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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ivan-savin-678930">Ivan Savin</a>, <a href="https://theconversation.com/institutions/escp-business-school-813">ESCP Business School</a> After a long battle, <a href="https://www.france24.com/en/europe/20240213-paris-booksellers-stay-olympics-macron-bouquiniste-france">Paris’s beloved bouquinistes will be staying put</a> this summer. The decision, announced on 13 February by the French government, came after considerable public backlash to the police prefecture’s original plan to move part of the iconic Seine booksellers elsewhere for the inauguration of the Olympics Games on 26 July. Meanwhile, less than six months away from the event, Parisians continue to grumble over a <a href="https://www.ouest-france.fr/jeux-olympiques/cest-aberrant-ce-maire-vient-dapprendre-que-sa-ville-accueillera-les-jeux-de-paris-ab1fa968-cfd1-11ee-89c0-6cefac77e04a">lack of consultations</a> with locals, warnings of <a href="https://www.rfi.fr/en/france/20231130-paris-vehicle-traffic-to-be-heavily-restricted-during-2024-olympic-games">gridlocked traffic</a>, closed metro stations, extensive video surveillance and other grievances. So for host countries, what was the point of the Olympics, again? In academia, the debate about the potential positive and negative effects of large-scale sporting events is ongoing. Although these events are often associated with substantial economic losses, the long-term benefits are the main argument in favour of hosting them. These include the development of material and soft infrastructure such as hotels, restaurants or parks. Big games can also help put the host region on the map as an attractive place for sports and cultural events, and inspire a better entrepreneurial climate. <h2>The pros and the cons of big sporting events?</h2> The cost of these benefits, as the Parisians have realised, is steep. Host countries appear to suffer from increased tax burdens, low returns on public investments, high construction costs, and onerous running cost of facilities after the event. Communities can also be blighted by noise, pollution, and damage to the environment, while increased criminal activity and potential conflicts between locals and visitors can take a toll on their quality of life. As a result, in the recent past several major cities, including Rome and Hamburg, <a href="https://www.dw.com/en/6-cities-that-rejected-the-olympics/a-46289852">withdrew their bids to host the games</a>. A common feature of the economics of large-scale sporting events is that our expectations of them are more optimistic than what we make of them once they have taken place. Typically, expenditure tends to tip over the original budget, while the revenue-side indicators (such as the number of visitors) are rarely achieved. When analysing the effect of hosting large-scale sporting events on tourist visits, it is important to take into consideration both the positive and negative components of the overall effect. While positive effects may be associated with visitors, negative effects may arise when “regular” tourists refuse to visit the location due to the event. This might be because of overloaded infrastructure, sharp increases in accommodation costs, and inconveniences associated with overcrowding or raucous or/and violent visitors. On top of that, reports of poverty or crime in the global media can actually undermine the location’s attractiveness. <h2>When big sporting events crowd out regular tourists</h2> In an <a href="https://doi.org/10.1177/1527002523120639">article published in the Journal of Sports Economics</a> with Igor Drapkin and Ilya Zverev, I assess the effects of hosting large-scale sporting events, such as Winter and Summer Olympics plus FIFA World Cups, on international tourist visits. We utilise a comprehensive dataset on flow of tourists covering the world’s largest destination and origin countries between 1995 and 2019. As a first step, we built an econometric model that effectively predicts the flow of tourists between any pair of countries in our data. Subsequently we compared the predicted tourist inflow in a hypothetical scenario where no large-scale sporting event would have taken place with the actual figures. If the actual figures exceed the predicted ones, we consider the event to have a net positive impact. Otherwise, we consider that it had a “crowding out” effect on “regular” tourists. While conducting this analysis, we distinguished between short-term (i.e., focusing just on the year of the event) and mid-term (year of the event plus three subsequent years). Our results show that the effects of large-scale sporting events vary a lot across host countries: The World Cup in Japan and South Korea 2002 and South Africa 2010 were associated with a distinct increase in tourist arrivals, whereas all other World Cups were either neutral or negative. Among the Summer Olympics, China in 2008 is the only case with a significant positive effect on tourist inflows. The effects of the other four events (Australia 2000, Greece 2004, Great Britain 2012, and Brazil 2016) were found to be negative in the short- and medium-term. As for the Winter Olympics, the only positive case is Russia in 2014. The remaining five events had a negative impact except the one-year neutral effect for Japan 1998. Following large-scale sporting events, host countries are therefore typically less visited by tourists. Out of the 18 hosting countries studied, 11 saw tourist numbers decline over four years, and three did not experience a significant change. <h2>The case for cautious optimism</h2> Our research indicates that the positive effect of hosting large-scale sporting events on tourist inflows is, at best, moderate. While many tourists are attracted by FIFA World Cups and Olympic games, the crowding-out effect of “regular” tourists is strong and often underestimated. This implies that tourists visiting for an event like the Olympics typically dissuade those who would have come for other reasons. Thus, efforts to attract new visitors should be accompanied by efforts to retain the already existing ones. Large-scale sporting events should be considered as part of a long-term policy for promoting a territory to tourists rather than a standalone solution. Revealingly, our results indicate that it is easier to get a net increase in tourist inflows in countries that are less frequent destinations for tourists – for example, those in Asia or Africa. By contrast, the United States and Europe, both of which are traditionally popular with tourists, have no single case of a net positive effect. Put differently, the large-scale sporting events in Asia and Africa helped promote their host countries as tourist destinations, making the case for the initial investment. In the US and Europe, however, those in the last few decades brought little return, at least in terms of tourist inflow.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222118/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ivan-savin-678930">Ivan Savin</a>, Associate professor of quantitative analytics, research fellow at ICTA-UAB, <a href="https://theconversation.com/institutions/escp-business-school-813">ESCP Business School</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-hosting-the-olympics-the-world-cup-or-other-major-sports-events-really-pay-off-222118">original article</a>. </div>

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If you squat in a vacant property, does the law give you the house for free? Well, sort of

<a href="https://theconversation.com/profiles/cathy-sherry-466">Cathy Sherry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Nothing excites law students like the idea of a free house. Or alternatively, enrages them. It depends on their politics. As a result, academics condemned to teaching property law find it hard to resist the “<a href="https://classic.austlii.edu.au/au/journals/MelbULawRw/2011/28.html">doctrine of adverse possession</a>”. The fact that a person can change the locks on someone else’s house, wait 12 years, and claim it as their own, makes students light up in a way that the Strata Schemes Management Act never will. The idea of “squatters’ rights” has received a lot of media attention recently amid the grim reality of the Australian housing market. It fuels commentators such as Jordan van den Berg, who <a href="https://www.instagram.com/purplepingers/">critiques bad landlords</a> on social media. Casting back to his days as a law student, <a href="https://www.sbs.com.au/news/the-feed/article/jordan-was-fed-up-with-australias-empty-houses-his-proposal-has-led-to-death-threats/stx6rv6fl">he’s promoting</a> the doctrine of adverse possession as a way of making use of vacant properties. As interesting as the doctrine is, it has little relevance in modern Australia. While it is necessary to limit the time someone has to bring legal proceedings to recover land – typically 12 or 15 years, depending on which state you’re in – most people don’t need that long to notice someone else is living in their house. If a family member is occupying a home that someone else has inherited or a tenant refuses to vacate at the end of a lease, owners tend to bring actions to recover their land pronto. So where did this doctrine come from, and what has it meant in practice? <h2>Free house fetching millions</h2> In unusual circumstances, people can lose track of their own land. Just before the second world war, Henry Downie moved out of his house in the Sydney suburb of Ashbury. Downie died a decade later, but his will was never administered. At the time of his death, a Mrs Grimes rented the house and did so for a further 50 years. Downie’s next of kin did not realise they had inherited the house or that they were Grimes’s landlord. Grimes died in 1998 and Bill Gertos, a property developer, saw the house was vacant. He changed the locks, did some repairs, then leased the house and paid the rates for the next 17 years. He then made an application under <a href="https://classic.austlii.edu.au/au/legis/nsw/consol_act/rpa1900178/s45d.html">NSW property laws</a> to become the registered proprietor. At this point, Downie’s next of kin became aware they may have been entitled to the property and disputed Gertos’s claim. The <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/cases/nsw/NSWSC/2018/1629.html">court held</a> Gertos had been “in possession” of the property since the late 1990s. The next of kin had a legal right to eject him, but they had failed to do so within the statutory time limit of 12 years. Gertos had the best claim to the house. He <a href="https://www.domain.com.au/6-malleny-street-ashbury-nsw-2193-2015821514">promptly sold it</a> for A$1.4 million. Outrageous as this may seem, the law encourages caring for land. If you fail to take responsibility for your land, and someone else does, you can lose it. <h2>An old English tradition</h2> Gertos’s jackpot was unusual, and adverse possession has always been more relevant in a country like England. First, for much of English history, many people did not have documentary title (deeds) to their land. People were illiterate, parchment was expensive, and documents could disappear in a puff of smoke in a house fire. The law often had to rely on people’s physical possession of land as proof of ownership. Second, as a result of feudalism, vast swathes of England were owned by the aristocracy. They and their 20th-century successors in title, often local councils, had a habit of forgetting they owned five suburbs in London. In the post second world war housing crisis, thousands of families, and later young people and students, <a href="https://www.bbc.co.uk/sounds/play/b017cfv4">squatted in vacant houses</a> owned by public and private landlords who lacked the means or motivation to maintain them. <h2>A sign of the times</h2> In contrast, in Australia, for most of our settler history, governments of all political persuasions actively prevented the emergence of a landed class. But now, courtesy of tax policies that <a href="https://www.quarterlyessay.com.au/essay/2023/11/the-great-divide">encourage investment</a> in residential real estate, we have a landlord class of Baby Boomer and Gen X investors. That has caused housing market stress as younger people cannot make the natural transition from being renters to homeowners. They are outbid by older, wealthier buyers whose tax benefits from negative gearing increase with every dollar they borrow to buy an investment property. Money flowing into the market then means that landlords’ greatest benefit is capital gain rather than income, and thanks to John Howard, investors pay <a href="https://theconversation.com/stranger-than-fiction-who-labors-capital-gains-tax-changes-will-really-hurt-109657">no tax</a> on half of that gain. Finally, an almost exclusive reliance by government on the <a href="https://australiainstitute.org.au/post/for-more-affordable-housing-we-need-more-public-housing/">private sector</a> to provide new homes – which it will only do if it is making a profit – has left many people in deep housing stress. While squatters in Australia are likely to find themselves swiftly subject to court orders for ejection, van den Berg’s rallying cry indicates just how inequitable the housing market has become. Baby Boomers and Gen X should be on notice – young people want their housing back. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227556/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cathy-sherry-466">Cathy Sherry</a>, Professor in Law, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-you-squat-in-a-vacant-property-does-the-law-give-you-the-house-for-free-well-sort-of-227556">original article</a>.

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Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

<a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.” “My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video. No further details have been released about the Princess of Wales’ treatment. But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment. <h2>It’s not the same as preventing cancer</h2> To <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">prevent cancer developing</a>, lifestyle changes such as diet, exercise and sun protection are <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">recommended</a>. Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at <a href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353">high risk of breast cancer</a>. Aspirin <a href="https://www.cancer.gov/about-cancer/causes-prevention/research/aspirin-cancer-risk">can also be used</a> for those at high risk of bowel and other cancers. <h2>How can chemotherapy be used as preventive therapy?</h2> In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning. If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer. If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate <a href="https://www.healthline.com/health/cancer/metastatic-cancer">around the body</a> . The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer <a href="https://www.verywellhealth.com/adjuvant-therapy-5198903">coming back</a>. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later. With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back. If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer. <h2>How effective is preventive therapy?</h2> The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy. Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564362/">first chemotherapy tested</a> improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%. Preventive chemotherapy is usually given for three to six months. <h2>How does chemotherapy work?</h2> Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations. Chemotherapy is not selective for cancer cells. It kills any dividing cells. But cancers consist of a higher proportion of dividing cells than the normal body cells. A <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment/chemotherapy/how-does-chemotherapy-work#:%7E:text=Chemotherapy%20works%20by%20killing%20cells%20that%20are%20rapidly,cells%20can%20repair%20the%20damage%20and%20can%20recover.">greater proportion of the cancer is killed</a> with each course of chemotherapy. Normal cells can recover between courses, which are usually given three to four weeks apart. <h2>What are the side effects?</h2> The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells. The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection. Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance. Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet. There are also generalised symptoms such as <a href="https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html">fatigue</a>. Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.<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/226461/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/kate-middleton-is-having-preventive-chemotherapy-for-cancer-what-does-this-mean-226461">original article</a>.

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Does intermittent fasting have benefits for our brain?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Intermittent fasting has become a popular dietary approach to help people lose or manage their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8683964/">weight</a>. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and <a href="https://pubmed.ncbi.nlm.nih.gov/27810402">improve overall health</a>. Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like <a href="https://link.springer.com/article/10.1007/s11011-023-01288-2">Alzheimer’s disease</a>. This is not a new idea – the ancient Greeks believed fasting <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839325/">enhanced thinking</a>. But what does the modern-day evidence say? <h2>First, what is intermittent fasting?</h2> Our <a href="https://pubmed.ncbi.nlm.nih.gov/35487190/">diets</a> – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains. Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast. Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods. <h2>4 ways fasting works and how it might affect the brain</h2> The brain accounts for about <a href="https://theconversation.com/how-much-energy-do-we-expend-thinking-and-using-our-brain-197990">20% of the body’s energy consumption</a>. Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain. 1. Ketosis The goal of many intermittent fasting routines is to flip a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">metabolic switch</a>” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. <a href="https://www.ncbi.nlm.nih.gov/books/NBK493179/">Ketones</a> – chemicals produced by this metabolic process – become the preferred energy source for the brain. Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844723/">cause symptoms</a> of hunger, fatigue, nausea, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754590/">low mood</a>, irritability, constipation, headaches, and brain “fog”. At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to <a href="https://www.science.org/doi/10.1126/science.aau2095">preserve brain function</a> and prevent <a href="https://pubmed.ncbi.nlm.nih.gov/32709961/">age-related neurodegeneration disorders and cognitive decline</a>. Consistent with this, increasing ketones through <a href="https://pubmed.ncbi.nlm.nih.gov/31027873/">supplementation</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/31757576/">diet</a> has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively. 2. Circadian syncing Eating at times that <a href="https://pubmed.ncbi.nlm.nih.gov/32480126/">don’t match our body’s natural daily rhythms</a> can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to <a href="https://pubmed.ncbi.nlm.nih.gov/22010477/">chronic disease</a>. Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in <a href="https://pubmed.ncbi.nlm.nih.gov/36599299/">expression of genes in tissue</a> and helps the body during rest and activity. A 2021 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827225/">study of 883 adults</a> in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions. 3. Mitochondria Intermittent fasting may provide <a href="https://pubmed.ncbi.nlm.nih.gov/35218914/">brain protection</a> through improving mitochondrial function, metabolism and reducing oxidants. Mitochondria’s <a href="https://www.genome.gov/genetics-glossary/Mitochondria">main role is to produce energy</a> and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to <a href="https://www.nature.com/articles/s41574-021-00626-7">mitochondrial dysfunction during ageing</a>. Rodent studies suggest alternate day fasting or reducing calories <a href="https://journals.sagepub.com/doi/10.1038/jcbfm.2014.114">by up to 40%</a> might protect or improve <a href="http://www.ncbi.nlm.nih.gov/pubmed/21861096">brain mitochondrial function</a>. But not all studies support this theory. 4. The gut-brain axis The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/">gut and the brain communicate with each other</a> via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health. In mice, intermittent fasting has shown promise for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">improving brain health</a> by increasing survival and <a href="https://pubmed.ncbi.nlm.nih.gov/12354284/">formation of neurons</a> (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion. There’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470960/">no clear evidence</a> on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646955/">lower meal frequency</a> (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging. Some research has suggested calorie restriction may have a protective effect against <a href="https://academic.oup.com/nutritionreviews/article/81/9/1225/7116310">Alzheimer’s disease</a> by reducing oxidative stress and inflammation and promoting vascular health. When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed <a href="https://pubmed.ncbi.nlm.nih.gov/26713821/">cognitive improvement</a> when participants followed a calorie restricted diet for 12 months. Another study found a 25% calorie restriction was associated with <a href="https://pubmed.ncbi.nlm.nih.gov/30968820">slightly improved working memory</a> in healthy adults. But a <a href="https://www.sciencedirect.com/science/article/pii/S0022316623025221?via%3Dihub">recent study</a>, which looked at the impact of calorie restriction on spatial working memory, found no significant effect. <h2>Bottom line</h2> Studies in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740746/">mice</a> support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed. Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749464/">older adults</a> whose nutritional needs may be higher. Further, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/">prolonged fasting</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9042193/">severe calorie restriction</a> may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions. If you’re considering <a href="https://www.nejm.org/doi/10.1056/NEJMra1905136?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">intermittent fasting</a>, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.<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/223181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-intermittent-fasting-have-benefits-for-our-brain-223181">original article</a>. Image: Getty

Body

Does British tourism really need the royal family?

<a href="https://theconversation.com/profiles/ross-bennett-cook-1301368">Ross Bennett-Cook</a>, <a href="https://theconversation.com/institutions/university-of-westminster-916">University of Westminster</a> Love them or loathe them, the royal family are up there with red telephone boxes and scones when it comes to images of Britishness. Souvenir shops are full of their faces, newspapers across the world discuss them, and <a href="https://www.euronews.com/culture/2022/09/13/netflixs-the-crown-skyrockets-in-popularity-following-the-queens-death">television dramas</a> based on their lives have never been more popular. Whenever people are critical of the royal family, the oft-repeated retort is “but think of the tourism!”. This has been particularly common rhetoric recently, as <a href="https://www.independent.co.uk/life-style/royal-family/who-paid-for-coronation-b2334669.html">many people question</a> how a country facing mass strikes and a crippling cost of living crisis can afford the estimated <a href="https://www.lbc.co.uk/news/explained/how-much-king-charles-iii-coronation-cost-who-pays-for-it/">£100 million</a> cost of King Charles III’s coronation. In a recent <a href="https://yougov.co.uk/topics/arts/survey-results/daily/2023/04/18/25178/3">YouGov poll</a>, 51% did not believe the coronation should be paid for by taxpayers. For young people, this figure was even higher, at 62%. But supporters will often use <a href="https://www.independent.co.uk/news/charles-iii-ap-coronation-buckingham-palace-elizabeth-ii-b2326220.html">tourism</a> as justification for lavish expenses. The royal family does bring tourism to the UK. The economic consultancy Centre for Economics and Business Research <a href="https://cebr.com/reports/uk-economy-raises-a-glass-to-337-million-coronation-boost-from-tourism-and-pub-activity/">estimated</a> that the coronation weekend would lead to a £337 million boost from tourism and pub spending. But if the royal family were to disappear, would the UK’s tourism industry suddenly implode? 2011 research by <a href="https://webarchive.nationalarchives.gov.uk/ukgwa/20140722183820/http://www.visitbritain.org/mediaroom/archive/2011/vbrwwedding.aspx">Visit Britain</a> found that around 60% of tourists to the UK are likely to visit places associated with the royal family. While there is no more recent specifically royal data, in 2022 Visit Britain found that history and heritage was the biggest <a href="https://www.visitbritain.org/MIDAS-research-project">pull factor to tourists</a>. And while the <a href="https://journals.sagepub.com/doi/10.1177/1468797606071477">international perception</a> of Britain is certainly intertwined with the royal family, this does not tell us whether a reigning royal family is necessary for tourism. After all, the history surrounding the monarchy and places associated with them would still be here even if the royal family was not. Ottoman palaces of Istanbul remain <a href="https://edition.cnn.com/travel/article/most-visited-castles-palaces/index.html">wildly popular</a> attractions 100 years since the collapse of the caliphate, as are the royal châteaus of France or imperial palaces of China. Lack of royalty does not seem to have affected these countries’ appeal, each of which attract <a href="https://www.e-unwto.org/doi/epdf/10.18111/wtobarometereng.2020.18.1.7">more tourists</a> annually than the UK. <h2>A special relationship</h2> The USA is the UK’s <a href="https://www.visitbritain.org/inbound-tourism-trends-old">largest tourist market</a>, and <a href="https://www.telegraph.co.uk/royal-family/2023/05/05/coronation-american-tourists-britain-boom-royal-family-usa/">American tourists</a> do seem to be very fond of things associated with British royalty. But this may change with the new monarch. In a <a href="https://today.yougov.com/topics/entertainment/articles-reports/2021/02/17/british-royals-popular-america-poll">poll taken in February 2021</a>, before the death of Queen Elizabeth II, a whopping 68% of Americans viewed her favourably. The same poll found only 34% had a favourable opinion of Charles – but this has changed in his favour following his accession to the throne, according to a <a href="https://today.yougov.com/topics/international/articles-reports/2023/05/05/americans-think-british-royal-family-charles">poll taken before the coronation</a> which gave him a 50% approval rating in the US. That said, 62% of people in the US said they did not care about the coronation very much or at all. Outside America, the UK’s next largest tourist groups have significantly less interest in the royal family. The holiday firm <a href="https://www.traveldailymedia.com/study-reveals-importance-of-royal-family-to-uk-tourism-industry/">Travelzoo</a> found in 2016 that just 19% of German, 15% of French and only 10% of Spanish travellers want to come to the UK because of the British monarchy. <h2>Where do tourists go?</h2> Typically, when commentators discuss the royal contributions to tourism, they talk about significant events such as weddings, jubilees, coronations and funerals. Even though these events attract huge crowds, they happen rarely and are unrepresentative of the tourism industry as a whole. Research <a href="https://journals.sagepub.com/doi/10.1177/13548166211004361">has found</a> that royal weddings massively improve a country’s image and brand awareness, but are not comparable to major mega events such as the Fifa World Cup, the Super Bowl or the Olympics. Even though royal places are popular, they are far from our most popular attractions. Of Britain’s <a href="https://www.visitbritain.org/annual-survey-visits-visitor-attractions-latest-results">ten most visited</a> free and paid-for attractions in 2021, none were royal attractions. The <a href="https://www.visitbritain.org/sites/default/files/vb-corporate/top_20_listings.pdf">highest ranking</a> royal attraction was the Tower of London, making only 17th on the list. Typically, Chester Zoo attracts more visitors than Windsor Castle or Buckingham Palace, although these statistics do not differentiate between domestic and international tourists. In the most recent <a href="https://www.windsor.gov.uk/dbimgs/Windsor%202017%20Visitor%20Survey%20final%20report%2028_11_17.pdf">Windsor visitor survey</a>, the majority of its tourists came from overseas. Anti-monarchy group <a href="https://www.republic.org.uk/tourism">Republic</a> has disputed the widely cited figure that the monarchy generates £500 million in tourism income for the UK annually – which itself would be only a small fraction of Britain’s £127 billion tourism economy. The group also questions why royalty <a href="https://www.youtube.com/watch?v=9hL9yDOK48A">barely feature</a> on British tourism campaigns or advertisements, if they are so vital to the tourism economy. It is impossible to deny that royalty adds to the UK’s appeal as a tourist destination – the history and associated heritage is famous worldwide. However, what is questionable is whether a reigning monarchy is necessary for this attractiveness to continue.<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/205158/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ross-bennett-cook-1301368">Ross Bennett-Cook</a>, Visiting Lecturer, School of Architecture + Cities, <a href="https://theconversation.com/institutions/university-of-westminster-916">University of Westminster</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-british-tourism-really-need-the-royal-family-205158">original article</a>.

International Travel

How long does menopause last? 5 tips for navigating uncertain times

<a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Around half of the world’s population are women or people who menstruate – yet the way their body works can be a mystery, even to them. Most women will experience periods roughly every month, many will go through childbirth and those who live into midlife will experience menopause. While menopause is a significant time of change, it isn’t talked about much, other than as a punchline. This may contribute to keeping it a <a href="https://www.theguardian.com/membership/2019/sep/21/breaking-the-menopause-taboo-there-are-vital-stories-we-should-continue-to-pursue">taboo topic</a>. So, what happens during menopause? How do you know when it is happening to you? And – the thing most women want to know – how long will it last? <h2>What is menopause?</h2> Menopause is <a href="https://www.nia.nih.gov/health/what-menopause">defined</a> as the permanent cessation of menstruation, which is medically determined to be one year after the final menstrual period. After this time women are considered to be postmenopausal. The <a href="https://pubmed.ncbi.nlm.nih.gov/26598775/">average age</a> of “natural menopause” (that is not caused by a medical condition, treatment or surgery) is considered to be around 51 years. However, natural menopause does not occur suddenly. <a href="https://www.researchgate.net/profile/Riitta-Luoto/publication/46425690_Prevalence_of_menopause_symptoms_and_their_association_with_lifestyle_among_Finnish_middle-aged_women/links/5c5704ac458515a4c7553c7b/Prevalence-of-menopause-symptoms-and-their-association-with-lifestyle-among-Finnish-middle-aged-women.pdf">Changes can begin</a> a number of years before periods stop and most often occur in a woman’s 40s but they can be earlier. Changes <a href="https://pubmed.ncbi.nlm.nih.gov/25686030/">can continue</a> for 10 years or more after periods have stopped. Using hormones such as the oral contraceptive pill or hormone intrauterine devices may make it more <a href="https://pubmed.ncbi.nlm.nih.gov/31934948/">difficult to determine</a> when changes start. Menopause that occurs <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">before 45</a> is called “early menopause”, while menopause before 40 is called “premature menopause”. <h2>What about perimenopause?</h2> Various <a href="https://www.menopause.org.au/hp/information-sheets/glossary-of-terms">terms</a> are used to describe this period of change, including “menopause” or “the menopause”, “menopausal transition”, “perimenopause” or “<a href="https://pubmed.ncbi.nlm.nih.gov/12188398/">climacteric</a>”. These terms tend to refer to the period before and after the final menstrual period, when changes are considered to be related to menopause. The difficulty with the definition of menopause is it can only be decided retrospectively. Yet women can experience changes many years before their periods stop (a lead up usually called “perimenopause”). Also, any <a href="https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0889854518300627/first-page-pdf">changes noticed</a> may not be associated with menopause (because people might not be aware of what to expect) or changes may be associated with a combination of factors such as stress, being busy or other health issues. <h2>So, what is going on?</h2> Through a feminist lens, menopause can be seen as a <a href="https://www.researchgate.net/publication/354652248_The_volcano_within_a_study_of_women's_lived_experience_of_the_journey_through_natural_menopause">complex and diverse experience</a>, influenced by biological, psychological, social and cultural aspects of women’s lives. However, it is usually viewed from the biomedical perspective. This sees it as a biological event, marked by the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">decline</a> in ovarian hormone levels leading to a reduction in reproductive function. The female reproductive system operates because of a finely tuned balance of hormones managed by the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466056/#:%7E:text=The%20hypothalamic%2Dpituitary%2Dovarian%20(HPO)%20axis%20must%20be,priming%20the%20endometrium%20for%20implantation.">hypothalamic-pituitary-ovarian axis</a>. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/">experts</a> have developed a staging system for female reproductive ageing, with seven stages from “early reproductive” years to “late postmenopause”. However, female reproductive hormones do not just affect the reproductive system but <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">other aspects</a> of the body’s function. These include the <a href="https://pubmed.ncbi.nlm.nih.gov/26007613/">neurological system</a>, which is linked to hot flushes and night sweats and disrupted sleep. Hormones may also affect the <a href="https://www.nature.com/articles/nrdp20154">heart and body’s blood circulation</a>, bone health and potentially the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">immune system</a>. Menopausal hormone changes may <a href="https://www.thewomens.org.au/health-information/menopause-information/menopause-symptoms/">cause</a> hot flushes, night/cold sweats, mood swings, sleep disruption and tiredness, vaginal dryness. Medical confirmation of menopausal changes in women over 45 years is based on two biological indicators: vasomotor symptoms (those hot flushes and night sweats again) and an <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">irregular menstrual cycle</a>. In early perimenopause the changes to the menstrual cycle may be subtle. Women may not recognise early indicators, unless they keep a record and know what to watch for. <h2>How long does it last?</h2> The body demonstrates an amazing ability to change over a lifetime. In a similar way to adolescence where long-lasting changes occur, the outcome of menopause is also change. Research suggests it is difficult to give an exact time frame for how long menopausal changes occur – the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">average</a> is between four and eight years. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">Penn Ovarian Ageing Study</a> found 79% of the 259 participants experienced hot flushes starting before the age of 50, most commonly between 45 and 49 years of age. A later report on the same study found one third of women studied experienced <a href="https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-016-0014-2">moderate to severe hot flushes</a> more than ten years after their periods had stopped. A <a href="https://journals.lww.com/menopausejournal/Abstract/2017/03000/Cultural_issues_in_menopause__an_exploratory.11.aspx">2017 study</a> found a small number of women continued to experience hot flushes and other symptoms into their 70s. So overall, the research cannot offer a specific window for perimenopause, and menopause does not appear to mark the end of changes for everyone. <h2>5 tips for uncertain times</h2> Shifts and changes can be recognised early by developing knowledge, paying attention to changes to our bodies and talking about menopause and perimenopause more openly. Here are five tips for moving from uncertainty to certainty: 1. talk to people and find out as much information as you can. The experiences of mothers and sisters may help, for some women there are familial similarities 2. notice any changes to your body and make a note of them, this will help you recognise changes earlier. There are <a href="https://www.redonline.co.uk/wellbeing/a36980118/menopause-apps/">menopause tracking apps</a> available 3. keep a note of your menstrual cycle: start date, duration, flow and note any changes. Again, an app might help 4. if you are worried, seek advice from a GP or nurse that specialises in women’s health. They may suggest ways to help with symptoms or refer to a specialist 5. remember changes are the indicator to pay attention to, not time or your age. Menopause is a natural process and although we have focused here on the time frame and “symptoms”, it can also be a time of freedom (particularly from periods!), reflection and a time to focus on yourself.<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/195211/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/lhosPUwWhfI?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Women speak about their experiences of menopause.</figcaption></figure> <a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, Nurse & Lecturer, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-menopause-last-5-tips-for-navigating-uncertain-times-195211">original article</a>.

Body

Does the royal family have a right to privacy? What the law says

<a href="https://theconversation.com/profiles/gemma-horton-1515949">Gemma Horton</a>, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> From court cases to conspiracy theories, the royal family’s right to privacy is, somewhat ironically, nearly always in the spotlight. The latest focus is Kate Middleton, Princess of Wales, whose whereabouts have been the subject of <a href="https://www.townandcountrymag.com/society/tradition/a60008117/kate-middleton-health-speculation-conspiracy-theories-online/">online speculation</a> after it was announced she was undergoing abdominal surgery and would be away from public duties until after Easter. This comes just weeks after King Charles <a href="https://www.bbc.co.uk/news/uk-68208157">revealed that he is undergoing treatment for cancer</a>, and a legal settlement between Prince Harry and Mirror Group Newspapers over <a href="https://www.bbc.co.uk/news/uk-68249009">illegal phone hacking</a>. Interest in the personal lives of the royals and other celebrities <a href="https://www.tandfonline.com/doi/full/10.1080/1461670X.2016.1150193">is a constant</a>, driving newspaper sales and online clicks for decades. You only needs to consider the media frenzy that followed Princess Diana to <a href="https://www.tandfonline.com/doi/full/10.1080/17512786.2013.833678">see this</a>, and its potentially devastating consequences. From a legal perspective, the British courts have ruled that everyone – the royal family included – is entitled to a right to privacy. The Human Rights Act incorporates into British law the rights set out by the European Convention on Human Rights. This includes article 8, which focuses on the right to privacy. In the years after the Human Rights Act came into force, courts ruled on a string of cases from celebrities claiming that the press invaded their privacy. Courts had to balance article 8 of the convention against article 10, the right to freedom of expression. Rulings repeatedly stated that, despite being in and sometimes seeking the limelight, celebrities should still be afforded a right to privacy. Some disagree with this position, such as prominent journalist <a href="https://www.independent.co.uk/news/uk/home-news/prince-harry-hacking-piers-morgan-b2336442.html">Piers Morgan, who has criticised</a> the Duke and Duchess of Sussex asking for privacy when they have also released a Netflix documentary, a broadcast interview with Oprah Winfrey and published a memoir. But the courts have made the position clear, as in the case concerning Catherine Zeta-Jones and Michael Douglas after Hello! Magazine published unauthorised photographs from their wedding. The <a href="https://eprints.whiterose.ac.uk/190559/3/Final%20Edited%20Version%20-%20Celebrity%20Privacy%20and%20Celebrity%20Journalism-%20Has%20anything%20changed%20since%20the%20Leveson%20Inquiry_.pdf">court stated</a> that: “To hold that those who have sought any publicity lose all protection would be to repeal article 8’s application to very many of those who are likely to need it.” There is no universal definition of privacy, but scholars have identified key concepts encompassing what privacy can entail. In my own research, I have argued that the <a href="https://eprints.whiterose.ac.uk/190559/3/Final%20Edited%20Version%20-%20Celebrity%20Privacy%20and%20Celebrity%20Journalism-%20Has%20anything%20changed%20since%20the%20Leveson%20Inquiry_.pdf">notion of choice</a> is one of these. Privacy allows us to control the spread of information about ourselves and disclose information to whom we want. <h2>Privacy and the public interest</h2> There are exceptions to these protections if the person involved had no reasonable expectation of privacy, or if it was in the public interest for this information to be revealed. There is no solid, legal definition of the “public interest”, so this is decided on a case-by-case basis. <a href="https://www.tandfonline.com/doi/full/10.1080/17577632.2021.1889866">In the past</a>, the public interest defence has been applied because a public figure or official has acted hypocritically and the courts have stated there is a right for a publisher to set the record straight. When it comes to medical records and information concerning health, case law and journalistic <a href="https://www.ipso.co.uk/editors-code-of-practice/">editorial codes of conduct</a> are clear that this information is afforded the utmost protection. Model Naomi Campbell was pictured leaving a Narcotics Anonymous meeting and these images were published by the Daily Mirror. The court found that there had been a public interest in revealing the fact she was attending these meetings, as she had previously denied substance abuse. The House of Lords accepted that there was a public interest in the press “setting the record straight”. Nonetheless, the publication of additional, confidential details, and the photographs of her leaving the meeting were a <a href="https://www.theguardian.com/media/2004/may/06/mirror.pressandpublishing1">step too far</a>. The House of Lords highlighted the importance of being able to keep medical records and information private. <h2>Royal health</h2> When it comes to the royals, the history of <a href="https://www.townandcountrymag.com/society/tradition/a23798094/lindo-wing-st-marys-hospital-facts-photos/">publicity</a> around royal births, often posing with the newborn royal baby outside of the hospital, has set a precedent for what the public can expect about the royals’ medical information. When they choose to go against this tradition, it can frustrate both royal-watchers and publishers. King Charles made the choice to openly speak about his enlarged prostate to “assist public understanding”. And, as Prostate Cancer UK noted, this has worked – they noted a <a href="https://www.independent.co.uk/news/uk/home-news/king-charles-cancer-statement-treatment-b2494190.html">500% increase in people visiting their website</a>. However, he has chosen to not to divulge information about his cancer diagnosis beyond the fact that he is receiving treatment. This is his right. While revealing further information might stop speculation and rumours about his health, it is not the king’s duty to divulge private, medical information. However, if his health begins to impact his ability to act as monarch, the situation could change. It might be that the press finds more information about his health without his knowledge, but unless they have a genuine public interest in publishing this information, privacy should prevail. You would no doubt want your private medical information kept secret, not shared around your workplace and speculated on unless it was absolutely necessary. It is thanks to these laws and court precedent that you don’t have to worry about this. The royal family, regardless of their position, should expect the same standard. <a href="https://theconversation.com/profiles/gemma-horton-1515949">Gemma Horton</a>, Impact Fellow for Centre for Freedom of the Media, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-the-royal-family-have-a-right-to-privacy-what-the-law-says-224881">original article</a>.

Legal

As Scott Morrison leaves parliament, where does he rank among Australian prime ministers?

<a href="https://theconversation.com/profiles/paul-strangio-1232">Paul Strangio</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> This week Scott Morrison, Australia’s 30th prime minister, will deliver his valedictory speech to the House of Representatives. As Morrison leaves parliament, it’s timely to ask where he is placed in the pantheon of Australia’s national leaders. Already there have been unflattering verdicts on Morrison’s prime-ministerial standing. For example, in her withering account of his leadership, veteran columnist and author <a href="https://scribepublications.com.au/books-authors/books/bulldozed-9781922585981">Niki Savva writes</a> that among detractors, “Morrison was regarded as the worst prime minister since Billy McMahon”. Moreover, according to Savva, following the August 2022 revelation of his commandeering of five ministries during the COVID pandemic, his reputation sunk still lower: “he was worse than McMahon. Worse even than Tony Abbott, who lasted a scant two years in the job”. <h2>How can we rank prime ministerial performance?</h2> How might we know how Morrison’s record stacks up against his prime-ministerial peers? One device for evaluating comparative leadership performance is expert rankings. Australia has had a slow take-up in this field, unlike the United States, where presidential rankings have a lineage stretching back three-quarters of a century and are a veritable scholarly cottage industry. In recent years, there have been forays into this territory in Australia, with three prime-ministerial rankings conducted by newspapers and two initiated by Monash University in 2010 and 2020. (I was the organiser of both of these Monash rankings.) These rankings have been largely consistent in their results. The experts, mostly political historians and political scientists, have judged the nation’s greatest prime minister to be its second world war leader, John Curtin. The other leaders in the top echelon are, in rough order, Bob Hawke, Ben Chifley, Alfred Deakin, Robert Menzies, Andrew Fisher, John Howard, Paul Keating and Gough Whitlam. At the other end of the scale, Billy McMahon, who is chiefly remembered for being defeated by Labor’s Whitlam at the December 1972 election, thereby bringing to a close the Liberal Party’s postwar ascendancy, has been consistently rated Australia’s prime-ministerial dunce. Even his biographer, Patrick Mullins, acknowledges that McMahon has become “a by-word for failure, silliness, ridicule”. However, in the most recent of the rankings, the Monash 2020 survey, McMahon had a close competitor for bottom place: Tony Abbott. Forty-four out of 66 respondents to that survey assessed Abbott’s prime ministership a failure. Other prime ministers to the rear of the field included Abbott’s contemporaries, Kevin Rudd and Malcolm Turnbull. Morrison was not included in the 2020 rankings because as the incumbent his prime ministership was incomplete, and so it was premature to evaluate his performance. Let us now, though, measure his record against the nine benchmarks that the experts were asked to consider in rating the nation’s leaders. <h2>So how does Morrison shape up?</h2> The first is “effectively managing cabinet”. To date, little has been disclosed about the integrity of cabinet processes under Morrison’s stewardship. Yet, whatever the merits of that management, his scandalous breach of the norms of cabinet government by <a href="https://theconversation.com/view-from-the-hill-the-bell-report-on-morrisons-multi-ministries-provides-a-bad-character-reference-195368">secretly assuming several ministries</a> will irretrievably stain his reputation in this regard. Next is “maintaining support of Coalition/party”. That Morrison avoided being deposed by his party, which was the fate of his immediate predecessors (Rudd, Julia Gillard, Abbott and Turnbull), counts in his favour. As the ABC docuseries Nemesis shows, however, his prime ministership was marked by serious frictions both within the Liberal Party and between the Liberal and National coalition partners. <figure><iframe src="https://www.youtube.com/embed/gLXdXUwGrJs?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> “Demonstrating personal integrity”. This was not one of Morrison’s strong suits. As Savva makes searingly evident, and Nemesis also highlights, Morrison earned a reputation for being economical with the truth (including hiding his acquisition of colleagues’ ministries), for evading accountability and shifting blame (“I don’t hold a hose, mate”), and for corrupted processes under his watch (an example being the <a href="https://theconversation.com/more-sports-rort-questions-for-morrison-after-bridget-mckenzie-speaks-out-133160">shameless pork-barrelling</a> of the community sport infrastructure program in the lead-up to the 2019 election). “Leaving a significant policy legacy”. Here Morrison is partly damned by his own words. In office, he insisted he was not concerned about his legacy, equating the idea with a vanity project. Indeed, an obsession with the theatre of politics and a corresponding lack of substance caused his prime ministership to come to be seen as bereft of purpose. On the other hand, management of the COVID pandemic, however mixed, accords a significance to his time in office. AUKUS stands as the other major legacy of Morrison’s prime ministership, entrenched as it has been by his successor, Anthony Albanese. The agreement promises to influence Australia’s defence capability until the middle of this century and beyond, although only time will tell whether it enhances the nation’s security or is a dangerous white elephant. “Relationship with the electorate”. Morrison’s record here is mixed. In his favour, he won an election (something McMahon couldn’t claim). Yet, by the time of the 2022 election, according to the Australian Election Study, he was the least popular major party leader in the history of that survey, which dates back to the 1980s. His public toxicity was a primary factor in the Coalition’s defeat, one of his Liberal colleagues comparing the depth of public sentiment against the prime minister in 2022 to “having a 10,000-tonne boulder attached to your leg”. “Communication effectiveness”. Styling himself as a Cronulla Sharks-supporting “daggy dad” from the suburbs, at least initially Morrison’s communication mode seemed to be well received in the community. He was relentlessly on message during the 2019 election campaign. But the shine rapidly wore off his persona following that victory, with growing doubts about his authenticity. Rather than persuade, his habit was to hector, and rather than empathise, he exuded smugness. A series of notorious tin-eared statements, which especially alienated women voters, came to define his image. By the end he was known as the “bulldozer-in-chief”. <figure><iframe src="https://www.youtube.com/embed/yamdw5VeNtA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> “Nurturing national unity”. An innovation of Morrison’s at the beginning of the pandemic was the national cabinet. Bringing together the prime minister and premiers, it worked effectively for a time, only for partisan interests over lockdowns to strain relations between Canberra and the states. Under pressure, Morrison also flirted with divisive culture-war politics, instances being his divisive Religious Discrimination Bill and his egregious handpicking of the anti-transgender Liberal candidate Katherine Deves to contest the 2022 election. “Defending and promoting Australia’s interests abroad”. The AUKUS pact has vehement critics, led by Morrison’s prime-ministerial peers Keating and Turnbull, who argue it jeopardises national sovereignty. There is no denying, however, that AUKUS was Morrison’s signature foreign policy enterprise. On the other hand, Australia’s reputation as a laggard on climate change under the Coalition hurt our international standing, not least among Pacific neighbours. The Morrison government’s belated commitment to a net zero carbon emissions by 2050 target was too little, too late. Bellicose rhetoric towards Beijing also led to a deterioration in relations with the nation’s major trading partner (as well as estranging Chinese-Australian voters). “Being able to manage turbulent times”. Here, again, Morrison’s record is at best mixed. In his favour is decisive early actions to ameliorate the COVID pandemic, headed by the JobKeeper program. As the pandemic progressed, however, his government was too often flat-footed, demonstrated by its dilatory approach to procuring vaccines. His response to natural disasters, most notably the 2019-20 Black Summer bushfires, was another shortcoming, exemplified by his secret holiday to Hawaii in the midst of the crisis. Arguably, his prime ministership was doomed from that moment. <h2>And the verdict?</h2> Prime-ministerial reputations can take time to settle. The passing of years fleshes out historical knowledge as well as providing greater perspective on performance in office. For example, the fate of AUKUS will quite possibly affect Morrison’s standing well into the future. Even allowing for this, it seems safe to forecast that Morrison will be rated among the least distinguished of Australian prime ministers. His government’s relatively successful early management of the COVID pandemic and the legacy of AUKUS might spare him from falling below McMahon and Abbott at the bottom of the prime-ministerial heap. But avoiding that ignominy will probably be a close-run thing.<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/223003/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-strangio-1232">Paul Strangio</a>, Emeritus professor of politics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/as-scott-morrison-leaves-parliament-where-does-he-rank-among-australian-prime-ministers-223003">original article</a>.

Retirement Life

How long does back pain last? And how can learning about pain increase the chance of recovery?

<a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>. Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>. If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups: <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain. Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access. <h2>More pain doesn’t mean a more serious injury</h2> Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease. There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine. Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system. The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement. The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain. <h2>Reduce your chance of lasting pain</h2> Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain: <ul> <li> understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want. These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover. But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure. When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>. Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community. But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<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/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.

Body

What is micellar water and how does it work?

<a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Micellar water, a product found in supermarkets, chemists and bathroom cabinets around the world, is commonly used to remove make-up. It’s a very effective cleanser and many people swear by it as part of their skincare routine. So, what is micellar water and why is it so good at getting makeup and sunscreen off? Here’s the science. <h2>What are micelles?</h2> Oil and water generally don’t mix, which is why you’ll struggle to remove makeup and sunscreen (which both contain oils) with just plain water. But micellar water products contain something called micelles – clusters of molecules that are very effective at removing oily substances. To understand why, you need to first know two chemistry terms: hydrophilic and hydrophobic. A hydrophilic substance “loves” water and mixes easily with it. Salt and sugar are examples. A hydrophobic substance “hates” water and generally refuses to mix with it. Examples include oil and wax. Hydrophilic materials will happily mix with other hydrophilic materials. The same goes for hydrophobic substances. But if you try to combine hydrophilic and hydrophobic materials, they won’t mix. <h2>How are micelles formed? It’s all about surfactants</h2> The micelles in micellar water are formed by special molecules known as surfactants. Surfactant stands for surface active agent. These molecules looked at their hydrophilic and hydrophobic brethren and said, why not both? They are typically comprised of two ends: a head group that is hydrophilic and a tail that is hydrophobic. When a small amount of surfactant is added to water, the two ends of the molecule have competing interests. The hydrophilic head wants to be in the water, but the hydrophobic tail can’t stand water. Add enough surfactant and, eventually, we will pass a critical micelle concentration and the surfactants will self-assemble into clusters of approximately 20 to 100 surfactant molecules. All the hydrophilic heads will be pointing outwards, while the hydrophobic tails remain “hidden” at the centre. These clusters are micelles. These micelles have a hydrophilic exterior, meaning that they are very happy to remain mixed throughout water. However, in the centre remains a hydrophobic pocket that’s very good at attracting oils. This is very handy, and helps explain why adding some detergent (a surfactant) to water will allow you to wash an oily saucepan. The surfactant first helps lift of the oil, and then the oil can remained mixed into the water, finding a new home in the hydrophobic centre of the micelle. <figure><iframe src="https://www.youtube.com/embed/fnRBCn8fm2o?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Micellar water in action</h2> Surfactants are in your dishwashing detergent, your body wash, your shampoo, your toothpaste and even many foods. In all of these cases, they are there to help the water interact with the dirt and oils, and micellar water is no different. When you apply some micellar water to a cotton pad, another convenient interaction occurs. The wet cotton is hydrophilic (loves water). Consequently, some of the micelles will unravel, with the hydrophilic heads being attracted to the wet cotton pad. Now, sticking out from the surface will be a layer of hydrophobic tail groups. These hydrophobic tails cannot wait to attract themselves to makeup, sunscreen, oils, dirt, grease and other contaminants on your face. As you sweep the cotton pad across your skin, these contaminants bind to the hydrophobic tails and are removed from the skin. Some contaminants will also find themselves encapsulated in the hydrophobic centres of the micelle. Either way, a cleaner surface is left behind. Look at how a cotton wipe soaked in micellar water cleans up a small oil spill, in comparison to water alone. <figure><iframe src="https://www.youtube.com/embed/5Nge5FEiuYE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>So why shouldn’t I just use dishwashing detergent to wash my face?</h2> Technically, that would work as detergent does indeed contain lots of micelle-forming surfactants. But these particular surfactants would probably cause a lot of skin and eye irritation, while also damaging and drying out your skin. Not nice. The surfactants in micellar water are chosen to be mild and well tolerated by most people’s skin. But micellar water isn’t the only skincare product to contain micelles. There are many other face-cleaning products that also make great use of surfactant molecules and work very well too. Now, it’s not perfect. While it is effective at removing a wide range of contaminants, thick or heavy makeup might not come off easily with micellar water (you might need to do a more vigorous clean). Some products say there is “zero residue”, although the fine print clearly states this refers to visible residue. Many products also state there is no rinse off required. Surfactants will remain on your skin after product use, but for many people they don’t cause irritation. If your skin is feeling irritated after using a micellar water product, you can try rinsing afterwards or discontinuing use. And as is the case with many cosmetic products, you should test it first on a small patch of skin before using it all over your face.<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/219492/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-micellar-water-and-how-does-it-work-219492">original article</a>.

Beauty & Style

How does cancer spread to other parts of the body?

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

Body

How long does immunity last after a COVID infection?

<a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Nearly four years into the pandemic, Australia, like many other countries, is still seeing large numbers of <a href="https://nindss.health.gov.au/pbi-dashboard/">COVID cases</a>. Some 860,221 infections were recorded around the country in 2023, while 30,283 cases have already been reported in 2024. This is likely to be a significant underestimate, with fewer people testing and reporting than earlier in the pandemic. But the signs suggest parts of Australia are experiencing yet <a href="https://www.abc.net.au/news/2024-01-23/covid-19-case-numbers-from-australia-states-and-territories/103374656">another COVID surge</a>. While some lucky people claim to have never had COVID, many are facing our second, third or even fourth infection, often despite having been vaccinated. You might be wondering, how long does immunity last after a previous infection or vaccination? Let’s take a look at what the evidence shows. <h2>B cells and T cells</h2> To answer this question, we need to understand a bit about how <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">immunity</a> to SARS-CoV-2 (the virus that causes COVID) works. After being infected or vaccinated, the immune system develops specific antibodies that can neutralise SARS-CoV-2. B cells remember the virus for a period of time. In addition, the immune system produces memory T cells that can kill the virus, and remain in the blood for some months after the clearance of the infection or a vaccination. A <a href="https://www.science.org/doi/full/10.1126/science.abf4063?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">2021 study</a> found 98% of people had antibodies against SARS-CoV-2’s spike protein (a protein on the surface of the virus that allows it to attach to our cells) one month after symptom onset. Six to eight months afterwards, 90% of participants still had these neutralising antibodies in their blood. This means the immune system should have recognised and neutralised the same SARS-CoV-2 variant if challenged within six to eight months (if an infection occurred, it should have resulted in mild to no symptoms). <h2>But what about when the virus mutates?</h2> As we know, SARS-CoV-2 has mutated over time, leading to the emergence of new variants such as alpha, beta, delta and omicron. Each of these variants carries mutations that are new to the immune system, even if the person has been previously infected with an earlier variant. A new variant likely won’t be <a href="https://www.science.org/doi/10.1126/science.adj0070">perfectly recognised</a> – or even <a href="https://www.cell.com/cell/pdf/S0092-8674(21)01578-6.pdf">recognised at all</a> – by the already activated memory T or B cells from a previous SARS-CoV-2 infection. This could explain why people can be so readily reinfected with COVID. A recent <a href="https://www.thelancet.com/article/S0140-6736(22)02465-5/fulltext#seccestitle10">review of studies</a> published up to the end of September 2022 looked at the protection conferred by previous SARS-CoV-2 infections. The authors found a previous infection provided protective immunity against reinfection with the ancestral, alpha, beta and delta variants of 85.2% at four weeks. Protection against reinfection with these variants remained high (78.6%) at 40 weeks, or just over nine months, after the previous infection. This protection decreased to 55.5% at 80 weeks (18 months), but the authors noted there was a lack of data at this time point. Notably, an earlier infection provided only 36.1% protection against a reinfection with omicron BA.1 at 40 weeks. Omicron has been described as an <a href="https://www.nature.com/articles/s41564-022-01143-7">immune escape variant</a>. A prior infection showed a high level of protection against severe disease (above 88%) up to 40 weeks regardless of the variant a person was reinfected with. <h2>What about immunity after vaccination?</h2> So far almost 70 million COVID vaccines <a href="https://www.health.gov.au/topics/covid-19/reporting">have been administered</a> to more than <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-12-january-2023?language=en">22 million people</a> in Australia. Scientists estimated COVID vaccines prevented around <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext">14.4 million deaths</a> in 185 countries in the first year after they became available. But we know COVID vaccine effectiveness wanes over time. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=050323">2023 review</a> found the original vaccines were 79.6% and 49.7% effective at protecting against symptomatic delta infection at one and nine months after vaccination respectively. They were 60.4% and 13.3% effective against symptomatic omicron at the same time points. This is where booster doses come into the picture. They’re important to keep the immune system ready to fight off the virus, particularly for those who are more vulnerable to the effects of a COVID infection. Plus, regular booster doses can provide immunity against different variants. COVID vaccines are constantly being <a href="https://mvec.mcri.edu.au/references/covid-19/">reviewed and updated</a> to ensure optimal protection against <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">current circulating strains</a>, with the latest shot available designed to target <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants">the omicron variant XBB 1.5</a>. This is similar to how we approach seasonal flu vaccines. A <a href="https://www.nature.com/articles/s41598-023-50335-6">recent study</a> showed a COVID vaccination provides longer protection against reinfection than natural protection alone. The median time from infection to reinfection in non-vaccinated people was only six months, compared with 14 months in people who had received one, two or three doses of vaccine after their first infection. This is called <a href="https://www.science.org/doi/10.1126/science.abj2258">hybrid immunity</a>, and other research has similarly found it provides better protection than natural infection alone. It also seems timing is important, as receiving a vaccine too soon after an infection (less than six months) appears to be <a href="https://www.nature.com/articles/s41598-023-50335-6">less effective</a> than getting vaccinated later. <h2>What now?</h2> Everyone’s immune system is slightly unique, and SARS-CoV-2 continues to mutate, so knowing exactly how long COVID immunity lasts is complicated. Evidence suggests immunity following infection should generally last six months in healthy adults, and can be prolonged with vaccination. But there are exceptions, and all of this assumes the virus has not mutated so much that it “escapes” our immune response. While many people feel the COVID pandemic is over, it’s important we don’t forget the lessons we have learned. Practices such as wearing a mask and staying home when unwell can reduce the spread of many viruses, not only <a href="https://www.bmj.com/content/375/bmj-2021-068302">COVID</a>. Vaccination is not mandatory, but for older adults eligible for a booster under the <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">current guidelines</a>, it’s a very good idea.<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/221398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-immunity-last-after-a-covid-infection-221398">original article</a>.

Body

What does a building need to call itself ‘accessible’ – and is that enough?

<a href="https://theconversation.com/profiles/ilan-wiesel-303040">Ilan Wiesel</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The <a href="https://www.ndisreview.gov.au/resources/reports/working-together-deliver-ndis">National Disability Insurance Scheme (NDIS) review</a> and the disability royal commission’s <a href="https://disability.royalcommission.gov.au/system/files/2023-09/Final%20Report%20-%20Volume%207%2C%20Inclusive%20education%2C%20employment%20and%20housing%20-%20Part%20C.pdf">final report</a> both highlighted the crucial role of accessible buildings and homes in ensuring the inclusion of people with disabilities. But the experiences of people with disability show Australia is a very long way from achieving this. There are the stories from people with disability who <a href="https://www.abc.net.au/news/2023-06-25/taylor-swift-concert-disability-access-concerns/102520088">can’t enjoy events</a> or <a href="https://www.abc.net.au/news/2023-03-09/harry-styles-concert-disability-tickets-consumer-rights/102060698">venues</a>. And researchers say even <a href="https://www.unsw.edu.au/arts-design-architecture/our-research/research-impact/case-studies/are-our-accessible-bathrooms-inaccessible-to-people-in-wheelchairs">accessible bathrooms are not usable</a> for half the people with disability. What can be called an accessible building or home? And should standards be improved? <h2>What is accessibility?</h2> The <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-persons-disabilities">Convention on the Rights of Persons with Disability</a> includes the right to accessibility. Australia’s 1992 <a href="https://humanrights.gov.au/our-work/disability-rights/frequently-asked-questions-access-premises">Disability Discrimination Act</a> includes premises standards to ensure people with disability have “dignified, equitable, cost-effective and reasonably achievable access to buildings, facilities and services”. However, a building is exempt if the owners can demonstrate modifying a building would cause them “unjustifiable hardship”. The burden of making a complaint about an inaccessible building falls on people with disability and the act also does not apply to private homes. Although experts follow different definitions of accessibility, they generally include some key principles: <ul> <li> easy entry and exit into a building </li> <li> easy navigation and functionality in and around the building </li> <li> potential for easy adaptation in response to changing needs of occupants. </li> </ul> An accessible building is one where people of all abilities are able move and carry out activities independently, safely, in comfort and with dignity. For people with disabilities <a href="https://disability.unimelb.edu.au/__data/assets/pdf_file/0010/3969109/Accessible-Housing-Research-Report-22-October-2020.pdf">many buildings are inaccessible</a>. In these buildings, basic everyday activities such as taking a shower or preparing breakfast becomes difficult, tiring, uncomfortable and sometimes dangerous. Some people have been <a href="https://disability.unimelb.edu.au/__data/assets/pdf_file/0010/3969109/Accessible-Housing-Research-Report-22-October-2020.pdf">injured</a> repeatedly in inaccessible homes, for example falling down a staircase. Such injuries may compound their disability. Many people with disabilities worry that if they’re injured at home, they will be forced to move permanently into a nursing home. <a href="https://www.sciencedirect.com/science/article/pii/S0016718523001525">Studies</a> have found living in inaccessible homes severely harms the dignity, independence, social inclusion, employment, health and wellbeing of people with disabilities. People become more reliant on family members for support, putting strain on their relationships. Difficulty getting in and out of the house for social activities worsens social isolation. A sense of fatigue also reduces the motivation and capacity to work. <h2>Access through the front door</h2> Dignity is a crucial aspect of accessibility but it is often forgotten. For example, many buildings’ front entry has stairs that make it inaccessible for wheelchair users. There may be an accessible ramp entry in the back of the building. The building is then considered accessible, since wheelchair users can enter and exit. But such a “backdoor treatment” can be experienced as an indignity and discrimination. Accessible toilets are sometimes used for <a href="https://www.sbs.com.au/news/article/most-public-toilets-inaccessible-to-people-with-disabilities/adsx7cnr8">storage, locked or out of order</a>. Again, although the design meets accessibility standards, in practice the building is inaccessible because of poor management. And accessibility is not exclusively about physical disabilities and physical barriers. People with cognitive disabilities, for example, might struggle to find their way in a building if way-finding signs are difficult to understand. <a href="https://theconversation.com/for-people-with-communication-disability-complaining-about-their-treatment-isnt-so-simple-214717">Communication accessibility</a> in building is achieved when the information needed to navigate and use the building is understood by everyone, no matter how they communicate. <h2>Silver, gold and platinum standards</h2> There are different levels of accessibility. In Australia, housing accessibility is most often assessed according to <a href="https://livablehousingaustralia.org.au/wp-content/uploads/2021/02/SLLHA_GuidelinesJuly2017FINAL4.pdf">Livable Housing Australia</a>’s (LHA) three standards of silver, gold and platinum. Silver-level homes have minimal accessibility features, but are designed in a way that enables easy home modifications over time. The silver standard of accessibility requires seven features: • a step-free path of travel from the street or parking area • at least one step-free entrance • internal doors and corridors that allow comfortable movement, including for people using wheelchairs • a toilet on the entry level with easy access • a bathroom with a hobless shower recess, so there isn’t a step-over barrier to entry • reinforced walls around the toilet, shower and bath. These allow installation of grabrails later if needed • stairways designed to reduce the risk of injury and also enable future adaptation. Gold-level homes have additional accessibility features. Platinum homes are designed for people with higher mobility needs and to allow ageing at home. <h2>A patchwork of standards and what the NDIS review says</h2> In 2021 Australian housing ministers <a href="https://www.industry.gov.au/news/building-ministers-meeting-communique-april-2021">agreed for the first time</a> to introduce minimum accessibility standards in the National Construction Code. It followed decades of campaigning by activist groups such as the <a href="https://anuhd.org/">Australian Network for Universal Housing Design</a>, <a href="https://riaustralia.org/">Rights and Inclusion Australia</a> and the <a href="https://www.summerfoundation.org.au/">Summer Foundation</a>. The code requires all new homes be built to silver standards. It does not apply to existing homes and exemptions will apply for some newly built homes because of site restrictions. When the code was introduced, New South Wales and Western Australia announced they would not adopt the new code. Both the NDIS review and the disability royal commission recommended all states and territories <a href="https://disability.royalcommission.gov.au/system/files/2023-09/Final%20Report%20-%20Volume%207%2C%20Inclusive%20education%2C%20employment%20and%20housing%20-%20Part%20C.pdf">immediately adopt</a> the code’s new accessibility standards. A consistent application of the code’s new standards across Australia is a good start. But the code provides only the minimum standard of accessibility. To make buildings and homes truly accessible, we need to improve education on accessibility for designers, operators and consumers. <h2>An urgent national priority</h2> With Australia’s ageing population, most people will experience disability – or have a household member with disability – at some point. Accessible homes and buildings can reduce pressure on the health system and improve quality of life. A consistent national construction code is just the first step urgently needed to improve building accessibility and inclusion so people with disability have autonomy and flourish.<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/217278/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ilan-wiesel-303040">Ilan Wiesel</a>, Associate Professor in Urban Geography, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, Professor of Social Epidemiology and Director of the Centre of Research Excellence in Healthy Housing at the Melbourne School of Population and Global Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-does-a-building-need-to-call-itself-accessible-and-is-that-enough-217278">original article</a>.

Caring

What does El Niño do to the weather in your state?

<a href="https://theconversation.com/profiles/kimberley-reid-767059">Kimberley Reid</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> You’ve probably heard El Niño brings hot and dry weather to the eastern states, but what about the rest of Australia? Are we all in for a scorcher this summer? El Niño is what scientists call a <a href="https://www.climatechangeinaustralia.gov.au/en/overview/climate-system/australian-climate-influences/">climate driver</a>. But it’s just one of many. These climate drivers control year-to-year variations in the weather. Some years are hotter and drier, while others are cooler and wetter. Australia is particularly prone to weather whiplash because our continent is buffeted by climate drivers to our north, south, east and west. The dominant driver in your state may be one of the lesser-known influences. <figure><iframe src="https://www.youtube.com/embed/iVhi1wq2sTY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Understanding Climate Drivers (Bureau of Meteorology)</figcaption></figure> <h2>East: El Niño Southern Oscillation</h2> The El Niño Southern Oscillation (ENSO) is the resident climate driver in the Pacific Ocean and the driver with the biggest influence over Australian weather. Differences in sea surface temperatures and winds across the Pacific determine whether we swing towards El Niño (the boy) or La Niña (the girl). <a href="http://www.bom.gov.au/climate/about/?bookmark=enso">During the El Niño phase</a>, sea surface temperatures near South America are warmer than normal and they are cooler than normal off the coast of eastern Australia. Additionally, trade winds that blow from east to west across the Pacific weaken. El Niño brings hotter daytime temperatures, but often <a href="http://www.bom.gov.au/climate/enso/#tabs=Pacific-Ocean&pacific=History">cooler nights</a>. That’s because reduced cloud cover allows more heat to escape into space overnight. So the same process that increases the chances of heatwaves can also raise the <a href="https://www.agric.wa.gov.au/climate-weather/historical-frost-and-heat-maps-south-west-land-division">risk of frost</a> in Western Australia, New South Wales, the Australian Capital Territory and Victoria. Australia as a whole is typically drier during an El Niño event. In the tropical regions, El Niño can delay the <a href="http://www.bom.gov.au/climate/updates/articles/a008-el-nino-and-australia.shtml">onset of the monsoon and reduce the likelihood of tropical cyclones</a>. In the southern states, the hot and dry conditions increase the chance of intense bushfires. La Niña is the opposite phase. Waters off eastern Australia are warmer than usual, increasing the <a href="http://www.bom.gov.au/climate/enso/#tabs=Pacific-Ocean&pacific=History&enso-impacts=La-Ni%C3%B1a-impacts">chance of tropical cyclones</a> and an earlier start to the monsoon for WA, the Northern Territory and Queensland. So what does El Niño do to the weather in your state? Hover over your state in the interactive map to find out. <iframe id="tc-infographic-1008" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1008/7f37ae91389db072906b320ffd54d0fefd840c0d/site/index.html" width="100%" height="400px" frameborder="0"></iframe> <h2>West: Indian Ocean Dipole</h2> The <a href="http://www.bom.gov.au/climate/about/?bookmark=iod">Indian Ocean Dipole</a> is like ENSO’s Indian Ocean cousin. A positive Indian Ocean Dipole is declared when ocean temperatures near Africa are warmer than normal and ocean temperatures off the coast of Sumatra are cooler than usual. A positive dipole tends to bring warmer and drier conditions, particularly to western and central Australia. A negative Indian Ocean Dipole is the reverse and is associated with wetter than normal weather and an increase in <a href="https://pursuit.unimelb.edu.au/articles/why-more-clouds-can-mean-less-rain-in-australia">northwest cloudbands</a>. <h2>North: Madden-Julian Oscillation</h2> The <a href="http://www.bom.gov.au/climate/about/?bookmark=mjo">Madden-Julian Oscillation</a> is a pulse of storms that start in the Indian Ocean, travel over Northern Australia and Indonesia and die in the Pacific Ocean. Ahead of the pulse, the air sinks, causing sunny and dry weather. Under the pulse is high storm activity and typically heavy rainfall. We describe the Madden-Julian Oscillation based on whether the pulse of storms is <a href="http://www.bom.gov.au/climate/mjo/">active or inactive</a> and where the storm activity is located on its path between the Indian and Pacific Oceans. As well as causing rainfall, the Madden-Julian Oscillation can control the timing of the monsoon onset and <a href="http://www.bom.gov.au/climate/about/?bookmark=tc">tropical cyclone formation</a>. <h2>South: Southern Annular Mode</h2> The <a href="http://www.bom.gov.au/climate/about/?bookmark=sam">Southern Annular Mode</a> controls the north and south position of the westerly winds that whizz around the globe in the Southern Ocean. When the winds are further north than usual, we call this the negative phase. But when the westerly wind move towards Antarctica, we call this the positive phase. The phase of the Southern Annular Mode <a href="https://rmets.onlinelibrary.wiley.com/doi/abs/10.1002/joc.1370">affects how many weather systems</a>, like cold fronts, make landfall over southern Australia. A positive mode may also draw tropical moist air south, which happened in 2022 during the extensive flooding over eastern Australia. <h2>Climate drivers control the odds, but not the result</h2> These four key climate drivers affect the weather on average (over months and seasons), but they do not dictate the exact day-to-day weather we experience. As the Gippsland region of Victoria <a href="https://www.theguardian.com/australia-news/2023/oct/05/victoria-floods-flooding-warnings-gippsland-region-flood-and-fires-evacuation">saw in October</a>, heavy rainfall can still occur during an El Niño. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=407&fit=crop&dpr=1 600w, https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=407&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=407&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=512&fit=crop&dpr=1 754w, https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=512&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/561494/original/file-20231124-16-ip8fja.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=512&fit=crop&dpr=3 2262w" alt="Map of Australia showing the difference from normal rainfall during October 2023, with a large wet patch around Gippsland, Victoria." /></a><figcaption>Difference from normal rainfall during October 2023, showing defined wet area around Gippsland, Victoria surrounded by drier conditions. The Bureau of Meteorology</figcaption></figure> Climate drivers are like a football coach. They can select the best players and develop ingenious strategies, but that doesn’t guarantee a win every time. Players can get injured on the field or simply have a bad game. These uncontrollable factors are challenging to predict and may change the result from what we would expect. Scientists call this stochasticity. The climate drivers are the football coach, but the day-to-day weather systems are the players. The Bureau of Meteorology <a href="http://www.bom.gov.au/climate/enso/">releases an update</a> on all of these drivers every two weeks. The update explains which drivers are currently active and the forecast for the next few weeks. So, if you are wondering why the weather is cooler during summer, or it’s raining in the middle of the dry season, perhaps take a look at which driver is steering Australia’s weather at the moment.<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/218257/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kimberley-reid-767059">Kimberley Reid</a>, Postdoctoral Research Fellow in Atmospheric Sciences, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-does-el-nino-do-to-the-weather-in-your-state-218257">original article</a>.

Domestic Travel

"Who does that?!" Outrage over horrific kerbside pick-up

Fury has erupted in Sydney's inner west after one callous resident left an unusual item in their pile of junk for council's kerbside pick-up. One a hot summer day, one local was walking past the pile of household items that held a giant "FREE" sign, inviting passersby to sift through the loot to take what they please. However, the concerned local was shocked to find a fish tank at the bottom of the stack, that still had pet fish living inside. The fish were swimming around in only a few inches of water in the tank, which had been left in the blazing sun. Taking to a local Facebook group, the woman posted a photo of the fish pleading for "anybody able to rescue them" from nearby, to which dozens of people responded offering their help. The post racked up an influx of comments from people condemning the original owner's actions, with one outraged neighbour saying, "Who does that!! They would boil in this heat." "Thanks for saving! What is wrong with people!!" replied another. By the end of the day, and after many offers from people willing to take in the two tiny pets, they found a new, loving home with an "experienced" fish owner. According to the <a href="https://www.dpi.nsw.gov.au" target="_blank" rel="noopener">NSW Department of Primary Industries</a>, the welfare of all animals, including fish, is protected by the Prevention of Cruelty to Animals Act 1979 and dumping an unwanted pet fish is illegal under Section 11 of the Act. "Most people accept that dumping a pet cat or dog into the wild is an act of animal cruelty, but did you know that fish are considered under the same animal welfare legislation in NSW?" they state on their website. Image credits: Facebook

Family & Pets

How does Australia’s health system stack up internationally? Not bad, if you’re willing to wait for it

<a href="https://theconversation.com/profiles/stephen-duckett-10730">Stephen Duckett</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> When things are going bad in the health system, we are reassured we’ve got one of the best health systems in the world. But we’re rarely told where we actually stand relative to others. A <a href="https://www.oecd.org/health/health-at-a-glance/">new report</a> from the Organisation for Economic Cooperation and Development (OECD) shows where Australia is doing relatively well – and not so well. The report is more than 200 pages with dozens of charts and tables. Here we highlight five charts showing Australia’s relative performance. Overall, Australia’s health system performs well, but can come after long waits. And our use of antibiotics is trending in the wrong direction. <h2>1. We spend less than average but live longer than average</h2> Despite the rhetoric about the unsustainability of the health system, Australia performs well. When mapping health expenditure against life expectancy, Australia (marked by the red dot) sits in the best performing quadrant – and has done so for the past decade. <iframe id="tc-infographic-996" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/996/32f7548791bf05b7559d74976bfa0b955319adc5/site/index.html" width="100%" height="400px" frameborder="0"></iframe> In contrast, the United States is stuck in the worst performing quadrant for the whole period – significantly higher spending than other countries with worse life expectancy. The life expectancy measure is used here but it involves an implicit assumption that the principal impact on life expectancy is from the health system, which is not really the case. Nevertheless, it is a good measure of overall system performance and combined with spending provides a good measure. <h2>2. Most Australians rate their health as good or very good</h2> The vast majority of Australians (about 85%) rate their health as good or very good, with Australia performing better on this metric than most other similar countries. Often good health is conflated with good health care, and the data show that Australia also has more doctors per head than other countries. <iframe id="Ygo7Z" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/Ygo7Z/1/" width="100%" height="400px" frameborder="0"></iframe> The founding charter of the World Health Organization (WHO) recognised that health is not just the absence of disease, but a “<a href="https://www.who.int/about/accountability/governance/constitution">state of complete physical, mental and social well-being</a>”. This points to a flaw in the nexus between good health and more health professionals. The WHO focus on well-being helps to explain why it is not surprising that, looking across countries, the number of doctors doesn’t appear to be a key determinant of performance on self-rated health. <h2>3. It’s harder to get a bed in aged care</h2> About 30% of people in OECD countries are over 65, while the Australian proportion is about 20%. The proportion of over-65s is rising everywhere. A minority of older Australians (14%) use aged care, with most of these using home care. However, monitoring access to residential aged care (represented here by the number of long-term care beds per thousand population over 65) might act as a “canary in the coal mine”, highlighting where access problems exist. <iframe id="lBe4O" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/lBe4O/1/" width="100%" height="400px" frameborder="0"></iframe> In Australia, access to aged care beds is falling, by about 27% between 2011 and 2021. We started in the middle of the pack so this is a concern and probably contributes to more Australians being stuck in acute hospitals, rather than being in more appropriate accommodation in residential aged care. This “<a href="https://www.ama.com.au/articles/hospital-exit-block-symptom-sick-system">exit block</a>” in turn leads to problems of ambulance ramping. <h2>4. Australians wait too long for public hospital hip replacements</h2> Most publicly funded health systems are characterised by long waiting times for access to planned procedures such as hip replacements. Some waiting is to be expected as part of efficient management of operating theatre scheduling. But long waits, especially when the person is in pain, reflect poorly on management of the public hospital system. <iframe id="LNntD" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/LNntD/2/" width="100%" height="400px" frameborder="0"></iframe> The data shows that almost two-thirds of people waiting for hip replacement surgery in Australia waited more than three months. This is marginally worse than the OECD average. Unfortunately, our performance is deteriorating. A number of states, such as <a href="https://www.health.vic.gov.au/planned-surgery-reform-blueprint">Victoria</a>, have developed strategies to improve the performance of the planned procedure system, or have identified opportunities for <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/about+sa+health/reporting+and+advisory+groups/health+performance+council/health+performance+council+reports">efficiency improvements in public hospitals</a> which would help address this issue. Although it’s understandable that <a href="https://www.sciencedirect.com/science/article/pii/S2049080122011554">planned procedures were affected</a> by the first few years of the COVID pandemic, governments should have adapted their funding and provision systems to bring waiting times back to the pre-pandemic levels. <h2>5. Our use of antibiotics is going in the wrong direction</h2> Antibiotics have saved millions of lives. But public health experts have long recognised the emerging <a href="https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance">problem of antimicrobial resistance</a>, where inappropriate use of these drugs can lead to their reduced effectiveness over time. Worldwide campaigns to promote appropriate use of antibiotics are bearing fruit and across the OECD, use of antibiotics is going down. Unfortunately, Australia’s trend is in the reverse direction. <iframe id="AK4GO" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/AK4GO/1/" width="100%" height="400px" frameborder="0"></iframe><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/218031/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephen-duckett-10730">Stephen Duckett</a>, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-does-australias-health-system-stack-up-internationally-not-bad-if-youre-willing-to-wait-for-it-218031">original article</a>.

Caring

Why did Hamas attack, and why now? What does it hope to gain?

<a href="https://theconversation.com/profiles/ian-parmeter-932739">Ian Parmeter</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a> In hindsight, the drivers of Hamas’s startlingly well-planned, land-sea-air attack on Israel on Saturday were in plain sight. The operation reflects a pattern of four wars and regular outbreaks of violence between Israel and Hamas militants in Gaza since 2005, when Israel withdrew its military posts and <a href="https://www.cfr.org/backgrounder/middle-east-gaza-withdrawal">forcibly removed</a> 9,000 Israeli settlers from the territory. Each time Hamas has launched rockets at Israel or engaged in similar provocations, it has drawn heavy retaliation from Israel in the form of major bombings on the Gaza Strip. Hamas, however, seems to regard this as a cost of doing business. An important factor motivating Hamas towards violence is that it has to watch its flanks. Other smaller, but increasingly extremist groups, are contesting its authority in Gaza, notably Palestinian Islamic Jihad. These groups have, at times, independently launched rocket attacks on Israel, which bring retribution on the whole territory. On top of this, the Israeli government formed by Prime Minister Benjamin Netanyahu last December is the most right wing in Israeli history. This government has made no secret of its desire to <a href="https://www.theguardian.com/world/2022/dec/28/benjamin-netanyahu-government-makes-west-bank-settlement-expansion-its-priority">annex</a> the West Bank and has permitted significant expansion of Jewish settlements in the territory, which are illegal under <a href="https://press.un.org/en/2016/sc12657.doc.htm">international law</a>. That has led to conflict between settlers and young West Bank Palestinians, who in the past year have formed a loose grouping known as the “<a href="https://www.economist.com/1843/2023/07/07/inside-the-lions-den-the-west-banks-gen-z-fighters">Lions’ Den</a>”. This grouping, comprising independent militants with apparently no central control, has scant regard for the Palestinian Authority, which governs the West Bank and is led by the octogenarian Mahmoud Abbas. The Palestinian Authority has little real administrative, security or moral authority in the territory. The “Lions’ Den” also vies with Gaza militant groups for influence among Palestinian youth – both in Gaza and the West Bank. Added to this, a minister in Netanyahu’s coalition, <a href="https://edition.cnn.com/2023/07/27/europe/ben-gvir-visit-israel-jerusalem-intl/index.html">Itamar Ben-Gvir</a>, has visited the Temple Mount, the site of the Al-Aqsa Mosque, one of the holiest shrines in Islam. This was considered a provocation by all Palestinians – both in the West Bank and Gaza. Further angering Palestinians, Israeli tourists also <a href="https://apnews.com/article/christians-jerusalem-old-city-spitting-524b3b8e92beb4c947b3b8b49e80cc45">travelled</a> to the site over the recent Sukkot holiday. A <a href="https://www.thenation.com/article/archive/september-28-2000-ariel-sharon-visits-the-temple-mount-sparking-the-second-intifada/">visit</a> to the Temple Mount by Ariel Sharon in 2000, then the leader of the opposition in Israel’s government, is generally regarded as the spark that ignited the Second Intifada from 2000-2005. Under an agreement predating Israel’s foundation, Jordan has <a href="https://www.middleeastmonitor.com/20231004-jordan-sends-memo-of-protest-to-israel-over-al-aqsa-settler-incursions/">custodianship</a> of the Al-Aqsa religious complex. Israel aimed to respect Jordan’s role when it signed the Israeli-Jordanian peace treaty in 1994. But Palestinians see the visits by Israeli ministers and non-Muslim tourists as disrespectful of the sanctity of the site and counter to this undertaking. Hamas has also claimed these visits have led to the desecration of the Al-Aqsa site, an argument obviously aimed at winning support from Muslims throughout the Arab and wider Islamic world. <h2>Why attack now?</h2> Significantly, Hamas has named its action “<a href="https://www.aljazeera.com/opinions/2023/10/8/there-is-nothing-surprising-about-hamass-operation">Operation Al-Aqsa Flood</a>”. This provides some clues to the primary reason for striking at this time, which emphasises what Hamas sees as Israeli acts of desecration of a holy Islamic site. However, an additional motivating factor was likely the increasing tendency of Arab states to make peace agreements with Israel, as evidenced by the <a href="https://www.state.gov/the-abraham-accords/">2020 Abraham Accords</a>, involving the United Arab Emirates, Bahrain, Sudan and Morocco. There has recently been strong speculation that Saudi Arabia is about to make its own agreement with Israel. This is of great concern to all Palestinians, not just those in the West Bank, as it further reduces pressure on Israel to reach a settlement with them. Netanyahu has made clear in his public statements that he prioritises peace with Arab states over eventual peace with the Palestinians. Hamas does not recognise Israel, but has said it would <a href="https://www.nbcnews.com/id/wbna24235665">observe a truce</a> if Israel withdrew to its 1967 borders. Israel would be unlikely to take Hamas’s word on this and withdraw as demanded. But there would be even less chance of that condition ever being realised if Saudi Arabia were to conclude its own deal with Israel. Another aspect of the timing is that it coincides almost precisely with the 50th anniversary of the start of the Yom Kippur or Ramadan War in October 1973, when Egypt and Syria attacked Israel together. The significance of a Palestinian entity being able to surprise Israel in the same way would not be lost on Hamas. So there were several objectives for Hamas to launch an attack at this time – and possibly a combination of them. Hamas is likely to gain much sympathy from the wider Arab world, but little in the way of material assistance. Hamas’s military operation will likely cause Saudi Arabia to hold back from normalising relations with Israel for now. That said, it’s unlikely any of the Arab states that have signed the Abraham Accords will withdraw from them now in protest over Israeli retaliation against Gaza. <h2>Where the conflict is headed?</h2> Where the conflict is headed is unclear. The Hezbollah militant group in Lebanon has already fired on positions in Israel’s north. But the extent to which it will become seriously involved will depend on its sponsor, Iran. Tehran has generally been seen to want to keep Hezbollah’s considerable rocket and missile strength in reserve in case of an Israeli strike on Iranian nuclear facilities. There is also the question of whether “Lions’ Den” militants in the West Bank will launch their own attacks, effectively creating a third front against Israel. And a possible fourth front could come from attacks on Jewish Israelis by Arab Israelis living in Israel. US President Joe Biden has <a href="https://www.bbc.com/news/world-us-canada-67049196">already promised</a> support for Israel, so there can be little doubt Israel will eventually get on top of these challenges. Netanyahu has warned of a long war, but it may prove reasonably short if Israel goes all out in its retaliation. The main constraint on Israeli action against Gaza will be the fact that an unknown number of Israeli citizens have been kidnapped by Hamas militants and taken to the strip. Indiscriminate Israeli bombing would certainly put those lives at risk. Israel will also be reluctant to put its defence forces in Gaza because of the risk of heavy casualties. However, it may send special forces if it gains intelligence on the whereabouts of its kidnapped citizens. A further risk for Israel in its retaliation is that too brutal an assault on Gaza could turn Western opinion against it. So far, however, Western governments are strongly supportive of Israel and unsympathetic towards Hamas. The overall lesson for Israel is that it has to develop a policy for managing the Palestinians living in the areas it controls. The current situation, in which hardline militants are contained in Gaza, while Israeli forces curtail the actions of Palestinians living in Israel and the West Bank, has suited the Israeli government for many years. It has been able to ignore Arab and international pressure to negotiate a two-state solution or to acquiesce in a <a href="https://theconversation.com/israels-new-government-doesnt-give-palestinians-much-hope-it-could-be-time-for-a-radical-approach-162077">one-state solution</a>. The real significance of Hamas’s operation is that such a non-policy can no longer continue.<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/215248/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-parmeter-932739">Ian Parmeter</a>, Research Scholar, Centre for Arab and Islamic Studies, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a> Image credits: CNN / X (Twitter) 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-did-hamas-attack-and-why-now-what-does-it-hope-to-gain-215248">original article</a>.

Legal

Lots of women try herbs like black cohosh for menopausal symptoms like hot flushes – but does it work?

<a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Menopause is the stage of life where the ovaries stop releasing eggs and menstrual periods cease. Most Australian women go through menopause between <a href="https://www.nature.com/articles/nrdp20154">45 and 55</a> years of age, with the average age being 51 years, although some women may be younger. Hot flushes and night sweats are <a href="https://www.nature.com/articles/nrendo.2017.180">typical symptoms</a> of menopause, with vaginal dryness, muscle and joint pains, mood changes and sleep disturbance also commonly reported. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">75% of women</a> experience menopausal symptoms, with nearly 30% severely affected. These symptoms can negatively impact day-to-day life and wellbeing. The main therapies available include menopausal hormone therapy (MHT) and non-hormonal prescription therapy. Some women will elect to try complementary and alternative medicines, such as herbal medicines and nutritional supplements. Black cohosh is one of them. <h2>What causes hot flushes</h2> The cause of hormonal hot flushes (also called hot flashes) still isn’t completely understood, but the decline in oestrogen at menopause appears to play a role in a process that involves the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833827/">area of the brain that regulates temperature</a> (the hypothalamus). Factors linked to a greater likelihood of hot flushes include <a href="https://pubmed.ncbi.nlm.nih.gov/19675142/">being overweight or having obesity</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">smoking</a>. MHT, previously known as hormone replacement therapy (HRT), usually includes oestrogen and is the <a href="https://pubmed.ncbi.nlm.nih.gov/26444994/">most effective treatment</a> for menopausal symptoms, such as hot flushes. But women may choose complementary and alternative medicines instead – either because they shouldn’t take hormone therapy, for example because they have breast cancer, or because of personal preference. Close <a href="https://pubmed.ncbi.nlm.nih.gov/26224187/">to 40%</a> of Australian women report using complementary and alternative medicines for menopausal symptoms, and up to 20% using them specifically to treat hot flushes and sweats. <h2>A long history</h2> Complementary and alternative medicines have a long history of use in many cultures. Today, their potential benefits for menopausal symptoms are promoted by the companies that make and sell them. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/">complementary and alternative medicines</a> women often try for menopausal symptoms include phytoestrogens, wild yam, dong quai, ginseng and black cohosh. Black cohosh (plant name Cimicifuga racemosa) was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">traditionally</a> used by Native Americans to treat a variety of health concerns such as sore throat, kidney trouble, musculoskeletal pain and menstrual problems. It is now a popular herbal choice for hot flushes and night sweats, as well as vaginal dryness and mood changes. There are <a href="https://pubmed.ncbi.nlm.nih.gov/37252752/">many theories</a> for how the active ingredients in black cohosh might work in the body, such as acting like oestrogen, or affecting chemical pathways in the brain. But despite extensive research, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">evidence to support these theories remains inconclusive</a>. It is also not clear whether black cohosh is effective for hot flushes. Results from individual studies are mixed, with <a href="https://pubmed.ncbi.nlm.nih.gov/17565936/">some</a> finding black cohosh improves hot flushes, while <a href="https://pubmed.ncbi.nlm.nih.gov/18257142/">others</a> have found it doesn’t. A 2012 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">review</a> combined all the results from studies of menopausal women using black cohosh to that date and found overall there was no proof black cohosh reduces hot flushes more effectively than an inactive treatment (placebo). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">This review</a> also revealed that many studies did not use rigorous research methods, so the findings are hard to interpret. A more recent <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review</a> of clinical trials claimed black cohosh may ease menopausal symptoms, but the included studies were mostly small, less than six months long, and included women with mild symptoms. There is also no meaningful evidence black cohosh helps other symptoms of menopause, such as vaginal symptoms, sexual problems, or poor general wellbeing, or that it protects against bone loss. Evidence for how black cohosh is absorbed and metabolised by the body is also lacking, and it is not known what dose or formulation is best to use. More good quality studies are needed to decide whether black cohosh works for hot flushes and other menopausal symptoms. <h2>Is it safe to try?</h2> A <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review of studies</a> suggests black cohosh is safe to use, although many of the studies have not reported possible adverse reactions in detail. Side effects such as gastrointestinal upset and rashes may occur. While there have been <a href="https://www.mja.com.au/journal/2008/188/7/liver-failure-associated-use-black-cohosh-menopausal-symptoms#0_i1091948">rare reports of liver damage</a>, there is <a href="https://pubmed.ncbi.nlm.nih.gov/21228727/">no clear evidence</a> black cohosh was the cause. Even so, in Australia, black cohosh manufacturers and suppliers are required to put a warning label for the potential of harm to the liver on their products. It is recommended black cohosh is not used by women with menopausal symptoms <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/impacted-by-breast-cancer/physical-changes/menopause/treatments-menopausal-symptoms">after breast cancer</a>, as its safety after breast cancer is uncertain. All women should consult with their doctor before using black cohosh if they are taking other medications in case of possible drug interactions. Many women like to try herbal therapies for hot flushes and other menopausal symptoms. While black cohosh is generally considered safe and some women may find it helps them, at the moment there is not enough scientific evidence to show its effects are any better than placebo. Women experiencing troublesome menopausal symptoms, such as hot flushes, should talk to their doctor about the best treatment options for them.<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/211272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, Research fellow, Chronic Disease & Ageing, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/lots-of-women-try-herbs-like-black-cohosh-for-menopausal-symptoms-like-hot-flushes-but-does-it-work-211272">original article</a>.

Body

Why is Rupert Murdoch stepping aside now and what does it mean for the company?

<a href="https://theconversation.com/profiles/andrew-dodd-5857">Andrew Dodd</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> At age 92, media mogul Rupert Murdoch is <a href="https://www.abc.net.au/news/2023-09-21/rupert-murdoch-steps-down-as-newscorp-chair/102887474">stepping down</a> as chairman of Fox Corporation and News Corp but will stay on in the role of chairman emeritus, presumably to help guide his eldest son Lachlan as the new head of the firm. In many ways, the news was inevitable. The company is clearly planning its succession and how it manages Rupert’s decline. It has one eye on the market and one on ensuring the company maintains its direction. But why now, and where to from here for the company? And what will Rupert Murdoch be remembered for? <h2>Why now?</h2> Rupert’s departure was always going to come in one of two ways: either Rupert dropping off the perch or him leaving on this own terms. He has opted for the latter. This means the company has chosen to manage the transition in a market-favourable way. The transition to Lachlan looks, for the moment, to be well and truly secure. This gives him the chance under the leadership of Rupert to guide the company in the direction he – or Rupert – wants. Rupert says he is in robust health but he was keen to hang on as long as possible. So, perhaps today’s news suggests his health is declining. We can only speculate but the man is, after all, 92. <h2>Would the recent lawsuits have played a role?</h2> Fox has been subject to several very expensive lawsuits in recent years, which caused a lot of turmoil internally. At the cost of US$787.5 million, Fox settled a defamation lawsuit brought by Dominion Voting Systems over baseless claims made about its voting machines in the 2020 US presidential election. A different voting technology company, <a href="https://www.theguardian.com/media/2023/sep/21/rupert-murdoch-fox-news-lawsuits-donald-trump">Smartmatic</a>, is also suing. But I doubt this played a huge role in Rupert stepping down because, in the end, a billion in lawsuits is nothing to a company that a few years ago made $70 billion by selling just some of its assets to <a href="https://www.forbes.com/sites/brianbushard/2023/09/21/fox-and-news-corp-stock-surges-as-rupert-murdoch-steps-down/?sh=37463b772a49">Disney</a>. This is the price the company pays for its take-no-prisoners approach. It is proud of its uncompromising editorial stance, which is designed to pander to its right-wing audience. And there is no indication Lachlan will take it in a different direction. <h2>What next for Lachlan, with Rupert as chairman emeritus?</h2> In a sense, Rupert is not really stepping down. His new papal-like title of chairman emeritus recognises he will struggle to let go. But the new role is also about calming the market and saying, “Don’t worry, I haven’t gone away; I am still here and I have my hand on Lachlan’s shoulder.” The best indication of Lachlan’s future stewardship of News Corp is his recent behaviour. He was at the helm of Fox News during Donald Trump’s presidential years and the immediate aftermath, when Fox News did enormous damage in its reporting on the 2020 election result. He was at the helm when Fox was making those baseless claims about Dominion Voting Systems. He had ample opportunity to guide the company in a different direction, but he didn’t. So I think we can expect News Corp will continue to be the zealous right-wing media company it currently is. <h2>How might this affect the 2024 US election?</h2> News Corp has finally seen what millions of US voters saw at the 2020 election, which was that Trump was ultimately destructive as a leader. Now, outlets like Fox News are umming and ahhing about whether to back him. Some at Fox are clearly reluctant to let go of their adoration of Trump while others are disappointed Florida Governor Ron DeSantis isn’t emerging as a viable challenger. If Trump continues to be the most popular Republican candidate, Fox will probably fall into line and support him, albeit with less enthusiasm than last time. There is a sense of confusion within Fox about whom to back and where to stand, which reflects the chaos in US politics more broadly. <h2>So what’s Rupert’s legacy?</h2> It comes down to a ledger. Has this man done more harm or good in his life in the media? On the good side, he has been a champion of newspapers. He has employed thousands of journalists and his outlets have often practised good public-interest journalism. But I am afraid I believe the good is outweighed by all the harm done on Rupert’s watch. His news media empire is fundamentally antisocial in the way it operates. I believe it’s caused so much harm to so many people along the way, and that cannot go unacknowledged. From the <a href="https://www.latimes.com/world/europe/la-fg-british-scandal-murdoch-20150611-story.html">UK phone hacking scandal</a> and beat ups to <a href="https://www.uts.edu.au/sites/default/files/Sceptical-Climate-Part-2-Climate-Science-in-Australian-Newspapers.pdf">climate denial</a> and the demonisation of minorities, News Corp can be counted on to dumb down complexity, make issues binary and turn one side against the other. He has damaged democracy and civil discourse and journalism itself. The behaviour of News Corp has on occasions been reprehensible, for which I think Rupert must take the blame.<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/214141/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-dodd-5857">Andrew Dodd</a>, Director of the Centre for Advancing Journalism, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-rupert-murdoch-stepping-aside-now-and-what-does-it-mean-for-the-company-214141">original article</a>.

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Why does my hair turn green from the swimming pool?

<a href="https://theconversation.com/profiles/magdalena-wajrak-1432339">Magdalena Wajrak</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> If you are a blonde like me and enjoy laps in a swimming pool, you may have noticed your hair acquires a green tint after frequent swims in chlorinated water. This happens to both bleached and natural blondes. In fact, the green tinge happens to everyone, but it’s less visible on dark hair and those whose hair isn’t damaged by chemical treatments such as bleaching. But what exactly causes this green discoloration, and what can we do about it? Most of us blame the chlorine in the pool water. However, although chlorine does play a part, it is not the main culprit. <h2>Which chemicals in the pool turn the hair green?</h2> The element to blame for the green staining of hair is copper. The main source of copper is copper sulfate (CuSO₄), a compound added to swimming pools to prevent the growth of algae. <a href="https://www.sciencedirect.com/science/article/pii/S1568988320301803?via%3Dihub">Contact with algae</a> can cause skin irritation and respiratory issues, and ingesting water with algae can lead to serious gastrointestinal problems. Only a small amount (around 0.5mg per litre or 0.5 parts per million) of copper sulfate is needed to prevent algal growth. However, copper can also enter swimming pools through the corrosion of water pipes, so concentrations may be higher in some pools. Copper sulfate crystals are greenish-blue in colour. So, when hair comes into contact with copper ions – a positively charged variant of a copper atom with extra electrons – those ions get absorbed by the hair and cause the greenish hue. Scientists were fascinated by the green “pool hair” phenomenon as far back as the 1970s, so we actually have research data on copper being the cause. One very <a href="https://jamanetwork.com/journals/jamadermatology/article-abstract/538197">interesting study in 1978</a> performed experiments by immersing hair samples into water containing different concentrations of copper ions, chlorine and various pH values (neutral and basic). Their results showed hair exposed to free copper ions does turn green. Furthermore, when hair is oxidised (meaning electrons are removed from the hair proteins) by chlorine, it actually damages the hair, enhancing the absorption of copper ions. Hair submerged in water with chlorine but without copper ions did not turn green. Meanwhile, hair exposed to water with only copper ions and no chlorine still formed a green colour. Hence, chlorine by itself does not play a role in causing the green hue we see in “pool hair”, but it does exacerbate it. <h2>So, how does copper get into the hair?</h2> <a href="https://doi.org/10.1007/978-1-4684-0943-7_24">Other research teams</a> have conducted <a href="https://doi.org/10.1071/ch9682437">more extensive studies</a>, using sophisticated instruments, such as scanning electron microscopy, to examine how exactly copper ions attach to the hair. Our hair is predominantly composed of protein called keratin. Keratin is classified as a “structural fibrous protein”, meaning it has an elongated, sheet-like structure. The keratin structure is composed of various <a href="https://chem.libretexts.org/Courses/University_of_Kentucky/UK%3A_CHE_103_-_Chemistry_for_Allied_Health_(Soult)/Chapters/Chapter_4%3A_Structure_and_Function/4.4%3A_Functional_Groups">chemical groups</a> (types of atom groupings with similar properties), such as carboxyl groups, amino groups and disulfide groups. Copper ions have the ability to form bonds with these groups, forming a copper-keratin complex. This complex remains in the hair, causing it to appear green. Interestingly, the most recent study <a href="https://doi.org/10.32657/10356/142466">conducted in 2020</a>, showed copper ions mainly bind to the disulfide groups. This study also found other metal ions such as zinc, lead, chromium and mercury also bind to hair in the same way. This is very useful in <a href="https://theconversation.com/forensic-breakthrough-study-suggests-humans-can-be-identified-by-the-proteins-in-their-hair-65051">forensic analysis</a>, for example, because forensic scientists can analyse hair samples to determine if a person has been exposed to a particular metal. Light-coloured hair already has the most visible green discoloration, but research has shown that damaged hair, caused by bleaching, straightening, or exposure to sun, is the <a href="https://pubmed.ncbi.nlm.nih.gov/19586601/">most susceptible</a> to the binding of copper ions. This is because in damaged hair the disulfide groups have “broken bonds” (the link that holds the elements within these groups together is broken), making it easier for the copper ions to bind to the hair. <h2>Can I prevent the green colour or get rid of it?</h2> To prevent your hair from turning green in a swimming pool, you have two basic options. The first is a physical barrier – just wear a swim cap. The second option is chemical – you can pre-treat your hair with an alkaline shampoo. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0891584918310050">Studies have shown</a> under alkaline pH conditions, the copper ions won’t attach to the hair. To treat your hair before going to the pool, you can either use a shampoo with a pH higher than 7, or you can even try mixing some baking soda into your regular shampoo. But what can you do if your hair has already turned greenish? Well, you can try washing your hair with a shampoo designed to achieve this, typically marketed as a “chlorine removal” shampoo. These products contain a chemical called EDTA – it can bind to metal ions (such as copper) and thus will remove copper from the hair. You may have heard tomato sauce or ketchup is a good way to get the green out of your pool hair – potentially because the red pigments are supposed to “cancel out” the green ones. However, I’m not aware of any scientific evidence this would work. Correction: This article has been amended to clarify that alkaline shampoos have a pH higher than 7, not lower.<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/211736/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/magdalena-wajrak-1432339">Magdalena Wajrak</a>, Senior lecturer, Chemistry, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-hair-turn-green-from-the-swimming-pool-211736">original article</a>.

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Entertainment

Travel

Health

Lifestyle

Finance

Property

Compare

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Information

Keep up to date

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

If you squat in a vacant property, does the law give you the house for free? Well, sort of

Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

Does intermittent fasting have benefits for our brain?

Does British tourism really need the royal family?

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As Scott Morrison leaves parliament, where does he rank among Australian prime ministers?

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How long does immunity last after a COVID infection?

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