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Parents under fire for taking their sick toddler on a long-haul flight

A couple has come under fire after documenting their experience online of boarding a long-haul flight with their toddler, despite the child being sick. Alina and her husband were excited to go on their long-awaited holiday to Thailand with their one-year-old son in tow, taking off on their first big family trip. However, shortly before they were set to take off, their child developed a raging fever, and they decided to go on the trip anyway. Taking the experience to social media, Alina said her son’s temperature soared to around 40 degrees, with their little boy’s condition escalating so rapidly that the parents were considering calling off their entire trip. “My husband and I even wanted to cancel the flight,” she confessed in the video, which has received around 1.4 million views. However, after realising they would be out of pocket by several thousands of dollars if they cancelled the trip at such short notice, they decided to take the risk and board the plane. “Our tickets would have been wasted, and the trip that cost us $3,000 would have been wasted,” the mum wrote. "One plus of this flight was that the flight was at night, and the child could sleep and recover.” In the clip, the parents were seen walking their son around the plane, cradling the sick toddler as he cried uncontrollably. Luckily, the parents “managed to bring down the temperature”, but they weren’t convinced their son would keep quiet for the rest of the trip. “We were so worried about how the baby would feel on an eight-hour flight,” she continued, walking the baby up and down the corridors of the airport, trying to calm him down. As they tried to settle the child, they realised that their hopes that he would sleep the whole way were misguided. “The flight turned out to be difficult,” Alina confessed. “The baby kept waking and crying.” In the middle of the night, their son’s fever returned, which forced the parents to “bring the temperature down again” and left them “very worried” about their son’s health. Their baby’s fever took a toll on the parents as well, who complained of feeling “squeezed like a lemon” while trying to keep his temperature down, as Alina recalled, “We took turns looking after the baby so each of us could sleep.” In a later video, the parents defended their choice to take their son on the flight despite his intense fever and blamed it on his teething, not sickness. “Our baby wasn’t sick, he was teething, and that’s why he had a fever,” she said. “If our child had been sick, we would have cancelled everything … I consider myself a wonderful mother.” Despite the mother's clarification of her son's fever, the parents were slammed for even considering taking a sick child on such a long flight. “It’s OK, don’t worry about making anyone else on that flight sick,” a sarcastic comment read. “This is so tremendously selfish, you are appalling for doing this to him and others.” “I was in the same situation,” another parent said. “I lost all bookings, but who cares, my daughter comes first always and forever, no matter the amount of money!” “Trips come and go; your baby’s health is priceless!” read another comment. “Forty degrees is a hospital admission! Not a flight to Thailand!” However, not everyone was as judgmental, with many parents extending their sympathies to the first-time parents, as one person wrote, “You know what’s best for your baby. Everyone will say things. But only you will know when you are in that situation.” “Everyone is a first-time parent,” another defended. “This was a lesson learned. A baby’s health is of utmost importance. No holiday is more important than that. I hope he is OK now.” Image credits: TikTok

Travel Trouble

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

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

Body

I’ve been sick. When can I start exercising again?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> You’ve had a cold or the flu and your symptoms have begun to subside. Your nose has stopped dripping, your cough is clearing and your head and muscles no longer ache. You’re ready to get off the couch. But is it too early to go for a run? Here’s what to consider when getting back to exercising after illness. <h2>Exercise can boost your immune system – but not always</h2> Exercise <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523821/">reduces the chance</a> of getting respiratory infections by increasing your immune function and the ability to fight off viruses. However, an acute bout of endurance exercise may temporarily increase your susceptibility to upper respiratory infections, such as colds and the flu, via the short-term suppression of your immune system. This is known as the “open window” theory. A <a href="https://pubmed.ncbi.nlm.nih.gov/20839496/">study</a> from 2010 examined changes in trained cyclists’ immune systems up to eight hours after two-hour high-intensity cycling. It found important immune functions were suppressed, resulting in an increased rate of upper respiratory infections after the intense endurance exercise. So, we have to be more careful after performing harder exercises than normal. <h2>Can you exercise when you’re sick?</h2> This depends on the severity of your symptoms and the intensity of exercise. Mild to moderate exercise (reducing the intensity and length of workout) may be OK if your symptoms are a runny nose, nasal congestion, sneezing and minor sore throat, without a fever. Exercise may help you feel better by opening your nasal passages and temporarily relieving nasal congestion. However, if you try to exercise at your normal intensity when you are sick, you risk injury or more serious illness. So it’s important to listen to your body. If your symptoms include chest congestion, a cough, upset stomach, fever, fatigue or widespread muscle aches, avoid exercising. Exercising when you have these symptoms may worsen the symptoms and prolong the recovery time. If you’ve had the flu or another respiratory illness that caused a high fever, make sure your temperature is back to normal before getting back to exercise. Exercising raises your body temperature, so if you already have a fever, your temperature will become high quicker, which makes you sicker. If you have COVID or other contagious illnesses, stay at home, rest and isolate yourself from others. When you’re sick and feel weak, don’t force yourself to exercise. Focus instead on getting plenty of rest. This may actually shorten the time it takes to recover and resume your normal workout routine. <h2>I’ve been sick for a few weeks. What has happened to my strength and fitness?</h2> You may think taking two weeks off from training is disastrous, and worry you’ll lose the gains you’ve made in your previous workouts. But it could be just what the body needs. It’s true that almost all training benefits are <a href="https://journals.lww.com/acsm-csmr/fulltext/2019/04000/sports_training_principles.2.aspx">reversible</a> to some degree. This means the physical fitness that you have built up over time can be lost without regular exercise. To study the effects of de-training on our body functions, researchers have undertaken “bed rest” studies, where healthy volunteers spend up to 70 days in bed. They <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00415.2017">found</a> that V̇O₂max (the maximum amount of oxygen a person can use during maximal exercise, which is a measure of <a href="https://my.clevelandclinic.org/health/articles/7050-aerobic-exercise">aerobic</a> fitness) declines 0.3–0.4% a day. And the higher pre-bed-rest V̇O₂max levels, the <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00415.2017">larger</a> the declines. In terms of skeletal muscles, upper thigh muscles <a href="https://doi.org/10.1152/japplphysiol.00363.2020">become smaller by</a> 2% after five days of bed rest, 5% at 14 days, and 12% at 35 days of bed rest. <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00363.2020">Muscle strength declines more</a> than muscle mass: knee extensor muscle strength gets weaker by 8% at five days, 12% at 14 days and more than 20% after around 35 days of bed rest. This is why it feels harder to do the same exercises after resting for even five days. But in <a href="https://iaaspace.org/product/guidelines-for-standardization-of-bed-rest-studies-in-the-spaceflight-context/">bed rest studies</a>, physical activities are strictly limited, and even standing up from a bed is prohibited during the whole length of a study. When we’re sick in bed, we have some physical activities such as sitting on a bed, standing up and walking to the toilet. These activities could reduce the rate of decreases in our physical functions compared with study participants. <h2>How to ease back into exercise</h2> Start with a lower-intensity workout initially, such as going for a walk instead of a run. Your first workout back should be light so you don’t get out of breath. Go low (intensity) and go slow. Gradually increase the volume and intensity to the previous level. It may take the same number of days or weeks you rested to get back to where you were. If you were absent from an exercise routine for two weeks, for example, it may require two weeks for your fitness to return to the same level. If you feel exhausted after exercising, take an extra day off before working out again. A day or two off from exercising shouldn’t affect your performance very much.<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/233130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, Professor of Exercise and Sports Science, <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/ive-been-sick-when-can-i-start-exercising-again-233130">original article</a>. </div>

Body

I feel sick. How do I know if I have the flu, COVID, RSV or something else?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> You wake with a sore throat and realise you are sick. Is this going to be a two-day or a two-week illness? Should you go to a doctor or just go to bed? Most respiratory illnesses have very similar symptoms at the start: sore throat, congested or runny nose, headache, fatigue and fever. This may progress to a dry cough. Best case scenario is that you have “<a href="https://lungfoundation.com.au/wp-content/uploads/2018/09/Factsheet-Common-Cold-Mar2016.pdf">a cold</a>” (which can be any one of hundreds of viruses, most commonly rhinovirus), which is short-lived and self-limiting. But some respiratory illnesses can be much more serious. Here is a brief guide to some important bugs to know about that are circulating this winter, and how to work out which one you have. <h2>Respiratory syncytial virus (RSV)</h2> For most people an RSV infection will feel like “a cold” – annoying, but only lasting a few days. However, for babies, older adults and people with immune issues, it can lead to <a href="https://www.rch.org.au/kidsinfo/fact_sheets/bronchiolitis/">bronchiolitis</a> or pneumonia, and even become life-threatening. RSV isn’t seasonal, which means you are just as likely to get it in summer as in winter. However, it is highly contagious so we noticed it <a href="https://pubmed.ncbi.nlm.nih.gov/32986804">disappearing almost completely</a> during COVID lockdowns. There is now a <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">rapid-antigen test (RAT) for RSV</a> which also checks for influenza and COVID, and is the best way of finding out if RSV is what is causing symptoms. Recently, a preventative immune therapy has become available for high risk babies (<a href="https://www.schn.health.nsw.gov.au/respiratory-syncytial-virus-rsv-monoclonal-antibody-factsheet">nirsevimab</a>) and there are also <a href="https://ncirs.org.au/ncirs-fact-sheets-faqs-and-other-resources/respiratory-syncytial-virus-rsv-frequently-asked">vaccines for higher risk adults</a>. Nirsevimab is also available to all babies for free in <a href="https://www.health.wa.gov.au/Articles/N_R/Respiratory-syncytial-virus-RSV-immunisation">Western Australia</a> and <a href="https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/immunisation/paediatric-rsv-prevention-program">Queensland</a>. But there are no specific treatments. Adults who get it simply have to ride it out (using whatever you need to <a href="https://www.mayoclinic.org/diseases-conditions/common-cold/diagnosis-treatment/drc-20351611">manage symptoms</a>). Babies and higher risk patients need to present to an emergency department if they test positive for RSV and are also looking or feeling very unwell (this might mean rapid shallow breathing, fevers not coming down with paracetamol or ibuprofen, a baby not feeding, mottled-looking skin, or going blue around the mouth). If a patient has developed a bronchiolitis or pneumonia, they may need to be hospitalised. <h2>Influenza</h2> Once you have had the “true flu” (influenza), you will find it frustrating when people call their sniffly cold-like symptoms a “flu”. Influenza infections generally start with a sore throat and headache which quickly turns into high fevers, generalised aches and excessive fatigue. You feel like you have been hit by a truck and may struggle to get out of bed. This can last a week or more, even in people who are generally fit and healthy. Influenza is a major public health issue internationally, with 3–5 million cases of severe illness and <a href="https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)">290,000 to 650,000 respiratory deaths annually</a>. People who are at <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu">greater risk of complications</a> from influenza include pregnant women, children under five, adults aged 65 and over, First Nations peoples, and people with chronic or immunosuppressive medical conditions. For this reason, annual vaccination is <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">recommended and funded</a> for vulnerable people. Vaccination is also readily available for <a href="https://www.health.gov.au/topics/immunisation/immunisation-contacts">all Australians who want it</a>, through pharmacies as well as medical clinics, usually at a cost of less than A$30. In <a href="https://www.vaccinate.initiatives.qld.gov.au/what-to-vaccinate-against/influenza#:%7E:text=The%20flu%20vaccine%20is%20free,.qld.gov.au">some states</a>, it’s free for all residents. Influenza is seasonal, with definite peaks in the winter months. This is why vaccines are offered from early autumn. If you think you may have influenza, there are now home-testing RATs: all current influenza RATs are in combination with COVID RATs, as the symptoms overlap. Treatment for most people is to manage symptoms and try to avoid spreading it around. Doctors can also <a href="https://theconversation.com/i-think-i-have-the-flu-should-i-ask-my-gp-for-antivirals-210457">prescribe antivirals</a> to vulnerable patients; these work best if started within 48 hours of symptoms. <h2>COVID</h2> It has been less than five years since COVID-19, caused by SARS-CoV-2, started to spread around the world in pandemic proportions. Although COVID is no longer a <a href="https://www.health.gov.au/news/ahppc-statement-end-of-covid-19-emergency-response">public health emergency</a>, it still causes <a href="https://www.abs.gov.au/articles/deaths-due-covid-19-influenza-and-rsv-australia-2022-may-2024">more deaths than influenza and RSV combined</a>. Unlike RSV and influenza, only those <a href="https://www.health.gov.au/topics/covid-19/protect-yourself-and-others/high-risk-groups">aged over 70</a> are in a high-risk age group for COVID. Other <a href="https://www.cdc.gov/covid/risk-factors/?CDC_AAref_Val=https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html">factors besides age</a> may put you at higher risk of becoming very unwell when infected by this virus. This includes having other respiratory diseases (such as asthma or chronic obstructive pulmonary disease, also known as COPD), diabetes, cancer, kidney disease, obesity or heart disease. Unlike most respiratory viruses, SARS-CoV-2 tends to set off inflammation beyond the respiratory system. This can involve a range of other organs including the heart, kidneys and blood vessels. Although most people are back to their usual work or study after a week or two, a significant proportion go on to experience extended symptoms such as fatigue, breathlessness, brain fog and mood changes. When these last <a href="https://aci.health.nsw.gov.au/statewide-programs/critical-intelligence-unit/post-acute-sequelae">more than 12 weeks</a>, without any other explanation for symptoms, it’s called <a href="https://www.healthdirect.gov.au/covid-19/post-covid-symptoms-long-covid">long COVID</a>. COVID vaccines can prevent serious illness and have been <a href="https://pubmed.ncbi.nlm.nih.gov/38282394/">monitored</a> for several years now for their safety and effectiveness. Current vaccination recommendations are <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024?language=en">based on age and immune status</a>. It’s worth discussing them with your doctor if you are unsure whether you would benefit or not. <a href="https://www.health.gov.au/topics/covid-19/oral-treatments">Antivirals</a> can treat COVID in higher-risk people who contract it, whether vaccinated or not. Specific advice about what to do if you test positive on a RAT will vary according to your current state guidelines and workplace, however the <a href="https://www.health.gov.au/topics/covid-19/testing-positive">general principles</a> are always: avoid spreading the virus to others, and give yourself time to rest and recover. <hr /> <iframe id="ConNR" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/ConNR/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>What if it’s not one of those?</h2> So you’ve done your combined RSV/flu/COVID RAT and the result is negative. But you still have symptoms. What else could it be? More than 200 different viruses can cause cold and flu symptoms, including rhinovirus (mentioned above), adenovirus and sometimes even <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130424/">undefined pathogens</a>. If an illness progresses to a cough which will not go away, and/or you start coughing up sputum, this could be a bacterial infection, such as pertussis (whooping cough), streptococcus pneumoniae, haemophilus influenzae or moraxella catarrhalis. So it’s worth <a href="https://www.racgp.org.au/getattachment/0a637812-c8f0-45a2-af9c-fa215b64f8e4/attachment.aspx">getting assessed by a GP</a> who may do a chest Xray and/or <a href="https://www.rcpa.edu.au/Manuals/RCPA-Manual/Pathology-Tests/M/MCS-sputum">test your sputum</a>, particularly if they suspect pneumonia. You also may also start out with what is clearly a viral infection but then get a secondary bacterial infection later. So if you are getting more unwell over time, it’s worth getting tested, in case antibiotics will help. However, taking antibiotics for a purely viral illness will not only be useless, it can contribute to harmful <a href="https://www.nps.org.au/consumers/antibiotic-resistance-the-facts">antibiotic resistance</a> and give you unwanted side effects.<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/234266/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond 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/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">original article</a>. </div>

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Stormy seas ahead: Why confidence in the cruise industry has plummeted

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jennifer-holland-969445">Jennifer Holland</a>, <a href="https://theconversation.com/institutions/university-of-suffolk-3830">University of Suffolk</a> The cruise industry has weathered many storms, including fairly regular brushes with disease. Outbreaks of <a href="https://www.cdc.gov/nceh/vsp/pub/norovirus/norovirus.htm">norovirus</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294517/">H1N1</a> and <a href="https://www.nytimes.com/2019/05/02/world/americas/measles-scientology-cruise-ship.html">measles</a> have all happened in the not too distant past. Despite this, a cruise has traditionally been regarded as a safe holiday – the kind where you don’t have to worry about a thing. COVID-19 has changed this. Cruise ships were a hotbed of transmission during the early stages of the pandemic, particularly the Diamond Princess, which was quarantined for six weeks in Japan in spring 2020. It had over <a href="https://www.bmj.com/content/369/bmj.m1632">700 confirmed cases</a>, and for a period was the world’s <a href="https://www.theguardian.com/world/live/2020/feb/20/coronavirus-live-updates-diamond-princess-cruise-ship-japan-deaths-latest-news-china-infections?page=with:block-5e4ea39f8f0811db2fafb3ec#block-5e4ea39f8f0811db2fafb3ec">leading COVID-19 hotspot</a> after China. Coverage of this and other ships’ outbreaks has taken its toll. <a href="https://www.sciencedirect.com/science/article/pii/S259019822100035X">Research</a> that I conducted with colleagues in Australia shows that the pandemic has changed how people think of cruise holidays. We surveyed over 600 people in the UK and Australia, both cruisers and non-cruisers, to ask them about their willingness to cruise and future travel intentions, to explore how COVID-19 has affected perceptions of travel and cruise risks. Nearly 45% of interviewees had less belief than before the pandemic that cruise lines are transparent and honest about safety or health issues. Respondents were also fearful of going on a cruise, with 47% saying they don’t trust cruise lines to look after them if something goes wrong. This is staggering for an industry that depends on repeat customers. We further found that 67% of people are less willing to cruise as a result of the pandemic, while 69% said they feel less positive about cruising now. What’s most surprising is that even repeat cruisers said they feel nervous about cruising as a result of the pandemic, with this emotion coming up repeatedly in the survey’s open-ended questions. This is a gamechanger. Until now, loyal cruisers have always come back, with previous disease outbreaks having <a href="https://www.sciencedirect.com/science/article/abs/pii/S0261517716300309">little</a> <a href="http://ijbssnet.com/journals/Vol_4_No_7_July_2013/2.pdf">impact</a>. <h2>What went wrong?</h2> When the pandemic began, cruise ships immediately suffered high infection rates among passengers and crew. During the first wave, thousands were <a href="https://www.theguardian.com/world/2020/mar/27/stranded-at-sea-cruise-ships-around-the-world-are-adrift-as-ports-turn-them-away">stranded onboard</a> ships as they were held in quarantine or <a href="https://www.sciencedirect.com/science/article/abs/pii/S0160738320302103?via%3Dihub">refused entry to ports</a> as borders closed. By the end of April 2020, <a href="https://www.miamiherald.com/news/business/tourism-cruises/article241640166.html">over 50 cruise ships</a> had confirmed cases of COVID-19 and at least 65 deaths had occurred among passengers and crew. The story of one ship – the Ruby Princess – gained particular attention. Its passengers were allowed to disembark in Sydney in mid-March, with a number carrying the virus. The ship would go on to be linked to more than <a href="https://www.bbc.co.uk/news/world-australia-53802816">900 COVID-19 cases and 28 deaths</a>. The state of New South Wales later launched a <a href="https://www.dpc.nsw.gov.au/assets/dpc-nsw-gov-au/publications/The-Special-Commission-of-Inquiry-into-the-Ruby-Princess-Listing-1628/Report-of-the-Special-Commission-of-Inquiry-into-the-Ruby-Princess.pdf">public inquiry</a> into the ship’s outbreak and found that the state’s ministry of health made a number of serious errors in allowing passengers to get off. It didn’t take long for cruises to be depicted as <a href="https://www.bloomberg.com/news/articles/2020-03-24/virus-explosion-in-australia-exposes-cruise-ships-hidden-menace">places of danger and infection</a>, particularly in Australia. Lots of information about COVID-19 on cruise ships was published, especially about the <a href="https://cruiseradio.net/the-cruise-ship-story-mainstream-media-got-wrong/">Ruby Princess</a>, grabbing the <a href="https://trends.google.com/trends/explore?date=today%205-y&q=Ruby%20Princess">public’s attention</a>. Undoubtedly, this amplified people’s perceptions of risk around cruise holidays. Our study found that the many stories on COVID-19 also reminded the public of previous illnesses and outbreaks onboard cruise ships. Given the high intensity of media interest in Australia, we weren’t surprised to find that perceived risks were higher there compared with the UK, with willingness to cruise lower. This suggests that there could be regional differences in how difficult it is for the industry to recover after the pandemic. <h2>What happens next?</h2> Most respondents in the study said they would wait until it was safe to cruise again – and there’s probably a long way to go on changing the current perception of cruise ships as giant incubators of disease. It’s doubtful pent-up demand from loyal cruisers will be enough to fill cruise ships to capacity – which is critical for <a href="https://link.springer.com/article/10.1057%2Fs41278-020-00158-3">long-term economic viability</a> – and so <a href="https://theconversation.com/can-the-cruise-industry-really-recover-from-coronavirus-144704">financial uncertainty</a> grows. The pandemic has been <a href="https://cruising.org/-/media/Facts-and-Resources/Cruise-Industry-COVID-19-FAQs_August-13-2020">catastrophic</a> for the industry so far, with financial losses of US$50 billion (£36 billion), 1.17 million job losses, 18 cruise ships sold or scrapped and at least <a href="https://www.maritime-executive.com/article/cmv-becomes-the-third-cruise-line-to-go-out-of-business-in-a-month">three cruise lines stopping trading</a>. Before the pandemic, a new cruise ship was built <a href="https://www.seatrade-cruise.com/news-headlines/golden-age-med-ports-need-prepare-new-generation-large-ships">every 47 days</a>, and off the back of the industry’s robust growth over the past two decades another <a href="https://cruising.org/en-gb/news-and-research/research/2020/december/state-of-the-cruise-industry-outlook-2021">19 ships</a> are due to enter operation in 2021, despite demand very likely to have fallen. To recover, the industry will need to address people’s perceptions of risk, which our research shows have heightened. Risk perception has a <a href="https://journals.sagepub.com/doi/10.1177/004728759803700209">significant influence</a> on holiday decision-making, and it will be even more critical post-COVID. In the wake of the pandemic, would-be cruisers will need to think about health protocols, outbreak prevention plans, onboard sanitation procedures, social distancing measures and health screenings. Also, they’ll need to consider the implications of potential outbreaks during the cruise. These could result in being quarantined in their cabin, needing to access healthcare, or even the cruise being terminated. All of this creates uncertainty, which adds to perceptions of risk. The industry will need to provide reassuring answers on all of these points to entice holidaymakers back onboard. Cruise companies will also need to convince customers that they are trustworthy and accountable, given the concerns about honesty and transparency raised by our research. Overall, the sector has been devastated by the pandemic. Possibly no other area of tourism has been as widely affected. A return to the robust growth enjoyed previously is unlikely for many years, if ever. But for there to be any chance of this happening, the industry must understand how the pandemic has affected people’s perceptions of cruises and address their concerns.<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/152146/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jennifer-holland-969445">Jennifer Holland</a>, Lecturer in Tourism, <a href="https://theconversation.com/institutions/university-of-suffolk-3830">University of Suffolk</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/stormy-seas-ahead-confidence-in-the-cruise-industry-has-plummeted-due-to-covid-19-152146">original article</a>. </div>

Cruising

“I’m sick of it": Boy's heartbreaking plea after racist abuse

An Anawain Gamilaroi woman has demanded change after her nine-year-old nephew was left crushed by racist abuse that he allegedly experienced at AFL training. Shaylee Matthews shared the heartbreaking video of Jarmilles breaking down in a car on LinkedIn. The young boy was still wearing his team jersey and was in tears as he repeated the racist abuse that was allegedly targeted towards him. "I hate it when you call me Black," he said through tears. "I hate when you call me monkey. It's got to stop." "I'm sick of this. I don't want there to be racism. I'm sick of it. It needs to be over." When asked if he was okay, Jarmilles replied: "No. I want to go home and go to bed now." Matthews, who works for the ACT government, said the video exposes the "harsh reality" of racism experienced by Aboriginal and Torres Strait Islander peoples. “This post and videos shared is of my 9 soon to be 10 year old nephew’s experience at AFL training (playing a game he loves) which highlights the harsh reality of racism that persists in our society, especially during National Reconciliation Week (with the theme being Now More Than Ever),” she said. “It’s a call to action for us all to confront privilege, challenge learned racism, and dismantle the systemic issues that perpetuate injustice for Indigenous youth.” "The hurtful comments and behaviours faced by Jarmilles not only reflect individual ignorance but also contribute to larger systemic inequalities," she added. She then called for the public to use Reconciliation Week as an opportunity to fight racism and advocate for change. "We must advocate for change, demand accountability, and ensure that all children, regardless of their background, are treated with dignity and respect," she said. "By standing in solidarity, raising our voices, and actively working towards a more just and inclusive society, we can create a future where every child feels safe, valued, and supported. "Let's turn this moment of pain into a catalyst for meaningful change and a brighter tomorrow for all our children." Image: LinkedIn/ news.com.au

Legal

Rough seas or smooth sailing? The cruise industry is booming despite environmental concerns

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/frederic-dimanche-836528">Frédéric Dimanche</a>, <a href="https://theconversation.com/institutions/toronto-metropolitan-university-1607">Toronto Metropolitan University</a> and <a href="https://theconversation.com/profiles/kelley-a-mcclinchey-1287281">Kelley A. McClinchey</a>, <a href="https://theconversation.com/institutions/wilfrid-laurier-university-1817">Wilfrid Laurier University</a> Cruise ship season is officially underway in British Columbia. The season kicked off with the arrival of Norwegian Bliss on April 3 — the <a href="https://www.cheknews.ca/first-cruise-ship-of-the-season-to-arrive-in-victoria-in-less-than-2-weeks-1196426/">first of 318 ships</a> that are scheduled to dock in Victoria this year. Victoria saw a record 970,000 passengers arrive in 2023, with more expected in 2024. The cruise industry <a href="https://doi.org/10.1016/j.trip.2021.100391">was badly hit</a> by the <a href="https://financialpost.com/financial-times/the-2020s-were-meant-to-be-a-boom-decade-for-cruises-then-covid-19-hit-them-like-a-tidal-wave">suspension of cruise operations due to the COVID-19 pandemic</a> in 2020. Fuelled by heavy consumer demand and industry innovation, cruising has made a comeback. It is now one of the fastest-growing sectors, rebounding even faster than international tourism. While many predicted <a href="https://www.cnbc.com/2020/04/05/carnivals-struggle-to-survive-the-coronavirus-as-outbreak-wipes-out-the-cruise-industry.html">a difficult recovery</a>, a <a href="https://cruising.org/en">recent industry report shows a remarkable post-pandemic rebound</a>. Two million more people went on cruises in 2023 versus 2019, with demand predicted to top 35 million in 2024. But environmental issues plague the sector’s revival. Are they an indication of rough seas ahead? Or will a responsive industry mean smooth sailing? Cruising has long been criticized <a href="https://www.sbs.com.au/news/article/their-purpose-is-to-be-fun-but-theres-a-dark-side-to-cruising-the-seas/dzxivdoos">for being Janus-faced</a>: on the surface, cruises are convenient, exciting holidays with reputed economic benefits. But lurking underneath are its <a href="https://doi.org/10.1016/j.tourman.2017.11.002">negative environmental and social impacts</a>. <h2>Unprecedented growth</h2> Newly constructed mega-ships are part of the industry’s unprecedented growth. Royal Caribbean’s Icon of the Seas is the <a href="https://www.cruisehive.com/top-10-biggest-cruise-ships-in-the-world/66448">largest cruise ship in the world</a>, with 18 decks, 5,600 passengers and 2,350 crew. MSC World Europa with 6,700 passengers and 2,100 crew, P&O Arvia with 5,200 passengers and 1,800 crew, and Costa Smeralda with 6,600 passengers and 1,500 crew also claim mega-ship status. Those sailing to and from Alaska via Victoria will be some of the <a href="https://hakaimagazine.com/features/cruise-ship-invasion/">estimated 700,000 passengers departing Seattle</a> on massive ships three sport fields in length. Baby boomers represent less than 25 per cent of cruise clientele. Gen X, <a href="https://www.thenewdaily.com.au/life/2024/01/15/cruise-millennials-gen-z">Millennials and Gen Z</a> have more interest than ever in cruising, with these younger markets being targeted as the future of cruise passengers. The Cruise Lines International Association asserts that <a href="https://cruising.org/-/media/clia-media/research/2024/2024-state-of-the-cruise-industry-report_041424_web.ashx">82 per cent of those who have cruised will cruise again</a>. To entice first-timers and meet the needs of repeat cruisers, companies are offering new itineraries and onboard activities, from <a href="https://www.timescolonist.com/business/royal-caribbean-quantum-cruise-ship-1st-at-sea-bumper-cars-skydiving-observation-capsule-4585987">simulated skydiving and bumper cars</a> to <a href="https://nationalpost.com/travel/cruise-ship-offers-pickleball-on-the-high-seas">pickleball</a> and lawn bowling. Solo cruise travel is also on the rise, and <a href="https://www.cruisetradenews.com/demand-for-multi-generational-cruise-holidays-on-the-up-data-finds/">multi-generational family cruise travel</a> is flourishing, explaining the extensive variety of cabin classes, activities and restaurants available on newly constructed and retrofitted ships. However, only a few cruise ports are large enough to dock mega ships. Cruise lines are responding by offering off-beat experiences and catering more to the distinct desires of travellers. In doing so, there is a <a href="https://www.positivelyosceola.com/2024s-top-cruise-trends-embracing-smaller-ships-solo-adventures-and-luxury-suites/">move towards smaller vessels and luxury liners</a>, river cruises and <a href="https://www.travelweek.ca/news/cruise/expedition-cruising-what-is-it-and-how-do-you-sell-it/">expedition cruising</a>. Leveraging lesser-known ports that can only be accessed via compact luxury ships <a href="https://www.cntraveler.com/story/small-cruise-ships-are-more-sustainble-and-on-the-rise">offers more mission-driven, catered experiences</a> for the eco-minded traveller. <h2>Cruising and environmental costs</h2> Cruise ship visitors are known to negatively impact Marine World Heritage sites. While most sites regulate ballast water and wastewater discharge, there are <a href="https://doi.org/10.3390/su12020611">concerns about ship air emissions and wildlife interactions</a>. Cruise ship journeys along Canada’s west coast, for example, <a href="https://www.theguardian.com/environment/2022/jul/09/us-cruise-ships-using-canada-as-toilet-bowl-for-polluted-waste-alaska-british-columbia">are leaving behind a trail of toxic waste</a>. <a href="https://foe.org/wp-content/uploads/2023/04/Comparison_of_CO2_Emissions_v2.pdf">A study by environmental organization Friends of the Earth</a> concluded that a cruise tourist generates eight times more carbon emissions per day than a land tourist in Seattle. Also, a rise in expedition cruising means more negative impacts (long-haul flights to farther ports, less destination management in fragile ecosystems, <a href="https://www.nytimes.com/2024/03/03/briefing/last-chance-tourism.html">last chance tourism</a>) and a rise in carbon dioxide emissions. Toxic air pollutants from cruise ships around ports are higher than pre-pandemic levels, <a href="https://www.transportenvironment.org/discover/europes-luxury-cruise-ships-emit-as-much-toxic-sulphur-as-1bn-cars-study/">leaving Europe’s port cities “choking on air pollution</a>.” Last year, Europe’s 218 cruise ships emitted as much sulphur oxides as one billion cars — a high number, considering the introduction of the <a href="https://doi.org/10.1016/S2542-5196(20)30002-4">International Maritime Organization’s sulphur cap in 2020</a>. <h2>Rough seas ahead or smooth sailing?</h2> Royal Caribbean said its Icon of the Seas is designed to <a href="https://www.reuters.com/business/environment/worlds-largest-cruise-ship-sets-sail-bringing-concerns-about-methane-emissions-2024-01-27/">operate 24 per cent more efficiently than the international standard</a> for new ships. International Maritime Organization regulations <a href="https://www.bloomberg.com/news/articles/2024-01-22/royal-caribbean-s-icon-of-the-seas-highlights-climate-impact-of-cruises">must be 30 per cent more energy-efficient</a> than those built in 2014. But despite the industry using liquefied natural gas instead of heavy fuel oil and electric shore power to turn off diesel engines when docking, industry critics still claim <a href="https://www.theguardian.com/environment/2024/jan/26/icon-of-the-seas-largest-cruise-ship-human-lasagne-climate-fuel-lng-greenwashing">the cruise sector is greenwashing</a>. As a result, some cities like Amsterdam, Barcelona and Venice are <a href="https://www.forbes.com/sites/maryroeloffs/2023/07/21/war-on-cruise-ships-amsterdam-latest-port-to-limit-or-ban-cruise-liners">limiting or banning cruise ships</a>. Environmental critiques remain strong, especially for <a href="https://dergipark.org.tr/en/pub/ijegeo/issue/65449/957262">polar expeditions</a>. The industry must respond and <a href="https://doi.org/10.1007/978-3-031-01949-4_131">increase sustainability efforts</a>, but their measures remain reactive (i.e., merely meeting international regulations) rather than proactive. In addition, by sailing their ships under <a href="https://www.washingtonpost.com/opinions/2020/05/13/real-problem-with-cruise-industry/">flags of convenience</a>, cruise companies evade taxes and demonstrate an unwillingness to abide by a nation’s environmental, health and labour regulations. In any case, environmental concerns are escalating along with the industry. <a href="https://www.nationalgeographic.com/travel/article/cruising-green-eco-operators-make-waves">Travel agents and industry figures are aware of these impacts</a> and should help promote cruise lines that demonstrate a commitment to sustainable practices. Local residents need to expect more from port authorities and local governments in order <a href="https://doi.org/10.1016/j.annals.2024.103732">to cope with cruise tourism</a>. Cruise consumers should recognize the environmental costs of cruising, and demand accountability and transparency from cruise lines.<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/228181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/frederic-dimanche-836528">Frédéric Dimanche</a>, Professor and Director, Ted Rogers School of Hospitality and Tourism Management, <a href="https://theconversation.com/institutions/toronto-metropolitan-university-1607">Toronto Metropolitan University</a> and <a href="https://theconversation.com/profiles/kelley-a-mcclinchey-1287281">Kelley A. McClinchey</a>, Teaching Faculty, Geography and Environmental Studies, <a href="https://theconversation.com/institutions/wilfrid-laurier-university-1817">Wilfrid Laurier 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/rough-seas-or-smooth-sailing-the-cruise-industry-is-booming-despite-environmental-concerns-228181">original article</a>. </div>

Cruising

Here’s why having chocolate can make you feel great or a bit sick – plus 4 tips for better eating

<a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Australians are <a href="https://www.retail.org.au/media/sweet-spending-boon-predicted-for-easter-retail">predicted</a> to spend around A$1.7 billion on chocolates, hot cross buns and other special foods this Easter season. Chocolate has a long history of production and consumption. It is made from cacao beans that go through processes including fermentation, drying, roasting and grounding. What is left is a rich and fatty liquor that is pressed to remove the fat (cocoa butter) and the cacao (or “cocoa”) powder which will then be mixed with different ingredients to produce dark, milk, white and other types of chocolates. There are several health benefits and potential problems that come in these sweet chocolatey packages. <h2>The good news</h2> Cacao beans contain <a href="https://foodstruct.com/food/cocoa-bean">minerals</a> like iron, potassium, magnesium, zinc and phosphorus and some vitamins. They are also rich in beneficial chemicals called <a href="https://pubmed.ncbi.nlm.nih.gov/23150750/">polyphenols</a>. These are great antioxidants, with the potential to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465250/">improve heart health</a>, increase <a href="https://pubmed.ncbi.nlm.nih.gov/25164923/">nitric oxide</a> (which dilates blood vessels) and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488419/">reduce blood pressure</a>, provide food for gut microbiota and <a href="https://www.mdpi.com/2072-6643/12/7/1908">promote gut health</a>, boost the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465250/">immune system</a> and reduce inflammation. However, the concentration of polyphenols in the chocolate we eat depends largely on the cocoa solid amounts used in the final product. In general terms, the darker the chocolate, the more cocoa solids, minerals and polyphenols it has. For example, dark chocolates may have around <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2011.614984">seven times more polyphenols</a> compared to white chocolates and <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2011.614984">three times more polyphenols</a> compared to milk chocolates. <h2>But also some bad news</h2> Unfortunately, the <a href="https://theconversation.com/treat-or-treatment-chocolate-is-good-but-cocoa-is-better-for-your-heart-3084">health benefits of cocoa solids</a> are easily offset by the high sugar and fat content of modern-day chocolates. For example, milk and white chocolate eggs are on average 50% sugar, 40% fat (mostly saturated fats) – which means a lot of added kilojoules (calories). Also, there may be some side effects that come with ingesting chocolate. Cocoa beans include a compound called theobromine. While it has the anti-inflammatory properties responsible for some of the health benefits of chocolate, it is also a mild brain stimulant that acts in a similar way to caffeine. The mood boost it offers may also be partly responsible for how much we <a href="https://www.frontiersin.org/articles/10.3389/fphar.2015.00030/full?crsi=662496658&cicada_org_src=healthwebmagazine.com&cicada_org_mdm=direct">like chocolate</a>. Dark chocolate has higher theobromine compared to milk and white chocolate. But accordingly, overindulging in chocolate (and therefore theobromine) may lead to feeling restless, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/">headaches</a> and nausea. <h2>What else is in your chocolate?</h2> Milk and dairy-based chocolates may also cause stomach upset, abdominal pain and bloating in people with <a href="https://dietitiansaustralia.org.au/health-advice/lactose-intolerance">lactose intolerance</a>. This happens when we don’t produce enough lactase enzymes to digest milk sugar (lactose). People with lactose intolerance can usually tolerate up to 6 grams of lactose without showing symptoms. Milk chocolate can have around <a href="https://www.ncbi.nlm.nih.gov/books/NBK310258/">3 grams of lactose</a> per 40 grams (the size of a standard chocolate bar). So two chocolate bars (or the equivalent in milk chocolate eggs or bunnies) may be enough to cause symptoms. It’s worth noting that lactase enzyme activity dramatically declines as we age, with the highest activity in newborns and children. So lactose sensitivity or intolerance may not be such an issue for your kids and your symptoms may increase over time. Genetics also plays a major role in how sensitive people are to lactose. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815241/">Allergic reactions</a> to chocolate are usually due to the added ingredients or cross-contamination with potential allergens such as nuts, milk, soy, and some sweeteners used in the production of chocolate. Symptoms can be mild (acne, rashes and stomach pain) or more severe (swelling of the throat and tongue and shortness of breath). If you or your family members have known allergic reactions, make sure you read the label before indulging – especially in a whole block or basket of the stuff. And if you or your family members do experience symptoms of an allergic reaction after eating chocolate, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/allergic-reactions-emergency-first-aid">seek medical attention</a> immediately. <h2>4 take home tips</h2> So, if you are like me and have a weakness for chocolate there are a few things you can do to make the experience a good one.<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/202848/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <ol> <li>keep an eye out for the darker chocolate varieties with higher cocoa solids. You may notice a percentage on labelling, which refers to how much of its weight is from cocoa beans. In general, the higher this percentage, the lower the sugar. White chocolate has almost no cocoa solid, and mostly cocoa butter, sugar and other ingredients. Dark chocolate has 50–100% cocoa beans, and less sugar. Aim for at least 70% cocoa</li> <li>read the fine print for additives and possible cross-contamination, especially if allergies might be an issue</li> <li>the ingredients list and nutrition information panel should tell you all about the chocolate you choosing. Go for varieties with lower sugar and less saturated fat. Nuts, seeds and dried fruits are better ingredients to have in your chocolate than sugar, creme, syrup, and caramel</li> <li>finally, treat yourself – but keep the amount you have within sensible limits!</li> </ol> <a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, Postdoctoral Fellow of the National Heart Foundation & Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</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/heres-why-having-chocolate-can-make-you-feel-great-or-a-bit-sick-plus-4-tips-for-better-eating-202848">original article</a>.

Food & Wine

Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a> Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above. Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>. While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey. As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way. <h2>The science behind altitude sickness</h2> Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research. The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent. When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>. Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations. As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level. <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Tips for preventing or reducing the risk of altitude sickness.</figcaption></figure> <h2>The importance of gradual ascent</h2> High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness. This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>. People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed. Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>. <h2>Effective medications</h2> For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye. If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent. Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>. A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken. Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize. <h2>Unproven therapies and remedies are common</h2> As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend. Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective. <a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>. <a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness. Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective. Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness. The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<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/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</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/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.

Travel Trouble

Passengers stranded after three-year cruise abruptly cancelled

When Life At Sea <a href="https://oversixty.com.au/travel/cruising/world-first-three-year-cruise-revealed" target="_blank" rel="noopener">announced</a> their world-first three-year voyage in early 2023, many were quick to jump at the opportunity to spend the next years of their life onboard. People from around the globe <a href="https://oversixty.com.au/travel/cruising/meet-the-woman-preparing-to-spend-three-years-at-sea#xd_co_f=YTM5MzVmOGQtNTY4My00NWE1LThjNDctMTUxMjJlNjVhMWNj~" target="_blank" rel="noopener">sold their homes</a> and belongings to fork out the hefty $180,000 price tag to spend 36 months travelling the world, with their once-in-a-lifetime voyage set to kick off in November. But now, as their departure date loomed, Life At Sea have left passengers stranded after abruptly cancelling the trip in its entirety. Life at Sea Cruises was scheduled to depart from Istanbul, Turkey on November 1st but departure was relocated and delayed twice to November 30th, before passengers were informed on November 17th the cruise was off, according to CNN. The news outlet reported that the ship that was destined to be the vessel of the three-year journey was bought by another company just one day before the voyage was cancelled. The owner of Life at Sea Cruises’ parent company Miray Cruises, then confirmed they couldn’t afford the ship because investors had pulled out “due to unrest in the Middle East” – but suggested they were working on getting another ship and a new departure date. The idea that the vessel would be replaced filled some travellers with hope they would still be embarking on their three-year adventure, before CEO of Miray Cruises was forced to clarify: “In case we weren’t clear, the Life at Sea cruise trip is cancelled.” Passengers were devastated by the news, with those who thought they had locked in the next three years of their lives telling CNN they felt “incredibly sad”, “angry” and “betrayed”. “I had the next three years of my life planned to live an extraordinary life, and now [I have] nothing,” said one cruiser. “I don’t think they will ever understand how much damage they’ve caused us,” said another. The more than $180,000 three-year trip had been celebrated by big cruising fans and called a “nightmare” and “claustrophobic” by critics across social media. The company’s website is still advertising the cruise as normal, with a countdown stating on Monday it was three hours “until we go for an adventure of a lifetime”. Image credits: Life At Sea

Travel Trouble

Why do I crave sugar and carbs when I’m sick?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Your nose is running, your head hurts and you feel like you’re coming down with a cold. You’re settling in on the couch for a sick day. Then you reach for the snacks. When you’re sick, your appetite often decreases. So why, at other times, do you crave sugary treats and carbohydrate-loaded comfort foods? A food <a href="https://pubmed.ncbi.nlm.nih.gov/28375878/">craving</a> goes beyond a mere desire to eat, it encompasses a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399671/#CR1">complex mix</a> of emotional, behavioural, cognitive and physiological processes. Whether it’s the need for a quick energy source or a temporary relief from discomfort, our bodies and minds work in tandem to drive our food preferences. Here we’ll explore the science behind why our bodies crave sugar and carbs – especially when we’re sick. <h2>Fuelling the immune system</h2> When sickness strikes, our immune system springs into action, requiring additional energy to combat invaders. This heightened activity often leads to an increase in our <a href="https://pubmed.ncbi.nlm.nih.gov/36505552/">metabolic rate</a>, energy demands and nutritional requirements. Sugary treats and carbs are quick sources of energy, satisfying this increased demand. But while a high sugar diet during times of illness may help meet increased metabolic demands, it could also exacerbate the immune and inflammatory response, potentially impeding recovery. In the longer term, high-sugar diets promote chronic <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a>, <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">alter gut microbiota</a> composition, and are associated with chronic disease. For a <a href="https://www.mdpi.com/2072-6643/12/4/1181">well-functioning immune system</a>, aim for a <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">balanced intake</a> of <a href="https://pubmed.ncbi.nlm.nih.gov/31267783/">fruits, vegetables</a>, fibre, protein, and low-glycaemic carbohydrates. <h2>The stress response</h2> Being sick is stressful for the body. Acute mild or intense stress, like we’d see if we’re sick, boosts the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5921333/">flight or fight</a>” hormones adrenaline and cortisol. This mobilises stored energy to meet increased demands, but it can also curb appetite. <a href="https://pubmed.ncbi.nlm.nih.gov/31125634/">Prolonged stress</a> can disrupt energy balance, and cause nutritional deficiencies and alterations in gut and brain functions. This can reduce a person’s threshold for craving sugar and salt, increasing their preferences towards energy-dense foods. The stress hormone cortisol can also increase your <a href="https://pubmed.ncbi.nlm.nih.gov/24123563/">preference</a> for high-calorie, comfort foods, which can <a href="https://pubmed.ncbi.nlm.nih.gov/36615866/">temporarily alleviate stress</a>. <h2>The brain’s reward system</h2> Comfort foods trigger your brain’s reward system, releasing feel-good neurotransmitters like <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a> and serotonin. But “<a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">sugar rushes</a>” are often short-lived and can lead to decreased alertness and heightened fatigue within an hour of consumption. The link between carbohydrates (which the body converts to sugar) and serotonin can be traced back to 1971 when <a href="https://www.science.org/doi/10.1126/science.174.4013.1023?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">researchers</a> found elevated tryptophan levels (serotonin’s precursor) in rats’ plasma and brains after a carbohydrate-rich diet. Subsequent studies in humans established connections between carbohydrates and mood, especially in relation to <a href="https://pubmed.ncbi.nlm.nih.gov/2903717/">obesity, depression and seasonal affective disorder</a>. Therapies enhancing serotonin have since been shown to <a href="https://pubmed.ncbi.nlm.nih.gov/2903717/">reduce carbohydrate intake</a>. Remarkably, around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911970/pdf/molecules-27-01680.pdf">90% of serotonin</a> production occurs in the gut. The vast microbial population in our gut exerts a potent influence on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106557/">immunity, metabolism</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293578/pdf/40168_2021_Article_1093.pdf">appetite</a>. Recent mouse studies have even identified specific microbes linked to <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01750-X">sugar binges after antibiotic treatment</a>. <h2>Some people eat less when they’re sick</h2> Not everyone craves sugar and carbs when they are sick. Some people eat less for a few reasons: <ul> <li> they have less of an appetite. While <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610818/pdf/JDR2017-4527980.pdf">ghrelin</a> (the “hunger” hormone) levels might initially rise, prolonged illness can suppress appetite due to nausea, fatigue and discomfort. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5921333/">Critically ill</a> patients have reduced food intake and are at risk of malnutrition </li> <li> <a href="https://pubmed.ncbi.nlm.nih.gov/30777142/">metabolic adaptation</a>. The body might slow specific metabolic processes to conserve energy, reducing overall calorie requirements </li> <li> altered taste perception. <a href="https://pubmed.ncbi.nlm.nih.gov/32195512/#:%7E:text=The%20ability%20of%20an%20individual%20to%20perceive%20tastes,intake%2C%20playing%20an%20important%20role%20in%20promoting%20satiation%2Fsatiety.">Taste</a> is an important component that affects both appetite and energy intake. Alterations in taste and smell is a common symptom when we are sick and was common with <a href="https://doi.org/10.1101/2020.04.05.20048421">COVID</a> </li> <li> consuming fluids like water, tea or broths might be more appealing and manageable than solid foods. These fluids provide hydration but contribute minimally to calorie intake.<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/210565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond 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/why-do-i-crave-sugar-and-carbs-when-im-sick-210565">original article</a>.

Body

Why we’re more prone to car-sickness when we set off on holiday

<a href="https://theconversation.com/profiles/william-emond-1431510">William Emond</a>, <a href="https://theconversation.com/institutions/universite-de-technologie-de-belfort-montbeliard-2637">Université de Technologie de Belfort-Montbéliard</a> Travel sickness isn’t just hearsay. Nearly <a href="https://www.autonomicneuroscience.com/article/S1566-0702(06)00212-8/fulltext">a third of people</a> experience motion sickness – and to this day we don’t exactly know what causes it. The prevailing theory suggests it is triggered by a <a href="https://onlinelibrary.wiley.com/doi/10.1111/cns.12468">poor perception of movement</a>. Departure to and return from summer holidays seem moments especially prone to this sickness’ stealthy advances. We (or at least those of us inclined to travel sickness) are more often ill during these particular journeys than during our normal comings and goings. Let’s note too that lots of travellers feel a sense of fatigue, drowsiness, apathy or lack of energy without having done any particularly exhausting activity. These are in fact symptoms of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0094576598001532">mild motion sickness</a>, which show that many more people are affected by the condition than you’d think. Why this apparent heightened susceptibility during holiday trips? There are many reasons. Compared to normal travel, these journeys feature certain conditions, all with the potential to increase the incidence and severity of symptoms. Here are some pieces of explanation, and advice to minimise the risk. <h2>Long journeys – repetition of movements that make you queasy</h2> In a car, the further one travels, the more likely one is to feel ill, as shown by a number of <a href="https://journals.sagepub.com/doi/10.1243/0954407042580093">mathematical models which predict motion sickness</a>. It’s the adding up of unpleasant movements which takes us over the threshold where we feel symptoms. For certain people, this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1566070206002128">can happen after just a few minutes</a>); for others it develops more slowly. Only on long journeys, after several hours on the road, in the air or on a boat, will this latter group be pushed over their limit and start feeling unwell. Activities undertaken to pass the time during a long journey could add to feelings of queasiness. Often people do something to occupy and entertain themselves: read a book, watch a film, play a video game or scroll through social media. Except, these visually stimulating activities absorb our attention to the point that we’re not tuned in to the visual cues that allows our brain to assess the movement of the vehicle. This creates a confusion in the perception of movement. As a result, it becomes <a href="https://www.sciencedirect.com/science/article/abs/pii/S0141938214000043?via%3Dihub">much easier to feel sick</a>. <h2>Journey conditions: risks adding up</h2> In summer, the temperature inside a vehicle is difficult to control, with the sun often imposing a stifling heat; conditions which <a href="https://www.ingentaconnect.com/content/asma/asem/2013/00000084/00000005/art00004">tend to accentuate the symptoms of motion sickness</a>. When it’s hot, <a href="https://theconversation.com/lesquels-de-nos-organes-sont-les-plus-menaces-par-la-canicule-119563">our body has to make an effort to regulate its temperature</a>, through sweat or breathing for example. These various signals amount to ‘primary symptoms’ as they can contribute to the appearance of other more substantive symptoms: dilation of the blood vessels, sickness, nausea or vomiting, as applicable. To counter these effects, one is tempted to switch the air conditioning on, which could itself, perversely, <a href="https://www.francetvinfo.fr/sante/environnement-et-sante/la-climatisation-rend-elle-malade_2885673.html">worsen the situation for passengers highly susceptible to motion sickness</a>. Ventilation and cabin air systems also push people toward their nausea thresholds. Unpleasant smells are another factor that can <a href="https://www.ingentaconnect.com/content/asma/asem/2013/00000084/00000005/art00004">accentuate car sickness symptoms</a>: traffic fumes, cigarette smoke, fetid air or even <a href="https://link.springer.com/article/10.1007/s00221-015-4209-9">the smell of leather</a> were identified as <a href="https://www.sciencedirect.com/science/article/pii/S1369847819306539">second most common cause of car sickness</a>! These are bigger risk factors at the start of holiday season, when <a href="https://www.francetvinfo.fr/economie/transports/trafic/vacances-les-vagues-de-departs-massifs-sont-associees-a-de-fortes-emissions-de-polluants_2839361.html">air pollution peaks regularly</a> and the sun’s rays heat up materials. It’s also known that there is a region of the brain – the area postrema or chemoreceptor trigger zone – which can trigger over-production of saliva and nausea specifically when certain smells are detected – a protective reflex against toxins and other poisonous substances. <h2>Traffic: a physical and mental imposition</h2> In a car, it isn’t speed that makes one ill but <a href="https://www.tandfonline.com/doi/abs/10.1080/001401399184730">changes in speed</a>, especially abrupt ones. Acceleration and breaking movements aggravate the human body, even more than turning corners. In practice, variations in speed are often forced on the driver by road design (speed limits, crossings, traffic lights), but also by the state of the traffic. A car stuck in jams will be forced to speed up and slow down at random intervals, <a href="https://www.researchgate.net/publication/366836220_Effect_of_Horizontal_Acceleration_and_Seat_Orientation_on_Motion_Sickness_in_Passenger_Cars">which grates, even at low speeds</a>. Traffic jams also have a psychological element. Delays to a journey (which might already have been very long), anxiousness about arriving at the arranged time, which is looking less and less likely, tiredness, stress and irritation can all cause the passengers’ mood to crash. It’s been observed that these factors <a href="https://journals.sagepub.com/doi/10.1177/0018720819876139">significantly impact the degree of motion sickness symptoms</a>. It would be better to take these setbacks calmly and stay in a relaxed frame of mind but that’s of course easier said than done. <h2>Some tips to limit the damage</h2> If you’re driving with passengers with a tendency to be car sick, or you’re susceptible yourself, some adjustments to your travel habits might help you. For the driver: <ul> <li> Take regular breaks. This allows passengers to take a breather, and to reduce to a significant extent or even get over their symptoms. Sometimes symptoms can take a while to disappear but <a href="https://content.iospress.com/articles/journal-of-vestibular-research/ves7-6-01">generally 15-30 minutes is enough</a>. </li> <li> Try to cut down the amount of hard acceleration and braking you do. Keep as far as possible to the same speed and adopt a smooth driving style, including when you overtake or brake. </li> <li> Avoid taking corners too sharply on winding roads. Passengers should be <a href="https://www.tandfonline.com/doi/abs/10.1080/00140139.2015.1109713">jolted in their seats as little as possible</a>. </li> </ul> For passengers <ul> <li> <a href="https://www.tandfonline.com/doi/abs/10.1080/001401399184730">Sit as far forward in the vehicle as possible</a>. Any movement while travelling is better absorbed by the body from this position. <a href="https://www.tandfonline.com/doi/abs/10.1080/00140139108964831">It’s in the driver’s seat that people are least affected by car sickness</a>, since one has control over the vehicle’s movement. </li> <li> Avoid looking at screens and other visual content (books, etc.), particularly when the vehicle isn’t moving at a constant speed. Instead, <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/000712699161594">try and look forward out of the window</a>, towards the horizon. </li> <li> <a href="https://www.tandfonline.com/doi/abs/10.1080/00140139.2015.1109713">Shut your eyes</a> or <a href="https://psycnet.apa.org/record/1976-12574-000">try to sleep</a>. Slowing down activity soothes the body. </li> <li> <a href="https://link.springer.com/chapter/10.1007/978-3-030-27928-8_26">Tilt your seat back</a>. This allows you to be less destabilised by the vehicle’s movements </li> <li> Go for car games with the other passengers if you get bored: play “I Spy”, <a href="https://theses.gla.ac.uk/80069/1/13905209.pdf">sing songs</a>, count cars of a particular colour or make, and other old favourites of proven effectiveness to help pass the time and, above all, <a href="http://iospress.com/articles/journal-of-vestibular-research/ves00541">take your attention away from the queasiness</a>. The emergence and disappearance of symptoms is mainly a psychological phenomenon. </li> </ul> Finally, given the role of the mind in car sickness symptoms, note that passengers experiencing queasiness can feel better with a placebo (something with no proven medicinal value but presented to them as a magic cure). Simple tips <a href="https://academic.oup.com/jtm/article/5/2/89/1801039">have been shown to be particularly effective</a>. For example, <a href="https://link.springer.com/article/10.1007/s00221-021-06303-5">offering a sweet, a piece of chewing gum</a>, <a href="https://link.springer.com/article/10.1007/s00221-017-5009-1">a sip of water or a breath of fresh air</a> while talking up their effectiveness will give your fellow travellers a little boost. We wish you happy travels, hoping your journey conditions are as good as they can be. <hr /> Translation from French to English by <a href="https://twitter.com/JoshNeicho">Joshua Neicho</a><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210338/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/william-emond-1431510">William Emond</a>, Doctorant en mal des transports (PhD Student on carsickness mitigation), <a href="https://theconversation.com/institutions/universite-de-technologie-de-belfort-montbeliard-2637">Université de Technologie de Belfort-Montbéliard</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-were-more-prone-to-car-sickness-when-we-set-off-on-holiday-210338">original article</a>.

Travel Tips

"Disgustingly sick": Family's horrifying find in rental home

A family of six have been forced to move out of their rental home after discovering it had disturbing levels of meth residue. The family became “disgustingly sick” after moving into the home located in Sandstone Point Queensland and were told to pay for toxicity testing and decontamination by their real estate agency. What the tests revealed shocked them, with dangerous levels of methamphetamine residue found in the lounge room, bedrooms, bathrooms and, worst of all, the space used as a toy room for their children. “(It was) basically everywhere,” Queensland mum Emily Thornton told 7News. She added that it was "disgusting" to know that her four kids played in that toxic environment. According to the Clandestine Drug Laboratory Remediation Guidelines, a safe level of meth residue is below 0.5 micrograms per 100 sq cm. Their house had 1.3 micrograms per 100 sq cm - which is reportedly enough to put people's lives at risk. The house was allegedly once used as a meth lab, and the family only got it tested for toxicity when a neighbour, who was suspicious of the previous tenants, flagged the possibility. Now, the family has been left homeless. “We’re not allowed in there,” Thornton said. “Basically, we’re starting from scratch — we’ve got nothing, absolutely nothing at all.” Thornton also added that her family first started feeling sick shortly after they moved in. “We moved in, (and) we lived here for a little while, (and then) everyone started getting sick,” she said. “We were told by the neighbours that they suspected something going on here, so we decided to contact a company to get them to come out and do some testing, and the testing came back positive for meth.” “They’ve told us just to get out, we’ve just taken what we’ve got and walked out the door.” On top of being homeless, the family had to pay $500 for the toxicity and decontamination testing as both the agent and landlord refused to help them pay to get the home tested. “They weren’t interested, and it was up to us to do it if we wanted to do it," Thorton said. 7News reported that the real estate agency will ensure that the property is decontaminated, but the family will still have to pay the cost of an emergency accommodation. “We just don’t know what we’re going to do. We don’t have the money to pay for it,” Thornton said. Australian Meth Alerts spokesperson David Pie said that Meth residue is a common problem that often gets ignored as the contamination is odourless and invisible to the human eye. “It is a well-known fact within the real estate industry with property managers that this is a real issue," he said. “It’s out of control … and it’s just getting ignored,” he added, “In the worst instances, it can cause death, in particular among young kids. But it creates anger and sleeping problems — it just goes on and on and on.” He also said that it was "wrong" for Thornton's family to pay out-of-pocket for the tests. Image: 7News

Caring

Sickness or health: Healthy life split along gender, education lines

Australians are living and working longer than ever, but the number of healthy years they’re enjoying with this added longevity isn’t shared equally between the sexes, or by those who finished school before Year 12. <div class="copy"> A paper recently <a href="https://doi.org/10.1016/S2468-2667(23)00129-9" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://doi.org/10.1016/S2468-2667(23)00129-9">published</a> in The Lancet Public Health from the Ageing Futures Institute at the University of New South Wales shows an increase in longevity in Australia. Other data in the publication reveal detail about “healthy years”. Men, and those with higher levels of education, worked about 2 years longer in good health. For women and those with lower education, the years of healthy life expectancy have gone backwards. The report, led by statistician Dr Kim Kiely who is now based at The University of Wollongong, compared representative cohorts of people aged 50-100 who participated in the Household Income and Labour Dynamics in Australia survey (HILDA). Those cohorts were measured over decade long periods – the first from 2001-2010 and the second from 2011-2020. Men added an extra 11 months of healthy life between the cohorts, while women lost a month. Similarly those of any gender who had completed year 12 added about 10 months to their healthy life expectancy, while the same amount of time was lost by those who hadn’t. “Everyone’s increasing their working life expectancy, so the years they’re expected to be working,” Kiely says. “What is different is how long they’re expected to be living in good health: women and people with low education didn’t have an improvement in healthy life expectancy. “Everyone’s also living longer than ever before, but for women, those extra years seem to be years of poor health. People with lower education – they end up going backwards, they’re losing years of healthy life.” Australia’s working life trends are similar to those in Europe and the UK, though this research suggests the Australian labour force works longer in poor health than their antipodean counterparts. Kiely says the findings are important considerations for policymakers pondering questions of retirement and pension ages: the demands of some labour may not be evenly spread when it comes to considering health implications. “We have a pension age that has been rising steadily over the past couple of decades – it’s not rising anymore – but there is a strong expectation for people to be working longer,” Kiely says. “And if that is the case, then we need opportunities for work for mature age, older adults, and those work opportunities have to be suitable for their capacity to work. “We do need to address things like age and gender discrimination in the workforce. And we need to think about how we support people who are unable to work before they reach the pension age.” Kiely is extending his research into how the nature of work in Australia influences these high-level findings. He hopes this can explain why gender and education influence healthy working years. Further drilling down into other subgroups is important, say Dr Marty Lynch and Dr Ross Wilkie from Keele University, UK. They investigated healthy working life expectancy as part of Britain’s Independent State Pension Age Review last year. They too found Briton were working longer, but not at a rate that keeps pace with the national pension age. In a Lancet editorial accompanying the Australian research, they point out that the HILDA data evaluation only shows changes in average ages on gender and education lines. “The extent of HWLE [Healthy Working Life Expectancy] inequalities between subpopulations with multiple specific characteristics are likely to be even wider and will also indicate targets and interventions to increase the number of years that people can be healthy and in work,” they say. The impact of socioeconomic status on life expectancy and disease burden was recently highlighted in a large-scale review of Australia’s 30-year health data. <a href="https://cosmosmagazine.com/people/society/australias-life-expectancy-is-up-but-healthy-years-are-a-different-story/">It found</a> while Australians have added 6 years to their life expectancy since 1990, those with lower socioeconomic backgrounds had a higher risk of death-causing disease. Image credits: Getty Images <a href="https://cosmosmagazine.com/people/society/sickness-or-health-healthy-life-split-along-gender-education-lines/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="null">Cosmos</a>. </div>

Retirement Life

Why can’t we just tow stranded whales and dolphins back out to sea?

<a href="https://theconversation.com/profiles/vanessa-pirotta-873986">Vanessa Pirotta</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> On Tuesday night, a pod of almost 100 long-finned pilot whales stranded itself on a beach on Western Australia’s south coast. Over the course of Wednesday, more than 100 parks and wildlife staff and 250 registered volunteers worked tirelessly to try to keep alive the 45 animals surviving the night. They used small boats and surf skis to try to get the pilot whales into deeper water. Volunteers helped keep the animals’ blowholes above water to prevent them drowning, and poured water on them to cool them down. Our rescue efforts were, sadly, unsuccessful. The animals (actually large ocean-going dolphins) able to be towed or helped out to deeper water turned around and stranded themselves again, <a href="https://www.facebook.com/watch/?v=228337910167574&ref=sharing">further down the beach</a>. Sadly, they had to be euthanised. Unfortunately, towing whales and dolphins is not simple. It can work and work well, as we saw in Tasmania last year, when dozens of pilot whales were rescued. But rescuers have to have good conditions and a fair dash of luck for it to succeed. <h2>Rescuing beached whales is hard</h2> When we try to rescue stranded whales and dolphins, the goal is to get them off the sandbars or beach, and back into deep water. Why is it so difficult? Consider the problem. First, you have to know that a pod has beached itself. Then, you have to be able to get there in time, with people skilled in wildlife rescue. These animals are generally too big and heavy to rely on muscle power alone. To get them out far enough, you need boats and sometimes tractors. That means the sea conditions and the slope of the beach have to be suitable. Often, one of the first things rescuers might do is look for those individuals who might be good candidates to be refloated. Generally, these are individuals still alive, and not completely exhausted. If rescuers have boats and good conditions, they may use slings. The boats need to be able to tow the animals well out to sea. Trained people must always be there to oversee the operation. That’s because these large, stressed animals could seriously injure humans just by moving their bodies on the beach. There are extra challenges. Dolphins and whales are slippery and extremely heavy. Long-finned pilot whales can weigh up to 2.3 tonnes. They may have never seen humans before and won’t necessarily know humans are there to help. They’re out of their element, under the sun and extremely stressed. Out of the water, their sheer weight begins to crush their organs. They can also become sunburnt. Because they are so efficient at keeping a comfortable temperature in the sea, they can overheat and die on land. Often, as we saw yesterday, they can’t always keep themselves upright in the shallow water. And to add to the problem, pilot whales are highly social. They want to be with each other. If you tow a single animal back out to sea, it may try to get back to its family and friends or remain disorientated and strand once again. Because of these reasons – and probably others – it wasn’t possible to save the pilot whales yesterday. Those that didn’t die naturally were euthanised to minimise their suffering. <h2>Successful rescues do happen</h2> Despite the remarkable effort from authorities and local communities, we couldn’t save this pod. Every single person working around the clock to help these animals did an amazing job, from experts to volunteers in the cold water to those making cups of tea. But sometimes, we get luckier. Last year, 230 pilot whales beached themselves at Macquarie Harbour, on Tasmania’s west coast. By the time rescuers could get there, <a href="https://www.theguardian.com/australia-news/2022/sep/27/44-pilot-whales-rescued-and-returned-to-sea-after-mass-stranding-at-tasmanian-beach">most were dead</a>. But dozens were still alive. This time, conditions were different and towing worked. Rescuers were able to bring boats close to shore. Surviving pilot whales were helped into a sling, and then the boat took them far out to sea. Taking them to the same location prevented them from beaching again. <h2>Every stranding lets us learn more</h2> Unfortunately, we don’t really know why whales and dolphins strand at all. Has something gone wrong with how toothed whales and dolphins navigate? Are they following a sick leader? Are human-made undersea sounds making it too loud? Are they avoiding predators such as killer whales? We don’t know. We do know there are stranding hotspots. Macquarie Harbour is one. In 2020, it was the site of one of the worst-ever strandings, with up to 470 pilot whales stranded. Authorities were able to save 94, drawing on trained <a href="https://www.theguardian.com/environment/2020/sep/25/death-at-hells-gates-rescuers-witness-tragic-end-for-hundreds-of-pilot-whales-on-australian-coast">rescue experts</a>. We will need more research to find out why they do this. What we do know suggests navigational problems play a role. That’s because we can divide whales and dolphins into two types: toothed and toothless. Whales and dolphins with teeth – such as pilot whales – appear to beach a lot more. These animals use echolocation (biological sonar) to find prey with high-pitched clicks bouncing off objects. But toothless baleen whales like humpbacks (there are no dolphins with baleen) don’t use this technique. They use low-frequency sounds, but to communicate, not hunt. So – it is possible to save beached whales and dolphins. But it’s not as easy as towing them straight back to sea, alas. The Conversation thanks 10-year-old reader Grace Thornton from Canberra for suggesting the question that gave rise to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210544/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vanessa-pirotta-873986">Vanessa Pirotta</a>, Postdoctoral Researcher and Wildlife Scientist, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/why-cant-we-just-tow-stranded-whales-and-dolphins-back-out-to-sea-210544">original article</a>.

Travel Trouble

6 habits of people who don’t get sick

Winter is a dangerous time. Although cold temperatures themselves don’t cause us to get sick, our winter habits invite the spread of germs and risk of contagion is high. If you find yourself sick every winter, here are some useful habits of those healthy people to take up. 1. They get enough sleep It’s easy to experience disrupted sleep during winter. When air is too cold, it will negatively affect melatonin production and cause the body's sleep cycle to be disrupted. However, research shows that people who sleep only five to six hours a night have a 30 per cent chance of catching a cold when exposed to the virus; those who get more than seven hours reduce their risk to 17 per cent. 2. They pay extra attention to hygiene With more germs in the air, now is the time to stay conscious about where they may be festering. Key areas include bathroom door handles, taps, fridges, elevator buttons and public transport. Keep antibacterial wipes on you so whenever you touch a high risk surface, you can cleanse you hand before eating, or touching your face and eyes. 3. They exercise regularly Winter is notorious for zapping our work-out motivation. However, exercise strengthens the immune system and makes you less likely to catch upper respiratory infections. 4. The get their flu shot Flu shots, approved for all adults, are effective 50 to 60 per cent of the time in preventing the flu and may also reduce the severity of symptoms. 5. They don’t smoke Cigarette smoke appears to damage the mucus membranes, which act as the frontline barrier to infectious agents, making smokers twice as likely to catch a cold and several times more likely to develop the flu. 6. They enjoy a drink Harvard University School of Public Health researchers found that red wine was particularly protective against colds, probably due to the anti-inflammatory action of the phenol, resveratrol. Just keep in mind that drinking more than two glasses a day raises the risk for infections. Image credit: Shutterstock

Body

Why does my back get so sore when I’m sick? The connection between immunity and pain

<a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID? This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”. A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats. <h2>Immunology basics</h2> Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing. When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology. This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual. <h2>Invisibly small changes</h2> Part of this self-protective response is a change in how we perceive threats, including sensory stimuli. When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain. Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>. <h2>Immune memories</h2> This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>. Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are. After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>. Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>. <h2>When to worry and what to do</h2> If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves. While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain. Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>. Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse. Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness. Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications. <h2>All in the mind?</h2> Is this all mind over matter? A little of yes and a lot of no. The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level. But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<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/207222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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/why-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.

Caring

Movies that received zero stars

There are good movies, so-so movies and bad movies. Is there anything worse, though, than a bad movie? Yes, there is. And I have seen my share. For decades, Newsday has used a four-star rating system for its film reviews. When I became the paper's movie critic in 2008, I had to figure out how to approach this system. Obviously, it's rare to see a four-star movie – even if it's not Citizen Kane, it has to be something truly outstanding. Three stars signals a wholehearted recommendation, though not exactly a masterpiece. Many movies fall into the two-and-a-half-star range: They're just meh. Tougher to call is the one-star or half-star movie – how do you decide between a D grade and a D-minus? Then there's the nuclear option: zero stars. What makes a movie so awful that it deserves zero stars? Like the four-star movie, this is a rare breed. This is a movie whose redeeming qualities are either infinitesimal or non-existent. It's a movie that fails so spectacularly it doesn't get credit for decent lighting or being in focus. A zero-star movie doesn't even get credit for existing. Every zero-star movie is unique in its own way, but over the years I've noticed that the worst of the worst tend to fall into a few different categories. Here are four examples. Vanity projects It's easy to poke fun at A-list stars and their outsize egos, but they often bring it upon themselves. Remember when John Travolta thought that Battlefield Earth would turn us all into Scientologists? Or when Mariah Carey played a version of herself in Glitter? Remember almost every movie Madonna ever made? For sheer self-centredness, though, nothing beats last year's By the Sea, written and directed by Angelina Jolie-Pitt and starring herself and her husband, Brad. (They produced it as well.) They play an American writer and his wife who stay in a beachside French hotel during the 1970s. He's depressed, she's depressed, they never have sex. With little dialogue and even less action, the movie mostly features the two stars standing around in chic outfits, smoking cigarettes and gazing with despair upon million-dollar views of the coast. Kinder critics praised the cinematography and scenery, but I couldn't find a reason to give this extended Chanel No. 5 commercial even a half-star. I figured the two actors got enough gratification just admiring themselves on screen for two hours. Insults to intelligence Filmmakers often assume their audiences will swallow just about anything. In the sci-fi failure Transcendence, Johnny Depp uploaded his consciousness into the cloud – a literal one, in the sky. (I gave that movie a half-star for sheer nuttiness.) In the zero-star fantasy Jupiter Ascending, the Wachowskis told the story of a housemaid (Mila Kunis) who sells her eggs to buy a telescope but discovers she's a princess. These movies took years to make, yet we spotted their idiocy within minutes. Then there's Aloha, Cameron Crowe's zero-star comedy-drama from 2015. Among its many terrible ideas were casting Emma Stone as a native Hawaiian (as if nobody would notice?), hoping we'd swoon when Bradley Cooper says cheesy things like "Would you stop getting more beautiful?" and creating a baffling climax in which an orbiting space object is destroyed by rock music. Filmmakers tend to be smart people, but moviegoers are no dopes, either. Aloha made just US$26.3 million on its US$37 million budget, one of the year's major flops. Lapses in taste Taste is subjective, of course, but some movies cross a line just to cross it. Adam Sandler's zero-star comedy That's My Boy (2012), whose plot hinged on statutory rape and incest, marked a new low – until Peter Farrelly reset the bar with Movie 43. An anthology comedy spearheaded by Farrelly with several directors and writers, Movie 43 (2013) rounds up more than a dozen A-list stars in an orgy of nastiness and vulgarity. Among the more hideous highlights are Chris Pratt and his real-life wife, Anna Faris, as lovers with a scatological fetish; Richard Gere as the CEO of a product that hacks off its customers' penises; and Chloe Grace Moretz as a teenager getting her period. "Once you see it, you can't unsee it," the trailers promised. As for the cast, they probably wish they could un-be in it. Sheer ineptitude Finally, some movies are so badly made that they barely qualify as movies. Left Behind, for instance, a faith-based rapture-fantasy starring Nicolas Cage, was so sloppy and disorganised that it literally couldn't keep track of night and day. At least that film was made by relative amateurs. The Last Airbender (2010), a fantasy-adventure based on the Nickelodeon series, was directed by M Night Shyamalan, the maestro who gave us The Sixth Sense. Here, Shyamalan completely loses his ability to coherently tell the story of Aang (Noah Ringer), a boy with mystical powers trying to unite four tribes. The dialogue is so crammed with fictional exposition that the actors sound like they're reading a Pokemon manual, while the choppy editing seemed almost random. Not even the special effects deserved a half-star: The postproduction 3-D made the whole movie look as flat as a View-Master slide. With its US$150 million budget, The Last Airbender was an inexcusable, zero-star disaster. As a last note, a truly terrible movie is just as exceptional as a truly great one, and in some ways just as fascinating. It's my job, though, to sit through them so you don't have to. You're welcome. THE WORST OF THE WORST 10. All About Steve (2009) There's a reason you've never heard of this romantic comedy starring A-listers Sandra Bullock and Bradley Cooper: It's because she plays an irritating crossword fanatic and he plays an uninteresting person. In terms of on-screen chemistry, they're the equivalent of bleach and ammonia. 9. Moms' Night Out (2014) This botched comedy (starring Trace Adkins and Patricia Heaton) stands out for many things, but one is a technical reason: The filmmakers somehow managed to capture the weirdest, ugliest facial expression on nearly every actor in nearly every scene. It's like a 90-minute flip-book of ruined family photos. 8. Jem and The Holograms (2015) Aubrey Peeples plays an aspiring singer who is shocked – shocked! – to discover that global stardom requires personal and artistic sacrifice. File this movie's profound message under Things a 9-Year-Old Could Have Told You. 7. Remember Me (2010) In this saccharine yet creepy romance, Robert Pattinson plays a young, moody guy – no stretch there – who sleeps with a woman to get revenge on her father. Aww, how cute! The plot also hinges on the World Trade Centre attacks. Double cute! 6. Jupiter Ascending (2015) This sci-fi fantasy from the Wachowskis (The Matrix) defies description, but here's an attempt: A humble house-cleaner (Mila Kunis) discovers she's a galactic princess thanks to a part-wolf warrior (Channing Tatum). It's a statistical marvel whose 127 minutes include not a single good idea. 5. Rock The Kasbah (2015) A washed-up rock manager (Bill Murray) decides to make a pop star out of an Afghan singer (Leem Lubany). Magically, she reverses centuries of religious and cultural stigmas by performing the songs of Cat Stevens, now known as Yusuf Islam. Possibly the most misguided comedy ever made. 4. Aloha (2015) Cameron Crowe's cloying romance stars Bradley Cooper as an ex-military man trying to bed a happily married woman (gross!) while flirting with a native Hawaiian (played by Emma Stone?) and trying to stop an outer-space missile (say what?). The movie is so wide of the mark that you can't even tell where it was aiming. 3. Movie 43 (2013) Richard Gere, Halle Berry, Kate Winslet, Hugh Jackman and many other talented people run through the most repulsive, unimaginative and unfunny skits ever filmed. The whole thing almost literally stinks. Movie 43 currently holds a difficult-to-attain 4 per cent rating on RottenTomatoes.com. 2. The Last Airbender (2010) M Night Shyamalan's fantasy-adventure is so disjointed and disorganised that you might think the reels got mixed up – possibly with a whole other movie. You could watch it 10 times and still not understand a thing, though by then you'd have gone permanently insane. 1. By The Sea (2015) Think back to the most pretentious European art-film you've ever had to endure. Now imagine Angelina Jolie making that movie, and you've got By the Sea, starring herself and Brad Pitt as depressed Americans who visit France and smoke a lot. Remember how Jean-Paul Sartre said hell is other people? That's because he hadn't seen this movie. Written by Rafer Guzman. First appeared on <a href="http://Stuff.co.nz" target="_blank" rel="noopener">Stuff.co.nz</a>. Images: Columbia Pictures

Movies

Around the world three-year cruise in crisis

When Life at Sea Cruises announced their record-breaking <a href="https://oversixty.com.au/travel/cruising/world-first-three-year-cruise-revealed">three-year voyage</a> around the world, eager travellers raced to book their cabins onboard. Marketed as the "world's first – and only three year cruise", demand for rooms was “unprecedented”, with some travel enthusiasts moving out of their homes and selling their possessions in preparation for the trip of a lifetime. Despite the demand for a spot on board the MV Gemini, the future of the voyage is now in jeopardy, with Life at Sea Cruises, a subsidiary of Miray Cruises, being inundated with demands for refunds just months after the bookings opened. The entire team at Life at Sea Cruises, which was set up specifically for the record-breaking project, has parted ways with Miray Cruises after an apparent breakdown in communication over the suitability of the ship. Mike Petterson, the now former managing director for <a href="https://www.lifeatseacruises.com/">Life at Sea Cruises</a> confirmed to <a href="https://edition.cnn.com/travel/article/three-year-cruise-crisis/index.html">CNN Travel</a> on Wednesday that he and the rest of the founding team have "stepped away" from the project. Despite the team breakdown, Kendra Holmes, director of business development and commercial operations at Miray International, insisted that the voyage will still go ahead. "This cruise is not cancelled," Holmes said. "We are moving ahead. It is departing November 1st as planned. So I just want to make sure to clear that up right now. We are not cancelling this." However, it's still unclear whether the voyage will go ahead on board MV Gemini, or a different ship. "Currently the name of the ship is Gemini," Holmes added, before explaining that she was not able to discuss a new ship at present. "I wish that we didn't have these kinds of situations," said Fuat G., hotel director at Miray Cruises. "We are moving forward. Whatever we have to do to finish that project. And [we will] go to a second, third, fourth and fifth ship. Whatever it is." A press release announcing the project back in March stated that the MV Gemini would be "overhauled" for the voyage. However, according to Irina Strembitsky, former director of sales and marketing of Life at Sea Cruises, the ship, which has capacity for up to 1,074 passengers, was deemed "unseaworthy" by an engineer, who also expressed doubt that it would be able to complete a three-year journey. Understandably, the news of the uncertainty that the trip will go ahead has caused major concern for passengers, with some demanding a refund. One traveller who voiced her concerns is retired teacher <a href="https://oversixty.com.au/travel/cruising/meet-the-woman-preparing-to-spend-three-years-at-sea">Sharon Lane</a>, who booked a ticket for the entire three-year journey and planned to sell most of her belongings before setting off. Lane says that regardless of how things turn out, she will not be going on the journey, which was due to visit 135 countries and seven continents. "Life at Sea says the trip is cancelled. Miray says it's still a go, but without the entire Life at Sea management team," she told CNN. "I don't really care who is right or wrong. I'm allergic to chaos. Going was a huge calculated risk to begin with. Now, it's far too risky for my liking." "It's very sad," she said. "I was all in. It will take me some time to undo what I have already set in place, but at least I'm not one of those who has already sold a house and all of my belongings. My heart aches for them." Image credits: Life at Sea Cruises

Cruising

Breaking the mould: why rental properties are more likely to be mouldy and what’s needed to stop people getting sick

<a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicola-willand-441807">Nicola Willand</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/tim-law-1438482">Tim Law</a> Rental properties are more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8835129/">likely be mouldy</a> than other homes. This is a concern as excessive mould growth is known to <a href="https://www.who.int/publications/i/item/9789289041683">harm human health</a>. Once buildings are infested with mould, the difficult and costly issue of remediation arises. Landlords and tenants are caught in the middle of a tussle over who is responsible for fixing the problem. As one Melbourne renter and research participant told our colleague Maria Gatto, during a study validating mould reporting: <blockquote> The landlord came around [and] walked [into] every room where there’s black mould on the ceiling – like it’s freaking [something out of the TV series] Stranger Things – and she’s like, ‘Oh, a little bit of mould in winter, it’s very normal, it’s fine […] this happens every winter, it’s not a big deal’. </blockquote> Heading into winter, after <a href="https://theconversation.com/la-nina-3-years-in-a-row-a-climate-scientist-on-what-flood-weary-australians-can-expect-this-summer-190542">three consecutive La Niñas</a>, <a href="https://theconversation.com/sudden-mould-outbreak-after-all-this-rain-youre-not-alone-but-you-are-at-risk-177820">conditions are ripe</a> for a mega-mould season. Combining our expertise in health, law, building and construction, we examine the problem of mould in homes and offer guidance for both renters and landlords. <h2>Ideal conditions for growth</h2> Mould is a <a href="https://www.cdc.gov/niosh/topics/indoorenv/whatismold.html">fungal growth</a> that reproduces via tiny airborne particles called spores. When these spores settle on moist, plant-based construction materials such as wood, wallpaper or plasterboard, they can form a new colony. Growth is more likely when homes are cold, humid, lack air flow, or suffer from water damage. Outbreaks have been reported in flooded parts of southeastern Australia. <figure><iframe src="https://www.youtube.com/embed/sD2Ij_QlzwA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Black mould an invisible threat growing behind walls of flood-affected homes (ABC News)</figcaption></figure> So why is the problem of household mould worse in rentals? <a href="https://www.ahuri.edu.au/research/final-reports/338">Weak regulation of tenancy legislation</a> is just one of many factors. Rental properties tend to be poorly maintained, with <a href="https://www.ahuri.edu.au/research/final-reports/338">structural problems</a> such as leaks. Given this, they can be expensive to heat. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&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/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=422&fit=crop&dpr=1 600w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=422&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=422&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=531&fit=crop&dpr=1 754w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=531&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=531&fit=crop&dpr=3 2262w" alt="A chart showing the percentage of homes with structural defects in each category" /></a><figcaption>Rental homes have more structural defects than owner-occupied homes. <a class="source" href="https://www.ahuri.edu.au/research/final-reports/338">Nicola Willand, using data from Moore et. al., (2020), Warm, cool and energy-affordable housing policy solutions for low-income renters, AHURI Final Report, vol. no. 338. Appendix 2</a>, Author provided</figcaption></figure> <h2>How mould makes people sick</h2> The <a href="https://www.who.int/publications/i/item/9789289041683">World Health Organization</a> recognises mould can be harmful. A 2022 Asthma Australia <a href="https://asthma.org.au/what-we-do/advocacy/housing/">report</a> revealed people living in mouldy homes were more likely to have asthma and allergies. A systematic review of peer-reviewed research found <a href="https://erj.ersjournals.com/content/38/4/812">children living in mouldy homes</a> were more likely to experience asthma, wheeze and allergic irritation of the eyes, nose, throat and mouth (allergic rhinitis). Living with mould is a source of stress. People worry about the consequences for their health and there is a growing body of evidence describing the <a href="https://jech.bmj.com/content/50/1/56">negative mental health effects</a> of mouldy, damp homes. <h2>Problems with managing mould in the rental sector</h2> There is a gap between building and residential tenancies legislation. A building deemed to meet the minimum standards of the construction code with respect to mould may not meet the minimum standards for rental. That’s because there’s ambiguity in the <a href="https://ncc.abcb.gov.au/">National Construction Code</a> around “minimum standards of health”. For example the Victorian <a href="https://www.legislation.vic.gov.au/in-force/acts/building-act-1993/136">Building Act 1993</a> contains some provisions for the relevant surveyor to serve a notice on the basis of a health circumstance affecting a user. However, there is no guidance on how to assess the health of the indoor environment, or to deliver a building direction that will address the root cause for mould. This varies by state and territory. Mould remediation can be costly. A <a href="https://www.vba.vic.gov.au/about/research/examining-indoor-mould-and-moisture-damage-in-victorian-residential-buildings">study</a> by Victoria University found half the defects causing mould were water-related. These were more expensive to fix than other problems, by an average of A$7,000. Each winter, <a href="https://tenantsvic.org.au/advice/common-problems/mould-and-damp/">Tenants Victoria</a> deals with a spike in renters seeking legal help to resolve their mould problems. This led to the service launching an annual winter Mould Clinic in 2021. Despite increased legal protections, renters are still struggling to get mould fixed. For these reasons, many renters find the legal process doesn’t offer a solution to their problem, and instead move to a new property, with all its attendant costs and stresses. Others can’t afford to leave, or live in social housing with limited transfer options. <h2>Charting mould in homes across Australia</h2> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&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/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="A bar chart comparing the prevalence of mould in homes across Australian states and territories" /></a><figcaption>Mould is more prevalent in rentals compared to owner-occupied dwellings. Mould is most commonly reported in New South Wales. The difference between owners and renters is greatest in the ACT. Australian Housing Conditions Dataset 2022 doi:10.26193/SLCU9J, Author provided</figcaption></figure> <h2>Where does the responsibility lie?</h2> Tenancy legislation varies by state and territory. Renters should familiarise themselves with the regulations in their jurisdiction. In Victoria, <a href="https://www.legislation.vic.gov.au/in-force/acts/residential-tenancies-act-1997/101">residential tenancies legislation</a> has set the criteria that “each room in the rented premises must be free from mould and damp caused by or related to the building structure”. Landlords now must disclose if they have treated mould in the past three years. Similarly, <a href="https://www.rta.qld.gov.au/rental-law-changes">new legislation in Queensland</a> (coming into effect in September) states rental properties should be free from vermin, damp and mould where this is caused by issues with the structural soundness of the property. In New South Wales, the landlord needs to <a href="https://www.fairtrading.nsw.gov.au/housing-and-property/renting/during-a-tenancy/health,-safety-and-security">disclose signs of mould</a> and dampness in the condition report (but not necessarily have fixed it). Mould is not mentioned in the <a href="https://www.legislation.act.gov.au/a/1997-84/">ACT residential tenancies legislation</a>. For the most part, the responsibility for mould in rental properties lies with landlords if the cause is structural –- for example, if a broken or faulty window frame has let rainwater inside. Requests for urgent repairs can be accompanied by an assessment report by an occupational hygienist, environmental health professional or expert from the local council. People with an existing health condition such as asthma can include a doctor’s report. <h2>What next?</h2> To achieve change across all relevant domains of regulation, construction, natural disaster response and government policy, we need a sustainable, broad healthy <a href="https://www.healthyhousing-cre.org">housing agenda in Australia</a>. We also need to consider options for immediate action. As one Victorian renter noted: <blockquote> When we buy a car for the purpose of driving on the roads, we’re required to get a roadworthy certificate to make sure it’s safe, because of the risk to other people […] Ideally it would be great if there was [some] kind of ‘rentworthy’ certificate […] to demonstrate that the property has been inspected, to identify any structural issues that might affect the tenant’s health and wellbeing. And that that be available to tenants […] before they enter into a lease or before (the property is) even able to be advertised. </blockquote> Quotes in this article were collected by Maria Gatto as part of her Masters of Public Health, conducted at the Melbourne School of Population and Global Health in 2022.<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/205472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, Professor of Social Epidemiology and Director of the Centre of Research Excellence in Healthy Housing at the Melbourne School of Population and Global Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicola-willand-441807">Nicola Willand</a>, Senior Lecturer, School of Property, Construction and Project Management, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/tim-law-1438482">Tim Law</a>, Guest lecturer and Practice Lead — Building Sciences, at Restoration Industry Consultants 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/breaking-the-mould-why-rental-properties-are-more-likely-to-be-mouldy-and-whats-needed-to-stop-people-getting-sick-205472">original article</a>.

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