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How do I know when it’s time to replace my running shoes?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/john-arnold-178470">John Arnold</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joel-fuller-2210202">Joel Fuller</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Any runner will tell you there’s nothing better than slipping on a brand new pair of shoes. But how regularly should runners fork out hundreds of dollars on their next pair? Conventional wisdom tells us the average lifespan of a running shoe is around 500 to 800 kilometres. But where did this advice come from, and is it based on science? Some evidence comes from <a href="https://doi.org/10.1177/0363546585013004">impact testing</a> with machines designed to simulate the shoe repeatedly contacting the ground during running. Other evidence comes from <a href="https://doi.org/10.1080/19424280.2010.519348">monitoring runners who have used shoes in the real world</a> for long periods. This research is often focused on shoe materials and structure. But we think more compelling markers for the runner are shoe comfort, performance benefit and injury risk. Rather than seeking a “one-size-fits-all” answer to how many kilometres your shoes should be limited to, it’s also better to consider individual signs based on your shoe type and its purpose. <h2>The three signs to watch for</h2> Runners tend to replace their shoes for three main reasons: <ol> <li>they believe their performance is being negatively impacted</li> <li>their shoes are leading to some bodily discomfort which may cause (or has already caused) an injury</li> <li>the shoes are no longer comfortable or “feel” as good as they used to.</li> </ol> So what does the evidence say about these factors? <h2>Performance</h2> Some shoe material properties do contribute to enhanced running efficiency. Degrading these materials by racking up the kilometres may hinder peak performance on race day. This is most clearly seen in carbon fibre plate shoes used by modern elite runners to achieve <a href="https://doi.org/10.1007/s40279-020-01420-7">rapid road race times</a>. The design features <a href="https://doi.org/10.1007/s40279-018-1024-z">thought to drive this</a> are the combination of highly compliant and resilient midsole foam and a stiff embedded carbon fibre plate, which support energy storage and return. Runners will typically “save” these shoes for race day and replace them after fewer kilometres, compared to conventional running shoes. The available research does support the <a href="https://doi.org/10.1007/s40279-017-0811-2">performance benefits of these shoes</a>. However, it’s not known how long the benefits last relative to kilometres of wear. To our best knowledge, there’s only one study on running performance and shoe wear, but unfortunately it did not involve carbon fibre plate shoes. A University of Connecticut 2020 <a href="http://hdl.handle.net/11134/20002:860659513">master’s thesis</a> investigated eight college-level runners over 400 miles (643km) of Nike Pegasus shoe use. Large reductions in running economy were reported at 240km, and this was statistically significant at 320km. No reduction was observed at 160km. So, if you’re chasing personal best times, the evidence above suggests that for peak performance, shoes should be replaced somewhere between 160 and 240km (although this is not directly based on carbon fibre plate shoe research). It appears that minimising training kilometres for your favourite racing shoes – keeping them “fresh” – could contribute to peak performance on race day, compared to racing in a pair of old shoes. <h2>Injury or discomfort</h2> The link between shoe wear and injury is unclear, and based on <a href="https://bjsm.bmj.com/content/37/3/239">minimal and often conflicting evidence</a>. One study did find that <a href="https://doi.org/10.1111/sms.12154">runners who alternate their running shoes</a> have a lower risk of injury than runners who run only in the same pair of shoes over a 22-week period. Runners who alternated shoes throughout the study period would have accumulated less wear in each shoe. This provides some support for the notion that accumulating too many kilometres in your shoes may increase risk of injury. Unfortunately, the exact age of running shoes was not reported in this study. However, based on the running characteristics reported, the single-shoe pair users completed an average of 320km in their shoes (after adjusting for a small fraction who had to replace shoes during the study). This was compared to the multi-shoe pair users who used an average of 3.6 pairs of shoes, ran more total kilometres, but accumulated an average of only 200km per shoe pair. <h2>Comfort</h2> Comfort and fit are the <a href="https://www.tandfonline.com/doi/full/10.1080/19424280.2024.2353597#abstract">two most important factors</a> to runners when selecting running shoes. Evidence linking improved shoe comfort to <a href="https://journals.lww.com/acsm-msse/fulltext/2001/11000/relationship_between_footwear_comfort_of_shoe.21.aspx">reduced injury rates</a> or <a href="https://www.tandfonline.com/doi/full/10.1080/17461391.2019.1640288">improved running economy</a> is mixed, but reducing harms from poorly fitting and uncomfortable shoes is clearly a priority for runners. Most <a href="https://commons.nmu.edu/isbs/vol35/iss1/293/">runners land on their heel</a>. The repeated compression of the midsole causes the material to harden, possibly after as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534152/pdf/ijspt-12-616.pdf">little as 160km</a>, according to one study from 2017. However, there was virtually no change in the amount of cushioning runners perceived under their heel after 160km. Even after using the shoes for 640km, they felt little difference – about 3%. While at first this might seem like runners are not very good at judging when shoes lose their cushioning, it also tells us changes in perceived shoe cushioning are very gradual and may not be important for runners until they reach a certain threshold. This amount will differ from person to person, and from shoe to shoe, but research suggests it’s not until perceived cushioning reaches about a <a href="https://www.tandfonline.com/doi/full/10.1080/02640414.2020.1773613?casa_token=P87vatZhOlgAAAAA%3ACu11TZmGjKc1xYsaUlEVfWvZDvcSnx3qgKL1E2DsRYwf6hMvBiyVAm-M_-4Iauq4lwHna0QMu1IRmw">10% change</a> that runners consider it meaningful. We must be careful when applying these findings to the latest running shoes which use newer materials. But you can use it as a rule of thumb – once you notice a drop in comfort, it’s time to get a new pair. <h2>When to choose new shoes</h2> Ultimately, there’s no one simple answer for when you should get new running shoes. You may also not keep close track of how many kilometres your favourite pair has racked up. Overall, we believe the most practical advice is to keep your racing shoes “fresh” (under 240km), alternate a couple of other pairs during regular training, and replace them when you detect a notable drop in comfort.<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/238997/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/john-arnold-178470">John Arnold</a>, Senior lecturer, Sport & Exercise Biomechanics, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joel-fuller-2210202">Joel Fuller</a>, Senior Lecturer, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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-i-know-when-its-time-to-replace-my-running-shoes-238997">original article</a>. </div>

Beauty & Style

Daylight savings is about to start. But why do the days get longer?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/laura-nicole-driessen-892965">Laura Nicole Driessen</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The days are getting longer and in Australia, the switch to daylight saving time is almost upon us (for about 70% of the population, anyway). But why do we have longer days in summer and shorter days in winter? <h2>It’s all about the tilt</h2> Earth goes around the Sun in an almost circular orbit. But not everything is lined up perfectly. Earth’s axis is tilted by 23.44 degrees relative to its orbit around the Sun. Imagine Earth’s orbit as a flat frisbee with the Sun in the middle and Earth as a ball on a stick going around the edge. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.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/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Diagram of Earth's rotation around the sun." /></a><figcaption>Earth goes around the Sun in an almost circular orbit. <a class="source" href="https://www.shutterstock.com/image-vector/earths-orbit-earth-rotation-around-sun-2441275921">Angela Cini/Shutterstock</a></figcaption></figure> If Earth’s axis wasn’t tilted (if its tilt was zero degrees) the stick would be exactly perpendicular to the frisbee. If you grab that perpendicular stick and tip it 23.44 degrees sideways, that’s what Earth’s tilt looks like now. As Earth orbits the Sun, the tilt of the stick does not rotate relative to the Sun. If you were in outer space looking at the Sun and you watched from the exact same position for a whole year, you would see Earth go around the Sun while the stick stayed tilted the same direction. In other words, if the top of the stick was pointing to the right when you started watching Earth go around the Sun, it would stay pointing to the right the whole way around. This tilt gives us longer days in summer and shorter days in winter. Let’s set up the scenario so the Northern Hemisphere is the top of the planet and the Southern Hemisphere is the bottom of the planet. When Earth is on one side of the Sun, the top of the stick is pointed towards the Sun. This is summer in the Northern Hemisphere and winter in the Southern Hemisphere. Six months later, when Earth is on the other side of the Sun, the bottom of the stick is pointed towards the Sun – and the seasons are reversed. <h2>Solstices and equinoxes</h2> Those two points, when the top of the stick is pointing directly towards the Sun or directly away from the Sun, are the solstices. They are the longest and shortest days of the year, depending on your hemisphere. The shortest day of 2024 in Australia was June 21. Looking forward to sunnier times, the longest day of the year in 2024 will be December 21. In between the summer and winter solstice, we have the equinoxes – when days and nights are almost exactly the same length. Those are the days when the stick through Earth is “side-on” to the Sun. The equinox is also the day when the Sun passes directly over Earth’s equator. In 2024 this happened on March 20 at 2:06pm AEDT and September 22 at 10:43pm AEST. That means that since September 22, days have been getting longer than nights in the Southern Hemisphere. <h2>What does daylight savings do?</h2> Earth’s tilt means the Sun both rises earlier and sets later as we head towards summer. When the clocks (in some states) switch to daylight saving time, people in these states all get one hour less of sleep. However, the total length of the day doesn’t change just because we changed our clocks. For me, daylight savings means I need an extra cup of coffee in the morning for about a week before I adjust to the daylight savings-lag (like jet lag, but without the fun of travel). What it really gives us is more daylight in the evening, instead of more daylight in the morning. If you’re already a morning person, this isn’t the way to go. But if you prefer to have a long dinner in the summer sun it’s ideal. <h2>Has it always been this way?</h2> Earth’s axis hasn’t always been tilted at 23.44 degrees. It cycles from a minimum 22.1 degree tilt to a maximum 24.5 degree tilt and back again once every approximately 41,000 years. Earth’s axis also “precesses”, where the stick through it draws a circle once every approximately 26,000 years. You can see this in the animation below. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?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/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="A gif of the Earth wobbling in a circle on its axis." /></a><figcaption>Demonstration of the precession of Earth’s axis. <a class="source" href="https://science.nasa.gov/resource/axial-precession-wobble/">NASA/JPL-Caltech</a></figcaption></figure> The length of a day on Earth hasn’t always been the same, either. At the moment, the length of a day is nearly exactly 24 hours. But it’s shifting all the time by tiny amounts. This is tracked very closely by a system of telescopes and satellites. These systems measure “<a href="https://ggos.org/item/earth-orientation-parameter/#:%7E:text=Accordingly%2C%20the%20EOP%20describe%20the,as%20tides%20and%20continental%20drift">Earth orientation parameters</a>” that describe Earth’s exact orientation compared to the position of stars in the sky. These are important to astronomers because the exact location of our telescopes is important for creating accurate maps of the sky. On top of all of this, the gravitational drag from the Moon causes days to become longer by around 2.3 milliseconds every 100 years. A few billion years ago, Earth’s day was a lot shorter – <a href="https://www.earthscope.org/news/a-day-is-not-always-24-hours-how-earths-shifting-systems-cause-day-length-variation/#:%7E:text=Billions%20of%20years%20ago%2C%20the,to%20the%20day%20every%20century">only 19 hours long</a>. Even though some of us are losing an hour of sleep this weekend, at least we get to enjoy 2.3 milliseconds longer every day than our great – and great-great – grandparents did.<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/240221/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-nicole-driessen-892965">Laura Nicole Driessen</a>, Postdoctoral researcher in radio astronomy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/daylight-savings-is-about-to-start-but-why-do-the-days-get-longer-240221">original article</a>. </div>

Domestic Travel

Snakes are waking up. What should you do if you’re bitten? And what if you’re a long way from help?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/hamish-bradley-2217649">Hamish Bradley</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>; <a href="https://theconversation.com/profiles/alice-richardson-252002">Alice Richardson</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>, and <a href="https://theconversation.com/profiles/breeanna-spring-1545193">Breeanna Spring</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> From the creeks that wind through inner city Melbourne to the far outback in Western Australia, snake season is beginning. Over the cooler months snakes have been in state of <a href="https://youtu.be/FjXOzNjZjoU?si=Mc0eeayVk4VU9906">brumation</a>. This is very similar to hibernation and characterised by sluggishness and inactivity. As warmer conditions return both snakes and humans become more active in the outdoors, leading to an increased likelihood of interaction. This may happen when people are hiking, dog-walking or gardening. The risk of being bitten by a snake is exceptionally small, but knowing basic first aid could potentially save your, or another person’s, life. <h2>When a snake bites</h2> Snake bite envenomation (when venom enters the blood stream) is a significant issue in Australia, with <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja17.00094">3,000 cases annually and an average of two deaths</a>. Snake bite should always be <a href="https://stjohnwa.com.au/online-resources/first-aid-information-and-resources/snake-bite">treated</a> as a life-threatening emergency, and if you are bitten in rural or remote Australia, you will often receive an air medical emergency pick up to a regional or metropolitan hospital for advanced care. The effects of snake bites vary, depending on the species of snake and first aid measures undertaken. Australian <a href="https://www.healthdirect.gov.au/snake-bites">standard first aid guidelines</a> include: <ul> <li>calling for help (dialing 000 or activating an emergency beacon)</li> <li>applying a pressure immobilisation bandage</li> <li>resting.</li> </ul> <h2>Why pressure is important</h2> Snake venom is carried within the <a href="https://theconversation.com/what-are-lymph-nodes-and-can-a-massage-really-improve-lymphatic-drainage-209334">lymphatic system</a>. This is a collection of tiny tubes throughout the body that return fluid outside of blood vessels back to the blood stream. Muscles act as a “<a href="https://theconversation.com/pneumatic-compression-therapy-can-it-really-help-olympians-or-you-recover-after-exercise-236228">pump</a>” to help the fluid move through this system. That’s why being still, or immobilisation, is vital to slow the spread of venom. A firm pressure immobilisation bandage, applied as tight as you would for a sprained ankle, will compress these tubes and help limit the venom’s spread. Ideally bandage the entire limb on which the bite occurred and apply a splint to help further with immobilisation. It is very important that the blood supply to the limb is not limited by this bandage. Never attempt to capture or kill the snake for identification. This risks further bites and is not required for specialist care. The decision about when to give antivenom (if any) is based on the geographical location, symptoms, the results of blood tests and discussion with a toxicologist. <h2>The tyranny of distance</h2> People living in rural and remote locations may also have limited access to health care, including access to ambulance services, <a href="https://www.tandfonline.com/doi/full/10.1080/10871209.2020.1769778">snake bite first aid</a> such as bandages and splints, and to antivenom. Availability and the prompt use of antivenom have been identified as <a href="https://www.sciencedirect.com/science/article/pii/S2590171022000558">crucial factors in the effective treatment</a> of snake envenomation – but not studied in detail. Over one year (as a component of a larger three-year study) we collected information on the pre-hospital care and in-flight care with the Royal Flying Doctors Service Western Operations. During this time, 85 people from regional, rural, remote and very remote Western Australia were flown by Royal Flying Doctor Service to hospital for suspected or confirmed snake bites. Reassuringly, only five of these patients (6%) ultimately received a toxicologist’s diagnosis of envenomation. <h2>To move or not to move?</h2> Troublingly, 38 (45%) of the 85 snake bite victims continued to move around and be active following their suspected snake bite. This raises questions about whether people lack knowledge of first-aid guidelines, or whether this is a consequence of being isolated, with limited access to health care. Either way, our as-yet-unpublished research highlights the vulnerability of Australia’s rural and remote people. All patients eventually received a pressure immobilisation bandage, with an average time from bite to application of 38 minutes. Three quarters of the patients made their way to health-care site by foot, or private car, arriving on average 65 minutes after the bite. <h2>What needs to change?</h2> Our results indicate rural and remote Australians need innovative health-care solutions beyond the metropolitan guidelines, particularly when outside ambulance service areas. Basic snake bite first aid education needs to be not only reiterated but also a pragmatic approach is required in these geographically isolated locations. This would involve being vigilant, staying safe and, when isolated, always carrying emergency technology to call for help. <hr /> The authors wish to acknowledge the efforts required through this research project as it continues, including by Fergus Gardiner, Kieran Hennelly, Rochelle Menzies, James Anderson, Alex McMillan and John Fisher. Hamish Bradley is an Aeromedical Retrieval Specialist and Principal Investigator in this project.<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/234365/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hamish-bradley-2217649">Hamish Bradley</a>, Adjunct Lecturer, Anaesthetist and Aeromedical Retrieval Specialist, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>; <a href="https://theconversation.com/profiles/alice-richardson-252002">Alice Richardson</a>, Associate professor and lead of Statistical Support Network, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>, and <a href="https://theconversation.com/profiles/breeanna-spring-1545193">Breeanna Spring</a>, PhD student, Molly Wardaguga Institute for First Nations Birth Rights, Faculty of Health, <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/snakes-are-waking-up-what-should-you-do-if-youre-bitten-and-what-if-youre-a-long-way-from-help-234365">original article</a>. </div>

Body

Why are we seeing more pandemics? Our impact on the planet has a lot to do with it

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/olga-anikeeva-1522907">Olga Anikeeva</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/jessica-stanhope-1129888">Jessica Stanhope</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/peng-bi-1522908">Peng Bi</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/philip-weinstein-882901">Philip Weinstein</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Pandemics – the global spread of infectious diseases – seem to be making a comeback. In the Middle Ages we had the Black Death (plague), and after the first world war we had the Spanish flu. Tens of millions of people <a href="https://assets.cureus.com/uploads/review_article/pdf/69273/20211019-25919-an4y6h.pdf">died from these diseases</a>. Then science began to <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2011.00053/full">get the upper hand</a>, with vaccination eradicating smallpox, and polio nearly so. Antibiotics became available to treat bacterial infections, and more recently antivirals as well. But in recent years and decades pandemics <a href="https://assets.cureus.com/uploads/review_article/pdf/69273/20211019-25919-an4y6h.pdf">seem to be returning</a>. In the 1980s we had HIV/AIDS, then several flu pandemics, SARS, and now COVID (no, COVID isn’t over). So why is this happening, and is there anything we can do to avert future pandemics? <h2>Unbalanced ecosystems</h2> Healthy, stable ecosystems provide services that keep us healthy, such as supplying food and clean water, producing oxygen, and making green spaces available for our <a href="https://www.millenniumassessment.org/documents/document.356.aspx.pdf">recreation and wellbeing</a>. Another key service ecosystems provide is disease regulation. When nature is in balance – with predators controlling herbivore populations, and herbivores controlling plant growth – it’s more difficult for pathogens to emerge in a way that causes pandemics. But when human activities <a href="https://books.google.com.au/books?hl=en&lr=&id=rWozz12K1aUC&oi=fnd&pg=PP15&dq=planetary+overload&ots=c9mWuESUXN&sig=-1iP3uSOWazvC2OFLk4vginWbQQ&redir_esc=y#v=onepage&q=planetary%20overload&f=false">disrupt and unbalance ecosystems</a> – such as by way of climate change and biodiversity loss – <a href="https://academic.oup.com/bioscience/article/58/8/756/381265">things go wrong</a>. For example, climate change affects the number and distribution of plants and animals. Mosquitoes that carry diseases can move from the tropics into what used to be temperate climates as the planet warms, and may infect more people in the months that are normally disease free. We’ve studied the relationship between weather and dengue fever transmission in China, and <a href="https://pubmed.ncbi.nlm.nih.gov/27883970/">our findings</a> support the same conclusion reached by <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008118">many other studies</a>: climate change is likely to put more people at risk of dengue. Biodiversity loss can have similar effects by disrupting food chains. When ranchers cleared forests in <a href="https://www.mdpi.com/1999-4915/6/5/1911">South America</a> for their cattle to graze in the first half of the 20th century, tiny forest-dwelling, blood-feeding vampire bats suddenly had a smörgåsbord of large sedentary animals to feed on. While vampire bats had previously been kept in check by the limited availability of food and the presence of predators in the balanced <a href="https://cir.nii.ac.jp/crid/1130000797648461952">forest ecosystem</a>, numbers of this species exploded in South America. These bats carry the rabies virus, which causes <a href="https://www.who.int/news-room/fact-sheets/detail/rabies">lethal brain infections</a> in people who are bitten. Although the number of deaths from bat-borne rabies has now fallen dramatically due to vaccination programs in South America, rabies caused by bites from other animals still <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168224/">poses a global threat</a>. As urban and agricultural development impinges on natural ecosystems, there are increasing opportunities for humans and domestic animals to become infected with pathogens that would normally only be seen in wildlife – particularly when people hunt and eat animals from the wild. The HIV virus, for example, <a href="https://www.tandfonline.com/doi/abs/10.1076/jmep.27.2.163.2992">first entered human populations</a> from apes that were slaughtered for food in Africa, and then spread globally through travel and trade. Meanwhile, bats are thought to be <a href="https://www.sciencedirect.com/science/article/pii/S0006291X20319434">the original reservoir</a> for the virus that caused the COVID pandemic, which has killed more than <a href="https://www.worldometers.info/coronavirus/">7 million people</a> to date. Ultimately, until we effectively address the unsustainable impact we are having on our planet, pandemics will continue to occur. <h2>Targeting the ultimate causes</h2> Factors such as climate change, biodiversity loss and other global challenges are the ultimate (high level) cause of pandemics. Meanwhile, increased contact between humans, domestic animals and wildlife is the proximate (immediate) cause. In the case of HIV, while direct contact with the infected blood of apes was the proximate cause, the apes were only being slaughtered because large numbers of very poor people were hungry – an ultimate cause. The distinction between <a href="https://link.springer.com/article/10.1007/BF02207379">ultimate causes and proximate causes</a> is important, because we often deal only with proximate causes. For example, people may smoke because of stress or social pressure (ultimate causes of getting lung cancer), but it’s the toxins in the smoke that cause cancer (proximate cause). Generally, health services are only concerned with stopping people from smoking – and with treating the illness that results – not with removing the drivers that lead them to smoke in the first place. Similarly, we address pandemics with lockdowns, mask wearing, social distancing and vaccinations – all measures which seek to stop the spread of the virus. But we pay less attention to addressing the ultimate causes of pandemics – until perhaps very recently. <h2>A planetary health approach</h2> There’s a growing awareness of the importance of adopting a “planetary health” approach to improve human health. This <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60901-1/fulltext?nr_email_referer=1">concept</a> is based on the understanding that human health and human civilisation depend on flourishing natural systems, and the wise stewardship of those natural systems. With this approach, ultimate drivers like climate change and biodiversity loss would be prioritised in preventing future pandemics, at the same time as working with experts from many different disciplines to deal with the proximate causes, thereby reducing the risk overall. The planetary health approach has the benefit of improving both the health of the environment and human health concurrently. We are heartened by the increased uptake of teaching planetary health concepts across the environmental sciences, humanities and health sciences in many universities. As climate change, biodiversity loss, population displacements, travel and trade continue to increase the risk of disease outbreaks, it’s vital that the planetary stewards of the future have a better understanding of how to tackle the ultimate causes that drive pandemics. This article is the first in a series on the next pandemic.<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/226827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/olga-anikeeva-1522907">Olga Anikeeva</a>, Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/jessica-stanhope-1129888">Jessica Stanhope</a>, Lecturer, School of Allied Health Science and Practice, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/peng-bi-1522908">Peng Bi</a>, Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/philip-weinstein-882901">Philip Weinstein</a>, Professorial Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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-are-we-seeing-more-pandemics-our-impact-on-the-planet-has-a-lot-to-do-with-it-226827">original article</a>. </div>

Body

Readers response: What do you regret not appreciating more when you were younger?

When it comes to ageing, we often learn to appreciate things that we often dismissed when we were younger. We asked our readers what they have only truly started to appreciate with age, and the response was overwhelming. Here's what they said. Ross Forbes - Being brought up on a farm in a family environment where I was taught excellent work ethics and the value of community. Alice McMurdo - The beauty of the scenery in Scotland and not taking the opportunity to see more of the beautiful countryside when I had the chance. Pat Isaacs - My health and energy. Esther Miller - Not having to pay bills. I now understand why my daddy was always telling us cut off the light, shut the door, stop wasting food, do not pour more milk than you are going to drink. I remember him saying "wait till you have to pay for it yourselves". Lesson learned. Marie Chong - My parents. Rosalie Jones - Movement without pain. Michelle Nightingale - My family. Sally O'Neill - Being happy and free, not having any responsibilities to worry about. Chris Gray - My mum. If only I had known what I now know. Margie Buckingham - My ability to always be employed and buy my first house at 21. Also, my upbringing and great start my parents gave me by ensuring I went to a good school and studied hard. Kerri Anderson - Being younger. Linda Kauffman - My mother. Image credits: Shutterstock

Family & Pets

Yes, you do need to clean your tongue. Here’s how and why

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health. The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity. But there’s no need to wait for a trip to the doctor. Cleaning your tongue <a href="https://pubmed.ncbi.nlm.nih.gov/21797979/">twice a day</a> can help you check how your tongue looks and feels – and improve your breath. <h2>What does a healthy tongue look like?</h2> Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move. The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface. These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. <figure><iframe src="https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light <a href="https://my.clevelandclinic.org/health/symptoms/24600-tongue-color">pink</a>. A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or <a href="https://www.healthline.com/health/tongue-problems-2">other issues</a>. <h2>How should I clean my tongue?</h2> Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine. You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface. Or you can use a special <a href="https://pubmed.ncbi.nlm.nih.gov/26865433/">tongue scraper</a>. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush. Your co-workers will thank you as well – cleaning your tongue can help combat <a href="https://pubmed.ncbi.nlm.nih.gov/24165218/">stinky breath</a>. Tongue scrapers are particularly <a href="https://pubmed.ncbi.nlm.nih.gov/15341360/">effective</a> at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface. <h2>What’s that stuff on my tongue?</h2> So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP. Here’s what your tongue might be telling you. White coating Developing a white coating on the tongue’s surface is one of the <a href="https://pubmed.ncbi.nlm.nih.gov/31309703/">most common changes</a> in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days. In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause <a href="https://www.nature.com/articles/s41368-022-00163-7">serious illnesses</a>. Yellow coating This may indicate oral thrush, a <a href="https://www.nidirect.gov.uk/conditions/oral-thrush-adults">fungal infection</a> that leaves a raw surface when scrubbed. Oral thrush is <a href="https://www.aafp.org/pubs/afp/issues/2008/1001/p845.html">common</a> in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary <a href="https://pubmed.ncbi.nlm.nih.gov/7636666/">suppression of the immune system</a> or <a href="https://www.stanfordchildrens.org/en/topic/default?id=candidiasis-in-children-90-P01888">antibiotic</a> use. If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month. Black coating Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a <a href="https://my.clevelandclinic.org/health/diseases/17918-black-hairy-tongue">black hairy tongue</a>. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene. Pink patches Pink patches surrounded by a white border can make your tongue look like a map – this is called “<a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396">geographic tongue</a>”. It’s <a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/diagnosis-treatment/drc-20354401">not known</a> what causes this condition, which usually doesn’t require treatment. Pain and inflammation A red, sore tongue can indicate a <a href="https://medlineplus.gov/ency/article/003047.htm">range of issues</a>, including: <ul> <li>nutritional deficiencies such as folic acid or vitamin B12</li> <li>diseases including <a href="https://my.clevelandclinic.org/health/diseases/22377-pernicious-anemia">pernicious</a> anaemia, <a href="https://www.rch.org.au/kidsinfo/fact_sheets/kawasaki_disease/">Kawasaki disease</a> and <a href="https://www.childrens.health.qld.gov.au/health-a-to-z/scarlet-fever">scarlet fever</a></li> <li>inflammation known as <a href="https://www.ncbi.nlm.nih.gov/books/NBK560627/">glossitis</a></li> <li>injury from hot beverages or food</li> <li>ulcers, including cold sores and canker sores</li> <li><a href="https://www.nidcr.nih.gov/health-info/burning-mouth">burning mouth syndrome</a>.</li> </ul> Dryness Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt. <h2>What about cancer?</h2> White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a <a href="https://oralcancerfoundation.org/cdc/premalignant-lesions/">higher risk</a> of turning into cancer, compared to other parts of the mouth. <a href="https://pubmed.ncbi.nlm.nih.gov/36852511/">Oral cancers</a> have low survival rates due to delayed detection – and they are on the rise. So <a href="https://youtu.be/Y6QkKhEjS5M">checking your tongue</a> for changes in colour, texture, sore spots or ulcers is <a href="https://www.dhsv.org.au/oral-health-programs/oral-cancer-screening-and-prevention">critical</a>.<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/237130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, Professor and Head of Discipline - Oral Health, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</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/yes-you-do-need-to-clean-your-tongue-heres-how-and-why-237130">original article</a>. </div>

Body

Your gas stove might be making your asthma worse. Here’s what you can do about it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> We may think of air pollution as an outdoor problem, made up of car exhaust and smog. But if the air inside our homes is polluted, this can also affect our health. In Australia, around 12% of childhood asthma can <a href="https://pubmed.ncbi.nlm.nih.gov/29642816/">be attributed</a> to gas stoves and the toxic chemicals they release into the air. And while there’s a growing push to phase out gas indoors, some 38% of Australian households <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">rely on natural gas</a> for cooking. Recommended interventions – such as replacing a gas stove with electric – may not be possible for those who are renting or struggling with the cost of living. This is important because, as our <a href="https://ghrp.biomedcentral.com/articles/10.1186/s41256-024-00361-2">research</a> shows, childhood asthma is more common in socioeconomically disadvantaged areas. If you’re living with gas, here’s how it can affect you or your child’s asthma, and what you can do to improve air quality. <h2>What is asthma?</h2> Asthma is the most common chronic condition in Australian children. The respiratory condition affects <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">almost</a> 400,000 of those aged aged 14 and under – close to 9% of that age group. Asthma narrows the airways and obstructs airflow, making it hard to breath. Many people manage the condition with inhalers and <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma action plans</a>. But it can be serious and even fatal. Australian emergency departments saw <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">56,600 presentations</a> for asthma in 2020-21. While there is no single cause for asthma, both indoor and outdoor air pollution play a <a href="https://pubmed.ncbi.nlm.nih.gov/38247719/">significant role</a>. Being exposed to small <a href="https://aafa.org/asthma/asthma-triggers-causes/air-pollution-smog-asthma/#:%7E:text=Air%20pollution%20can%20increase%20your,if%20you%20already%20have%20asthma.&text=Small%20airborne%20particles%2C%20found%20in,%E2%80%9Cparticulate%20matter%E2%80%9D%20or%20PM.">airborne particles</a> increases your risk of getting asthma, and can aggravate symptoms if you already have it. <h2>Gas stoves release nitrogen dioxide</h2> The gas stoves commonly found in Australian homes release toxic chemicals into the air. They include carbon monoxide (CO), PM₂.₅ (small particles, often from <a href="https://www.epa.vic.gov.au/for-community/environmental-information/air-quality/pm25-particles-in-the-air">smoke</a>), benzene, formaldehyde and nitrogen dioxide (NO₂). All are harmful, but nitrogen dioxide in particular is <a href="https://go.gale.com/ps/i.do?id=GALE%7CA656312383&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00220892&p=AONE&sw=w&userGroupName=anon%7E7027bb9f&aty=open-web-entry">associated</a> with asthma developing and getting <a href="https://www.atsjournals.org/doi/10.1164/rccm.200408-1123OC">worse</a>. Gas heaters can also <a href="https://pubmed.ncbi.nlm.nih.gov/9731022/">produce</a> nitrogen dioxide. As nitrogen dioxide is a tasteless, invisible gas, it’s difficult to know how much is in your air at home unless you have an air monitor. However one US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662932/">study</a> showed houses with gas stoves can have nitrogen dioxide levels three times higher than houses with electric stoves. This is particularly concerning for households with children, given children tend to spend <a href="https://pubmed.ncbi.nlm.nih.gov/11477521/">most</a> of their time indoors. <h2>Banning gas</h2> There is a growing push across Australia to replace gas stoves with electric stoves, which are more energy efficient and can reduce indoor air pollution. <a href="https://www.premier.vic.gov.au/new-victorian-homes-go-all-electric-2024">Victoria</a> and the <a href="https://www.climatechoices.act.gov.au/energy/canberras-electrification-pathway/preventing-new-gas-network-connections">Australian Capital Territory</a> have announced bans on gas connections in new homes from 2024. Sydney’s Waverley council recently made a similar <a href="https://www.waverley.nsw.gov.au/environment/climate_resilience_and_reducing_emissions/go_electric">move</a>. But until a ban on using household gas appliances is implemented across the country, the problem persists for children who are currently living in old homes or rented properties with gas stoves. <h2>Do exhaust fans in the kitchen help?</h2> Using a high-efficiency <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">exhaust hood</a> placed over an existing gas cooktop can be effective. They can <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">capture</a> more than 75% of air pollutants and direct them outside. Cooking on the back burner – rather than the front burner – can also <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">improve their efficiency</a>. However exhaust hoods with lower flow rates, or hoods that don’t vent the air outside, are less effective. And an exhaust hood only improves air quality if you use it. One <a href="https://pubmed.ncbi.nlm.nih.gov/10520075/">study</a> in Melbourne found more than 40% of people didn’t use an exhaust hood regularly while cooking. For many people, installing high-efficiency exhaust hoods will not be practical – especially for those renting or experiencing socio-economic disadvantage. <h2>Natural ventilation</h2> There is a free way to ventilate your home. Keeping windows open during and after cooking will increase air flow and <a href="https://pubmed.ncbi.nlm.nih.gov/32970538/">evidence shows</a> this can improve overall air quality. However this is not always possible, especially during cooler months of the year which can be especially chilly in places such as Victoria and Tasmania. Unfortunately, people are also more likely to use gas heaters during those cooler months. <h2>What about heaters?</h2> There are two kinds of gas heaters, flued and unflued. Like cooking with gas, unflued gas heaters release air pollutants including nitrogen dioxide directly into the home. Flued heaters are better for air quality because they use a chimney, or “flue”, to send emissions outside. If you can, replacing your unflued gas heater with a flued one – or even better, an electric heater – can significantly <a href="https://pubmed.ncbi.nlm.nih.gov/15075170/">alleviate</a> asthma symptoms. If you can’t replace your unflued gas heater, <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/unflued-gas-heaters.aspx">do not use it overnight</a> in the room where you or your children sleep. Asthma can’t be cured, but its symptoms can be controlled by managing triggers – and this may be easier to do indoors than out. Improving air quality, even in a rented or old property, can help people with asthma breathe more easily.<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/238787/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, Senior Lecturer, School of Clinical Medicine, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-gas-stove-might-be-making-your-asthma-worse-heres-what-you-can-do-about-it-238787">original article</a>. </div>

Body

The psychology of retirement: why do so many athletes struggle to call time?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sarah-tillott-1462234">Sarah Tillott</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/diarmuid-hurley-1462235">Diarmuid Hurley</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Think back to when you met someone for the first time. One of the first questions you asked, or were asked, was likely: “what do you do for work?” It’s a polite, innocuous and socially ingrained way of getting to know more about a person. But it also demonstrates the central role of our professional lives as part of our personal identities. For professional athletes, their careers, exploits and recognition can become the defining aspect of their identity. So what happens when sporting careers end? The transition to retirement, across professions and countries, can be extremely tough to navigate. It can be especially difficult for elite sportspeople, who can experience retirement as a <a href="https://www.sciencedirect.com/science/article/pii/S1469029221001679?casa_token=L4g3UTN8T78AAAAA:VHqcgJN7jIpW82cp32TXq9gIcKFzD2jtf6Jc_OX-3fjpHVnowlp0p8fcqE01BVF3Qjx0bmiRz4T1">loss of identity</a>, connected to their sense of achievement, meaning and control in life. <h2>How retirement impacts athletes</h2> A common saying with many sportspeople is “<a href="https://www.forbes.com/sites/jannfreed/2024/06/29/athletes-die-twice-retirement-as-a-death/">athletes die twice</a>” – once when they retire and again at their death. Former Wallaby Brendan Cannon <a href="https://www.impact.acu.edu.au/lifestyle/after-the-final-siren-helping-athletes-to-adapt-to-life-after-sport">has spoken of</a> this difficulty: <blockquote> [People] want to talk to you about what you used to be, and all you want to focus on is what you want to become. </blockquote> During the transition to retirement, elite athletes can be affected by how they got into their chosen sport, how long they stayed in the system and the variables that either accelerated or ended their careers. Other factors include whether they played a team or individual sport, male vs female pathways, whether their exit from sport was voluntary or involuntary and their age when retiring. My (Sarah) interviews with former professional athletes demonstrate the complexity of retiring from elite sport. To the public, William Zillman, former NRL star turned vet, seems to have it all together. But it didn’t come without hardship, pain and struggles in navigating the harsh terrain of retirement. When asked about his retirement, Zillman said: “[Being an NRL player was] all I knew.” <blockquote> I turned up to work each day, I was told what to do, how to do it and when to do it […] but when I left the system, I think I lost the ability to think for myself. I went from having all the help in the world to very little – it was tough. </blockquote> Retiring from high-performance sport can have profound effects on an athlete’s <a href="https://journals.lww.com/acsm-csmr/fulltext/2020/10000/the_psychological_burden_of_retirement_from_sport.11.aspx/1000">physical and mental health</a>, as well as their social and professional development. While “regular people” usually retire in their 60s or 70s, an athlete’s retirement often occurs earlier, coinciding with crucial phases of career development and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513329/">family planning</a>. Some have to adjust from being highly paid and highly managed to surviving on minimum wages with very little support. “It’s a recipe for disaster,” Ryan James, who considers himself one of the lucky ones, said. A former forward for the Gold Coast Titans, James has been working closely with the Rugby League Players Association (RLPA) with the aim to address some of the complex issues with the transition experience. James knows only too well the struggles some people in the system face as their careers begin to wind down: <blockquote> Many of our players come into the system from disadvantaged and vulnerable backgrounds and while we have made a start, there is more we can be doing. Financial literacy and management is just one avenue we need to tackle. I’ve known too many retired, vulnerable players who were homeless, sleeping in cars with their young families. It’s devastating. </blockquote> It took former English captain turned NRL superstar James Graham a good part of 18 months to re-configure his identity: <blockquote> You come out feeling so lost and alone. Most of your life is spent training, connecting with mates, having a lot of routine and structure to almost nothing. It’s strange and confronting. </blockquote> <h2>What are the major codes doing?</h2> Across various sporting codes there are programs that aim to assist athletes to prepare for retirement. For example, <a href="https://www.rlpa.com.au/past-player-and-transition-program">the RLPA has a program</a> to support athletes who are transitioning. Other major professional Australian codes have similar programs, including <a href="https://www.aflplayers.com.au/app/uploads/2021/10/Player-Retirement-Scheme_Booklet_A5_4.pdf">the AFL</a>, <a href="https://www.thepfa.com/players/union-support/pension-scheme">Professional Footballers Association</a> (soccer) and <a href="https://auscricket.com.au/programs-community/past-player-programs/">cricket</a>. However, whether or not athletes choose to participate in these programs is usually at the discretion of the players. <h2>The importance of planning, preparation and support</h2> One of the key factors influencing how an athlete transitions into life after sport is how much they have <a href="https://theconversation.com/its-not-just-retiring-athletes-who-need-mental-health-support-young-sportspeople-need-it-too-230296">prepared for it</a>. Research with elite athletes from <a href="https://elevateaus.com.au/wp-content/uploads/2021/09/The-end-of-a-professional-sport-career-ensuring-a-positive-transition.pdf">the AFL, NRL and A-League</a> shows those who planned and prepared for life after sport and who had goals, direction and identities beyond sport, experienced more acceptance, autonomy (control) and optimism about the future. On the other hand, those who were unprepared or did not plan ahead experienced negative emotional and psychological states, and struggled to move on. This negative effect is even more pronounced for those who were forced to <a href="https://journals.lww.com/acsm-csmr/fulltext/2020/10000/the_psychological_burden_of_retirement_from_sport.11.aspx/1000">end their career due to injury</a>. <hr /> <iframe id="lQixA" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/lQixA/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How to improve the situation</h2> A recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513329/">scoping review</a> explored the notion of retirement for professional athletes and their ability to adapt to life after sport. It summarised many areas that need more attention: Make athletes aware of what’s ahead Expect that when you leave, it may be hard. Reach out to your club, coach and support services and surround yourself with people who you can talk to and who may be able to help. Athletes should expect that it will take time to adjust, and this adjustment period is crucial for mitigating the adverse effects of retirement. This adjustment period can also significantly reduce the initial negative impacts on their mental and physical health. Tailored support programs Developing tailored support programs that address the specific needs of different sports and athlete sub-groups can help mitigate the challenges associated with retirement. These programs might include career counselling, mental health support and opportunities for continuous involvement in the sports community. A need for further research There is a pressing need for more research to identify effective support mechanisms for retiring athletes. Understanding the types of support that facilitate a smoother transition can help in designing programs and interventions tailored to the unique needs of elite athletes. Additionally, mapping out the factors that aid or hinder the transition across different sports and athlete sub-groups would provide valuable insights.<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/234559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-tillott-1462234">Sarah Tillott</a>, Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/diarmuid-hurley-1462235">Diarmuid Hurley</a>, Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross 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/the-psychology-of-retirement-why-do-so-many-athletes-struggle-to-call-time-234559">original article</a>. </div>

Retirement Life

Readers response: How do you feel about online shopping compared to traditional in-store shopping?

When it comes to shopping for things we want and need, many people have a preference over whether they shop in a physical store or online. We asked our readers which they prefer when shopping for food, clothes or anything else their hearts desire, and the response was overwhelming. Here's what they said. Ellen Polsen - Why would one buy online? I like to feel and see the things I purchase, particularly garments, as fabrics today are mostly rubbish. Jennie Craven - I do a little of each. But usually use stores that I know or brands where the sizing is correct for me. I always use a payment system that I understand. Gail Ladds - I love online shopping! I often forget that I’ve bought something then get a nice surprise when it arrives lol. Debra Coats - Online is okay when you cant go to the store. I did online shopping for about 8 months after open heart surgery but when i was given the all clear to shop and drive, I was in my element as its a moment of getting out of the house and seeing others around me. Karen Peardon - I have done some online shopping (mainly craft supplies) only because I have been very ill for months but I love in-store shopping more. Retail therapy!! Christine Whyte - Have not and will not ever do it, very old school and too wary of the dangers out there, besides I like getting out and choosing for myself. Helga Bonello - I like to see feel and touch products before I buy. Online scammers are a worry, besides we need a reason to go out and be sociable. Olimpia Palumbo - My family does on line shopping and usually end up with the worst fruit and sometimes the wrong items. Image credits: Shutterstock

Money & Banking

Readers response: Do you find technology has made travel easier or more complicated?

When it comes to travelling, advancements in technology over the years have made the world much more accessible. However, sometimes tech can backfire and leave you lost or stranded. We asked our readers if they find technology has made travel easier or more complicated, and the response was overwhelming. Here's what they said. Dawn Douglas - Easier by far. You can find hotels, cafes, restaurants, tours and so on. Christine James - Easier, but we would still rather book through a travel agent. It can be good for research to where you are going though. Brian Adams - Travel without a smartphone is nearly impossible! There’s no other option to get around sometimes! June Maynard - More complicated. I'm glad I'm married to an IT tech guy! I leave it all up to him. Pat Isaacs - Everything seems more complicated with technology for me!! Karen Salvietti - Much easier to get around with technology overseas. Val Goodwin - Far more complicated for me, I'm technically challenged lol. Rosemary Miles - I’m 81 and technology has made everything easier for me. I travel overseas twice a year and hope to be able to keep doing it for a few years longer. I’m spending the grandkids’ inheritance! Image credits: Shutterstock

Travel Trouble

What causes food cravings? And what can we do about them?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/gabrielle-weidemann-91497">Gabrielle Weidemann</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/justin-mahlberg-1634725">Justin Mahlberg</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard? High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928395/">activate</a> the brain’s reward system because in the past they were <a href="https://doi.org/10.1037/a0030684">rare</a>. Now, they’re all around us. In wealthy modern societies we are bombarded by <a href="https://theconversation.com/junk-food-is-promoted-online-to-appeal-to-kids-and-target-young-men-our-study-shows-234285">advertising</a> which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering <a href="https://doi.org/10.1111/obr.12354">an intense urge</a> to eat them. Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods. <h2>What causes cravings?</h2> A food craving is an intense desire or urge to eat something, <a href="https://pubmed.ncbi.nlm.nih.gov/15589112/">often focused on a particular food</a>. We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt. Something that <a href="https://doi.org/10.1111/obr.12354">reminds us</a> of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to <a href="https://doi.org/10.1111/obr.12354">crave it</a>. The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control. <h2>What else influences our choices?</h2> While the effect of cues on our physical response is relatively automatic, what we do next is influenced by <a href="https://journals.sagepub.com/doi/pdf/10.1177/1090198107303308">complex</a> factors. Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals. But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the <a href="https://doi.org/10.1016/j.physbeh.2010.04.029">pleasure of eating</a>, over one that’s delayed or abstract – including health goals that will make us feel good in the long term. <a href="https://doi.org/10.1016/S0022-3999(00)00076-3">Stress</a> can also make us eat more. When hungry, we <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656885/">choose larger portions</a>, underestimate calories and find eating more <a href="https://www.sciencedirect.com/science/article/pii/S0195666315000793">rewarding</a>. <h2>Looking for something salty or sweet</h2> So what if a cue prompts us to look for a certain food, but it’s not available? <a href="https://doi.org/10.1016/j.appet.2014.04.005">Previous research</a> suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol. But our <a href="https://doi.org/10.1016/j.appet.2024.107640">new research</a> has confirmed something you probably knew: it’s more specific than that. If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy. <h2>Food cues and mindless eating</h2> Your <a href="https://core.ac.uk/download/pdf/161283824.pdf">eating history</a> and <a href="https://doi.org/10.1002/eat.24179">genetics</a> can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is <a href="https://doi.org/10.1016/j.appet.2015.01.004">hard</a> for almost everyone. Food cues are so powerful they can prompt us to <a href="https://doi.org/10.1177/0956797613484043">seek</a> out a certain food, even if we’re not overcome by a particularly <a href="https://doi.org/10.1177/0956797613484043">strong urge</a> to eat it. The effect is more intense if the food is easily available. This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we <a href="https://doi.org/10.1016/0031-9384(81)90310-3">eat</a>. Sometimes we use finishing the packet as the signal to stop <a href="https://doi.org/10.1016/j.physbeh.2015.03.025">eating</a> rather than hunger or desire. <h2>Is there anything I can do to resist cravings?</h2> We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in. <ul> <li> Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit. </li> <li> Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle. </li> <li> At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment. </li> <li> Make sure your goals for eating are <a href="https://www.aafp.org/pubs/fpm/issues/2018/0300/p31.html">SMART</a>. This means they are specific, measurable, achievable, relevant and time-bound. </li> <li> Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.<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/237035/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/gabrielle-weidemann-91497">Gabrielle Weidemann</a>, Associate Professor in Psychological Science, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/justin-mahlberg-1634725">Justin Mahlberg</a>, Research Fellow, Pyschology, <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/what-causes-food-cravings-and-what-can-we-do-about-them-237035">original article</a>. </div>

Food & Wine

Why do I need to take some medicines with food?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to? There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food. To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food. Different brands of the same medicine may also have different recommendations when it comes to taking it with food. <h2>Food impacts drug absorption</h2> Food can affect how fast and how much a drug is absorbed into the body in up to <a href="https://academic.oup.com/jpp/article-abstract/71/4/510/6122024?login=false">40% of medicines</a> taken orally. When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption. Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505616/">gastric emptying</a>. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption. Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly. But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach. <h2>Food can make medicines more tolerable</h2> Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets. Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452716/">one in four users affected</a>. To combat these side effects, it is generally recommended to be taken with food. The same <a href="https://amhonline.amh.net.au/auth">advice</a> is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline). Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed. <h2>Can food make medicines safer?</h2> Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/medications/latest-release">within a two-week period</a>. While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of <a href="https://www.tandfonline.com/doi/full/10.1586/14737175.6.11.1643#d1e212">bleeding, ulceration and perforation</a> with long-term use. But there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">isn’t enough research</a> to show taking ibuprofen with food reduces this risk. Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration. The <a href="https://amhonline.amh.net.au/auth">Australian Medicines Handbook</a>, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">A systematic review published in 2015</a> found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses. To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs">non-steroidal anti-inflammatory medicines</a> at the same time. For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a <a href="https://australianprescriber.tg.org.au/articles/peptic-ulcer-disease-and-non-steroidal-anti-inflammatory-drugs.html">proton pump inhibitor</a>, a medicine that reduces stomach acid and protects the stomach lining. <h2>How much food do you need?</h2> When you need to take a medicine with food, how much is enough? Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone. However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised. Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.<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/235782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Associate Professor in Pharmacy, <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/why-do-i-need-to-take-some-medicines-with-food-235782">original article</a>. </div>

Body

Thinking of trying a new diet? 4 questions to ask yourself before you do

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/melissa-eaton-1522868">Melissa Eaton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>; <a href="https://theconversation.com/profiles/verena-vaiciurgis-1647095">Verena Vaiciurgis</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>, and <a href="https://theconversation.com/profiles/yasmine-probst-235268">Yasmine Probst</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> We live in a society that glorifies dieting, with around <a href="https://doi.org/10.1111%2Fobr.12466">42% of adults globally</a> having tried to lose weight. Messages about <a href="https://doi.org/10.2196/38245">dieting and weight loss</a> are amplified on social media, with a never-ending cycle of weight loss fads and diet trends. Amid often conflicting messages and misinformation, if you’re looking for diet advice online, it’s easy to become confused and overwhelmed. So before diving into the latest weight loss trend or extreme diet, consider these four questions to help you make a more informed decision. <h2>1. Is the diet realistic?</h2> Have you considered the financial cost of maintaining the diet or lifestyle, and the time and resources that would be required? For example, do you need to purchase specific products, supplements, or follow a rigid meal plan? If the diet is coming from someone who is trying to sell you something – such as a particular weight-loss product you need in order to follow the diet – this could be a particular red flag. Many extreme diet recommendations come from a place of privilege and overlook food access, affordability, cooking skills, where you live, or even your culture and ethics. If the diet has these sorts of issues it can lead to <a href="https://doi.org/10.1017/S1368980024000132">frustration, stress, stigmatisation</a> and feelings of failure for the person trying to adhere to the diet. But the problem may be with the diet itself – not with you. <h2>2. Is there evidence to support this diet?</h2> Self-proclaimed “experts” online will often make claims focused on specific groups, known as <a href="https://doi.org/10.4103%2F0972-6748.77642">target populations</a>. This might be 30- to 50-year-old men with diabetes, for example. In some cases, evidence for claims made may come from animal studies, which might not be applicable to humans at all. So be aware that if research findings are for a group that doesn’t match your profile, then the results might not be relevant to you. It takes time and a lot of high-quality studies to tell us a “diet” is safe and effective, not just one study. Ask yourself, is it supported by multiple studies in humans? Be critical and question the claims before you accept them. For accurate information look for government websites, or ask your GP or dietitian. <h2>3. How will this diet affect my life?</h2> Food is much more than calories and nutrients. It plays many roles in our lives, and likewise diets can influence our lives in ways we often overlook. Socially and culturally, food can be a point of <a href="https://doi.org/10.1017/S1368980024000132">connection and celebration</a>. It can be a source of enjoyment, a <a href="https://doi.org/10.1016/j.jbusres.2018.12.024">source of</a> comfort, or even a way to explore new parts of the world. So when you’re considering a new diet, think about how it might affect meaningful moments for you. For example, if you’re going travelling, will your diet influence the food choices you make? Will you feel that you can’t sample the local cuisine? Or would you be deterred from going out for dinner with friends because of their choice of restaurant? <h2>4. Will this diet make me feel guilty or affect my mental health?</h2> What is your favourite meal? Does this diet “allow” you to eat it? Imagine visiting your mum who has prepared your favourite childhood meal. How will the diet affect your feelings about these special foods? Will it cause you to feel stressed or guilty about enjoying a birthday cake or a meal cooked by a loved one? Studies have shown that dieting can negatively impact our <a href="https://doi.org/10.1007%2FBF03405201">mental health</a>, and skipping meals can increase symptoms of <a href="https://doi.org/10.1016/j.jagp.2020.01.160">depression and anxiety</a>. Many diets fail to consider the psychological aspects of eating, even though our mental health is just as important as physical health. Eating should not make you feel stressed, anxious, or guilty. So before starting another diet, consider how it might affect your mental health. <h2>Moving away from a dieting mindset</h2> We’re frequently told that weight loss is the path to better health. Whereas, we can prioritise our health without focusing on our weight. Constant messages about the need to lose weight can also be harmful to mental health, and not necessarily helpful for <a href="https://doi.org/10.1152/ajpregu.00755.2010">physical health</a>. Our research has found eating in a way that prioritises health over weight loss is linked to a range of <a href="https://doi.org/10.1016/j.appet.2024.107361">positive outcomes</a> for our health and wellbeing. These include a more <a href="https://books.google.com.au/books?hl=en&lr=&id=IuZzDgAAQBAJ&oi=fnd&pg=PT9&dq=%22relationship+with+food%22&ots=e-NxLzUIFF&sig=s7p6_SijfgZE6Odx7ztV4xXPGp8&redir_esc=y#v=onepage&q=%22relationship%20with%20food%22&f=false">positive relationship</a> with food, and less guilt and stress. Our research also indicates <a href="https://doi.org/10.1016/j.appet.2024.107361">mindful and intuitive eating</a> practices – which focus on internal cues, body trust, and being present and mindful when eating – are related to lower levels of depression and stress, and greater body image and self-compassion. But like anything, it takes practice and time to build a positive relationship with food. Be kind to yourself, seek out <a href="https://www.sizeinclusivehealth.org.au/find-a-provider">weight-inclusive</a> health-care professionals, and the changes will come. Finally, remember you’re allowed to find joy in food.<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/237766/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/melissa-eaton-1522868">Melissa Eaton</a>, Accredited Practising Dietitian; PhD Candidate, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>; <a href="https://theconversation.com/profiles/verena-vaiciurgis-1647095">Verena Vaiciurgis</a>, Accredited Practising Dietitian; PhD Candidate, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>, and <a href="https://theconversation.com/profiles/yasmine-probst-235268">Yasmine Probst</a>, Associate Professor, School of Medical, Indigenous and Health Sciences, <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/thinking-of-trying-a-new-diet-4-questions-to-ask-yourself-before-you-do-237766">original article</a>. </div>

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Do mobile phones cause brain cancer? Science makes definitive call

The question of whether mobile phones - specifically the electromagnetic radiation or radio waves emitted by these devices - cause cancer has been debated and researched for a long time, and now scientists have made a definitive call. A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. The systematic review, led by the Australian Radiation Protection and Nuclear Safety Agency (Arpansa), examined over 5,000 studies, which included 63 observational studies on humans published between 1994 and 2022 and is "the most comprehensive review to date" according to review lead author, associate prof Ken Karipidis. “We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. They found no overall association between mobile phone use and cancer, even if people have used it for a long time (over 10 years) or spend a lot of time on their phones. “I’m quite confident with our conclusion. And what makes us quite confident is … even though mobile phone use has skyrocketed, brain tumour rates have remained stable,” Karipidis continued. Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. Karipidis said people hear the word radiation and assume it is similar to nuclear radiation, “and because we use a mobile phone close to the head when we’re making calls, there is a lot of concern.” He clarified that “radiation is basically energy that travels from one point to another. There are many different types, for example, ultraviolet radiation from the sun." “We’re always exposed to low-level radio waves in the everyday environment.” While exposure from mobile phones is still low, it is much higher than exposure from any other wireless technology sources since they are used close to the head, Karipidis said. The association between mobile phones and cancers came about from early studies comparing differences between those with and without brain tumours and asking about their exposure history. According to Karipidis, who is also the vice-chair of the International Commission on Non-Ionizing Radiation Protection, the results from these kind of studies tend to be biased, as the group with the tumour tend to overreport their exposure. Based on these early studies WHO’s International Agency for Research on Cancer (IARC) designated radio-frequency fields like those from mobile phones as a possible cancer risk, but Karipidis said "this classification doesn’t mean all that much”. This is because the IARC has different classifications of cancer risk, with some substances classified as a “definite” carcinogen (such as smoking), and others as “probable” or “possible” carcinogens. Tim Driscoll, a professor at the University of Sydney and chair of the Australian Cancer Council’s occupational and environmental cancers committee, also backed the systematic review. “I think people should feel reassured by this study … but it’s worthwhile just remembering that the studies aren’t perfect, but the weight of evidence certainly is that mobile phones should be considered safe to use in terms of any concerns about increased risk of cancer,” Driscoll said. Images: Shutterstock

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Readers response: What would you do if you won $1,000,000 in the lottery tomorrow?

Many people, especially those who indulge in weekly lottery tickets, like to fantasise about what they would do if they came into a huge sum of money. For some people, their first purchase would be a house or a once in a lifetime holiday, while others would give the money to family or charity. We asked our reader what they would do if they won $1 million in the lottery tomorrow, and the response was overwhelming. Here's what they said. Anne Hare - I'd find a really good accountant and put him on retainer. I'd tell no one until I'd got my finances in order. Then I'd go nuts! Irene Winters - Give most of it to our children and grandchildren, and keep a bit to pay for our old age. Erica Whitehead - Help my family and do a kitchen and bathroom renovation. Julie Armstrong - 1 million would be perfect for us to buy a house and live out the rest of ours days comfortably and not have to stress over the rent increases. Plus, we could pay off our daughter's mortgage. Darlene Challen - Fix this house up properly, sell it and find my dream little house for myself and my dog, might spend Christmas in NY and/or go on a tropical cruise, then put the rest away for my 9 grandies. Karen Neilson - Give a big chunk to my children and grandchildren, then give some to each of my siblings and Brother in Law. Keep some for myself, just enough to live comfortably for the few years I’m still on this earth! Give some to Cancer Research, The Heart Foundation and the Rescue Chopper. Give some to a couple of friend who do it tough. Marlene Hassett - Buy a new car and a couple of things around my house and the rest to my kids and grandkids. Alex Elson - I would finally, finally take our van out of the shed and go away for a while! Jeannine Litmanowicz - I would open a scholar fund for my grandchildren so they have money for higher education when they grow up. And also, since they are still young, I would treat them to a week travelling around with them and my daughters and husbands to the Balkans. Christine Whyte - Keep myself very comfortable till it was time to distribute to 10 grandkids. Image credits: Shutterstock

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I’m due for a cervical cancer screening. What can I expect? Can I do it myself? And what happened to Pap smears?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/karen-canfell-22668">Karen Canfell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/deborah-bateson-16105">Deborah Bateson</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/megan-smith-131901">Megan Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Cervical screening in Australia has <a href="https://pubmed.ncbi.nlm.nih.gov/34499374/">changed</a> over the past seven years. The test has changed, and women (and people with a cervix) now have much more choice and control. Here’s why – and what you can expect if you’re aged 25 to 74 and are <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">due for a test</a>. <h2>When and why did the test change?</h2> In 2017, Australia became one of the first two countries to transition from Pap smears to tests for the presence of the human papillomavirus (HPV). HPV causes virtually all cervical cancers, so testing for the presence of this virus is a very good indicator of a person’s current and future risk of the disease. This contrasts with the older Pap smear technology, which involved inspection of cells every two years for the changes resulting from HPV infection. The change to screening was supported by a very large body of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62218-7/abstract">international</a> and <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002388">Australian</a> data showing primary testing for HPV is more accurate than Pap smears. Women and people with a cervix who do not have HPV detected on their test are at a very low risk of developing cervical cancer over the next five years, or even longer. This was the basis for lengthening the screening interval when HPV screening was introduced. Australia now <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">recommends</a> five-yearly HPV screening, starting at age 25 up to the age of 74 for eligible people, whether or not they have been vaccinated against HPV. Many other countries are following suit to transition to HPV screening. All established screening tests – which are conducted in people without any symptoms – are associated with health benefits but also with some harms. These can include the psychological and clinical consequences of receiving a “positive” screening result, which needs to be investigated further. However, recent World Health Organization (WHO) <a href="https://www.nejm.org/doi/full/10.1056/NEJMsr2030640">reviews of the evidence</a> have found: <ul> <li>HPV is a more effective screening test than Pap smears or any other method</li> <li>it substantially reduces incidence and death rates from cervical cancer</li> <li>it is the method of cervical screening that has the <a href="https://www.nature.com/articles/s41591-023-02600-4">best balance</a> of benefits to harms.</li> </ul> As a consequence, the WHO now unequivocally <a href="https://www.who.int/publications/i/item/9789240030824">recommends</a> HPV screening as the best-practice method. <h2>Now you can collect your own sample</h2> One of the major benefits of switching to HPV screening is it opened the door for a person being able to <a href="https://www.health.gov.au/self-collection-for-the-cervical-screening-test">collect their own sample</a> (which was impossible with the Pap smear). If HPV is present, it can be detected in the vagina rather than having to directly sample the cervix. In 2022, Australia became one of the <a href="https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/landmark-changes-improving-access-to-life-saving-cervical-screenings">first countries</a> in the world to introduce a universal option to choose self-collection within a major national-level screening program. This means people eligible for screening, under the guidance of a primary care practitioner, can now choose to collect their own vaginal sample, in privacy, using a simple swab. By the end of 2023, <a href="https://www.ncsr.gov.au/about-us/news-and-media/self-collection-for-cervical-screening--at-an-all-time-high.html">27% of people</a> were choosing to take the test this way, but this is on an upward trajectory and is likely to increase further, with an <a href="https://acpcc.org.au/self-collection-campaign/">awareness campaign</a> due to start next month. <h2>So what happens when I have a test?</h2> You’ll receive an invitation from the <a href="https://www.ncsr.gov.au/information-for-participants/participant-forms-and-guides.html#cervical-forms">National Cancer Screening Register</a> to attend your first screen when you turn 25. If you’re older, you’ll receive reminders when you are due for your next test. You will be invited to visit your GP or community health service for the test. You should be asked whether you would prefer to have a clinician collect the test or whether you would prefer to take the sample yourself. There’s no right or wrong way. The accuracy of testing has been <a href="https://www.bmj.com/content/363/bmj.k4823">shown</a> to be equivalent for clinician or self-collected sampling. This is a matter of choice. If the clinician does the test, they will undertake a pelvic examination with a speculum inserted into the vagina. This enables the doctor or nurse to view the cervix and take a sample. If you are interested in the self-collection option, check whether the practice is offering it when making an appointment. If you opt for self-collection, you’ll be able to do so in private. You’ll be given a swab (which looks like a COVID test swab with a longer stem), and you’ll be given instructions about how to insert and rotate the swab in the vagina to take the sample. It takes only a few minutes. <h2>What does it mean if my test detects HPV?</h2> If your test detects HPV, this means you have an HPV infection. These are very common and by itself doesn’t mean you have cancer, or even pre-cancer (which involves changes to cervical cells that make them more likely to develop into cancer over time). It does mean, however, that you are at higher risk of having a pre-cancer, or developing one in future, and that you will benefit from further follow-up or diagnostic testing. Your doctor or nurse will <a href="https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening">guide you</a> on the next steps in line with national guidelines. If you require a diagnostic examination, this will involve a procedure called colposcopy, where the cervix is closely examined by a gynaecologist or other specially trained healthcare practitioner, and a small sample may be taken for detailed examination of the cells. If you have a pre-cancer, you can be treated simply and quickly, usually without needing to be admitted to hospital. Treatment involves ablating or removing a small area of the cervix. This treatment will drastically reduce your risk of ever developing cervical cancer. <h2>What does this mean for cervical cancer rates?</h2> Cervical screening for HPV is a very effective method of preventing cervical cancer. Because of Australia’s HPV screening, combined with HPV vaccination in younger people, Australia is <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30183-X/fulltext">expected</a> to achieve such low rates of cervical cancer by 2035 that it will be considered eliminated. Last year, the government launched a <a href="https://www.health.gov.au/sites/default/files/2023-11/national-strategy-for-the-elimination-of-cervical-cancer-in-australia.pdf">national strategy for cervical cancer elimination</a> which provides key recommendations for eliminating cervical cancer, and for doing so equitably in all groups of women and people with a cervix. One of the best things you can do to protect yourself is to have your cervical screening test when you become eligible, whether or not you have been vaccinated against HPV. Marion Saville, a pathologist and Executive Director at the Australian Centre for the Prevention of Cervical Cancer, co-authored this article.<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/229495/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/karen-canfell-22668">Karen Canfell</a>, Professor & Director, Daffodil Centre, A Joint Venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/deborah-bateson-16105">Deborah Bateson</a>, Professor of Practice, The Daffodil Centre, a joint venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/megan-smith-131901">Megan Smith</a>, Principal Research Fellow, The Daffodil Centre, a joint venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-due-for-a-cervical-cancer-screening-what-can-i-expect-can-i-do-it-myself-and-what-happened-to-pap-smears-229495">original article</a>. </div>

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Australia’s gender pay gap has hit a record low – but we still have work to do

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/leonora-risse-405312">Leonora Risse</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Australia’s gender pay gap – a key measure of economic inequality between men and women – has fallen to a record low of 11.5%. That’s down from 13% this time last year, the steepest annual fall since 2016. Ten years ago, it was almost 19%. The latest figures are great news for our economy and our society – evidence we’re getting better at recognising and fairly valuing women’s capabilities and contributions. More opportunities are now open to women in the workforce, helping them gain and retire with greater financial independence than in previous decades. But national averages don’t tell the whole story. While gender pay gaps have fallen in some industries, they’ve also been rising in others. Today, August 19, is <a href="https://www.wgea.gov.au/pay-and-gender/equal-pay-day-2024">equal pay day</a>. This marks the 50 extra days past the end of the last financial year that Australian women would need to work for their earnings to match those of their male colleagues. This offers us a timely opportunity to reflect on what exactly has driven this year’s improvement – and where we still have work to do. <h2>Women’s earnings picking up pace</h2> We calculate the gender pay gap by comparing the average weekly ordinary-time, full-time <a href="https://www.abs.gov.au/statistics/labour/earnings-and-working-conditions/average-weekly-earnings-australia">earnings</a> for men and women. In dollar terms, women are now earning $231.50, or 11.5%, less than men, on average, in their weekly full-time pay packet. <hr /> <iframe id="HwwJ5" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/HwwJ5/1/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> The recent narrowing is being driven by women’s average earnings growth picking up pace. This contrasts with <a href="https://www.abc.net.au/news/2018-10-02/fact-check-gender-pay-gap/10302358">earlier periods</a> in which the narrowing of the gap tended to be due to a slowdown in the growth of men’s earnings. <hr /> <iframe id="R7uFE" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/R7uFE/1/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>What’s behind the improvement?</h2> While changes in the gender pay gap reflect a range of economy-wide factors, the Albanese government has been quick to attribute the recent fall to the various <a href="https://www.linkedin.com/feed/update/urn:li:activity:7229747376511447040/">targeted actions</a> it has taken since coming to office. Let’s look at whether and how these actions have played a role. First, the government sought to make wage information more transparent. It <a href="https://theconversation.com/pay-secrecy-clauses-are-now-banned-in-australia-heres-how-that-could-benefit-you-195814">banned pay secrecy clauses</a> and now requires the gender pay gaps of all large companies in Australia to be <a href="https://theconversation.com/qantas-pays-women-37-less-telstra-and-bhp-20-fifty-years-after-equal-pay-laws-we-still-have-a-long-way-to-go-223870">publicly reported</a>. These reforms took effect from 2023, targeting private companies. The gender pay gap in the private sector, though higher to begin with, has fallen more swiftly than that of the public sector, suggesting these actions have had an effect. <hr /> <iframe id="ZKMdm" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/ZKMdm/1/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> Second, the government targeted gender-patterned biases in industrial relations – including the <a href="https://theconversation.com/50-years-after-equal-pay-the-legacy-of-womens-work-remains-118761">legacy effects</a> of past decisions – and instilled gender equity as a new objective of Australia’s Fair Work Act. The Fair Work Commission is now required to take gender equity into account in its wage deliberations, including its <a href="https://www.fwc.gov.au/documents/resources/2024fwcfb3500.pdf">minimum wage decision</a>. The government also introduced multi-employer bargaining in an attempt to strengthen workers’ bargaining capacity in female-concentrated sectors. The effects of these changes will continue to flow across the workforce as the Fair Work Commission undertakes its review of modern awards, prioritising those affecting <a href="https://www.fwc.gov.au/hearings-decisions/major-cases/gender-undervaluation-priority-awards-review">female-concentrated industries</a>. <figure class="align-right zoomable"><figcaption></figcaption></figure> And third, further addressing the historical undervaluation of “women’s work”, the government directly addressed low pay in female-concentrated sectors by supporting a pay rise for <a href="https://www.fairwork.gov.au/newsroom/news/15-per-cent-wage-increase-aged-care-sector">aged care workers</a>. Targeting the low pay and under-valuation of an industry that is about 87% female helped fuel the downward momentum in the overall gender pay gap. The government’s recently announced pay rise for <a href="https://ministers.education.gov.au/anthony-albanese/pay-rise-early-educators-while-keeping-fees-down-families">early childhood education and care workers</a> – a workforce that is around 95% female – will also target gender patterns in low pay once they come into effect. These government actions have been essential for undoing the gender biases embedded in existing systems. And they have complemented other initiatives that have taken effect in the past year, such as the <a href="https://www.respectatwork.gov.au/new-positive-duty-employers-prevent-workplace-sexual-harassment-sex-discrimination-and-victimisation">Respect At Work Act</a>, requiring employers to proactively stamp out sexual harassment. But there is still a way to go to keep closing the gender gaps across all parts of the workforce. <h2>Falling in some industries, rising in others</h2> Breaking down the gender pay gap in earnings by sector paints a more varied picture. In industries like construction, public administration and safety, and retail trade, it has fallen notably over the past two years. <hr /> <iframe id="poLND" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/poLND/1/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> But it remains high in industries like healthcare and social assistance, at over 20%, and finance and insurance at 18%. <hr /> <iframe id="6cLnT" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/6cLnT/2/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> In some industries, the gap has actually increased over the past two years. In arts and recreation services, as well as electricity, gas, waste and water services, it’s been continually rising. <hr /> <iframe id="M8fve" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/M8fve/1/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>That could reflect a bigger shift</h2> It’s important to interpret these figures carefully. In some instances, a widening of the gender pay gap can reflect a positive shift in an industry’s makeup, if it reflects more women joining a male-dominated sector at entry level, and growing a pipeline of senior women for the future. That’s why the Workplace Gender Equality Agency (WGEA) gives organisations a chance to explain these dynamics in their <a href="https://www.wgea.gov.au/about/our-legislation/publishing-employer-gender-pay-gaps">employer statements</a>, which are published on the WGEA website alongside organisations’ gender pay gaps. Over time, the entry of more women at the junior level can flow through to more gender balance as these women progress to senior and decision-making roles. The real test will be to ensure – by fostering more gender equitable, inclusive and respectful work cultures and systems – that they do.<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/236894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leonora-risse-405312">Leonora Risse</a>, Associate Professor in Economics, <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/australias-gender-pay-gap-has-hit-a-record-low-but-we-still-have-work-to-do-236894">original article</a>. </div>

Money & Banking

"What do you say?" TV host's heartbreaking parenting plea

An Aussie TV host has shared a heartfelt plea for advice after revealing that his 12-year-old daughter has been bullied at school. Barry Du Bois, co-host of The Living Room, shared an emotional post on Instagram admitting he is struggling to help Arabella with the bullying issue, and asked other parents for advice. “I just watched my little girl walk out the gate of our home, a place where I know she is safe and feels a sense of security and belonging,” Barry said. “She is heading to a place that doesn’t offer that same security, her school. As a parent, I’m supposed to protect and guide her through difficult times, but this morning, I am lost.” “Yesterday, Arabella came home from school claiming she was sick,” he continued. "This isn’t the first time it has happened. She wasn’t actually sick but is instead being bullied again.” Barry then asked for help from his followers on how to help his daughter, asking, “What do you say to a child when you’ve already said, ‘Don’t let them upset you. Just keep being kind. You are not the horrible things they say’.” “She said, ‘I don’t want to be special; I just want to be liked’,” the TV star added before revealing he felt “weak, angry, confused and a little fearful”. The touching post encouraged some of his famous friends to share their own stories of helping their kids deal with bullying. “My mate sent his daughter to Jiu Jitsu after being bullied. She fell in love with it and gained another level of confidence,” wrote The Bachelor Australia star Tim Robards. “Sometimes you’ve just got to go up to the parents and say, ‘your kid bullies mine’,” added Married At First Sight’s Ryan Gallagher. Image credits: Instagram

Family & Pets

I’ve recovered from a cold but I still have a hoarse voice. What should I do?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Cold, flu, COVID and <a href="https://theconversation.com/rsv-is-everywhere-right-now-what-parents-need-to-know-about-respiratory-syncytial-virus-208855">RSV</a> have been <a href="https://www.abc.net.au/news/2024-06-21/flu-whooping-cough-rsv-cases-up-as-covid-cases-unkown/104002964">circulating across Australia this winter</a>. Many of us have caught and recovered from <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">one of these</a> common upper respiratory tract infections. But for some people their impact is ongoing. Even if your throat isn’t <a href="https://theconversation.com/sore-throats-suck-do-throat-lozenges-help-at-all-184454">sore</a> anymore, your voice may still be hoarse or croaky. So what happens to the voice when we get a virus? And what happens after? Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved. <h2>Why does my voice get croaky during a cold?</h2> A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear. The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds. When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse. <figure class="align-center "><img src="https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.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/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=366&fit=crop&dpr=1 600w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=366&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=366&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=460&fit=crop&dpr=1 754w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=460&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=460&fit=crop&dpr=3 2262w" alt="Two drawn circles comparing normal vocal cords with inflamed, red vocal cords." /><figcaption>Viruses such as the common cold can inflame the vocal cords. <a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458117">Pepermpron/Shutterstock</a></figcaption></figure> Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky. In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether. Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (<a href="https://www.health.harvard.edu/staying-healthy/treatments-for-post-nasal-drip">post-nasal drip</a>). But coughing slams the vocal cords together with force. Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs. Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality. <figure class="align-center "><img src="https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.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/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=376&fit=crop&dpr=1 600w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=376&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=376&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=473&fit=crop&dpr=1 754w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=473&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=473&fit=crop&dpr=3 2262w" alt="Diagram compares healthy vocal cords with cords that have nodules, two small bumps." /><figcaption>Coughing and exertion can cause inflamed vocal cords to thicken and develop nodules. <a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458126">Pepermpron/Shutterstock</a></figcaption></figure> <h2>How can you care for your voice during infection?</h2> People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478078/">more at risk</a> of forcing their voice before it’s ready. The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold. Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest. Drink plenty of water, avoid alcohol and exposure to cigarette smoke. <a href="https://www.healthdirect.gov.au/laryngitis#:%7E:text=You%20can%20help%20your%20voice%20recover%20by%3A%201,avoid%20nasal%20decongestants%20%28these%20make%20your%20throat%20drier%29">Inhaling steam</a> by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords. Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199704001730">strains the muscles</a>. Instead, consider using “<a href="https://www.instagram.com/reel/C0d-oNIMM1y/">confidential voice</a>”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by. During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally. <h2>What should you do if your voice is still hoarse after recovery?</h2> If your voice hasn’t returned to normal after <a href="https://www.healthdirect.gov.au/laryngitis">two to three weeks</a>, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist. If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be <a href="https://britishvoiceassociation.org.uk/voicecare_vocal-nodules.htm">treated</a> with voice therapy and don’t require surgery. You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold. In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, <a href="https://www.youtube.com/watch?v=fwNPp-RS4IY">lip trills</a> (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.<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/236398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-recovered-from-a-cold-but-i-still-have-a-hoarse-voice-what-should-i-do-236398">original article</a>. </div>

Body

Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care. So what is knee osteoarthritis and what are the best ways to manage it? <h2>More than 2 million Australians have osteoarthritis</h2> Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year. Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles. Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs. <h2>Is it caused by ‘wear and tear’?</h2> Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”. <a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions. Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain. This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis. <h2>What’s the best way to manage osteoarthritis?</h2> Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines. Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms. Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management. Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future. Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you. Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time. Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>. Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs. Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits. <h2>What about surgery?</h2> People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement. Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain. However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis. Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis. Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management. The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments. <h2>I have knee osteoarthritis. What should I do?</h2> The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include: <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<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/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <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-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>. </div>

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