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Australians are reading less than other countries, a new report shows. Why?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/katya-johanson-425719">Katya Johanson</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Recent international research shows Australians are buying and reading fewer books than people in many other countries. But why? A <a href="https://risebookselling.eu/consumer-behaviour">report</a> by the European and International Book Federation found that only 64% of Australians bought a book in the past year, compared to an average 72% of people across 19 countries. Similarly, 80% of Australians read a book in the past year, slightly below the international average of 85%. These differences are slim, but as book buyers and readers, we are among the lowest in the sample, alongside Aotearoa New Zealand, Finland, Latvia and the United States. The number of people who had read a book in the past year in Italy, Spain, the United Kingdom and Ireland all came in at over 90%. Local research also suggests reading rates in Australia are falling. Back in 2017, a Macquarie University study found 92% of us read books at least once in the previous year. By 2021, in the <a href="https://australiareads.org.au/research/the-national-reading-survey/">Australia Reads national survey</a> that figure had dropped to 75%. What’s behind these numbers? Price might be less of a factor than we often assume – and surprisingly, Australia’s dependence on cars could play a role. International examples showing how other countries protect and value their book cultures – from government policies to counter the strength of Amazon to public holidays for poets – suggest measures to actively boost our own could help. <h2>The price myth</h2> There’s a general perception that books cost too much in Australia. But they’re not necessarily more expensive here than elsewhere. Competition from online retailers like Amazon and increases in production costs globally <a href="https://www.ibisworld.com/au/industry/book-publishing/171/">have levelled prices internationally</a>. In fact, Australians often pay similar or less for books than readers in Canada, New Zealand and the US. Tim Winton’s new novel, <a href="https://theconversation.com/tim-winton-goes-cli-fi-his-dystopian-novel-juice-breaks-new-ground-to-face-the-climate-emergency-238769">Juice</a>, for example, has an Australian recommended retail price of A$49.99. It’s almost exactly the same price in Aotearoa New Zealand (A$49.81) and costs more in Canada (A$54.59). In the US, Juice is A$44.02, and in the UK, it’s A$43.07. While UK book prices are lower, this is mainly because books there don’t attract sales tax. The UK <a href="https://www.accountingfirms.co.uk/blog/are-books-vat-exempt/#:%7E:text=In%20the%20UK%2C%20books%20are,to%20most%20goods%20and%20services">made books exempt</a> from its value-added tax (VAT) applied to most goods and services – a deliberate decision to make reading more affordable. Pauline MacLeod, the children’s and young adult literature specialist at Brisbane’s Riverbend Books, told me children’s publishers are “trying hard to keep local books priced between $22.99 and $25.99”. Still, <a href="https://theconversation.com/why-australian-workers-true-cost-of-living-has-climbed-far-faster-than-weve-been-told-221590">in the current cost of living squeeze</a> books are a discretionary spend some cannot afford. <h2>Public transport is good for reading</h2> Interestingly, countries where <a href="https://www.statista.com/topics/8282/rail-passenger-transport-in-europe/#statisticChapter">more people use public transport</a> – like the UK, France, Germany and Spain – tend to have higher reading rates. It’s easier to read a book on a train than in a car, and these countries often have bookshops in train stations, creating a culture of reading while commuting. In contrast, car-dependent countries like Australia, the US and Aotearoa New Zealand show lower reading rates. Our reliance on cars might explain why audiobooks are more popular in Australia than in many other countries. <h2>A holiday for a poet</h2> In Ireland, where 91% of people have read a book in the past 12 months, there is a strong cultural history of storytelling. Reading is <a href="https://www.theguardian.com/books/article/2024/aug/20/we-all-read-like-hell-how-ireland-became-the-worlds-literary-powerhouse">supported by</a> an arts council providing grants and bursaries, and a healthy ecosystem of literary festivals and magazines, public libraries and bookshops. Australia has many of these things, but Ireland also significantly supports writers, with a tax exemption on artists’ income up to €50,000 (approximately A$81,500) and a basic-income pilot scheme granting 2,000 artists €325 (approximately A$530) a week. In France, where the government <a href="https://www.culture.gouv.fr/en/regions/drac-grand-est/services/idc/reading-book/Support-for-the-book-economy">actively protects its reading culture</a>, 88% of people have read a book in the past 12 months. In 2022, <a href="https://www.theguardian.com/world/2022/sep/23/france-minimum-book-delivery-fee-amazon">France introduced a law</a> to make French bookshops more competitive with online retailers like Amazon which often offer free delivery of books. By setting a minimum delivery fee for all online book orders of less than €35 (around A$57), the government aims to level the playing field for local booksellers. Perhaps unsurprisingly, only 5% of French people buy all their books online (as opposed to 12% in Australia). Australia has public holidays dedicated to sports, like the Melbourne Cup and the AFL Grand Final (both in Victoria). In Portugal, a national holiday, Portugal Day, commemorates the death of poet <a href="https://www.britannica.com/biography/Luis-de-Camoes">Luís de Camões</a>, considered Portugal’s greatest. While 85% of Portuguese people have read a book in the past 12 months (exactly the international average), they consider reading as one of their hobbies (37%) and have bought a book in the past year (76%) at rates above the international average. Interestingly, just 32% of Australians said they consider reading a hobby, compared to 44% in Spain and 42% in the UK. Families, the education system and the media are also all key to inculcating this culture of reading, as is a strong local publishing industry. <h2>The way forward</h2> Local booksellers report declining reading rates in Australia, too. Robbie Egan, CEO of Australia’s peak bookselling industry body, BookPeople, told me: “The competition for eyeballs is real and it is fierce, and consumer discretionary dollars are scarce”. Industry leaders like Egan suggest we need a national campaign to promote the benefit of reading. We know from local research that <a href="https://www.bookpeople.org.au/images/BookPeople_Papers_Imagination.pdf">Australians value books and storytelling</a>. With increasing competition from other forms of entertainment and tighter household budgets, encouraging a stronger reading culture may be more important than ever.<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/243272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katya-johanson-425719">Katya Johanson</a>, Professor of Publishing and Audience Studies, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australians-are-reading-less-than-other-countries-a-new-report-shows-why-243272">original article</a>. </div>

Books

What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a <a href="https://apnews.com/article/bronny-james-cardiac-arrest-3953eee8789e83f3cccfb6dd798bc54e">cardiac arrest</a>. Many media outlets incorrectly referred to the event as a “<a href="https://en.as.com/nba/lebron-james-son-bronny-plays-for-the-usc-trojans-for-the-first-time-since-suffering-a-heart-attack-n/">heart attack</a>” or used the terms interchangeably. A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart. With some background in <a href="https://www.youtube.com/watch?v=uKrgEv7-rVM&t=16s">how the heart works</a>, we can see how they differ and how they’re related. <h2>Understanding the heart</h2> The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body. For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs. This can cause the heart muscle to become injured or die, and results in the heart not pumping properly. <h2>Heart attack or cardiac arrest?</h2> Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle. A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump. In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other. <h2>Why do they happen? Who’s at risk?</h2> Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease. The underlying cause in about <a href="https://www.ncbi.nlm.nih.gov/books/NBK507799/#:%7E:text=It%20has%20been%20reported%20that,increases%20beyond%20age%2050%20years.">75% of people</a> is a process called <a href="https://youtu.be/jwL4lkSlvSA?si=H2as7dQkhbIqWWkU">atherosclerosis</a>. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot. Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process. Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle. Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.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/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="Heart attack vs cardiac arrest" /></a><figcaption>Here’s a simple way to remember the difference. Author provided</figcaption></figure> But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to <a href="https://www.youtube.com/watch?v=M_soKG-Tzh0&t=903s">electrical malfunctions</a> in the heart. There are four distinct types: <ul> <li> ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541285/">100 beats per minute</a> (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately </li> <li> ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute </li> <li> pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse </li> <li> asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart. </li> </ul> Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a <a href="https://www.espn.com.au/mens-college-basketball/story/_/id/38260006/bronny-james-cardiac-arrest-caused-congenital-heart-defect">congenital heart defect</a>, a heart condition he was born with. But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting <a href="https://pubmed.ncbi.nlm.nih.gov/11898927/">for 70%</a> of all cases. So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest. So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack. <h2>What do they look like?</h2> Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin. But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating. <h2>What’s the take-home message?</h2> While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes. A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring. Despite their different nature both conditions can have severe consequences and require immediate medical attention.<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/229633/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, Associate Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, Senior lecturer, School of Nursing and Midwifery, <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/whats-the-difference-between-a-heart-attack-and-cardiac-arrest-ones-about-plumbing-the-other-wiring-229633">original article</a>. </div>

Body

Beyond the Barrier Reef: Australia’s 3 other World Heritage reefs are also in trouble

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/kate-marie-quigley-1400512">Kate Marie Quigley</a>, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/andrew-hamilton-baird-11285">Andrew Hamilton Baird</a>, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> The Great Barrier Reef is world famous – it’s the largest coral reef system in the world and home to tens of thousands of species. No wonder it is World Heritage listed. But Australia has three lower profile reefs which are also World Heritage listed – Ningaloo and Shark Bay in Western Australia, and Lord Howe Island, 600 kilometres off the New South Wales coast, the <a href="https://www.guinnessworldrecords.com/world-records/612288-most-southerly-coral-reef">southernmost coral</a> in the world. Ningaloo has 260km of coral reef, while the reefs of Shark Bay have less coral but are home to ancient stromatolites, vast seagrass beds and iconic species such as dugongs. This month, the World Heritage Committee will meet in New Delhi. On the agenda will be how the world’s natural World Heritage sites are faring. The Australian government will be under increased scrutiny to prove it has upheld its <a href="https://www.dcceew.gov.au/parks-heritage/heritage/about/world/management-australias-world-heritage-listed/managing-world-heritage-australia/protecting-world-heritage#regulation">international commitments</a> to protecting these reefs. Our <a href="https://onlinelibrary.wiley.com/doi/10.1111/gcb.17407">new research</a> has found all four of these reefs are in greater danger than we thought – even those in subtropical waters, such as Lord Howe Island. Our two Indian Ocean reefs at <a href="https://whc.unesco.org/en/list/578/">Shark Bay</a> and Ningaloo actually face more species and function loss than the Great Barrier Reef. At 1.5°C of warming, we are likely to lose about 20% of the 400-odd coral species which currently live across these four reefs (equating to about 70 extinctions). At 2°C warming, our modelling of species abundance and ecosystem functions predict an almost complete collapse in reef ecosystems – even for the subtropical reefs. This aligns with <a href="https://www.annualreviews.org/docserver/fulltext/animal/12/1/annurev-animal-021122-093315.pdf?expires=1721002489&id=id&accname=guest&checksum=A9A203CC0F3AEB7D1FE9420F50EDF69A,%20https://backend.orbit.dtu.dk/ws/files/238807594/AGR2020.pdf">predictions</a> by the Intergovernmental Panel on Climate Change for the future of coral reefs. We believe our work adds to the need to consider whether Australia’s four iconic reefs should be <a href="https://whc.unesco.org/en/danger/">on the list</a> of World Heritage sites in danger. <h2>What does it mean when a reef is World Heritage listed?</h2> Declaring a natural or cultural site as World Heritage is done to encourage the preservation of locations of immense ecological and cultural value. Nations have to <a href="https://whc.unesco.org/en/nominations/">nominate sites</a> they think are worthy of protection. Australia has 20 World Heritage sites, <a href="https://www.dcceew.gov.au/parks-heritage/heritage/places/world-heritage-list">of which</a> 12 are natural. When sites are formally listed, the United Nations Educational, Scientific and Cultural Organization (UNESCO) requires the country’s government to look after it. If the site is degrading, it can be listed as in danger. UNESCO has considered listing the Great Barrier Reef as in danger twice, in 2021 and again in <a href="https://www.theguardian.com/environment/article/2024/jun/24/set-more-ambitious-climate-targets-to-save-great-barrier-reef-unesco-urges-australia">June this year</a>. For the reef to keep its World Heritage status, the government must prove its policies are sufficient to keep the reefs in <a href="https://www.dcceew.gov.au/parks-heritage/heritage/about/world-heritage/outstanding-universal-value">good health</a>. In the debate over the Great Barrier Reef, two things have been missed – first, any mention of Australia’s other World Heritage reefs, and second, whether the federal government’s current policies to cut greenhouse gases are enough to protect the reefs into the future. <h2>What did we find?</h2> Our new results suggest all four reefs are in trouble. Given current warming trends, they will only deteriorate further in the future if we stay on this course. While the Barrier Reef has drawn a great deal of attention, it’s actually the ecosystems at Ningaloo, Shark Bay and Lord Howe Island which are projected to warm the most. When standardised to park boundaries, temperatures here are projected to increase by up to 1.3°C by the end of the century. (This temperature estimate is for sea temperatures, not the overall surface temperature which we use as shorthand when we talk about 1.5°C or 2°C of warming). While that might not sound like much, it will be enough to push many corals to potential extinction. Many coral species already exist within 1-2°C of the maximum temperature they can tolerate. Our modelling shows Shark Bay and Ningaloo actually face a greater risk of species and function loss than the Barrier Reef. It also suggests the ability of our reefs to bounce back will be overcome when warming tips over 1.5°C globally. While these models incorporate the baseline heat tolerance of coral species on these reefs, they don’t yet include their <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-animal-021122-093315;jsessionid=mfIBuwjZ-ru5bkBMhWXDjumNnsvZgxkl02fPAg63.annurevlive-10-241-10-101">potential for genetic adaptation</a>. The question of whether some corals could adapt to this rapid warming is still open. A lot is riding on their ability to do so. <h2>Looming danger</h2> This year, the <a href="https://theconversation.com/sentinels-of-the-sea-ancient-boulder-corals-are-key-to-reef-survival-in-a-warmer-world-223207">Great Barrier Reef</a> and <a href="https://www.theguardian.com/australia-news/2024/mar/06/lord-howe-island-coral-bleaching-moving-south-fears-ocean-temperatures">Lord Howe Island</a> have suffered intense stress from high sea temperatures – the direct result of burning fossil fuels and producing heat-trapping greenhouse gases. This year is <a href="https://www.reuters.com/business/environment/2024-could-be-worlds-hottest-year-june-breaks-records-2024-07-08/#:%7E:text=The%20latest%20data%20suggest%202024,so%20far%2C%20some%20scientists%20said.">on track</a> to again be the hottest year on record, overtaking the previous record holder of 2023. Australia is already in the midst of an extinction crisis. Australia has one of the worst track records for extinctions. Since European colonisation, 34-38 mammal species have <a href="https://www.science.org/doi/abs/10.1126/science.adg7870">gone extinct</a> compared to just one from the contiguous United States, which covers a similar area. You might have read that coral cover – a measure of how much coral there is in an area – <a href="https://link.springer.com/article/10.1007/s00338-024-02498-5">hit historic highs</a> on the Great Barrier Reef last year. Coral cover is a helpful and important metric, but it’s <a href="https://theconversation.com/record-coral-cover-doesnt-necessarily-mean-the-great-barrier-reef-is-in-good-health-despite-what-you-may-have-heard-188233">not perfect</a>. For instance, fast-growing heat tolerant coral species might expand as less heat tolerant species die off. Importantly, relying on coral cover alone can mask significant changes in how the <a href="https://royalsocietypublishing.org/doi/10.1098/rspb.2019.2628">reef is functioning</a>. It’s hard to assess how species in our oceans are doing, given the difficulty of access and the large number of species, including many <a href="https://theconversation.com/the-first-step-to-conserving-the-great-barrier-reef-is-understanding-what-lives-there-146097">unknown to science</a>. If warming continues unabated, we will likely start to lose species before we have even documented them. Our results are based on “moderate” climate models of global surface temperature changes. Australia has committed to cutting emissions by 43% below 2005 levels by 2030. While that sounds good, it’s not enough – this decrease is compatible with <a href="https://environment.govt.nz/what-you-can-do/climate-scenarios-toolkit/climate-scenarios-list/ipccs-ssp-rcp-scenarios/">hitting 3.2ºC by 2100</a>. To limit warming to 1.5ºC or below by 2050, we would need to commit to much greater cuts in emissions – 90% below 2005 levels by 2030. Our results clearly suggest Australia’s four World Heritage reefs will be dramatically affected by warming in the near future. They will no longer qualify as being maintained under “conditions of integrity”. It’s hard to see how they can avoid being added to the in danger list.<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/234268/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kate-marie-quigley-1400512">Kate Marie Quigley</a>, DECRA Research Fellow in molecular ecology, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/andrew-hamilton-baird-11285">Andrew Hamilton Baird</a>, Professorial fellow in coral reef ecology, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook 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/beyond-the-barrier-reef-australias-3-other-world-heritage-reefs-are-also-in-trouble-234268">original article</a>. </div>

Domestic Travel

Are you up to date with your COVID, flu and other shots? It might depend on who your GP is

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/anika-stobart-1014358">Anika Stobart</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Too many older Australians are <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">missing out</a> on recommended vaccinations for COVID, flu, shingles and pneumococcal that can protect them from serious illness, hospitalisation and even death. A new <a href="https://grattan.edu.au/">Grattan Institute report</a> shows vaccination rates vary widely from GP to GP, highlighting an important place to look for opportunities to boost vaccination. Many people get vaccinated at pharmacies, and those vaccinations are counted in our analysis. But we looked at GPs because they have a unique role overseeing someone’s health care, and an important role promoting vaccination. We found that for some GPs, nine in ten of their older patients were vaccinated for flu. For others, the rate was only four in ten. The differences for shingles and COVID were even bigger. For pneumococcal disease, there was a 13-fold difference in GPs’ patient vaccination rates. While some variation is inevitable, these differences are large, and they result in too many people missing out on recommended vaccines. <h2>Some GPs treat more complex patients</h2> A lot of these differences reflect the fact that GPs see different types of patients. Our research shows older people who aren’t proficient in English are up to 15% less likely to be vaccinated, even after other factors are taken into account. And the problem seems to be getting worse. COVID vaccination rates for people 75 years and older fell to just 36% in May 2024. But rates were even lower – a mere 11% – for people who don’t speak English proficiently, and 15% for those who speak a language other than English at home. Given these results, it’s no surprise that GPs with fewer patients who are vaccinated also have more patients who struggle with English. For GPs with the lowest vaccination rates, one-quarter of their patients aren’t proficient in English. For GPs with the highest vaccination rates, it is only 1%. GPs with fewer vaccinated patients also saw more people who live in rural areas, are poorer, didn’t go to university, and don’t have regular access to a GP, all of which reduce the likelihood of getting vaccinated. Many of these barriers to vaccination are difficult for GPs to overcome. They point to structural problems in our health system, and indeed our society, that go well beyond vaccination. But GPs are also a key part of the puzzle. A <a href="https://www.ijidonline.com/article/S1201-9712(14)01379-4/fulltext">strong</a> <a href="https://www.tandfonline.com/doi/full/10.1080/21645515.2020.1780848">recommendation</a> from a GP can make a big difference to whether a patient gets vaccinated. <a href="https://www.aihw.gov.au/reports/primary-health-care/general-practice-allied-health-primary-care">Nearly all</a> older Australians visit a GP every year. And some GPs have room for improvement. <h2>But GPs seeing similar patients can have very different vaccination rates</h2> We compared GPs whose patients had a similar likelihood of being vaccinated, based on a range of factors including their health, wealth and cultural background. Among the GPs whose patients were least likely to get a flu vaccination, some saw less than 40% of their patients vaccinated, while for others in that group, the rate was over 70%. Among GPs with patients who face few barriers to vaccination, the share of their patients who were vaccinated also varied widely. Even within neighbourhoods, GP patient vaccination rates vary a lot. For example, in Bankstown in Sydney, there was a seven-fold difference in COVID vaccination rates and an 18-fold difference for pneumococcal vaccination. Not everything about clinics and patients can be measured in data, and there will be good reasons for some of these differences. But the results do suggest that some GPs are beating the odds to overcome patient barriers to getting vaccinated, while other GPs could be doing more. That should trigger focused efforts to raise vaccination rates where they are low. <h2>So what should governments do?</h2> A comprehensive national reform agenda is <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">needed to increase adult vaccination</a>. That includes clearer guidance, national advertising campaigns, SMS reminders, and tailored local programs that reach out to communities with very low levels of vaccination. But based on the big differences in GPs’ patient vaccination rates, Australia also needs a three-pronged plan to help GPs lift older Australians’ vaccination rates. First, the way general practice is funded needs to be overhauled, providing more money for the GPs whose patients face higher barriers to vaccination. Today, clinics with patients who are poorer, sicker and who struggle with English tend to get less funding. They should get more, so they can spend more time with patients to explain and promote vaccination. Second, GPs need to be given data, so that they can easily see how their vaccination rates compare to GPs with similar patients. And third, Primary Health Networks – which are responsible for improving primary care in their area – should give clinics with low vaccination rates the help they need. That might include running vaccination sessions, sharing information about best practices that work in similar clinics with higher vaccination rates, or offering translation support. And because pharmacies also play an important role in promoting and providing vaccines, governments should give them data too, showing how their rates compare to other pharmacies in their area, and support to boost vaccination uptake. These measures would go a long way to better protect some of the most vulnerable in our society. Governments have better data than ever before on who is missing out on vaccinations – and other types of health care. They shouldn’t miss the opportunity to target support so that no matter where you live, what your background is, or which GP or pharmacy you go to, you will have the best chance of being protected against disease.<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/234175/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/anika-stobart-1014358">Anika Stobart</a>, Senior Associate, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</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/are-you-up-to-date-with-your-covid-flu-and-other-shots-it-might-depend-on-who-your-gp-is-234175">original article</a>. </div>

Body

Emirates takes cheeky swipe at other airlines in new safety video

Emirates have taken a cheeky swipe at Qantas, Air New Zealand and British Airways with their new “no nonsense” in-flight safety video. The Dubai-based airline took a different approach to other major airlines, saying they chose not to include dancers and singers for its in-flight entertainment because they “take your safety seriously”. “Hello and welcome on board your Emirates flight today,” a flight attendant says at the start of the four minute video. “This is your no-nonsense safety video. We do not have dancers breaking into song, characters from movies, or celebrities trying to be funny I’m afraid.” Another cabin crew member then chips in, “But at Emirates, safety always comes first. So it’s important that we take you through some safety features before takeoff. And then you can all get back to our award-winning entertainment system.” <iframe title="YouTube video player" src="https://www.youtube.com/embed/MCW5kH1G_1Y?si=IgvSjvOEa-n_f01v" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe> The decision to stick to the basics for such an important video has been praised online, with many comparing the video to others by competing airlines. “Excellent video. No fuss, no faff, just informative and not distracting. These videos are about safety first and foremost, not entertainment,” wrote one fan. “Emirates got it right. This is THE safety video, simple and comprehensive which it should be,” agreed another. “This video is sending a message to other airlines,” stated a third. Emirates has gone in the opposite direction to its Aussie partner <a href="https://oversixty.com.au/travel/travel-trouble/disappointing-new-inflight-qantas-video-slammed-for-missing-the-mark">Qantas</a>, as a safety video from the Flying Kangaroo went viral earlier this year for all the wrong reasons. The video was widely panned for being “elitist” and “sexist”, while skimming over vital safety information, as one person on social media wrote, “I’d prefer just focus on, oh I dunno, in flight safety during the in-flight safety video? “Why do we need a long video with all this added stuff?” The video, which replaced an earlier retro video released in 2020 that marked the airline’s 100th birthday, features frequent flyers and Qantas staff delivering the pre-flight safety announcement from their favourite “magic places” around the world. Image credits: Emirates

International Travel

We finally know why some people got COVID while others didn’t

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times. Through a collaboration between University College London, the Wellcome Sanger Institute and Imperial College London in the UK, we set out to answer this question using the world’s first controlled <a href="https://www.nature.com/articles/s41591-022-01780-9">“challenge trial” for COVID</a> – where volunteers were deliberately exposed to SARS-CoV-2, the virus that causes COVID, so that it could be studied in great detail. Unvaccinated healthy volunteers with no prior history of COVID were exposed – via a nasal spray – to an extremely low dose of the original strain of SARS-CoV-2. The volunteers were then closely monitored in a quarantine unit, with regular tests and samples taken to study their response to the virus in a highly controlled and safe environment. For our <a href="https://www.nature.com/articles/s41586-024-07575-x">recent study</a>, published in Nature, we collected samples from tissue located midway between the nose and the throat as well as blood samples from 16 volunteers. These samples were taken before the participants were exposed to the virus, to give us a baseline measurement, and afterwards at regular intervals. The samples were then processed and analysed using single-cell sequencing technology, which allowed us to extract and sequence the genetic material of individual cells. Using this cutting-edge technology, we could track the evolution of the disease in unprecedented detail, from pre-infection to recovery. To our surprise, we found that, despite all the volunteers being carefully exposed to the exact same dose of the virus in the same manner, not everyone ended up testing positive for COVID. In fact, we were able to divide the volunteers into three distinct infection groups (see illustration). Six out of the 16 volunteers developed typical mild COVID, testing positive for several days with cold-like symptoms. We referred to this group as the “sustained infection group”. Out of the ten volunteers who did not develop a sustained infection, suggesting that they were able to fight off the virus early on, three went on to develop an “intermediate” infection with intermittent single positive viral tests and limited symptoms. We called them the “transient infection group”. The final seven volunteers remained negative on testing and did not develop any symptoms. This was the “abortive infection group”. This is the first confirmation of abortive infections, which were previously <a href="https://www.nature.com/articles/s41586-021-04186-8">unproven</a>. Despite differences in infection outcomes, participants in all groups shared some specific novel immune responses, including in those whose immune systems prevented the infection. When we compared the timings of the cellular response between the three infection groups, we saw distinct patterns. For example, in the transiently infected volunteers where the virus was only briefly detected, we saw a strong and immediate accumulation of immune cells in the nose one day after infection. This contrasted with the sustained infection group, where a more delayed response was seen, starting five days after infection and potentially enabling the virus to take hold in these volunteers. In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the “interferon” response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly. <h2>Protective gene</h2> Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection and could hence be used as a marker of protection. Therefore, we might be able to use this information and identify those who are probably going to be protected from severe COVID. These findings help us fill in some gaps in our knowledge, painting a much more detailed picture regarding how our bodies react to a new virus, particularly in the first couple of days of an infection, which is crucial. We can use this information to compare our data to other data we are currently generating, specifically where we are “challenging” volunteers to other viruses and more recent strains of COVID. In contrast to our current study, these will mostly include volunteers who have been vaccinated or naturally infected – that is, people who already have immunity. Our study has significant implications for future treatments and vaccine development. By comparing our data to volunteers who have never been exposed to the virus with those who already have immunity, we may be able to identify new ways of inducing protection, while also helping the development of more effective vaccines for future pandemics. In essence, our research is a step towards better preparedness for the next pandemic.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233063/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, Principal Research Fellow/Honorary consultant Respiratory Medicine, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, Postdoc Research Fellow, Molecular and Cellular Biology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-finally-know-why-some-people-got-covid-while-others-didnt-233063">original article</a>. </div>

Body

"Why is the water so salty?" and other priceless questions from clueless tourists

In the heart of the stunning intersection where the Daintree Rainforest kisses the Great Barrier Reef, you’ll find <a href="https://www.tripadvisor.com.au/Attraction_Review-g499639-d1045292-Reviews-Ocean_Safari-Cape_Tribulation_Daintree_Region_Queensland.html" target="_blank" rel="noopener">Ocean Safari</a> – a top-notch, eco-certified tour company. Brooke Nikola, one of their delightful tour guides, has been guiding wide-eyed adventurers through this paradise for years. With thousands of tourists coming from all corners of the globe, she’s accumulated a treasure trove of amusing anecdotes that could rival the size of the reef itself. Let’s dive right into the deep end with some classic moments <a href="https://www.news.com.au/travel/australian-holidays/queensland/hilarious-comments-from-clueless-tourists/news-story/ad90a419cbf4fed9d454d3edef0cb096" target="_blank" rel="noopener">per news.com.au</a>. One sunny day, while marvelling at the endless blue expanse, a curious tourist asked Brooke, “Why does the water taste so salty?” “Well, it’s the ocean,” Brooke gently reminded them. Ah, the wonders of seawater – still a mystery to some. Then there was the time aboard the Ocean Safari vessel, cruising serenely over the waves, when a perplexed guest inquired, “How far above sea level are we?” And who could forget the would-be scientist who attempted to bottle the stunning blue ocean water, only to be baffled when it turned out clear. We can only imagine Brooke explaining the tricky science of light refraction and how the ocean's mesmerising blue doesn't quite fit into a bottle. No doubt their holiday turned into an impromptu science lesson. The complaints Brooke hears are just as priceless. One guest, dripping after a snorkelling session, grumbled, “Ugh, snorkelling makes me so wet.” Then there was the revelation about the rainforest. As rain drizzled through the lush canopy, a bewildered tourist remarked, “It’s so rainy in the rainforest!” Who knew that rain would be part of the rainforest experience? Certainly not that guest! Geography can be tricky, especially in a place as uniquely named as Cape Tribulation. As tourists boarded the Ocean Safari vessel from Cape Tribulation beach, one asked where the Daintree Rainforest was – oblivious to the verdant scenery they had driven through for the past hour. Brooke had to kindly point out that they had been in it this whole time. Another classic came from a guest who thought Cape Tribulation was an island. They earnestly asked, “So, how big is the whole island?” To which Brooke replied, “It’s pretty big. So big, in fact, it’s known as Australia!” Through all of these delightful moments, no doubt Brooke remained a fountain of patience and good humour. So, next time you find yourself at Cape Tribulation, remember to bring your sense of wonder – and a good laugh. Because as Brooke can tell you, the Great Barrier Reef is full of surprises, both above and below the water! Images: Ocean Safari / Instagram

Travel Trouble

‘Sleeping on it’ really does help and four other recent sleep research breakthroughs

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a> Twenty-six years. That is roughly <a href="https://www.nature.com/articles/s41467-022-34624-8">how much of our lives</a> are spent asleep. Scientists have been trying to explain why we spend so much time sleeping since at least the <a href="https://plato.stanford.edu/entries/alcmaeon/">ancient Greeks</a>, but pinning down the exact functions of sleep has proven to be difficult. During the past decade, there has been a surge of interest from researchers in the nature and function of sleep. New experimental models coupled with advances in technology and analytical techniques are giving us a deeper look inside the sleeping brain. Here are some of the biggest recent breakthroughs in the science of sleep. <h2>1. We know more about lucid dreaming</h2> No longer on the fringes, the neuroscientific study of dreaming has now become mainstream. US researchers in a 2017 study woke their participants up at regular intervals during the night and asked them what was going through their minds prior to the alarm call. Sometimes participants couldn’t recall any dreaming. The study team then looked at what was <a href="https://www.nature.com/articles/nn.4545">happening in the participant’s brain</a> moments before waking. Participants’ recall of dream content was associated with increased activity in the posterior hot zone, an area of the brain closely <a href="https://www.nature.com/articles/d41586-018-05097-x">linked to conscious awareness</a>. Researchers could predict the presence or absence of dream experiences by monitoring this zone in real time. Another exciting development in the study of dreams is research into lucid dreams, in which <a href="https://theconversation.com/the-ability-to-control-dreams-may-help-us-unravel-the-mystery-of-consciousness-52394">you are aware that</a> you are dreaming. A 2021 study established <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00059-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982221000592%3Fshowall%3Dtrue">two-way communication</a> between a dreamer and a researcher. In this experiment, participants signalled to the researcher that they were dreaming by moving their eyes in a pre-agreed pattern. The researcher read out maths problems (what is eight minus six?). The dreamer could respond to this question with eye movements. The dreamers were accurate, indicating they had access to high level cognitive functions. The researchers used <a href="https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877">polysomnography</a>, which monitors bodily functions such as breathing and brain activity during sleep, to confirm that participants were asleep. These discoveries have dream researchers excited about the future of “interactive dreaming”, such as practising a skill or solving a problem in our dreams. <h2>2. Our brain replays memories while we sleep</h2> This year marks the centenary of the first demonstration that <a href="https://www.jstor.org/stable/1414040?origin=crossref">sleep improves our memory</a>. However, a 2023 review of recent research has shown that memories formed during the day <a href="https://portlandpress.com/emergtoplifesci/article/7/5/487/233796/Neural-reactivation-during-human-sleep">get reactivated</a> while we are sleeping. Researchers discovered this using machine learning techniques to “decode” the contents of the sleeping brain. <a href="https://www.nature.com/articles/s41467-021-24357-5">A 2021 study</a> found that training algorithms to distinguish between different memories while awake makes it possible to see the same neural patterns re-emerge in the sleeping brain. A different study, also in 2021, found that the more times these patterns re-emerge during sleep, <a href="https://www.nature.com/articles/s41467-021-23520-2">the bigger the benefit</a> to memory. In other approaches, scientists have been able to reactivate certain memories by <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)31035-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219310358%3Fshowall%3Dtrue">replaying sounds</a> associated with the memory in question while the participant was asleep. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144680/">2020 meta-analysis of 91 experiments</a> found that when participants’ memory was tested after sleep they remembered more of the stimuli whose sounds were played back during sleep, compared with control stimuli whose sounds were not replayed. Research has also shown that sleep strengthens memory for the <a href="https://www.pnas.org/doi/10.1073/pnas.2202657119">most important aspects</a> of an experience, restructures our memories to form <a href="https://www.jneurosci.org/content/40/9/1909">more cohesive narratives</a> and helps us come up with <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344">solutions to problems</a> we are stuck on. Science is showing that sleeping on it really does help. <h2>3. Sleep keeps our minds healthy</h2> We all know that a lack of sleep makes us feel bad. Laboratory sleep deprivation studies, where researchers keep willing participants awake throughout the night, have been combined with <a href="https://www.open.edu/openlearn/body-mind/health/health-sciences/how-fmri-works">functional MRI brain scans</a> to paint a detailed picture of the sleep-deprived brain. These studies have shown that a lack of sleep severely disrupts the <a href="https://www.nature.com/articles/nrn.2017.55">connectivity between</a> different brain networks. These changes include a breakdown of connectivity between brain regions <a href="https://link.springer.com/article/10.1007/s11682-018-9868-2">responsible for cognitive control</a>, and an amplification of those involved in <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)30761-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219307614%3Fshowall%3Dtrue">threat and emotional processing</a>. The consequence of this is that the sleep-deprived brain is worse at <a href="https://academic.oup.com/cercor/article/33/5/1610/6573958">learning new information</a>, <a href="https://academic.oup.com/sleep/article/44/6/zsaa289/6053003">poorer at regulating emotions</a>, and unable to <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">suppress intrusive thoughts</a>. Sleep loss may even make you less likely to <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001733">help other people</a>. These findings may explain why poor sleep quality is so <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13930">ubiquitous in poor mental health</a>. <h2>4. Sleep protects us against neurodegenerative diseases</h2> Although we naturally <a href="https://www.nature.com/articles/s41467-022-34624-8">sleep less as we age</a>, mounting evidence suggests that sleep problems earlier in life <a href="https://jnnp.bmj.com/content/91/3/236">increase the risk</a> of dementia. The build-up of β-amyloid, a <a href="https://www.nhs.uk/conditions/alzheimers-disease/causes/">metabolic waste product</a>, is one of the mechanisms underlying Alzheimer’s disease. Recently, it has become apparent that deep, undisturbed sleep is good for <a href="https://www.science.org/doi/10.1126/sciadv.aav5447">flushing these toxins</a> out of the brain. Sleep deprivation increases the the rate of build-up of β-amyloid in parts of the brain involved in memory, <a href="https://www.pnas.org/doi/full/10.1073/pnas.1721694115">such as the hippocampus</a>. A longitudinal study published in 2020 found that sleep problems were associated with a higher rate of β-amyloid accumulation at a follow-up <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(20)31171-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982220311714%3Fshowall%3Dtrue">four years later</a>. In a different study, published in 2022, sleep parameters <a href="https://elifesciences.org/articles/78191">forecasted the rate</a> of cognitive decline in participants over the following two years. <h2>5. We can engineer sleep</h2> The good news is that research is developing treatments to get a better night’s sleep and boost its benefits. For example, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.14035">European Sleep Research Society</a> and the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8986">American Academy of Sleep Medicine</a> recommend cognitive behavioural therapy for insomnia (CBT-I). <a href="https://www.cntw.nhs.uk/services/nctalkingtherapies/what-do-nc-talking-therapies-offer/cbt-i-cbt-for-insomnia/">CBT-I works by</a> identifying thoughts, feelings and behaviour that contribute to insomnia, which can then be modified to help promote sleep. In 2022, a CBT-I app became the <a href="https://www.nice.org.uk/news/article/nice-recommends-offering-app-based-treatment-for-people-with-insomnia-instead-of-sleeping-pills">first digital therapy</a> recommended by England’s National Institute for Health and Care Excellence for treatment on the NHS. These interventions can improve other aspects of our lives as well. A <a href="https://www.sciencedirect.com/science/article/pii/S1087079221001416?via%3Dihub">2021 meta-analysis</a> of 65 clinical trials found that improving sleep via CBT-I reduced symptoms of depression, anxiety, rumination and stress.<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/230484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, Marie Skłodowska-Curie Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</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/sleeping-on-it-really-does-help-and-four-other-recent-sleep-research-breakthroughs-230484">original article</a>. </div>

Body

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

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

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Does hosting the Olympics, the World Cup or other major sports events really pay off?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ivan-savin-678930">Ivan Savin</a>, <a href="https://theconversation.com/institutions/escp-business-school-813">ESCP Business School</a> After a long battle, <a href="https://www.france24.com/en/europe/20240213-paris-booksellers-stay-olympics-macron-bouquiniste-france">Paris’s beloved bouquinistes will be staying put</a> this summer. The decision, announced on 13 February by the French government, came after considerable public backlash to the police prefecture’s original plan to move part of the iconic Seine booksellers elsewhere for the inauguration of the Olympics Games on 26 July. Meanwhile, less than six months away from the event, Parisians continue to grumble over a <a href="https://www.ouest-france.fr/jeux-olympiques/cest-aberrant-ce-maire-vient-dapprendre-que-sa-ville-accueillera-les-jeux-de-paris-ab1fa968-cfd1-11ee-89c0-6cefac77e04a">lack of consultations</a> with locals, warnings of <a href="https://www.rfi.fr/en/france/20231130-paris-vehicle-traffic-to-be-heavily-restricted-during-2024-olympic-games">gridlocked traffic</a>, closed metro stations, extensive video surveillance and other grievances. So for host countries, what was the point of the Olympics, again? In academia, the debate about the potential positive and negative effects of large-scale sporting events is ongoing. Although these events are often associated with substantial economic losses, the long-term benefits are the main argument in favour of hosting them. These include the development of material and soft infrastructure such as hotels, restaurants or parks. Big games can also help put the host region on the map as an attractive place for sports and cultural events, and inspire a better entrepreneurial climate. <h2>The pros and the cons of big sporting events?</h2> The cost of these benefits, as the Parisians have realised, is steep. Host countries appear to suffer from increased tax burdens, low returns on public investments, high construction costs, and onerous running cost of facilities after the event. Communities can also be blighted by noise, pollution, and damage to the environment, while increased criminal activity and potential conflicts between locals and visitors can take a toll on their quality of life. As a result, in the recent past several major cities, including Rome and Hamburg, <a href="https://www.dw.com/en/6-cities-that-rejected-the-olympics/a-46289852">withdrew their bids to host the games</a>. A common feature of the economics of large-scale sporting events is that our expectations of them are more optimistic than what we make of them once they have taken place. Typically, expenditure tends to tip over the original budget, while the revenue-side indicators (such as the number of visitors) are rarely achieved. When analysing the effect of hosting large-scale sporting events on tourist visits, it is important to take into consideration both the positive and negative components of the overall effect. While positive effects may be associated with visitors, negative effects may arise when “regular” tourists refuse to visit the location due to the event. This might be because of overloaded infrastructure, sharp increases in accommodation costs, and inconveniences associated with overcrowding or raucous or/and violent visitors. On top of that, reports of poverty or crime in the global media can actually undermine the location’s attractiveness. <h2>When big sporting events crowd out regular tourists</h2> In an <a href="https://doi.org/10.1177/1527002523120639">article published in the Journal of Sports Economics</a> with Igor Drapkin and Ilya Zverev, I assess the effects of hosting large-scale sporting events, such as Winter and Summer Olympics plus FIFA World Cups, on international tourist visits. We utilise a comprehensive dataset on flow of tourists covering the world’s largest destination and origin countries between 1995 and 2019. As a first step, we built an econometric model that effectively predicts the flow of tourists between any pair of countries in our data. Subsequently we compared the predicted tourist inflow in a hypothetical scenario where no large-scale sporting event would have taken place with the actual figures. If the actual figures exceed the predicted ones, we consider the event to have a net positive impact. Otherwise, we consider that it had a “crowding out” effect on “regular” tourists. While conducting this analysis, we distinguished between short-term (i.e., focusing just on the year of the event) and mid-term (year of the event plus three subsequent years). Our results show that the effects of large-scale sporting events vary a lot across host countries: The World Cup in Japan and South Korea 2002 and South Africa 2010 were associated with a distinct increase in tourist arrivals, whereas all other World Cups were either neutral or negative. Among the Summer Olympics, China in 2008 is the only case with a significant positive effect on tourist inflows. The effects of the other four events (Australia 2000, Greece 2004, Great Britain 2012, and Brazil 2016) were found to be negative in the short- and medium-term. As for the Winter Olympics, the only positive case is Russia in 2014. The remaining five events had a negative impact except the one-year neutral effect for Japan 1998. Following large-scale sporting events, host countries are therefore typically less visited by tourists. Out of the 18 hosting countries studied, 11 saw tourist numbers decline over four years, and three did not experience a significant change. <h2>The case for cautious optimism</h2> Our research indicates that the positive effect of hosting large-scale sporting events on tourist inflows is, at best, moderate. While many tourists are attracted by FIFA World Cups and Olympic games, the crowding-out effect of “regular” tourists is strong and often underestimated. This implies that tourists visiting for an event like the Olympics typically dissuade those who would have come for other reasons. Thus, efforts to attract new visitors should be accompanied by efforts to retain the already existing ones. Large-scale sporting events should be considered as part of a long-term policy for promoting a territory to tourists rather than a standalone solution. Revealingly, our results indicate that it is easier to get a net increase in tourist inflows in countries that are less frequent destinations for tourists – for example, those in Asia or Africa. By contrast, the United States and Europe, both of which are traditionally popular with tourists, have no single case of a net positive effect. Put differently, the large-scale sporting events in Asia and Africa helped promote their host countries as tourist destinations, making the case for the initial investment. In the US and Europe, however, those in the last few decades brought little return, at least in terms of tourist inflow.<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/222118/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ivan-savin-678930">Ivan Savin</a>, Associate professor of quantitative analytics, research fellow at ICTA-UAB, <a href="https://theconversation.com/institutions/escp-business-school-813">ESCP Business School</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-hosting-the-olympics-the-world-cup-or-other-major-sports-events-really-pay-off-222118">original article</a>. </div>

Travel Tips

Vitamin D supplements can keep bones strong – but they may also have other benefits to your health

<a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> Most of us don’t worry about getting vitamin D when the weather’s warm and the sun is shining. But as winter approaches, accompanied by overcast days and long nights, you may be wondering if it could be useful to take a vitamin D supplement – and what benefit it might have. During the summer, the best way to get vitamin D is by getting a bit of sunshine. Ultraviolet rays (specifically UVB, which have a shorter wavelength) interact with a form of cholesterol called <a href="https://www.ncbi.nlm.nih.gov/books/NBK278935/">7-dehydrocholesterol</a> in the skin, which is then converted into vitamin D. Because vitamin D production is dependent on UVB, this means our ability to make it <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/#:%7E:text=From%20about%20late%20March%2Fearly,enough%20vitamin%20D%20from%20sunlight.">declines in the winter months</a>. Vitamin D production also <a href="https://pubmed.ncbi.nlm.nih.gov/24494042/">depends on where you live</a>, with people living nearer to the equator making more vitamin D than those living nearer the poles. Vitamin D deficiency is a <a href="https://assets.publishing.service.gov.uk/media/5a804e36ed915d74e622dafa/SACN_Vitamin_D_and_Health_report.pdf">problem in the UK</a> during the winter months. This is due to its northerly position and cloudy weather, and lack of time spent outdoors. One study of over 440,000 people in the UK found that <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">18% were vitamin D deficient</a> during the winter months. Vitamin D deficiency was even higher in certain ethnic groups – with the data showing 57% of Asian participants and 38% of black participants were vitamin D deficient. This is because the melanin content of skin determines a person’s ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946242/#:%7E:text=Skin%20pigmentation%2C%20i.e.%2C%20melanin%2C,%5B7%5D%20and%20more%20generally.">make UVB into vitamin D</a>. Given the prevalence of vitamin D deficiency in the UK, and the importance it has for our health, in 2016 the UK’s Science Advisory Council on Nutrition outlined recommendations for the <a href="https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report#:%7E:text=In%20a%20change%20to%20previous,aged%204%20years%20and%20older">amount of vitamin D</a> people should aim to get in the winter. They recommend people aim to get ten micrograms (or 400 IU – international units) of vitamin D per day. This would help people avoid severe deficiency. This can be achieved either by taking a supplement, or eating <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/ask-the-expert/foods-high-in-vitamin-d">certain foods</a> that are rich in vitamin D – including fatty fish such as herring, mackerel and wild salmon. A 100 gram serving of fresh herring, for example, would have approximately five micrograms of vitamin D. The clearest benefit of taking a vitamin D supplement is for <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/">bone health</a>. In fact, vitamin D was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899558/">first discovered</a> 100 years ago because of its ability to prevent the disease rickets, which causes weak bones that bend. Although rickets <a href="https://www.nhs.uk/conditions/rickets-and-osteomalacia/#:%7E:text=The%20number%20of%20rickets%20cases,from%20sunlight%2C%20can%20develop%20rickets.">isn’t very common</a> in the UK today, it can still occur in children if they lack vitamin D. In adults, vitamin D deficiency can cause bone pain, tenderness and muscles weakness, as well as increased risk of osteomalacia – often called “soft bone disease” – which leads to weakening or softening bones. The reason a lack of vitamin D can have such an effect on bone health is due to the vitamin’s relationship with <a href="https://pubmed.ncbi.nlm.nih.gov/18844850/">calcium and phosphate</a>. Both of these minerals help keep our bones strong – but they require vitamin D in order to be able to reinforce and strengthen bones. <h2>Other health benefits</h2> In addition to its effects on the skeleton, a growing body of research is beginning to indicate that vitamin D supplements may have additional benefits to our health. For example, <a href="https://ar.iiarjournals.org/content/42/10/5009.long">research shows</a> there’s a link between vitamin D deficiency and increased risk of catching certain viral illnesses, including the <a href="https://pubmed.ncbi.nlm.nih.gov/19237723/">common cold</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231123/">flu</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385774/">COVID</a>. Similarly, several studies – <a href="https://pubmed.ncbi.nlm.nih.gov/32904944/">including my own</a> – have demonstrated in cell models that vitamin D promotes immunity against microbes, such as the bacteria which causes tuberculosis. This means vitamin D may potentially prevent some types of infections. Vitamin D may also dampen inflammatory immune responses, which could potentially protect against autoimmune diseases, such as <a href="https://pubmed.ncbi.nlm.nih.gov/29243029/">multiple sclerosis</a> and <a href="https://www.frontiersin.org/articles/10.3389/fmed.2020.596007/full">rheumatoid arthritis</a>. One 2022 trial, which looked at over 25,000 people over the age of 50, found taking a 2,000 IU (50 micrograms) vitamin D supplement each day was associated with an <a href="https://www.bmj.com/content/376/bmj-2021-066452">18% lower risk</a> of autoimmune disease – notably rheumatoid arthritis. Vitamin D supplements may also be linked with lower risk of cardiovascular disease. A <a href="https://www.bmj.com/content/381/bmj-2023-075230">major Australian study</a>, which looked at over 21,000 people aged 60-84, found that participants who took a 2,000 IU vitamin D supplement a day for five years had a lower risk of suffering a major cardiovascular event (such as stroke or heart attack) compared to those who didn’t take a supplement. It’s currently not known why vitamin D may have these benefits on these other areas of our health. It’s also worth noting that in many of these trials, very few of the participants were actually vitamin D deficient. While we might speculate the observed health benefits may be even greater in people with vitamin D deficiency, it will be important for future research to study these factors. While it’s too early to say whether vitamin D supplements have broad health benefits, it’s clear it’s beneficial for bone health. It may be worthwhile to take a supplement in the winter months, especially if you’re over 65, have darker skin or spent a lot of time indoors as these factors can put you at <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-deficiency/faq-20058397#:%7E:text=However%2C%20some%20groups%20%E2%80%94%20particularly%20people,sun%20exposure%20or%20other%20factors.">increased risk of vitamin D deficiency</a>. The research also shows us that we should be rethinking vitamin D supplementation advice. While in the UK it’s recommended people get 400 IU of vitamin D a day, many trials have shown 2,000 IU a day is associated with health benefits.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219521/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, Professor of Molecular Endocrinology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</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/vitamin-d-supplements-can-keep-bones-strong-but-they-may-also-have-other-benefits-to-your-health-219521">original article</a>.

Body

"Other cities will follow": Big trouble ahead for SUV owners

Paris residents have voted to charge SUVs triple the cost of parking compared to standard sized cars in a bid to tackle air pollution and improve safety. 54.6 per cent of residents voted to pass the plan, with the new parking tariffs expected to start in September. The price increase will apply to on-street parking for vehicles with combustion or hybrid engines weighing more than 1.6 tonnes and electric vehicles weighing over two tonnes. The change means that the vehicles will pay €18 (A$29.69) an hour for parking in the centre of Paris, up from €6 (A$9.90), and €12 (A$19.79) an hour in the rest of the city, up from €4 (A$6.60). "Parisians have made a clear choice … other cities will follow,” Paris mayor Anne Hidalgo said. Experts are onboard with the move and believe the Australia should do the same thing. Urban access consultant and author of the book Rethinking Parking David Mepham said that the move could help improve safety as: “SUVs are actually some of the most unsafe vehicles on the road for pedestrians with a fatality rate that is significantly higher than other vehicles.” “The injury and fatality rate should be a concern in highly pedestrianised areas such as city centres.” In 2022 alone, SUV and light commercial vehicles made up 76.8 per cent of car sales, coming in eighth on the top 10 vehicle sales according to the Federal Chamber of Automotive Industries. With spaces in the cities limited, Mepham added: “If you’ve got a larger car you should expect to pay more for that, you should pay for what you use.” Standards Australia has recently proposed to increase the size of off-street parking spaces by 20 centimetres in Australia, from 5.4 metres to 5.6 metres, which would make it easier for larger vehicles to park, but would limit car spaces. Executive director of the Australia Institute, Richard Dennis also said that SUV owners need to face the consequences of owning a larger vehicle. “If we want to drive much bigger cars, are we going to widen all of our city streets, are we going to have less car parking spaces?” he said. “Because if we want to drive these cars we need to own the consequences.” Marion Terrill, an independent transport expert, also agreed that higher parking fees for large vehicles are “absolutely reasonable.” “If you want more of it you can pay more, it’s the same principle as paying for parking at all," she said. Image: Getty

Travel Trouble

How does cancer spread to other parts of the body?

<a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> All cancers begin in a single organ or tissue, such as the lungs or skin. When these cancers are confined in their original organ or tissue, they are generally more treatable. But a cancer that spreads is much more dangerous, as the organs it spreads to may be vital organs. A skin cancer, for example, might spread to the brain. This new growth makes the cancer much more challenging to treat, as it can be difficult to find all the new tumours. If a cancer can invade different organs or tissues, it can quickly become lethal. When cancer spreads in this way, it’s called metastasis. Metastasis is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745820/">responsible for</a> the majority (67%) of cancer deaths. <h2>Cells are supposed to stick to surrounding tissue</h2> Our bodies are made up of trillions of tiny cells. To keep us healthy, our bodies are constantly replacing old or damaged cells. Each cell has a specific job and a set of instructions (DNA) that tells it what to do. However, sometimes DNA can get damaged. This damage might change the instructions. A cell might now multiply uncontrollably, or lose a property known as adherence. This refers to how sticky a cell is, and how well it can cling to other surrounding cells and stay where it’s supposed to be. If a cancer cell loses its adherence, it can break off from the original tumour and travel through the bloodstream or lymphatic system to almost anywhere. This is how metastasis happens. Many of these travelling cancer cells will die, but some will settle in a new location and begin to form new cancers. Particular cancers are more likely to metastasise to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381616/">particular organs</a> that help support their growth. Breast cancers commonly metastasise to the bones, liver, and lungs, while skin cancers like melanomas are more likely to end up in the brain and heart. Unlike cancers which form in solid organs or tissues, blood cancers like leukaemia already move freely through the bloodstream, but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722462/">can escape</a> to settle in other organs like the liver or brain. <h2>When do cancers metastasise?</h2> The longer a cancer grows, the more likely it is to metastasise. If not caught early, a patient’s cancer may have metastasised even before it’s initially diagnosed. Metastasis can also occur after cancer treatment. This happens when cancer cells are dormant during treatment – drugs may not “see” those cells. These invisible cells can remain hidden in the body, only to wake up and begin growing into a new cancer months or even years later. For patients who already have cancer metastases at diagnosis, identifying the location of the original tumour – called the “primary site” – is important. A cancer that began in the breast but has spread to the liver will probably still behave like a breast cancer, and so will respond best to an anti-breast cancer therapy, and not anti-liver cancer therapy. As metastases can sometimes grow faster than the original tumour, it’s not always easy to tell which tumour came first. These cancers are called “cancers of unknown primary” and are the <a href="https://www.canceraustralia.gov.au/cancer-types/unknown-primary-cancer/statistics">11th most commonly diagnosed cancers in Australia</a>. One way to improve the treatment of metastatic cancer is to improve our ways of detecting and identifying cancers, to ensure patients receive the most effective drugs for their cancer type. <h2>What increases the chances of metastasis and how can it be prevented?</h2> If left untreated, most cancers will eventually acquire the ability to metastasise. While there are currently no interventions that specifically prevent metastasis, cancer patients who have their tumours surgically removed may also be given chemotherapy (or other drugs) to try and weed out any hidden cancer cells still floating around. The best way to prevent metastasis is to diagnose and treat cancers early. Cancer screening initiatives such as Australia’s <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">cervical</a>, <a href="https://www.health.gov.au/our-work/national-bowel-cancer-screening-program">bowel</a>, and <a href="https://www.health.gov.au/our-work/breastscreen-australia-program">breast</a> cancer screening programs are excellent ways to detect cancers early and reduce the chances of metastasis. New screening programs to detect cancers early are being researched for many types of cancer. Some of these are simple: CT scans of the body to look for any potential tumours, such as in England’s new <a href="https://theconversation.com/how-englands-new-lung-cancer-screening-could-save-thousands-of-lives-expert-qanda-208867">lung cancer screening program</a>. Using artificial intelligence (AI) to help examine patient scans is also <a href="https://theconversation.com/ai-can-help-detect-breast-cancer-but-we-dont-yet-know-if-it-can-improve-survival-rates-210800">possible</a>, which might identify new patterns that suggest a cancer is present, and improve cancer detection from these programs. More advanced screening methods are also in development. The United States government’s Cancer Moonshot program is currently funding research into blood tests that could detect <a href="https://theconversation.com/a-blood-test-that-screens-for-multiple-cancers-at-once-promises-to-boost-early-detection-191728">many types of cancer at early stages</a>. One day there might even be a RAT-type test for cancer, like there is for COVID. <h2>Will we be able to prevent metastasis in the future?</h2> Understanding how metastasis occurs allows us to figure out new ways to prevent it. One idea is to <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2019/breast-cancer-chemotherapy-sensitizing-dormant-cells">target dormant cancer cells</a> and prevent them from waking up. Directly preventing metastasis with drugs is not yet possible. But there is hope that as research efforts continue to improve cancer therapies, they will also be more effective at treating metastatic cancers. For now, early detection is the best way to ensure a patient can beat their cancer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219616/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, Senior Resarch Officer, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">original article</a>.

Body

5 reasons why climate change may see more of us turn to alcohol and other drugs

<a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a> Climate change will affect every aspect of our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01859-7/fulltext">health and wellbeing</a>. But its potential harms go beyond the body’s ability to handle extreme heat, important as this is. Extreme weather events, such as floods, droughts, storms and wildfires, are becoming more frequent and severe. These affect our <a href="https://pubmed.ncbi.nlm.nih.gov/36165756/">mental health</a> in a multitude of <a href="https://www.nature.com/articles/s41558-018-0102-4">ways</a>. Coping with climate change can be overwhelming. Sometimes, the best someone can do is to seek refuge in alcohol, tobacco, over-the-counter and prescription drugs, or other psychoactive substances. This is understandable, but dangerous, and can have serious consequences. We outline <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221132739">five ways</a> climate change could increase the risk of harmful substance use. <h2>1. Mental health is harmed</h2> Perhaps the most obvious way climate change can be linked to harmful substance use is by damaging mental health. This <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12448">increases the risk</a> of new or worsened substance use. People with a mental disorder are <a href="https://www.hindawi.com/journals/psychiatry/2018/5697103/">at high risk</a> of also having a <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-25#:%7E:text=Prevalence%20of%20comorbidity%20in%20epidemiological%20studies&text=Among%20subjects%20with%20an%20alcohol,a%20comorbid%20SUD%20%5B39%5D.">substance-use disorder</a>. This often precedes their mental health problems. Climate change-related increases in the number and nature of extreme events, in turn, are escalating risks to mental health. For example, extreme heat is linked to increased <a href="https://pubmed.ncbi.nlm.nih.gov/27727320/">distress</a> across the whole population. In extreme heat, more people go to the <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2789481">emergency department</a> for psychiatric problems, including for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969720338249">alcohol</a> and <a href="https://www.nature.com/articles/s43856-023-00346-1">substance use</a> generally. This is even true for <a href="https://www.sciencedirect.com/science/article/pii/S0048969720325572">a single very hot day</a>. Post-traumatic stress disorder, depression, anxiety and <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja13.10307">other mental health</a> problems are <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00367/full">common</a> at the time of extreme weather events and can persist for months, even years afterwards, especially if people are exposed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116266/">multiple events</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101235/">increase</a> the likelihood of using substances as a way to cope. <h2>2. Worry increases</h2> With <a href="https://climatecommunication.yale.edu/publications/climate-change-in-the-american-mind-beliefs-attitudes-december-2022/">increasing public awareness</a> of how climate change is endangering wellbeing, people are <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/worriesaboutclimatechangegreatbritain/septembertooctober2022#:%7E:text=The%20level%20of%20worry%20about,lives%20right%20now%20(29%25).">increasingly worried</a> about what will happen if it remains unchecked. Worrying isn’t the same as meeting the criteria for a mental disorder. But <a href="https://www.undp.org/publications/peoples-climate-vote">surveys</a> show climate change generates complex emotional responses, <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00278-3/fulltext">especially in children</a>. As well as feelings of worry, there is anxiety, fear, guilt, anger, grief and helplessness. Some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/">emotional states</a>, such as <a href="https://www.pnas.org/doi/full/10.1073/pnas.1909888116">sadness</a>, are linked with long-term tobacco use and also make substance use <a href="https://pubmed.ncbi.nlm.nih.gov/16011392/">relapse</a> more likely. <h2>3. Physical injuries hurt us in many ways</h2> Physical injuries caused by extreme weather events – such as smoke inhalation, burns and flood-related cuts and infections – increase the risk of harmful substance use. That’s partly because they <a href="https://pubmed.ncbi.nlm.nih.gov/20033251/">increase</a> the risk of psychological distress. If injuries cause long-term illness or disability, consequent feelings of hopelessness and depression can dispose some people to self-medicate with alcohol or other drugs. Substance use itself can also generate long-term physiological harm, disabilities or other chronic health problems. These are <a href="https://www.tandfonline.com/doi/abs/10.3109/00952999609001655">linked with</a> higher rates of harmful substance use. <h2>4. Our day-to-day lives change</h2> A single catastrophic event, such as a storm or flood, can devastate lives overnight and change the way we live. So, too, can the more subtle changes in climate and day-to-day weather. Both can disrupt behaviour and routines in ways that risk new or worsened substance use, for example, using stimulants to cope with fatigue. Take, for example, hotter temperatures, which disrupt <a href="https://www.cell.com/one-earth/fulltext/S2590-3322(22)00209-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2590332222002093%3Fshowall%3Dtrue">sleep</a>, undermine <a href="https://jhr.uwpress.org/content/57/2/400">academic performance</a>, <a href="https://www.nature.com/articles/s41562-017-0097">reduce physical activity</a>, and promote <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00173-5/fulltext">hostile language</a> and <a href="https://www.cambridge.org/core/elements/abs/climate-change-and-human-behavior/F64471FA47B8A6F5524E7DDDDE571D57">violent behaviour</a>. <h2>5. It destabilises communities</h2> Finally, climate change is destabilising the socioeconomic, natural, built and geopolitical <a href="https://www.nature.com/articles/s41558-018-0102-4">systems</a> on which human wellbeing – <a href="https://theconversation.com/climate-change-and-health-ipcc-reports-emerging-risks-emerging-consensus-24213">indeed survival</a> – depends. Damaged infrastructure, agricultural losses, school closures, homelessness and displacement are significant <a href="https://www.nature.com/articles/s41558-018-0102-4">sources of psychosocial distress</a> that prompt acute (short-term) and chronic (long-term) stress responses. <a href="https://doi.org/10.1196/annals.1441.030">Stress</a>, in turn, can <a href="https://doi.org/10.1007/s002130100917">increase</a> the risk of <a href="https://link.springer.com/article/10.1007/s002130100917">harmful substance use</a> and make people more likely to relapse. <h2>Why are we so concerned?</h2> Substance-use disorders are economically and socially <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30337-7/fulltext">very costly</a>. Risky substance use that doesn’t meet the criteria for a formal diagnosis <a href="https://digitalcommons.fiu.edu/srhreports/health/health/32/">can also harm</a>. Aside from its direct physical harm, harmful substance use disrupts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843305/">education</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234116/">employment</a>. It increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676144/">accidents</a> and <a href="https://www.tandfonline.com/doi/abs/10.1080/09595230600944479">crime</a>, and it undermines social relationships, intimate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795906/#:%7E:text=Results%20indicated%20that%20alcohol%20use,drinkers%20with%20low%20relationship%20satisfaction.">partnerships</a> and <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/abs/longitudinal-relations-between-parental-drinking-problems-family-functioning-and-child-adjustment/CE508589A9E799FD6DC9E23DF364FB8F">family functioning</a>. <h2>Politicians take note</h2> As we head towards the <a href="https://www.cop28.com">COP28 global climate talks</a> in Dubai, climate change is set to hit the headlines once more. Politicians know climate change is undermining human health and wellbeing. It’s well past time to insist they act. As we have seen for populations as a whole, there are multiple possible ways for climate change to cause a rise in harmful substance use. This means multidimensional <a href="https://www.nature.com/articles/s41558-018-0102-4">prevention strategies</a> are needed. As well as addressing climate change more broadly, we need strategies including: <ul> <li> supporting vulnerable individuals, especially <a href="https://journals.sagepub.com/doi/full/10.1177/21677026211040787">young people</a>, and marginalised commmunities, who are <a href="https://www.nature.com/articles/s41558-018-0102-4">hit hardest</a> by extreme weather-related events </li> <li> focusing health-related policies more on broadscale health promotion, for example, healthier eating, active transport and community-led mental health support </li> <li> investing in climate-resilient infrastructure, such as heat-proofing buildings and greening cities, to prevent more of the destabilising effects and stress we know contributes to mental health problems and harmful substance use. </li> </ul> There is now <a href="https://news.un.org/en/story/2022/10/1129912">no credible pathway</a> to avoiding dangerous climate change. However, if <a href="https://carnegieendowment.org/2023/01/12/climate-protests-tracking-growing-unrest-pub-88778#:%7E:text=These%20are%20just%20a%20few,even%20more%20numerous%20and%20influential.">increasing rates</a> of climate protests are anything to go by, the world may finally be ready for radical change – and perhaps for reduced harmful substance use.<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/217894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, Honorary Professor, Centre for Health Systems and Safety Research, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, Associate Professor, Psychosocial Difficulties, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/5-reasons-why-climate-change-may-see-more-of-us-turn-to-alcohol-and-other-drugs-217894">original article</a>.

Mind

Do racehorses even know they’re ‘racing’ each other? It’s unlikely

<a href="https://theconversation.com/profiles/cathrynne-henshall-572585">Cathrynne Henshall</a>, <a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a> When racing season arrives, everyone becomes an expert on the horses that are the stars of the spectacle. TV personalities, professional pundits and form guides talk confidently about the favourite’s “<a href="https://www.racenet.com.au/news/tony-brassel-on-the-great-unmeasurable-ticker">will to win</a>”. In close races, the equine contestants “<a href="https://www.justhorseracing.com.au/news/australian-racing/war-machine-to-battle-it-out/120326">battle it out</a>”, demonstrating “heart”, “grit” and “determination”. But do horses even know they are in a race, let alone have a desire to win it? Do they understand what it means when their nose is the first one to pass the post? Based on decades of experience and everything we know about horse behaviour, I think the most plausible answer is “no”. <h2>From the horse’s perspective</h2> From a horse’s perspective, there are few intrinsic rewards for winning a race. Reaching the end might mean relief from the pressure to keep galloping at high speed and hits from the jockey’s whip, but the same is true for all the horses once they pass the finishing post. If the race is close, the horse that eventually wins might even be <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015622">whipped more often</a> in the final stages than horses further back in the field. So while being first to reach the winning post can be crucially important to the horse’s human connections, there is very little direct, intrinsic benefit to the horse that would motivate it to voluntarily gallop faster to achieve this outcome. So does a horse even know it’s in a race? Again, the answer is likely “no”. Running (cantering or galloping) is a quintessential horse behaviour and horses voluntarily run together in groups when given the opportunity – even in races <a href="https://www.thenationalnews.com/world/2022/08/22/riderless-race-horses-take-to-the-streets-in-central-italy-in-pictures/">without jockeys</a>. However, there are a number of reasons to think horses have not evolved a desire to “win” during a group gallop. Horses are social animals. In the wild, to minimise their individual exposure to predators, they <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258944">synchronise their movement</a> with other horses in their group. This synchronisation includes maintaining similar speeds to other group members (to keep the group together), being alert to the positions of their own body and their neighbours’ to avoid collisions, and adapting their speed to the terrain and environmental cues that indicate upcoming danger or obstacles. In the wild, “winning” – that is, arriving first, long before other group members – could even be a negative, exposing the “winner” to an increased risk of predation. This collective behaviour is the opposite of what owners, trainers and punters want from horses during a race. <h2>The horse’s preferences (and how riders override them)</h2> Horse races depend on two horse-related factors: the horse’s innate tendency to synchronise with other horses, and its ability to be trained to ignore these tendencies in response to cues from the jockey during a race. Trainers and jockeys also harness the preferences of individual horses. Some horses are averse to bunching up with others during the race, so jockeys let them move to the front of the field (these are “<a href="https://www.racingnsw.com.au/news/feature-articles/the-art-of-the-front-runner-timing-a-jockeys-best-friend/">front runners</a>”). Other horses seek the security of the group, so jockeys let them remain in the bunch until closer to the winning post (these are “come-from-behind” winners). Jockeys use several different interventions to override the horse’s innate tendency to synchronise. These might include: <ul> <li> directing the horses to travel much closer to the other horses (risking the sometimes fatal injuries we sometimes see at the track) </li> <li> travelling at speeds not of the horse’s choosing (usually at far higher speeds and for longer durations, and often maintained by use of the whip) </li> <li> preventing the horse from changing course to adapt its position relative to other horses in the field (directing its path via pressure on the mouth from the bit or taps from the whip). </li> </ul> During the early stages of a race, jockeys rely on horses’ innate desire to remain with the group to ensure they maintain the physical effort required to keep in touch with the front runners. This tendency may then be overruled so the horse will act independently of the group, leave it behind and come to the front to hopefully win. <h2>No concept of being in a race</h2> So horses most likely have no concept of being in a “race”, where the goal of their galloping is to get to a certain location on the track before any of the other horses. However, they undoubtedly know what it’s like to be in a race. That is, they learn through prior experience and training what is likely to happen and what to do during a race. And with jockeys and trainers who understand the individual preferences of their horses to maximise their chances during the race, there will always be one horse that reaches that part of the track designated the winning post before the other horses in the group. But as for winning horses understanding they are there to “win”? It’s far more likely it is the combination of natural ability, physical fitness and jockey skill that accounts for which horse wins, rather than any innate desire by that horse to get to the winning post before the other horses.<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/216641/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cathrynne-henshall-572585">Cathrynne Henshall</a>, Lecturer, School of Agricultural, Environmental and Veterinary Sciences, <a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-racehorses-even-know-theyre-racing-each-other-its-unlikely-216641">original article</a>.

Money & Banking

It wasn’t just a tree: why it feels so bad to lose the iconic Sycamore Gap tree and others like it

<a href="https://theconversation.com/profiles/rebecca-banham-830381">Rebecca Banham</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> The famous <a href="https://oversixty.com.au/finance/legal/you-can-t-forgive-that-teen-arrested-after-felling-of-iconic-200-year-old-tree" target="_blank" rel="noopener">Sycamore Gap tree</a> was felled last week, prompting global expressions of sorrow, anger and horror. For some, the reaction was puzzling. Wasn’t it just a single tree in northern England? But for many, the tree felt profoundly important. Its loss felt like a form of grief. Trees tell us something important about ourselves and who we are in the world. That is, they contribute to <a href="https://www.tandfonline.com/doi/full/10.1080/23251042.2020.1717098">ontological security</a> – our sense of trust that the world and our selves are stable and predictable. Trees – especially those celebrated like England’s sycamore or Tasmania’s 350-year-old El Grande mountain ash – feel like they are stable and unchanging in a world where change is constant. Their loss can destabilise us. <h2>What makes a tree iconic?</h2> Individual trees can become important to us for many reasons. When the wandering ascetic Siddhartha Gautama sat at the foot of a sacred fig around 500 BCE, he achieved the enlightenment which would, a few centuries later, lead to his fame as the Buddha. This sacred fig would become known as the Bodhi Tree. One of its descendants <a href="https://www.britannica.com/plant/Bo-tree">attracts millions</a> of pilgrims every year. Sometimes a tree becomes iconic because of its association with pop culture. U2’s hit 1987 album The Joshua Tree has inspired fans to seek out the tree on the cover in the United States’ arid southwest – <a href="https://www.rollingstone.com/feature/u2s-the-joshua-tree-10-things-you-didnt-know-106885/">a potentially dangerous trip</a>. Other trees become famous because they’re exceptional in some way. The location of the world’s tallest tree – a 115-metre high redwood known as Hyperion – is <a href="https://www.smithsonianmag.com/smart-news/the-worlds-tallest-tree-is-officially-off-limits-180980509/">kept secret for its protection</a>. Niger’s Tree of Ténéré was known as the world’s most isolated, eking out an existence in the Sahara before the lonely acacia was accidentally knocked down by a truck driver in 1973. Its site is <a href="https://www.atlasobscura.com/places/last-tree-tenere">marked by a sculpture</a>. In 2003, the mountain ash known as El Grande – then the world’s largest flowering plant – was accidentally killed in a burn conducted by Forestry Tasmania. The death of the enormous tree – 87 metres tall, with a 19 metre girth – drew <a href="https://catalogue.nla.gov.au/catalog/3945157">“national and international”</a> media attention. This year, <a href="https://www.abc.net.au/news/2023-08-14/vandalism-sacred-birthing-tree-buangor-police-investigate/102726014">vandals damaged</a> a birthing tree sacred to the local Djab Wurrung people amidst conflicts about proposed road works in western Victoria. And in 2006, someone poisoned Queensland’s Tree of Knowledge – a 200-year-old ghost gum <a href="https://www.australiantraveller.com/qld/outback-qld/longreach/tree-of-knowledge-is-dead/">famous for its connection</a> to the birth of trade unionism in Australia. Under its limbs, shearers organised and marched for better conditions. The dead tree has been preserved in a memorial. <h2>What is it to lose a tree?</h2> Sociologist Anthony Giddens defines ontological security as a <a href="https://books.google.com.au/books/about/Modernity_and_Self_Identity.html?id=Jujn_YrD6DsC&redir_esc=y">“sense of continuity and order in events”</a>. To sustain it, we seek out feelings of safety, trust, and reassurance by engaging with comfortable and familiar objects, beings and people around us – especially those important to our self-identity. When there is an abrupt change, it challenges us. If your favourite tree in your street or garden dies, you mourn it – and what it gave you. But we mourn at a distance too – the Sycamore Gap tree was <a href="https://www.theguardian.com/uk-news/gallery/2023/sep/28/hadrians-wall-sycamore-gap-tree-in-pictures">world-famous</a>, even if you never saw it in real life. In <a href="https://figshare.utas.edu.au/articles/thesis/Seeing_the_forest_for_the_trees_ontological_security_and_experiences_of_Tasmanian_forests/23238422">my research</a>, I have explored how Tasmanian forests – including iconic landscapes and individual trees – can give us that sense of security we all seek in ourselves. As one interviewee, Leon, told me: <blockquote> These places should be left alone, because in 10,000 years they could still be there. Obviously I won’t be, we won’t be, but perhaps [the forest will be]. </blockquote> Temporality matters here. That is, we know what to expect by looking to the past and imagining what the future could be. Trees – especially ancient ones – act as a living link between the past, present, and future. As my interviewee Catherine said: <blockquote> You lie under an old myrtle and you just go, ‘wow - so what have you seen in your lifetime?’ Shitloads more than me. </blockquote> That’s why the loss of the Sycamore Gap tree has upset seemingly the entire United Kingdom. The tree was famous for its appearance: a solitary tree in a <a href="https://www.northumberlandnationalpark.org.uk/places-to-visit/hadrians-wall/sycamore-gap/">photogenic dip</a> in the landscape. Its loss means a different future for those who knew it. It’s as if you were reading a book you know – but someone changed the ending. <h2>Loss of connection</h2> We respond very differently when humans do the damage compared to natural processes. In one study, UK homeowners found it <a href="https://www.tandfonline.com/doi/full/10.1080/13698570802381162">harder to accept</a> their house being burgled than for it to be flooded, seeing flooding as more natural and thus less of a blow to their sense of security. This is partly why the sycamore’s death hurt. It didn’t fall in a storm. It was cut down deliberately – something that wasn’t supposed to happen. The sycamore was just a tree. But it was also not just a tree – it was far more, for many of us. It’s more than okay to talk about what this does to us – about how the loss of this thread of connection makes us grieve. Yes, we have lost the Sycamore Gap tree, just as we lost El Grande and many others. It is useful to talk about this - and to remember the many other beautiful and important trees that live on. <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/214841/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rebecca-banham-830381">Rebecca Banham</a>, Postdoctoral fellow, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/it-wasnt-just-a-tree-why-it-feels-so-bad-to-lose-the-iconic-sycamore-gap-tree-and-others-like-it-214841">original article</a>.

Travel Trouble

Taking an antidepressant? Mixing it with other medicines – including some cold and flu treatments – can be dangerous

<a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> In the depths of winter we are more at risk of succumbing to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522168/">viral respiratory infections</a> – from annoying sore throat, common cold and sinusitis, to the current resurgence of respiratory syncytial virus (RSV), influenza and COVID. Symptoms of upper respiratory tract infection range in severity. They can include fever, chills, muscle or body aches, cough, sore throat, runny or stuffy nose, earache, headache, and fatigue. Most antibiotics target bacteria so are <a href="https://pubmed.ncbi.nlm.nih.gov/32495003/">not effective</a> for viral infections. Many people seek relief with over-the-counter medicines. While evidence varies, guidelines suggest medicines taken by mouth (such as cough syrups or cold and flu tablets) have a <a href="https://pubmed.ncbi.nlm.nih.gov/25420096/">limited but potentially positive</a> short-term role for managing upper respiratory infection symptoms in adults and children older than 12. These include: <ul> <li>paracetamol or ibuprofen for pain or fever</li> <li>decongestants such as phenylephrine or pseudoephedrine</li> <li>expectorants and mucolytics to thin and clear mucus from upper airways</li> <li>dry cough suppressants such as dextromethorphan</li> <li>sedating or non-sedating antihistamines for runny noses or watery eyes.</li> </ul> But what if you have been prescribed an antidepressant? What do you need to know before going to the pharmacy for respiratory relief? <h2>Avoiding harm</h2> An audit of more than 5,000 cough-and-cold consumer enquiries to an Australian national medicine call centre found questions frequently related to drug-drug interactions (29%). An 18-month analysis showed 20% of calls <a href="https://pubmed.ncbi.nlm.nih.gov/26590496/">concerned</a> potentially significant interactions, particularly with antidepressants. Australia remains in the “<a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-%20prescriptions#Prescriptionsbytype">top ten</a>” antidepressant users in the <a href="https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_PHMC">OECD</a>. More than <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">32 million</a> antidepressant prescriptions are dispensed on the Pharmaceutical Benefits Scheme each year. Antidepressants are commonly prescribed to manage symptoms of anxiety or depression but are also used in chronic pain and incontinence. They are classified primarily by how they affect chemical messengers in the nervous system. These classes are: <ul> <li>selective serotonin reuptake inhibitors (SSRI) such as fluoxetine, escitalopram, paroxetine and sertraline</li> <li>serotonin and noradrenaline reuptake inhibitors (SNRI) such as desvenlafaxine, duloxetine and venlafaxine</li> <li>tricyclic antidepressants (TCA) such as amitriptyline, doxepin and imipramine</li> <li>monoamine oxidase inhibitors (MAOI) such as tranylcypromine</li> <li>atypical medicines such as agomelatine, mianserin, mirtazapine, moclobemide, reboxetine and vortioxetine</li> <li>complementary medicines including St John’s wort, S-adenosyl methionine (SAMe) and L-tryptophan</li> </ul> Medicines within the same class of antidepressants have similar actions and side-effect profiles. But the molecular differences of individual antidepressants mean they may have different interactions with medicines taken at the same time. <h2>Types of drug interactions</h2> Drug interactions can be: <ul> <li>pharmacokinetic – what the body does to a drug as it moves into, through and out of the body. When drugs are taken together, one may affect the absorption, distribution, metabolism or elimination of the other</li> <li>pharmacodynamic – what a drug does to the body. When drugs are taken together, one may affect the action of the other. Two drugs that independently cause sedation, for example, may result in excessive drowsiness if taken together.</li> </ul> There are many <a href="https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.429">potential interactions</a> between medications and antidepressants. These include interactions between over-the-counter medicines for upper respiratory symptoms and antidepressants, especially those taken orally. Concentrations of nasal sprays or inhaled medicines are generally lower in the blood stream. That means they are less likely to interact with other medicines. <h2>What to watch for</h2> It’s important to get advice from a pharmacist before taking any medications on top of your antidepressant. Two symptoms antidepressant users should monitor for shortly after commencing a cough or cold medicine are central nervous system effects (irritability, insomnia or drowsiness) and effects on blood pressure. For example, taking a selective SSRI antidepressant and an oral decongestant (such as pseudoephedrine or phenylephrine) can cause irritability, insomnia and affect blood pressure. Serotonin is a potent chemical compound produced naturally for brain and nerve function that can also constrict blood vessels. Medicines that affect serotonin are common and include most antidepressant classes, but also decongestants, dextromethorphan, St John’s wort, L-tryptophan, antimigraine agents, diet pills and amphetamines. <a href="https://reference.medscape.com/drug-interactionchecker">Combining drugs</a> such as antidepressants and decongestants that both elevate serotonin levels can cause irritability, headache, insomnia, diarrhoea and blood pressure effects – usually increased blood pressure. But some people experience orthostatic hypotension (low blood pressure on standing up) and dizziness. For example, taking both a serotonin and SNRI antidepressant and dextromethorphan (a cough suppressant) can add up to high serotonin levels. This can also occur with a combination of the complementary medicine St John’s Wort and an oral decongestant. Where serotonin levels are too high, <a href="https://pubmed.ncbi.nlm.nih.gov/15666281/">severe symptoms</a> such as confusion, muscle rigidity, fever, seizures and even death have been reported. Such symptoms are rare but if you notice any of these you should stop taking the cold and flu medication straight away and seek medical attention. <h2>Ways to avoid antidepressant drug interactions</h2> There are a few things we can do to prevent potentially dangerous interactions between antidepressants and cold and flu treatments. 1. Better information Firstly, there should be more targeted, consumer-friendly, <a href="https://www.webmd.com/interaction-checker/default.htm">online drug interaction information</a> available for antidepressant users. 2. Prevent the spread of viral infections as much as possible Use the non-drug strategies that have worked well for COVID: regular hand washing, good personal hygiene, social distancing, and facemasks. Ensure adults and children are up to date with immunisations. 3. Avoid potential drug interactions with strategies to safely manage symptoms Consult your pharmacist for strategies most appropriate for you and only use cold and flu medications while symptoms persist: <ul> <li>treat muscle aches, pain, or a raised temperature with analgesics such as paracetamol or ibuprofen</li> <li>relieve congestion with a nasal spray decongestant</li> <li>clear mucus from upper airways with expectorants or mucolytics</li> <li>dry up a runny nose or watery eyes with a non-sedating antihistamine.</li> </ul> Avoid over-the-counter cough suppressants for an irritating dry cough. Use a simple alternative such as honey, steam inhalation with a few drops of eucalyptus oil or a non-medicated lozenge instead. 4. Ask whether your symptoms could be more than the common cold Could it be influenza or COVID? Seek medical attention if you are concerned or your symptoms are not improving. <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/208662/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-an-antidepressant-mixing-it-with-other-medicines-including-some-cold-and-flu-treatments-can-be-dangerous-208662">original article</a>.

Body

Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

<a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, <a href="http://www.theconversation.com/">The Conversation</a> Australian of the Year and body positivity advocate Taryn Brumfitt has <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">called for</a> doctors to avoid discussing a patient’s weight when they seek care for unrelated matters. A 15-minute consultation isn’t long enough to provide support to change behaviours, Brumfitt says, and GPs don’t have enough training and expertise to have these complex discussions. “Many people in larger bodies tell us they have gone to the doctor with something like a sore knee, and come out with a ‘prescription’ for a very restrictive diet, and no ongoing support,” Brumfitt <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">told the Nine newspapers</a>. By raising the issue of weight, Brumfitt says, GPs also risk turning patients off seeking care for other health concerns. So should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts. Brett Montgomery - GP academic Yes, sometimes – but with great care. I agree that weight stigma is damaging, and insensitively raising weight in consultations can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251566" target="_blank" rel="noopener">hurt people's feelings and create barriers</a>to other aspects of health care. I also agree people can sometimes be “overweight” yet <a href="https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0287218" target="_blank" rel="noopener">quite healthy</a>, and that common measures and categories of weight are <a href="https://theconversation.com/bmi-alone-will-no-longer-be-treated-as-the-go-to-measure-for-weight-management-an-obesity-medicine-physician-explains-the-seismic-shift-taking-place-208174">questionable</a>. On the other hand, I know obesity <a href="https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf" target="_blank" rel="noopener">is associated with</a> heart disease, joint problems, diabetes and cancers. GPs should be ready to help people with their weight when they want help. <a href="https://www.bmj.com/content/377/bmj-2021-069719.full?ijkey=FnARkmvxLOMFvlb&keytype=ref">Our assistance somewhat effective</a>, though sadly dietary efforts often have minimal effect on weight in the long term. Meanwhile, treatments causing larger weight changes (<a href="https://insightplus.mja.com.au/2021/10/bariatric-surgery-public-system-access-still-terrible/">surgery</a> and <a href="https://www.nature.com/articles/s41366-022-01176-2">some medicines</a> are often financially inaccessible. I feel safe discussing weight when my patient raises the issue. Fearing hurting people, I often avoid raising it myself. I focus instead on health rather than weight, discussing physical activity and healthy diet – these are good things for people of any size. Emma Beckett - Nutrition scientist No. It’s not likely to succeed. Large systematic reviews bringing together multiple studies of multiple weight-loss diets show weight loss is not generally maintained long term (<a href="https://pubmed.ncbi.nlm.nih.gov/32238384/">12 months</a> to <a href="https://www.nature.com/articles/0802982">four years</a>). The idea that weight is about willpower is outdated. The current body of evidence <a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">suggests</a> we each have a weight set point that our body defends. This is determined by genetics and environment more so than education. There may be associations between weight and health outcomes, but losing weight <a href="https://theconversation.com/just-because-youre-thin-doesnt-mean-youre-healthy-101185">does not necessarily equate</a> with improving health. Fat stigma and fatphobia are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866597/">harmful too</a> and can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/">compromise access to health care</a>. Instead, consider asking a better question. Healthy eating reduces disease risk <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/">regardless of weight</a>. So maybe ask how many vegetables are your patients eating. Would they like to see a dietitian to discuss strategies for a better-quality diet? Liz Sturgiss - GP/researcher No. A <a href="https://pubmed.ncbi.nlm.nih.gov/33211585/">US study</a> estimates it would take a family doctor 131% of their work hours to implement all preventive health-care recommendations. It's impossible to address every recommendation for preventative care at every consultation. One of the key skills of a GP is balancing the patient and doctor agenda. <a href="https://www.obesityevidencehub.org.au/collections/treatment/weight-bias-and-stigma-in-health-care">Weight stigma</a> can deter people from seeking health care, so raising weight when a patient doesn't have it on their agenda can be harmful. A strong <a href="https://academic.oup.com/fampra/article/38/5/644/6244494?login=false">therapeutic relationship</a> is critical for safe and effective health care to address weight. Weight is always on my agenda when there is unexpected weight loss. If a patient has rapid weight loss, I am concerned about an undetected <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283307/">cancer</a> or infection. Additionally, I am increasingly seeing patients who are unable to afford food, who often have <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/introduction">poor oral health</a>, who lose weight due to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1747-0080.12580">poverty</a>. Weight loss for the wrong reasons is also a very concerning part of general practice. Nick Fuller - Obesity researcher Yes. GPs should play a role in the early detection of weight issues and direct patients to evidence-based care to slow this progression. <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Research</a> shows many people with obesity are motivated to lose weight (48%). <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Most</a> want their clinician to initiate a conversation about weight management and treatment options. However, this conversation <a href="https://pubmed.ncbi.nlm.nih.gov/32385580/">rarely occurs</a>, resulting in <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">significant delays to treatment</a>. Starting the conversation presents challenges. Although obesity is a complex disease related to multiple factors, it's still <a href="https://pubmed.ncbi.nlm.nih.gov/25752756/">highly stigmatised</a>in our society and even in the <a href="https://pubmed.ncbi.nlm.nih.gov/23144885/">clinical setting</a>. Sensitivity is required and the wording the clinician uses is important to make the patient feel safe and avoid placing blame on them. Patients often <a href="https://pubmed.ncbi.nlm.nih.gov/20823355/">prefer terms</a> such as “weight” and “BMI” (body mass index) over “fatness,” “size” or “obesity”, <a href="https://pubmed.ncbi.nlm.nih.gov/27354290/">particularly women</a>. Measuring weight, height and waist circumference should be <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">considered routine in primary care</a>. But this needs to be done without judgement, and in collaboration with the patient. Helen Truby - Nutrition scientist Yes. A high body weight contributes to many chronic conditions that negatively impact the <a href="https://www.aihw.gov.au/australias-health/summaries">quality of life and mental health</a> of millions of Australians. Not all GPs feel confident having weight conversations, given the sensitive nature of weight and its stigma. GPs' words matter – they are a <a href="https://doi.org/10.1111/nbu.12320">trusted source</a> of health information. It’s critical GPs gain the skills to know when and how to have <a href="https://doi.org/10.1186/s12875-019-1026-4">positive weight conversations</a>. GPs need to offer supportive and affordable solutions. But effective specialist weight management programs are few and far between. More equitable access to programs is essential so GPs have referral pathways after conversations about weight. GPs' time is valuable. Activating this critical workforce is essential to meet the <a href="https://www.health.gov.au/resources/publications/national-obesity-strategy-2022-2032?language=en">National Obesity Strategy.</a> <a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, Deputy Editor and Senior Health Editor, <a href="http://www.theconversation.com/">The Conversation</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-gps-bring-up-a-patients-weight-in-consultations-about-other-matters-we-asked-5-experts-209681">original article</a>.

Body

"We love each other": Mayor marries reptile in stunning ceremony

Love comes when you least expect it and for one mayor in the small town of San Pedro Huamelula, Mexico, his match caiman he never looked back. Victor Hugo Sosa, the mayor of the town has said “I do” to his “princess girl”, a caiman named Alicia Adriana, and his wedding speech is one for the books. 'I accept responsibility because we love each other. That is what is important. You can't have a marriage without love... I yield to marriage with the princess girl,' he vowed. Onlookers clapped and danced in celebration as the mayor kissed and embraced his new bride who was dressed in a white gown and veil. The ceremony is part of a 230-year tradition which symbolises the joining of humans with the divine, as she is thought to be a deity representing mother earth. It also commemorates the day when two Indigenous groups came to peace- with the marriage between a Chontal king, now represented by the mayor, and a princess girl of the Huave Indigenous group, now represented by the female alligator. The age-old ritual involves the reptile being taken house to house before the wedding so that residents can take their turn dancing with it. She is later on changed into her wedding dress, which Olivia Perez was in charge of during this ceremony. "For us, the crocodile is important because she is the princess who comes to bring us water, a good harvest, rains, so that God the Almighty Father sends us food, fish, corn, the harvest," she said. After the wedding, the mayor dances with his bride to traditional music. Local fishermen would also take part in the ritual and toss their nets on the ground in hopes that their marriage would bring “'good fishing, so that there is prosperity, equilibrium and ways to live in peace.” Images: Getty, Oaxaca Informa10 Twitter

Relationships

“We will lean on each other”: Singleton Roosters open up on their devastating loss

Aboriginal and Torres Strait Islander readers are advised that the following article may contain the name and image of a person who has died. Singleton Roosters AFC, a regional football club rocked by the Hunter Valley wedding bus tragedy, has released a heartbreaking statement on their devastating losses. 10 people passed away in the devastating crash, with seven of them members of, or close to, the club - Kane Symons, Rebecca Mullen, Tori Cowburn, Andrew and Lynan Scott, and Nadene and Kyah McBride. “The Singleton Roosters Australian Football Club has been devastated by the tragic bus incident in the Hunter Valley,” the club’s president Dylan Hixon said from their home ground at Rose Point Park. “Our community has experienced unfathomable heartache, distress, and sadness, after a number of people closely connected to the club were on board and either injured or killed.” He went on to share that their “first priority and focus is on supporting the families, friends, and those from our wider club community who have been affected by this unspeakable tragedy. “We thank every person and organisation that has offered support and condolences to our club and the families affected, not only within our town and AFL community but also for those associated with the wedding party.” And as the 4261 residents of the town mourned their loss, he called for “the privacy of our community to be respected”, noting that “our club has been formed out of great people and the relationships fostered within it, and we will lean on each other through this incredibly difficult time, with the memory of everyone that has been lost at the forefront of our thoughts.” The same statement was shared to the club’s social media, where supporters and well-meaning readers showered the post with their love and sympathies, with many opting to share heart emojis in the team’s colours in remembrance for those they’d lost. <iframe style="border: none; overflow: hidden;" src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Fpermalink.php%3Fstory_fbid%3Dpfbid02Kx9jra6awxLn7uyP7Psj9S14AV8Ufd747JPk1SCpjmmqweBL1HfvQBWgLet5s8Lrl%26id%3D100057365271717&show_text=true&width=500" width="500" height="278" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe> The club and its supporters had already taken steps towards helping the families impacted by the tragedy, having raised $121,159 with a now-closed GoFundMe. The assistance wasn’t to stop there though, with Singleton Roosters AFC now directing any potential donors to the <a href="https://donations.rawcs.com.au/78-2022-23">Hunter Valley (NSW) Bus Tragedy Fund</a>, where a further $611,00 - and counting - has been raised for “relief and support to survivors, victims, and their immediate families from the events of the fatal bus accident”. Images: Facebook

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Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

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“We will lean on each other”: Singleton Roosters open up on their devastating loss

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