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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<div class="theconversation-article-body"> <p><em><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> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels.</p> <p>However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>.</p> <p>Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes.</p> <p>Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?</p> <h2>Osteoarthritis and obesity</h2> <p>Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis.</p> <p>Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation.</p> <p>For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>.</p> <p>Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help.</p> <p>But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.</p> <p>Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.</p> <h2>Semaglutide for osteoarthritis?</h2> <p>The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.</p> <p>They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.</p> <p>As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.</p> <p>The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.</p> <p>This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.</p> <p>The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>.</p> <p>Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.</p> <h2>How could semaglutide reduce knee pain?</h2> <p>It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.</p> <p>But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>.</p> <p>While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.</p> <p>The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.</p> <p>It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue.</p> <p>There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this.</p> <p>Further, it can be difficult to access.</p> <h2>I have knee osteoarthritis, what should I do?</h2> <p>Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstocl</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>.</em></p> </div>

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Balance declines with age, but exercise can help stave off some of the risk of falling

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a></em></p> <p>My wife and I were in the grocery store recently when we noticed an older woman reaching above her head for some produce. As she stretched out her hand, she lost her balance and began falling forward. Fortunately, she leaned into her grocery cart, which prevented her from falling to the ground.</p> <p>Each year, about <a href="https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm">1 in every 4 older adults experience a fall</a>. In fact, falls are the leading cause of injuries in adults ages 65 and older. Falls are the <a href="https://doi.org/10.1007/bf00298717">most common cause of hip fractures</a> and <a href="https://doi.org/10.1111/j.1553-2712.2000.tb00515.x">traumatic brain injuries</a>.</p> <p>Injuries like those are also <a href="https://doi.org/10.1056/NEJM199710303371806">risk factors for placement in a nursing home</a>, where the fall risk is <a href="https://doi.org/10.7326/0003-4819-121-6-199409150-00009">nearly three times higher than for people living in the community</a>.</p> <p>A number of physical changes with aging often go unseen preceding falls, including muscle weakness, decreased balance and changes in vision.</p> <p>I am a <a href="https://facultyprofiles.tufts.edu/evan-papa">physical therapist</a> and <a href="https://scholar.google.com/citations?user=T9B_dHQAAAAJ&amp;hl=en">clinical scientist focused on fall prevention</a> in older adults, commonly ages 65 and older. I’ve spent most of my career investigating why older adults fall and working with patients and their families to prevent falls.</p> <h2>Why aging leads to increased risk of falls</h2> <p>Aging is a process that affects the systems and tissues of every person. The rate and magnitude of aging may be different for each person, but overall physical decline is an inevitable part of life. Most people think aging starts in their 60s, but in fact we spend most of our life span <a href="https://doi.org/10.1093%2Fgeront%2Fgnv130">undergoing the process of decline</a>, typically beginning in our 30s.</p> <p>Older adults are more prone to falling for various reasons, including age-related changes in their bodies and vision changes that leave them vulnerable to environmental factors such as curbs, stairs and carpet folds.</p> <figure><iframe src="https://www.youtube.com/embed/ztPbKP68P2Q?wmode=transparent&amp;start=24" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Some straightforward measures to improve the safety of the home environment for older adults can significantly lower the risk of falls.</span></figcaption></figure> <p>Based on my experience, here are some common reasons older adults may experience falls:</p> <p>First, <a href="https://my.clevelandclinic.org/health/diseases/23167-sarcopenia">aging leads to a natural loss of muscle strength</a> and flexibility, making it more challenging to maintain balance and stability. The loss of strength and poor balance are two of the most common causes of falls.</p> <p>Second, older adults often have chronic conditions such as arthritis, Parkinson’s disease or diabetes that can affect their mobility, coordination and overall stability.</p> <p>In addition, certain medications commonly taken by older adults, <a href="https://doi.org/10.4088/jcp.18f12340">such as sedatives</a> or <a href="https://doi.org/10.1001/jamainternmed.2013.14764">blood pressure drugs</a>, can cause dizziness, drowsiness or a drop in blood pressure, leading to an increased risk of falls.</p> <p>Age-related vision changes, such as reduced depth perception and peripheral vision and difficulty in differentiating colors or contrasts, can make it harder to navigate and identify potential hazards. Hazards in the environment, such as uneven surfaces, slippery floors, inadequate lighting, loose rugs or carpets or cluttered pathways, can <a href="https://doi.org/10.1186/s12877-021-02499-x">significantly contribute to falls among older adults</a>.</p> <p>Older adults who lead a sedentary lifestyle or have limited physical activity may also experience reduced strength, flexibility and balance.</p> <p>And finally, such conditions as dementia or Alzheimer’s disease can affect judgment, attention and spatial awareness, leading to increased fall risk.</p> <h2>Theories of aging</h2> <p>There are numerous theories about why we age but there is no one unifying notion that explains all the changes in our bodies. A large portion of aging-related decline is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295054/">caused by our genes</a>, which determine the structure and function of bones, muscle growth and repair and visual depth perception, among other things. But there are also numerous lifestyle-related factors that influence our rate of aging including diet, exercise, stress and exposure to environmental toxins.</p> <p>A recent advance in scientific understanding of aging is that there is a difference between your <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">chronological age and your biological age</a>. Chronological age is simply the number of years you’ve been on the Earth. Biological age, however, refers to how old your cells and tissues are. It is based on physiological evidence from a blood test and is related to your physical and functional ability. Thus, if you’re healthy and fit, your biological age may be lower than your chronological age. However, the reverse can also be true.</p> <p>I encourage patients to focus on their biological age because it empowers them to take control over the aging process. We obviously have no control over when we are born. By focusing on the age of our cells, we can avoid long-held beliefs that our bodies are destined to develop cancer, diabetes or other conditions that <a href="https://doi.org/10.1016/j.cub.2012.07.024">have historically been tied to how long we live</a>.</p> <p>And by taking control of diet, exercise, sleep and other lifestyle factors you can actually <a href="https://doi.org/10.1111%2Facel.13538">decrease your biological age</a> and improve your quality of life. As one example, our team’s research has shown that moderate amounts of aerobic exercise <a href="https://doi.org/10.1371/journal.pone.0188538">can slow down motor decline</a> even when a person begins exercise in the latter half of the life span.</p> <h2>Fall prevention</h2> <p>Adopting lifestyle changes such as regular, long-term exercise can <a href="https://doi.org/10.1001/jamainternmed.2018.5406">reduce the consequences of aging</a>, including falls and injuries. Following a healthy diet, managing chronic conditions, reviewing medications with health care professionals, maintaining a safe home environment and getting regular vision checkups can also help reduce the risk of falls in older adults.</p> <p>There are several exercises that physical therapists use to improve balance for patients. It is important to note however, that before starting any exercise program, everyone should consult with a health care professional or a qualified physical therapist to determine the most appropriate exercises for their specific needs. Here are five forms of exercise I commonly recommend to my patients to improve balance:</p> <ol> <li> <p>Balance training can help improve coordination and <a href="https://www.sciencedirect.com/topics/neuroscience/proprioception">proprioception</a>, which is the body’s ability to sense where it is in space. By practicing movements that challenge the body’s balance, such as standing on one leg or walking heel-to-toe, the nervous system becomes better at coordinating movement and maintaining balance. A large research study analyzing nearly 8,000 older adults found that balance and functional exercises <a href="https://doi.org/10.1002/14651858.cd012424.pub2">reduce the rate of falls by 24%</a>.</p> </li> <li> <p>Strength training exercises involve lifting weights or using resistance bands to increase muscle strength and power. By strengthening the muscles in the legs, hips and core, older adults can improve their ability to maintain balance and stability. Our research has shown that strength training can also lead to <a href="https://doi.org/10.2147/cia.s104674">improvements in walking speed and a reduction in fall risk</a>.</p> </li> <li> <p>Tai chi is a gentle martial art that focuses on slow, controlled movements and shifting body weight. Research shows that it can improve balance, strength and flexibility in older adults. Several combined studies in tai chi have demonstrated a 20% reduction in the <a href="https://doi.org/10.1002/14651858.cd012424.pub2">number of people who experience falls</a>.</p> </li> <li> <p>Certain yoga poses can enhance balance and stability. Tree pose, warrior pose and mountain pose are examples of poses that can help improve balance. It’s best to <a href="https://theconversation.com/yoga-modern-research-shows-a-variety-of-benefits-to-both-body-and-mind-from-the-ancient-practice-197662">practice yoga</a> under the guidance of a qualified instructor who can adapt the poses to individual abilities.</p> </li> <li> <p>Flexibility training involves stretching the muscles and joints, which can improve range of motion and reduce stiffness. By improving range of motion, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990889/">older adults can improve their ability to move safely</a> and avoid falls caused by limitations in mobility.</p> </li> <li> <p>Use of assistive devices can be helpful when strength or balance impairments are present. Research studies involving the evaluation of canes and walkers used by older adults confirm that <a href="https://doi.org/10.1016/j.apmr.2004.04.023">these devices can improve balance and mobility</a>. Training from a physical or occupational therapist in the proper use of assistive devices is an important part of improving safety.</p> </li> </ol> <p>When I think back about the woman who nearly fell in the grocery store, I wish I could share everything we have learned about healthy aging with her. There’s no way to know if she was already putting these tips into practice, but I’m comforted by the thought that she may have avoided the fall by being in the right place at the right time. After all, she was standing in the produce aisle.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/204174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, Associate Professor of Physical Therapy and Rehabilitation Science, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/balance-declines-with-age-but-exercise-can-help-stave-off-some-of-the-risk-of-falling-204174">original article</a>.</em></p> </div>

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Coldplay pause concert to help young boy in distress

<p>Coldplay's frontman Chris Martin has paused their concert in Sydney to help a young fan in distress.</p> <p>At Sydney's Accor stadium, Martin spotted a young boy in the crowd who was being crushed behind a wall of pushing fans.</p> <p>A video of the moment was shared on TikTok, showing the singer checking in on the kid before giving him the best seat in the house.</p> <p>"You can sit right here, OK? You don't have to be squeezed," Martin told the boy during Wednesday night's show, pointing to a spot over the crowd control barriers.</p> <p>Martin then turned to the security team if they could "get some headphones for him" before turning his attention back to the boy, as he explained, "Then you don't have to be squished by all these adults is all."</p> <div class="embed" style="font-size: 16px; box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; vertical-align: baseline; outline: currentcolor !important;"><iframe class="embedly-embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border-width: 0px; border-style: none; vertical-align: baseline; width: 600px; max-width: 100%; outline: currentcolor !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7434149552611020040&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40rubygxpim%2Fvideo%2F7434149552611020040%3Flang%3Den&image=https%3A%2F%2Fp16-sign-sg.tiktokcdn.com%2Fobj%2Ftos-alisg-p-0037%2Fok6scDVKIAojceAI4DZEVneANEAjAAFROrEg6f%3Flk3s%3Db59d6b55%26x-expires%3D1731196800%26x-signature%3DOcK0QZUELKCqtkgmIvPpGukhRCc%253D%26shp%3Db59d6b55%26shcp%3D-&key=59e3ae3acaa649a5a98672932445e203&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> <p>"You sit right there my little brother, OK. Better? Now let's get you ... do you want some coke or something? The drink, I mean," he said to laughs from the crowd.</p> <p>"We'll take care of you man."</p> <p>Once the boy was safely in position, Martin carried on with the show. </p> <p>The video quickly went viral, with many commenting that Martin's care for the young fan was a "class act", with many praising his "wonderful" actions. </p> <p><em>Image credits: TikTok/Sonia Moskowitz Gordon/ZUMA/Shutterstock Editorial</em></p>

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When a baby is stillborn, grandparents are hit with ‘two lots of grief’. Here’s how we can help

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jane-lockton-811825">Jane Lockton</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/clemence-due-100240">Clemence Due</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/melissa-oxlad-811406">Melissa Oxlad</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><a href="https://www.stillbirthcre.org.au/resources/stillbirth-facts/">Six babies</a> are stillborn every day in Australia. This significant loss <a href="https://www.sciencedirect.com/science/article/pii/S1744165X12001023">affects parents</a> for years to come, often the rest of their lives. However, stillbirth also affects many others, including grandparents.</p> <p>But until now, we have not heard the experiences of grandparents whose grandchildren are stillborn. Their grief was rarely acknowledged and there are few supports tailored to them.</p> <p>Our recently published <a href="https://www.ncbi.nlm.nih.gov/pubmed/31387781">research</a> is the first in the world to specifically look at grandmothers’ experience of stillbirth and the support they need.</p> <p>In Australia, a baby <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0037109">is defined as</a> stillborn when it dies in the womb from 20 weeks’ gestation, or weighs more than 400 grams. Other countries have slightly different definitions.</p> <p><a href="https://www.stillbirthcre.org.au/resources/stillbirth-facts/">About 2,200</a> babies are stillborn each year here meaning stillbirth may be more common than many people think. And people <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60107-4/fulltext">don’t tend to talk</a> about this openly despite it leading to significant grief.</p> <p>To explore grandparents’ experience of stillbirth, we interviewed 14 grandmothers for our initial study, and a further 23 grandmothers and grandfathers since then.</p> <p>Many grandparents were not aware stillbirth was a risk today. Most felt unprepared. Like parents, grandparents experienced grief like no other after their grandchild was stillborn.</p> <p>Rose said: "The grief is always there, it never leaves you […] I don’t know why but sometimes it is still very raw."</p> <p>Sally said: "I [would do] anything in my power to take it away, even if it meant, you know, something dreadful happening to me, I would have done it."</p> <p>Grandparents also spoke of anticipating the arrival of their grandchild, and disbelief at their loss.</p> <p>Donna said: "It was as bad as it could be and […] I thought it just couldn’t be real, it couldn’t be real."</p> <p>Where grandparents lived a long way from their child, the loss was even more profound. Distance prevented them from holding their grandchild after birth, attending memorials, or helping their own children.</p> <p>Iris said: "I still miss her now […] When she was born and they had her in the hospital they would text me and say you know she’s got hair like her daddy […] and they would describe her and how beautiful she was, and that’s all they have, you know […] that’s all I have really."</p> <p>Grandparents said they wanted to hide their grief to protect their child from pain. This often made them isolated. Their relationships with family members often changed.</p> <p>Mary said: "It’s like two lots of grief […] but I don’t want it to sound like it’s as bad as my daughter’s loss. It’s different, it’s a different grief, because you’re grieving the loss of a grandchild, and you’re also grieving for your daughter and her loss and it’s like yeah you’ve been kicked in the guts twice instead of once."</p> <h2>What grandparents wanted</h2> <p>Grandparents stressed the importance and ongoing value of being involved in “memory making” and spending time with their stillborn grandchild where possible.</p> <p>Creating mementos, such as taking photos and making footprints and hand prints, were all important ways of expressing their grief. These mementos kept the baby “alive” in the family. They were also a way to ensure their own child knew the baby was loved and remembered.</p> <p>Our research also identified better ways to support grandparents. Grandparents said that if they knew more about stillbirth, they would be more confident in knowing how to help support their children. And if people were more aware of grandparents’ grief, and acknowledged their loss, this would make it easier for them to get support themselves, and reduce feelings of isolation.</p> <p>Our research also found families can recognise that grandparents grieve too, for both their child and grandchild. Grandparents can be encouraged to seek support from other family and friends. Families could also encourage grandparents to seek support from professionals if needed.</p> <p>In hospitals, midwives can adopt some simple, time efficient strategies, with a big impact on grandparents. With parent consent, midwives could include grandparents in memory making activities.</p> <p>By acknowledging the connection grandparents have to the baby, midwives can validate the grief that they experience. In recognising the supportive role of grandparents, midwives can also provide early guidance about how best to support their child.</p> <p>Hospitals can help by including grandparents in the education provided after stillbirth. This might include guidance about support for their child, or simply providing grandparents with written resources and guiding them to appropriate supports.</p> <p>In time, development of peer support programs, where grandparents support others in similar situations, could help.</p> <p>And, as a community, we can support grandparents the same way they support their own children. We can be there, listen and learn.</p> <hr /> <p><em>All grandparents’ names in this article are pseudonyms.</em></p> <p><em>If this article raises issues for you or someone you know, contact <a href="http://www.sands.org.au">Sands</a> (stillbirth and newborn death support) on 1300 072 637. Sands also has <a href="https://www.sands.org.au/images/sands-creative/brochures/127517-For-Grandparents-Brochure.pdf">written information specifically for grandparents</a> of stillborn babies.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/122313/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jane-lockton-811825">Jane Lockton</a>, PhD Candidate (Psychology, Health), <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/clemence-due-100240">Clemence Due</a>, Senior Lecturer in the School of Psychology, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/melissa-oxlad-811406">Melissa Oxlad</a>, Lecturer in the School of Psychology, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/when-a-baby-is-stillborn-grandparents-are-hit-with-two-lots-of-grief-heres-how-we-can-help-122313">original article</a>.</em></p> </div>

Family & Pets

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"I’m coming home from a party, and I don’t want to end up getting arrested": do driving apps help people break road rules?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</a></em></p> <p>Apps such as Google Maps, Apple Maps and Waze can tell drivers when they are approaching speed cameras or random breath testing stations. Countries such as Germany, France and Switzerland have banned apps from displaying these enforcement locations.</p> <p>But what effect are these apps having in Australia – are they helping drivers break road rules?</p> <p>Our new <a href="https://www.sciencedirect.com/science/article/pii/S0925753524002972">paper</a>, published in the journal Safety Science, examined this question.</p> <p>We found this technology can, in some cases, contribute to people thinking they are invincible on the roads. However, we also found they can sometimes help people drive more safely.</p> <h2>Being made aware of enforcement can help road safety</h2> <p>We conducted focus groups and interviews with a total of 58 drivers from Queensland, to understand how the use of this technology influences perceptions of being caught for breaking road rules.</p> <p>One driver told us: "If I know it’s coming up, I’ll put my phone down. If I was, say, texting or checking something, but then like once a good few 100 metres away, I sort of pick it up again, depending though."</p> <p>Another said: "It sort of depends where I am driving, I guess. Like, if I am driving on a country road and there is a speed camera there I would probably slow down for the speed camera and then sort of speed up again once I am sort of past that; it sort of depends on the circumstances."</p> <p>We also found that, for some people, being made aware of enforcement locations can help drivers better regulate their speed. This helped them comply with road rules more consistently.</p> <p>Waze also shows the speed limit in the area, which further assisted some drivers to stick to the speed limit. One driver told us: "I’m a bit careful if I just look at the speedo and just double check that I’m on the right amount of speed."</p> <p>Another said: "It just gives you a warning like, ‘OK, you need to check your speed.’ Just to double-check you’re going on the right speed perhaps or when it’s a camera coming up."</p> <h2>Concerning behaviours</h2> <p>Concerningly, we also found some drivers who use these apps are looking at and touching their screens more than they otherwise would. This can distract drivers and increase their <a href="https://www.sciencedirect.com/science/article/pii/S0925753524001097">risk of crashing</a>.</p> <p>One driver told us they post traffic updates on the app they use while driving, “which I know is wrong.”</p> <p>Another said: "Just hit the button on the phone. Just two steps after I go past the camera."</p> <p>Another driver told us: "It’s so helpful […] Especially if it’s, say, late night and I’m coming home from a party, and I don’t want to end up getting arrested."</p> <p>One driver said: "I probably feel slightly more invincible, which is probably not a good thing."</p> <p>When asked why these apps are used, one driver said: "I guess the drug and the drink-driving."</p> <h2>Apps can help and hinder road safety</h2> <p>We know breaking road rules significantly contributes to <a href="https://www.who.int/teams/social-determinants-of-health/safety-and-mobility/global-status-report-on-road-safety-2023">crashes and road fatalities</a>, with deaths on Australian roads continuing to <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">increase</a> over time.</p> <p>On the one hand, when drivers are aware of enforcement measures like cameras and police, they are more likely to stop breaking the rules in those areas. That’s particularly true for behaviours such as speeding and using a phone while driving, we found.</p> <p>Using apps that flag where cameras and police are located also means drivers would be more exposed to enforcement activities than they otherwise would be on a normal drive.</p> <p>On the other hand, our results suggest some drivers are using these applications to break road rules more often in places where they think they won’t be caught.</p> <p>These apps are also not always completely accurate.</p> <p>For instance, even though Waze can display some police operation locations such as roadside breath testing, it can’t capture <em>all</em> on-road police activities. Further, camera locations are not always up to date or accurate.</p> <h2>Weighing benefits against risks</h2> <p>While these apps do have some benefits, it’s important to weigh these against the risks.</p> <p>It’s also important to recognise traffic enforcement isn’t just there to make you comply with road rules at a specific point; it is meant to remind you of the constant risk of being caught and to encourage consistent rule compliance.</p> <p>The goal is to ensure that drivers are following the traffic rules across the entire network, not just in isolated spots.</p> <p>With road fatalities at some of the <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">highest rates we’ve seen in recent years</a>, we need everyone to work together to stop more preventable deaths and injuries.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237664/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, Senior Research Fellow in Road Safety Research, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, A/Professor Responsible Risk Management, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-coming-home-from-a-party-and-i-dont-want-to-end-up-getting-arrested-do-driving-apps-help-people-break-road-rules-237664">original article</a>.</em></p> </div>

Legal

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Who dies in a heat wave? How to help protect the vulnerable in our communities

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/myles-david-sergeant-1542267">Myles David Sergeant</a>, <a href="https://theconversation.com/institutions/mcmaster-university-930">McMaster University</a></em></p> <p>Extreme heat is a silent killer.</p> <p>From time to time, we hear about shocking cases of <a href="https://www.theguardian.com/world/2023/sep/24/football-player-heat-deaths-athlete">football players</a> and other athletes who die suddenly while exerting themselves on hot days. Those deaths are certainly tragic, but statistically they are very rare.</p> <p>Most deaths from extreme heat <a href="https://www.epa.gov/climate-indicators/climate-change-indicators-heat-related-deaths">are in older people</a>, who frequently die alone inside their homes. They often die slowly, as the heat creeps up to and sometimes past body temperature, especially when heat domes park themselves over cities and keep the temperature high all day and all night. When such deaths happen, they rarely make the news.</p> <p>Of all the climate change disasters our world is already experiencing, heat is the top killer, <a href="https://library.wmo.int/viewer/68500/download?file=1335_WMO-Climate-services-Health_en.pdf&amp;type=pdf&amp;navigator=1">as the World Meteorological Organization reported</a>. The planet was more than <a href="https://www.theguardian.com/environment/article/2024/jul/08/temperatures-1-point-5c-above-pre-industrial-era-average-for-12-months-data-shows">1.5 C above the pre-industrial baseline</a> for 12 consecutive months from July 2023 to June 2024. In July this year, we saw the hottest three days ever on record, prompting <a href="https://www.un.org/sg/en/content/sg/press-encounter/2024-07-25/secretary-generals-press-conference-extreme-heat">a special statement from United Nations Secretary-General Antonio Guterres</a>.</p> <h2>Health risks and heat</h2> <p><a href="https://www.ncbi.nlm.nih.gov/books/NBK499843/">Our bodies are made to dump excess heat</a> when we are too warm, but that process goes into reverse when the air is warmer than our core temperature. Our other main defence, sweating, doesn’t help when humidity saturates the air, making it impossible for our own moisture to evaporate.</p> <p>For the frail and elderly, who are more likely to be labouring with heart troubles, COPD or other challenges, simply sitting still in a heat wave requires an effort equivalent to walking on a treadmill. The effort is not great, but it is <a href="https://doi.org/10.1016/j.cjco.2021.10.002">steady and relentless</a>. It exhausts the body, sometimes to the <a href="https://doi.org/10.1016/S2542-5196(22)00117-6">point of no return</a>.</p> <p>Tracking heat-related deaths is challenging, and it’s changing as authorities become more aware of heat as a contributing or underlying factor to deaths by other causes. <a href="https://doi.org/10.2105/AJPH.2006.100081">A paper published by the <em>American Journal of Public Health</em></a> points out that the 1995 heat wave in Chicago likely contributed to hundreds more deaths than had first been attributed to heat itself.</p> <h2>Who is at risk?</h2> <p>Many people lack air conditioning or a way to get to a place that has it, such as a library, recreation centre or shopping mall. As a result, too many people in cities are forced to <a href="https://wmo.int/publication-series/2023-state-of-climate-services-health">endure long waves of heat</a> — waves that are occurring more frequently, lasting longer, and reaching higher temperatures — in a trend that appears set to continue getting worse.</p> <p>Air conditioning, <a href="https://www.lpm.org/news/2015-07-24/the-history-of-movie-theaters-and-air-conditioning-that-keeps-film-lovers-cool">once a luxury that drew people to summertime movie theatres on hot nights</a>, has become a necessity. Increasingly, it is also a legal requirement, as cities pass bylaws requiring landlords not to allow the temperature in their tenants’ quarters to rise above a certain level. Toronto has <a href="https://www.toronto.ca/home/311-toronto-at-your-service/find-service-information/article/?kb=kA06g000001xvbiCAA">such a bylaw</a> for rental units that have air conditioning available, capping indoor temps at 26 C between June 2 and Sept. 14.</p> <p>Such laws recognize the vulnerability of tenants who lack control over the temperature in their rental units, making heat death an especially urban tragedy, as confirmed in <a href="https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2024006/article/00001-eng.pdf?st=e6jLNMuq">a recent Statistics Canada study</a> between 2000 and 2020. Deaths from extreme heat were more likely in cities with a higher percentage of renter households.</p> <p>During a single week-long heat wave in June 2021 — the year after the period captured in the Statistics Canada study — <a href="https://www.cbc.ca/news/canada/british-columbia/bc-heat-dome-sudden-deaths-570-1.6122316">B.C.’s chief coroner found that 570 people died from heat-related causes</a> — 79 per cent of them were seniors.</p> <h2>Taking action at the community level</h2> <p>From this Global North perspective, the community members who are most likely to die from extreme heat included:</p> <ul> <li>Those over 65</li> <li>Those with more than one chronic condition (including hypertension, mental health, diabetes, heart disease, lung disease)</li> <li>Socially disadvantaged populations in our communities</li> <li>Those with mobility issues</li> <li>Those experiencing social isolation (living alone)</li> <li>Tenants with lack of air conditioning</li> <li>Those living in an urban heat island</li> </ul> <p>This problem is not going away.</p> <p>Some of the <a href="https://www.intactcentreclimateadaptation.ca/wp-content/uploads/2022/06/UoW_ICCA_2022_04-Irreversible-Extreme-Heat.pdf">actions we can take</a> to protect our most vulnerable community members include:</p> <ul> <li>Increase awareness that excessive heat is not merely uncomfortable, but dangerous.</li> <li>Make sure people are warned about impending heat waves.</li> <li>Advocate for everyone to have access to air conditioning.</li> <li>Check on and support people who live alone, especially those with no air conditioning.</li> <li>Invite people over if you have air conditioning, or help them get to community cooling stations.</li> <li>Help vulnerable people who do not have air conditioning to improvise, by freezing wet cloths, for example, to take out and hang around their necks. Doing this, especially with a fan blowing, can be surprisingly effective.</li> <li>Learn and share the <a href="https://www.canada.ca/en/health-canada/services/publications/healthy-living/fact-sheet-staying-healthy-heat.html">warning signs of heat-related illness</a>.</li> <li>Make sure they drink plenty of water and other replenishing fluids.</li> </ul> <p>While we must do our best to limit climate change to keep our planet from getting ever hotter, we must also make every effort to protect the vulnerable from the impacts of the heat that is already here.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236829/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/myles-david-sergeant-1542267">Myles David Sergeant</a>, Assistant Clinical Professor, Department of Family Medicine, <a href="https://theconversation.com/institutions/mcmaster-university-930">McMaster University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/who-dies-in-a-heat-wave-how-to-help-protect-the-vulnerable-in-our-communities-236829">original article</a>.</em></p> </div>

Caring

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For type 2 diabetes, focusing on when you eat – not what – can help control blood sugar

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Type 2 diabetes affects <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-common-is-diabetes/type-2-diabetes">1.2 million Australians</a> and accounts for <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">85-90%</a> of all diabetes cases. This chronic condition is characterised by high blood glucose (sugar) levels, which carry serious <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30058-2/abstract">health</a> risks. <a href="https://www.nature.com/articles/nrendo.2017.151">Complications</a> include heart disease, kidney failure and vision problems.</p> <p>Diet is an important way people living with type 2 diabetes manage blood glucose, alongside exercise and medication. But while we know individualised, professional dietary advice improves blood glucose, it can be <a href="https://linkinghub.elsevier.com/retrieve/pii/S0168822717317588">complex</a> and is not always <a href="https://www.publish.csiro.au/py/PY13021">accessible</a>.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">Our new study</a> looked at the impact of time-restricted eating – focusing on when you eat, rather than what or how much – on blood glucose levels.</p> <p>We found it had similar results to individualised advice from an accredited practising dietitian. But there were added benefits, because it was simple, achievable, easy to stick to – and motivated people to make other positive changes.</p> <h2>What is time-restricted eating?</h2> <p>Time-restricted eating, also known as <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-082018-124320">the 16:8 diet</a>, became popular for weight loss around 2015. Studies have since shown it is also an <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">effective way</a> for people with type 2 diabetes to manage blood glucose.</p> <p>Time-restricted eating involves limiting when you eat each day, rather than focusing on what you eat. You restrict eating to a window during daylight hours, for example between 11am and 7pm, and then fast for the remaining hours. This can sometimes naturally lead to also eating less.</p> <p>Giving your body a break from constantly digesting food in this way helps align eating with natural <a href="https://doi.org/10.1111/jne.12886">circadian rhythms</a>. This <a href="https://doi.org/10.1111/jnc.15246">can help</a> regulate metabolism and improve overall health.</p> <p>For people with type 2 diabetes, there may be specific benefits. They often have their <a href="https://doi.org/10.2337/dc12-2127">highest blood glucose</a> reading in the morning. Delaying breakfast to mid-morning means there is time for physical activity to occur to help reduce glucose levels and prepare the body for the first meal.</p> <h2>How we got here</h2> <p>We ran an <a href="https://www.mdpi.com/2072-6643/12/11/3228">initial study</a> in 2018 to see whether following time-restricted eating was achievable for people with type 2 diabetes. We found participants could easily stick to this eating pattern over four weeks, for an average of five days a week.</p> <p>Importantly, they also had improvements in blood glucose, spending less time with high levels. <a href="https://www.mdpi.com/2072-6643/12/2/505">Our previous research</a> suggests the reduced time between meals may play a role in how the hormone insulin is able to reduce glucose concentrations.</p> <p><a href="https://doi.org/10.1001/jamanetworkopen.2023.39337">Other studies</a> have confirmed these findings, which have <a href="https://doi.org/10.1186/s12986-021-00613-9">also shown</a> notable improvements in HbA1c. This is a <a href="https://www.ncbi.nlm.nih.gov/books/NBK304271/">marker</a> in the blood that represents concentrations of blood glucose over an average of three months. It is the <a href="https://journals.sagepub.com/doi/10.4137/BMI.S38440">primary clinical tool</a> used for diabetes.</p> <p>However, these studies provided intensive support to participants through weekly or fortnightly meetings with researchers.</p> <p>While we know this level of support <a href="https://www.nature.com/articles/0802295">increases</a> how likely people are to stick to the plan and improves outcomes, it is not readily available to everyday Australians living with type 2 diabetes.</p> <h2>What we did</h2> <p>In our <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">new study</a>, we compared time-restricted eating directly with advice from an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a>, to test whether results were similar across six months.</p> <p>We recruited 52 people with type 2 diabetes who were currently managing their diabetes with up to two oral medications. There were 22 women and 30 men, aged between 35 and 65.</p> <p>Participants were randomly divided into two groups: diet and time-restricted eating. In both groups, participants received four consultations across the first four months. During the next two months they managed diet alone, without consultation, and we continued to measure the impact on blood glucose.</p> <p>In the diet group, consultations focused on changing their diet to control blood glucose, including improving diet quality (for example, eating more vegetables and limiting alcohol).</p> <p>In the time-restricted eating group, advice focused on how to limit eating to a nine-hour window between 10am and 7pm.</p> <p>Over six months, we measured each participant’s blood glucose levels every two months using the HbA1c test. Each fortnight, we also asked participants about their experience of making dietary changes (to what or when they ate).</p> <h2>What we found</h2> <p>We found time-restricted eating was as effective as the diet intervention.</p> <p>Both groups had reduced blood glucose levels, with the greatest improvements occurring after the first two months. Although it wasn’t an objective of the study, some participants in each group also lost weight (5-10kg).</p> <p>When surveyed, participants in the time-restricted eating group said they had adjusted well and were able to follow the restricted eating window. Many told us they had family support and enjoyed earlier mealtimes together. Some also found they slept better.</p> <p>After two months, people in the time-restricted group were looking for more dietary advice to further improve their health.</p> <p>Those in the diet group were less likely to stick to their plan. Despite similar health outcomes, time-restricted eating seems to be a simpler initial approach than making complex dietary changes.</p> <h2>Is time-restricted eating achievable?</h2> <p>The main barriers to following time-restricted eating are social occasions, caring for others and work schedules. These factors may prevent people eating within the window.</p> <p>However, there are many benefits. The message is simple, focusing on when to eat as the main diet change. This may make time-restricted eating more translatable to people from a wider variety of socio-cultural backgrounds, as the types of foods they eat don’t need to change, just the timing.</p> <p>Many people don’t have access to more individualised support from a dietitian, and receive nutrition advice from their GP. This makes time-restricted eating an alternative – and equally effective – strategy for people with type 2 diabetes.</p> <p>People should still try to stick to <a href="https://www.eatforhealth.gov.au/guidelines/guidelines">dietary guidelines</a> and prioritise vegetables, fruit, wholegrains, lean meat and healthy fats.</p> <p>But our study showed time-restricted eating may also serve as stepping stone for people with type 2 diabetes to take control of their health, as people became more interested in making diet and other positive changes.</p> <p>Time-restricted eating might not be appropriate for everyone, especially people on medications which don’t recommend fasting. Before trying this dietary change, it’s best speak to the healthcare professional who helps you manage diabetes.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, Research Fellow in Exercise Metabolism and Nutrition, Mary MacKillop Institute for Health Research, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, Lecturer in Nutrition and Dietetics, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/for-type-2-diabetes-focusing-on-when-you-eat-not-what-can-help-control-blood-sugar-241472">original article</a>.</em></p> </div>

Body

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Music and dementia: researchers are still making discoveries about how songs can help sufferers

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/rebecca-atkinson-1288605">Rebecca Atkinson</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/ming-hung-hsu-2215063">Ming-Hung Hsu</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>Music is woven into the fabric of our everyday lives. Whether it’s lifting our spirits, pushing us to run faster or soothing us to sleep, we can all <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.713818/full">recognise its power</a>. So it’s no wonder it is increasingly being used in medical treatment.</p> <p>As well as proving very useful in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863265/">cancer treatment</a>, managing <a href="https://www.sciencedirect.com/science/article/pii/S1526590022000153">chronic pain</a> and even helping the brain <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2014.00245/full">recover after a stroke</a>, researchers have also been making great strides in using music to help patients with dementia.</p> <p>It reduces patients’ <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003477/full">anxiety and depression</a>, and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00401-7/fulltext">improves wellbeing</a> both for them and their carers <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/individual-music-therapy-for-depression-randomised-controlled-trial/A1CD72904929CECCB956F4F3B09605AF">by enhancing</a> everyone’s ability to adapt and cope with adversity or stress.</p> <p><a href="https://www.bamt.org">Music therapy</a> in the form of playing, singing or listening to music can also have a <a href="https://journals.sagepub.com/doi/abs/10.1177/1362361309105660">positive effect</a> on cognitive function – particularly for <a href="https://link.springer.com/article/10.1186/1472-6882-10-39">older adults</a> either with dementia or memory issues.</p> <p>So why does music appear to have such a powerful effect for people with dementia?</p> <h2>Music and the brain</h2> <p>About a decade ago, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053811911013000">researchers discovered that</a> when people listened to music, multiple areas of the brain were involved in processing it. These included the limbic (which processes emotions and memory), cognitive (involved with perception, learning and reaction) and motor areas (responsible for voluntary movement). This challenged preconceptions that music was processed more narrowly in the brain – and helped explain why it has such a unique neurological impact.</p> <p>Not only that, research has shown that music might help <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306987708002880">regenerate the brain</a> and its connections. Many <a href="https://www.nhs.uk/conditions/dementia/about-dementia/causes/">causes of dementia</a> centre around cell death in the brain, raising the possibility that music could help people with dementia by mending or strengthening damaged neural connections and cells.</p> <p>It’s not just any music that has a regenerative effect on the brain, though. <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2016.00103/full">Familiar and favourite music</a> has been shown to have the biggest impact on the way we feel, and is closely linked with memory and emotions. This is because listening to our favourite songs <a href="https://www.nature.com/articles/nn.2726">releases feel-good hormones</a> that give us a sense of pleasure. Curated music playlists of favourite music could be the key in helping us deal with the <a href="https://journals.sagepub.com/doi/full/10.1177/10298649211030318">stress of everyday life</a>.</p> <p>This is relevant to Alzheimer’s and other forms of dementia because researchers have discovered that parts of the brain linked with <a href="https://academic.oup.com/brain/article/138/8/2438/330016">musical memories</a> are less affected by these conditions than other areas of the brain. This explains why memories and experiences that are linked to <a href="https://link.springer.com/article/10.14283/jpad.2018.19">favourite music</a> are often preserved for people with such conditions.</p> <p>Listening to music can also <a href="https://pubmed.ncbi.nlm.nih.gov/34346261/">help manage</a> their experiences of distress, agitation and “<a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/sundowning">sundowning</a>” – where a person is more confused in the afternoon and evening.</p> <p>In a <a href="https://www.sciencedirect.com/science/article/pii/S0197457224002209?utm_campaign=STMJ_219742_AUTH_SERV_PA&amp;utm_medium=email&amp;utm_acid=224973760&amp;SIS_ID=&amp;dgcid=STMJ_219742_AUTH_SERV_PA&amp;CMX_ID=&amp;utm_in=DM500444&amp;utm_source=AC_">small study</a> conducted by us and our colleagues at the Cambridge Institute for Music Therapy Research, we showed just how great of an effect listening to music can have for people with dementia. We found that when people with dementia repeatedly listened to their favourite music, their heart rate and movements changed in direct response.</p> <p>This showed that people’s physical responses were affected by musical features like rhythm and arrangement. Their heart rate also changed when they sang along to music, or when they began reminiscing about old memories or stories while listening to a song or thinking about the music. These changes are important because they show how music affects movement, emotions and memory recall.</p> <p>Studies have also shown that during and after listening to music, people with dementia <a href="https://www.mdpi.com/2076-3425/13/7/1103">experienced less agitation</a>, aggression and anxiety, and their general mood was improved. They even needed less medication when they had regular music sessions.</p> <p>Other researchers have even begun testing the effects of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.4721?casa_token=VufeKQP7aNsAAAAA%3AMSOgiwUQYKqmmrLsUFv9glmSnc5BMxoqeMmmt3HX4BJX2Fs2UKeXjnN2850o1Umz0j1NvmrpQ3W3Pw">music training programmes</a> to support cognition for people with dementia. Results have been promising so far – with adults in the study showing improved executive functioning (problem solving, emotion regulation and attention) compared to those who took part in just physical exercise.</p> <p>So, music is likely to continue to be a useful medical treatment for people with dementia. But based on what we know so far, it’s important that it comes from the patient’s own music collection – and is used alongside other management techniques such as using drugs that can slow the progression of dementia or help manage symptoms to support self-care and wellbeing.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239446/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/rebecca-atkinson-1288605">Rebecca Atkinson</a>, Researcher in Music Therapy, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/ming-hung-hsu-2215063">Ming-Hung Hsu</a>, Senior Research Fellow, Music Therapy, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/music-and-dementia-researchers-are-still-making-discoveries-about-how-songs-can-help-sufferers-239446">original article</a>.</em></p> </div>

Mind

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NRL legend calls for help to get newborn baby home

<p>NRL legend Jesse Ramien and his partner Shell are pleading for help to get their newborn baby home after Shell's traumatic birth experience in Bali. </p> <p>The Cronulla Sharks player and his wife travelled to Bali for a friend's wedding while Shell was 33 weeks pregnant, who was cleared by her doctor before their trip. </p> <p>However, after just three days into their holiday, Shell went into early labour which quickly led to an emergency C-section, with mum under anaesthetic and baby boy Teo needing five minutes of resuscitation.</p> <p>Baby Teo was rushed into a neonatal intensive care unit, with his parents not able to meet him until the day after he was born. </p> <p>The family has been torn apart since with the parents still yet to hold Teo, who remains in an incubator, and older son Tallen returning home after Shell’s mother rushed to Bali to help.</p> <p>It is not known when the family can return to Australia, as Teo's condition is still unstable. </p> <p>“There’s just so much uncertainty here. We’ve been told by doctors it could be four weeks before our baby is okay to travel, but that could quickly change to five, six, or seven weeks, who knows,” Ramien told <em><a href="https://www.dailytelegraph.com.au/sport/nrl/sharks-star-jesse-ramiens-impassioned-plea-for-help-from-the-australian-government-to-source-flight-to-bring-baby-back-to-australia/news-story/1208830641c06ecb8c2450b95eeabece" target="_blank" rel="noopener" data-link-type="article-inline">News Corp</a></em>.</p> <p>“We’re doing everything to contact the Australian embassy to see how we can get home both as quickly as possible, so that our boy can get the medical attention he needs.”</p> <p>A family friend has set up a <a href="https://www.gofundme.com/f/need-your-help-to-fly-our-boy-teo-home" target="_blank" rel="noopener">GoFundMe</a> page to help the couple get home with their baby on an emergency flight, with $45,000 of their $100,000 goal already raised. </p> <p>“I’ll play for nothing just to get our baby boy home safely,” Ramien said.</p> <p>Shell, who received clearance from her obstetrician and the airline before travelling, ensured her pregnancy was covered by a top travel insurance package, however baby Teo’s medical costs — tallying more than $20,000 so far — are not included, while the total costs to get Baby Teo home could exceed $130,000.</p> <p>Ramien has been sharing updates on Instagram, posting a picture of his new son with the caption, “Home soon my boy,” while Shell added, “Won’t be long my boy, we'll be home soon.”</p> <p><em>Image credits: Instagram / GoFundMe</em></p>

Caring

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Eight simple changes to our neighbourhoods can help us age well

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jerome-n-rachele-251972">Jerome N Rachele</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>; <a href="https://theconversation.com/profiles/james-f-sallis-407885">James F Sallis</a>, <a href="https://theconversation.com/institutions/university-of-california-san-diego-1314">University of California, San Diego</a>, and <a href="https://theconversation.com/profiles/venurs-loh-118864">Venurs Loh</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a></em></p> <p>Where we live can play a big part in ageing well, largely because of the links between physical activity and wellbeing. <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0012/2181/AHURI_Final_Report_No214_Downsizing-amongst-older-Australians.pdf">Research shows</a> that two-thirds of Australians prefer to age in place. That is, we want to live independently in our homes for as long as we can. Our neighbourhoods and their design can then improve or hinder our ability to get out of the house and be physically active.</p> <p>The rapid ageing of Australia’s population only adds to the importance of neighbourhood design. In 2016, 15% of Australians were aged 65 or older. That proportion is <a href="https://www.aihw.gov.au/reports-statistics/population-groups/older-people/overview">projected to double</a> by 2056.</p> <p>These trends present several <a href="https://www.aihw.gov.au/reports-statistics/population-groups/older-people/reports">social and economic challenges</a>, particularly for the health sector. Designing neighbourhoods in ways that promote physical activity can help overcome these challenges.</p> <h2>Eight simple steps</h2> <p>The following is a short list of <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0471-5">evidence-based steps</a> local and state governments can take to assist older people to be physically active. These involve minor but effective changes to neighbourhood design.</p> <p><strong>Improve footpaths:</strong> Research indicates that older people have a <a href="https://theconversation.com/why-older-people-get-osteoporosis-and-have-falls-68145">higher risk of falls</a>. Ensuring footpaths are level and crack-free, and free from obstructions, will encourage walking among older people – especially those with a disability.</p> <p><strong>Connected pedestrian networks:</strong> Introducing footpaths at the end of no-through-roads and across long street blocks reduces walking distances to destinations. This makes walking a more viable option.</p> <p><strong>Slowing traffic in high-pedestrian areas:</strong> Slowing traffic <a href="https://www.heartfoundation.org.au/images/uploads/publications/Safe-Speed-Evidence-Report.pdf">improves safety</a> by reducing the risk of a collision. It also reduces the risk of <a href="https://www.ncbi.nlm.nih.gov/pubmed/28557669">death and serious injury</a> in the event of a collision.</p> <p><strong>Age-friendly street crossings:</strong> Installing longer pedestrian crossing light sequences gives older pedestrians <a href="https://academic.oup.com/ageing/article/41/5/690/47318/Most-older-pedestrians-are-unable-to-cross-the">more time to cross</a>, and installing refuge islands means those who walk more slowly can cross the street in two stages.</p> <p><strong>Disabled access at public transport:</strong> Although a form of motorised transport, public transport users undertake more incidental physical activity compared with car users. This is because they walk between transit stops and their origins and destinations. Improving disabled access helps make public transport a viable option for more older people.</p> <p><strong>Places to rest:</strong> <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1054">Providing rest spots</a> such as benches enables older people to break up their walk and rest when needed.</p> <p><strong>Planting trees:</strong> Planting trees <a href="http://www.sciencedirect.com/science/article/pii/S0277953614004109?via%3Dihub">creates more pleasant scenery</a> to enjoy on a walk. It also provides shade on hot days.</p> <p><strong>Improving safety:</strong> Ensuring that streets are well-lit and reducing graffiti and signs of decay are likely to <a href="https://www.ncbi.nlm.nih.gov/pubmed/24552845">improve perceptions of safety</a> among older people.</p> <h2>Why physical activity matters</h2> <p>Physical function – the ability to undertake everyday activities such as walking, bathing and climbing stairs – often declines as people age. The reason for this is that ageing is often accompanied by a reduction in muscle strength, flexibility and cardiorespiratory reserves.</p> <p>Regular physical activity can <a href="https://www.ncbi.nlm.nih.gov/pubmed/14552936">prevent or slow the decline</a> in physical function, even among those with existing health conditions.</p> <p>Middle-to-older aged adults can reduce their risk of physical function decline <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-7-38">by 30%</a> with regular physical activity (at least 150 minutes per week). This includes recreational physical activity, like walking the dog, or incidental physical activity, such as walking to the shops or to visit friends.</p> <p>By making minor changes as outlined above, the health and longevity of our elderly population can be extended. Such changes will help our elderly age well in place.</p> <p><em><a href="https://theconversation.com/profiles/jerome-n-rachele-251972">Jerome N Rachele</a>, Research Fellow in Social Epidemiology, Institute for Health and Ageing, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>; <a href="https://theconversation.com/profiles/james-f-sallis-407885">James F Sallis</a>, Professorial Fellow, Institute for Health and Ageing, Australian Catholic University, and Emeritus Professor, Department of Family Medicine and Public Health, <a href="https://theconversation.com/institutions/university-of-california-san-diego-1314">University of California, San Diego</a>, and <a href="https://theconversation.com/profiles/venurs-loh-118864">Venurs Loh</a>, PhD Candidate, Institute for Health and Ageing, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eight-simple-changes-to-our-neighbourhoods-can-help-us-age-well-83962">original article</a>.</em></p> </div>

Travel Tips

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Mother helps raise over $1 million for her children ahead of her death

<p>A single mother from America has left an enduring financial legacy to her two young children in the weeks before her untimely death. </p> <p>Erika Diarte-Carr, 30, started a <a href="https://www.gofundme.com/f/help-erika-and-her-children-with-funeral-expenses" target="_blank" rel="noopener">GoFundMe</a> page after she was diagnosed with terminal cancer in order to cover costs of her own funeral, as well as providing funds to raise her two kids,  Jeremiah, 7, and Aaliyah, 5.</p> <p>After setting the fundraising goal for $5,000 USD, generous members of her community spread the word of her selfless actions, with the fundraiser now reaching over $1.7 million USD and counting. </p> <p>Titled “Support Erika: A Mother planning her own funeral”, the page has garnered more than 38,000 individual donations.</p> <p>The page reads, “Dear family, friends and to all of those of you who may or may not know know me..."</p> <p>“My name is Erika Diarte-Carr. I am 30 years old and a single mother of two beautiful children. Jeremiah (7) and Aaliyah (5). ❤️ They are my whole life, light and soul. My children are my fight and what keep me going.”</p> <p>The mother then shared the tragic details of her cancer journey, as she recalled being diagnosed with stage 4 terminal cancer in May 2022 after presenting for “normal shoulder surgery”.</p> <p>“By that point, the damage had already been done. In that moment, mine and my kids’ entire lives had changed forever, as well as all of those around us,” she wrote.</p> <p>On top of her cancer diagnosis, Erika was hit with another blow in January 2024 as she was diagnosed with Cushing's Syndrome, which resulted in rapid weight gain, Type 2 diabetes, and further debilitating symptoms the mother claimed had “taken so much away” from her family.</p> <p>The page was updated in mid-September upon advice Ms Diarte-Carr had just three months to live and that treatments would “no longer help”.</p> <p>The mother added to the GoFundMe page how the excess funds would be allocated, writing, “For anyone’s concern, all the funds that have exceeded my funeral costs goal will be now put into a trust fund for my babies that way I can leave behind something for them and I can still ensure they are going to be ok as they grow up."</p> <p>On October 4th, the mother thanked donors and announced she and her family were able to take one final trip together hoping to leave her kids with “memories that’ll last a lifetime”.</p> <p>Just days later, Erika's cousin shared a post to social media to announce that Erika had passed away on October 12th.</p> <p>“It is with a heavy heart that this is the final update I will be giving for my cousin Erika,” she wrote on Facebook.</p> <p>“She fought a long and hard battle. She was strong and held on as long as she could for her babies. I know she was so thankful for all of your support and love and prayers.”</p> <p><em>Image credits: GoFundMe</em></p>

Caring

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The science of happier dogs: 5 tips to help your canine friends live their best life

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>When you hear about “science focused on how dogs can live their best lives with us” it sounds like an imaginary job made up by a child. However, the field of <a href="https://www.rnz.co.nz/podcast/ourchangingworld?share=2ec8e0ad-5008-4b2d-ae2e-a288e2a77f50">animal welfare science is real</a> and influential.</p> <p>As our most popular animal companion and coworker, dogs are very deserving of scientific attention. In recent years we’ve learned more about <a href="https://theconversation.com/dogs-can-get-dementia-but-lots-of-walks-may-lower-the-risk-189297">how dogs are similar to people</a>, but also how they are distinctly themselves.</p> <p>We often think about how dogs help us – as companions, <a href="https://theconversation.com/meet-moss-the-detection-dog-helping-tassie-devils-find-love-142909">working as detectors</a>, and keeping us <a href="https://theconversation.com/is-owning-a-dog-good-for-your-health-238888">safe and healthy</a>. Dog-centric science helps us <a href="https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2021.666898/full">think about the world from a four-paw perspective</a> and apply this new knowledge so dogs can enjoy a good life.</p> <p>Here are five tips to keep the tails in your life wagging happily.</p> <h2>1. Let dogs sniff</h2> <p>Sniffing <a href="https://www.psychologytoday.com/intl/blog/animal-emotions/201902/allowing-dogs-sniff-helps-them-think-positively">makes dogs happier</a>. We tend to forget they live in a smell-based world because we’re so visual. Often taking the dog for a walk is our daily physical activity but we should remember it could be our dogs’ only time out of the home environment.</p> <p>Letting them have a really good sniff of that tree or post is full of satisfying information for them. It’s their nose’s equivalent of us standing at the top of a mountain and enjoying a rich, colour-soaked, sunset view.</p> <h2>2. Give dogs agency</h2> <p>Agency is a <a href="https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2023.1284869/full">hot topic in animal welfare science</a> right now. For people who lived through the frustration of strict lockdowns in the early years of COVID, it’s easy to remember how not being able to go where we wanted, or see who we wanted, when we wanted, impacted our mental health.</p> <p>We’ve now learned that <a href="https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2023.1250251/full">giving animals choice and control</a> in their lives is important for their mental wellbeing too. We can help our dogs enjoy better welfare by creating more choices and offering them control to exercise their agency.</p> <p>This might be installing a doggy door so they can go outside or inside when they like. It could be letting them decide which sniffy path to take through your local park. Perhaps it’s choosing which three toys to play with that day from a larger collection that gets rotated around. Maybe it’s putting an old blanket down in a new location where you’ve noticed the sun hits the floor for them to relax on.</p> <p>Providing choices doesn’t have to be complicated or expensive.</p> <h2>3. Recognise all dogs are individuals</h2> <p>People commonly ascribe certain personality traits to certain dog breeds. But just like us, dogs have their own personalities <a href="https://scitechdaily.com/food-vs-toys-scientists-reveal-what-dogs-truly-prefer/">and preferences</a>. Not all dogs are going to like the same things and a new dog we live with may be completely different to the last one.</p> <p>One dog might like to go to the dog park and run around with other dogs at high speed for an hour, while another dog would much rather hang out with you chewing on something in the garden.</p> <p>We can see as much <a href="https://www.science.org/content/article/your-dog-s-breed-doesn-t-determine-its-personality-study-suggests">behavioural variation within breeds as we do between them</a>. Being prepared to meet dogs where they are, as individuals, is important to their welfare.</p> <p>As well as noticing what dogs like to do as individuals, it’s important not to force dogs into situations they don’t enjoy. <a href="https://www.rspca.org.uk/adviceandwelfare/pets/dogs/behaviour/understanding">Pay attention to behaviour</a> that indicates dogs aren’t comfortable, such as looking away, licking their lips or yawning.</p> <h2>4. Respect dogs’ choice to opt out</h2> <p>Even in our homes, we can provide options if our dogs don’t want to share in every activity with us. Having a quiet place that dogs can retreat to is really important in enabling them to opt out if they want to.</p> <p>If you’re watching television loudly, it may be too much for <a href="https://www.psychologytoday.com/au/blog/canine-corner/202407/how-good-is-a-dogs-hearing-compared-to-humans">their sensitive ears</a>. Ensure a door is open to another room so they can retreat. Some dogs might feel overwhelmed when visitors come over; giving them somewhere safe and quiet to go rather than forcing an interaction will help them cope.</p> <p>Dogs can be terrific role models for children when teaching empathy. We can demonstrate consent by letting dogs approach us for pats and depart when they want. Like seeing exotic animals perform in circuses, dressing up dogs for our own entertainment seems to have had its day. If you asked most dogs, they don’t want to wear costumes or be part of your Halloween adventures.</p> <h2>5. Opportunities for off-lead activity – safely.</h2> <p>When dogs are allowed to run off-lead, they use space differently. They tend to explore more widely and go faster than they do when walking with us on-lead. This offers them important and fun physical activity to keep them fit and healthy.</p> <figure><iframe src="https://www.youtube.com/embed/2AchEFiDwA8?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Demonstrating how dogs walk differently when on- and off-lead.</span></figcaption></figure> <p>A recent exploration of <a href="https://pursuit.unimelb.edu.au/articles/we-checked-if-melbourne-really-is-a-dog-friendly-city">how liveable cities are for dogs</a> mapped all the designated areas for dogs to run off-leash. Doggy density ranged from one dog for every six people to one dog for every 30 people, depending on where you live.</p> <p>It also considered how access to these areas related to the annual registration fees for dogs in each government area compared, with surprising differences noted across greater Melbourne. We noted fees varied between A$37 and $84, and these didn’t relate to how many off-lead areas you could access.</p> <p>For dog-loving nations, such as Australia, helping our canine friends live their best life feels good. <a href="https://www.rnz.co.nz/national/programmes/afternoons/audio/2018957756/our-changing-world-the-science-behind-dog-welfare">Science that comes from a four-paw perspective</a> can help us reconsider our everyday interactions with dogs and influence positive changes so we can live well, together.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236952/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, Research Fellow, Animal Welfare Science Centre, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-science-of-happier-dogs-5-tips-to-help-your-canine-friends-live-their-best-life-236952">original article</a>.</em></p> </div>

Family & Pets

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Hugh Jackman pleads for help in search for missing Broadway star

<p>Hugh Jackman is using his influence and wide reach to assist in the search for his former Broadway co-star, Zelig Williams, who has been missing since early October.</p> <p>Williams, a 28-year-old performer known for his roles in <em>MJ The Musical</em> and <em>Hamilton</em>, was last seen on October 3 at his home in Columbia, South Carolina. At the time of his disappearance, he was wearing a white T-shirt, black shorts and brown slides.</p> <p>The non-profit organisation <a href="https://blackandmissinginc.com/" target="_blank" rel="noopener">Black and Missing</a> has released a missing person poster, stating that authorities believe Williams was last spotted driving in the Congaree National Park area, where his vehicle was later found abandoned.</p> <p>Jackman, who performed with Williams during the 2019 concert tour <em>The Man. The Music. The Show</em>, has taken to social media to amplify the call for information. On his 56th birthday, the Australian actor shared a photo of Williams and his mother with a link to a news report from <em>Good Morning America</em>, urging his 34.5 million Instagram followers to report any information to local authorities.</p> <p>"If anyone has any information on the whereabouts of ZELIG WILLIAMS please reach out to your local authorities," Jackman wrote in his post. He has continued to spread the message, using Instagram stories to ask followers to contact the Richland County Sheriff's Office with any potential leads.</p> <p>"Zelig, we love you and are praying for your safe return. Please pass this message on!!!" Jackman added.</p> <p>Williams' disappearance has left his family in anguish. His aunt, Christine McLaughlin Barber, initially believed he might have been involved in a car accident after receiving an SOS signal from his phone around 9:50am on October 3, shortly after he left home. However, authorities have since ruled out this possibility.</p> <p>Richland County Sheriff Leon Lott revealed to local news outlet WISTV that an extensive search operation has been underway, utilising helicopters, boats and drones to cover vast areas. "We've searched on foot, in the air, at various locations," Lott said. "We are also using other investigative techniques involving cell phones and other means, which I cannot disclose at this time."</p> <p>Lott also said that Williams is in need of prescription medication, adding urgency to the search.</p> <p>Williams' cousin, Mieoki Corbin-Jacobs, expressed the family's heartbreak, telling WISTV: "It's devastation. It's devastation for someone who is so close to his family to just disappear like that... there's no way to describe it."</p> <p>The Broadway community, along with Jackman, continues to rally in hopes of locating Williams and bringing him home safely.</p> <p><em>Images: Instagram</em></p>

Caring

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Helping alleviate the pain of arthritis  

<p>One in seven Australians, or 3.6 million people, are living with arthritis, a leading cause of chronic pain and the second most common cause of disability and early retirement due to ill health, according to Arthritis Australia.</p> <p>Mike Whitney is a big fan of Arborvitae after having spent years playing cricket for NSW and Australia resulting in many aches and pains throughout his body. The joys of sport that many people experience as they get older.</p> <p>Arborvitae Health and Wellbeing has spent years formulating a solution to target debilitating pain caused by arthritis and other chronic conditions. “We wanted it to be a natural product as well,” says Arborvitae Director Brendan Howell.</p> <p>Since it was founded in 2014, Arborvitae Health and Wellbeing, has used Pycnogenol (French maritime pine bark extract) as the main ingredient in its range of natural anti-inflammatory and antioxidant supplements. The natural plant extract, which grows on the coast of south-west France, is used alongside aloe vera, papain enzyme and honey.</p> <p>“Arborvitae’s unique formulation of natural ingredients provides a potent supplement and is based on years of research into the impact of inflammation in the human body,” Howell says.</p> <p>The company’s main product, Arborvitae Joint Health, may help provide relief from symptoms of mild-moderate arthritis, joint pain, inflammation, soreness and stiffness.</p> <p>‘‘Arborvitae does make a difference, and that has been supported by over 160 clinical trials on its main ingredient Pycnogenol across a broad range of conditions and Arborvitae’s own clinical study,” Howell says.</p> <p>The recent clinical study on Arborvitae Joint Health has shown some exceptional results with pain relief (<strong>66%</strong> decrease in pain test scores), a <strong>50%</strong> increase in walking distance, a <strong>56%</strong> decrease in inflammation in blood tests (CRP), a <strong>78%</strong> reduction in their use of on-demand medications and a <strong>50%</strong> improvement in quality-of-life scores.</p> <p><img class="alignnone size-full wp-image-71490" src="https://oversixtydev.blob.core.windows.net/media/2024/10/Infographic_1280.jpg" alt="" width="1280" height="899" /></p> <p>“The customer feedback we receive also demonstrates the product's efficacy and enables us to provide real examples of its success when speaking with customers,” Brendan Howell said.</p> <p>As an example, Tracy from All Sort Cakes in Sydney is a regular Arborvitae customer and states:</p> <p>“<em>Arborvitae has been a game </em><em>changer for me. I’ve suffered with sore hands for years and I probably don’t have to tell all of you fellow cake makers how debilitating it can be. A friend suggested I try Arborvitae. So the first bottle I wasn’t sure but I was told to wait till I finish the second bottle to feel the full effects. And yep! Omg!!! The pain all but disappeared.”</em></p> <p><img class="alignnone size-full wp-image-71488" src="https://oversixtydev.blob.core.windows.net/media/2024/10/Tracy-Wilson-May-2023_1280.jpg" alt="" width="1280" height="1477" /></p> <p>Whilst Gary from Kenthurst, another regular customer, states:</p> <p>“<em>To be told at 50 I may need a knee operation one day was an obvious shock. I run a small Forklift Business and 19 months ago became a grandfather, so I need to be mobile. </em></p> <p><em>Not wanting an operation at this point I needed an alternative, and what an alternative I found. In obvious pain I started my Arborvitae Joint Health treatment and after 2 weeks my pain and swelling had reduced. Now my pain is gone. If I am going to have a big day in the yard or in the bobcat I make sure I take my Arborvitae Joint Health first. What a fabulous product this is. </em></p> <p><em>No one should go through life in pain and I will tell anyone that will listen - if you have early onset mild Osteo Arthritis start taking Arborvitae Joint Health it has certainly helped me, and I can keep up with my grandson Max.</em>”</p> <p><img class="alignnone size-full wp-image-71487" src="https://www.readersdigest.com.au/wp-content/uploads/2024/10/Gary-copy-holding-new-blue-bottle_770.jpg" alt="" width="770" height="482" /></p> <p>Arborvitae’s main product is Arborvitae Joint Health, however the other stars in the range are Arborvitae Health and Wellbeing Supplement for blood glucose, cholesterol and the immune system and Arborvitae Cognitive Function, Memory and Eye Health.</p> <p>Mr Howell said the natural anti-inflammatory comes in an easy to take daily liquid supplement that has been designed to reset the immune system and bring down inflammation in the body quickly and efficiently. The inflammation reduction (of 56%) at the cellular level is confirmed by the CRP results in the recent clinical study. This reduction in inflammation alone is significant.</p> <p>Supplements are sold via Arborvitae’s website and at over 2000 chemists and health food shops Australia wide – including Chemist Warehouse, TerryWhite Chemmart and Blooms The Chemist. To find the closest store near you, visit <a href="http://www.arborvitae.com.au/pages/where-to-buy" target="_blank" rel="noopener">www.arborvitae.com.au/pages/where-to-buy</a></p> <p>To find out more on the clinical study and Arborvitae’s health supplements you can visit the website: <a href="http://www.arborvitae.com.au" target="_blank" rel="noopener">www.arborvitae.com.au</a> or call 1300 879 863.</p> <p>Always read the label and follow the directions for use.</p> <p><em>Images: Courtesy of Arborvitae</em></p> <p><em>This is a sponsored article produced in partnership with Arborvitae</em></p>

Body

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

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

Travel Tips

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Kate Middleton helps teen with cancer fulfill "bucket list" dream

<p>Kate Middleton has taken another step back to public duties after inviting a teenage girl with a rare form of cancer to Windsor Castle. </p> <p>The Prince and Princess of Wales invited 16-year-old Liz, a budding photographer from Harrogate, North Yorkshire, to Windsor Castle after the teen was told by doctors earlier this year that she only had between six months and three years to live. </p> <p>“A pleasure to meet with Liz at Windsor today,” the Prince and Princess of Wales wrote in a social media post shared on Wednesday, with a photo of Kate hugging the teenager.</p> <p>“A talented young photographer whose creativity and strength has inspired us both. Thank you for sharing your photos and story with us.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/DAoPPEMNX6F/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/DAoPPEMNX6F/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>Liz had a photography bucket list "to create a lifetime of memories" after being diagnosed with desmoplastic small round cell tumour in January. The cancer has no form of standard treatment. </p> <p>She first took up photography in Year 6 after saving up to buy her first camera. </p> <p>Liz was given the opportunity to take photos of cyclist Mark Cavendish and ex-footballer Ally McCoist's investiture ceremony, after Prince William heard about her through his  patronage of London Air Ambulance Charity.</p> <p>A Kensington Palace spokesperson said: “Following the investiture both the Prince and Princess of Wales met Liz privately with her family to hear about her day and journey."</p> <p>Liz said she was "over the moon" after meeting the couple at the castle.</p> <p>“Such lovely, genuine and kind people, I’m over the moon that my family and I had this experience,” she recalled on social media. </p> <p>The event is a rare appearance for the Princess who has been out of the public eye for most of the year following her own cancer diagnosis earlier this year.</p> <p>While the meeting is not being treated as an official engagement for the Prince and Princess, it was their first joint appearance this year. </p> <p><em>Images: Instagram</em></p> <p> </p>

Caring

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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"> <p><em><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></em></p> <p>From the creeks that wind through inner city Melbourne to the far outback in Western Australia, snake season is beginning.</p> <p>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.</p> <p>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.</p> <h2>When a snake bites</h2> <p>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>.</p> <p>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.</p> <p>The effects of snake bites vary, depending on the species of snake and first aid measures undertaken.</p> <p>Australian <a href="https://www.healthdirect.gov.au/snake-bites">standard first aid guidelines</a> include:</p> <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> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>The tyranny of distance</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>To move or not to move?</h2> <p>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.</p> <p>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.</p> <h2>What needs to change?</h2> <p>Our results indicate rural and remote Australians need innovative health-care solutions beyond the metropolitan guidelines, particularly when outside ambulance service areas.</p> <p>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.</p> <hr /> <p><em>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.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234365/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/snakes-are-waking-up-what-should-you-do-if-youre-bitten-and-what-if-youre-a-long-way-from-help-234365">original article</a>.</em></p> </div>

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

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member.</p> <p>Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%.</p> <p>Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed.</p> <h2>What are compassionate grounds?</h2> <p>Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds.</p> <p><a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are:</p> <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> <p>The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness.</p> <p>The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded.</p> <p>You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan.</p> <p>People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible.</p> <h2>Why are people using this scheme more?</h2> <p>The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures.</p> <p>But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues.</p> <p>There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system.</p> <p>Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system.</p> <p>While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated.</p> <h2>Lack of clarity</h2> <p>As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation.</p> <p>For example, the meaning of “mental disturbance” is not defined.</p> <p>You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early.</p> <p>People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues.</p> <p>Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications.</p> <p>In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment.</p> <h2>A closed-loop system</h2> <p>Conflict of interest is another major issue.</p> <p>There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment.</p> <p>Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments.</p> <p>This raises important questions about the independence of the process, as well as professional ethics.</p> <p>Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds.</p> <p>Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight.</p> <h2>What is needed?</h2> <p><strong>1. Mandatory financial counselling</strong></p> <p>The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications.</p> <p><strong>2. Tightening of the criteria</strong></p> <p>Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited.</p> <p><strong>3. Better oversight</strong></p> <p>Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest.</p> <p>Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239588/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/neera-bhatia-15189"><em>Neera Bhatia</em></a><em>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>.</em></p> </div>

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How cutting edge AI technology is helping doctors reduce waitlists

<div> <p>Artificial intelligence is now being used by Australian specialist doctors to reduce patient wait times and experts say it could be a game changer for the health sector, where some patients are waiting months or even years for an appointment.</p> </div> <div> <p>Leading Australian tech company <a title="https://www.medowhealth.ai/" href="https://www.medowhealth.ai/" data-outlook-id="ad0ccae0-1f97-484e-ba83-d8d566a7608a">Medow Health</a> has developed an AI “co-pilot” technology which automates medical reports for specialist doctors while operating in the background during patient consultations, saving clinicians hours  which allows them to see more patients each day. </p> </div> <div> <p>“This technology transforms the way medical reports are formulated and processed, helping specialists reduce their paperwork and freeing up valuable time and resources which can be better spent on patient care,” said Joel Freiberg who co-founded Medow Health with his brother after his own experience with a chronic illness coupled with watching their father who is a respiratory specialist dictate reports until 10pm from the dinner table, prompting them to come up with a more efficient way for clinicians to work.</p> </div> <div> <p>“The idea was to improve what really is an archaic reporting system, which saw specialists taking notes with their back to the patient during consultations or having to speak into a dictaphone to be transcribed later, instead of solely focusing on the patient in front of them,” Mr Freiberg said.</p> </div> <div> <p>The uptake from specialists utilising the new technology has been swift, with doctors reporting the technology is giving them back two to three hours a day, reducing burnout and allowing them to see multiple more patients in that time if they choose.</p> </div> <div> <p>“Instead of your doctor staring into the computer typing notes, they can really concentrate on your needs and wellbeing while the technology does the note taking in the background and creates an almost instant report that the doctor just has to review rather than formulate from scratch,” Mr Freiberg said.</p> </div> <div> <p>Data from the Australian Medical Association on “hidden waitlists” for a specialist outpatient appointment shows some people are languishing for years for an initial consultation - up to 800 days for an initial appointment for an Ear, Nose and Throat Surgeon, up to 898 days for an urgent appointment with a  neurosurgeon, while waitlists for a gastroenterologist or ophthalmologist can be as long as five years and up to 36 months to see a paediatrician.</p> </div> <div> <p>Mr Freiberg said the new cutting edge technology could supercharge a reduction in waitlists and speed up the appointment process.</p> </div> <div> <p>“We’re not trying to replace doctors, we’re trying to help them. Manually producing medical reports is a time-consuming and complex process that requires extensive paperwork and hours of labour-intensive work,” he said.</p> </div> <div> <p>“By using cutting edge AI specific to each medical specialty to examine patient interactions, formulate reports, and provide valuable insights we can enable doctors to do what they do best - focus on patient care,” Mr Freiberg said.</p> </div> <div> <p>Chris O’Brien Life House Chief Executive and medical oncologist Professor Michael Boyer who is on the Medow Health Clinical Advisory Council agreed the technology will improve patient care and help reduce waiting lists.</p> </div> <div> <p>"Any piece of technology that allows doctors to focus on the patient, helps deliver better care,” Prof Boyer said.</p> </div> <div> <p>"This technology helps the health professional to really turn their attention to the patient and what matters, instead of worrying about what notes they need and what letters they need to write. It allows them to focus on what is important.</p> </div> <div> <p>"There's no doubt this technology saves time and while it might only allow a single doctor to see an extra one of two patients a day, if you multiply that across the health system then it makes a big difference,” Prof Boyer said.</p> </div> <div> <p>Engagement with Medow Health is taking off in Australia, with the company reporting growth of more than 50 percent month on month across 15 different specialties including Cardiology, Gastroenterology, ENT, Geriatric, Orthopaedic Surgery, Paediatric, Neurology, General Surgery and Breast Surgeons, with some of Australia’s leading specialist doctors among the investors and Medtech Entrepreneurs to invest in its recent Seed round.</p> </div> <div> <p><strong>About Medow Health AI</strong></p> </div> <div> <p><em>Medow Health AI is a pioneering Australian based healthcare technology company dedicated to revolutionising the medical industry through the power of artificial intelligence to streamline processes, improve patient care, and enhance overall efficiency in healthcare settings.</em></p> </div> <div> <p><em> The company was founded by Joel Freiberg and soon after his brother Josh and former CTO and colleague Andrew joined as co-founders using their combined 30 years experience in technology and software to help build the business into the leading Specialist AI platform it is today.</em></p> </div> <div> <p><em>Joel lives with Crohn’s disease and has experienced long waits to see a specialist. The pair recognised there was a need for change growing up as they watched their father, a respiratory physician spend endless hours doing admin after work. </em></p> </div> <div> <p><em>The company has just completed a $1M funding round in the first half of 2024, grown the team to 10 full time employees and signed a partnership with Magentus the owner of leading specialist electronic medical record systems Genie &amp; Gentu (who Medow Health integrates with).</em></p> <p><em>Image credits: Shutterstock</em></p> </div>

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