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Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact? The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines). I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65. <h2>Polypharmacy among older adults</h2> Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics. Is it a good idea to take so many drugs? According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability. In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses? </li> <li> The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences. </li> <li> The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death. </li> <li> Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks. </li> </ol> Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements. Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ? </li> <li> Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced? </li> <li> Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter. </li> </ol> <h2>Benefits should outweigh the risks</h2> Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion. Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<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/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>. </div>

Body

Spending too much time on social media and doomscrolling? The problem might be FOMO

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> For as long as we have used the internet to <a href="https://www.theguardian.com/technology/2016/mar/07/email-ray-tomlinson-history">communicate and connect with each other</a>, it has influenced how we think, feel and behave. During the COVID pandemic, many of us were <a href="https://www.sciencedirect.com/science/article/pii/S0277953622007985">“cut off” from our social worlds</a> through restrictions, lockdowns and mandates. Understandably, many of us tried to <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258344">find ways to connect online</a>. Now, as pandemic restrictions have lifted, some of the ways we use the internet have become concerning. Part of what drives problematic internet use may be something most of us are familiar with – the fear of missing out, or FOMO. In <a href="https://link.springer.com/article/10.1186/s12888-024-05834-9">our latest research</a>, my colleagues and I investigated the role FOMO plays in two kinds of internet use: problematic social media use and “doomscrolling”. <h2>What are FOMO, problematic social media use and doomscrolling?</h2> FOMO is the fear some of us experience when we get a sense of “missing out” on things happening in our social scene. Psychology researchers have been studying FOMO for <a href="https://doi.org/10.1016/j.chb.2013.02.014">more than a decade</a>, and it has consistently been linked to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283615/">mental health and wellbeing</a>, <a href="https://www.sciencedirect.com/science/article/pii/S0376871624001947">alcohol use</a> and <a href="https://doi.org/10.1016/j.chb.2021.106839">problematic social media use</a>. Social media use becomes a problem for people when they have difficulty controlling urges to use social media, have difficulty cutting back on use, and where the use has a negative impact on their everyday life. Doomscrolling is characterised by a need to constantly look at and <a href="https://www.bbc.com/worklife/article/20210226-the-darkly-soothing-compulsion-of-doomscrolling">seek out “bad” news</a>. Doomscrollers may constantly refresh their news feeds or stay up late to read bad news. While problematic social media use has been around for a while, doomscrolling seems to be a more recent phenomenon – <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735659/">attracting research attention</a> during and following the pandemic. <h2>What we tried to find out</h2> In our study, we wanted to test the idea that FOMO leads individuals to engage in problematic use behaviours due to their difficulty in managing the “fear” in FOMO. The key factor, we thought, was <a href="https://link.springer.com/article/10.1023/b:joba.0000007455.08539.94">emotion regulation</a> – our ability to deal with our emotions. We know some people tend to be good at this, while others find it difficult. In fact, greater difficulties with emotion regulation was linked to experiencing <a href="https://www.sciencedirect.com/science/article/pii/S088761852100058X">greater acute stress related to COVID</a>. However, an idea that has been gaining attention recently is <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.636919/full">interpersonal emotion regulation</a>. This means looking to others to help us regulate our emotions. Interpersonal emotion regulation can be helpful (such as “<a href="https://link.springer.com/article/10.1007/s11031-016-9569-3">affective engagement</a>”, where someone might listen and talk about your feelings) or unhelpful (such as “<a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2F0012-1649.43.4.1019">co-rumination</a>” or rehashing problems together), depending on the context. In our analyses, we sought to uncover how both intrapersonal emotion regulation (ability to self-manage our own emotional states) and interpersonal emotion regulation (relying on others to help manage our emotions) accounted for the link between FOMO and problematic social media use, and FOMO and doomscrolling, respectively. <h2>What we found – and what it might mean for the future of internet use</h2> Our findings indicated that people who report stronger FOMO engage in problematic social media use because of difficulty regulating their emotions (intrapersonally), and they look to others for help (interpersonally). Similarly, people who report stronger FOMO are drawn to doomscrolling because of difficulty regulating their emotions intrapersonally (within themselves). However, we found no link between FOMO and doomscrolling through interpersonal emotion regulation. We suspect this difference may be due to doomscrolling being more of a solitary activity, occurring outside more social contexts that facilitate interpersonal regulation. For instance, there are probably fewer people with whom to share your emotions while staying up trawling through bad news. While links between FOMO and doomscrolling have been observed before, our study is among the first to try and account for this theoretically. We suspect the link between FOMO and doomscrolling may be more about having more of an online presence while things are happening. This would account for intrapersonal emotion regulation failing to help manage our reactions to “bad news” stories as they unfold, leading to doomscrolling. Problematic social media use, on the other hand, involves a more complex interpersonal context. If someone is feeling the fear of being “left out” and has difficulty managing that feeling, they may be drawn to social media platforms in part to try and elicit help from others in their network. <h2>Getting the balance right</h2> Our findings suggest the current discussions around <a href="https://www.nbcnews.com/news/us-news/psychology-group-says-infinite-scrolling-social-media-features-are-par-rcna147876">restricting social media use for young people</a>, while controversial, are important. We need to balance our need for social connection – which is happening increasingly online – with the <a href="https://www.biomedcentral.com/collections/spia#tab-3">detrimental consequences </a> associated with problematic internet use behaviours. It is important to also consider the nature of social media platforms and how they have changed over time. For example, adolescent social media use patterns across various platforms are <a href="https://link.springer.com/article/10.1007/s10964-019-01060-9">associated with</a> different mental health and socialisation outcomes. Public health policy experts and legislators have quite the challenge ahead of them here. Recent work has shown how loneliness is <a href="https://doi.org/10.1371/journal.pone.0190033">a contributing factor</a> to all-cause mortality (death from any cause). We have long known, too, that social connectedness is <a href="https://doi.org/10.1371/journal.pone.0190033">good for our mental health</a>. In fact, last year, the World Health Organization established a <a href="https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection">Commission on Social Connection</a> to help promote the importance of socialisation to our lives. The recent controversy in the United States around the ownership of TikTok illustrates how central social media platforms are to our lives and ways of interacting with one another. We need to <a href="https://www.theguardian.com/commentisfree/article/2024/may/27/dominic-andre-tiktok-ban">consider the rights of individuals</a> to use them as they please, but understand that governments carry the responsibility of <a href="https://www.theguardian.com/technology/2023/apr/04/what-does-tiktoks-ban-on-australian-government-devices-mean-for-its-future">protecting users from harm</a> and safeguarding their privacy. <hr /> If you feel concerned about problematic social media use or doomscrolling, you can speak to a healthcare or mental health professional. You can also call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14, or <a href="https://www.13yarn.org.au/">13 YARN</a> (13 92 76) to yarn with Aboriginal or Torres Strait Islander crisis supporters.<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/230980/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, Senior Lecturer - Psychology | Chair, Researchers in Behavioural Addictions, Alcohol and Drugs (BAAD), <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin 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/spending-too-much-time-on-social-media-and-doomscrolling-the-problem-might-be-fomo-230980">original article</a>. </div>

Technology

"Taken way too soon": TV star's brother breaks silence after shocking death

The grieving brother of slain TV star Johnny Wactor has broken his silence over his brother's untimely death. Johnny Wactor, 37, was <a href="https://oversixty.com.au/health/caring/soap-star-killed-in-robbery-gone-wrong" target="_blank" rel="noopener">killed</a> in Los Angeles in the early hours of Saturday morning when he intercepted a group of men trying to steal the catalytic converter from his vehicle, and was shot dead at the scene. Now, Wactor's brother Grant has shared more details on the events surrounding his Johnny's death, telling <a href="https://people.com/general-hospital-actor-johnny-wactors-brother-speaks-out-on-killing-taken-way-too-early-8654340" target="_blank" rel="noopener">People</a> magazine that he had finished a shift working as a bartender at the time he was shot. After his shift finished at about 3:25am local time, he walked to his car with a female co-worker when he noticed that his car had been “jacked up or lifted in some way”. Initially, the actor thought his car was being towed away, but quickly realised the people surrounding his car were not tow-truck drivers. Grant said his brother physically shielded his female colleague to prevent her from being hurt and had his hands up in the air when he was shot. “He did not confront them,” he told the publication. “He did not try to stop them. He was just trying to diffuse the situation by stepping back.” After the shooting the men fled the scene in a different car, and LAPD officer Jeff Lee said the suspects were “still outstanding”. Grant Wactor said his family were “hoping and praying” that the killers were found and brought to justice. “We just want (them to be found) as quickly as possible and correctly,” he said, describing his brother as “a good person”. “He was taken way too early, and no one should be taken like this at all,” he said. “He touched a lot of people. He believed in his core values to the end, and he lived life to the fullest the way he wanted to. And he was happy doing that.” Image credits: Instagram / Ouzounova / Shutterstock Editorial

Family & Pets

“Too chaotic for me”: Bride and groom slammed for “unreasonable” wedding rules

A bride and groom has been slammed online for giving their wedding guests an extensive list of rules they must abide by on their big day. The list of 15 demands was shared on Reddit, where social media users tore the newlyweds to shreds with their “unreasonable” rules. The post racked up thousands of comments on the Wedding Shamers subreddit, with one person writing, 'If someone sent this to me, I would simply just not go.' The rules included that guests needed to remember their opinions on the wedding are “irrelevant” while also banning attendees from “sitting down all night” or making their own big announcements. The first rule urged guests to remember that this was the bride and groom's big day, “not yours”, while also telling guests, “Do not get in the photographer's way.” They also made a strict dress code, writing, “the attire is BLACK and/or GOLD not red, blue, green and definitely NO WHITE!” “Do not rearrange the seats, we have a seating chart for a reason.” The rules continued, “If you didn't put out any money for the wedding, keep your "should've, could've, would've" to yourself. Your opinion is irrelevant.” But the couple did not stop there as they also urged guests to pace themselves when drinking and banned “big announcements or proposals.” Next up, it read, “If you can't handle or dislike the music being played, simply go home. This is a celebration, not a funeral.” The lovebirds then instructed their friends and family to use their own personalised hashtag when posting photos on social media. Rounding out the demands, the final five read, “Do not sit down all night. No outside liquor. If caught, you will be escorted out.” “Refer back to rule number one. The bride and groom said what they said! Turn ALL the way up!” The post was soon flooded with comments with many insisting that the couple had taken it too far. One person wrote, “What kind of list is this? Too chaotic for me.” Another person added, “Yeah, I would not be going to that wedding. Sounds like too much drama.” On the other hand, there were a few commenters who understood the need for issuing such strict guidelines and defended the couple. One person wrote, “They're not asking for anything out of order. They're just stating what should be obvious, but they probably have seen from their family and friends past behaviour, that it NEEDS to be addressed.” “Is it a little tacky? Yes, but the only people that will be bothered by any of it are the ones that would have been an issue.” Image credits: Reddit / Shutterstock

Relationships

Too many Australians aren’t getting a flu vaccine. Why, and what can we do about it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/holly-seale-94294">Holly Seale</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Australia’s childhood immunisation program gets very good uptake every year – <a href="https://www.health.gov.au/topics/immunisation/immunisation-data/childhood-immunisation-coverage">almost 94% of five-year-olds</a> have had all their routine vaccinations. But our influenza vaccine coverage doesn’t get such a good report card. Looking back over <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/historical-national-influenza-vaccination-coverage-end-year-age">recent years</a>, for kids aged six months to five years, we saw a peak in flu vaccine coverage at the beginning of the COVID pandemic at 46%, which then declined to 30% by the 2023 season. While we’re still relatively early in the 2024 flu season, only <a href="https://ncirs.org.au/influenza-vaccination-coverage-data">7% of children</a> under five have received their flu shot this year so far. Although young children are a particular concern, flu vaccination rates appear to be lagging for the population as a whole. Reports indicate that <a href="https://www.abc.net.au/news/2024-05-07/calls-to-vaccinate-young-children-against-flu-as-season-begins/103783508">from March 1 to April 28</a>, 16% fewer people were vaccinated against the flu compared with the same period last year. So what’s going on, and what can we do to boost uptake? <h2>Why do we vaccinate kids against the flu?</h2> Last year, <a href="https://www.health.gov.au/sites/default/files/2023-12/aisr-2023-national-influenza-season-summary.pdf">reported cases of flu</a> were highest in children aged five to nine, followed by those aged zero to four. This is not a new trend – we record a high number of flu cases and hospital admissions in kids every year. So far <a href="https://nindss.health.gov.au/pbi-dashboard/">this year</a> children aged zero to four have had the highest number of infections, marginally ahead of five- to nine-year-olds. While kids are more likely to catch and spread the flu, they’re also <a href="https://theconversation.com/kids-are-more-vulnerable-to-the-flu-heres-what-to-look-out-for-this-winter-117748">at greater risk</a> of getting very sick from it. This particularly applies to children under five, and the flu vaccine is available for free for this age group. The flu vaccine isn’t perfect – it may not prevent infections entirely – but it’s definitely our best chance of protection. Research has shown influenza-related visits to the GP were <a href="https://pubmed.ncbi.nlm.nih.gov/27577556/">more than halved</a> in vaccinated children compared with unvaccinated children. <h2>So why are kids not receiving the vaccine?</h2> Often, it comes down to misunderstandings about who is eligible for the vaccine or whom it’s recommended for. But we can address this issue by nudging people via <a href="https://www.annfammed.org/content/15/6/507?sf174332549=1">a text message reminder</a>. Some parents <a href="https://www.sciencedirect.com/science/article/pii/S0264410X17318285">report concerns</a> about the vaccine, including the old dogma that it can cause the flu. The flu vaccine <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/flu-influenza-immunisation">can’t give you the flu</a> because it doesn’t contain live virus. Unfortunately, that myth is really sticky. For <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.15235">some parents</a>, the challenge can be forgetting to book or accessing an appointment. <h2>It’s not just kids at higher risk</h2> Adults aged 65 and over are also <a href="https://theconversation.com/im-over-65-and-worried-about-the-flu-which-vaccine-should-i-have-204810">more vulnerable</a> to the flu, and can receive a <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">free vaccine</a>. For this group, we usually get around <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/historical-national-influenza-vaccination-coverage-end-year-age">65% vaccinated</a>. So far this year, <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/national-influenza-vaccination-coverage-all-people-age-group">around 35%</a> of over-65s have received their flu vaccine. Aboriginal and Torres Strait Islander people are likewise eligible for a free flu vaccine. While previously coverage rates were higher among Aboriginal and Torres Strait Islander peoples compared to the overall population, this gap has narrowed. There’s even some movement backwards, especially <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/historical-national-influenza-vaccination-coverage-end-year-age">in younger age groups</a>. The flu vaccine is also free for pregnant women and anyone who has <a href="https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/immunisation-for-people-with-medical-risk-conditions">a medical condition</a> such as heart disease, chronic lung disease, diabetes or kidney disease. Past studies have found flu vaccine coverage <a href="https://www.phrp.com.au/wp-content/uploads/2022/06/PHRP31232111.pdf">for pregnant women</a> varies around the country from 39% to 76% (meaning in some jurisdictions up to 60% of pregnant women are not getting vaccinated). When it comes to adults with chronic health conditions, we don’t have a good sense of how many people receive the vaccine. The reasons adults don’t always get the flu vaccine overlap with the reasons for children. Often <a href="https://www.tandfonline.com/doi/full/10.1080/08870446.2021.1957104">concerns about side effects</a> are cited as the reason for not getting vaccinated, followed by time constraints. We also know <a href="https://www.aihw.gov.au/reports/primary-health-care/coordination-of-health-care-experiences-barriers/summary">accessing medical services</a> can be difficult for some people, such as those living in rural areas or experiencing financial hardship. <h2>Filling the gaps</h2> In Australia, GPs offer flu vaccines for all ages, while flu vaccination is also available at pharmacies, generally from age five and up. While some people make a conscious decision not to get themselves or their children vaccinated, for many people, the barriers are related to access. Programs offering vaccination outside the doctor’s office are increasing globally, and may assist in <a href="https://www.tandfonline.com/doi/full/10.1080/14760584.2019.1698955">filling gaps</a>, especially among those who don’t have regular access to a GP. For some people, their only point of contact with the <a href="https://pubmed.ncbi.nlm.nih.gov/34272104/">medical system</a> may be during emergency department visits. Others may have more regular contact with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046372/">specialist</a> who coordinates their medical care, rather than a GP. Offering vaccine education and programs <a href="https://journals.sagepub.com/doi/10.1177/0009922810374353">in these settings</a> has been shown to improve immunisation rates and may play a pivotal role in filling access gaps. Outside medical and pharmacy settings, the workplace is the most common place for Australian adults to receive their flu vaccine. A <a href="https://www.sciencedirect.com/science/article/pii/S1326020023004272">survey</a> showed Australian adults find workplace vaccination convenient and cost-effective, especially where free or subsidised vaccines are offered. Expanding vaccination settings, such as with <a href="https://journals.sagepub.com/doi/10.1177/19375867221087360?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">drive-through</a> and mobile clinics, can benefit groups who have unique access barriers or are under-served. Meanwhile, offering vaccination through faith-based organisations has been shown to improve uptake among <a href="https://pubmed.ncbi.nlm.nih.gov/37013523/">racial and ethnic minority groups</a>. Eleftheria Lentakis, a masters student at the School of Population Health at UNSW Sydney, contributed to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229477/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/holly-seale-94294">Holly Seale</a>, Associate Professor, School of Population Health, <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/too-many-australians-arent-getting-a-flu-vaccine-why-and-what-can-we-do-about-it-229477">original article</a>. </div>

Body

"A step too far": Grandparents barred from school event for bizarre reason

A Melbourne school has come under fire for refusing to let a group of grandparents into the classroom for a special event because they did not have a Working With Children Check (WWCC). Furious grandparents have slammed St Joseph’s Primary School in Yarra Junction for taking it "a step too far" when they asked them to provide the WWCC after being invited to attend the “Inquiry Afternoon”. The event was held for year one and two students to speak about “technology and the world has changed over time”, according to The Herald Sun. Grandparents were asked to provide a WWCC on the back of the invitation, which some of them missed. “The Working With Children Check isn’t set up for the one-off visit — it is a step too far,” founder of the National Grandparent Movement Ian Barnett told Sunrise. “I understand we’re living in a time when we want more checks and balances, but it is unrealistic to think that grandparents attending such a day would actually need to go and provide a Working With Children Check." The grandparents without a WWCC were forced to sit in the principal's office and do their show-and-tell via a video call. “I’m sure they had very good intentions — no one set out for this to happen,” Herald Sun education editor Susie O’Brien said. “But imagine turning up, arranging your entire week, your day to come to your grandchild’s event … and the child’s school refuses entry.” She added that although schools did have some discretion over such requirements, when a group of people are invited for a specific event, it is usually not required. Barnett also said that "for such visits you don’t need a Working With Children Check,” in most states. “I haven’t heard of this in NSW. I have to admit, I’m from NSW. So it is really going a bit extreme. Schools do have the right to decide who comes onsite. But it just seems it’s not required. “To actually drag the child out from the classroom to sit with nana or grandad, it’s a step too far and embarrassing, I think, for the school as well.” A spokesperson for the primary school acknowledged that although there was some confusion, the school had to comply with the child safe standards. “There was advance notice to all St Joseph’s families on this requirement, with 29 grandparents signing in on Friday with a working with children clearance," they told the Herald Sun. “We acknowledge the disappointing experience of the four grandparents who couldn’t attend the grandparents’ day and are attempting to call these families this morning.” Images: Sunrise/ The Herald Sun

Legal

New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Mild cognitive impairment – an early stage of dementia – is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team. In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed. Our <a href="https://doi.org/10.1186/s13195-023-01272-z">finding was sobering</a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed. In the second study, we analyzed data for 226,756 primary care clinicians and found that <a href="https://doi.org/10.14283/jpad.2023.131">over 99% of them underdiagnosed mild cognitive impairment</a> in this population. <h2>Why it matters</h2> Mild cognitive impairment is an early symptom of Alzheimer’s disease in <a href="https://doi.org/10.1001/jama.2019.2000">about half of cases</a> and progresses to dementia <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">at a rate of 10% to 15% per year</a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression. Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a href="https://theconversation.com/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714">vitamin B12 deficiency</a>. Since mild cognitive impairment has <a href="https://doi.org/10.1016/j.amjopharm.2008.06.004">the same risk factors as cardiovascular disease</a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a href="https://doi.org/10.1016/S0140-6736(15)60461-5">can reduce the risk of progression</a>. In 2023, the Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval">approved the drug lecanemab</a> as the <a href="https://theconversation.com/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460">first disease-modifying treatment</a> <a href="https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease">for Alzheimer’s disease</a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease. Lecanemab, a monoclonal antibody, <a href="https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx">reduces amyloid plaques</a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a href="https://doi.org/10.1056/NEJMoa2212948">reduce the progression</a> of early-stage Alzheimer’s disease. A similar drug, donanemab, also <a href="https://doi.org/10.1001/jama.2023.13239">succeeded in a clinical trial</a> and is expected to be <a href="https://www.medicalnewstoday.com/articles/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think">approved sometime in 2024</a>. However, these drugs must be used in the early stages of Alzheimer’s disease, ideally when a patient has only mild cognitive impairment, as there is <a href="https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi">no evidence that they are effective in advanced stages</a>. <figure><iframe src="https://www.youtube.com/embed/w3IbAscNjsQ?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>An earlier diagnosis leads to early treatment and better outcomes.</figcaption></figure> <h2>What still isn’t known</h2> Many factors contribute to the <a href="https://doi.org/10.1002/alz.13051">lack of timely detection</a>. But researchers don’t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis. While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year’s holiday, when children who haven’t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily. Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor’s visit and may require a follow-up appointment. <h2>What’s next</h2> People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor’s appointments and insist on a formal assessment. The <a href="https://www.medicare.gov/coverage/yearly-wellness-visits">Medicare yearly “wellness” visit</a> is an opportunity to explore such concerns, but only about half of beneficiaries <a href="https://doi.org/10.1377/hlthaff.2019.01795">take advantage of it</a>. Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient’s cognitive state need to become the norm. The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.<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/216892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, Director of the USC Dornsife Brain Health Observatory, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, Research Scientist, Center for Economic and Social Research, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892">original article</a>. </div>

Mind

Think $5.50 is too much for a flat white? Actually it’s too cheap, and our world-famous cafes are paying the price

<a href="https://theconversation.com/profiles/emma-felton-143029">Emma Felton</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Even in a stubborn cost-of-living crisis, it seems there’s one luxury most Australians <a href="https://www.comparethemarket.com.au/news/what-australians-wont-give-up-cost-of-living-crisis-report/">won’t sacrifice</a> – their daily cup of coffee. Coffee sales have largely <a href="https://www.statista.com/statistics/866543/australia-domestic-consumption-of-coffee/">remained stable</a>, even as financial pressures have bitten over the past few years. So too have prices. Though many of us became upset when prices began to creep up last year, they’ve since largely settled in the range between $4.00 and $5.50 for a basic drink. But this could soon have to change. By international standards, Australian coffee prices are low. No one wants to pay more for essentials, least of all right now. But our independent cafes are struggling. By not valuing coffee properly, we risk losing the <a href="https://bizcup.com.au/australian-coffee-culture/">internationally renowned</a> coffee culture we’ve worked so hard to create, and the phenomenal quality of cup we enjoy. <h2>Coffee is relatively cheap in Australia</h2> Our recent survey of Australian capital cities found the average price of a small takeaway flat white at speciality venues is A$4.78. But in <a href="https://pabloandrustys.com.au/blogs/drinkbettercoffee/global-coffee-prices">some international capitals</a>, it’s almost double this, even after adjusting for local <a href="https://www.investopedia.com/updates/purchasing-power-parity-ppp/">purchasing power parity</a>. <iframe id="gaplH" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/gaplH/" width="100%" height="400px" frameborder="0"></iframe> In London, a small flat white costs about A$6.96. Singapore, A$8.42. In Athens, as much as A$9.95. <h2>The cafe business is getting harder</h2> Over the past few decades, coffee prices haven’t kept pace with input costs. In the early 2000s, after wages, food costs, utilities and rent, many cafes <a href="https://www.coffeecommune.com.au/blog-why-are-cafes-so-expensive/">earned healthy profit margins</a> as high as 20%. The <a href="https://www.ibisworld.com/au/industry/cafes-coffee-shops/2015/">most recent data from IBISWorld</a> show that while Australian cafe net profits have recovered from a drop in 2020, at 7.6%, they remain much lower than the Australian <a href="https://www.money.com.au/research/australian-business-statistics">average business profit margin of 13.3%</a>. For an independent owner operating a cafe with the <a href="https://www.ibisworld.com/au/industry/cafes-coffee-shops/2015/">average turnover of A$300,000</a>, this would amount to a meagre A$22,800 annual net profit after all the bills are paid. <h2>What goes into a cup?</h2> Just looking at the cost of raw inputs – milk, beans, a cup and a lid – might make the margin seem lucrative. But they don’t paint the whole picture. <figure class="align-center "><img src="https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584949/original/file-20240328-24-rlngpk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="A takeaway coffee cup showing the price inputs, with wages and operation costs making up over 65% of the cost of a coffee" /><figcaption>Chart: The Conversation. <a class="source" href="https://pabloandrustys.com.au/blogs/drinkbettercoffee/whats-in-the-cost-of-coffee">Data: Pablo and Rusty's Coffee Roasters</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></figcaption></figure> Over the past few years, renting the building, keeping the lights on and paying staff have all become <a href="https://www.reuters.com/business/ground-down-australia-coffee-shops-an-early-inflation-casualty-2023-07-10/">much bigger factors</a> in the equation for coffee shop owners, and many of these pressures aren’t easing. 1. Green coffee price Increasingly <a href="https://www.aa.com.tr/en/environment/brewing-crisis-how-climate-change-is-reshaping-coffee-production/3113886">subject to the effects</a> of climate change, the baseline commodity price of green (unroasted) coffee is <a href="https://perfectdailygrind.com/2024/02/demand-for-robusta-prices-record-high/">going up</a>. Arabica – the higher quality bean you’re most likely drinking at specialty cafes – is a more expensive raw product. Despite levelling off from post-pandemic highs, its price is still trending up. In 2018, it <a href="https://www.statista.com/statistics/675807/average-prices-arabica-and-robusta-coffee-worldwide/">sold</a> for US$2.93 per kilogram, which is projected to increase to US$4.38 dollars in 2025. Robusta coffee is cheaper, and is the type <a href="https://www.lavazza.com.au/en/coffee-secrets/difference-type-arabica-robusta-coffee">typically used to make instant coffee</a>. But serious drought in Vietnam has just pushed the price of robusta to an <a href="https://www.barchart.com/story/news/25094367/coffee-rallies-with-robusta-at-a-record-high-on-shrinking-coffee-output-in-vietnam">all-time high</a>, putting pressure on the cost of coffee more broadly. 2. Milk prices The price of fresh milk has risen by <a href="https://cdn-prod.dairyaustralia.com.au/-/media/project/dairy-australia-sites/national-home/resources/reports/situation-and-outlook/situation-and-outlook-report-march-2024.pdf?rev=b0222df4b01b40d0ae36cf8ac7b01bc0">more than 20%</a> over the past two years, and remains at a peak. This has put sustained cost pressure on the production of our <a href="https://gitnux.org/australian-coffee-consumption-statistics/#:%7E:text=Coffee%20is%20a%20beloved%20beverage,approximately%206%20billion%20cups%20annually.">most popular drink orders</a>: cappuccinos and flat whites. 3. Wages and utilities Over the past year, Australian wages have grown at their <a href="https://ministers.treasury.gov.au/ministers/jim-chalmers-2022/media-releases/real-wages-growth-back">fastest rate</a> since 2009, which is welcome news for cafe staff, but tough on operators in a sector with low margins. Electricity prices remain elevated after significant inflation, but could <a href="https://www.sbs.com.au/news/article/heres-how-much-your-energy-bills-might-go-down-by-and-when/k8g00jheg">begin to fall mid-year</a>. <h2>Specialty vs. commodity coffee: why price expectations create an industry divide</h2> One of the key factors keeping prices low in Australia is consumer expectation. For many people coffee is a fundamental part of everyday life, a marker of livability. Unlike wine or other alcohol, coffee is not considered a luxury or even a treat, where one might expect to pay a little more, or reduce consumption when times are economically tough. We anchor on familiar prices. <iframe id="oDbah" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/oDbah/" width="100%" height="400px" frameborder="0"></iframe> Because of this, it really hurts cafe owners to put their prices up. In touch with their customer base almost every day, they’re acutely aware of how much inflation can hurt. But in Australia, a huge proportion of coffee companies are also passionate about creating a world-class product by only using “<a href="https://medium.com/@samandsunrise/why-is-specialty-coffee-so-expensive-6cf298935e4b#:%7E:text=Specialty%20Shops%20Feature%20High%20Grade%20Coffees&text=Their%20coffees%20are%20hand%2Dpicked,even%20on%20the%20same%20tree.">specialty coffee</a>”. Ranked at least 80 on a quality scale, specialty beans cost significant more than commodity grade, but their production offers better working conditions for farmers and encourages more sustainable growing practices. Although not commensurate with the wine industry, there are similarities. Single origin, high quality beans are often sourced from one farm and demand higher prices than commodity grade coffee, where cheaper sourced beans are often combined in a blend. Running a specialty cafe can also mean roasting your own beans, which requires a big investment in expertise and equipment. It’s an obvious example of doing the right thing by your suppliers and customers. But specialty cafes face much higher operating costs, and when they’re next to a commodity-grade competitor, customers are typically unwillingly to pay the difference. <h2>Approach price rises with curiosity, not defensiveness</h2> When cafe owners put up their prices, we often rush to accuse them of selfishness or profiteering. But they’re often just trying to survive. Given the quality of our coffee and its global reputation, it shouldn’t surprise us if we’re soon asked to pay a little bit more for our daily brew. If we are, we should afford the people who create one of our most important “<a href="https://theconversation.com/how-cafes-bars-gyms-barbershops-and-other-third-places-create-our-social-fabric-135530">third spaces</a>” kindness and curiosity as to why. <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/226015/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emma-felton-143029">Emma Felton</a>, Adjunct Senior Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/think-5-50-is-too-much-for-a-flat-white-actually-its-too-cheap-and-our-world-famous-cafes-are-paying-the-price-226015">original article</a>.

Money & Banking

How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a> COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others. So how much stress is too much, and what can you do about it? I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues. I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.” A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging. <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit. Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.” The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface. When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions. For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors. <h2>‘Treating’ stress</h2> Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan. Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure. Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>. Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress. Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses. <h2>Suffering from toxic stress</h2> Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood. Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be. And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all. Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress. <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Exercise, meditation and a healthy diet help fight toxic stress.</figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>. The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate. Adopting these lifestyle changes is not quick or easy, but it works. The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits. There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<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/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.

Mind

Attempts to access Kate Middleton’s medical records are no surprise. Such breaches are all too common

<a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> The <a href="https://www.abc.net.au/news/2024-03-20/claim-hospital-staff-tried-to-access-kate-middleton-health-info/103608066">alleged</a> data breach involving Catherine, Princess of Wales tells us something about health privacy. If hospital staff can apparently access a future queen’s medical records without authorisation, it can happen to you. Indeed it may have already happened to you, given many breaches of health data go under the radar. Here’s why breaches of health data keep on happening. <h2>What did we learn this week?</h2> Details of the alleged data breaches, by <a href="https://www.mirror.co.uk/news/royals/breaking-kate-middleton-three-london-32401247">up to three staff</a> at The London Clinic, emerged in the UK media this week. These breaches are alleged to have occurred after the princess had abdominal surgery at the private hospital earlier this year. The UK Information Commissioner’s Office <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/03/ico-statement-in-response-to-reports-of-data-breach-at-the-london-clinic/">is investigating</a>. Its report should provide some clarity about what medical data was improperly accessed, in what form and by whom. But it is unlikely to identify whether this data was given to a third party, such as a media organisation. <h2>Health data isn’t always as secure as we’d hope</h2> Medical records are inherently sensitive, providing insights about individuals and often about biological relatives. In an ideal world, only the “right people” would have access to these records. These are people who “need to know” that information and are aware of the responsibility of accessing it. Best practice digital health systems typically try to restrict overall access to databases through hack-resistant firewalls. They also try to limit access to specific types of data through grades of access. This means a hospital accountant, nurse or cleaner does not get to see everything. Such systems also incorporate blocks or alarms where there is potential abuse, such as unauthorised copying. But in practice each health records ecosystem – in GP and specialist suites, pathology labs, research labs, hospitals – is less robust, often with fewer safeguards and weaker supervision. <h2>This has happened before</h2> Large health-care providers and insurers, including major hospitals or chains of hospitals, have a <a href="https://www.theguardian.com/australia-news/2023/dec/22/st-vincents-health-australia-hack-cyberattack-data-stolen-hospital-aged-care-what-to-do">worrying</a> <a href="https://www.afr.com/technology/medical-information-leaked-in-nsw-health-hack-20210608-p57z7k">history</a> of <a href="https://www.innovationaus.com/oaic-takes-pathology-company-to-court-over-data-breach/">digital breaches</a>. Those breaches include hackers accessing the records of millions of people. The <a href="https://www.theguardian.com/world/2022/nov/11/medical-data-hacked-from-10m-australians-begins-to-appear-on-dark-web">Medibank</a> data breach involved more than ten million people. The <a href="https://www.hipaajournal.com/healthcare-data-breach-statistics/">Anthem</a> data breach in the United States involved more than 78 million people. Hospitals and clinics have also had breaches specific to a particular individual. Many of those breaches involved unauthorised sighting (and often copying) of hardcopy or digital files, for example by nurses, clinicians and administrative staff. For instance, this has happened to public figures such as <a href="https://www.latimes.com/archives/la-xpm-2008-mar-15-me-britney15-story.html">singer</a> <a href="https://journals.lww.com/healthcaremanagerjournal/abstract/2009/01000/health_information_privacy__why_trust_matters.11.aspx">Britney Spears</a>, actor <a href="https://www.nytimes.com/2007/10/10/nyregion/10clooney.html">George Clooney</a> and former United Kingdom prime minister <a href="https://www.theguardian.com/uk-news/2024/mar/20/when-fame-and-medical-privacy-clash-kate-and-other-crises-of-confidentiality">Gordon Brown</a>. Indeed, the Princess of Wales has had her medical privacy breached before, in 2012, while in hospital pregnant with her first child. This was no high-tech hacking of health data. Hoax callers from an Australian radio station <a href="https://theconversation.com/did-2day-fm-break-the-law-and-does-it-matter-11250">tricked</a> hospital staff into divulging details over the phone of the then Duchess of Cambridge’s health care. <h2>Tip of the iceberg</h2> Some unauthorised access to medical information goes undetected or is indeed undetectable unless there is an employment dispute or media involvement. Some is identified by colleagues. Records about your health might have been improperly sighted by someone in the health system. But you are rarely in a position to evaluate the data management of a clinic, hospital, health department or pathology lab. So we have to trust people do the right thing. <h2>How could we improve things?</h2> Health professions have long emphasised the need to protect these records. For instance, medical ethics bodies <a href="https://www.bmj.com/content/350/bmj.h2255">condemn</a> medical students who <a href="https://www.abc.net.au/news/2014-04-14/picture-sharing-app-for-doctors-raises-privacy-concerns/5389226">share</a> intimate or otherwise inappropriate images of patients. Different countries have various approaches to protecting who has access to medical records and under what circumstances. In Australia, for instance, we have a mix of complex and inconsistent laws that vary across jurisdictions, some covering privacy in general, others specific to health data. There isn’t one comprehensive law and set of standards <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">vigorously administered</a> by one well-resourced watchdog. In Australia, it’s mandatory to report <a href="https://www.oaic.gov.au/privacy/notifiable-data-breaches">data breaches</a>, including breaches of health data. This reporting system is currently <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">being updated</a>. But this won’t necessarily prevent data breaches. Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data. The best policy <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1475-4932.12693">nudges</a> involve increasing penalties for breaches. This is so organisations act as responsible custodians rather than negligent owners of health data. We also need to step-up enforcement of data breaches and make it easier for victims to sue for breaches of privacy – princesses and tradies alike.<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/226303/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> 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/attempts-to-access-kate-middletons-medical-records-are-no-surprise-such-breaches-are-all-too-common-226303">original article</a>. Images: Getty

Legal

"Am I being too sensitive?": Woman's dilemma after partner forgets 60th birthday

A woman has shared her dilemma on how to approach her partner of 30 years, after he forgot her 60th birthday. "It's my 60th birthday today, and my partner of 30 years has not acknowledged it. Should I tell him?" she titled her post on Reddit. "It's my actual birthday today, and whilst we have planned a big party for next weekend, when I woke up this morning I expected a 'Happy Birthday!' and a smile," she continued. "I didn't get anything. He started my coffee but he does that almost every morning. "At first I thought maybe he forgot but now I am thinking that he thinks he doesn't have to say anything because we are having a big party this weekend. "Am I being too sensitive? Should I tell him? If so, how?" she asked in her post. Hundreds of Reddit users took to the comments to share their thoughts on how to approach the situation, with a few sharing crafty solutions of their own. "I'd make a joke of it. 'I can't believe they moved my birthday!' Or 'I saw on the TV we should ask easy questions to check for dementia- I'll ask you first, when's my birthday?'" one user playfully suggested. "I'm going to say the absolute minimum I'd expect for ANY birthday is my wife wishing me a Happy Birthday. Don't let it fester and ruin your day - just ask him about it" another added. One user saw the bright side of things and said: "He's handed you the best birthday present of all - the opportunity to use this against him for the next twenty years. "I'd be rubbing my hands with glee. Happy Birthday!" "Happy Birthday. Go out and buy a large cake. Eat it all yourself. Nobody need ever know" to which she responded: "there is a Costco not that far away. Go big or go home." Another Redditor came up with an elaborate plan on how she could get her partner's attention. "Purchase this 'Acknowledge Me' t-shirt of WWE wrestle Roman Reigns. Then write 'Birthday' on a piece of card and use some tape to stick on the t-shirt. 'Acknowledge Me Birthday.' Then just wear it around the house," they said. The woman was onboard with the plan, but luckily she didn't need to apply any of their crafty solutions and shared an update. "He just came up to my home office and gave me a big hug, admitting he had forgotten because he was so focussed on both work and next weekend's party," she wrote. "He apologised sheepishly, which was exactly the best outcome possible. Now I have both my birthday acknowledged as well as a fine story and/or bit of ammo to be saved for another day. "So there you go. I've cancelled the 'acknowledge me' t-shirt order, and shall now share my Costco cake with him instead of eating it from across the table, glaring. "Thank you everyone for the very fine passive aggressive suggestions which made me smile. Much appreciated!" Image: Getty

Relationships

“The system is too soft”: Ally Langdon fires up over stabbing death of Vyleen White

Ally Langdon has called for an overhaul of the youth crime system in the wake of the violent death of Queensland grandmother Vyleen White. The A Current Affair host was discussing the death of the 70-year-old, as she became visibly frustrated while talking about the rising rates of youth crime. Langdon hinted at a nationwide issue, citing the recent stabbing death of young doctor Ash Gordon in Melbourne, who was also allegedly murdered by a teenager less than a month ago. “Whatever we’re doing to deal with youth crime, it’s failing,” she said. “The police do everything they can, but the system is too soft on serious crime, and we have lost faith in it and our politicians.” <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/C29TB0HvWGj/?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/C29TB0HvWGj/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by A Current Affair (@acurrentaffair9)</a> </div> </blockquote> Ms White’s daughter and widowed husband echoed Ally's sentiment thoughts on the program, saying, “Justice has to be done, not for my sake, for the memory of Vyleen.” “People want action and harsher laws for crimes they are committing,” her husband Victor said. “For several years (politicians) have been promising a lot, a lot of rubbish talk to the public out there, and nothing happens." “All you hear is increase of violence, car stealing … This is due to slackness in the law." “The law is weak as water.” Ms White’s daughter, Cindy Micallef said harsher penalties for youth crimes are needed. “Youth crime, I hate to say it, it’s like having a koala, it’s a protected species, there’s no action,” she said. “They do heinous crimes and it’s getting worse, I don’t care what nationality or race. “If we let people get away with this, it’s going to increase.” A 16-year-old boy was <a href="https://oversixty.com.au/finance/legal/update-on-tragic-stabbing-of-queensland-grandmother" target="_blank" rel="noopener">charged</a> with Ms White’s murder on Tuesday morning, and is also facing charges of unlawful use of a motor vehicle and stealing. Vyleen was <a href="https://www.oversixty.com.au/health/caring/grandmother-fatally-stabbed-in-front-of-granddaughter" target="_blank" rel="noopener">fatally stabbed</a> in the chest in Town Square Redbank Plains Shopping Centre’s underground carpark around 6pm on Saturday, while she was shopping with her granddaughter. Image credits: Facebook / A Current Affair

Legal

"Too good to be true": Bank teller saves couple from losing $40k

A Tasmanian couple have been saved from losing $40k into an online investment scam after a bank teller noticed the red flags. The couple visited the NAB branch in Rosny, Hobart after their account was blocked during an attempt to transfer the money to an ‘online investment firm’ in Perth. The payment was the first of two instalments that they were set to pay the "firm" but NAB Customer Advisor Erin Bugg saved them from a massive loss. Bugg became suspicious of the firm after they promised a 12 per cent return on their term deposit and a guaranteed pay out if the firm went bust. “If there was a scam red flags bingo card, ‘online investment opportunity’ would be top of the list,” the NAB Customer Advisor said. “Immediately, alarm bells went off for me. It sounded like an investment scam and I was concerned this couple could lose their life savings.” The couple, however, insisted that they weren't being scammed so Bugg decided to look into the matter further and found a website and article about the firm. When she looked into the rates they offered she realised it “was literally too good to be true." “No one likes to be told they’re being lied to, especially when they feel like they’ve done all the right things. They had done their own research, and even spoken to the company on the phone,” she said. She added that "alarm bells" started ringing when the wife explained that a man from the firm kept calling her to thank her for the investment and encourage her to open an account. The couple then rang the "firm" in front of Bugg to try and convince her it was real. “I declined to speak to the ‘firm’, but I could hear them telling the customers, ‘Oh, NAB always flags us as a scam’,’” she recalled. NAB’s fraud team then informed them that the firm had a bank account at another bank, and to call the bank to confirm whether it was legit. After calling the other bank, they found that the account was not connected to the investment firm and suggested them to not transfer anything. “It was such a relief to hear from the customer that they’d avoided being scammed,” Bugg said. This comes after Scamwatch received over 7,000 reports of investment scams collectively costing Aussies over $275 million in the last year. Image: NAB

Money & Banking

"Gone way too soon”: Neighbours star dead at 48

Neighbours star Troy Beckwith, who immortalised the infamous villain Michael Martin, has passed away at the age of 48. The news was confirmed by his former co-star, Kym Valentine, leaving the Neighbours community and fans around the world mourning the loss of a talented actor and cherished friend. Valentine took to social media to share the heartbreaking news, saying, “It pains me so much to have to say this. Our dear old friend Troy Beckwith has passed away.” The void left by his departure is felt deeply by those who knew him, with Valentine expressing sorrow over the untimely loss of another member of their TV family. “Another member of our TV family gone way too soon. There will be no funeral as per Troy’s request. Thanks for all the memories my cheeky mate and all my love to your friends and family.” Troy's character, "Sicko Micko", became an iconic figure in the world of Neighbours during his run from 1992 to 1998. Ausculture even likened him to "the Charles Manson of Ramsay Street" because of the profound impact he had on fans and the show's legacy. His portrayal of Michael Martin earned him a special place in the hearts of viewers, and he remains a fixture in lists ranking the best Neighbours characters of the 1990s. As the news spread, tributes poured in from fellow cast members and friends. Brett Stark actor Brett Blewitt, currently part of the Neighbours revival, shared his thoughts, describing Troy as a "lovely person" who was "deeply thoughtful and empathetic". The pain of the loss is palpable in Blewitt's words, echoing the sentiments of many who had the privilege of knowing Troy. Even as the Neighbours family grapples with the shock, Lucinda Cowden, who plays Melanie Pearson, expressed her sorrow through a series of broken heart emojis. The collective grief is evident, as the cast and crew mourn the departure of a talent gone too soon. Troy's friend Selina Laine Bonica reflected on the complexity of their relationship, saying, “Troy, you were a pain in my a**, but I loved you dearly. I’m just glad you’re free from pain.” Beckwith's impact extended beyond Neighbours, as evidenced by his role in the series Pugwall. Ricky Fleming, his co-star, paid tribute by remembering the mischievous adventures they shared, saying, “May you be in peace and still be the infectious joy of those who are in your presence now.” The absence of a cause of death only deepens the sense of loss, leaving fans to remember a talent that graced their screens and a person who touched the hearts of many. Images: Facebook

Caring

"It's too late": Sister of mother who died waiting for ambulance speaks out

A Current Affair host Ally Langdon teared up during an interview with the heartbroken sister of Cath Groom, the Brisbane mum who <a href="https://www.oversixty.com.au/health/caring/mother-dies-after-ambulance-fails-to-arrive" target="_blank" rel="noopener">died after waiting for an ambulance</a> that never arrived. Groom had initially complained of severe chest pain in the hours before she was found dead by her son, Nicholas, on the morning of her 52nd birthday. Groom's sister, Bec McQuilty said that her family will never get over the tragedy, as she details exactly what happened that night. McQuilty said her sister had not only complained of severe chest pains, but was also vomiting profusely and had pain between the shoulder blades. She said Nicholas, Grooms's only son, called triple zero "multiple times" to request an ambulance, but after 90 minutes of no help, Groom decided to go to sleep. She got up at some point in the night, collapsed and died. "For a young boy to have to see his mum like that, it just shouldn't happen," McQuilty said. "He was petrified he didn't know what to do. "He's been taught through all his life that you can rely on these people and to make a phone call to triple zero and them not be there for him when they should have been, is just blatant neglect. "I will never forget the look on his face of just absolute despair." The A Current Affair broke down the moment McQuilty recalled Nicholas calling her in a panic after finding his dead mum. "I just think this hits all of us, hearing this," Langdon said. "That scene no doubt will haunt you for a long time." McQuilty shared that prior to Groom's passing the family was experiencing "the highest of highs to the lowest of lows in the space of 24 hours," after celebrating Nicholas' high school graduation on the Friday. "To get to such an incredible point of his high school graduation and just to be so proud of him on that day," McQuilty said. "I could see it in her face that she was just, you know, so so proud. "And literally 24 hours later he's finding his mother deceased, unnecessarily. "He's numb, he's angry and he's got a really long road ahead of him." Nicholas has now lost both parents, as his dad passed away when he was a baby. McQuilty revealed that her mum was admitted to the ER after finding out the devastating news and "never come back from this". "She herself was taken to the ER from just complete shock and her own heart," McQuilty said. "So I have my sister deceased in the house. I have my mom in the ER. "You know, it's just, no family, Ally, should ever ever have to go through what our family has gone through." McQuilty hopes that there will be changes made to emergency health system in the wake of her sister's death. "Put some more money into our hospital system and our health system maybe. "It's too late for my family, it's too late. But maybe that can save somebody else." Images: Nine/ A Current Affair

Caring

How 22 minutes of exercise a day could reduce the health risks from sitting too long

<a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> People in developed countries spend an average of <a href="https://doi.org/10.1136/bjsports-2022-106568">nine to ten hours</a> a day sitting. Whether it’s spending time in front of a computer, stuck in traffic, or unwinding in front of the TV, our lives have become increasingly sedentary. This is concerning because prolonged time spent sitting is <a href="https://bjsm.bmj.com/content/54/24/1451?s=09&int_source=trendmd&int_medium=cpc&int_campaign=usage-042019">linked to a number of health issues</a> including obesity, heart disease, and certain types of cancers. These health issues can contribute to earlier death. But a <a href="https://doi.org/10.1136/bjsports-2022-106568">new study</a> suggests that for people over 50, getting just 22 minutes of exercise a day can lower the increased risk of premature death from a highly sedentary lifestyle. <h2>What the researchers did</h2> The team combined data from two studies from Norway, one from Sweden and one from the United States. The studies included about 12,000 people aged 50 or older who wore wearable devices to track how active and sedentary they were during their daily routines. Participants were followed up for at least two years (the median was 5.2 years) during the study period, which spanned 2003-2020. Analyses took several lifestyle and health factors into account, such as education, alcohol intake, smoking status, and previous history of heart disease, cancer and diabetes. All this data was linked to national death registries. <h2>A 22 minute threshold</h2> A total of 805 participants died during follow up. The researchers found people who were sedentary for more than 12 hours a day had the highest risk of death (a 38% higher risk than people who were sedentary for eight hours). However, this was only observed in those who did less than 22 minutes of moderate to vigorous physical activity daily. So for people who did more than 22 minutes of exercise, there was no longer a significantly heightened risk – that is, the risk became generally similar to those who were sedentary for eight hours. Higher daily duration of physical activity was consistently associated with lower risk of death, regardless of total sedentary time. For example, the team reported an additional ten minutes of moderate to vigorous physical activity each day could lower mortality risk by up to 15% for people who were sedentary less than 10.5 hours a day. For those considered highly sedentary (10.5 hours a day or more), an additional ten minutes lowered mortality risk by up to 35%. <h2>The study had some limitations</h2> The team couldn’t assess how changes in physical activity or sedentary time over several months or years may affect risk of death. And the study included only participants aged 50 and above, making results less applicable to younger age groups. Further, cultural and lifestyle differences between countries may have influenced how data between studies was measured and analysed. Ultimately, because this study was observational, we can’t draw conclusions on cause and effect with certainty. But the results of this research align with a growing body of evidence exploring the relationship between physical activity, sedentary time, and death. <h2>It’s positive news</h2> Research has previously suggested <a href="https://bjsm.bmj.com/content/54/24/1499">physical activity may offset</a> health risks associated with <a href="https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.02.031">high sedentary time</a>. The good news is, even short bouts of exercise can have these positive effects. In this study, the 22 minutes wasn’t necessarily done all at once. It was a total of the physical activity someone did in a day, and would have included incidental exercise (activity that’s part of a daily routine, such as climbing the stairs). Several studies using wearable devices have found short bursts of high-intensity everyday activities such as stair climbing or energetic outdoor home maintenance activities such as mowing the lawn or cleaning the windows can lower <a href="https://www.nature.com/articles/s41591-022-02100-x">mortality</a>, <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">heart disease</a> and <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">cancer</a> risk. A recent study using wearable devices found moderate to vigorous bouts of activity <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00183-4/fulltext">lasting three to five minutes</a> provide similar benefits to bouts longer than ten minutes when it comes to stroke and heart attack risk. Several other studies have found <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2596007">being active just on the weekend</a> provides similar health benefits as <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2794038">being active throughout the week</a>. Research has also shown the benefits of <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2795819">physical activity</a> and <a href="https://jamanetwork.com/journals/jama/article-abstract/2809418">reducing sedentary time</a> extend to cognitive health. Routines such as desk jobs can foster a sedentary lifestyle that may be difficult to shift. But mixing short bursts of activity into our day can make a significant difference towards improving our health and longevity. Whether it’s a brisk walk during lunch, taking the stairs, or even a short at-home workout, this study is yet another to suggest that every minute counts.<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/216259/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-22-minutes-of-exercise-a-day-could-reduce-the-health-risks-from-sitting-too-long-216259">original article</a>.

Body

Feeling lonely? Too many of us are. Here’s what our supermarkets can do to help

<a href="https://theconversation.com/profiles/louise-grimmer-212082">Louise Grimmer</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Even <a href="https://endingloneliness.com.au/wp-content/uploads/2020/11/Ending-Loneliness-Together-in-Australia_Nov20.pdf">before COVID-19</a>, <a href="https://aifs.gov.au/resources/resource-sheets/understanding-and-defining-loneliness-and-social-isolation">social isolation and loneliness</a> were all too common across the community. Living among millions of other people is no comfort for people in cities, where the pace of life is often hectic, and technology and digitisation often limit, rather than help with, social interaction. The pandemic <a href="https://www.apa.org/pubs/journals/releases/amp-amp0001005.pdf">amplified these problems</a>. In its wake, more of us report we’re lonely. For some, a weekly shopping trip may be the only chance to interact with others. A supermarket chain in the Netherlands is helping to combat loneliness with so-called “slow” checkouts where chatting is encouraged. Could a similar approach work here? <h2>We’re getting lonelier</h2> Around a third of Australians report feeling lonely. <a href="https://lonelinessawarenessweek.com.au/download/512/">One in six</a> experience severe loneliness. According to the annual Household, Income and Labour Dynamics in Australia (<a href="https://melbourneinstitute.unimelb.edu.au/hilda/publications/hilda-statistical-reports">HILDA</a>) Survey, people <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">aged 15 to 24</a> report the greatest increase in social isolation over the past 20 years and the highest rates of loneliness. Another <a href="https://www.abc.net.au/news/2023-07-14/middle-aged-men-experiencing-high-level-loneliness/102563492">Australian survey</a> found men aged 35 to 49 had the highest levels of loneliness. Loneliness and social isolation are <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">not the same</a>. Social isolation is a matter of how often we have contact with friends, family and others, which can be measured. Loneliness is more subjective. It describes how we feel about the “quality” of our interactions with others. Technology is <a href="https://www.psychologytoday.com/au/blog/live-long-and-prosper/202210/technology-use-loneliness-and-isolation#:%7E:text=Technology%20compulsion%20might%20lead%20to,disconnection%20and%20reduce%20well%2Dbeing.">contributing</a> to <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">high rates of loneliness</a>. Instead of meaningful face-to-face interactions, many of us now rely on social media, phone apps and video calls to socialise. We’re also working longer hours, often at home. And due to the cost of living, many of us are choosing to stay home and save money, rather than eat out or go to “the local”. It isn’t only in Australia where this is happening. In the UK, around <a href="https://www.lonelinessawarenessweek.org/statistics">3.9 million older people</a> say television is their main company. Half a million may go five or six days a week without seeing anyone. The World Health Organisation <a href="https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness">recognises</a> loneliness and social isolation as public health issues and priorities for policymakers. These issues seriously affect people’s mental and physical health as well as longevity. The impacts are comparable with other <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15967-3">risk factors</a> such as smoking, alcohol consumption, obesity and not being physically active. <h2>Could slow, ‘chatty’ checkouts be part of the solution?</h2> For many, a visit to the supermarket may be the only time they interact with others. Sadly, increased use of technology, including self-serve checkouts, and cashiers tasked with speedily processing customers can make it challenging to have a conversation. <iframe title="The FASTEST checkout cashier ever😮 TikTok: rogerlopez7511" src="https://www.youtube.com/embed/TpALSOvw4LU" width="100%" height="750" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Four years ago, the Netherlands’ second-largest supermarket chain, <a href="https://jumbo.com">Jumbo</a>, introduced Kletskassa or “chat checkout”. It’s for shoppers who want to chat and aren’t in a hurry. Recognising loneliness was an issue for many, the idea was to increase social interaction between customers and staff by slowing things down and encouraging conversation. Jumbo’s chief commercial officer, Colette Cloosterman-van Eerd, <a href="https://www.dutchnews.nl/2021/09/jumbo-opens-chat-checkouts-to-combat-loneliness-among-the-elderly/">explained</a>: <blockquote> Many people, especially the elderly, sometimes feel lonely. As a family business and supermarket chain, we are at the heart of society. Our shops are an important meeting place for many people, and we want to play a role in identifying and reducing loneliness. </blockquote> The first Kletskassa, in Vlijmen in Brabant, was so successful the family-owned company started rolling out slow checkouts in <a href="https://www.dutchnews.nl/2021/09/jumbo-opens-chat-checkouts-to-combat-loneliness-among-the-elderly/">200 of its stores</a>. Not only were customers responding positively, the concept also appealed to Jumbo’s employees. They are trained to recognise signs of loneliness and come up with local initiatives to combat social isolation. Cloosterman-Van Eerd said: <blockquote> We are proud our staff want to work the chat checkout. They really want to help people and make contact with them. It’s a small gesture but it’s a valuable one, particularly in a world that is becoming more digital and faster. </blockquote> The original focus of Jumbo’s initiative was older shoppers. However, the trial showed people of all ages were keen to use the Kletskassa. The desire for human interaction didn’t change across age groups. So, these “chatty” checkouts are open to anyone who will benefit from social connection. Some Jumbo stores also have an <a href="https://www.brightvibes.com/dutch-supermarket-introduces-a-unique-chat-checkout-to-help-fight-loneliness/">All Together Coffee Corner</a>, where locals can enjoy a coffee and chat with neighbours and volunteers who also <a href="https://scoop.upworthy.com/dutch-supermarket-introduces-a-unique-slow-checkout-lane-to-help-fight-loneliness-595693-595693">help out</a> with shopping and gardening. The Netherlands’ government is partnering a range of organisations, local government and companies to come up with solutions to combat loneliness across the country. Some 50% of the 1.3 million people over 75 report they regularly feel lonely. Jumbo’s initiatives are part of the Health Ministry’s <a href="https://www.globalwellnesssummit.com/blog/governments-ramp-up-the-war-on-loneliness/">One Against Loneliness</a> campaign. <figure><iframe src="https://www.youtube.com/embed/11SY0wG6Zc8?wmode=transparent&start=10" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Jumbo supermarket’s innovation of slow chat checkouts has been extended to 200 of its stores.</figcaption></figure> <h2>Supermarkets as ‘third places’ to combat loneliness</h2> In the 1980s, sociologist Ray Oldenberg coined the term <a href="https://link.springer.com/article/10.1007/BF00986754">“third place”</a> – a place that’s not home (the “first place”) and not work (the “second place”). Third places are familiar public spaces where people can connect over a shared interest or activity. Libraries, coffee shops, book stores, community gardens, churches, gyms and clubs are examples of third places. They all provide the opportunity for close proximity, interaction and often serendipitous conversations with other people we might not usually meet. Kletkassa have helped thousands of people, of all ages and backgrounds, by providing a few minutes of kindness and conversation. Imagine what could be achieved if our supermarkets offered their own version of the “slow checkout” for anyone who’s in need of a chat to brighten their day. The first chain to introduce this sort of initiative in Australia would have a solid advantage over competitors through differentiation and prioritising customers. At the same time, it would make a small but meaningful contribution to improving social wellbeing. Challenge extended!<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/211126/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/louise-grimmer-212082">Louise Grimmer</a>, Senior Lecturer in Retail Marketing, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/feeling-lonely-too-many-of-us-are-heres-what-our-supermarkets-can-do-to-help-211126">original article</a>.

Caring

Beyond Barbie and Oppenheimer, how do cinemas make money? And do we pay too much for movie tickets?

<a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> I’ve got two questions about blockbuster movies like Barbie and Oppenheimer. <ol> <li> Why aren’t the cinemas charging more for them, given they’re so popular? </li> <li> Why are they the same price, given Oppenheimer is an hour longer? </li> </ol> The opening weekend <a href="https://www.smh.com.au/culture/movies/how-australian-cinemas-and-audiences-handled-the-barbenheimer-juggernaut-20230724-p5dqso.html">for both films</a> saw an avalanche of Australians returning to the cinema. Extra staff had to be put on (although probably not enough) to manage queues, turn away pink-clad fans who couldn’t get in, and clean up mountains of popcorn trampled underfoot. An obvious solution to such a rush of demand is to push up prices. Airlines do it when they are getting low on seats. When more people want to get a ride share, Uber makes them pay with “<a href="https://www.uber.com/au/en/drive/driver-app/how-surge-works/">surge pricing</a>”. Even books are sold at different prices, depending on the demand, their length, their quality and how long they’ve been on the shelves. But not movie tickets, which are nearly always the same price, no matter the movie. Why? And how much has the cost of a trip to the movies risen over the past 20 years? <h2>Why not charge more for blockbusters?</h2> In suburban Melbourne, Hoyts is charging $24.50 for the two-hour Barbie – the same as it is charging for the three-hour Oppenheimer, even though it could fit in far fewer showings of Oppenheimer in a day. It’s also the same price as it is charging for much less popular movies, such as Indiana Jones and the Dial of Destiny. It’s also how things are in the United States, where James Surowiecki, author of <a href="https://www.penguinrandomhouse.com/books/175380/the-wisdom-of-crowds-by-james-surowiecki/">The Wisdom of Crowds</a> blames convention and says "it costs you as much to see a total dog that’s limping its way through its last week of release as it does to see a hugely popular film on opening night." Australian economists Nicolas de Roos of The University of Sydney and Jordi McKenzie of Macquarie University quote Surowiecki in their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167718714000174">2014 study</a> of whether cinema operators could make more by cutting the price of older and less popular films and raising the price of blockbusters. By examining what happened to demand on <a href="https://www.eventcinemas.com.au/Promotions/HalfPriceTuesdays#cinemas=59">cheap Tuesdays</a>, and developing a model taking into account advertising, reviews and the weather, they discovered Australian cinemas could make a lot more by <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167718714000174">varying their prices</a> by the movie shown. We turn out to be highly price sensitive. So why don’t cinemas do that? <h2>‘There’s a queue, it must be good’</h2> It’s the sort of thing that puzzled <a href="https://www.nobelprize.org/prizes/economic-sciences/1992/becker/biographical/">Gary Becker</a>, an economic detective of sorts who won the Nobel Prize for Economics in the early 1990s. A few years earlier, he turned his attention to <a href="https://www.jstor.org/stable/2937660">restaurants</a> and why one particular seafood restaurant in Palo Alto, California, had long queues every night but didn’t raise its prices. Across the road was a restaurant that charged slightly more, sold food that was about as good, and was mostly empty. His conclusion, which he used a lot of maths to illustrate, was there are some goods for which a consumer’s demand depends on the demand of other consumers. Queues for restaurants (or in 2023, long queues and sold out sessions, as crowds were turned away from Barbie) are all signals other consumers want to get in. This would make queues especially valuable to the providers of such goods, even if the queues meant they didn’t get as much as they could from the customers who got in. The “buzz” such queues create produces a supply of future customers persuaded that what was on offer must be worth trying. Importantly, Becker’s maths showed that getting things right was fragile. It was much easier for a restaurant to go from being “in” to “out” than the other way around. Once a queue had created a buzz, it was wise not to mess with it. <h2>Cashing in from the snack bar</h2> There are other reasons for cinemas to charge a standard ticket price, rather than vary it movie by movie. One is that it is hard to tell ahead of time which movies are going to soar and which are going to bomb, even if you spend a fortune on advertising as the <a href="https://variety.com/2023/film/box-office/barbie-marketing-campaign-explained-warner-bros-1235677922/">makers of Barbie did</a>. In the words of an insider, “<a href="https://variety.com/2018/film/opinion/william-goldman-dies-appreciation-1203030781/">nobody knows anything</a>.” Another is the way cinemas make their money. They have to pay the distributor a share of what they get from ticket sales (typically <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167718714000174">35-40%</a>). But they don’t have to pay a share of what they make from high-margin snacks. This means it can make sense for some cinemas to charge less than what the market will bear – because they’ll sell more snacks – even if it means less money for the distributor. <h2>Rising prices, despite some falling costs</h2> But cinemas still charge a lot. From 2002 to 2022, Australian cinemas jacked up their average (not their highest) prices <a href="https://www.screenaustralia.gov.au/fact-finders/cinema/industry-trends/box-office/ticket-prices">from $9.13 to $16.26</a> – an increase of 78%. In the same 20 year period, overall prices in Australia, as measured by the <a href="https://theconversation.com/whats-in-the-cpi-and-what-does-it-actually-measure-165162">consumer price index</a>, climbed 65% – less than the rise in movie ticket prices. <hr /> <iframe id="E2kxi" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/E2kxi/5/" width="100%" height="400px" frameborder="0"></iframe> <hr /> A 2015 study found Australian cinemas charge more <a href="https://www.researchgate.net/publication/306227560_Counting_the_cost_the_impact_of_cinema_ticket_prices_in_Australia">than cinemas in the US</a>. Yet some of the cinemas’ costs have gone down. They used to have to employ projectionists to lace up and change reels of film. Digital delivery means much less handling. A now-dated <a href="https://www.accc.gov.au/about-us/publications/developments-in-the-cinema-distribution-exhibition-industry">1990s report</a> to the Australian Competition and Consumer Commission found the two majors, Hoyts and Greater Union/Village, charged near identical prices except where they were faced with competition from a nearby independent, in which case they discounted. Whether “<a href="https://www.accc.gov.au/system/files/The%20Cinema%20Industry.pdf">by design or circumstance</a>”, the two cinema chains rarely competed with each other, clustering their multiplexes in different geographical locations. <h2>Longer films no longer displace shorter films</h2> I think it might be the multiplex that answers my second question: why cinemas don’t charge more for movies that are longer (and movies are <a href="https://www.smh.com.au/culture/movies/bigger-than-ben-hur-why-movies-are-getting-longer-and-longer-20220322-p5a6ty.html">getting longer</a>). In the days of single screens, a cinema that showed a long movie might only fit in (say) four showings a day instead of six. So it would lose out unless it charged more. But these days, multiplexes show many, many films on many screens, some of them simultaneously, meaning long films needn’t displace short films. Although we have <a href="https://www.screenaustralia.gov.au/fact-finders/cinema/industry-trends/screens-and-theatres">fewer cinema seats</a> than we had a decade ago (and at least until the advent of Barbie, we’ve been <a href="https://www.screenaustralia.gov.au/fact-finders/cinema/industry-trends/screens-and-theatres">going less often</a>) we now have <a href="https://www.screenaustralia.gov.au/fact-finders/cinema/industry-trends/screens-and-theatres">far more screens</a>. Long movies no longer stop the multiplexes from playing standard ones. And because cinemas like to keep things simple, you pay the same price, no matter which movie you chose. <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/211121/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/beyond-barbie-and-oppenheimer-how-do-cinemas-make-money-and-do-we-pay-too-much-for-movie-tickets-211121">original article</a>.

Movies

UK family at risk of deportation for being "too old"

A family from the UK are at risk of being deported from Australia, after the immigration policy deemed them "too old" to stay. In 2015, Parents Glenn, 57, and Sheena Tunnicliff, 50, moved from the UK to Perth to start a new life with their two young daughters, Tazmin and Molly. The family settled in the city's north, where Glenn started working as a plasterer and Sheena opened a Helloworld franchise, where she employed three others. Their daughters are now starting their own careers, as Tazmin, 21, has started working as a nurse and Molly, 18, is studying Australian Sign Language (ASLAN). Despite living, studying and working in Australia for almost a decade, the entire family is now being faced with the reality of being deported back to their home country. Glenn and Sheena were ordered to leave the country by August 4th after they were unable to secure permanent residency due to various visa and job changes over the years. Permanent residency has an age limit of 45, meaning now, neither parent qualifies. “We don’t want to go back to the UK. We’ve made a life here,” Sheena previously told <a href="https://www.9news.com.au/national/visa-exclusive-immigration-australia-perth-family-face-being-sent-back-to-uk-despite-in-demand-job/2d59c8eb-e720-48bc-8d74-7be5a883ebf4?ocid=Social-9News" target="_self" data-tgev="event119" data-tgev-container="bodylink" data-tgev-order="2d59c8eb-e720-48bc-8d74-7be5a883ebf4" data-tgev-label="national" data-tgev-metric="ev">Nine News</a>. “Now we are over that magic figure of 45 there is no route to PR for us. Australia classes us as too old [but] we are the ones with the experience and training.” Since moving to Australia, the family has spent over $80,000 in visas, and will now have to fork out more for a "temporary Band-Aid fix" hat will extend their visas until July 2024. However, the family are planning to relocate to New Zealand, where the age cut-off for permanent residency is 55, meaning Sheena would be eligible. Bizarrely, after five years across the Tasman, the Tunnicliffs could become New Zealand citizens which would allow them to return to Australia to live. “We’d take all our skills and we’d go to New Zealand,” Sheena said. “It’s crazy. Australia’s lost all our skills. In five years time we could walk back into Australia.” Image credits: Facebook

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10 pantry items you’re probably keeping for too long

Should you toss these pantry items? It’s likely that many of the items you store in your pantry have a surprising expiration date months (or even years) from now. But just because a product hasn’t expired yet doesn’t mean that it’s in its ideal state for consumption. While you already know which foods you shouldn’t eat past the expiration date, like milk and cheese, it wouldn’t be surprising if you didn’t give a second thought about the food in your pantry. It may be worthwhile to double check the items you have had sitting in your pantry forever. And make sure you think about removing these foods that shouldn’t go in your pantry in the first place. Quinoa The shelf life of whole grains like quinoa and farro is largely dependent on their fat content. Heat, air, and moisture are the top three enemies of whole grains because the elements can negatively affect their healthy oils, which in turn can cause your grains to go rancid sitting in your pantry. “Grains should always look and smell faintly sweet or have no aroma at all,” states the Whole Grains Council. “If you detect a musty or oily scent, the grains have passed their peak.” Turmeric Your favourite ground spices like turmeric, paprika, and nutmeg generally lose their potency after about two to three years. Eating old spices isn’t harmful to your health, but they won’t add any flavour to your recipes anymore. Do a quick sniff and taste test to determine if your spice is still fresh. Baking powder The same rules for ground spices apply to baking ingredients as well. Bags of baking powder and baking soda will lose their leavening power over time, which means a sad, flat cake for you. You can test their leavening power with this easy science experiment in your kitchen: Mix baking soda with vinegar and baking powder with hot water. If they foam up and bubble, it means the ingredients are still fresh enough for baking. Nuts and seeds You’ll want to eat un-shelled nuts like almonds and peanuts within a matter of a few weeks to a few months. “Nuts and seeds typically have a high amount of oil in them and that oil will start to go rancid after a couple of months in your pantry,” Tryg Siverson, chef and co-founder of Feel Good Foods, told INSIDER. Signs of rancidity on a nut or seed include a grassy or paint-like odour and dark or oily appearance. For optimal freshness and longevity, place the nuts and seeds in a clear freezer bag and pop them in your fridge for up to a year. Tea Your tea bags should be consumed within a year because the oils in the tea will go old and give your morning cup of tea a bad flavour. The same goes for your coffee beans and grounds. According to Isabel Maples, MEd, RDN, a registered dietitian nutritionist, you’re best off consuming beans and grounds within two to four weeks. Instant coffee lovers have a bit more time: about two months. Brown sugar An opened bag of brown sugar tends to dry up and harden from exposure to the air after four months in your pantry. Slip the brown sugar into a resealable plastic bag or airtight container to keep it soft and make it last longer. Olive oil Light and heat are not olive oil’s friends. You shouldn’t get sick from an old bottle of olive oil, but an opened bottle of the stuff can taste a bit off after six months. If you don’t use olive oil often, only buy a small bottle so you can use it before the flavour spoils. Whole grain flour Most people store their flour in the pantry, but you should actually store it in the refrigerator or freezer to keep it fresh longer. And does flour ever expire? Whole grain flour lasts up to eight months in the fridge and up to a year in the freezer. “Whole grain flours turn rancid before white flour does,” Maples said. “It doesn’t affect food safety but does affect food quality and taste.” Potatoes The spuds typically last up to two weeks in the refrigerator and two months in the pantry. You’ll know their time is up when they start growing sprouts and developing soft black spots on the skin. Brown rice Although brown rice is a slightly healthier alternative to white rice, it doesn’t last nearly as long on your pantry shelf. “With brown rice, there is oil in its bran layer,” Siverson told INSIDER. “When that oil goes rancid, it gives brown rice a shorter shelf life of about six months. You can store it in the freezer for up to a year.” Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/food-home-garden/10-pantry-items-youre-probably-keeping-for-too-long?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

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