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"Just so tragic": Grandfather of slain boys speaks out

Warning: This article contains distressing content that readers may find upsetting. The grandfather of the two young boys who were <a href="https://oversixty.com.au/finance/legal/mother-arrested-after-two-boys-found-dead-in-blue-mountains-home" target="_blank" rel="noopener">found dead</a> in their home in the Blue Mountains has spoken out about his profound loss, while also sharing an update on his daughter's mental state while she remains in prison. Geoff Densmore is preparing to bury his grandsons Ben, 9 and Russell, 11, who were found dead in their mother’s Faulconbridge home on September 10th. Mr Densmore is also trying to support his daughter, Trish Smith, who has been charged over the alleged murder of her two children, as she remains under police guard. Ms Smith was rushed to hospital with self-inflicted injuries after the bodies of the two young brothers were discovered in their beds by their father, with both boys suffering fatal stab wounds. Mr Densmore told <a href="https://www.dailytelegraph.com.au/news/nsw/trish-smith-living-a-bad-nightmare-after-allegedly-killing-her-sons-at-their-blue-mountains-home/news-story/b8a91443d155a988155dd5e27410becb" target="_blank" rel="noopener">The </a><a href="https://www.dailytelegraph.com.au/news/nsw/trish-smith-living-a-bad-nightmare-after-allegedly-killing-her-sons-at-their-blue-mountains-home/news-story/b8a91443d155a988155dd5e27410becb" target="_blank" rel="noopener">Daily Telegraph</a> that he is preparing to bury his grandsons, while trying to cope with the devastating loss. “The kids, they were special kids, so special,” Mr Densmore said. “I have to put them under the ground. I’ve got so much to do. So many people are affected by this, the government has got to do something about this.” He went on to clarify that both he and his wife had no idea about their daughter's mental health struggles until it was too late. “We really don’t know what happened. We had no idea she was unwell. Many prayers and private masses have been said for her,” he said. “You can’t imagine what it’s like. Imagine if it happened to your family." “Linda, she’s not good, she’s very religious. She’s praying. I think I might crack one day but I’m trying not to. I’m trying to be strong for everyone. I still can’t understand that Ben … Russell. They’re gone.” Mr Densmore said he was not angry with Ms Smith, instead saying: “There is only one word for it: tragic. It’s just so tragic.” The grandfather has not spoken to his daughter following her charges, however, he did say Ms Smith was in “a bad way”. “We are all dealing with this, the whole community. We have to bury two children, we’ve never been in this situation before. We’re not sure what to do.” Need to talk to someone? Don't go it alone. Call Lifeline on 13 11 14 or visit lifeline.org.au Beyond Blue: 1300 224 636 SANE: 1800 187 263; saneforums.org Image credits: Supplied / NSW Police

Family & Pets

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sarah-tillott-1462234">Sarah Tillott</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/diarmuid-hurley-1462235">Diarmuid Hurley</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Think back to when you met someone for the first time. One of the first questions you asked, or were asked, was likely: “what do you do for work?” It’s a polite, innocuous and socially ingrained way of getting to know more about a person. But it also demonstrates the central role of our professional lives as part of our personal identities. For professional athletes, their careers, exploits and recognition can become the defining aspect of their identity. So what happens when sporting careers end? The transition to retirement, across professions and countries, can be extremely tough to navigate. It can be especially difficult for elite sportspeople, who can experience retirement as a <a href="https://www.sciencedirect.com/science/article/pii/S1469029221001679?casa_token=L4g3UTN8T78AAAAA:VHqcgJN7jIpW82cp32TXq9gIcKFzD2jtf6Jc_OX-3fjpHVnowlp0p8fcqE01BVF3Qjx0bmiRz4T1">loss of identity</a>, connected to their sense of achievement, meaning and control in life. <h2>How retirement impacts athletes</h2> A common saying with many sportspeople is “<a href="https://www.forbes.com/sites/jannfreed/2024/06/29/athletes-die-twice-retirement-as-a-death/">athletes die twice</a>” – once when they retire and again at their death. Former Wallaby Brendan Cannon <a href="https://www.impact.acu.edu.au/lifestyle/after-the-final-siren-helping-athletes-to-adapt-to-life-after-sport">has spoken of</a> this difficulty: <blockquote> [People] want to talk to you about what you used to be, and all you want to focus on is what you want to become. </blockquote> During the transition to retirement, elite athletes can be affected by how they got into their chosen sport, how long they stayed in the system and the variables that either accelerated or ended their careers. Other factors include whether they played a team or individual sport, male vs female pathways, whether their exit from sport was voluntary or involuntary and their age when retiring. My (Sarah) interviews with former professional athletes demonstrate the complexity of retiring from elite sport. To the public, William Zillman, former NRL star turned vet, seems to have it all together. But it didn’t come without hardship, pain and struggles in navigating the harsh terrain of retirement. When asked about his retirement, Zillman said: “[Being an NRL player was] all I knew.” <blockquote> I turned up to work each day, I was told what to do, how to do it and when to do it […] but when I left the system, I think I lost the ability to think for myself. I went from having all the help in the world to very little – it was tough. </blockquote> Retiring from high-performance sport can have profound effects on an athlete’s <a href="https://journals.lww.com/acsm-csmr/fulltext/2020/10000/the_psychological_burden_of_retirement_from_sport.11.aspx/1000">physical and mental health</a>, as well as their social and professional development. While “regular people” usually retire in their 60s or 70s, an athlete’s retirement often occurs earlier, coinciding with crucial phases of career development and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513329/">family planning</a>. Some have to adjust from being highly paid and highly managed to surviving on minimum wages with very little support. “It’s a recipe for disaster,” Ryan James, who considers himself one of the lucky ones, said. A former forward for the Gold Coast Titans, James has been working closely with the Rugby League Players Association (RLPA) with the aim to address some of the complex issues with the transition experience. James knows only too well the struggles some people in the system face as their careers begin to wind down: <blockquote> Many of our players come into the system from disadvantaged and vulnerable backgrounds and while we have made a start, there is more we can be doing. Financial literacy and management is just one avenue we need to tackle. I’ve known too many retired, vulnerable players who were homeless, sleeping in cars with their young families. It’s devastating. </blockquote> It took former English captain turned NRL superstar James Graham a good part of 18 months to re-configure his identity: <blockquote> You come out feeling so lost and alone. Most of your life is spent training, connecting with mates, having a lot of routine and structure to almost nothing. It’s strange and confronting. </blockquote> <h2>What are the major codes doing?</h2> Across various sporting codes there are programs that aim to assist athletes to prepare for retirement. For example, <a href="https://www.rlpa.com.au/past-player-and-transition-program">the RLPA has a program</a> to support athletes who are transitioning. Other major professional Australian codes have similar programs, including <a href="https://www.aflplayers.com.au/app/uploads/2021/10/Player-Retirement-Scheme_Booklet_A5_4.pdf">the AFL</a>, <a href="https://www.thepfa.com/players/union-support/pension-scheme">Professional Footballers Association</a> (soccer) and <a href="https://auscricket.com.au/programs-community/past-player-programs/">cricket</a>. However, whether or not athletes choose to participate in these programs is usually at the discretion of the players. <h2>The importance of planning, preparation and support</h2> One of the key factors influencing how an athlete transitions into life after sport is how much they have <a href="https://theconversation.com/its-not-just-retiring-athletes-who-need-mental-health-support-young-sportspeople-need-it-too-230296">prepared for it</a>. Research with elite athletes from <a href="https://elevateaus.com.au/wp-content/uploads/2021/09/The-end-of-a-professional-sport-career-ensuring-a-positive-transition.pdf">the AFL, NRL and A-League</a> shows those who planned and prepared for life after sport and who had goals, direction and identities beyond sport, experienced more acceptance, autonomy (control) and optimism about the future. On the other hand, those who were unprepared or did not plan ahead experienced negative emotional and psychological states, and struggled to move on. This negative effect is even more pronounced for those who were forced to <a href="https://journals.lww.com/acsm-csmr/fulltext/2020/10000/the_psychological_burden_of_retirement_from_sport.11.aspx/1000">end their career due to injury</a>. <hr /> <iframe id="lQixA" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/lQixA/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How to improve the situation</h2> A recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513329/">scoping review</a> explored the notion of retirement for professional athletes and their ability to adapt to life after sport. It summarised many areas that need more attention: Make athletes aware of what’s ahead Expect that when you leave, it may be hard. Reach out to your club, coach and support services and surround yourself with people who you can talk to and who may be able to help. Athletes should expect that it will take time to adjust, and this adjustment period is crucial for mitigating the adverse effects of retirement. This adjustment period can also significantly reduce the initial negative impacts on their mental and physical health. Tailored support programs Developing tailored support programs that address the specific needs of different sports and athlete sub-groups can help mitigate the challenges associated with retirement. These programs might include career counselling, mental health support and opportunities for continuous involvement in the sports community. A need for further research There is a pressing need for more research to identify effective support mechanisms for retiring athletes. Understanding the types of support that facilitate a smoother transition can help in designing programs and interventions tailored to the unique needs of elite athletes. Additionally, mapping out the factors that aid or hinder the transition across different sports and athlete sub-groups would provide valuable insights.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-tillott-1462234">Sarah Tillott</a>, Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/diarmuid-hurley-1462235">Diarmuid Hurley</a>, Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-psychology-of-retirement-why-do-so-many-athletes-struggle-to-call-time-234559">original article</a>. </div>

Retirement Life

"So Australian": Local trust praised for response to illegal tree cutting

A resident's decision to cut down a tree for a better view of Sydney Harbour has backfired after a sign was erected where the tree once stood, to condemn tree vandalism. Following multiple reports of resident carrying out tree vandalism along affluent streets, the Sydney Harbour Federation Trust has called out the behaviour by setting up the sign in the Sydney lower North Shore suburb of Woolwich. "Tree vandalism has occurred in this area," the sign read. "The Sydney Harbour Federation Trust protects and manages this land for the enjoyment of the public. "Acts of vandalism like this deprive all of us of the natural environment." The sign also warned that offenders could be subject to fines and/or prosecution as punishment, and urged those who notice any suspicious activity to contact 8969 2100. After an image of the sign was shared to a Sydney group on social media, the local trust's actions have been praised, with many saying they "loved how petty this is" and one even declaring the response "so Australian". "I hope they keep this sign, as a reminder to anyone contemplating doing something similar," one commented. "We're petty but we have a right to be. You don't f**n poison or cut down trees. F**n unacceptable behaviour," another added. Others accused the person who cut down the tree of being "entitled". In last November alone, over 300 native trees and shrubs vanished in front of multi-million dollar homes along the Sydney Harbour waterfront strip. Lane Cove Council believe that hand tools were used to silently cut down the trees, which impacts plants, and local wildlife including wallabies, possums and dozens of other species. On Monday, the council put out a statement saying its "pursuit of justice" is now ramping up, referring to the incident as "the largest tree vandalism case in Lane Cove’s recent history". They are trying to obtain permission to put up a sign to block "the harbour view of the property which would most benefit from the mass clearing of the trees." "As the area is classified as a Threatened Ecological Community and contains some items of Aboriginal Heritage, it was important the appropriate approvals were in place before installing the signage," the council added. "The legal case and banner installation are important steps in our commitment to seeking the strongest possible recourse response to send a message that we stand tall against tree vandalism." Images: Reddit

Legal

Why is it so hard to cancel subscriptions or end ‘free’ trials? Report shows how companies trap you into paying

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/katharine-kemp-402096">Katharine Kemp</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Many businesses are trapping Australian consumers in paid subscriptions by making them hard to cancel, hiding important details and offering “free” trials that auto-renew with hefty charges. We need law reform to tackle this continuing problem. <a href="https://cprc.org.au/report/let-me-out">A new report</a> shows 75% of Australian consumers have had negative experiences when trying to cancel a subscription, according to the Consumer Policy Research Centre (CPRC). It shows businesses use “<a href="https://www.wired.com/story/how-to-spot-avoid-dark-patterns/">dark patterns</a>”, which are designs that hinder consumers who try to act in their own best interests. Subscription traps are often called “<a href="https://www.ftc.gov/business-guidance/blog/2022/11/checking-out-ftcs-100-million-settlement-vonage">Hotel California</a>” techniques, referring to The Eagles’ famous lyric: “you can check out any time you want, but you can never leave”. In some of these cases, consumers may have remedies under our existing consumer law, including for misleading conduct. But we need law reform to capture other <a href="https://treasury.gov.au/consultation/c2023-430458">unfair practices</a>. In the meantime, the CPRC’s research also gives examples of businesses with fair, consumer-friendly subscription practices. These also benefit the business. <h2>Examples of unfair subscription traps</h2> <a href="https://www.forbes.com/councils/forbesbusinessdevelopmentcouncil/2022/09/12/the-evolution-of-the-subscription-model-and-whats-on-the-horizon/">Subscription business models</a> have become common – many products are now provided in the form of software, an app or access to a website. Some of these would once have been a physical book, newspaper, CD or exercise class. Most people who use online services have experienced the frustration of finding a credit card charge for an unwanted, unused subscription or spending excessive time trying to cancel a subscription. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.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/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=643&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=643&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=643&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=808&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=808&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=808&fit=crop&dpr=3 2262w" alt="Infographic with a few statistics from the report." /></a><figcaption><a class="source" href="https://cprc.org.au/wp-content/uploads/2024/08/CPRC_LetMeOut_SubsTraps_Report_FINAL.pdf">CPRC, Let me out – Subscription trap practices in Australia, August 2024</a></figcaption></figure> Businesses can make it difficult for consumers to stop paying for unwanted subscriptions. Some do this by allowing consumers to start a subscription with a single click, but creating multiple obstacles if you want to end the subscription. This can include obscuring cancellation options in the app, requiring consumers to phone during business hours or making them navigate through multiple steps and offers before terminating. The report points out many of the last-ditch discounts offered in this process are only short term. One survey respondent said: <blockquote> I wasn’t able to cancel without having to call up and speak to someone. Their business hours meant I had to call up during my work day and it took some time to action. </blockquote> Other businesses badger consumers with frequent emails or messages after they cancel. One respondent said a business made “the cancellation process impossible by making you call and then judging your reason for cancellation”. <h2>What does consumer law say?</h2> Some subscription traps already fall foul of the Australian Consumer Law and warrant investigation by the <a href="https://www.accc.gov.au/media-release/accc-warns-consumers-to-beware-of-subscription-traps">Australian Competition & Consumer Commission</a> (ACCC). Consumers may have remedies where the business has engaged in misleading conduct or imposes an unfair contract term. For example, the ACCC is <a href="https://www.accc.gov.au/media-release/accc-court-action-against-eharmony-for-alleged-misleading-online-dating-membership-statements#:%7E:text=The%20ACCC%20has%20today%20commenced%20proceedings%20in%20the,the%20pricing%2C%20renewal%20and%20duration%20of%20its%20memberships.">suing dating site eHarmony</a> for its allegedly misleading subscription practices. In the United States, the Federal Trade Commission <a href="https://www.ftc.gov/news-events/news/press-releases/2024/06/ftc-takes-action-against-adobe-executives-hiding-fees-preventing-consumers-easily-cancelling">has filed a complaint against software company Adobe</a> for allegedly using dark patterns in its subscription practices. The Federal Trade Commission has alleged that “Adobe pushed consumers toward the ‘annual paid monthly’ subscription without adequately disclosing that cancelling the plan in the first year could cost hundreds of dollars”. Adobe <a href="https://news.adobe.com/news/news-details/2024/Adobes-Recent-Statement-Regarding-Updated-Federal-Trade-Commission-Complaint-/default.aspx">issued a statement</a> arguing the commission’s complaint “mischaracterises” its business. The litigation is ongoing. <h2>We need an unfair practices prohibition</h2> Some subscription traps would fall outside the existing consumer law. This is because they don’t meet the test for misleading conduct or unfair contract terms, but make it practically very difficult to cancel. The <a href="https://www.accc.gov.au/media-release/accc-welcomes-consultation-on-possible-unfair-trading-practices-regulatory-reforms">ACCC has advocated</a> for Australia to follow other countries such as the United Kingdom and the United States to enact an unfair practices prohibition to capture conduct like this. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.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/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=769&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=769&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=769&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=966&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=966&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=966&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The shift businesses can make today. <a class="source" href="https://cprc.org.au/wp-content/uploads/2024/08/CPRC_LetMeOut_SubsTraps_Report_FINAL.pdf">CPRC, Let me out – Subscription trap practices in Australia, August 2024</a></figcaption></figure> <h2>Better practices benefit businesses too</h2> The CPRC report also revealed that 90% of Australians would likely purchase from the same organisation if cancelling a subscription process was quick and simple. Businesses focused on a short-sighted cash grab fail to realise that consumers might cancel but later return if treated well. The CPRC highlights businesses that are doing a good job. For instance, the habit change app Atoms (based on James Clear’s book Atomic Habits) has a genuinely free trial. It doesn’t require credit card details, doesn’t auto-renew, and lets consumers know how many trial days remain. The CPRC says the charity World Vision doesn’t auto-renew annual sponsorships, but reminds supporters about when the sponsorship will lapse. Importantly, some businesses – such as Netflix – use their data for good in this context. They notice when users are paying for the service without using it and help them unsubscribe. These practices should be applauded. But we need an unfair practices prohibition for businesses who don’t follow suit and recognise the long-term benefits of treating customers fairly.<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/237236/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katharine-kemp-402096">Katharine Kemp</a>, Associate Professor, Faculty of Law & Justice; Lead, UNSW Public Interest Law & Tech Initiative, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-it-so-hard-to-cancel-subscriptions-or-end-free-trials-report-shows-how-companies-trap-you-into-paying-237236">original article</a>. </div>

Money & Banking

No, your aches and pains don’t get worse in the cold. So why do we think they do?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather. It’s a common idea, but a myth. When we looked at the evidence, <a href="https://www.sciencedirect.com/science/article/pii/S0049017224000337">we found</a> no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains. So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on. <h2>Weather can be linked to your health</h2> The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures <a href="https://pubmed.ncbi.nlm.nih.gov/27021573/">may worsen</a> asthma symptoms. Hot temperatures <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00117-6/fulltext">increase the risk</a> of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease. Many people are also convinced the weather is linked to their aches and pains. For example, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1479-8077.2004.00099.x?casa_token=jvpSbA4szqoAAAAA%3ATyHyGaqXmfevWyuJe6LW_3Pap3IPHC8HSMTl3RN63mFzNO0X7ozQjBb6Bi3yVFuPjqkrf-WlB-J5A1q1">two in every three</a> people with knee, hip or hand osteoarthritis <a href="https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-15-66">say</a> cold temperatures trigger their symptoms. Musculoskeletal conditions affect more than <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions-comorbidity-australia/summary">seven million Australians</a>. So we set out to find out whether weather is really the culprit behind winter flare-ups. <h2>What we did</h2> Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies. We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included. We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry). <h2>What we found</h2> We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis. The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain. In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis. It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather. The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions. Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up. <h2>Why do people blame the weather?</h2> The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain. For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know <a href="https://pubmed.ncbi.nlm.nih.gov/28700451/">prolonged sitting</a>, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. Likewise, changes in mood, often experienced in cold weather, trigger increases in both <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself. Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the <a href="https://link.springer.com/article/10.1186/s12891-018-1943-8">nocebo effect</a>. <h2>What to do about winter aches and pains?</h2> It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather). You can: <ul> <li> become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool </li> <li> lose weight if obese or overweight, as this is linked to <a href="https://jamanetwork.com/journals/jama/article-abstract/2799405">lower levels</a> of joint pain and better physical function </li> <li> keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep <a href="https://www.sciencedirect.com/science/article/pii/S0033350623003359">less well</a> in cold rooms </li> <li> maintain a healthy diet and <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">avoid smoking</a> or drinking high levels of alcohol. These are among <a href="https://ard.bmj.com/content/annrheumdis/82/1/48.full.pdf">key lifestyle recommendations</a> to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with <a href="https://pubmed.ncbi.nlm.nih.gov/36208321/">higher levels</a> of physical function.<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/235117/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, Rheumatologist and Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-your-aches-and-pains-dont-get-worse-in-the-cold-so-why-do-we-think-they-do-235117">original article</a>. </div>

Body

It’s hard to reach out to old friends, but doing so may help alleviate loneliness

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a> Millions of <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=4510004801">Canadians are lonely</a>. This is worrisome because loneliness, defined by the World Health Organization as “<a href="https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection">the social pain of not feeling connected</a>,” predicts both lower mental and physical health. Research shows that lacking a sense of social connection can pose an <a href="https://doi.org/10.1177/1745691614568352">equivalent health risk to smoking 15 cigarettes per day</a>. To combat loneliness, people are commonly advised to seek out social connection. For many, this guidance brings to mind spending time with loved ones, such as close friends, family and romantic partners. But are there other people we can reach out to? In our research, recently published in Communications Psychology, we examined whether people have “old friends” — individuals that they care about but with whom they have lost touch — and <a href="https://doi.org/10.1038/s44271-024-00075-8">how easily these relationships can be rekindled</a>. We found that certain strategies can help people reconnect — and, in new research, we are getting a sense that certain values and personality traits may make it easier for people to stay in touch far into the future. <h2>Reconnecting with old friends</h2> Across a series of seven studies, we found the majority of people reported having an old friend. Yet, when we asked over 400 participants how willing they would be to reach out to an old friend right now, most said they were neutral or unwilling. In fact, in one study, people reported being no more willing to reach out to an old friend than they were to talk to a stranger or pick up trash. This reluctance was observable in behaviour too. We conducted two experiments in which more than 1,000 people were given several minutes to draft and send a message to an old friend. Only 30 per cent sent the message to their old friend. Given that reaching out to an old friend could boost <a href="https://www.forbes.com/sites/nextavenue/2018/08/19/the-power-and-joy-of-reconnecting-with-old-friends/">feelings of social connection and happiness</a>, we tried designing interventions to encourage reaching out. For instance, we reminded participants that reaching out to an old friend was an act of kindness and that the recipient would appreciate it more than they realize. We also tried telling participants not to overthink it — to just send their message. Unfortunately, neither prompt was effective at encouraging more people to reach out. <h2>Reluctance to reconnect</h2> Why are people reluctant to reach out to old friends? There may be a number of reasons, including the possibility that old friends feel like strangers after time has passed. In one study with over 500 participants we asked people to list between three to five old friends, and tell us how close each one felt to them right now. The more unfamiliar an old friend felt, the less willing people were to reach out. Research has found that when people <a href="https://doi.org/10.1016/j.jesp.2022.104356">practise talking to strangers for a week</a>, they become less anxious about it. If old friends can feel like strangers, might a similar strategy encourage people to reach out to old friends? To find out, we conducted an experiment in which we randomly assigned some people to complete a three-minute warm-up activity in which they messaged current family or friends. Other participants were randomly assigned to a control condition in which they simply browsed social media for three minutes instead. Afterward, all participants were given an opportunity to write and send a message to an old friend. While only 30 per cent of participants sent their message in the control condition, over 50 per cent did so after warming-up, suggesting that practising the behaviour that underlies reaching out may make this act easier. <h2>Personality traits</h2> We are extending this research in a number of new directions. For instance, in some newly conducted and unpublished research, we are examining whether people with certain personality traits or beliefs are more likely to send a message to an old friend. Responses from over 300 people suggest that people who are open to new experiences — <a href="https://www.psychologytoday.com/ca/basics/big-5-personality-traits">one of the five key personality traits studied by psychologists</a> — say they are willing to reach out to an old friend. Despite this inclination, our research found that highly open people do not necessarily communicate with old friends when given the chance. On the other hand, people’s values and beliefs may be important determinants of whether they stay in touch. Our preliminary work shows that people who see friendship as a bond that does not easily break may be more likely to reach out than others. We hope this work helps normalize the fact that friendships can fade and be hard to rekindle. That said, with some practice, people can overcome this reluctance and hit “send” to potentially open a path to connection and less loneliness.<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/234895/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, Distinguished Professor of Social Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, Senior Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, Master's Student, Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser 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/its-hard-to-reach-out-to-old-friends-but-doing-so-may-help-alleviate-loneliness-234895">original article</a>. </div>

Relationships

Why IBD is so hard to treat – and how scientists are making progress

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/falk-hildebrand-1490022">Falk Hildebrand</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>; <a href="https://theconversation.com/profiles/katarzyna-sidorczuk-1490026">Katarzyna Sidorczuk</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>, and <a href="https://theconversation.com/profiles/wing-koon-1490274">Wing Koon</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a> Inflammatory bowel disease (IBD) is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478758/">life altering</a> chronic illness that is <a href="https://bmjopen.bmj.com/content/13/3/e065186">rising dramatically globally</a>. It is stubbornly difficult to treat, and many people find the treatments we have just don’t work for them. Over the last 30 years, there has been almost a 50% increase in cases – now affecting around 5 million people. Not to be confused with irritable bowel syndrome (IBS) which is a condition that affects the digestive system, IBD is more serious. It is the term for two severe illnesses called <a href="https://www.nhs.uk/conditions/crohns-disease/">Crohn’s disease</a> and <a href="https://www.nhs.uk/conditions/ulcerative-colitis/">ulcerative colitis</a>. More women are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958616/#:%7E:text=Male%20predominance%20in%20IBD.,%2C%202.32%3A1%20in%20CD.">diagnosed with Crohn’s disease</a> while more men are affected by ulcerative colitis. People with IBD can experience a variety of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106026/">symptoms</a>, ranging from diarrhoea and blood in the stool, to weight loss and belly aches. On paper, this may sound no worse than mild food poisoning, however, this is no normal stomach upset. Experiences are often extreme; people with IBD can suffer excruciating pain and in some cases, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963331/">require surgery</a> to remove parts of the bowel. This is done by redirecting the bowel to a hole in the abdomen, where faeces are collected in a <a href="https://www.nhs.uk/conditions/colostomy/">colostomy bag</a>. However, we still don’t fully understand the cause of IBD. <h2>The impact of inflammation</h2> The main symptom of IBD is excessive and uncontrolled <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805548/">inflammation</a> – normally a sign of the body fighting off an infection. Although inflammation is an important aspect of our immune system, in IBD it is happening when the body is not under attack. Since we don’t know what causes this over-the-top reaction, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720971/">treatments</a> are limited to managing the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964397/">derailed immune system</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373857/">Inflammation is controlled</a> by cell signalling. Our cells detect bacteria using receptors that attach to parts of bacteria. This activates the receptor, causing it to send a signal to proteins, and each protein sends on more signals, creating a signal cascade. This is what tells the body it’s under attack. Many treatments follow the strategy of intercepting signals and preventing the signal cascade from starting. However, they are <a href="https://journals.lww.com/co-gastroenterology/abstract/2022/07000/management_of_refractory_inflammatory_bowel.6.aspx">not effective</a> for many people. Scientists are trying to target a different protein network, called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924159/">NOD2</a>, that often goes haywire in people with IBD but is not targeted by current treatments. A protein, called <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.650403/full">RIPK2</a>, seems like a promising target since it is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939834/">only found</a> in this network. Researchers from the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10485824/">European Molecular Biology Laboratory</a> are investigating its structure to help scientists design a new medication that will block the signals from this protein. <h2>Importance of the microbiome</h2> Another inspiration for new treatments comes from the bacteria residing in our guts. This community of bacteria, called the gut microbiome, has been associated with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314516/">all sorts of health conditions</a> ranging from asthma to obesity. Gut bacteria work closely with our bodies and play a vital role in digesting food and managing our <a href="https://www.nature.com/articles/s41422-020-0332-7">immune system</a>. In a healthy person, there is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143175/">fine balance</a> between gut bacteria and the immune system. Disruption of this balance can lead to disease, starting from minor discomfort to more severe, long-term conditions. Scientists are trying to understand how our bodies interact with gut bacteria, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102608/">what changes</a> when people develop IBD. The gut microbiome is an ecosystem. Just like a forest has animals eating different things, microbes can form a <a href="https://www.frontiersin.org/articles/10.3389/fevo.2019.00153/full">food web</a>. Some bacteria will use up one type of food, while others feed off other foods. Some rely on the waste of other bacteria after they’ve eaten. It is now believed that disruption to the gut microbiome is a characteristic of IBD and contributes to its development and progression. It’s a chicken and egg situation. Is there a change in the bacteria and food web that alters our bodies? Or does something else in the body, like our immune system, change the food web, subsequently limiting which bacteria can grow? Scientists aren’t sure of the answer. Instead of trying to figure out what happens first, a team at the <a href="https://www.nature.com/articles/s41467-023-42112-w">Hudson Institute of Medical Research</a> in Australia have focused on investigating which interactions in the food web are the most affected in IBD. This could help scientists to prioritise certain gut bacteria, or their food source, to restore the balance in the microbiome and improve patients’ symptoms. Hopefully, this specialised targeting of the microbiome will lead to more effective and longer lasting treatments. Although we have a long way to go before these ideas for treatments can become a reality, it is a step in the right direction. Targeting a new signalling pathway will hopefully control the inflammation in more patients. And studying the microbiome may reveal how we can reverse changes associated with IBD. Since they are key features of IBD, these developments could allow doctors to stop the disease in the early stages and reduce complications.<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/218307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/falk-hildebrand-1490022">Falk Hildebrand</a>, Researcher in Bioinformatician, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>; <a href="https://theconversation.com/profiles/katarzyna-sidorczuk-1490026">Katarzyna Sidorczuk</a>, Research Scientist in Metagenomics, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>, and <a href="https://theconversation.com/profiles/wing-koon-1490274">Wing Koon</a>, PhD student in Bioinformatics, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-ibd-is-so-hard-to-treat-and-how-scientists-are-making-progress-218307">original article</a>. </div>

Body

What is competition, and why is it so important for prices?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/paul-blacklow-1546097">Paul Blacklow</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> It’s hard to remember a time before the <a href="https://theconversation.com/you-dont-have-to-be-an-economist-to-know-australia-is-in-a-cost-of-living-crisis-what-are-the-signs-and-what-needs-to-change-210373">cost-of-living crisis</a> dominated news headlines. Most of us would certainly like it to be over. But the fundamental question at its heart – which points to the problem we have to solve – seems simple. What determines the prices we pay? The cost of producing goods and services is certainly one big factor in determining how much we pay for them. So, too, is what we’re prepared to fork out. But when we talk about lowering prices, we often also talk about increasing competition – the number of firms vying to sell us a particular offering. It’s so important for efficient pricing that the government body tasked with making our markets fair is called the Australian Competition and Consumer Commission – the “ACCC” for short. But why does having more people trying to sell us things drive down their prices? And can companies find ways to get around this? <h2>More sellers, lower prices</h2> In a free market system, there are a few different types of competition. In the most ideal, a perfectly competitive market, firms must use resources efficiently to produce what we consumers want at the lowest possible cost. In perfect competition: <ul> <li>the products and services traded are identical (or very similar)</li> <li>there are many buyers and sellers</li> <li>information is perfect</li> <li>firms can enter and exit freely.</li> </ul> A firm charging prices well above the minimum cost will sell no goods or services and be forced to leave the market. Why? Because its competitors will be able to steal customers by charging slightly less for exactly the same thing. Only lower-cost firms will remain and compete prices down until they cover the lowest cost of supplying the good or service, plus an average or normal “return on capital”. At a high level, think of this return as an acceptable monetary reward for the business for investing the inputs and taking on the risks required to operate. If ever an industry is earning above-average returns given its level of risk, new firms will enter and charge less, until only normal returns are earned. Conversely, below-normal profits will see firms exit, decreasing supply and raising prices. Do perfectly competitive markets exist? There are arguably some examples that come close, such as casual labour services, some agricultural commodities like grain, livestock and fruit, and financial and currency markets. But there are more examples of less competitive markets. <h2>The winner takes it all</h2> At the opposite extreme, in monopoly markets, there is only one seller of a good or service. Typically, there is some barrier preventing new firms from entering the market and driving prices down. Without government regulation, monopoly firms will reduce supply, increase prices and earn above-normal profit levels. However, sometimes monopolies emerge naturally because it is far more efficient to have a single coordinating supplier of a particular service – such as in letter delivery, rail tracks, or internet infrastructure. To strike a balance, governments typically regulate or own monopolies. <h2>Same same, but different</h2> More common than monopoly is what’s called monopolistic competition, which is the market structure for many of our tech, entertainment and dining goods and services. In monopolistic competition, firms try to make their offering different by investing in R&D and advertising, so that they do not have to compete on price alone. Think Apple’s iPhone versus Samsung’s Galaxy. Both are technically the same kind of product, but have created their own unique markets. Differentiation allows firms to price above minimum cost and earn above-normal rates of return. At least, that is, until new firms enter and imitate them, increasing supply and lowering prices and profits to normal levels. <h2>A few big players hold market power</h2> In Australia, many key goods and services are traded in oligopoly markets. Oligopolies arise when a few large firms dominate a particular industry, such as supermarkets, domestic airlines, banking, mobile telecommunications, and petrol retailing. Some oligopoly markets are very competitive and drive prices down to cost, plus normal return to capital. But in other more concentrated markets with a few powerful firms, firms may have significant market power and be able to keep prices above the competitive level. It is not illegal to possess market power, but according to Australia’s Competition and Consumer Act 2010, it is illegal to use it “for the purpose, effect, or likely effect of substantially lessening competition”. It is illegal, for example, for firms to explicitly work together when setting prices. This is called collusion. Neither can they force suppliers to deal with them exclusively, or set prices below cost when new firms attempt to enter a market. But that doesn’t mean some firms haven’t learned subtle and legal ways of reducing competition. For example, loyalty programs and charging special loss-leading prices can seem at first glance to be good for consumers, but can also increase the <a href="https://theconversation.com/loyalty-programs-may-limit-competition-and-they-could-be-pushing-prices-up-for-everyone-220669">cost of switching</a> to the lowest-priced firm. <h2>Are we getting a good deal?</h2> Still, you may have noticed the prices charged for many goods and services are very similar across different firms in the economy. Have these prices been driven down by competition to their cost plus a normal return to capital? Or are firms abusing their market power to lessen competition in the market? What can we do if firms are reducing competition through legal measures? These are just some of the difficult questions both government and industry are currently grappling with.<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/234082/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-blacklow-1546097">Paul Blacklow</a>, Lecturer in Economics, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-competition-and-why-is-it-so-important-for-prices-234082">original article</a>. </div>

Money & Banking

So when should you book that flight? The truth on airline prices

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yuriy-gorodnichenko-144556">Yuriy Gorodnichenko</a>, <a href="https://theconversation.com/institutions/university-of-california-berkeley-754">University of California, Berkeley</a> and <a href="https://theconversation.com/profiles/volodymyr-bilotkach-145437">Volodymyr Bilotkach</a>, <a href="https://theconversation.com/institutions/newcastle-university-906">Newcastle University</a> How airlines price tickets is a source of many <a href="http://airtravel.about.com/od/travelindustrynews/a/mythticket.htm">myths</a> and urban legends. These include tips about the best day of the week to buy a ticket, last-minute discounts offered by the airlines, and the conspiracy theories suggesting that the carriers use cookies to increase prices for their passengers. None of these three statements is entirely true. Studies have suggested that prices can be higher or lower on a given day of the week – yet, there is no clear consensus on which day that is. Offered prices can in fact drop at any time before the flight, yet they are much more likely to increase than decrease over the last several weeks before the flight’s departure. Further, the airlines prefer to wait for the last-minute business traveler who’s likely to pay full fare rather than sell the seat prematurely to a price conscious traveler. And no, the airlines do not use cookies to manipulate fare quotes – adjusting their inventory for specific customers appears to be beyond their technical capabilities. What is true about pricing in the airline industry is that carriers use complex and sophisticated pricing systems. The airline’s per passenger cost is the lowest when the flight is full, so carriers have incentive to sell as many seats as possible. This is a race against time for an airline and, of course, no company wants to discount its product more than it has to. Hence, the airlines face two somewhat contradictory goals: to maximize revenue by flying full planes and to sell as many full-fare seats as possible. This a process known in the industry as yield or revenue management. <h2>Airlines and their bucket lists</h2> Here is how <a href="http://commons.erau.edu/cgi/viewcontent.cgi?article=1522&context=jaaer">yield management</a> works. For each flight or route (if we are talking about multi-segment itineraries), the airline has a set of available price levels – from the most expensive fully refundable fare to the cheapest deeply discounted non-refundable price. The industry jargon for these prices is “buckets.” Then, seats can be interpreted as balls that are allocated among these buckets. Initial allocation of seats between the price buckets is determined by historical data indicating how well a certain flight sells. For example, fewer deeply discounted seats will be offered on a flight on Thanksgiving week than on the same flight during the third week of February. As the seats on a flight sell, yield managers monitor and adjust the seat allocation. If, for instance, the sales are slower than expected, some of the seats might be moved to lower-priced buckets – this shows up as a price drop. As noted above, such price drops can occur at any time before the flight. However, the general trend of price quotes is upward starting from about two to three weeks before the flight departure date. Of course, an average traveler wants to know when he or she should buy the tickets for the next trip. Another important question is where to buy this ticket. Airlines distribute their inventory on their own websites and on several computer distribution systems, meaning that prices can sometimes differ depending on where one looks. We are not entirely sure what precipitates this phenomenon – likely explanations include differences in contracts between the airlines and the distribution systems/travel agents, implying that different travel agents may not have access to the airline’s entire inventory of available prices. <h2>When to book</h2> The airlines’ yield managers start looking at flight bookings about two months before the departure date. This implies that it generally does not pay to book more than two months in advance: studies show that initially the airlines leave the cheapest price buckets empty, and yield managers may move some seats into those buckets if a couple of months before the departure date the flight is emptier than expected. Between two months and about two to three weeks before the flight date, the fare quotes remain mostly flat, with a slight upward trend. However, and perhaps paradoxically, there is a good chance of a price drop during this period. We tend to monitor prices for several days – sometimes up to a week – hoping for a potentially lower quote. It does not always pay off, but sometimes we do manage to save a considerable amount of money. Two to three weeks before the flight date, the price quotes start increasing. This is the time when business travelers start booking. While price drops are still possible, a chance of a price increase is much higher if you wait to book within this time period. This is also the time when one can find significant differences between price quotes, depending on where one looks and what contract they have with the airlines. Thus, if we book a trip earlier than three weeks before the flight date, we tend not to delay the purchase. At the same time, we check quotes from multiple travel agents, or go directly to a site that allows for a quick comparison of prices (such as <a href="https://www.kayak.com">kayak.com</a> or <a href="http://www.skyscanner.net">skyscanner.net</a>). Or check the airline itself. As for answering the original question we posed, here are some simple tips. First, if you have to travel during a peak period, such as Thanksgiving week, it is generally best not to delay buying that ticket. Otherwise, it might pay to monitor the offered prices for some time before committing. The best strategy for booking within the last couple of weeks before the flight, however, is not to delay the purchase, but to try getting quotes from several agents, which is easy to do in the internet age.<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/34033/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yuriy-gorodnichenko-144556">Yuriy Gorodnichenko</a>, Associate Professor of Economics, <a href="https://theconversation.com/institutions/university-of-california-berkeley-754">University of California, Berkeley</a> and <a href="https://theconversation.com/profiles/volodymyr-bilotkach-145437">Volodymyr Bilotkach</a>, Senior Lecturer in Economics, <a href="https://theconversation.com/institutions/newcastle-university-906">Newcastle 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/so-when-should-you-book-that-flight-the-truth-on-airline-prices-34033">original article</a>. </div>

Travel Tips

We know what to eat to stay healthy. So why is it so hard to make the right choices?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/nina-van-dyke-822557">Nina Van Dyke</a>, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> A healthy diet <a href="https://www.who.int/initiatives/behealthy/healthy-diet">protects us</a> against a number of chronic diseases, including heart disease, diabetes and cancer. From early childhood, we receive an abundance of <a href="https://cdn.who.int/media/docs/default-source/healthy-diet/healthy-diet-fact-sheet-394.pdf?sfvrsn=69f1f9a1_2&download=true">information</a> about how we <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">should eat</a> to be healthy and reduce our risk of disease. And most people have a <a href="https://link.springer.com/content/pdf/10.1186/1479-5868-11-63.pdf">broad understanding</a> of what healthy eating looks like. But this knowledge <a href="https://www.sciencedirect.com/science/article/pii/S0001209216310584?casa_token=6CZgCmT1RMgAAAAA:sSRsj2o6swVfvoBxMIVrMTxqdczSAiFwfTCYzYQ8U3z4ey_WLQ6knpmk8WRH77zugAS3wEAQrA">doesn’t always result</a> in healthier eating. In our new research, we set out to <a href="https://link.springer.com/content/pdf/10.1186/s12889-024-18432-x.pdf">learn more</a> about why people eat the way they do – and what prevents them from eating better. Lack of time was a major <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.12472?casa_token=1D1mi-l0TR0AAAAA:dgebTQx-wgw7jbREfdawxZ5AZSDRztvrt8t1tuKyDy1x2mmXlyLDY8z9NbUf0v4hnh80HY_RbAk08Q">barrier</a> to cooking and eating healthier foods. <h2>How do you decide what to eat?</h2> We spoke with <a href="https://link.springer.com/content/pdf/10.1186/s12889-024-18432-x.pdf">17 adults</a> in a regional centre of Victoria. We chose a regional location because less research <a href="https://link.springer.com/content/pdf/10.1186/s40900-020-0179-6.pdf">has been done</a> with people living outside of metropolitan areas and because rates of obesity and other diet-related health issues are <a href="https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health">higher</a> in such areas in Australia. Participants included a mix of people, including some who said they were over their “most healthy weight” and some who had previously dieted to lose weight. But all participants were either: <ul> <li>young women aged 18–24 with no children</li> <li>women aged 35–45 with primary school aged children</li> <li>men aged 35–50 living with a partner and with pre- or primary-school aged children.</li> </ul> We selected these groups to target <a href="https://www.sciencedirect.com/science/article/pii/S0022318212803669">ages and life-stages</a> in which shifts in eating behaviours may occur. Previous research has found younger women <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1470-6431.2007.00642.x?casa_token=33QKWwhc2ogAAAAA:ZvJ6wfXiRC_6eoqvoxD121JOSKSPmIRHcrdiGl2uHzkq5pY6VVPL6WI2DhmxQ2q9i6bBGvLiFl8afQ">tend to</a> be particularly concerned about appearance rather than healthy eating, while women with children often shift their focus to providing for their family. Men <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.12472?casa_token=KakMB6hAOQ0AAAAA:fLnpoxZQiiJIdEkg_TOcCq8hBwZef1iZETZKTiG5W6zW2x_PYzK0oLeOg5F9arKThq9RzMWEi4x4Xw">tend to be less interested</a> in what they eat. We asked participants about how they decided what food to eat, when, and how much, and what prevented them from making healthier choices. <h2>It’s not just about taste and healthiness</h2> We found that, although such decisions were determined in part by taste preferences and health considerations, they were heavily influenced by a host of other factors, many of which are outside the person’s control. These included other household members’ food preferences, family activities, workplace and time constraints, convenience and price. <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2767106">Healthy eating</a> means consuming a balanced diet rich in nutrients, including a variety of fruits, vegetables, whole grains, lean proteins and healthy fats, while limiting processed foods, added sugars and excessive salt. Healthy eating also includes how we eat and <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244292">how we think about</a> food and eating, such as having a positive relationship with food. One 35- to 45-year-old woman, for example, said that time constraints and family preferences made it difficult to prepare healthier food: <blockquote> I love the chance when I can actually get a recipe and get all of the ingredients and make it properly, but that doesn’t happen very often. It’s usually what’s there and what’s quick. And what everyone will eat. </blockquote> One of the 35- to 50-year-old men also noted the extent to which family activities and children’s food preferences dictated meal choices: <blockquote> Well, we have our set days where, like Wednesday nights, we have to have mackie cheese and nuggets, because that’s what the boys want after their swimming lesson. </blockquote> <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/joss.12649?casa_token=gsnU9O_G2GQAAAAA:mV2vtHlnEd0jqBGJPFkfml_ecLIDqwSlH5xksSwt4eQb_FP_UShyAKm9sLNnKy6Mkf2q9aKAlDEixA">Research shows</a> that children are often more receptive to new foods than their parents think. However, introducing new dishes takes additional time and planning. An 18- to 24-year-old woman discussed the role of time constraints, her partner’s activities, and price in influencing what and when she eats: <blockquote> My partner plays pool on a Monday and Wednesday night, so we always have tea a lot earlier then and cook the simple things that don’t take as long, so he can have dinner before he goes rather than buying pub meals which cost more money. </blockquote> Despite popular perceptions, healthy diets are not more expensive than unhealthy diets. A <a href="https://preventioncentre.org.au/wp-content/uploads/2017/03/1702_FB_LEE_4p_final_lr.pdf">study</a> comparing current (unhealthy) diets with what the <a href="https://www.health.gov.au/resources/publications/the-australian-dietary-guidelines">Australian Dietary Guidelines</a> recommend people should eat found that the healthy diet was 12–15% cheaper than unhealthy diets for a family of two adults and two children. However, learning and planning to prepare new types of meals <a href="https://www.mdpi.com/2072-6643/12/3/877">takes effort and time</a>. Simply educating people about what they should eat won’t necessarily result in healthier eating. People want to eat healthier, or at least know they should eat healthier, but other things <a href="https://link.springer.com/content/pdf/10.1007/s00394-017-1458-3.pdf">get in the way</a>. A key to improving people’s eating behaviours is to make it easy to eat more healthily. Policy changes to make healthy eating easier could include subsidising healthier foods such as fresh produce, providing incentives for retailers to offer healthy options, and ensuring access to nutritious meals in schools and workplaces. <h2>So how can you make healthier food choices easier?</h2> Here are five tips for making healthy choices easier in your household: <ol> <li> If certain days of the week are particularly busy, with little time to prepare fresh food, plan to cook in bulk on days when you have more time. Store the extra food in the fridge or freezer for quick preparation. </li> <li> If you’re often pressed for time during the day and just grab whatever food is handy, have healthy snacks readily available and accessible. This could mean a fruit bowl in the middle of the kitchen counter, or wholegrain crackers and unsalted nuts within easy reach. </li> <li> Discuss food preferences with your family and come up with some healthy meals everyone likes. For younger children, <a href="https://healthykids.nsw.gov.au/downloads/file/campaignsprograms/NewFoodsFussyEaters.pdf">try serving</a> only a small amount of the new food, and serve new foods alongside foods they already like eating and are familiar with. </li> <li> If you rely a lot on take-away meals or meal delivery services, try making a list ahead of time of restaurants and meals you like that are also healthier. You might consider choosing lean meat, chicken, or fish that has been grilled, baked or poached (rather than fried), and looking for meals with plenty of vegetables or salad. </li> <li> Remember, fruit and vegetables taste better and are often cheaper when they are in season. Frozen or canned vegetables are a <a href="https://www.sbs.com.au/news/article/the-cost-of-fresh-fruit-and-veggies-is-rising-is-canned-or-frozen-produce-just-as-healthy/tzuhnfrnr">healthy and quick alternative</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/231489/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ol> <a href="https://theconversation.com/profiles/nina-van-dyke-822557">Nina Van Dyke</a>, Associate Professor and Associate Director, Mitchell Institute, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-know-what-to-eat-to-stay-healthy-so-why-is-it-so-hard-to-make-the-right-choices-231489">original article</a>. </div>

Food & Wine

Southern Australia is freezing. How can it be so cold in a warming climate?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/andrew-king-103126">Andrew King</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> People living in southern Australia won’t have failed to notice how cold it is. Frosty nights and chilly days have been the weather for many of us since the start of July. As winter continues, we are left wondering how unusual the cold is and whether we can expect several more months of this. Warmer conditions are in the forecast but winter has a long way to go. Further cold snaps could occur. Cold conditions have been in place across southern Australia for the past few days. Temperatures have fallen below zero overnight in many places. It’s not just the nights that have been cold. Maximum temperatures have also been below or well below average across most of the country. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=518&fit=crop&dpr=1 754w, https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=518&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/604809/original/file-20240704-20-l50kpt.gif?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=518&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Maximum temperatures have been below average across most of the continent since the last day of June. <a class="source" href="http://www.bom.gov.au/jsp/awap/temp/index.jsp">Bureau of Meteorology</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> <h2>What’s causing the cold?</h2> A <a href="http://www.bom.gov.au/australia/charts/synoptic_col.shtml">persistent and strong high-pressure system</a> has been hanging around over southeast Australia. The atmospheric pressure was so high it approached the Australian record of 1,044.3 hPa set on June 7 1967. An <a href="https://www.abc.net.au/news/2024-07-04/australias-highest-air-pressure-recorded-weather/104055462">initial observation</a> of a new record has since been disregarded, but nonetheless this is an exceptional, near-record high-pressure pattern. This high-pressure system has kept the weather dry but clear nights have allowed strong cooling of the land surface. The long nights and short days of early July mean that temperatures struggle to rise during the day and can fall quickly in the evenings. In winter we expect cold weather across most of Australia and occasional cold snaps that bring widespread frosty and icy conditions. However, this current cold weather is pretty unusual and we are seeing some records fall. Notably, Tasmania has had its <a href="https://www.weatherzone.com.au/news/tasmanias-2ndcoldest-night-on-record/1889603">lowest July temperature on record</a> and the second-lowest minimum temperature for any time of year with –13.5°C at Liawenee in central Tasmania early on Thursday morning. While Tasmania has produced the most remarkable records, the cold conditions have been unusual elsewhere too. Adelaide recorded its lowest temperature in 18 years on Wednesday morning. And many suburbs of Melbourne experienced a sub-zero night and consecutive nights of <a href="https://www.metoffice.gov.uk/weather/learn-about/weather/types-of-weather/frost-and-ice/frost">ground frost</a>. <h2>Winters are warming but cold spells still occur</h2> As the world is warming, it might seem surprising we can still break cold records. Indeed, across Australia <a href="http://www.bom.gov.au/cgi-bin/climate/change/timeseries.cgi?graph=tmean&area=aus&season=0608&ave_yr=0&ave_period=6190">winters have been warming</a>. The <a href="http://www.bom.gov.au/cgi-bin/climate/change/extremes/trendmaps.cgi?map=CN05&period=1950">frequency</a> and <a href="http://www.bom.gov.au/cgi-bin/climate/change/extremes/trendmaps.cgi?map=TNmn&period=1950">intensity</a> of very low temperatures have been decreasing over the past few decades. We also see many more hot records than cold records being set in Australia and around the globe. This is <a href="https://theconversation.com/why-hot-weather-records-continue-to-tumble-worldwide-86158">due to human-caused climate change</a>. However, when we have the right weather conditions, cold records are still occasionally broken locally. As we continue to warm the planet, it’s getting harder for us to find cold records, particularly over larger regions or longer time periods. While we still see record cold temperatures at individual weather stations, we won’t see another cold record in the global average temperature and probably not even in the Australian average temperature. As this week shows, we still occasionally get daily cold records in the current climate. But it’s much harder to get record cold months, and record cold years at a given location are almost impossible. As we average weather conditions across locations or over time, the climate change signal becomes clearer over background weather variability. It makes new cold records much less likely to occur. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.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/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=536&fit=crop&dpr=1 754w, https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=536&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/605048/original/file-20240704-21-7ep1rt.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=536&fit=crop&dpr=3 2262w" alt="A graphic showing the increase in annual average temperature for Australia from 1910 to 2023" /></a><figcaption>The climate change signal is becoming clearer as Australia’s annual average temperature continues to increase with each decade, widening the difference from the long-term mean. <a class="source" href="http://www.bom.gov.au/climate/current/annual/aus/#tabs=Temperature">Bureau of Meteorology</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> <h2>How much longer will this cold snap last?</h2> Southern Australia is experiencing a cold snap at close to the coldest time of year. It’s not long after the winter solstice, when we experience the longest night of the year. We still have a few more cold days and nights ahead in parts of southeastern Australia. By early next week, the forecast suggests <a href="http://www.bom.gov.au/australia/charts/viewer/index.shtml">warmer conditions</a> will return as the high-pressure system moves east and winds turn northerly. The outlook for the rest of winter points firmly to <a href="http://www.bom.gov.au/climate/outlooks/#/overview/summary">above-average daytime and night-time temperatures</a>. This is partly because a historical average (1981–2018) is used and warming since then means above-average temperatures are going to happen most of the time. In any winter, Australia has cold outbreaks. So, even if the next few months are likely to be warmer than normal, we should expect a few cold days and nights at some point. Learning to live with the cold and improving the <a href="https://www.theguardian.com/news/ng-interactive/2024/jul/03/why-so-many-australian-homes-are-either-too-hot-or-too-cold">quality of insulation in Australian homes</a> would help make our winter cold snaps seem a lot less harsh.<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/233977/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-king-103126">Andrew King</a>, Senior Lecturer in Climate Science, <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/southern-australia-is-freezing-how-can-it-be-so-cold-in-a-warming-climate-233977">original article</a>. </div>

Domestic Travel

Breast cancer screening in Australia may change. Here’s what we know so far

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The way women are screened for breast cancer in Australia may <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/early-detection/breast-cancer/rosa/key-findings">change</a>. There’s international debate on the <a href="https://www.bmj.com/content/385/bmj.q1353">age</a> women should be invited for screening. But an even larger change being considered worldwide is whether to screen women at <a href="https://www.nature.com/articles/s41416-021-01550-3">high and low risk</a> of breast cancer differently. But what such a “risk-based” approach to screening might look like in Australia is not yet clear. Here’s why researchers and public health officials are floating a change to breast cancer screening in Australia, and what any changes might mean. <h2>Why breast cancer screening may need to change</h2> Mass screening (known as population-based screening) for breast cancer was introduced in Australia and many other developed countries in the 1980s and 90s. This was based on <a href="https://pubmed.ncbi.nlm.nih.gov/26756588/">robust research</a> that found early detection and treatment of cancers before there were symptoms prevented some women from dying from breast cancer. These programs offer regular breast cancer screening to women within a specific age group. For example, <a href="https://www.aihw.gov.au/reports/cancer-screening/national-cancer-screening-programs-participation/contents/breastscreen-australia">in Australia</a>, women aged 40-74 years can have free mammograms (x-rays of the breasts) every two years. The BreastScreen program sends invitations for screening to those aged 50-74. However, evidence has been mounting that mammography screening could be inadvertently causing <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61611-0/abstract">harm</a> for some women. For some, screening causes a false alarm that may cause anxiety, and unnecessary tests and procedures. Even though these tests rule out cancer, these women may remain anxious and perceive something is wrong <a href="https://bmjopen.bmj.com/content/13/4/e072188">for many years</a>. A more insidious harm is <a href="https://theconversation.com/five-warning-signs-of-overdiagnosis-110895">overdiagnosis</a>, where screening detects a non-growing or slow-growing lesion that looks like “cancer” under the microscope, but would not have progressed or caused harm if it had been left alone. This means some women are having unnecessary surgery, radiotherapy and hormone therapy that will not benefit them, but may harm. Although trials have shown screening reduces the risk of dying from breast cancer, questions are being raised about how much it <a href="https://www.bmj.com/content/352/bmj.h6080.abstract">saves lives overall</a>. That is, it’s uncertain how much the reduced risk of dying from breast cancer translates into improvements in a woman’s overall survival. <h2>How about better targeting women?</h2> One idea is to target screening to those most likely to benefit. Under such a “<a href="https://www.nature.com/articles/s41416-021-01550-3">risk-based</a>” approach, a women’s personal risk of breast cancer is estimated. This may be based on her age and many other factors that may include breast density, family history of breast cancer, body-mass index, genetics, age she started and stopped her periods, and the number of children she’s had. Women who are at higher risk would be recommended to start screening at a younger age and to screen more frequently or to use different, more sensitive, imaging tests. Women at lower risk would be recommended to start later and to screen less often. The idea of this more “precise” approach to screening is to direct efforts and resources towards the smaller number of women most likely to benefit from screening via the early detection of cancer. At the same time, this approach would reduce the risk of harm from false positives (detection of an anomaly but no cancer is present) and overdiagnosis (detection of a non-growing or slow-growing cancer) for the larger number of women who are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230256/">unlikely to benefit</a>. On face value this sounds like a good idea, and could be a favourable change for breast cancer screening. <h2>But there’s much we don’t know</h2> However, it’s uncertain how this would play out in practice. For one thing, someone’s future risk of a cancer diagnosis includes the risk of detecting both <a href="https://www.acpjournals.org/doi/10.7326/m17-2792">overdiagnosed cancers</a> as well as potentially lethal ones. This is proving to be a problem in risk-based screening for <a href="https://www.nature.com/articles/s41698-022-00266-8">prostate cancer</a>, another cancer prone to overdiagnosis. Ideally, we’d want to predict someone’s risk of <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00113-9/fulltext">potentially lethal cancers</a> as these are the ones we want to catch early. It is also still uncertain how many women found to be at <a href="https://pubmed.ncbi.nlm.nih.gov/31701797/">low risk</a> will accept a recommendation for <a href="https://pubmed.ncbi.nlm.nih.gov/23092125/">less screening</a>. These uncertainties mean we need robust evidence the benefits outweigh the harms for Australian women before we make changes to the breast cancer screening program. There are several international <a href="https://www.nature.com/articles/s41416-021-01550-3">randomised controlled trials</a> (the gold standard for research) under way to evaluate the effectiveness of risk-based screening compared to current practice. So it may be prudent to wait for their findings before making changes to policy or practice. Even if such trials did give us robust evidence, there are still a number of issues to address before implementing a risk-based approach. One key issue is having enough staff to run the program, including people with the skills and time to discuss with women any concerns they have about their calculated risk. <h2>How about breast density?</h2> Women with dense breasts are at <a href="https://www.sciencedirect.com/science/article/pii/S0960977622001618#:%7E:text=Mammographic%20density%20is%20a%20well,increased%20risk%20of%20breast%20cancer.">higher risk of breast cancer</a>. So notifying women about their breast density has been proposed as a “first step” on the pathway to risk-based screening. However, this ignores the many other factors that determine a woman’s risk of breast cancer. Legislation in the <a href="https://www.fda.gov/radiation-emitting-products/mammography-quality-standards-act-and-program">United States</a> and changes in some <a href="https://australianbreastcancer.org.au/news-stories/latest-news/breast-density-reporting-at-all-sa-clinics/">Australian states</a> mean some women are already being notified about their breast density. The idea is to enhance their knowledge about their breast cancer risk so they can make informed decisions about future screening. But this has happened before we know what the best options are for such women. An <a href="https://www.mja.com.au/journal/2023/219/9/psychosocial-outcomes-and-health-service-use-after-notifying-women-participating">ongoing Australian trial</a> is investigating the effects that breast density notification has on individual women and the health system. <h2>What next?</h2> Robust evidence and careful planning are needed before risk-based screening or other changes are made to Australia’s breast cancer screening program. Where changes are made, there needs to be early evaluation of both the <a href="https://www.bmj.com/content/350/bmj.h1566.abstract">benefits and harms</a>. Programs also need <a href="https://www.bmj.com/content/374/bmj.n2049.long">independent, regular re-evaluation</a> in the longer term.<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/231917/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, NHMRC Emerging Leader Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, Professor in Clinical Epidemiology, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/breast-cancer-screening-in-australia-may-change-heres-what-we-know-so-far-231917">original article</a>. </div>

Body

Flight attendant reveals the unexpected reason why it's so cold on planes

When it comes to packing essentials in your carry-on for your next flight, many people add a jumper, extra socks, or even their own blanket to their bags. Because one thing’s for sure: you’ll probably be cold on your flight. But have you ever stopped to think of the reason why the cabin of a plane is so cold? According to a Canadian flight attendant, it's to do with keeping you feeling good. Vanessa Settimi told Reader's Digest that a cooler cabin helps passengers who are prone to fainting or have motion sickness during turbulence. She also clarified that despite what travellers may think, cabin crew don’t have control over the cabin temperature. "Temperature in the cabin is controlled by the pilots. Even though travellers often ask to get the temperature turned up during flights, it is kept on the cooler side." She went on to say that the key to staying warm on your next flight is bringing extra layers. "Now this might just be the flight attendant in me," says Settimi, "but you will never catch me flying as a traveller in sandals and a tank top!" Image credits: Shutterstock

Travel Trouble

Is social media making you unhappy? The answer is not so simple

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/melissa-humphries-584274">Melissa Humphries</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/lewis-mitchell-266859">Lewis Mitchell</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> You may have seen headlines that link social media to sadness and depression. Social media use goes up, happiness goes down. But recent studies suggest those findings might not be so straightforward. Although it is true that people’s feelings of envy and depression are linked to high social media use, there is evidence to suggest social media use may not be causing that relationship. Instead, your mindset may be the biggest thing affecting how social media connects to your wellbeing. People who feel they are able to use social media, rather than social media “using them”, tend to gain more benefits from their online interactions. <h2>Why do people use social media?</h2> Social media covers a broad range of platforms: social networking, discussion forums, bookmarking and sharing content, disseminating news, exchanging media like photos and videos, and microblogging. These appeal to a wide range of users, from individuals of all ages through to massive businesses. For some, social media is a way to connect with people we may not otherwise see. In the United States, 39% of people say they <a href="https://www.americansurveycenter.org/research/the-state-of-american-friendship-change-challenges-and-loss">are friends with people they only interact with online</a>. For older people, this is especially important for increasing feelings of connectedness and wellbeing. Interestingly though, for older people, <a href="https://www.sciencedirect.com/science/article/pii/S0747563223004545">social media contact with family does not increase happiness</a>. Meanwhile, younger adults report increased happiness when they have more social media contact with family members. Teens, in particular, find social media most useful for <a href="https://www.pewresearch.org/internet/2022/11/16/connection-creativity-and-drama-teen-life-on-social-media-in-2022/">deepening connections and building their social networks</a>. With social media clearly playing such an important role in society, many researchers have tried to figure out: does it make us happier or not? <h2>Does social media make us happier?</h2> Studies have taken a variety of approaches, including asking people directly through surveys or looking at the content people post and seeing how positive or negative it is. One survey study from 2023 showed that as individuals’ social media use increased, <a href="https://www.researchgate.net/publication/372582895_The_Relationship_Between_Social_Media_Addiction_Happiness_and_Life_Satisfaction_in_Adults_Analysis_with_Machine_Learning_Approach">life satisfaction and happiness decreased</a>. Another found that <a href="https://www.tandfonline.com/doi/full/10.1080/0144929X.2023.2286529">less time on social media</a> was related to increases in work satisfaction, work engagement and positive mental health – so improved mental health and motivation at work. Comparing yourself to others on social media is connected to feelings of envy and depression. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955439/">there is evidence</a> to suggest depression is the predictor, rather than the outcome, of both social comparison and envy. All this shows <a href="https://academic.oup.com/jcmc/article/29/1/zmad048/7612379?login=false">the way you feel about social media matters</a>. People who see themselves using social media rather than “being used” by it, tend to gain benefits from social media and not experience the harms. Interviews with young people (15–24 years) using social media suggest that positive mental health among that age group was influenced by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8933808/">three features</a>: <ul> <li>connection with friends and their global community</li> <li>engagement with social media content</li> <li>the value of social media as an outlet for expression.</li> </ul> There are also studies that look at the emotions expressed by more frequent social media users. The so-called “<a href="https://epjdatascience.springeropen.com/articles/10.1140/epjds/s13688-017-0100-1">happiness paradox</a>” shows that most people think their friends on social media appear happier than themselves. This is a <a href="https://dl.acm.org/doi/10.1145/3110025.3110027">seeming impossibility</a> that arises because of <a href="https://www.nature.com/articles/srep04603">the mathematical properties</a> of how friendship networks work on social media. In one of our studies, Twitter content with recorded locations showed residents of cities in the United States that <a href="https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0064417.g007">tweeted more tended to express less happiness</a>. On the other hand, in Instagram direct messages, happiness has been found to be <a href="https://journals.sagepub.com/doi/full/10.1177/20563051241229655">four times more prevalent than sadness</a>. <h2>How does internet use in general affect our wellbeing?</h2> Some of the factors associated with decreased mental health are not aligned with social media use alone. <a href="https://journals.sagepub.com/doi/full/10.1177/0963721419838244">One recent study</a> shows that the path to decreased wellbeing is, at least partially, connected to digital media use overall (rather than social media use specifically). This can be due to sleep disruption, reduced face-to-face social interaction or physical activity, social comparison, and cyberbullying. None of these exist for social media alone. However, social media platforms are known to be driven by recommendation algorithms that may send us down “rabbit holes” of the same type of (increasingly extreme) content. This can lead to a distorted view of the world and our place in it. The important point here is to maintain a diverse and balanced information diet online. Interestingly, interacting on social media is not the only thing affecting our mental state. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090315">Rainfall influnces</a> the emotional content of social media posts of both the user experiencing rain, and parts of their extended network (even if they don’t experience rain!). This suggests that how we feel is influenced by the emotions in the posts we see. The good news is that happy posts are the most influential, with each happy post encouraging close to two additional happy updates from a user’s friends. The secret to online happiness therefore may not be to “delete your account” entirely (which, <a href="https://www.nature.com/articles/s41562-018-0510-5">as we have found</a>, may not even be effective), but to be mindful about what you consume online. And if you feel like social media is starting to use you, it might be time to change it up a bit.<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/232490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/melissa-humphries-584274">Melissa Humphries</a>, Senior Lecturer, School of Computer and Mathematical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/lewis-mitchell-266859">Lewis Mitchell</a>, Professor of Data Science, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-social-media-making-you-unhappy-the-answer-is-not-so-simple-232490">original article</a>. </div>

Mind

"So embarrassing": Tourist slammed for "stupid" stunt in Bali

A British tourist has gone viral for all the wrong reasons after his "stupid" stunt in a Bali resort left him red-faced. The British traveller was believed to be staying at the 5-star Apurva Kempinski hotel in Nusa Dua, considered the island’s most luxurious location, when he came across a large decorative bowl filled with water and flower petals. The man was then filmed and egged on by a friend who can be heard saying "Okay now put your face in it", before he followed the instruction. When he went to submerge himself, he proceeded to accidentally tip over the bowl sending water and rose petals flying through the lobby of the resort, and all over himself too. The video, which has amassed a whopping 41 million views, was quickly subject to a wave of backlash online, with many slamming the tourist's "stupid" actions. <div class="embed" style="font-size: 16px; box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; vertical-align: baseline; outline: currentcolor !important;"><iframe class="embedly-embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border-width: 0px; border-style: none; vertical-align: baseline; width: 600px; max-width: 100%; outline: currentcolor !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7380708475237666081&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40milzo09%2Fvideo%2F7380708475237666081&image=https%3A%2F%2Fp16-sign-useast2a.tiktokcdn.com%2Fobj%2Ftos-useast2a-p-0037-euttp%2F9eff1d6040b74f98b167ccb18b4559ef_1718455117%3Fx-expires%3D1718924400%26x-signature%3DIcusEtP7QnSZKUZGZe5cGhO6cFg%253D&key=59e3ae3acaa649a5a98672932445e203&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> “You come to Bali without bringing your brain? Why do you have to destroy everything in someone else’s country?” one person wrote. “Omg money can’t buy brains. So stupid and embarrassing.” said another. A third added sarcastically, “Well that’s just lovely isn’t it, so careful and respectful and cultured.” Despite the thousands of comments sharing their condemnation of the tourist's actions, others were quick to leap to his defence, saying it was clearly an accident. “I mean it’s just a bowl of water and flowers. Nothing broke it’ll be OK. Just say you’re sorry,” one person said. “Am I the only one who feels bad for him,” another wrote .Other viewers admitted they would be “mortified” if it had happened to them. “I would just lay on the floor like I passed out,” one joked. “I would leave the country,” another wrote. It’s not clear what happened afterwards but many were hopeful the tourist helped staff clean up the mess. Image credits: TikTok

Travel Trouble

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

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

Travel Trouble

Australia can afford to bulk bill all GP visits. So why don’t we?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/yuting-zhang-1144393">Yuting Zhang</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/karinna-saxby-1045932">Karinna Saxby</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Being able to afford health care is a <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">pressing issue</a> for many Australians. And encouraging GPs to bulk bill is <a href="https://theconversation.com/cheaper-medicines-and-a-new-approach-for-mental-health-care-will-the-budget-make-us-healthier-229612">one measure</a> the government is taking to ease the strain. So what would it take for GPs to bulk bill everyone? In our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-8462.12553">recent paper</a>, we calculated this is possible and affordable, given the current health budget. But we show recent incentives for GPs to bulk bill aren’t enough to get us there. Instead, we need to adjust health policies to increase bulk-billing rates and to make our health system more sustainable. <h2>How do the incentives work?</h2> In recent years, the government has introduced various incentives to try and encourage GPs to bulk bill (so patients pay nothing out-of-pocket). The most recent has been the “<a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments#1-november-2023-changes">triple bulk-billing incentives</a>” or “triple bonus” for short. These have been in place since November 2023. Under these incentives, GPs in metropolitan areas are paid a A$20.65 bonus if they bulk bill concession card holders or children under 16 years. GPs in rural and remote areas are paid $31.35-$39.65 extra. These bonus payments are in addition to regular Medicare rebates GPs receive. But when we looked at whether these latest incentives are likely to work to boost bulk billing, we found a city-country divide. <h2>City GPs may not be convinced</h2> We worked out the triple bonus will not help most people in metropolitan areas. That’s because in these areas the bonus is much lower than what patients currently pay out-of-pocket. In other words, if GPs did bulk bill these groups, their income would be lower than what they could have charged. So the bonus wouldn’t be enough incentive for them to bulk bill. For example, we found in greater Melbourne, the average out-of-pocket costs for a non-bulk billed GP visit <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">is about</a> $30-$56 depending on the suburb. This is much higher than the $20.65 triple bonus amount in metropolitan regions. We see similar patterns across all metropolitan areas. <h2>But country GPs may be swayed</h2> The picture is different in rural and remote areas. Here, the average out-of-pocket cost for a non-bulk billed GP visit <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">varies substantially</a> – around $28-52 in rural regions and $32-123 in remote areas. The highest cost on the mainland was $79 but GP visits on Lord Howe Island were the most expensive overall, at $123. For patients living in areas where their actual payment is less than the bonus amount, the incentive does help. In other words, it would be financially advantageous for GPs to bulk bill these patients, but not where the out-of-pocket costs are higher than the bonus. Our <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">online map</a> shows where GPs are most likely to bulk bill. The map below shows how out-of-pocket costs vary around Australia. <iframe id="SPzgj" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/SPzgj/" width="100%" height="400px" frameborder="0"></iframe> <h2>How about bulk billing for all?</h2> The picture is a little more complex when we start talking about bulk billing all GP visits – regardless of location or patients’ concession card status. We worked out this would cost about $950 million a year for all GP services, or $700 million a year for face-to-face GP consultations. This is within reach under the current budget, especially for face-to-face GP consultations. The government has earmarked <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/budget-2023-24-building-a-stronger-medicare#:%7E:text=%243.5%20billion%20in%20bulk%20billing,40%2Dyear%20history%20of%20Medicare">$3.5 billion</a> over <a href="https://archive.budget.gov.au/2023-24/bp2/download/bp2_2023-24.pdf">five years</a> for the “triple bonus” incentives. That’s $700 million a year. <h2>We can afford to, but should we?</h2> Introducing free GP visits for all would require careful consideration, as it would encourage more GP visits. This might be a good thing, particularly if people had previously skipped beneficial care <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">due to high costs</a>. However, it may encourage more people to see their <a href="https://www.sciencedirect.com/science/article/abs/pii/S1574006400801675">GP unnecessarily</a>, taking away limited resources from those who really need them. This could ultimately increase wait times for everyone. So providing free GP visits for all may not be efficient or sustainable, even if it’s within the budget. But paying more than $50 for a GP visit, as many do, seems too expensive and also makes the health-care system less efficient. That’s because primary care is <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/primary-health-care">often considered</a> high-value and preventive care. So if people can’t afford to go to the GP, it can lead to more expensive hospital and emergency room costs down the track. So we need to strike a balance to make primary care more affordable and sustainable. <h2>How do we strike a balance?</h2> One, concession card holders and children should get free primary care regardless of where they live. This would allow more equitable care to populations who need health care the most. Bulk bulling children is a <a href="https://www.sciencedirect.com/science/article/abs/pii/S016726812200292X#:%7E:text=Beside%20the%20benefits%20for%20the,and%20Kuh%2C%202002%3B%20Centers%20for">long-term investment</a>, which may delay onset of diseases, and prevent intergenerational poverty and poor health. Two, the government could also provide free primary care to all people in rural and remote areas. It can do this by lowering the triple bonus to match what GPs currently charge. Over time, GPs and the government can evaluate and <a href="https://www.auspublaw.org/blog/2023/4/the-civil-conscription-sub-clause-in-section-51xxiiia-of-the-australian-constitution-no-impediment-to-reform-of-medicare">negotiate</a> fair prices for GPs to charge. This can be adjusted in line with inflation and other measures. Three, the government can increase Medicare rebates (the amount Medicare pays a doctor for a GP visit) so patients not covered above only pay about $20-30 a visit. We consider this an affordable amount that will not result in more use of primary care than necessary. Four, the government can design a policy to reduce unnecessary GP visits that take away limited GP time from high-need patients. For example, patients currently need to see GPs to get <a href="https://theconversation.com/specialist-referral-rules-havent-changed-much-since-the-70s-but-australias-health-needs-sure-have-144506">referral letters</a> although they already have an established specialist for their ongoing chronic conditions. Five, the government can provide GPs funding needed to improve patient outcomes and reward GPs who provide <a href="https://bmjopenquality.bmj.com/content/10/1/e001127.abstract">high-quality preventive care</a>. The current fee-for-service funding model hurts good doctors who keep their patients healthy because doctors are not paid if their patients do not come back.<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/230204/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yuting-zhang-1144393">Yuting Zhang</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/karinna-saxby-1045932">Karinna Saxby</a>, Research Fellow, Melbourne Institute of Applied Economic and Social Research, <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/australia-can-afford-to-bulk-bill-all-gp-visits-so-why-dont-we-230204">original article</a>. </div>

Money & Banking

"I'm so sad": Woman declined entry into music venue because of her baby

A mother has shared her frustration after she was denied entry into a live music venue due to the fact that she had her baby with her. Jasmine and her partner were excited to see one of their favourite artists, Angie McMahon, at Melbourne's iconic concert venue The Forum, and made the decision to bring their five-month-old baby with them. The baby was strapped to the mum's chest in a carrier and was wearing headphones, but jasmine was soon confronted by venue staff that she was not allowed entry into the venue, and instead offered to return without their child for another night. The singer herself later called in to the 3AW radio show, where Jasmine had recalled the incident, to say that she would not have minded having a baby in the audience. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C7lk_LGPqta/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7lk_LGPqta/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by 3AW Melbourne (@3aw693)</a> </div> </blockquote> “I’m so sad. I’m sorry that it’s happened. We’ve had newborns at some of the other shows on the tour and it’s been so special,” McMahon said. “It’s like a really lovely moment to know that their parents have taken them to come see us, and that’s one of their first gigs. It’s so special for us to know that that’s happening so I wouldn’t have minded at all.” McMahon said she thinks mums, particularly new mums, are typically doing it tough and they should be able to have a night out and enjoy it with their baby. The Forum’s parent company The Marriner Group said the event was a “licensed general admission standing” and that they were respectful of the situation, but stood by their decision. “The promoter has offered for the customer to come back to attend the show on Friday instead, but without the baby, and hope that is an agreeable solution for everyone.,” they said in a statement. Image credits: 3AW

Family & Pets

"I am so lost without you": Sam Rubin's son speaks out

Sam Rubin’s son has delivered an emotional on-air tribute to his late dad just days after his <a href="https://oversixty.com.au/health/caring/legendary-today-show-reporter-dies-unexpectedly" target="_blank" rel="noopener">passing</a>. The entertainment reporter died unexpectedly at the age of 64, after reportedly suffering a heart attack in his Los Angeles home last Friday. He worked for LA TV station KTLA as their entertainment reporter, and was a regular guest on Aussie programs like Today and Today Extra. Colby Rubin, the youngest of the reporter's four children, joined KTLA 5 Morning News on Monday to reflect on his father's death. “Hi dad. I wrote this under the desk in your cubicle – only you weren’t there to wake me up this time. Dad, I can’t believe you’re gone,” the 16-year-old began. “I love you so much. On the day you died, I hope you heard me say that. You were the kindest soul, the light in every room. I can’t imagine my life without you... You were always there.” He said he idolised his father calling him his hero, and said: “I never got to tell you that, and I’m so sorry dad.” Colby then shared some of their private texts showing how encouraging his father was when he was unsure of himself, telling him: "You can do this,” and "you have every gift. Respect your own talent." At this point, Colby was overwhelmed with emotion, with the hosts telling him he could take a break but the teen powered on. “I can’t believe I’ve lost you. I had more of a father in 16 years than some people get in their entire lives, and I’m so grateful. "You are a beautiful human and you will never be forgotten. Dad I love you. I am so lost without you, I’ll miss you every day. I hope you know how loved you are.” Colby's tribute left his father's colleagues in tears with one co-host telling him simply: “He knew.” “He would be so proud of you. All of us are parents, we all can say – that is the most beautiful thing I’ve ever heard,” another said as she fought back tears. Viewers praised Colby for his “strength and composure” in delivering such an emotional tribute just days after losing his father. “Amazing how Colby was able to do this with such grace, strength, and composure. You can tell Sam was an amazing father through Colby’s tribute,” TV anchor Stephanie Myers wrote on X. Sam is survived by his wife Leslie and four children: Perry, 28, Rory, 23, Darcy, 18, and Colby. Image: KTLA/ X

Family & Pets

It’s so hard to see a doctor right now. What are my options?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Deciding whether to wait and see if your health condition improves or go to a GP can be a difficult task. You might be unsure about where to go, whom to see, how much it will cost and whether you’ll need to take time off work. These choices can create significant barriers to accessing health care in Australia. There is often limited information available about the pros and cons of the different options. Often, we stick to what we know, unaware of better alternatives. But making the wrong decision about how to access care can impact both your health and finances. So what are your options? And what policy reforms are needed to improve affordable access to care for all Australians? <h2>How quickly can I be seen?</h2> Access depends on how long it takes you to speak to a GP, or be seen in an emergency department, or by a community pharmacist, or a nurse practitioner whom you can see directly. Access depends on where you live and the time of day. The rise of telehealth means GPs now get paid to talk to you on the phone, which is great for many minor ailments, medical certificates, repeat scripts or getting test results. Call centres such as <a href="https://www.healthdirect.gov.au/">Healthdirect</a> have been available for some time and now <a href="https://www.vved.org.au/patients/">virtual emergency departments</a> can also see you online. There are even GPs who only provide their services <a href="https://www.instantscripts.com.au/gp-online/">online</a> if you can pay. A phone call can save you valuable time. Before COVID, you needed to take half a day off work to see a GP, now it takes five to ten minutes and the GP even calls you. Things get more tricky outside of normal working hours and at weekends – appointments are harder to come by, it is unlikely you will be able to see a GP whom you know, and out-of-pocket costs might be higher. If you can’t wait, your local emergency department is likely to be more accessible, or you might be lucky enough to live near a bulk-billed Medicare <a href="https://www.health.gov.au/find-a-medicare-ucc">urgent care clinic</a>, where you don’t need an appointment. Tomorrow’s federal budget <a href="https://www.smh.com.au/politics/federal/more-free-urgent-care-clinics-part-of-8-5-billion-health-commitment-20240511-p5jcse.html">will include</a> funding for another 29 urgent care clinics, on top of the 58 already operating. But things are much worse if you live if a rural or remote area, where choice is limited and you need to wait much longer for GP appointments or travel long distances. Telehealth helps but can be expensive if it is not with your usual doctor. <h2>Who will I see?</h2> Access depends on who you will see. At the moment, this will usually be your GP (or, depending on the severity of your health concern, your community pharmacist or local emergency department staff). But to see your preferred GP you might need to wait as they are usually very busy. But a <a href="https://www.health.gov.au/resources/collections/issues-papers?language=en">review</a> of “scope of practice” in primary care aims to free up GPs’ time and use their skills more effectively. So in future, you could receive more of your health care from qualified nurses, nurse practitioners, pharmacists and other health professionals. But which tasks can be delegated to other health professionals is a significant bone of contention for GPs. For GP practices facing significant cost pressures, safely delegating tasks to other less costly health professionals also makes good business sense. <h2>How much will it cost?</h2> Access depends on out-of-pocket costs. Bulk billing of GP services reached a peak of <a href="https://www.health.gov.au/resources/publications/medicare-quarterly-statistics-state-and-territory-december-quarter-2023-24?language=en">89.6%</a> in the September quarter of 2022 but plummeted to 76.5% by the September quarter of 2023. Last November, bulk billing incentives for children under 16 and those on concession cards were tripled, and between November and December 2023 bulk billing had <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/bulk-billing-slide-stopped-thanks-to-albanese-government?language=en">increased</a> from 76.5% to 77.7%. They key issue for patients is that it remains uncertain whether a GP will bulk bill you. You often don’t know this until you get into the consultation, at which point you can’t back out. Unless the whole practice bulk bills and so it is guaranteed, it’s entirely up to the GP whether you are bulk billed. It’s difficult to think of any other service where you don’t know how much you will pay until after you have used it. <h2>How can policymakers improve access to care?</h2> Government policies to strengthen primary care have focused on giving patients improved access through telehealth, urgent care clinics and <a href="https://www.health.gov.au/resources/publications/strengthening-medicare-taskforce-report?language=en">Strengthening Medicare</a> initiatives, which are currently being developed. But uncertainty surrounding out-of-pocket costs can deter people from seeking medical attention, or delay care or go instead to the emergency department or urgent care clinic where there is no out-of-pocket cost. <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release">Cost is a factor</a> that leads to 20% of those with a mental health problem and 30% of those with chronic disease to delay or avoid visiting a health professional. Those most in need are more likely to miss out on necessary visits and prescriptions, sometimes with disastrous consequences. A recent <a href="https://academic.oup.com/qje/advance-article-abstract/doi/10.1093/qje/qjae015/7664375?login=false">study</a> shows people can die if they stop heart medications due to increased out-of-pocket costs. The next task for policymakers should be developing policies to guarantee there are no out-of-pocket costs for those on low incomes. This could be a worthwhile investment in our health and should be included in tomorrow’s budget.<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/229191/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/its-so-hard-to-see-a-doctor-right-now-what-are-my-options-229191">original article</a>. </div>

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