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New research proves travelling can slow down the ageing process

It turns out that going on holiday is good for you in more ways than one. According to new research conducted at Edith Cowan University in Western Australia, travelling can actually slow the ageing process both physically and mentally. The study, published in the <a title="Journal of Travel Research" href="https://journals.sagepub.com/doi/10.1177/00472875241269892#:~:text=The%20principle%20of%20entropy%20increase%20provides%20a%20dynamic%20perspective%20to,Silva%20%26%20Annamalai%2C%202008)." target="_blank" rel="noopener">Journal of Travel Research</a>, is believed to be the first-ever that applied the theory of entropy - the general trend of the universe towards death and disorder – to tourism. "Tourism isn't just about leisure and recreation. It could also contribute to people's physical and mental health," ECU PhD candidate Fangli Hu said. "Ageing, as a process, is irreversible. While it can't be stopped, it can be slowed down." According to the research, travelling, exploring new corners of the world and engaging in unique and relaxing activities can stimulate stress responses and elevate metabolic rates, positively influencing metabolic activities and the body's self-organising capabilities. "Leisurely travel activities might help alleviate chronic stress, dampen over-activation of the immune system, and encourage normal functioning of the self-defence system," Fangli added. While some people prefer relaxing holidays, others prefer to stay on their feet and keep active during their travels, enjoying the many well-known benefits of exercise. It can "enhance the body's immune function and self-defence capabilities, bolstering its hardiness to external risks". In response to their study, the experts suggested that "travel therapy could serve as a groundbreaking health intervention." Despite the positive results of the research, experts also warned that travelling can exposed to infectious diseases, accidents, injuries, violence, water and food safety issues, and concerns related to inappropriate tourism engagement, which in turn will have the opposite effect on our health. "Conversely, tourism can involve negative experiences that potentially lead to health problems, paralleling the process of promoting entropy increase," Fangli said. Image credits: Shutterstock

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Common drug shows potential in reversing ageing

A common medication has been found to have anti-ageing qualities, with scientists finding that the drug can de-age monkeys. Metformin, a cheap and common diabetes drug that has been used since the 1950s, could be an anti-ageing elixir, with scientists from the Chinese Academy of Sciences and Beijing Institute of Genomics using the pill to "markedly" slow down ageing in the animals. According to the experts, the medication reduced deterioration of the brain and boosted cognitive abilities in the primates while also slowing down bone loss and aiding in the "rejuvenation" of several tissues and organs. The most significant improvements were seen in the liver and frontal lobe, the part of the brain responsible for language, reasoning, problem solving, memory, movement and personality. Researchers said all of the findings led to the conclusion that "metformin can reduce biological age indicators" up to six years, with the medication paving the way for ageing reversal in humans. The drug was previously tested on mice, but since testing the medication on Cynomolgus monkeys - that are both physiologically and functionally similar to humans - the tests have shown more promise for potential human trials. The researchers said of the 40-month study, "Our research pioneers the systemic reduction of multi-dimensional biological age in primates through metformin, paving the way for advancing pharmaceutical strategies against human ageing." The scientists added, "[The study] represents an important advance in the quest to delay human ageing, with geriatric medicine research gradually shifting its focus from treating individual chronic diseases to systemic intervention against ageing." Image credits: Shutterstock

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What the government’s home care changes mean for ageing Australians

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The Albanese government has this week announced it will introduce one of the <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">largest reforms</a> to Australia’s aged-care sector to date. The package includes a A$4.3 billion investment in home care, now called “<a href="https://www.health.gov.au/our-work/support-at-home">Support at Home</a>”, to come into effect from July 2025. This reflects both the desire of many people to remain living at home as they age, and the government’s desire to reduce the costs of residential aged care. So what changes is the government making to home care packages? And what will these changes mean for ageing Australians? <h2>Reducing waiting times</h2> One of the major complaints about the current home care system is the long waiting times. Estimates suggest there’s a <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">6–to-12-month wait</a> for the higher level 3 and 4 home care packages. For people with the highest needs, this is far too long. As of March this year, around <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">45,000 people</a> were waiting for any level of home care. An additional 14,000 were already receiving a package, but on a lower level of home care than they were entitled to. With additional funding, the new system will <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">support more participants</a>. It aims to shorten wait times to <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">an average of three months</a> from July 2027. <h2>Changes to services</h2> The new system will replace the current four levels of home care packages with <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">eight classifications</a> of funding for services. When participants are assessed, they will be assigned the most suitable category. There’s currently very limited information on what these classifications are, but the idea is they will provide more targeted services. A number of short-term supports will also be available. These include assistive technology (such as mobility aids) and home modifications. Some people will be able to access 12 weeks of restorative care – a more intensive program designed to build function after injury or illness – as well as palliative care support. The way different types of services are subsidised is also changing. Previously, the same means-tested co-contribution applied regardless of the type of service. Under the new system, services are categorised into clinical care (for example, physiotherapy or wound care), independence (such as help with bathing or cooking) and everyday living (for example, gardening or home maintenance). The new reforms fully subsidise clinical services regardless of income, whereas independence and everyday living services will attract co-contributions based on means testing. For example, <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-support-at-home.pdf">a self-funded retiree</a> would pay nothing out of pocket for physiotherapy, but would pay 50% for help with showering and 80% towards gardening costs. A full pensioner would also pay nothing for physiotherapy, but pay 5% for help with showering and 17.5% of the cost of gardening. This is a positive change. Our research has previously highlighted a tendency for people with home care packages to choose everyday living services <a href="https://onlinelibrary.wiley.com/doi/full/10.1155/2023/4157055">such as gardening</a> and cleaning and refuse clinical care such as allied health and nursing as these types of services were more expensive. These changes should make older people more likely to choose allied health and clinical care services, which will help them maintain their function and stay fitter for longer. <h2>Some challenges</h2> For the government’s reforms to deliver faster and better support at home, a number of issues need to be addressed. As people stay at home for longer, we also see that these <a href="https://academic.oup.com/ageing/article/52/5/afad058/7147101">people are frailer</a> and have more health conditions than in the past. This requires a different and more highly skilled home care workforce. The current <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">home care workforce</a> consists largely of personal care and domestic support workers alongside a much smaller skilled workforce of registered nurses and allied health professionals. But with the changing profile of people receiving care at home, there will need to be a greater focus on maintaining functional capacity. This might mean more allied health input will be required, such as from physiotherapists and occupational therapists. It’s difficult to source an appropriately skilled workforce across the sector, and almost impossible in <a href="https://www.ruralhealth.org.au/sites/default/files/publications/fact-sheet-allied-health.pdf">rural and remote areas</a>. Alternative models, such as training personal care workers to act as allied health assistants, and effectively using technology such as telehealth, will be necessary to meet demand without compromising on quality of care. One example of the need for upskilling in specific areas relates to caring for people with dementia. The majority of people who are living with dementia at home receive care from family carers, supported by home care workers. It’s vital that these care workers have adequate knowledge and skills specific to dementia. However, research has shown the home care workforce may <a href="https://pubmed.ncbi.nlm.nih.gov/31646701/">lack the knowledge and skills</a> to provide best-practice care for people living with dementia. Specialised <a href="https://onlinelibrary.wiley.com/doi/10.1002/gps.6140">dementia training</a> for home care workers is effective in improving knowledge, attitudes and sense of competence in providing care. It should be rolled out across the sector. <h2>What about unpaid care at home?</h2> Unpaid carers, such as family members, provide <a href="https://www.pmc.gov.au/resources/draft-national-strategy-care-and-support-economy/goal-1-quality-care-and-support/support-for-informal-carers">significant amounts of care</a> for older people. The value of this unpaid care is estimated to be in the billions. As older people stay at home for longer, this is set to increase even further. However, carers with high care burdens are particularly vulnerable to <a href="https://www.sciencedirect.com/science/article/pii/S2352827316300283#s0025">poor physical and mental health</a>. Without adequate support, we may find extra caring pressures lead to a breakdown in caring relationships and an increase in other health-care costs for both the carer and care recipient. So we need to ensure carers have adequate financial, psychological and practical support. But the currently available detail on the reforms doesn’t indicate this has been adequately addressed. With careful implementation and ongoing evaluation, these reforms have the potential to significantly enhance the home care system. However, their success will depend on addressing workforce challenges, ensuring adequate support for unpaid carers, and maintaining a focus on the holistic needs of older Australians. More information about Support at Home is <a href="https://www.health.gov.au/our-work/support-at-home/about">available online</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238890/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, Executive Director, National Ageing Research Institute; Professor, Centre for Health Services Research, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, Director Clinical Gerontology & Senior Principal Research Fellow, National Ageing Research Institute, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">original article</a>. </div>

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Landmark aged care reforms set to benefit millions of Aussies

The federal government has reached a deal with the coalition for the long-awaited aged care reforms including $4.3 billion for in-home services. This means that senior citizens will be given more support and choice to live their golden years in dignity, as they intend to help them live at home for longer and improve conditions and protections for those in aged care facilities. "$4.3 billion will be invested in Support at Home, to come into effect on the first of July next year," Prime Minister Anthony Albanese announced at Parliament House on Thursday. The Support at Home package is expected to help 1.4 million Australians live independently at home with support, before going into aged care by 2035. It will provide support for nursing, occupational therapy and day-to-day tasks like cleaning, showering, dressing and shopping, with wait times for packages cut from 12 to three months. The government will also pay all of the cost of clinical care services, with a lifetime contribution cap of $130,000 for non-clinical care costs. Those using the Support at Home program could also get $25,000 in aid to spend their final three months at home, instead of the hospital. The $5.6 billion reform package is also set to affect the availability of funding for residential aged care, including a "no worse off" assurance that people currently in aged care won't be asked to pay more for their care. New aged care quality standards will also be implemented to improve the sector and drive higher-quality care. The government also promised more resources to investigate and penalise bad behaviour by providers. Albanese said the reforms will be the "greatest improvement" to the aged care sector in 30 years. “This is about caring for the generation that cared for us,” he said. “We will deliver historic aged care reforms to ensure the viability and quality of our aged care system and support the growing number of older Australians choosing to retain their independence and remain in their homes as they age.” Aged Care Minister Anika Wells said the changes would lead to more services for older Australians. “Our reforms will create better and safer care, help reduce the fear of a system that has been neglected for far too long,” she said. The reform has been welcomed as the number of Australians over the age of 65 is expected to double and those older than 85 are predicted to triple in the next four decades. Images: Shutterstock

Caring

Rolf Harris' widow dies at age 93

The wife of disgraced paedophile TV star Rolf Harris has passed away at the age of 93, just one year after the death of her husband. Alwen Hughes stood by Harris when he was jailed in 2014 for 12 indecent assaults on four underage girls between 1968 and 1986. Hughes passed away due to a “stroke, frailty of old age, vascular dementia”, according to her death certificate. Harris died in May 2023 from neck cancer, after the couple were married for 65 years. According to reports by The Sun, Hughes has been pictured in a wheelchair and was reportedly suffering from Alzheimer’s disease in the years before her death. Alwen stood by her husband through the court proceedings and his. subsequent jail term, attending every day of Harris’ initial trial alongside their daughter Bindi. Speaking shortly after Harris’ conviction in 2014, singer Vince Hill said, “Alwen is very poorly. We’re all very worried about her." “I don’t know if she will survive his prison term. She’s quite fragile. She suffers from arthritis and she’s had hip replacements and God knows what.” Image credits: BER/CLS/Shutterstock Editorial

Caring

Hollywood legend dies at age 93

Hollywood acting legend James Earl Jones has died at the age of 93. <a href="https://deadline.com/2024/09/james-earl-jones-dead-1236082801/" target="_blank" rel="noopener">Deadline</a> revealed that the actor passed away at his home in Dutchess County, New York, although no cause of death has yet been given. Jones was responsible for some of the most memorable roles in modern cinema history, lending his voice to iconic characters including Star Wars’ Darth Vader and The Lion King’s Mufasa. After making his big screen debut in the 1964 film Dr Strangelove, he went on to rack up hundreds of roles and didn't stop working until 2021, with his latest project being in the Eddie Murphy sequel, Coming 2 America. Jones' most notable roles came in films such as the original Coming To America, Field of Dreams and The Hunt for Red October, making him a household name in the movie industry. Throughout his career, Earl Jones won three Tony Awards, two Emmy Awards, a Grammy Award, and was also inducted into the American Theatre Hall of Fame in 1985. He went on to receive an honorary Academy Award in 2011, as well as a special Tony for lifetime achievement in 2017. Image credits: Joanne Davidson/Shutterstock Editorial

Caring

Olympian killed at just 33 years of age

Ugandan Olympic athlete Rebecca Cheptegei, 33, has tragically passed away at Moi Teaching and Referral Hospital in Eldoret, Kenya, where she had been receiving treatment for severe burns sustained in an attack by her former boyfriend. A hospital spokesperson, Owen Menach, confirmed that Cheptegei succumbed to her injuries after suffering multiple organ failures. Cheptegei, who competed in the women’s marathon at the Paris Olympics just weeks ago, sustained burns to 80% of her body after her ex-partner, Dickson Ndiema, allegedly doused her in petrol and set her on fire during a domestic dispute. Trans Nzoia County Police Commander Jeremiah ole Kosiom revealed that Ndiema also suffered burns in the incident to 30% of his body, and that he remains in intensive care but is in a stable condition. Cheptegei's parents stated that she had recently bought land in Kenya’s Trans Nzoia County to be near athletic training centres in the region. A report from the local chief indicated that Cheptegei and her former boyfriend were involved in a heated argument over the property before the attack occurred. The Uganda Athletics Federation and the Uganda Olympic Committee have expressed their grief over the loss of Cheptegei. In a statement shared on the social media platform X, the Athletics Federation wrote, "We are deeply saddened to announce the passing of our athlete, Rebecca Cheptegei early this morning who tragically fell victim to domestic violence." They further condemned the attack, calling for justice. Uganda Olympic Committee president Donald Rukare added, “May her gentle soul rest in peace and we strongly condemn violence against women. This was a cowardly and senseless act that has led to the loss of a great athlete. Her legacy will continue to endure.” Image: Narnabi / Wikimedia Commons

Caring

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

Body

"My heart is broken": Mariah Carey reveals sad double tragedy

Mariah Carey has revealed a devastating double tragedy, as both her mother and sister passed away on the same day. In a heartbreaking statement to <a href="https://people.com/mariah-carey-mom-patricia-sister-alison-both-died-same-day-exclusive-8701561" target="_blank" rel="noopener">People</a>, the singer announced the deaths of her mum Patricia, 87, and sister Alison, 63, who died over the weekend. Carey's statement read, "My heart is broken that I've lost my mother this past weekend. Sadly, in a tragic turn of events, my sister lost her life on the same day." "I feel blessed that I was able to spend the last week with my mom before she passed." "I appreciate everyone's love and support and respect for my privacy during this impossible time." No cause of death has been revealed for either member of the family. Carey famously had a turbulent relationship with her mother and sister over the years, and was estranged from Alison for three decades before her untimely death. In 2016, Alison, who was a recovering drug addict, made a plea to her famous sister through the Daily Mail to ask for support, saying, "Mariah I love you, I desperately need your help." As well as substance abuse, Alison endured homelessness throughout her life and tested positive for the HIV virus. Mariah opened up about complicated relationships with her mom and sister in her 2020 memoir, The Meaning Of Mariah Carey. "Like many aspects of my life, my journey with my mother has been full of contradictions and competing realities. It's never been only black-and-white — it's been a whole rainbow of emotions," she explained. She said their relationship was a "prickly rope of pride, pain, shame, gratitude, jealousy, admiration, and disappointment", however the book was still dedicated to Patricia. "And to Pat, my mother, who, through it all, I do believe actually did the best she could," the singer penned in the dedication. "I will love you the best I can, always." Image credits: Paul Archuleta/Shutterstock Editorial

Family & Pets

"You are ruining my life": Driver's plea to parking ranger

A desperate motorist has left a note for suspecting parking rangers to beg for leniency over fines. A photo of the note, that quickly went viral, shows the driver asking to not receive any more tickets after already being slapped with three in one week. The note explains the driver's difficult situation, as he asked the rangers to have mercy. "Please stop giving me tickets," the note read. "I already have three this week. I am obviously broke already." "I have ordered my new sticker. It's in the mail. I can't make it get here faster. Have some mercy, you are ruining my life." The note insinuates the other parking fines may have been written up because of an expired registration or damaged licence plate. After the photo of the note went viral, many were shocked that the parking officer wrote up several tickets in the same week. "Usually you wouldn't get the second and third as there's a grace period to go to traffic court to show you did the paperwork to drop the first ticket," one person said. Another driver revealed a similar plight, saying, "I ordered my tags in the mail and it took 34 days to get here." But others weren't as understanding, as one person sarcastically commented, "If only people had an entire year to plan ahead to know when their tags would expire ... oh, wait." Image credits: Facebook / Shutterstock

Legal

Hollywood legend dies at age 94

The Notebook star Gena Rowlands has passed await the age of 94 after a lengthy battle with Alzheimer's. Her death was confirmed today by representatives for her son, filmmaker Nick Cassavetes, who told TMZ that Rowlands died on Wednesday afternoon at her home in Indian Wells, California, surrounded by family including her husband Robert and daughter Alexandra Cassavetes. While no official cause of death has been announced, Rowlands had been suffering from Alzheimer's for five years. In June, director of The Notebook and Rowland's son Nick Cassavetes was discussing the film's 20th anniversary when he shared <a href="https://oversixty.com.au/health/caring/hollywood-star-s-heartbreaking-health-update" target="_blank" rel="noopener">details</a> of his mother's diagnosis and how it was reminiscent of her character in the movie. “I got my mum to play older Allie, and we spent a lot of time talking about Alzheimer’s and wanting to be authentic with it, and now, for the last five years, she’s had Alzheimer’s,” Cassavetes told <a href="https://ew.com/the-notebook-star-gena-rowlands-has-alzheimers-8668642">Entertainment Weekly</a> of Rowlands’ character, who also had dementia. “She’s in full dementia. And it’s so crazy — we lived it, she acted it, and now it’s on us.” Gena’s mother, fellow actress Lady Rowlands, had also suffered from the same disease. While The Notebook was Rowlands’ most notable 21st century role, the acting veteran broke into the industry in the 1950s and earned two Academy Award nominations and multiple Golden Globe and Emmy Award wins throughout her career. She was known for her frequent collaborations with actor-director husband John Cassavetes in ten films, including 1974’s A Woman Under the Influence and 1980s Gloria. Image credits: New Line Cinema/Demmie Todd/Warner Bros/Spring Creek/Kobal/Shutterstock Editorial <div class="more-coverage-v2" style="box-sizing: inherit; margin-bottom: 0px; border-top-width: 1px; border-top-style: solid; border-top-color: #e0e1e2; float: right; margin-left: 16px; max-width: 40%; padding: 16px 0px;"> </div>

Caring

"My daughter was right": Gracious grandma praised for humble act

Watching your parents become grandparents is a beautiful experience, but it often comes with disagreements or differences in opinion in terms of how you are raising your kids. One grandma has gone viral for her wise words when it comes to navigating these differences. "If I don't agree with every little decision that my daughter makes for the baby, I usually don't say anything," TikTok user @mommom.maria, who frequently posts about being a grandma, shared recalled her most recent babysitting experience. "Sometimes I can't help myself, and when it came to this I couldn't help myself, I had to say something." She explained that her 13-month-old granddaughter has two bottles a day, one in the morning and one at night. "My husband and I were babysitting the other night and my daughter said to put her milk before bed in this," she said, holding up a sippy cup with a straw. The grandmother didn't think it was okay that her granddaughter was drinking out of a sippy cup that young, but admitted that it's not her decision to make. "I'm not the decision maker. I'm not the mum: I'm the Mum-Mum, the privileged Mum-Mum that gets to babysit her," she explained. She decided to respect her daughter's choices, and said that her granddaughter drank her milk with no issues. "So I guess my daughter was right, and that's really what I wanted to say to the other grandmothers: You don't have to agree, but you have to do it," she finished. Many have praised the grandmother for respecting her daughter's wishes, with the video gaining over 100k views. "Protect this sweet woman at all costs," commented one person. "Oh how I wish my MIL (mother in law) was like you," another added. "You are so emotionally mature about it. I'm so proud of you showing what respecting your children's right to parent looks like!" wrote a third. One woman also shared the way she approached parenting differences and replied, "I told my Mom and MIL this 'I'm not saying you're wrong with how you chose to do things with your kids. I just do things differently.' Helped a lot!" Images: TikTok

Family & Pets

My Kitchen Rules star dies at just 46

My Kitchen Rules New Zealand contestant Michael Murray has passed away at just 46. An extended family member, who asked not to be named, has confirmed his death on Monday afternoon. “It’s a shock to all those who know him,” the relative told Daily Mail Australia. No cause of death has yet been released. Murray, of Ngāti Maniapoto heritage, competed in the 2024 season of the popular cooking show with his cousin Piki Knap. According to their biography for the series, the pair grew up together in Te Kūiti, south of Auckland, and developed their love of cooking from entertaining family guests. Murray was a huge Jamie Oliver fan, and was comfortable in front of the camera, after spending 12 years in Mexico where he worked on telenovela soap operas and did small stints on other shows. He returned to New Zealand after the pandemic. “My background is modelling and acting,” he told The New Zealand Herald. “I was Mr New Zealand back in 2005, and that’s what took me overseas and eventually to Mexico. Obviously, I’m not Mexican, but they thought I was Latino! "I did some great work there, then to come home and be a part of this whole journey with MKR is a blessing in disguise. I’ve always put my hand up to opportunity.” Murray's family are now dealing with the devastation of losing another loved one after Murray's aunt passed away from terminal cancer a few months after the duo started filming for MKR. Images: My Kitchen Rules NZ

Caring

What if I discover mould after I move into a rental property? What are my rights?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/tim-law-1438482">Tim Law</a>, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> A startling number of Australian rental homes come with an unwanted housemate: mould. If you discover mould in a rented home, who is responsible and what can you do if the landlord seems unwilling to fix it? <h2>Find the cause</h2> The landlord is responsible if the mould is caused by the structural condition of the property. This can include things like leaking pipes, gutters, roofs or windows. Tenants are responsible for mould remediation if the way they occupy a home has promoted mould growth. For example, if they have not been using exhaust fans in bathrooms, have been failing to ventilate their home or have been storing wet clothes in a cupboard. This means establishing the cause of the mould is crucial to working out who’s responsible for repairs. <h2>Why are so many rentals mouldy?</h2> Australia has a rental home mould problem chiefly because much of our housing hasn’t been built to suit our climate. Houses tend not to be built with sufficient consideration of: <ul> <li> efficient energy consumption to regulate indoor temperature </li> <li> the orientation of homes </li> <li> the use of double glazing and insulation to regulate temperature and humidity. </li> </ul> It is estimated that nearly 17% of privately rented homes and 22% of social housing dwelling require <a href="https://www.abs.gov.au/statistics/people/housing/housing-mobility-and-conditions/2019-20">major repairs</a>. This includes structural defects, such as large cracks in walls or leaking gutters, that can generate mould growth. Tenant representatives have said in the past there is also a problem of weak enforcement of laws concerning the <a href="https://www.ahuri.edu.au/sites/default/files/documents/2022-11/AHURI-Final-Report-391-Regulation-of-residential-tenancies-and-impacts-on-investment.pdf">condition of rental homes</a>. <h2>4 ways to cut mould risk</h2> To reduce your mould risk, you need to manage indoor moisture and temperature. Try to: <ul> <li> keep the home well ventilated </li> <li> open windows and use exhaust fans in the bathroom and kitchen </li> <li> in humid climates, use air conditioning or a dehumidifier </li> <li> in cold climate, use a dehumidifier (desiccant dehumidifiers might more appropriate in very cold places) </li> <li> reduce moisture in the home by wiping up spills and condensation on surfaces </li> <li> dry washing outside </li> <li> if buying a dryer, opt for a condensing dryer instead of a conventional dryer (condensing driers put out much less vapour) </li> <li> report any structural issues (such as leaking pipes or windows that don’t close properly) to the agent or landlord as soon as you notice them. </li> </ul> <h2>Rental minimum standards differ by state or territory</h2> In New South Wales, adequate ventilation is one of the <a href="https://www.fairtrading.nsw.gov.au/housing-and-property/renting/new-residential-tenancy-laws">minimum standards</a> properties must meet to be considered fit to live in. If the rental provider has been notified about mould problems in the house but has failed to act, you might consider getting advice from the <a href="https://www.tenants.org.au/?gclid=CjwKCAiAjfyqBhAsEiwA-UdzJEj1YE27QhWKv2W5hPiiFTXMeX5Yqe61X4WlsHwRcq5kh5qDnU-MEBoC2LgQAvD_BwE">Tenants’ Union of NSW</a>. Its <a href="https://www.tenants.org.au/factsheet-24-mould">fact sheet on mould</a> also explains what to do if you’d like to contact the <a href="https://www.ncat.nsw.gov.au">NSW Civil and Administrative Tribunal</a> to apply for repairs, rent reduction or compensation. In Victoria, <a href="https://www.consumer.vic.gov.au/housing/renting/repairs-alterations-safety-and-pets/minimum-standards/minimum-standards-for-rental-properties">rental minimum standards</a> say “all rooms must be free from mould and damp caused by or related to the building structure.” The <a href="https://tenantsvic.org.au/advice/common-problems/mould-and-damp/">Tenants Victoria</a> website has information on how to ask a landlord to fix a mould problem or structural problems leading to mould and how to apply to the <a href="https://www.vcat.vic.gov.au">Victorian Civil and Administrative Tribunal</a> if the landlord fails to act. In Queensland, it depends on when you signed the lease. If you signed after September 1 this year (after new <a href="https://www.housing.qld.gov.au/about/initiatives/rental-law-reform">standards</a> were introduced) tenants should notify the landlords of <a href="https://www.rta.qld.gov.au/during-a-tenancy/maintenance-and-repairs/mould">mould as soon as they discover it</a>. If mould is a result of problems with the property and the landlord doesn’t undertake repairs, tenants can contact the <a href="https://www.qcat.qld.gov.au">Queensland Civil and Administrative Tribunal</a>. The guidelines in <a href="https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_821_homepage.html">Western Australia</a> say the landlord must ensure the premises is “in a reasonable state of cleanliness and a reasonable state of repair […] and must conduct any repairs within a reasonable period after the need for the repair arises.” And in <a href="https://www.commerce.wa.gov.au/publications/maintenance-your-rental-property-who-responsible-landlord-bulletin-issue-12-september">Western Australia</a>, mould caused by faults in gutters or other fixtures is the responsibility of the rental provider. Further information on <a href="https://www.commerce.wa.gov.au/consumer-protection/resolving-rental-property-issues">what to do</a> if a dispute over the premises can’t be resolved amicably is available on the state government website. In <a href="https://www.housingsafetyauthority.sa.gov.au/minimum-housing-standards/whole-property">South Australia</a> rental properties must be “reasonably free from mould or other irritants [and] reasonably free from the adverse effects of moisture or damp.” If a landlord refuses to fix something after being asked, the tenant can <a href="https://www.sa.gov.au/topics/housing/renting-and-letting/renting-privately/during-a-tenancy/Repairs-and-maintenance">apply to the South Australian Civil and Administrative Tribunal</a>. In <a href="https://www.cbos.tas.gov.au/topics/housing/renting/rental-maintenance-repairs-changes/requesting-repairs">Tasmania</a>, rental properties must be clean and in good repair when leased out. <a href="https://www.cbos.tas.gov.au/topics/housing/renting/beginning-tenancy/minimum-standards/types">According to</a> the Tasmanian government website on the issue, <blockquote> ‘Clean’ includes having no […] serious mould/rising damp issues. </blockquote> If the tenant requests repairs and the landlord doesn’t act, the tenant can lodge a repair order with the <a href="https://www.cbos.tas.gov.au/topics/housing/renting/rental-maintenance-repairs-changes/requesting-repairs">Commisioner’s office</a>. In the Australian Capital Territory, the Tenants’ Union ACT has guidance on what to do if you discover <a href="https://www.tenantsact.org.au/what-can-i-do-about-mould/">mould</a> in a property you rent. In the Northern Territory, tenants may wish to seek advice from the <a href="https://www.dcls.org.au/tenants-advice/">Tenants’ Advice Service</a> if there is a mould problem in a property they rent. <h2>What policy change could help?</h2> If the cause of indoor mould is related to the design and construction of the house, rental providers should act. But tenants may not have the information they need to determine and substantiate this claim and can’t do much to get rental providers to act on mould if it’s not clear what’s causing it. Also, renters often worry asking for repairs could lead to a rent increase or eviction. Solutions include strengthening tenants rights to compel landlords to investigate the cause of mould in a house (given that knowing the cause is essential to assign responsibility for repairs). There should also be more stringent enforcement of current minimum standards relating to mould in rental properties. Given the scale of problems like mould in Australian homes, policymakers may wish to consider whether a parliamentary inquiry on home environments and health is needed. This would give Australians a chance to speak about their experiences – something that could help policy makers improve regulation in the rental sector. <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/215146/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, Professor of Social Epidemiology and Director of the Centre of Research Excellence in Healthy Housing at the Melbourne School of Population and Global Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/tim-law-1438482">Tim Law</a>, Adjunct lecturer, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-if-i-discover-mould-after-i-move-into-a-rental-property-what-are-my-rights-215146">original article</a>. </div>

Legal

Last Australian 'Rat of Tobruk' dies age 102

Thomas Pritchard, Australia's last "Rat of Tobruk" has passed away at the age of 102. Pritchard was part of the famous garrison who held the eponymous Libyan port against a furious Nazi siege in World War II. The Rats of Tobruk Association announced Pritchard's death on Saturday, honouring his service to his country. "Tommy was a stalwart member of our association and a most humble veteran, having served with the 2/5th field ambulance throughout the Middle East and the South West Pacific," the association wrote in a post. "We as an Association are extremely grateful to have had Tommy for so long yet we mourn his loss and the last direct linkage with some 14,000 Australian servicemen who served in Tobruk." The post added that Pritchard would be farewelled in a private family funeral, as was Tommy's wishes. However, they added that a public memorial for all Rats of Tobruk will take place in Melbourne, with the date yet to be confirmed. The Rats of Tobruk were an Allied garrison of about 26,000 soldiers, including 14,000 Australians, commanded by Australian Lieutenant-General Leslie Morehead. They were besieged by the Nazi Afrika Korps, comprised of German and Italian troops, from April 10th to November 27th 1941. The Africa Korps, under the leadership of Nazi general Erwin Rommel, had never known defeat, until he faced the Rats for 231 days, who denied Rommel a port on the Libyan coast as the Nazis were unable to take control of Tobruk. The nickname came from American-born Nazi propagandist William Joyce, who, when he heard the Allied soldiers were taking cover in the pre-existing below-ground defences of the city, derided them as living like "rats". However, Aussies took the nickname with pride as they celebrated their victory. Image credits: Rats of Tobruk Association

Caring

"Wasn’t my choice": Star spills on Neighbours exit

Neighbours star Ryan Moloney has revealed the truth about his surprise exit from the soap opera after almost 30 years on the show. The actor made the announcement that he would be leaving the show, and his character Toadfish, in a video posted to Neighbours' Instagram account in late June. In a recent interview with Australian soap opera website Back to the Bay, he finally opened up about leaving Toadfish behind after all these years. “Well, it actually wasn’t my choice. It was their choice,” he told the outlet. “So, yeah, I’ve been wanting to leave for quite a long time, but Neighbours is one of those jobs that you work with awesome people. You get paid really well. And if you had a mate who had one of these jobs, you’d be saying, ‘oh, mate, what are you doing? You’ve got to stay there. See it out for as long as you can.’” The actor said that he felt pressure to “suck it up and stay” despite wanting to move on - so in the end, he was “quite grateful that they actually made that decision for me because I don’t think that I could ever say no to a contract.” “And that’s kind of not the way you want to be doing Neighbours. You don’t want to have that kind of level of resentment in there. So I was very grateful for it,” he said. Moloney made his debut on Neighbours as a teen in 1995, and stayed with the show until it was axed in 2022. He was then a returning cast member when the show was rebooted a year later. Image: Network 10

"Oh my god!": Natalya Diehm wins Australia's first women's BMX medal

Natalya Diehm has become the first Australian woman to win an Olympic medal in BMX Freestyle. Fans witnessed the moment the 26-year-old found out that she had won the Bronze medal, as she was filming a live story on Instagram. Diehm was sharing footage of fellow BMX competitor, Hannah Roberts on the track, when Paris 2024 officials made the announcement that she had scored higher. "Oh my god! oh my god!" the Olympian screamed as her teammates embraced her in the moments that followed. She placed third with a final score of 88.80. "I have dreamt of this moment for so long and I felt it all week, I was like 'I know I'm third, I know I'm going to make it on that podium," Diehm told Nine. "I wanted this so bad, I don't know else to say, I can't believe it. This is the first medal I have ever got in an international competition and what better way to do it than at the Paris 2024 Olympics." After her Olympic debut at the Tokyo 2020 Games, the athlete has suffered with a few injuries over the past few years, with her having to undergo six ACL surgeries and two shoulder surgeries. Following her win she has encouraged any aspiring athletes who may be struggling physically or mentally, to not give up on their dreams. "There is always light at the end of the tunnel, when you feel like there is not, keep pushing," she said. "I had full belief in myself and as long as you have that, you have hope and the world is going to keep on spinning, every day it will keep on going and you will keep getting better. "Have the belief and trust in yourself and you can get anything done." Images: Instagram

"My days are numbered": Rod Stewart reveals candid thoughts on death

Sir Rod Stewart is one of the best-selling music artists of all time, and he's well aware he can't live forever. As he nears 80-years-old, the music legend shared his views on death, and how he knows his "days are numbered", but that won't stop him from toning down his rock 'n' roll lifestyle as he kicks off his last run of Las Vegas shows after 13 years of residency. "I'm aware my days are numbered but I've got no fear," he told The Sun. "We have all got to pass on at some point, so we are all in the same basket. "I am going to be enjoying myself for these last few years as much as I can. I say few — probably another 15. I can do that easy mate, easy," he added. He then admitted: "I'm not like I was in the '70s and '80s and I can't stay up all night, get drunk and go mad and still have a voice just like that. Nowadays I have to protect my voice before and after every show." The singer said he counts on staying hydrated to keep up with his performance demands as he got older, but he definitely has not vowed off the booze. "You're talking to Rod Stewart here, mate. We go mad after every show. There are 13 of us, six women, really great musicians and I make them drink. We absolutely love it," he said. Despite keeping up his party ways, the rock star is also very conscious of his health, after he revealed that he had experienced a private three-year battle with prostate cancer in 2019. "I am more aware of my health now than before. You should be when you start getting on a bit. It's very important," he said. The rock star said he works out three or four times a day with his personal trainer of three years who has been keeping him in check for over three decades. Images: Kiko Huesca/EPA-EFE/ Shutterstock Editorial

Family & Pets

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Migraine is many things, but one thing it’s not is “just a headache”. “Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided. Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function. Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands. In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect. <iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Aspirin For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication. Triptans For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”. Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack. However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers. <h2>What about preventing migraines?</h2> The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol. Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives. Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached. It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more. <hr /> <iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>‘Nothing works for me!’</h2> In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP. The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections. These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist. Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away. Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives. Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<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/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>. </div>

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Our research shows 4 in 10 Australians in aged care are malnourished. What can we do about it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In the next 40 years <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150-fs.pdf">in Australia</a>, it’s predicted the number of Australians aged 65 and over will more than double, while the number of people aged 85 and over will more than triple. If you’re not really interested in aged care, you should be. Given these figures, you will almost certainly be engaging with aged care services at some stage – either for yourself, or supporting family members or friends seeking aged care. One service you are likely to encounter is residential aged care homes. In the past few years this sector has been under more scrutiny than ever before. Changes to legislation, workforce and funding are in motion. But the question remains as to whether these changes can happen fast enough to meet our ageing population’s needs. One area of need not being adequately met at present is nutrition. In a <a href="https://www.mdpi.com/2227-9032/12/13/1296">new study</a>, we’ve found four in ten older Australians living in residential aged care are not receiving enough of the right types of nutrients, resulting in loss of weight and muscle. This is known as malnutrition. <h2>Good nutrition is essential for healthy ageing</h2> Malnutrition in older people is <a href="https://www.agedcarequality.gov.au/providers/food-nutrition-dining/why-meals-matter">associated with</a> poorer overall health, such as increased risk of falls and infections. This can accelerate loss of independence for older people, including the need for extra assistance with basic activities such as bathing and dressing. Older people are at increased risk of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02612-5/abstract">malnutrition</a> for a range of reasons. These can include decreased appetite, difficulties with chewing and swallowing, and the presence of other chronic diseases such as Parkinson’s disease or dementia. Importantly, ensuring adequate nutrition is about more than just offering healthy foods. We eat not only to meet nutritional requirements, but for enjoyment and socialisation. We each have different preferences around what we want to eat, when and with whom. Food provision poses a challenge for residential aged care providers who must navigate the range of residents’ preferences together with dietary restrictions and texture modifications. This must also be balanced against the practicalities of having the right number of appropriately trained kitchen and mealtime assistance staff, and working within funding constraints. Understanding more about who is malnourished in aged care can help providers better address this problem. <h2>Malnutrition is an ongoing problem in aged care</h2> We looked at more than 700 aged care residents in New South Wales, Queensland and South Australia. We assessed participants for malnutrition using a screening tool that collects data on medical history and dietary intake, and includes a physical examination of muscle and fat. We found 40% were malnourished, including 6% who were severely malnourished. This likely underestimates the true rate of malnutrition, as residents with dementia were excluded. International <a href="https://www.mdpi.com/2072-6643/15/13/2927">studies</a> have shown an average of 80% of aged care residents with dementia are malnourished or at risk of developing malnutrition. Our findings are broadly in line with a synthesis of <a href="https://www.sciencedirect.com/science/article/pii/S0378512219301148">38 international studies</a>, which reported an average malnutrition rate in residential aged care of 52%. In Australia, malnutrition was highlighted as <a href="https://www.royalcommission.gov.au/aged-care">a priority</a> for immediate attention in the 2021 Royal Commission into Aged Care Quality and Safety. Its report cited <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dairy-food-supplementation-may-reduce-malnutrition-risk-in-institutionalised-elderly/52E93ADD586C634A3913A2AFE9D07847">an Australian study</a> of 215 residents, published in 2017, which found 68% were malnourished or at risk of malnutrition. It’s difficult to directly compare malnutrition rates between studies due to differences in diagnostic measurements. But it’s clear malnutrition is an ongoing challenge in aged care. <h2>What can we do about it?</h2> Since the royal commission, we’ve seen the strengthening of the <a href="https://www.agedcarequality.gov.au/providers/quality-standards/strengthened-quality-standards">quality standards</a> to be included in the new Aged Care Act, anticipated to be introduced to parliament in 2025. The strengthened quality standards provide an important framework to guide action by aged care providers on malnutrition. Key requirements include partnering with residents to design food options, regular assessment and reassessment of resident nutrition requirements, developing systems to monitor and improve satisfaction with food, designing pleasant dining environments, and providing staff with the training they need to achieve all of the above. However, achieving these standards will require investment of money and time. At the moment, <a href="https://kpmg.com/au/en/home/insights/2023/09/australian-aged-care-sector-analysis.html">64% of residential aged care providers</a> in Australia are operating at a financial loss. While we know carers and facility managers want to provide the best care possible, it’s difficult to achieve this when contending with underlying financial problems. As such, our teams at Monash and Griffith universities are focusing on strategies that minimise the burden on staff and providers. We are working on automating malnutrition screening. Current tools take 10–15 minutes and should be used when a new resident moves into an aged care home and regularly during their stay. But anecdotal evidence suggests providers lack the staff and funding needed to routinely carry out this screening. Instead, we aim to use existing data from aged care providers, including quarterly reports from the <a href="https://www.health.gov.au/our-work/qi-program">National Aged Care Mandatory Quality Indicator Program</a>, to detect malnutrition automatically. This will allow staff to focus more on care. Given the complexity of malnutrition, it’s likely that addressing the issue at a national scale will take some time. In the short term, for those with loved ones in aged care homes, we encourage you to be actively involved in their care, including noticing and speaking up if you think more can be done to optimise their nutrition.<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/235507/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, Lecturer, Physiotherapy, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, Senior Lecturer, School of Health Sciences and Social Work, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/our-research-shows-4-in-10-australians-in-aged-care-are-malnourished-what-can-we-do-about-it-235507">original article</a>. </div>

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Our research shows 4 in 10 Australians in aged care are malnourished. What can we do about it?

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