plant sterols, at doses of at least 2 grams a day, produced an average reduction in serum LDL-C (bad cholesterol) of about 9–14%. This could reduce the risk of heart disease by <a href="https://pubmed.ncbi.nlm.nih.gov/10731187/">25% in two years</a></li> <li>less unhealthy (saturated or trans) fats and more low-fat protein sources (lean meat, poultry, fish – especially oily fish high in omega-3 fatty acids), legumes and low-fat dairy</li> <li>less high-calorie, high-sodium foods such as processed or fast foods</li> <li>a reduction or cessation of smoking (nicotine or cannabis) and alcohol</li> <li>weight-gain management or prevention.</li> </ul> <h2>What about hormone therapy medications?</h2> Hormone therapy remains the most effective means of <a href="https://pubmed.ncbi.nlm.nih.gov/15495039/">managing hot flushes and night sweats</a> and is beneficial for <a href="https://pubmed.ncbi.nlm.nih.gov/18418063/">slowing the loss of bone mineral density</a>. The decision to recommend oestrogen alone or a combination of oestrogen plus progesterone hormone therapy depends on whether a woman has had a hysterectomy or not. The choice also depends on whether the hormone therapy benefit outweighs the woman’s disease risks. Where symptoms are bothersome, hormone therapy has <a href="https://pubmed.ncbi.nlm.nih.gov/33841322/">favourable or neutral effects on coronary heart disease risk</a> and medication risks are low for healthy women younger than 60 or within ten years of menopause. Depending on the level of stroke or heart risk and the response to lifestyle strategies, some women may also require medication management to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351755/">control high blood pressure or elevated cholesterol levels</a>. Up until the early 2000s, women were underrepresented in most outcome trials with lipid-lowering medicines. The <a href="https://pubmed.ncbi.nlm.nih.gov/25579834/">Cholesterol Treatment Trialists’ Collaboration</a> analysed 27 clinical trials of statins (medications commonly prescribed to lower cholesterol) with a total of 174,000 participants, of whom 27% were women. Statins were about as effective in women and men who had similar risk of heart disease in preventing events such as stroke and heart attack. Every woman approaching menopause should ask their GP for a 20-minute <a href="https://www.health.gov.au/news/heart-health">Heart Health Check</a> to help better understand their risk of a heart attack or stroke and get tailored strategies to reduce it. <a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/menopause-can-bring-increased-cholesterol-levels-and-other-heart-risks-heres-why-and-what-to-do-about-it-228010">original article</a>. </div>

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Do red bags get loaded onto a plane first? Travel hack goes viral

One TikTok user has racked up over 75 million views for their hack which warns travellers against buying red suitcases. The reason behind it? He claims that red suitcases are always loaded onto a plane first - meaning that they will be the last ones to come out at the baggage carousel. The <a href="https://www.tiktok.com/@airportlife_/video/7359248989134327072" target="_blank" rel="noopener">viral video</a> showed a plane's cargo being loaded, with all the red bags being loaded first. Many commenters have shared their theories on why this might be the case. "If the red are at the back then they are less likely to get left behind when unloading," one wrote. "So that it's easier to check if there is any bag left at end corner of loading area and prevent missing out black bags at dark corners, maybe," another added. However, a spokesperson for KLM Royal Dutch Airlines has debunked this theory and claimed that the video is "nonsense" and "was made purposefully to mislead or provide false information". They also said that there was simply not enough time for their baggage handlers to sort suitcases out by colour. The question of "Do red bags get loaded onto a plane first?" also made its way to Reddit, after the video went viral, and one user who claimed to be a ramp worker denied the theory. "If we had taken the time and brain power to load bags based on colour I'd still be loading flights from 2015." Image: TikTok

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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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Ambulance ramping is getting worse in Australia. Here’s why – and what we can do about it

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

I’ve been diagnosed with cancer. How do I tell my children?

What is ‘breathwork’? And do I need to do it?

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Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it

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

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