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Could not getting enough sleep increase your risk of type 2 diabetes?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936"><em>University of Technology Sydney</em></a></em></p> <p>Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.</p> <p>So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.</p> <h2>The study</h2> <p>Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.</p> <p>The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.</p> <p>As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.</p> <p>Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.</p> <p>The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.</p> <p>One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.</p> <p>Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.</p> <h2>Why might short sleep increase diabetes risk?</h2> <p>In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.</p> <p>We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.</p> <p>Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>.</p> <p>This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.</p> <p>These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.</p> <p>While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.</p> <p>Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.</p> <p>The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>.</p> <h2>Good sleep, healthy diet</h2> <p>Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.</p> <p>Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.</p> <p>While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health.</p> <p>The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk.</p> <p>In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.</em></p> </div>

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Millions of phones at risk of being cut off from calling triple-0

<p>Over a million Aussies may be unable to contact triple-0 as two major telcos cut their 3G networks. </p> <p>Telstra's network will be closed on June 30 this year followed by Optus, which will shut their 3G network in September.</p> <p>While most late model phones are now serviced by either 4G or 5G networks, there are many devices that still rely on 3G. </p> <p>Approximately 113,000 Telstra customers have not upgraded their 3G handsets, while Optus have not disclosed a figure.</p> <p>The greater concerns lie for older 4G-enabled handsets that may not be able to call triple-0 once the 3G networks are switched off, because of the way those phones are configured.</p> <p>In March, Communications Minister Michelle Rowland was informed that 740,000 Australians were in that category.  </p> <p>A month later, that figure was revised to over a million. </p> <p>"I welcome the industry’s first report to government but am concerned around their disclosure of around one million potentially impacted consumers,” the minister said. </p> <p>“I am considering the detail provided and next steps, and the government will have more to say about the 3G switchover soon.”</p> <p>She also said that they were open to delaying the switchover  "if warranted in the public interest”.</p> <p>“Options exist under law for the government to consider proposals to delay the planned switchover, subject to consultation and procedural processes,” she said.</p> <p>Telstra has informed customers about what to do if they are affected, and how they could check. </p> <p>“If your mobile device doesn’t have Voice over LTE (VoLTE) technology, even if it uses 4G data, it will not be able to make voice calls on our network after 30 June 2024,” they informed their customers. </p> <p>“Not all VoLTE enabled devices support emergency VoLTE calling, meaning they will not be able to make an emergency call to triple-0 once 3G closes." </p> <p>“Without taking the recommended action you won’t be able to connect to a network after 30 June 2024,” they warned. </p> <p>Customers who are worried that they might be impacted, are encouraged to text 3 to the number 3498, so that the telco can inform the customer on their connection status.</p> <p>Optus have also encouraged customers to contact them if they think they may be affected. </p> <p><em>Image: Getty</em></p>

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Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<p><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <em><a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs.</p> <p>As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns.</p> <p>But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug.</p> <h2>Potential benefits</h2> <p><strong>1) It’s likely to help you lose weight</strong></p> <p>The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity.</p> <p>The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight).</p> <p>In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg.</p> <p>Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication.</p> <p><strong>2) It may reduce your chronic disease risk factors</strong></p> <p>When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases.</p> <p>In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels.</p> <p>In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels.</p> <p><strong>3) It might improve your quality of life, emotional wellbeing or sense of achievement</strong></p> <p>The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health.</p> <p>Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image.</p> <h2>What about the risks?</h2> <p><strong>1) You may experience gastrointestinal symptoms</strong></p> <p>In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%).</p> <p>In the UK study, nausea and diarrhoea were also commonly reported.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living.</p> <p>Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study.</p> <p><strong>2) You might feel fatigued</strong></p> <p>Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants.</p> <p><strong>3) You might be among the minority who don’t tolerate the drug</strong></p> <p>Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia.</p> <p>In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing.</p> <p>More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period.</p> <p>A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period.</p> <p>Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions.</p> <p><strong>4) It might be difficult to access</strong></p> <p>Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024.</p> <p>To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication.</p> <p><strong>5) You might not always get clear information from vested interests</strong></p> <p>Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>.</p> <p>Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications.</p> <h2>Bottom line</h2> <p>Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.</em></p>

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Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

<p><em><a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.</p> <p>The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.</p> <p>Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.</p> <p>The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.</p> <h2>What’s CJD got to do with Alzehimer’s?</h2> <p>CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.</p> <p>Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s.</p> <h2>Human growth hormone used to come from donated organs</h2> <p>Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.</p> <p>But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>.</p> <p>An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.</p> <p>hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.</p> <h2>What are the latest findings about Alzheimer’s disease?</h2> <p>The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.</p> <p>The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.</p> <p>They considered other explanations for the findings but concluded donated hGH was the likely cause.</p> <p>Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.</p> <p>Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible.</p> <p>However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.</p> <h2>When was this process used in Australia?</h2> <p>In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility.</p> <p><a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.</p> <p>The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small.</p> <p>Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.</p> <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> <p>The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.</p> <p>Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.</p> <p>The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/steve-macfarlane-4722"><em>Steve Macfarlane</em></a><em>, Head of Clinical Services, Dementia Support Australia, &amp; Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.</em></p>

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Millions of high-risk Australians aren’t getting vaccinated. A policy reset could save lives

<p><em><a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/ingrid-burfurd-1295906">Ingrid Burfurd</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p>Each year, vaccines prevent thousands of deaths and hospitalisations in Australia.</p> <p>But millions of high-risk older Australians <a href="https://grattan.edu.au/report/a-fair-shot-ensuring-all-australians-can-get-the-vaccines-they-need/">aren’t getting</a> recommended vaccinations against COVID, the flu, pneumococcal disease and shingles.</p> <p>Some people are more likely to miss out, such as migrant communities and those in rural areas and poorer suburbs.</p> <p>As our new <a href="https://grattan.edu.au/report/a-fair-shot-ensuring-all-australians-can-get-the-vaccines-they-need/">Grattan report shows</a>, a policy reset to encourage more Australians to get vaccinated could save lives and help ease the pressure on our struggling hospitals.</p> <h2>Adult vaccines reduce the risk of serious illness</h2> <p>Vaccines slash the risk of <a href="https://www.ncirs.org.au/sites/default/files/2021-03/Influenza-fact-sheet_31%20March%202021_Final.pdf">hospitalisation</a> and serious illness, <a href="https://ncirs.org.au/recent-covid-19-vaccination-highly-effective-against-death-caused-sars-cov-2-infection-older">often by more than half</a>.</p> <p>COVID has already caused more than <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/latest-release">3,000 deaths in Australia this year</a>. On average, the flu kills about <a href="https://www.doherty.edu.au/news-events/news/statement-on-the-doherty-institute-modelling">600 people a year</a>, although a bad flu season, like 2017, can mean <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0%7E2017%7EMain%20Features%7EAustralia's%20leading%20causes%20of%20death,%202017%7E2">several thousand deaths</a>. And pneumococcal disease may also kill <a href="https://www.aihw.gov.au/getmedia/49809836-8ead-4da5-81c4-352fa64df75b/aihw-phe-263.pdf?inline=true">hundreds</a> of people a year. Shingles is rarely fatal, but can be extremely painful and cause <a href="https://www.healthdirect.gov.au/shingles#complications">long-term nerve damage</a>.</p> <p>Even before COVID, vaccine-preventable diseases caused tens of thousands of potentially preventable hospitalisations each year – more than <a href="https://www.aihw.gov.au/reports/primary-health-care/disparities-in-potentially-preventable-hospitalisa/data">80,000 in 2018</a>.</p> <p>Vaccines offered in Australia have been tested for safety and efficacy and have been found to be <a href="https://www.health.gov.au/topics/immunisation/about-immunisation/vaccine-safety#:%7E:text=serious%20side%20effects.-,Vaccine%20safety%20monitoring,approved%20for%20use%20in%20Australia.">very safe</a> for people who are <a href="https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/national-immunisation-program-schedule">recommended to get them</a>.</p> <h2>Too many high-risk people are missing out</h2> <p>Our <a href="https://grattan.edu.au/report/roundabouts-overpasses-carparks-hauling-the-federal-government-back-to-its-proper-role-in-transport-projects">report</a> shows that before winter this year, only 60% of high-risk Australians were vaccinated against the flu.</p> <p>Only 38% had a COVID vaccination in the last six months. Compared to a year earlier, two million more high-risk people went into winter without a recent COVID vaccination.</p> <p>Vaccination rates have fallen further since. Just over one-quarter (<a href="https://www.health.gov.au/sites/default/files/2023-11/covid-19-vaccine-rollout-update-10-november-2023.pdf">27%</a>) of people over 75 have been vaccinated in the last six months. That leaves more than 1.3 million without a recent COVID vaccination.</p> <p>Uptake is also low for other vaccines. Among Australians in their 70s, <a href="https://ncirs.org.au/sites/default/files/2022-12/Coverage%20report%202021%20SUMMARY%20FINAL.pdf">less than half</a> are vaccinated against shingles and only one in five are vaccinated against pneumococcal disease.</p> <p>These vaccination rates aren’t just low – they’re also unfair. The likelihood that someone is vaccinated changes depending on where they live, where they were born, what language they speak at home, and how much they earn.</p> <p>For example, at the start of winter this year, the COVID vaccination rate for high-risk Aboriginal and Torres Strait Islander adults was only 25%. This makes them about one-third less likely to have been vaccinated against COVID in the previous six months, compared to the average high-risk Australian.</p> <p>For more than 750,000 high-risk adults who do not speak English at home, the COVID vaccination rate is below 20% – about half the level of the average high-risk adult.</p> <p>Within this group, 250,000 adults aren’t proficient in English. They were 58% less likely to be vaccinated for COVID in the previous six months, compared to the average high-risk person.</p> <p>High-risk adults who speak English at home have a flu vaccination rate of 62%. But for people from 29 other language groups, who aren’t proficient in English, the rate is less than 31%. These 39,000 people have half the vaccination rate of people who speak English at home.</p> <p>These vaccination gaps contribute to the differences in people’s health. Australians born overseas don’t just have much lower rates of COVID vaccination, they also have much higher rates of death from COVID.</p> <p>Where people live also affects vaccination rates. High-risk people living in remote and very remote areas are less likely to be vaccinated, and even within capital cities there are big differences between different areas.</p> <h2>We need to set ambitious targets</h2> <p>Australia needs a vaccination reset. A new National Vaccination Agreement between the federal and state governments should include ambitious but achievable targets for adult vaccines.</p> <p>This can build on the success of targets for childhood and adolescent vaccination, setting targets for overall uptake and for communities that are falling behind.</p> <p>The federal government should ask the Australian Technical Advisory Group on Immunisation (ATAGI) to advise on vaccination targets for COVID, flu, pneumococcal and shingles for all high-risk older adults.</p> <h2>Different solutions for different barriers</h2> <p>Barriers to vaccination range from the trivial to the profound. A new national vaccination strategy needs to dismantle high and low barriers alike.</p> <p>First, to increase overall uptake, vaccination should be easier, and easier to understand.</p> <p>The federal government should introduce vaccination “surges”, especially in the lead-up to winter, as <a href="https://www.who.int/europe/news/item/09-10-2023-vulnerable--vaccinate.-protecting-the-unprotected-from-covid-19-and-influenza">countries in Europe</a> do.</p> <p>During surges, high-risk people should be able to get vaccinated even if they have had a recent infection or injection. This will make the rules simpler and make vaccination in aged care easier.</p> <p>Surges should be reinforced with advertising explaining who should get vaccinated and why. High-risk people should get SMS reminders.</p> <p>Second, targeted policies are needed for the many people who are happy to use mainstream primary care services, but who don’t get vaccinated – for example, due to <a href="https://theconversation.com/how-can-governments-communicate-with-multicultural-australians-about-covid-vaccines-its-not-as-simple-as-having-a-poster-in-their-language-156097">language barriers</a>, or living in <a href="https://theconversation.com/over-half-of-eligible-aged-care-residents-are-yet-to-receive-their-covid-booster-and-winter-is-coming-205403">aged care</a>.</p> <p><a href="https://www.health.gov.au/our-work/phn/what-PHNs-are">Primary Health Networks</a> should get funding to coordinate initiatives such as vaccination events in aged care and disability care homes, workforce training to support culturally appropriate care, and provision of interpreters.</p> <p>Third, tailored programs are needed to reach <a href="https://www.aihw.gov.au/reports/australias-health/health-promotion">people who are not comfortable or able to access mainstream health care</a>, who have the most complex barriers to vaccination – for example, distrust of the health system or poverty.</p> <p>These communities are all very different, so one-size-fits-all programs don’t work. The pandemic showed that vaccination programs can succeed when they are designed and delivered with the communities they are trying to reach. Examples are “<a href="https://pubmed.ncbi.nlm.nih.gov/36366401/">community champions</a>” who challenge misinformation, or health services organising vaccination events where communities work, gather or <a href="https://www.theguardian.com/australia-news/2021/aug/11/hundreds-queue-for-hours-and-some-camp-overnight-at-pop-up-vaccine-clinic-in-sydneys-lakemba">worship</a>.</p> <p>These programs should get ongoing funding, but also be accountable for achieving results.</p> <p>Adult vaccines are the missing piece in Australia’s whole-of-life vaccination strategy. For the health and safety of the most vulnerable members of our community, we need to close the vaccination gap. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/217915/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/peter-breadon-1348098"><em>Peter Breadon</em></a><em>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/ingrid-burfurd-1295906">Ingrid Burfurd</a>, Senior Associate, Health Program, Grattan Institute, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/millions-of-high-risk-australians-arent-getting-vaccinated-a-policy-reset-could-save-lives-217915">original article</a>.</em></p>

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

<p><em><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></em></p> <p>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.</p> <p>This is concerning because prolonged time spent sitting is <a href="https://bjsm.bmj.com/content/54/24/1451?s=09&amp;int_source=trendmd&amp;int_medium=cpc&amp;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.</p> <p>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.</p> <h2>What the researchers did</h2> <p>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.</p> <p>Participants were followed up for at least two years (the median was 5.2 years) during the study period, which spanned 2003-2020.</p> <p>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.</p> <h2>A 22 minute threshold</h2> <p>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).</p> <p>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.</p> <p>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%.</p> <h2>The study had some limitations</h2> <p>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.</p> <p>Further, cultural and lifestyle differences between countries may have influenced how data between studies was measured and analysed.</p> <p>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.</p> <h2>It’s positive news</h2> <p>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>.</p> <p>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).</p> <p>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.</p> <p>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.</p> <p>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>.</p> <p>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.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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>.</em></p>

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Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<p><em><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>.</p> <p>Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease.</p> <p>Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link?</p> <h2>What the study did and found</h2> <p>This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period.</p> <p>Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia.</p> <p>During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease.</p> <h2>Important considerations</h2> <p>In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk.</p> <p>Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively.</p> <p>These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable.</p> <p>Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves.</p> <p>This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association.</p> <h2>What does other evidence say?</h2> <p><a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both.</p> <p>High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too.</p> <p>For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life.</p> <h2>Why the link?</h2> <p>There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia.</p> <p>Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline.</p> <p>Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>.</p> <p>We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.</em></p>

Mind

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Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

<p><em><a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies.</p> <p>While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low.</p> <p>But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections.</p> <h2>What diseases can pets carry?</h2> <p>Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people.</p> <p>Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs.</p> <p>Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water.</p> <p>Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms.</p> <p>Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva.</p> <p>Dogs also commonly carry <em>Capnocytophaga</em> bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>.</p> <p>Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray.</p> <p>Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium <em>Bartonella henselae</em>.</p> <p>Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium <em>Staphylococcus aureus</em></a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission.</p> <h2>Birds, turtles and fish can also transmit disease</h2> <p>But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to <em>Salmonella</em> infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis.</p> <p>Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink.</p> <p>Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to <em>Pasteurella multicoda</em> infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats.</p> <p>Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets.</p> <p>Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed.</p> <p>For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>.</p> <h2>What should I do if I’m worried about catching a disease from my pet?</h2> <p>There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include:</p> <ul> <li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li> <li>not allowing your pets to lick your face or open wounds</li> <li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li> <li>wearing gloves when changing litter trays or cleaning aquariums</li> <li>wetting bird cage surfaces when cleaning to minimise aerosols</li> <li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)</li> <li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments</li> <li>seeking veterinary care if you think your pet is unwell.</li> </ul> <p>It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/210898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, Lecturer in environmental health, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Getty </em><em>Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-okay-to-kiss-your-pet-the-risk-of-animal-borne-diseases-is-small-but-real-210898">original article</a>.</em></p>

Family & Pets

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New bushfire map reveals areas of greater risk to homes

<p>Australia is rapidly transitioning to drier conditions after a three-year spell of wet weather. And with this shift comes a significantly heightened risk of spring bushfires, potentially leading to an earlier onset of the fire danger period across the eastern coast of the country.</p> <p>The offical <a href="https://www.afac.com.au/auxiliary/publications/newsletter/article/seasonal-bushfire-outlook-spring-2023" target="_blank" rel="noopener">bushfire outlook for spring 2023</a>, released by the country's fire chiefs, underscores the increased vulnerability of substantial areas in the Northern Territory, Queensland, New South Wales, and to a lesser extent, Victoria and South Australia.</p> <p>The prevailing concern revolves around the emergence of fast-spreading grassfires, fuelled by the remarkable growth spurred by three years of relatively moist La Niña conditions. Another alarming aspect is the potential threat to bushland that remained untouched by the devastating Black Summer fires in 2019 and 2020.</p> <p>Rob Rogers, Commissioner of the NSW Rural Fire Service, has conceded that the approaching fire season will be a challenging one. He anticipates an above-average fire threat for the spring season from the Queensland border down to areas south of Sydney, including the Blue Mountains. Some regions within the state are covered in dense, one-metre-tall grass that is ripe for ignition.</p> <p>Rogers also emphasised in a press conference that “There’s also a strip along the coast both in the north and in the far south coast in Bega — areas that didn’t burn in 2019-2020. All of those areas we’re quite concerned about... <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">While it’s correct that we’re not as dry as we were in 2019-2020, some areas in the north and the south, on the coastal areas, are already staring to experience drought conditions.”</span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> </span></p> <p>These same conditions are echoed in Queensland, where the fire risk extends from the NSW border northwards towards Cairns and across the western regions. The Northern Territory and southern areas of Darwin have also not been spared from the elevated threat due to the vigorous growth of invasive gamba grass, fuelled by years of abundant rainfall.</p> <p>Greg Leach, Commissioner of Queensland Fire and Emergency Services, cautions that the state is grappling with high fuel loads amplified by below-average rainfall over the past six months. He stresses the importance of developing a comprehensive bushfire plan.</p> <p>In the Northern Territory, authorities express confidence in the protective buffer created by early-season controlled burns in regions south of Darwin and north of Katherine. However, Deputy Chief Commissioner Stephen Sewell bluntly advises against relying solely on rural or remote assistance, emphasising the need for every individual in the territory to have a survival strategy.</p> <p>Victorians are bracing for a warmer and drier spring than usual, heightening the risk of fires and possibly prompting an earlier commencement of the danger period. Gippsland and the Mallee region face particular concern due to their rapid desiccation.</p> <p>The Bureau of Meteorology predicts drier and warmer conditions nationwide in spring, with a possibility of unusual warmth in most areas and exceptionally dry conditions in parts of southern and eastern Australia. Naomi Benger from the bureau warns that these conditions could rapidly parch vegetation, potentially escalating fire dangers in a short span.</p> <p>Despite the country not being as parched as it was prior to the devastating Black Summer fires, authorities stress that we don't need those exact conditions for a genuine and imminent danger to exist. The resounding call to all of Australia is to get ready.</p> <p>“We need the community to do their part and make sure they plan for their survival, knowing whether they are going to stay and defend, or whether they are going to leave. And if they are going to leave, where are they going to go? Make sure all members of your family understand that,” Rogers concluded.</p> <p><em>Image: AFAC</em></p>

Home & Garden

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Not all mental health apps are helpful. Experts explain the risks, and how to choose one wisely

<p><em><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>There are thousands of mental health apps available on the app market, offering services including meditation, mood tracking and counselling, among others. You would think such “health” and “wellbeing” apps – which often present as solutions for conditions such as <a href="https://www.headspace.com/">anxiety</a> and <a href="https://www.calm.com">sleeplessness</a> – would have been rigorously tested and verified. But this isn’t necessarily the case.</p> <p>In fact, many may be taking your money and data in return for a service that does nothing for your mental health – at least, not in a way that’s backed by scientific evidence.</p> <h2>Bringing AI to mental health apps</h2> <p>Although some mental health apps connect users with a <a href="https://www.betterhelp.com/get-started/?go=true&amp;utm_source=AdWords&amp;utm_medium=Search_PPC_c&amp;utm_term=betterhelp+australia_e&amp;utm_content=133525856790&amp;network=g&amp;placement=&amp;target=&amp;matchtype=e&amp;utm_campaign=15228709182&amp;ad_type=text&amp;adposition=&amp;kwd_id=kwd-401317619253&amp;gclid=Cj0KCQjwoeemBhCfARIsADR2QCtfZHNw8mqpBe7cLfLtZBD-JZ5xvAmDCfol8npbAAH3ALJGYvpngtoaAtFlEALw_wcB¬_found=1&amp;gor=start">registered therapist</a>, most provide a fully automated service that bypasses the human element. This means they’re not subject to the same standards of care and confidentiality as a registered mental health professional. Some aren’t even designed by mental health professionals.</p> <p>These apps also increasingly claim to be incorporating artificial intelligence into their design to make personalised recommendations (such as for meditation or mindfulness) to users. However, they give little detail about this process. It’s possible the recommendations are based on a user’s previous activities, similar to Netflix’s <a href="https://help.netflix.com/en/node/100639">recommendation algorithm</a>.</p> <p>Some apps such as <a href="https://legal.wysa.io/privacy-policy#aiChatbot">Wysa</a>, <a href="https://www.youper.ai/">Youper</a> and <a href="https://woebothealth.com/">Woebot</a> use AI-driven chatbots to deliver support, or even established therapeutic interventions such as cognitive behavioural therapy. But these apps usually don’t reveal what kinds of algorithms they use.</p> <p>It’s likely most of these AI chatbots use <a href="https://www.techtarget.com/searchenterpriseai/feature/How-to-choose-between-a-rules-based-vs-machine-learning-system">rules-based systems</a> that respond to users in accordance with predetermined rules (rather than learning on the go as adaptive models do). These rules would ideally prevent the unexpected (and often <a href="https://www.vice.com/en/article/pkadgm/man-dies-by-suicide-after-talking-with-ai-chatbot-widow-says">harmful and inappropriate</a>) outputs AI chatbots have become known for – but there’s no guarantee.</p> <p>The use of AI in this context comes with risks of biased, discriminatory or completely inapplicable information being provided to users. And these risks haven’t been adequately investigated.</p> <h2>Misleading marketing and a lack of supporting evidence</h2> <p>Mental health apps might be able to provide certain benefits to users <em>if</em> they are well designed and properly vetted and deployed. But even then they can’t be considered a substitute for professional therapy targeted towards conditions such as anxiety or depression.</p> <p>The <a href="https://theconversation.com/pixels-are-not-people-mental-health-apps-are-increasingly-popular-but-human-connection-is-still-key-192247">clinical value</a> of automated mental health and mindfulness apps is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1077722918300233?casa_token=lwm1E6FhcG0AAAAA:saV7szbZl4DqbvmZiomLG9yMWi_4-zbmy3QCtQzVEQr957QX1E7Aiqkm5BcEntR0mVFgfDVo">still being assessed</a>. Evidence of their efficacy is generally <a href="https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000002">lacking</a>.</p> <p>Some apps make ambitious claims regarding their effectiveness and refer to studies that supposedly support their benefits. In many cases these claims are based on less-than-robust findings. For instance, they may be based on:</p> <ul> <li><a href="https://sensa.health/">user testimonials</a></li> <li>short-term studies with narrow <a href="https://www.wired.co.uk/article/mental-health-chatbots">or homogeneous cohorts</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9533203/">studies involving</a> researchers or funding from the very group <a href="https://www.theguardian.com/us-news/2022/apr/13/chatbots-robot-therapists-youth-mental-health-crisis">promoting the app</a></li> <li>or evidence of the benefits of a <a href="https://www.headspace.com/meditation/anxiety">practice delivered face to face</a> (rather than via an app).</li> </ul> <p>Moreover, any claims about reducing symptoms of poor mental health aren’t carried through in contract terms. The fine print will typically state the app does not claim to provide any physical, therapeutic or medical benefit (along with a host of other disclaimers). In other words, it isn’t obliged to successfully provide the service it promotes.</p> <p>For some users, mental health apps may even cause harm, and lead to increases in the very <a href="https://pubmed.ncbi.nlm.nih.gov/34074221/">symptoms</a> people so often use them to address. The may happen, in part, as a result of creating more awareness of problems, without providing the tools needed to address them.</p> <p>In the case of most mental health apps, research on their effectiveness won’t have considered <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505389/">individual differences</a> such as socioeconomic status, age and other factors that can influence engagement. Most apps also will not indicate whether they’re an inclusive space for marginalised people, such as those from culturally and linguistically diverse, LGBTQ+ or neurodiverse communities.</p> <h2>Inadequate privacy protections</h2> <p>Mental health apps are subject to standard consumer protection and privacy laws. While data protection and <a href="https://cybersecuritycrc.org.au/sites/default/files/2021-07/2915_cscrc_casestudies_mentalhealthapps_1.pdf">cybersecurity</a> practices vary between apps, an investigation by research foundation Mozilla <a href="https://foundation.mozilla.org/en/privacynotincluded/articles/are-mental-health-apps-better-or-worse-at-privacy-in-2023">concluded that</a> most rank poorly.</p> <p>For example, the mindfulness app <a href="https://www.headspace.com/privacy-policy">Headspace</a> collects data about users from a <a href="https://foundation.mozilla.org/en/privacynotincluded/headspace/">range of sources</a>, and uses those data to advertise to users. Chatbot-based apps also commonly repurpose conversations to predict <a href="https://legal.wysa.io/privacy-policy">users’ moods</a>, and use anonymised user data to train the language models <a href="https://www.youper.ai/policy/privacy-policy">underpinning the bots</a>.</p> <p>Many apps share so-called <a href="https://theconversation.com/popular-fertility-apps-are-engaging-in-widespread-misuse-of-data-including-on-sex-periods-and-pregnancy-202127">anonymised</a> data with <a href="https://www.wysa.com/">third parties</a>, such as <a href="https://www.headspace.com/privacy-policy">employers</a>, that sponsor their use. Re-identification of <a href="https://www.unimelb.edu.au/newsroom/news/2017/december/research-reveals-de-identified-patient-data-can-be-re-identified">these data</a> can be relatively easy in some cases.</p> <p>Australia’s Therapeutic Goods Administration (TGA) doesn’t require most mental health and wellbeing apps to go through the same testing and monitoring as other medical products. In most cases, they are lightly regulated as <a href="https://www.tga.gov.au/how-we-regulate/manufacturing/medical-devices/manufacturer-guidance-specific-types-medical-devices/regulation-software-based-medical-devices">health and lifestyle</a> products or tools for <a href="https://www.tga.gov.au/sites/default/files/digital-mental-health-software-based-medical-devices.pdf">managing mental health</a> that are excluded from TGA regulations (provided they meet certain criteria).</p> <h2>How can you choose an app?</h2> <p>Although consumers can access third-party rankings for various mental health apps, these often focus on just a few elements, such as <a href="https://onemindpsyberguide.org/apps/">usability</a> or <a href="https://foundation.mozilla.org/en/privacynotincluded/categories/mental-health-apps/">privacy</a>. Different guides may also be inconsistent with each other.</p> <p>Nonetheless, there are some steps you can take to figure out whether a particular mental health or mindfulness app might be useful for you.</p> <ol> <li> <p>consult your doctor, as they may have a better understanding of the efficacy of particular apps and/or how they might benefit you as an individual</p> </li> <li> <p>check whether a mental health professional or trusted institution was involved in developing the app</p> </li> <li> <p>check if the app has been rated by a third party, and compare different ratings</p> </li> <li> <p>make use of free trials, but be careful of them shifting to paid subscriptions, and be wary about trials that require payment information upfront</p> </li> <li> <p>stop using the app if you experience any adverse effects.</p> </li> </ol> <p>Overall, and most importantly, remember that an app is never a substitute for real help from a human professional.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/211513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, Associate Professor, School of Psychological Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, Postdoctoral Research Fellow, Disability Research Initiative, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/not-all-mental-health-apps-are-helpful-experts-explain-the-risks-and-how-to-choose-one-wisely-211513">original article</a>.</em></p>

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Climb the stairs, lug the shopping, chase the kids. Incidental vigorous activity linked to lower cancer risks

<p><em><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> and <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></em></p> <p>Many people know exercise reduces the risk of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521826">cancers</a>, including liver, lung, breast and kidney. But structured exercise is time-consuming, requires significant commitment and often financial outlay or travel to a gym. These practicalities can make it infeasible for <a href="https://bjsm.bmj.com/content/42/11/901">most adults</a>.</p> <p>There is <a href="https://www.nature.com/articles/s41591-022-02100-x">very little research</a> on the potential of incidental physical activity for reducing the risk of cancer. Incidental activities can include doing errands on foot, work-related activity or housework as part of daily routines. As such they do not require an extra time commitment, special equipment or any particular practical arrangements.</p> <p>In our <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">study</a> out today, we explored the health potential of brief bursts of vigorous physical activities embedded into daily life. These could be short power walks to get to the bus or tram stop, stair climbing, carrying heavy shopping, active housework or energetic play with children.</p> <h2>How was the study done?</h2> <p>Our <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">new study</a> included 22,398 <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a> participants who had never been diagnosed with cancer before and did not do any structured exercise in their leisure time. Around 55% of participants were female, with an average age of 62. Participants wore wrist activity trackers for a week. Such trackers monitor activity levels continuously and with a high level of detail throughout the day, allowing us to calculate how hard and exactly for how long people in the study were moving.</p> <p>Participants’ activity and other information was then linked to future cancer registrations and other cancer-related health records for the next 6.7 years. This meant we could estimate the overall risk of cancer by different levels of what we call “<a href="https://pubmed.ncbi.nlm.nih.gov/33108651/">vigorous intermittent lifestyle physical activity</a>”, the incidental bursts of activity in everyday life. We also analysed separately a group of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521826">13 cancer sites in the body</a> with more established links to exercise, such such as breast, lung, liver, and bowel cancers.</p> <p>Our analyses took into account other factors that influence cancer risk, such as age, smoking, diet, and alcohol habits.</p> <h2>What we found out</h2> <p>Even though study participants were not doing any structured exercise, about 94% recorded short bursts of <a href="https://pubmed.ncbi.nlm.nih.gov/33108651/">vigorous activity</a>. Some 92% of all bouts were done in very short bursts lasting up to one minute.</p> <p>A minimum of around 3.5 minutes each day was associated with a 17–18% reduction in total cancer risk compared with not doing any such activity.</p> <p>Half the participants did at least 4.5 minutes a day, associated with a 20–21% reduction in total cancer risk.</p> <p>For cancers such as breast, lung and bowel cancers, which we know are impacted by the amount of exercise people do, the results were stronger and the risk reduction sharper. For example, a minimum of 3.5 minutes per a day of vigorous incidental activity reduced the risk of these cancers by 28–29%. At 4.5 minutes a day, these risks were reduced by 31–32%.</p> <p>For both total cancer and those known to be linked to exercise, the results clearly show the benefits of doing day-to-day activities with gusto that makes you huff and puff.</p> <h2>Our study had its limits</h2> <p>The study is observational, meaning we looked at a group of people and their outcomes retrospectively and did not test new interventions. That means it cannot directly explore cause and effect with certainty.</p> <p>However, we took several statistical measures to minimise the possibility those with the lowest levels of activity were not the unhealthiest, and hence the most likely to get cancer – a phenomenon called “<a href="https://www.sciencedirect.com/topics/computer-science/reverse-causation">reverse causation</a>”.</p> <p>Our study can’t explain the biological mechanisms of how vigorous intensity activity may reduce cancer risk. Previous <a href="https://journals.lww.com/acsm-msse/Fulltext/2017/02000/Brief_Intense_Stair_Climbing_Improves.10.aspx">early-stage trials</a> show this type of activity leads to rapid improvements in heart and lung fitness.</p> <p>And higher fitness is linked to lower <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002934320300097">insulin resistance</a> and lower <a href="https://www.sciencedirect.com/science/article/pii/S0735109704017036">chronic inflammation</a>. High levels of these are risk <a href="https://www.sciencedirect.com/science/article/pii/S0735109704017036">factors for cancer</a>.</p> <p>There is very little research on incidental physical activity and cancer in general, because most of the scientific evidence on lifestyle health behaviours and cancer is based on questionnaires. This method doesn’t capture short bursts of activity and is very inaccurate for measuring the incidental activities of daily life.</p> <p>So the field of vigorous intensity activity and cancer risk is at its infancy, despite some <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">very promising</a> recent findings that vigorous activity in short bouts across the week could cut health risks. In another recent study of ours, we found benefits from daily <a href="https://www.nature.com/articles/s41591-022-02100-x%22%22">vigorous intermittent lifestyle activity</a> on the risk of death overall and death from cancer or cardiovascular causes.</p> <h2>In a nutshell: get moving in your daily routine</h2> <p>Our study found 3 to 4 minutes of vigorous incidental activity each day is linked with decreased cancer risk. This is a very small amount of activity compared to <a href="https://bjsm.bmj.com/content/54/24/1451">current recommendations</a> of 150–300 minutes of moderate intensity or 75–150 minutes of vigorous intensity activity a week.</p> <p>Vigorous incidental physical activity is a promising avenue for cancer prevention among people unable or unmotivated to exercise in their leisure time.</p> <p>Our study also highlights the potential of technology. These results are just a glimpse how wearables combined with machine learning – which our study used to identify brief bursts of vigorous activity – can reveal health benefits of unexplored aspects of our lives. The future potential impact of such technologies to prevent cancer and possibly a <a href="https://www.nature.com/articles/s41591-022-02100-x">host of other</a> conditions could be very large.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/210288/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783"><em>Emmanuel Stamatakis</em></a><em>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/climb-the-stairs-lug-the-shopping-chase-the-kids-incidental-vigorous-activity-linked-to-lower-cancer-risks-210288">original article</a>.</em></p>

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

<p>A family from the UK are at risk of being deported from Australia, after the immigration policy deemed them "too old" to stay. </p> <p>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.</p> <p>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. </p> <p>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). </p> <p>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. </p> <p>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. </p> <p>Permanent residency has an age limit of 45, meaning now, neither parent qualifies. </p> <p>“We don’t want to go back to the UK. We’ve made a life here,” Sheena previously told <em><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></em>. </p> <p>“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.”</p> <p>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. </p> <p>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.</p> <p>Bizarrely, after five years across the Tasman, the Tunnicliffs could become New Zealand citizens which would allow them to return to Australia to live. </p> <p>“We’d take all our skills and we’d go to New Zealand,” Sheena said. </p> <p>“It’s crazy. Australia’s lost all our skills. In five years time we could walk back into Australia.” </p> <p><em>Image credits: Facebook</em></p>

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More than a game: Crosswords and puzzles may reduce dementia risk

<p>Playing games, doing crosswords, writing letters or learning something new are all associated with reduced dementia risk in older adults, according to a large, long-term study.</p> <p>A team of Melbourne and US-based researchers study tracked 10,318 older Australians over a period of ten years (2010 to 2020), collecting detailed information on the types of leisure activities they engaged in, along with regular health checks and cognitive assessments.</p> <p>The study is <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807256" target="_blank" rel="noreferrer noopener">published</a> in <em>JAMA Network Open.</em></p> <p>Paper co-author Dr Joanne Ryan from Monash University says “the findings show that engaging in mentally stimulating activities can help preserve cognitive function and may help delay the onset of dementia.”</p> <p>“We know the importance of physical activity. We need to think about helping to keep our mind stimulated as well.”</p> <p><iframe title="Why do Women Live Longer than Men? And What About Gender Diverse People?" src="https://omny.fm/shows/huh-science-explained/why-do-women-live-longer-than-men-and-what-about-g/embed?in_playlist=podcast&amp;style=Cover" width="100%" height="180" frameborder="0"></iframe></p> <p>Adult literacy activities such as writing, using a computer or taking education classes were associated with an 11% lower risk of dementia, the study found. </p> <p>Active mental health activities such as playing games or doing puzzles were associated with a 9% lower risk.</p> <p>Creative activities like craft or woodwork and passive mental activities (reading books, watching television or listening to the radio) also reduced risks but to a lesser extent.</p> <p>Meanwhile, social activities were not associated with dementia risk. Ryan says this was a “little bit unexpected”. But she says it’s possible one of the reasons is those who volunteered to participate in the study were broadly already socially engaged. </p> <p>The median age of those participating in the study was 73.8 years. Around 2% of the cohort participating in the study developed dementia, Ryan says. </p> <p>Dementia risk varies depending on age and health status of individuals, she says.</p> <p>For instance, “we know that the risk of dementia actually increases exponentially as you get then over 80 years and over 90 years,” she says.</p> <p><em>Image credits: Getty Images </em></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/body-and-mind/more-than-a-game-crosswords-and-puzzles-may-reduce-dementia-risk/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock">Petra Stock</a>. </em></p> </div>

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Why is extreme ‘frontier travel’ booming despite the risks?

<p><em><a href="https://theconversation.com/profiles/anne-hardy-151480">Anne Hardy</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/can-seng-ooi-399312">Can Seng Ooi</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/hanne-e-f-nielsen-139245">Hanne E.F. Nielsen</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/joseph-m-cheer-104606">Joseph M. Cheer</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>The world has watched in shock as rescue crews feverishly search for the <a href="https://oceangate.com/our-subs/titan-submersible.html">Titan</a> submersible vehicle, which <a href="https://www.theguardian.com/uk-news/2023/jun/19/titanic-tourist-submarine-missing-north-atlantic">disappeared</a> while attempting to take tourists to view the wreckage of the Titanic in the North Atlantic.</p> <p>The horror of the incident raises questions as to why people engage in risky tourism activities in remote locations and whether there should be more restrictions to what adrenaline-seeking tourists can do.</p> <h2>What is frontier tourism?</h2> <p>This type of travel, known as “<a href="https://research.monash.edu/en/publications/frontier-tourism-retracing-mythic-journeys">frontier tourism</a>”, is becoming big business.</p> <p>The wider adventure tourism industry is already worth <a href="https://www.futuremarketinsights.com/reports/adventure-tourism-market">billions of dollars</a> – and is growing quickly. Frontier tourism is an exclusive and extreme form of adventure travel. The trips are very expensive, aim to overstimulate the senses and go to the outer limits of our planet – the deep oceans, high mountains, polar areas – and even space.</p> <p>Frontier tourism is not new; humans have explored remote locations for millennia. Pasifika people used the stars to navigate the oceans for migration and trade. Europeans sailed to the edges of what they believed to be a flat Earth.</p> <p>In recent years, however, frontier tourism has attracted widespread attention thanks to the common occurrence of long queues on <a href="https://theconversation.com/70-years-after-the-first-ascent-of-everest-the-impact-of-mass-mountaineering-must-be-confronted-204270">Mount Everest</a>, the trending <a href="https://www.tiktok.com/discover/Drake-Shake">TikTok phenomenon</a> of crossing the #DrakePassage in <a href="https://theconversation.com/more-than-100-000-tourists-will-head-to-antarctica-this-summer-should-we-worry-about-damage-to-the-ice-and-its-ecosystems-192843">Antarctica</a> and the rapid development of <a href="https://theconversation.com/virgin-galactics-use-of-the-overview-effect-to-promote-space-tourism-is-a-terrible-irony-206868">space tourism</a> for the wealthy.</p> <p>The rise of travel content sharing on social media and <a href="https://www.tandfonline.com/doi/abs/10.1080/10548408.2021.2006858?journalCode=wttm20">revenge travel following COVID-19</a> have contributed to the surge in its popularity.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">When you’re happily having dinner and the ocean decides to scare the shit out of you! <br />Cue debate around just how strong those windows are… <a href="https://twitter.com/hashtag/DrakePassage?src=hash&amp;ref_src=twsrc%5Etfw">#DrakePassage</a> <a href="https://twitter.com/hashtag/SouthernOcean?src=hash&amp;ref_src=twsrc%5Etfw">#SouthernOcean</a> <a href="https://twitter.com/hashtag/BigSwell?src=hash&amp;ref_src=twsrc%5Etfw">#BigSwell</a> <a href="https://t.co/OLDq5W2Wkm">pic.twitter.com/OLDq5W2Wkm</a></p> <p>— Dan Brown (@DanBrownNature) <a href="https://twitter.com/DanBrownNature/status/1598669901350293509?ref_src=twsrc%5Etfw">December 2, 2022</a></p></blockquote> <h2>Why are we so obsessed with extreme forms of tourism?</h2> <p>Risky activities release chemicals in the brain that can be addictive. Research <a href="https://doi.org/10.1177/0013916594261001">suggests</a> engaging in risky tourism activities, such as scaling a high mountain, can bring about feelings of accomplishment and euphoria. Travellers report feeling alive and experiencing a sense of transformation.</p> <p>Some are also <a href="https://doi.org/10.1080/09669582.2021.1897131">attracted</a> to the pristine, untouched and remote aspects of the locations that they visit. Furthermore, the <a href="https://www.nytimes.com/2023/06/20/movies/james-cameron-titanic.html">element of fantasy</a> associated with imagining certain places or stories, like the movie Titanic, can be alluring.</p> <p>Besides physical frontiers, there is also the <a href="https://www.cabidigitallibrary.org/doi/10.1079/9781780642093.0111">thrill people get</a> at pushing the human body to its limits and facing one’s fears. Base-jumping, skydiving, bungee jumping and polar plunges are common examples of this.</p> <p>In a slightly more mundane way, even tasting “<a href="https://journals.sagepub.com/doi/10.1177/1356766709104271">scary food</a>” pushes tourists outside of their comfort zone and helps them <a href="https://www.insider.com/harvard-psychologist-why-wealthy-seek-high-risk-trips-titanic-space-2023-6">feel alive</a>.</p> <p>Still others make extreme tourist journeys to follow in the <a href="https://www.nebraskapress.unl.edu/nebraska/9781496221216/">footsteps of their heroes</a>, such as those who travel to Antarctica to pay homage to explorer Ernest Shackleton.</p> <p>Extreme and risky activities not only make participants feel euphoric, but they also convey status. When bucket lists are ticked off and experiences shared on social media, this brings bragging rights. <a href="https://www.cambridge.org/core/journals/polar-record/article/from-awe-to-satisfaction-immediate-affective-responses-to-the-antarctic-tourism-experience/2B65FEDCEF9D7DEBB689C39C93549702">Research</a> suggests many travellers seek recognition for undertaking the first, longest or most extreme experiences possible.</p> <p>But frontier tourism is clearly not for all. It is usually only accessible to a privileged few, as the tragic circumstances of the Titan highlight. Passengers onboard the vessel reportedly paid <a href="https://www.bbc.com/news/world-us-canada-65953872">US$250,000</a> for the voyage.</p> <h2>What are the impacts of frontier tourism?</h2> <p>Beyond the unspeakable angst that friends and family must endure when things go wrong, there are many other impacts of this form of tourism.</p> <p>This type of travel can create <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003219866-11/tourist-experiences-attention-products-seng-ooi">environmental harm and negatively impact local communities</a>. For example, after decades of mass mountaineering, the environmental <a href="https://theconversation.com/70-years-after-the-first-ascent-of-everest-the-impact-of-mass-mountaineering-must-be-confronted-204270">impact</a> on Mount Everest must be addressed.</p> <p>And when mishaps do occur, the cost of search and rescue efforts can be massive and put rescue teams at great risk. The plight of frontier tourists are usually the focus of media reports, while emergency responders are often overlooked.</p> <p>Recent efforts by sherpas such as <a href="https://www.netflix.com/au/title/81464765">Nimsdai Purja</a> are trying to overcome this issue. Through the Netflix documentary, 14 Peaks, he publicises the behind-the-scene preparations and heavy lifting work done by sherpas who guide and rescue tourists up Everest and other mountains.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Climbers have been filmed crushed together in a “human traffic jam” as they battle the elements in an attempt to reach the summit of Mount Everest. Terrifying. <a href="https://t.co/pehNmJCPdP">https://t.co/pehNmJCPdP</a> <a href="https://t.co/nxVhADM0L8">pic.twitter.com/nxVhADM0L8</a></p> <p>— news.com.au (@newscomauHQ) <a href="https://twitter.com/newscomauHQ/status/1133978847387430912?ref_src=twsrc%5Etfw">May 30, 2019</a></p></blockquote> <h2>Frontier tourism is not going away</h2> <p>Despite tragedies like the Titan disappearance, tourists remain attracted to the quest for the most unique experiences in the most remote, uncharted places.</p> <p>Tourists also increasingly feel able to embark on trips once perceived as too dangerous because technology and other innovations have ostensibly made them safer and more accessible.</p> <p>In many instances that danger remains, but the commercial transaction <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1835-9310.2002.tb00213.x">strips away the perceived risks</a> involved. Marketing materials aim to sell “safe” adventures, with the risks are often listed in the fineprint. A <a href="https://www.tandfonline.com/doi/full/10.1080/11745398.2017.1286512">polar plunge</a> in Antarctica, for instance, is often marketed as safe because participants are attached to a tether and the swim time is limited to prevent hypothermia.</p> <p>Two decades ago, in forecasting the growth of space tourism, anthropologist Valene Smith <a href="https://www.tandfonline.com/doi/pdf/10.1080/02508281.2000.11014920">said</a> what tourists want, the industry will provide. This has become a truism, as the Titan voyages demonstrate.</p> <p>The massive growth of frontier tourism could lead to even greater problems if the industry doesn’t respond in the right way. If travellers are going to expose themselves to extreme risks, whose responsibility is it, then, to ensure their safety and recovery should accidents occur?</p> <p>Many tourism businesses and travel insurance companies make risks known to their guests. But regulations on disclosing risks differ between countries. These means travellers may have to evaluate the risks themselves, and this is fraught with danger if company standards are low.</p> <p>One solution is frontier tourism might be best experienced in controlled and safe environments through <a href="https://www.tandfonline.com/doi/full/10.1080/14616688.2023.2224043">digital storytelling</a> or <a href="https://www.mdpi.com/2071-1050/15/4/3348">augmented and mixed reality</a>. However, this may not be enough to satisfy the adrenaline junkies out there.</p> <p>As the Titan incident illustrates, the unpredictable nature and unintended consequences of frontier tourism are very real things. While money can allow us to travel almost anywhere, it’s worth considering whether some places should just remain untouched, sacred and off limits completely.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/208201/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/anne-hardy-151480">Anne Hardy</a>, Associate Professor, Tourism and Society, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/can-seng-ooi-399312">Can Seng Ooi</a>, Professor, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/hanne-e-f-nielsen-139245">Hanne E.F. Nielsen</a>, Senior lecturer, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/joseph-m-cheer-104606">Joseph M. Cheer</a>, Professor of Sustainable Tourism and Heritage | Co Chair - World Economic Forum Global Future Council on the Future of Sustainable Tourism, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: OceanGate</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-extreme-frontier-travel-booming-despite-the-risks-208201">original article</a>.</em></p>

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Why being married cuts your risk of skin cancer

<p>A new study has found that married couples are less likely to die of skin cancer because they spot warning signs earlier than singles.</p> <p>The study, which observed 50,000 American skin cancer patients, found that 45.7 per cent of those who were married, had stage 1 tumours – which have a 98 per cent survival rate.</p> <p>The chance of catching skin cancer early dropped 32 per cent for singles, 38 per cent for divorcees and 70 per cent for widowers.</p> <p>The researchers from the University of Pennsylvania said they were stunned by the striking difference in diagnoses.</p> <p>The researchers believe these findings should help dermatologists adjust their advice to patients based on their relationship status, suggesting screening at an earlier age for single patients and encouraging home-screen training for those in relationships.</p> <p>Victims of melanoma, the deadliest form of skin cancer, are expected to increase by seven per cent by 2035.</p> <p>For those diagnosed with stage 1 disease, the five-year survival is reportedly 98 per cent. The five-year survival drops to 62 per cent for those diagnosed with stage 3 disease</p> <p>The study, published in the<em> Journal of the American Heart Association</em>, aimed to investigate how lifestyle and relationships could impact patients’ early detection chances.</p> <p>“Spouses likely facilitate early detection of melanomas by assisting in identification of pigmented lesions that may have otherwise gone unnoticed,” said corresponding author Dr Cimarron Sharon, a dermatologist at the Hospital of the University of Pennsylvania.</p> <p>“They may also provide support and encouragement to see a physician for evaluation.</p> <p>“Thus, married patients are likely to receive a better prognosis because of earlier surgical management.”</p> <p>The study also found that married patients were more likely than single, divorced or widowed patients to have a sentinel lymph node biopsy.</p> <p>SLNB is linked to survival as the sentinel lymph node is closest to a tumour and is the first place it would spread.</p> <p>Dr Sharon said this could be “associated with the spouse's role in supporting the patient and engaging in further discussion”. A partner also reduces the difficulty in travelling to and from a hospital and finding a carer post-surgery.</p> <p>This study is the largest of its kind to find the influence of marriage on the detection of melanoma.</p> <p>Dr Sharon said, “These findings support increased consideration of spousal training for partner skin examination and perhaps more frequent screening for unmarried patients.</p> <p>“Marital status should be considered when counselling patients for melanoma procedures and when recommending screening and follow-up to optimize patient care.”</p> <p><em>Image credit: Shutterstock</em></p>

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COVID-19 infection linked to a higher risk of diabetes

<p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">A Canadian study looking at more than 600,000 people has found a higher rate of new diabetes diagnoses in those who’d been infected with </span><a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://cosmosmagazine.com/health/covid/" target="_blank" rel="noreferrer noopener">COVID-19</a><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">.</span></p> <div class="copy"> <p>The study, which is <a href="https://doi.org/10.1001/jamanetworkopen.2023.8866" target="_blank" rel="noreferrer noopener">published</a> in <em>JAMA Network Open</em>, suggests that COVID may be responsible for a 3% to 5% excess burden of diabetes at the population level.</p> <p>The Canadian researchers drew on data from the British Columbia COVID-19 Cohort: a study that collected the health records of people tested for SARS-CoV-2 in the province from January 2020 to December 2021.</p> <p>From this cohort, 125,987 people tested positive to COVID-19. The researchers matched each of these people with four unexposed people of the same age, sex, and test date.</p> <p>This gave them a sample of 629,935 people, a fifth of whom had been infected with SARS-CoV-2.</p> <p>They then went looking for incident diabetes – that is, a new diagnosis – more than 30 days after the COVID test.</p> <p>The COVID-positive group had a rate of 672.2 new diabetes diagnoses per 100,000 people, significantly higher than the control group’s rate of 508.7 new diagnoses per 100,000.</p> <p>This translates to roughly 3-5% extra diabetes cases at a population level, according to the researchers’ analysis.</p> <p>“Our overall results were consistent with several other studies finding higher risk of incident diabetes after SARS-CoV-2 infection; however, the increase in risk was lower in our analysis compared with other studies,” they write in their paper.</p> <p>They suggest a few differences in study populations for this discrepancy.</p> <p>It’s not yet clear <em>why</em> there’s a link between COVID infection and diabetes.</p> <p>In their paper, the researchers point out that SARS-CoV-2 has been shown to attack pancreatic cells which are involved with insulin production. Low-grade inflammation from COVID could also play a role. But these processes are still poorly understood.</p> <p>“Our study highlights the importance of health agencies and clinicians being aware of the potential long-term consequences of COVID-19 and monitoring people after COVID-19 infection for new-onset diabetes for timely diagnosis and treatment,” conclude the researchers.</p> </div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/covid/diabetes-covid-link/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian.</em></p> <p><em>Images: Getty</em></p> </div>

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Mediterranean diet associated with big reduction in the risk of heart disease and dementia

<p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Further scientific evidence of the benefits of a “Mediterranean diet” on health have been published this week, extolling the virtues of fruit, veggies, nuts and even a little wine.</span></p> <div class="copy"> <p>In one Australian-led <a href="https://doi.org/10.1136/%20heartjnl-2022-321930" target="_blank" rel="noreferrer noopener">review</a> researchers found women who closely followed a Mediterranean diet were associated with up to 24% lower risk of cardiovascular disease and up to 23% lower risk of death from any cause.</p> <p>This is the first study to examine the association between the Mediterranean diet, cardiovascular disease, and mortality in women specifically, and is published in the journal <em>Heart.</em></p> <p>A <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02772-3" target="_blank" rel="noreferrer noopener">UK study</a> in <em>BMC Medicine</em> has also found that men and women with a strict Mediterranean diet had up to 23% lower risk for developing dementia in comparison with those with the lowest level of adherence to the diet.</p> <p>The Mediterranean diet is rich in fruits, vegetables, legumes, nuts, seeds, wholegrains, and olive oil; moderate in fish and shellfish; low to moderate in wine; and low in red meat and processed meats, dairy products, animal fat, and processed foods.</p> <p>Cardiovascular disease is an umbrella term that includes heart, stroke, and blood vessel diseases, and was the <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/about" target="_blank" rel="noreferrer noopener">underlying cause</a> of one in four deaths in Australia in 2019.</p> <p>“The Mediterranean diet is known for its health benefits, especially for heart health, but most studies and research into diet and heart disease are done primarily in men,” says Anushriya Pant, University of Sydney PhD candidate at the Westmead Applied Research Centre (WARC) and first author of the <em>Heart</em> paper.</p> <p>The study analysed pooled data from 16 studies published between 2006 and 2021, involving over 722,000 female participants aged 18 and above who followed the Mediterranean diet and whose cardiovascular health was monitored for an average of 12.5 years.</p> <p>The researchers found that the reduced risk of cardiovascular disease and death applied to women of all ethnicities..</p> <p>“Now we have confirmed that similar benefits apply for women’s dietary guidelines, and this reflects the strength of the Mediterranean diet for good heart health,” adds Pant.</p> <p>“In medical research, there are sex disparities in how clinical trials are designed. This creates large gaps in clinical data, which can potentially impact the development of health advice. Our work is a step towards addressing this gap.”</p> <p>The researchers acknowledge some limitations to their findings. All studies analysed were observational – so could only establish an association, not causation, between the Mediterranean diet and lowered risk of cardiovascular disease and death – and relied on self-reported food frequency questionnaires. Adjustments for potentially influencing factors also varied across the studies.</p> <p>The second study into dementia is equally supportive of the diet guidelines.</p> <p>UK scientists analysed data from 60,298 individuals from the <a href="https://www.ukbiobank.ac.uk/" target="_blank" rel="noreferrer noopener">UK Biobank</a> – a large-scale biomedical database containing genetic and health information from half a million UK participants – who completed a dietary assessment.</p> <p>Participants were followed for nine years, during which there were 882 cases of dementia.</p> <p>The researchers scored individuals based on how closely their diet matched the key features of a Mediterranean one, while taking into account their genetic risk for dementia.</p> <p>The authors say the findings indicate that, even for those with a higher genetic risk for dementia, having a better diet could reduce the likelihood of developing the condition.</p> <p>“Dementia impacts the lives of millions of individuals throughout the world, and there are currently limited options for treating this condition,” says Dr Oliver Shannon, a lecturer in Human Nutrition and Ageing at Newcastle University, and first author of the study.</p> <p> “Finding ways to reduce our risk of developing dementia is, therefore, a major priority for researchers and clinicians.</p> <p> “Our study suggests that eating a more Mediterranean-like diet could be one strategy to help individuals lower their risk of dementia.”</p> <p>The authors caution that there are limitations to this study, including that their analysis is limited to individuals who self-reported their ethnic background as white, British, or Irish, as only genetic data based on European ancestry was available.</p> <p>Further research is needed in a range of populations to determine the potential benefit for all people.</p> <p>In 2022, it was estimated that there were 401,300 <a href="https://www.aihw.gov.au/reports/dementia/dementia-in-aus/contents/summary" target="_blank" rel="noreferrer noopener">Australians living with dementia</a>. With an ageing and growing population this number is predicted to more than double to 849,300 people by 2058.</p> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=239397&amp;title=Mediterranean+diet+associated+with+big+reduction+in+the+risk+of+heart+disease+and+dementia" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div id="contributors"> <p><a href="https://cosmosmagazine.com/health/mediterranean-diet-heart-dementia/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto">Imma Perfetto</a>. </p> <p><em>Image credit: Shutterstock</em></p> </div>

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Losing the natural world comes with major risks for your super fund and bank

<p>As the economist Herman Daly pithily said, the economy is a wholly owned subsidiary of the environment – not the reverse. Nature makes our lives possible through what scientists call <a href="https://theconversation.com/do-humans-really-need-other-species-185171">ecosystem services</a>. Think healthy food, clean water, feed for livestock, building materials, medicine, flood and storm control, recreation, and attractions for tourists. </p> <p>Despite this, Australian businesses and financial institutions have so far failed to track how their activities both rely on and affect nature. This means our investments and superannuation could be exposed to <a href="https://post.parliament.uk/research-briefings/post-pn-0667/">hidden financial risks</a>because of nature loss – and may also contribute to the destruction of nature. </p> <p>That’s set to change. The private sector is <a href="https://theconversation.com/taking-care-of-business-the-private-sector-is-waking-up-to-natures-value-153786">waking up</a> to nature’s value (and the risks of losing it). The world’s biodiversity rescue plan <a href="https://theconversation.com/the-historic-cop15-outcome-is-an-imperfect-game-changer-for-saving-nature-heres-why-australia-did-us-proud-196731">agreed to last year</a> could help motivate governments and businesses to clean up their investments by directing more money to protect nature and less towards <a href="https://www.theguardian.com/environment/2020/oct/28/banks-lent-1-9tn-linked-to-ecosystem-and-wildlife-destruction-in-2019-report-aoe">bankrolling extinction</a>. </p> <p>There’s one crucial plank we’re missing though – mandatory reporting of how businesses both depend on and impact nature.</p> <h2>Nature and financial health are inextricably linked</h2> <p>Fully half of the world’s total economic activity – <a href="https://www.weforum.org/press/2020/01/half-of-world-s-gdp-moderately-or-highly-dependent-on-nature-says-new-report/">around A$61 trillion</a> – is moderately or highly dependent on nature and its services. </p> <p>In Australia, that figure is very similar: <a href="https://www.acf.org.au/the-nature-based-economy-how-australias-prosperity-depends-on-nature">around half</a> of our GDP – $896 billion – has a moderate to very high direct dependence on ecosystem services provided by nature.</p> <p>What happens when we breach nature’s limits? Ecosystem services seize up or collapse, eventually disrupting these sectors. The tireless pollination work of honeybees, for instance, is <a href="https://www.wheenbeefoundation.org.au/wp-content/uploads/2020/02/Karasinski-JM-2018_The-Economic-Valuation-of-Australian-Managed-and-Wild-Honey-Bee-Pollinators-in-2014-2015.pd">valued at</a> $14 billion a year. Or take Australia’s wheatbelt, where poor soil health is <a href="https://onlinelibrary.wiley.com/doi/10.1002/ldr.3130">now costing</a> farmers almost $2 billion a year in lost income. </p> <p>Ecosystem services are not hypothetical. They have real value – and we will absolutely notice if they are gone.</p> <h2>What does this have to do with my super?</h2> <p>Australia’s super sector is responsible for the retirement savings of around <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/super-accounts-data/multiple-super-accounts-data/">12 million Australians</a>. Super funds are directly exposed to <a href="https://www.mckinsey.com/capabilities/sustainability/our-insights/sustainability-blog/nature-risk-is-the-next-challenge-that-demands-a-global-solution">financial risk</a> from nature loss through their investment portfolios. </p> <p>Just as farmers can’t grow crops without healthy soils or pollinators, developers can’t build apartments without timber or environmental permits. In turn, that has implications for their value as investments.</p> <p>And because so many sectors are exposed, classic investment strategies such as <a href="https://moneysmart.gov.au/how-to-invest/diversification">diversification</a> may no longer protect your super from losses. </p> <p>So what are our super funds and banks doing about it?</p> <p>To find out, we <a href="https://www.acf.org.au/risky-business-report">surveyed</a> ten super funds and ten retail banks about their responses to nature-related risks. The survey – commissioned by the Australian Conservation Foundation – is the first time this has been done in Australia. </p> <p>The findings? Not ideal. Every participating super fund and bank agreed the loss of nature now presented a serious risk to investment returns. They all agreed it was part of their responsibility to members and customers to measure and manage these risks. But only 20% of super funds and 10% of banks had attempted to assess how exposed they were.</p> <p>Again, this is not abstract. Super funds often have large holdings in the big four banks. Together, these banks have $170 billion in exposure to agriculture, mining, fisheries, and forestry – sectors directly reliant on a functioning natural world. </p> <p>So why isn’t it a higher priority? One issue may be that many financial institutions are currently focused on climate change, given how rapidly impacts are mounting. But climate change and the breakdown of natural systems are twin crises. Nature offers far and away the largest method of taking carbon back out of the atmosphere, for instance. But that only works if salt marshes and wetlands and forests are intact. </p> <p>Net zero targets for our banks and super funds are not fully credible unless there is a commitment to end the <a href="https://www.un.org/en/climatechange/high-level-expert-group">financing of deforestation</a>. Only one organisation, Australian Ethical, had made such a commitment.</p> <p>You would think Australia’s super funds and banks would be interested to find out how exposed their investments were to this growing risk. Tools to do this such as <a href="https://www.ibat-alliance.org/">IBAT</a> and <a href="https://encore.naturalcapital.finance/en">ENCORE</a> are readily available. </p> <p>But to date, our survey findings don’t indicate banks and funds will do this <a href="https://www.greenbiz.com/article/why-more-firms-think-mandatory-biodiversity-risk-reporting-needed">voluntarily</a>. </p> <h2>Banks and super funds may soon have to report these risks</h2> <p>The biodiversity rescue plan agreed to last year – known as the <a href="https://www.cbd.int/doc/decisions/cop-15/cop-15-dec-04-en.pdf">Kunming-Montreal agreement</a> – is intended to set expectations for responsible finance and business globally, as the Paris Agreement did for climate change. </p> <p>That means Australia will be expected to introduce disclosure requirements. If this comes to pass, banks, super funds, and the businesses they invest our savings in will have to measure and publicly report their impact on nature – as well as how much they rely on nature to make a profit.</p> <p>First, though, the Australian government must introduce mandatory nature risk reporting. It’s already moving ahead with plans to make climate risk disclosures <a href="https://treasury.gov.au/consultation/c2022-314397">mandatory</a>. </p> <p>Treasurer Jim Chalmers has indicated nature is <a href="https://ministers.treasury.gov.au/ministers/jim-chalmers-2022/speeches/address-australian-sustainable-finance-institute-sydney">also on his radar</a>.</p> <p>The question then will be whether making this information public will actually do what we hope it will and use money to help natural systems rather than extract from them.</p> <h2>What happens next?</h2> <p>Since taking office, the Labor government has pledged to take action on the perilous decline of the natural world with plans such as bringing the value of nature into our <a href="https://www.theguardian.com/australia-news/2022/dec/16/cop15-australia-us-commit-to-measuring-value-of-nature-and-reflecting-it-in-national-accounts">national accounts</a>. </p> <p>While positive, the real action won’t happen until nature risk reporting is mandatory, <a href="https://theconversation.com/complete-elation-greeted-pliberseks-big-plans-to-protect-nature-but-hurdles-litter-the-path-196287">environment laws with teeth</a> are introduced, and until both governments and private industry direct <a href="https://conbio.onlinelibrary.wiley.com/doi/pdf/10.1111/conl.12682">serious money</a> into helping nature, not harming it. Risky <a href="https://theconversation.com/the-government-hopes-private-investors-will-help-save-nature-heres-how-its-scheme-could-fail-193010">nature credit markets</a> aren’t going to cut the mustard. </p> <p>You don’t have to sit back and wait. Why not ask your super fund and bank what nature-related risks they are exposing your money to?</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/losing-the-natural-world-comes-with-major-risks-for-your-super-fund-and-bank-198669" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t

<p>The question of whether and to what extent face masks work to prevent respiratory infections such as COVID and influenza has split the scientific community for <a href="https://www.baltimoresun.com/news/bs-xpm-2007-03-06-0703060040-story.html">decades</a>.</p> <p>Although there is strong evidence face masks <a href="https://www.sciencedirect.com/science/article/pii/S0020748920301139?via%3Dihub">significantly reduce transmission of such infections</a> both in health-care settings and in the community, some experts do not agree.</p> <p>An updated <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full">Cochrane Review</a> published last week is the latest to suggest face masks don’t work in the community.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">"Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks"<a href="https://twitter.com/CochraneLibrary?ref_src=twsrc%5Etfw">@CochraneLibrary</a> Review.<br />Published: 30 January 2023 <a href="https://t.co/zODu6QEF1M">https://t.co/zODu6QEF1M</a> <a href="https://t.co/c26yHPaSCD">pic.twitter.com/c26yHPaSCD</a></p> <p>— Robin Monotti (@robinmonotti) <a href="https://twitter.com/robinmonotti/status/1620311528523304960?ref_src=twsrc%5Etfw">January 31, 2023</a></p></blockquote> <p>However there are problems with the review’s methodology and its underpinning assumptions about transmission.</p> <p>The Cochrane Review combined randomised controlled trials (RCTs) using <a href="https://ebn.bmj.com/content/16/1/3">meta-analysis</a>. RTCs test an intervention in one group and compare it with a “control” group that doesn’t receive the intervention or receives a different intervention. A meta-analysis pools the results of multiple studies.</p> <p>This approach assumes (a) RCTs are the “best” evidence and (b) combining results from multiple RCTs will give you an average “effect size”.</p> <p>But RCTs are only the undisputed gold standard for certain kinds of questions. For other questions, a mix of study designs is better. And RCTs should be combined in a meta-analysis only if they are all addressing the same research question in the same way.</p> <p>Here are some reasons why the conclusions of this Cochrane Review are misleading.</p> <h2>It didn’t consider how COVID spreads and how masks work</h2> <p>COVID, along with influenza and many other respiratory diseases, is transmitted primarily <a href="https://theconversation.com/covid-how-the-disease-moves-through-the-air-173490">through the air</a>.</p> <p>Respirators (such as N95s) are designed and regulated to prevent airborne infections by fitting <a href="https://theconversation.com/high-filtration-masks-only-work-when-they-fit-so-we-created-a-new-way-to-test-if-they-do-155987">closely to the face</a> to prevent air leakage and by filtering out 95% or more of potential infectious particles.</p> <p>In contrast, surgical masks are designed to prevent splatter of fluid on the face and are loose-fitting, causing unfiltered air to leak in through the gaps around the mask. The filtration of a surgical mask is not regulated.</p> <p>In other words, respirators are designed for respiratory protection and cloth and surgical masks are not.</p> <p>The review starts with an assumption that masks provide respiratory protection, which is flawed. An understanding of these differences should inform both studies and reviews of those studies.</p> <h2>The studies addressed quite different questions</h2> <p>A common mistake in meta-analysis is to combine apples and oranges. If apples work but oranges don’t, combining all studies in a single average figure may lead to the conclusion that apples do not work.</p> <p>This Cochrane Review combined RCTs where face masks or respirators were worn part of the time (for example, when caring for patients with known COVID or influenza: “occasional” or “targeted” use) with RCTs where they were worn at all times (“continuous use”).</p> <p>Because both SARS-CoV-2 and influenza viruses are airborne, an unmasked person could be infected anywhere in the building and even after an infectious patient has left the room, especially since some people have <a href="https://www.pnas.org/doi/10.1073/pnas.2109229118">no symptoms</a> while contagious.</p> <p>Most RCTs of masks and N95s included in the review have not had a <a href="https://jamanetwork.com/journals/jama/fullarticle/184819">control arm</a> – therefore finding no difference could indicate equal efficacy or equal inefficacy.</p> <p><a href="https://jamanetwork.com/journals/jama/fullarticle/2749214">Studies</a> examining wearing a surgical mask or respirator (such as an N95) only when in contact with sick people or when doing a high-risk procedure (occasional use) have generally shown that, when worn in this way, there is no difference.</p> <p>An RCT comparing occasional versus continuous use of respirators in health care workers <a href="https://www.atsjournals.org/doi/10.1164/rccm.201207-1164OC?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubme">showed</a> N95 respirators and surgical masks were equally ineffective when only worn occasionally by hospital workers. They had to wear them all the time at work to be protected.</p> <p>We also combined only apples and apples in a <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">meta-analysis</a> of two RCTs conducted in exactly the same way and measuring the same interventions and outcomes. We found N95 respirators provide significant protection against respiratory infections when surgical masks did not, even against infections assumed to be “droplet spread”.</p> <h2>Most trials addressed only half the question</h2> <p>Face masks and respirators work in two ways: they protect the wearer from becoming infected and they prevent an infected wearer from spreading their germs to other people.</p> <p>Most RCTs in this Cochrane Review looked only at the former scenario, not the latter. In other words, the researchers had asked people to wear masks and then tested to see if those people became infected.</p> <p>A previous <a href="https://pubmed.ncbi.nlm.nih.gov/20092668/">systematic review</a> found face masks worn by sick people during an influenza epidemic reduced the risk of them transmitting the infection to family members or other carers. Preventing an infection in one person also prevents onward transmission to others within a closed setting, which means such RCTs should use a special method called “cluster randomisation” to account for this.</p> <p>Data from a RCT of N95 respirator use by <a href="https://journals.sagepub.com/doi/full/10.1177/0300060516665491?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org">health workers</a> showed even their unmasked colleagues were protected. Yet some of the trials included in the review did not use cluster randomisation.</p> <h2>The new paper combined health and community settings</h2> <p>This is another apples-plus-oranges issue. Different settings have widely differing risks of transmission, since airborne particles build up when sick patients are exhaling the virus in <a href="https://theconversation.com/heres-where-and-how-you-are-most-likely-to-catch-covid-new-study-174473">underventilated, crowded settings</a> especially if many infected people are present (such as in a hospital).</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Here’s where (and how) you are most likely to catch COVID – new study <a href="https://t.co/Ro88Shc897">https://t.co/Ro88Shc897</a> <a href="https://t.co/TlFA9EQskF">pic.twitter.com/TlFA9EQskF</a></p> <p>— Jeffrey J Davis (@JeffreyJDavis) <a href="https://twitter.com/JeffreyJDavis/status/1484210379093954564?ref_src=twsrc%5Etfw">January 20, 2022</a></p></blockquote> <p>A genuine protective effect of masks or respirators shown in a RCT in a high-risk setting will be obscured if that trial is combined in a meta-analysis with several other RCTs that were conducted in low-risk settings.</p> <p>A large <a href="https://www.science.org/doi/10.1126/science.abi9069">RCT in the community in Bangladesh</a> found face masks reduced the risk of infection by 11% overall and 35% in people over 60 years. In contrast, in <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">hospitals</a>, N95 reduce risk by 67% against bacterial infections and 54% against viral infections.</p> <p>Viruses like influenza also vary substantially from year to year – some years there is very little influenza, and if a RCT is conducted during such a year, it will not find enough infections to show a difference. The review failed to account for such seasonal effects.</p> <h2>But did they actually wear the mask?</h2> <p>The authors of the Cochrane Review acknowledged compliance with masking advice was poor in most studies. In the real world, we can’t force people to follow medical advice, so RCTs should be analysed on an “intention to treat” basis.</p> <p>For example, people who are prescribed the active drug but who choose not to take it should not be shifted to the placebo group for the analysis. But if in a study of masking, most people don’t actually wear them, you can’t conclude that masks don’t work when the study shows no difference between the groups. You can only conclude that the mask advice didn’t work in this study.</p> <p>There is a great deal of <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246317">psychological evidence</a> on why people do or don’t choose to comply with advice to mask and how to improve uptake. The science of masking needs to separate the impact of the mask itself from the impact of the advice to mask.</p> <p>Mask-wearing <a href="https://www.ijidonline.com/article/S1201-9712(21)00274-5/fulltext">goes up</a> substantially to over 70% if there is an actual mandate in place.</p> <h2>It didn’t include other types of research</h2> <p>A comprehensive review of the evidence would also include other types of study besides RCTs. For example, a <a href="https://www.sciencedirect.com/science/article/pii/S0140673620311429">large systematic review</a> of 172 various study designs, which included 25,697 patients with SARS-CoV-2, SARS, or MERS, concluded masks were effective in preventing transmission of respiratory viruses.</p> <p>Well-designed <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm?s_cid=mm7106e1_w">real-world studies</a> during the pandemic showed any mask reduces the risk of COVID transmission by 50–80%, with the highest protection offered by N95 respirators.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/20095070/">Many lab-based studies</a> have shown respirators are superior to masks at preventing airborne respiratory infections and the <a href="https://thorax.bmj.com/content/75/11/1024.long">incremental superiority</a> from a single to two layered cloth mask to a three-layered surgical mask in blocking respiratory aerosols.</p> <h2>Yes, masks reduce the spread of COVID</h2> <p>There is strong and consistent evidence for the effectiveness of masks and (even more so) respirators in protecting against respiratory infections. Masks are an important protection against serious infections.</p> <p>Current COVID vaccines protect against death and hospitalisation, but do <a href="https://fortune.com/well/2023/01/06/kraken-xbb15-omicron-covid-variant-most-transmissible-yet-could-spawn-more-immune-evasive-variants-study-china-vaccine-monoclonal-antibodies-breakthrough-infection/">not prevent infection</a> well due to waning vaccine immunity and substantial immune escape from new variants.</p> <p>A systematic review is only as good as the rigour it employs in combining similar studies of similar interventions, with similar measurement of outcomes. When very different studies of different interventions are combined, the results are not informative.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Toxic pollutants can build up inside our homes. Here are 8 ways to reduce the risks

<p>We know everything in our homes gathers dust. What you probably don’t know is whether there are toxic contaminants in your house dust, and where these might come from. </p> <p>Our <a href="https://doi.org/10.1016/j.envres.2022.115173">newly published research</a> found most of the dust inside homes came from outside and contains potentially toxic trace metals such as lead, arsenic and chromium. </p> <p>Worryingly, we found some contaminants can accumulate at higher concentrations inside homes than outside. This happened in homes with certain characteristics: older properties, metal construction materials enriched in zinc, recent renovations and deteriorating paint. </p> <p>Fortunately, you can take some simple steps to reduce your exposure, which we explain later.</p> <h2>What’s in house dust?</h2> <p>Our study explored the connected sources, pathways and potentially harmful exposures to trace metals at homes across Sydney. We collected and analysed 383 samples from nearby road dust (51 samples) and garden soil (166), as well as indoor dust (166).</p> <p>We found the dust in homes comes from a range of sources including outdoor environments and soil, skin, cleaning products, pet hair and cooking particles.<br />Nearly 60% of dust particles inside the homes originated from their immediate outdoor environment – it was <a href="https://theconversation.com/wearing-shoes-in-the-house-is-just-plain-gross-the-verdict-from-scientists-who-study-indoor-contaminants-177542">dirt from outside</a>! Wind, your shoes or your pets can carry in <a href="https://www.sciencedirect.com/science/article/pii/S0160412021002075?via%3Dihub">soil</a> and <a href="https://pubs.acs.org/doi/10.1021/acs.est.1c04494">dust</a>-related contaminants.</p> <p>The remaining 40% of home dust came from indoor sources. These included <a href="https://theconversation.com/microplastics-are-common-in-homes-across-29-countries-new-research-shows-whos-most-at-risk-189051">fibres from clothes, carpets and furnishings</a>, cleaning products, skin and hair.</p> <p>Some dust sources can carry a cocktail of potentially harmful contaminants including:</p> <ul> <li> <p><a href="https://doi.org/10.1016/j.envpol.2021.117064">microplastics</a></p> </li> <li> <p><a href="https://doi.org/10.1016/j.envres.2014.10.009">persistent organic pollutants</a></p> </li> <li> <p><a href="https://doi.org/10.1016/j.scitotenv.2019.05.463">perfluorinated chemicals</a> (PFAS)</p> </li> <li> <p><a href="https://doi.org/10.1016/j.envpol.2021.117593">trace metals</a></p> </li> <li> <p><a href="https://doi.org/10.3389/fenvs.2021.754657">bacterial communities</a></p> </li> <li> <p><a href="https://doi.org/10.1016/j.envint.2021.106501">antimicrobial resistance genes</a>. </p> </li> </ul> <p>The nature of the risk is related to how much of the contaminant you’re exposed to and for how long. The risks are greatest in children under the age of five. This is because they are small, closer to the floor and have frequent hand-mouth contact, which increases ingestion of contaminants.</p> <h2>How do contaminants build up in homes?</h2> <p>Industrial activity has left a marked legacy of contaminants in many city neighbourhoods. We analysed road dust, garden soil and vacuum dust samples from 166 homes in Sydney to see how this risk translated to inside homes. We used high-magnification microscopy and <a href="https://www.climate-policy-watcher.org/earth-sciences/lead-isotopes-as-tools-for-source-identification.html">lead isotopic ratios</a> to understand trace metal composition in the samples. </p> <p>On average, concentrations of trace metals arsenic, chromium, copper, manganese, lead and zinc were all higher inside homes than outside. This means homes are not only “accumulators” of trace metal contaminants but also important sources of a significant proportion of harmful contaminants that we can be exposed to. </p> <p>The lead isotopic ratios, or the lead “fingerprints”, of each home and its garden soil matched. This confirms the soil is the main source of lead inside homes. </p> <p>Most of this lead is the result of the pre-1970s use of high concentrations of lead in <a href="https://www.dcceew.gov.au/environment/protection/chemicals-management/lead/lead-in-house-paint">paints</a> and <a href="http://dx.doi.org/10.1016/j.apgeochem.2017.02.007">petrol</a>, which contaminated many garden soils. Even <a href="https://theconversation.com/why-lead-is-dangerous-and-the-damage-it-does-116506">low levels of lead exposure</a> can be harmful. Lead levels in some <a href="https://theconversation.com/elevated-lead-levels-in-sydney-back-yards-heres-what-you-can-do-68499">Sydney backyards</a> pose a risk for <a href="https://doi.org/10.1016/j.dib.2021.107151">urban veggie growers</a> and <a href="https://theconversation.com/backyard-hens-eggs-contain-40-times-more-lead-on-averagethan-shop-eggs-research-finds-187442">backyard chickens and their eggs</a>.</p> <p>High-magnification images of house dust showed mineral particles that have been blown in or tracked in on shoes. The rest of the dust was elongated fibres and hair from indoor sources.</p> <h2>Which homes are most at risk?</h2> <p>We also collected information about each house, relevant activities and renovations at the property. We found house age, proximity to the city centre and renovations had the greatest influence on levels of lead and other trace metals in the home. </p> <p>All homes more than 50 years old had higher concentrations of arsenic, copper, lead and zinc in their garden soil and house dust. They are typically <a href="https://iupui-earth-science.shinyapps.io/MME_Sydney/">located closer to city centres</a>, where early industrial activity has contaminated soils. </p> <p>As older homes in former industrial areas are renovated, trace metal loads in these homes and gardens can increase. Walls and ceilings contain decades of dust. Old paint buried under more recent layers can also be released, causing <a href="https://www.abc.net.au/radionational/programs/backgroundbriefing/3983094">lead exposure risks</a>. </p> <p>It is critical that home renovators take appropriate remediation steps or <a href="https://painters.edu.au/Training-Courses/CPCCPD3031-Work-safely-with-lead-painted-surfaces-in-the-painting-industry.htm">employ a qualified paint professional</a> so lead dust isn’t spread across the area.</p> <h2>8 ways to reduce your risk</h2> <p>We spend about <a href="https://escholarship.org/uc/item/1zg3q68x#main">70% of our time at home</a>, which the pandemic has increased. Understanding the environmental <a href="https://www.cdc.gov/niosh/topics/exposome/default.html">conditions and contaminants we encounter</a>and their effects on our health is more important than ever. </p> <p>Armed with this knowledge, though, you can take some simple steps to reduce your exposure to contaminants in your home and garden:</p> <ol> <li> <p>regularly vacuum carpeted areas with a good vacuum cleaner fitted with a <a href="https://www2.education.vic.gov.au/pal/ventilation-air-purification/print-all">HEPA filter</a></p> </li> <li> <p>wet mop and wet dust hard surfaces</p> </li> <li> <p>mulch areas of exposed soil in your garden</p> </li> <li> <p>use a quality doormat and wash it regularly, which can roughly <a href="https://nrl.northumbria.ac.uk/id/eprint/51148/1/Manuscript_File_Global_Pb_Modeling_Final_clean_1%20%281%29.pdf">halve the amount of lead</a> in your home within three months</p> </li> <li> <p>leave your shoes at the door as they can <a href="https://theconversation.com/wearing-shoes-in-the-house-is-just-plain-gross-the-verdict-from-scientists-who-study-indoor-contaminants-177542">bring all sorts of nasties into the home</a></p> </li> <li> <p>wash your hands and your veggies thoroughly </p> </li> <li> <p>close windows on windy days</p> </li> <li> <p>when renovating, use dust-mitigation strategies and personal protective equipment (PPE).</p> </li> </ol> <p>You can dig a little deeper into what’s in your own home environment by sending your soil to <a href="https://www.360dustanalysis.com/">VegeSafe Australia</a> or <a href="https://www.epa.vic.gov.au/for-community/get-involved/citizen-science-program/gardensafe">EPA Victoria’s GardenSafe</a> for analysis. If you live in the United States, Canada, United Kingdom or Australia you can also send your vacuum dust to <a href="https://www.360dustanalysis.com/">DustSafe</a> for testing. You will receive a report outlining what was in your sample, with links and advice on what to do next where necessary.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/toxic-pollutants-can-build-up-inside-our-homes-here-are-8-ways-to-reduce-the-risks-197908" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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