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The dos and don’ts of caring for your hearing aids

Proper care and maintenance of your hearing aids is important. It will ensure you to get the most out of your aids, prevent problems and maintain optimum hearing conditions. Here are some guidelines to help you care for them. DO: clean your hearing aids regularly with a dry cloth or tissue. DON’T: get your hearing aids wet. That means no wearing them in the shower or when swimming. If they happen to get wet, dry it off immediately. DO: put your hearing aids in their case when you’re not using them DON’T: wear your aids when using aftershave, hairspray, perfume, sunscreen, insect repellent and so on. They contain chemicals that could damage it. Allow time for drying before putting back on hearing aids. DO: use a moisture protection kit/anti-humidity kit. They help with moisture problems (which can affect performance of hearing aids) and extend life of hearing aids. DO: keep out of reach of pets and visiting grandkids. Dogs have been known to chew them up and if swallowed by either pet or grandkid, can be very dangerous. DON’T: expose your device to extreme heats. Don’t leave them in a parked car, near a heater or wear while using a hairdryer. DO: Store your hearing aid in a safe place that's dry and cool. DON’T: leave your hearing aids switched on when you’re not using them. DO: change batteries often so you won’t be stuck with aids that have suddenly run out of power. DON’T: ever insert anything into the sound outlet as it could damage the receiver. If you can’t clean it properly, ask your hearing professional. DO: remove any earwax that gets into your hearing aid. It could cause permanent damage. Image credits: Getty Images

Hearing

6 kitchen mistakes you don’t know you're making

The kitchen is the heart of the home, but it can also be an area where we make the most mistakes in the way we use it. Check out our top tips to help keep your kitchen ship-shape. Clean the inside of the dishwasher You may not realise that the appliance that keeps everything clean can in fact be quite dirty. The inside of the dishwasher can be a breeding ground for bacteria. Run a hot cycle with nothing but a cup of white vinegar in the top and bottom shelves. Then simply wipe clean the sides and seams of the dishwasher. Don’t wash your chicken You may think this is necessary, but in fact washing your chicken can spread bacteria across your work surface, towels, cloths, and your hands. You can avoid it altogether as cooking will get rid of anything harmful on your meat. Change your kitchen towel The towel can be harbouring many kinds of bacteria, so it’s best to change them daily. Don’t rely on the sniff test to see if it needs a wash. A dirty towel used to dry your clean dishes can quickly spread germs that can make you sick. Avoid putting wooden items in the dishwasher The heat from the appliance can cause wooden items to warp and crack. That means wooden chopping boards, salad servers, or pots and pans with wooden handles need to be hand washed. Never wipe up floor spills with the dishcloth or tea towel If you wipe up some spilled milk off the floor and then use that same cloth to wipe your bench, germs can quickly spread. Same goes with a tea towel. Always use paper towel for cleaning mess from the floor. Fix leaking taps It’s too easy to ignore the drip drip of a leaky tap. But did you know a leaking tap could use over 6,000L of water in a month? Save the Earth (and reduce your water bill) by staying on top of any leaks around the home. Have a separate chopping board for meat Cross contamination can occur if you chop raw meat on a chopping board and then use it later (even after cleaning) for chopping fruit or vegetables. It’s best to have a board designated just for meat – it’s great if it’s a different colour to your everyday boards. Wash in hot soapy water after each use. Image credits: Getty Images

Home & Garden

Stay or go? Most older Australians want to retire where they are, but renters don’t always get a choice

<a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>, and <a href="https://theconversation.com/profiles/william-clark-1488932">William Clark</a>, <a href="https://theconversation.com/institutions/university-of-california-los-angeles-1301">University of California, Los Angeles</a> As Australia’s population gets older, more people are confronted with a choice: retire where they are or seek new horizons elsewhere. Choosing to grow old in your existing home or neighbourhood is known as “ageing in place”. It enables older people to stay connected to their community and maintain familiarity with their surroundings. For many, the decision to “age in place” will be tied to their connection to the family home. But for many, secure and affordable housing is increasingly <a href="https://theconversation.com/ageing-in-a-housing-crisis-growing-numbers-of-older-australians-are-facing-a-bleak-future-209237">beyond reach</a>. This choice may then be impeded by a lack of suitable accommodation in their current or desired neighbourhoods. Our recently published <a href="https://doi.org/10.1177/01640275231209683">study</a> asks what motivates older homeowners and renters to age in place or relocate, and what factors disrupt these preferences. It suggests older renters are often not given a fair choice. <h2>Most older Australians want to age in place</h2> Having the option to age in place enables older people to retain autonomy over their lifestyles and identity, promoting emotional wellbeing. Using 20 years of data from the government-funded Household, Income and Labour Dynamics in Australia (HILDA) survey, we tracked the preferences of Australians aged 55 and over. Encouragingly, most older Australians are already where they want to be. Two-thirds (67%) of respondents strongly preferred to stay in their current neighbourhood, and an additional one-fifth (19%) had a moderate preference to stay. Only 6% showed a moderate or strong desire to leave. Ageing in place is then the natural choice for a vast majority of older Australians. <iframe id="s3LTM" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/s3LTM/1/" width="100%" height="400px" frameborder="0"></iframe> Our study highlights several motivations for people to stay put as they retire. For homeowners, family ties matter. Owners with children residing nearby were around one and a half times more likely to have a higher preference to stay. Older owners might then have a reason to call on their substantial <a href="https://theconversation.com/the-housing-wealth-gap-between-older-and-younger-australians-has-widened-alarmingly-in-the-past-30-years-heres-why-197027">housing wealth</a> and keep their children nearby via the <a href="https://360info.org/how-to-help-the-young-buy-a-home/">“bank of mum and dad”</a>. For renters, how long they stay is important. Those renting their home for 10 years or more were 1.7 times more likely to have a higher preference to stay than short-term renters. <h2>Renters face the most disruption</h2> The survey enabled us to follow where older people lived a year after they provided their preferences. This helped us gauge how often they turned their desires into reality. The chart below indicates that private renters face greater obstacles to ageing in place. Around one in 10 private renters that desired to age in place were disrupted – they wanted to stay in their neighbourhood but didn’t. This suggests they moved out of their neighbourhood involuntarily. Only 2% of homeowners and social renters experienced the same disruption. However, for those in these tenures that did not desire to age in place, involuntary immobility was a greater concern. Only 15% of those that wanted to leave succeeded, leaving the vast majority “stuck in place”. <iframe id="IlliV" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/IlliV/1/" width="100%" height="400px" frameborder="0"></iframe> The private rental market is the least secure of tenures, and so private tenants are often exposed to involuntary moves. Australia’s private rental system is lightly regulated compared to many other countries, creating tenure insecurity concerns. On the other hand, social renters were particularly susceptible to involuntary immobility. Social housing is scarce in Australia and subject to <a href="https://theconversation.com/its-soul-destroying-how-people-on-a-housing-wait-list-of-175-000-describe-their-years-of-waiting-210705">lengthy waiting lists</a>. A neighbourhood move often requires transferring to the less affordable and less secure private rental housing. Even after considering financial status, social renters were four times as likely to be stuck as compared to private renters. Social tenants are strongly deterred from moving in the current system. <h2>How can we support older Australians’ preferences?</h2> Our study exposes some barriers in the housing system that hinder people from being able to age in place, or move when they want to. Clearly, older renters enjoy fewer protections against disruptions to their preferences to age in place than older owners. For private renters, tenure insecurity in the <a href="https://theconversation.com/insecure-renting-ages-you-faster-than-owning-a-home-unemployment-or-obesity-better-housing-policy-can-change-this-216364">private rental sector</a> is a key reform priority. This can be achieved through stronger regulation that improves tenants’ rights. For example, more states could adopt <a href="https://theconversation.com/how-5-key-tenancy-reforms-are-affecting-renters-and-landlords-around-australia-187779?utm_source=twitter&utm_medium=bylinetwitterbutton">recent regulatory rental reforms</a> that support the rights of pet owners and protect against no-grounds evictions. Large numbers of older private renters also face severe <a href="https://www.oldertenants.org.au/publications/ageing-in-a-housing-crisis-older-peoples-housing-insecurity-homelessness-in-australia">rental stress</a>, which may force them to move from their preferred neighbourhood. <a href="https://theconversation.com/1-billion-per-year-or-less-could-halve-rental-housing-stress-146397">Commonwealth rent assistance reform</a> would alleviate some of this stress through an increase in rates and better targeting. An increase in the supply of social housing would play an important role in improving both tenure security and housing affordability. Older social renters enjoy fewer obstacles to ageing in place than older private renters. However, if social renters want to move into the private rental market to relocate, they face difficulty securing accommodation. This will likely discourage moves as it would require sacrificing the tenure security offered by social housing. However, policy initiatives that improve the <a href="https://www.ahuri.edu.au/sites/default/files/migration/documents/PES-358-Lessons-from-public-housing-urban-renewal-evaluation.pdf">quality of the public housing stock</a> can reduce feelings of being stuck. As <a href="https://www.aihw.gov.au/reports/australias-welfare/home-ownership-and-housing-tenure">homeownership rates decline</a> both among young people and those nearing retirement, we can expect the population of older renters to grow. Overall, our findings support a strong case for policy reform in the rental sectors to address the needs and preferences of older renters.<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/218024/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, Research Fellow, School of Accounting, Economics and Finance, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, ARC Future Fellow & Professor of Economics, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>, and <a href="https://theconversation.com/profiles/william-clark-1488932">William Clark</a>, Research Professor of Geography, <a href="https://theconversation.com/institutions/university-of-california-los-angeles-1301">University of California, Los Angeles</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/stay-or-go-most-older-australians-want-to-retire-where-they-are-but-renters-dont-always-get-a-choice-218024">original article</a>.

Retirement Income

“Don’t be alarmed”: Better Homes and Gardens star makes shock announcement

Better Homes and Gardens star Karen Martini has announced she will be “stepping back” from her role on the program. After almost two decades on the show, the 52-year-old admitted she has “so much on my plate” this year as she balances a range of different projects. The chef and restaurateur will be taking a break from the show to focus on work, while also making more time for her teenage daughters, Stella, 17, and Amber, 15. She told <a href="https://7news.com.au/entertainment/tv/better-homes-and-garden-star-karen-martini-makes-shock-announcement-stepping-back-c-13310981">7News</a>, “With my two new restaurants— Johnny’s Green Room already open and Saint George set to launch soon — as well as so many other projects on the go, 2024 is shaping up to be my busiest year ever.” “My daughters are in their last teenage years too — it’s quite daunting as Stella is in year 12 and also on her Ls.” “With so much on my plate, I’ve made the decision to step back from Better Homes and Gardens (BHAG) this year while I focus on some of my other exciting projects.” “So don’t be alarmed if I’m not in your living room every Friday night.” Karen will continue to make the occasional guest appearance on the show, but will not feature in every episode. After the news of Karen’s departure was announced on the Better Homes & Gardens Instagram account, longtime viewers shared their messages of support to the chef in her next ventures. One person wrote, “Been watching since you joined in 2007 and I’ve loved watching you in the kitchen. All the best.” The 52-year-old also shared her excitement over the newest addition to the Better Homes line-up: chef and MKR judge Colin Fassnidge. “I’m so excited that my mate Colin Fassnidge is entering the Better Homes kitchen,” she went on. “I think his cheeky flavour is sure to spice up the show and I can’t wait to see him on air when we are back on Friday, February 2.” Image credits: Instagram

More than a third of people with dementia don’t know they have it – what to do if you suspect your partner has the condition

<a href="https://theconversation.com/profiles/kate-irving-1493654">Kate Irving</a>, <a href="https://theconversation.com/institutions/dublin-city-university-1528">Dublin City University</a> Around <a href="https://www.bbc.co.uk/news/uk-england-67613465">36% of people</a> in England with dementia are unaware they have the condition, according to a new report from the Dementia Commission. <a href="https://chamberuk.com/wp-content/uploads/2023/12/231127-Dementia-Commission-Report-Embargoed.pdf">The report</a> suggests things health and care professionals can do to improve spotting early signs of dementia. But what can you do if you think your partner has the condition? And how can you broach the topic with them? If you are worried about your partner having dementia, here are some useful things to know. Dementia is a term for a range of diseases (for example, Alzheimer’s) which develop over time (months and years) and cause problems with memory and reasoning, communication, changes in personality and a reduction in a person’s ability to carry out daily activities, such as shopping, washing, paying bills or cooking. Dementia can present very differently in each person, so it’s about knowing what’s normal for your loved one. A person who has always been conscientious and organised starting to unravel is very different from a scatterbrained person just being slightly more scatterbrained. Grief and stress can affect memory yet not be the start of dementia. But they can also mask the start of dementia: we call this “diagnostic over-shadowing”. There are also age-related changes to cognition. For example, we take longer to learn when we get older. But a one-off event – no matter how dramatic – is not necessarily dementia. It’s about looking for a pattern of decline. If you see these changes happen in a short space of time (weeks or days) it is unlikely to be dementia and could be something more serious. This requires urgent investigation by a doctor. <h2>Greatest fear</h2> Dementia is one of the greatest fears of our age. The horror of perceived loss of self can cause people to avoid discussing the issue, discussing it in an unhelpful way (such as criticising or inadvertently humiliating) or discussing it with other relatives, but not the person they are noticing changes in. Over time, this can cause a lack of trust to develop. Discussing memory problems openly with the person at the point of a memory failure or if they raise the concern is best. Of course, it takes courage and makes us face our own vulnerability. Sometimes the person will be in denial or lack insight into the memory problems (this can be a symptom of dementia, but isn’t always). If someone raises a concern about their memory issues, I would urge you not to minimise this, as it probably took courage to admit their concerns. I heard a relative say to my mother: “Oh, you left the pot on the stove. I lost the car in the multistory the other day.” My mother had dementia – the relative did not. If they are adamant that they do not have concerns, this is harder to deal with. One approach is to say: “I know you are not concerned, but I am concerned and I wonder if you would see a doctor to ease my worries?” Also explaining that memory problems can at least to some extent have reversible causes means a visit to the doctor to at least rule these out is an important step. It may also be encouraging to say to the person: “If there is something with your memory that will get worse over time, would you want to know?” (Most people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408568/">answer yes</a> to this). <h2>Seeing a GP</h2> If your partner agrees to visit a GP, it is helpful to prepare by filling in a diary for a week with the kind of memory (or other) problems experienced, what was happening at the time and the effect of the memory failure. This can be shared with a GP to help them to understand the issues. When people hear even the suggestion of the word dementia, they are faced with the uncertainties of what will become of them, of what they will lose, what they can keep up and where they will end up. These uncertainties are often shared with family members. But research shows that positive aspects of timely diagnosis <a href="https://www.scie.org.uk/dementia/symptoms/diagnosis/early-diagnosis.asp">outweigh fears</a> over time. At the same time, there are often ongoing stresses to do with memory impairments or confusion. With these stresses, everyday life can be troublesome, family relationships can suffer, and people can find it difficult to be supportive of each other. Being honest and open is the best policy. Stating that we are in this together, I want to help, let’s meet whatever happens head on, can help. If a person becomes resistant, it may be there is another family member who might better assist the person.<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/219172/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kate-irving-1493654">Kate Irving</a>, Professor of Clinical Nursing, <a href="https://theconversation.com/institutions/dublin-city-university-1528">Dublin City 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/more-than-a-third-of-people-with-dementia-dont-know-they-have-it-what-to-do-if-you-suspect-your-partner-has-the-condition-219172">original article</a>.

Mind

"You don’t know why they’re filming or what they’ll do with it": flight attendants on being unwilling stars of viral videos

<a href="https://theconversation.com/profiles/liz-simmons-1376255">Liz Simmons</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/gui-lohmann-1476773">Gui Lohmann</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/rawan-nimri-1482182">Rawan Nimri</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> As any frequent social media user knows, airline passengers often record and post in-flight incidents – from frightening turbulence to unruly members of the public. Often, these viral videos feature flight attendants just trying to do their duties, while being filmed without their consent. These videos usually portray flight attendants either as heroes effortlessly managing difficult passengers or “villains” accused of being rude and unprofessional. Either way, the trend is emerging as an industrial issue, with unions arcing up about it and airlines bringing in new rules aimed at curbing the practice. <h2>Unkind comments about appearance and age</h2> Going to work knowing that at any moment you may become the unwilling star of a viral video can exact a considerable toll on the wellbeing of flight attendants. I (Liz Simmons) speak daily with flight attendants in Australia and abroad as part of my PhD research. From these discussions, I’ve heard from attendants who worry often about discovering videos of themselves featuring unkind comments about their appearance, age or employer. One flight attendant, Kate*, described the disconcerting feeling of someone aiming a smartphone camera at her while she was simply trying to do her job, saying: "You don’t know why they’re filming or what they’ll do with it." Marie spoke of being featured in a TikTok video during a safety demonstration, with viewers making fun of her appearance. Charlotte, after refusing to serve more alcohol to an intoxicated passenger, had a camera thrust in her face, accompanied by threats to her job. Mark told of how uncomfortable he felt having to ask a passenger to stop taking photos of the crew during service. These personal accounts illustrate the <a href="https://www.news.com.au/travel/travel-updates/health-safety/flight-attendant-reveals-creepy-passenger-behaviour/news-story/3b2b1ad25f758e24ef37b74794684ea6">distress</a> flight attendants can experience when being filmed or photographed without their knowledge. <h2>A broader industrial issue</h2> This issue is drawing the attention of policymakers, airlines and the unions that represent flight attendants. Japan recently introduced <a href="https://japannews.yomiuri.co.jp/society/crime-courts/20230408-102309/">laws</a> aimed at curbing sneak photography in a range of settings, which may be used to prevent passengers voyeuristically filming flight attendants. <a href="https://mondortiz.com/japan-flight-attendants-call-for-action-versus-stolen-photo-taking/">Research</a> by Japan’s aviation workers union found that about 70% of the 1,573 flight attendants surveyed believed they’d had their pictures taken surreptitiously while they were working. Passengers have been arrested in <a href="https://www.jpost.com/israel-news/crime-in-israel/article-748799">Turkey</a> and <a href="https://www.dailymail.co.uk/travel/travel_news/article-3554181/IndiGo-passenger-arrested-recording-video-flight-attendants.html">India</a> after unauthorised filming. And flight attendant unions in <a href="https://www.japantimes.co.jp/news/2023/03/09/national/crime-legal/flight-attendant-photo/">Japan</a>, <a href="https://www.thestandard.com.hk/breaking-news/section/4/204104/Union-says-flight-attendants-can-ask-passengers-to-delete-photos-and-videos-taken-without-consent">Hong Kong</a> and <a href="https://www.stuff.co.nz/travel/news/300750512/why-you-shouldnt-film-your-cabin-crew">Australia</a> have voiced concerns about the issue. Of course, videos can occasionally play a crucial role in understanding what transpired during an <a href="https://www.nbcnews.com/news/us-news/passenger-assault-attendant-detained-fbi-american-airlines-mexico-cabo-rcna48884">in-flight incident</a>, and flight attendants themselves can also be found on social media sharing their stories, consenting to the video. But many videos still feature airline staff simply going about their job (while being filmed, without their consent). <h2>Unclear rules</h2> News <a href="https://www.smh.com.au/traveller/reviews-and-advice/why-you-shouldnt-film-your-cabin-crew-20221122-h2813d.html">reports</a> suggest staff aboard Dutch carrier KLM “now commonly make an announcement during the safety briefing asking passengers not to take photos of any crew members.” The <a href="https://www.klm.com.au/information/legal/conditions-carriage">rules</a> on the KLM website are less clear, saying only that, "Recording videos and/or taking photographs other than personal videos and photographs is prohibited on board the aircraft." Virgin Australia’s rules state anyone travelling on their planes must "use cameras or photographic devices (including mobile phones) for personal use only. You must comply with the directions of flight crew when using cameras or photographic devices while on board. In November 2023, Qantas introduced new <a href="https://www.qantas.com/au/en/book-a-trip/flights/conditions-of-carriage.html#conduct-during-flight">rules</a> requiring passengers to "seek consent before filming or photographing Qantas Group staff, contractors or other customers." This is a start. For most airlines, however, there is a notable absence of clear guidelines against recording and publishing footage of flight attendants in their workplace. The existing rules are often buried in the fine print of terms and conditions, which few passengers take the time to read. This underscores the necessity for airlines to reconsider how these restrictions are communicated to passengers. Looking ahead, it may be timely for more airlines to establish clearer rules on filming cabin crew while they work. There should be an acknowledgement that unsolicited filming is frequently unfair, invasive and distressing. Developing a framework to enforce these provisions and enhancing communication about these rules would help inform passengers about how to respect the privacy and comfort of flight attendants in their workplace. * All names have been changed to protect identities.<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/217089/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/liz-simmons-1376255">Liz Simmons</a>, PhD Candidate, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/gui-lohmann-1476773">Gui Lohmann</a>, Professor in Air Transport and Tourism Management, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/rawan-nimri-1482182">Rawan Nimri</a>, Lecturer in Tourism and Hospitality, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith 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/you-dont-know-why-theyre-filming-or-what-theyll-do-with-it-flight-attendants-on-being-unwilling-stars-of-viral-videos-217089">original article</a>.

Travel Trouble

"I just don't like old skin": Jane Fonda's bizarre confession

Jane Fonda has made an unusual confession about her dating life, explaining why she would only date people of a certain age. The Hollywood legend, 85, has been married three times throughout her life: first to director Roger Vadim from 1965 to 1973, then to activist Tom Hayden from 1973 to 1990, and finally to CNN founder Ted Turner from 1991 to 2001. Fonda is currently single, but doesn't plan on staying that way. Despite being open to finding love, the actress has a very specific criteria for potential suitors to meet before agreeing to a date. On the Absolutely Not podcast, the Oscar winner initially suggested she was done with men for good, saying, “I’m done, I’m over, I’m [almost] 86 years old, even in the dark I wouldn’t want to be naked in front of anybody.” But she then went on to confess that there’s still a chance she could fall for a man, but they would just have to be substantially younger. “And here’s another thing, I’m ashamed to say this, if I were to take a lover, he’d have to be 20. Because I don’t like old skin,” said Fonda. She continued, “And consequently, I don’t want to foist that on anybody else. I assume other people are like me, I just don’t like old skin.” “I disapprove of 86-year-old men with 20-year-old women, so I’m not going to repeat it. I can ogle them, and I can’t pretend that I don’t get turned on if I see a certain kind of a person, but no, no, no, I don’t want to force that on anybody.” Her confession has been criticised on social media, with some suggesting the star would be “cancelled” if it was a man that had said the same about young women. “This is seriously weird,” tweeted one fan, while another said: “But an 85 year old man wanting to date a 20 year old woman is disgusting? Am I right?” Image credits: Getty Images

Relationships

Drinking alcohol this Christmas and New Year? These medicines really don’t mix

<a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> A glass or two of champagne with Christmas lunch. A cool crisp beer at the beach. Some cheeky cocktails with friends to see in the New Year. There seem to be so many occasions to unwind with an alcoholic drink this summer. But if you’re taking certain medications while drinking alcohol, this can affect your body in a number of ways. Drinking alcohol with some medicines means they may not work so well. With others, you risk a life-threatening overdose. Here’s what you need to know if you’re taking medication over summer and plan to drink. <h2>Why is this a big deal?</h2> After you take a medicine, it travels to the stomach. From there, your body shuttles it to the liver where the drug is metabolised and broken down before it goes into your blood stream. Every medicine you take is provided at a dose that takes into account the amount of metabolism that occurs in the liver. When you drink alcohol, this is also broken down in the liver, and it can affect how much of the drug is metabolised. Some medicines are metabolised more, which can mean not enough reaches your blood stream to be effective. Some medicines are metabolised less. This means you get a much higher dose than intended, which could lead to an overdose. The effects of alcohol (such as sleepiness) can act in addition to similar effects of a medicine. Whether or not you will have an interaction, and what interaction you have, depends on many factors. These include the medicine you are taking, the dose, how much alcohol you drink, your age, genes, sex and overall health. Women, older people and people with liver issues are more likely to have a drug interaction with alcohol. <h2>Which medicines don’t mix well with alcohol?</h2> Many medicines interact with alcohol regardless of whether they are prescribed by your doctor or bought over the counter, such as <a href="https://www.drugs.com/article/herbal-supplements-alcohol.html">herbal medicines</a>. 1. Medicines + alcohol = drowsiness, coma, death Drinking alcohol and taking a medicine that depresses the <a href="https://adf.org.au/drug-facts/depressants/">central nervous system</a> to reduce arousal and stimulation can have additive effects. Together, these can make you extra drowsy, slow your breathing and heart rate and, in extreme cases, lead to coma and death. These effects are more likely if you use more than one of this type of medicine. Medicines to look out for include those for depression, anxiety, schizophrenia, pain (except <a href="https://www.nps.org.au/australian-prescriber/articles/alcohol-and-paracetamol">paracetamol</a>), sleep disturbances (such as insomnia), allergies, and colds and flu. It’s best not to drink alcohol with these medicines, or to keep your alcohol intake to a minimum. 2. Medicines + alcohol = more effects Mixing alcohol with some medicines increases the effect of those medicines. One example is with the sleeping tablet zolpidem, which is <a href="https://www.tga.gov.au/news/product-recalls/zolpidem-stilnox">not to be taken with alcohol</a>. Rare, but serious, side effects are strange behaviour while asleep, such as sleep-eating, sleep-driving or sleep-walking, which are more likely with alcohol. 3. Medicines + craft beer or home brew = high blood pressure Some types of medicines only interact with some types of alcohol. Examples include some medicines for depression, such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid, the Parkinson’s drug selegiline, and the cancer drug procarbazine. These so-called <a href="https://www.mydr.com.au/medicine/monoamine-oxidase-inhibitors-maois-for-depression/">monoamine oxidase inhibitors</a> <a href="https://www.health.qld.gov.au/__data/assets/pdf_file/0020/145802/oncol_maoi.pdf">only interact with</a> some types of boutique and artisan beers, beers with visible sediment, Belgian, Korean, European and African beers, and home-made beers and wine. These types of alcohol contain high levels of tyramine, a naturally occurring substance usually broken down by your body that doesn’t ordinarily cause any harm. However, monoamine oxidase inhibitors prevent your body from breaking down tyramine. This increases levels in your body and can cause your blood pressure to rise to dangerous levels. 4. Medicines + alcohol = effects even after you stop drinking Other medicines interact because they affect the way your body breaks down alcohol. If you drink alcohol while using such medicines you may you feel nauseous, vomit, become flushed in the face and neck, feel breathless or dizzy, your heart may beat faster than usual, or your blood pressure may drop. This can occur even after you stop treatment, then drink alcohol. For example, if you are taking metronidazole you should avoid alcohol both while using the medicine and for at least 24 hours after you stop taking it. An example of where alcohol changes the amount of the medicine or related substances in the body is acitretin. This medication is used to treat skin conditions such as severe psoriasis and to prevent skin cancer in people who have had an organ transplant. When you take acitretin, it changes into another substance – <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2017-CMI-02034-1&d=20221221172310101">etretinate</a> – before it is removed from your body. Alcohol increases the amount of etretinate in your body. This is especially important as etretinate can cause birth defects. To prevent this, if you are a woman of child-bearing age you should avoid alcohol while using the medicine and for two months after you stop taking it. <h2>Myths about alcohol and medicines</h2> Alcohol and birth control One of the most common myths about medicines and alcohol is that you can’t drink while using <a href="https://youly.com.au/blog/sexual-reproductive-health/does-alcohol-make-the-pill-less-effective/">the contraceptive pill</a>. It is generally safe to use alcohol with the pill as it <a href="https://www.healthline.com/health/womens-health/birth-control-and-alcohol#:%7E:text=There's%20a%20bit%20of%20good,a%20less%20effective%20birth%20control.">doesn’t directly affect</a> how well birth control works. But the pill is most effective when taken at the same time each day. If you’re drinking heavily, you’re more likely to forget to do this the next day. Alcohol can also make some people nauseous and vomit. If you vomit within three hours of taking the pill, it will not work. This increases your risk of pregnancy. Contraceptive pills can also affect your response to alcohol as the hormones they contain can change the way your body <a href="https://americanaddictioncenters.org/alcoholism-treatment/birth-control">removes alcohol</a>. This means you can get drunk faster, and stay drunk for longer, than you normally would. Alcohol and antibiotics Then there’s the myth about not mixing alcohol with any <a href="https://theconversation.com/mondays-medical-myth-you-cant-mix-antibiotics-with-alcohol-4407">antibiotics</a>. This only applies to <a href="https://www.healthdirect.gov.au/medicines/medicinal-product/aht,21161/metronidazole">metronidazole</a> and <a href="https://www.healthdirect.gov.au/medicines/brand/amt,1011571000168100/linezolid-apo">linezolid</a>. Otherwise, it is generally safe to use alcohol with antibiotics, as alcohol does not affect how well they work. But if you can, it is best to avoid alcohol while taking antibiotics. Antibiotics and alcohol have similar side effects, such as an upset stomach, dizziness and drowsiness. Using the two together means you are more likely to have these side effects. Alcohol can also reduce your energy and increase how long it takes for you to recover. <h2>Where can I go for advice?</h2> If you plan on drinking alcohol these holidays and are concerned about any interaction with your medicines, don’t just stop taking your medicines. Your pharmacist can advise you on whether it is safe for you to drink based on the medicines you are taking, and if not, provide advice on alternatives.<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/196646/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drinking-alcohol-this-christmas-and-new-year-these-medicines-really-dont-mix-196646">original article</a>.

Caring

Taste depends on nature and nurture. Here are 7 ways you can learn to enjoy foods you don’t like

<a href="https://theconversation.com/profiles/nicholas-archer-181464">Nicholas Archer</a>, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> and <a href="https://theconversation.com/profiles/astrid-poelman-1481227">Astrid Poelman</a>, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> You’re out for dinner with a bunch of friends, one of whom orders pizza with anchovies and olives to share, but you hate olives and anchovies! Do you pipe up with your preferred choice – Hawaiian – or stay quiet? This scene plays out every day around the world. Some people ferociously defend their personal tastes. But many would rather expand their palate, and not have to rock the boat the next time someone in their friend group orders pizza. Is it possible to train your tastebuds to enjoy foods you previously didn’t, like training a muscle at the gym? <h2>What determines ‘taste’?</h2> Taste is a complex system we evolved to help us navigate the environment. It helps us select foods with nutritional value and reject anything potentially harmful. Foods are made up of different compounds, including nutrients (such as proteins, sugars and fats) and <a href="https://www.youtube.com/watch?v=2P_0HGRWgXw">aromas</a> that are detected by sensors in the mouth and nose. These sensors create the <a href="https://www.youtube.com/watch?v=MZn2PMUWO-Y">flavour of food</a>. While taste is what the tastebuds on your tongue pick up, flavour is the combination of how something smells and tastes. Together with texture, appearance and sound, these senses collectively influence your food preferences. <figure><iframe src="https://www.youtube.com/embed/MZn2PMUWO-Y?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Flavour is the overall impression you get when eating.</figcaption></figure> Many factors influence food preferences, including age, genetics and environment. We each live in our own sensory world and no two people will have the same <a href="https://theconversation.com/curious-kids-why-do-some-people-find-some-foods-yummy-but-others-find-the-same-foods-yucky-77671">experience while eating</a>. Food preferences also change with age. Research has found young children have a <a href="https://pubmed.ncbi.nlm.nih.gov/24452237/">natural preference</a> for sweet and salty tastes and a dislike of bitter tastes. As they grow older their ability to like bitter foods grows. Emerging evidence shows bacteria in saliva can also produce enzymes that influence the taste of foods. For instance, saliva has been shown to cause the release of sulphur aromas in cauliflower. The <a href="https://www.acs.org/pressroom/presspacs/2021/acs-presspac-september-22-2021/childrens-dislike-of-cauliflower-broccoli-could-be-written-in-their-microbiome.html">more sulphur that is produced</a>, the less likely a kid is to enjoy the taste of cauliflower. <h2>Nature versus nurture</h2> Both genetics and the environment play a crucial role in determining food preferences. Twin studies estimate genetics have a moderate influence on food preferences (between 32% and 54%, depending on the food type) in <a href="https://www.sciencedirect.com/science/article/pii/S000291652305027X?via%3Dihub">children</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/27385609/">adolescents</a> and <a href="https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/dietary-patterns-and-heritability-of-food-choice-in-a-uk-female-twin-cohort/8507AAF01330C599BAC62BCC0EF4CF06">adults</a>. However, since our cultural environment and the foods we’re exposed to also shape our preferences, these <a href="https://pubmed.ncbi.nlm.nih.gov/24452237/">preferences are learned</a> to a large degree. A lot of this learning takes place during childhood, at home and other places we eat. This isn’t textbook learning. <a href="https://www.cabidigitallibrary.org/doi/10.1079/9780851990323.0093">It’s learning</a> by experiencing (eating), which typically leads to increased liking of the food – or by watching what others do (modelling), which can lead to both positive or negative associations. <a href="https://www.sciencedirect.com/science/article/pii/S000291652305027X?via%3Dihub">Research</a> has shown how environmental influences on food preferences change between childhood and adulthood. For children, the main factor is the home environment, which makes sense as kids are more likely to be influenced by foods prepared and eaten at home. Environmental factors influencing adults and adolescents are more varied. <h2>The process of ‘acquiring’ taste</h2> Coffee and beer are good examples of bitter foods people “acquire” a taste for as they grow up. The ability to overcome the dislike of these is largely due to: <ul> <li> the social context in which they’re consumed. For example, in many countries they may be associated with passage into adulthood. </li> <li> the physiological effects of the compounds they contain – caffeine in coffee and alcohol in beer. Many people find these effects desirable. </li> </ul> But what about acquiring a taste for foods that don’t provide such desirable feelings, but which are good for you, such as kale or fatty fish? Is it possible to gain an acceptance for these? Here are some strategies that can help you learn to enjoy foods you currently don’t: <ol> <li> eat, and keep eating. Only a small portion is needed to build a liking for a specific taste over time. It may take 10–15 attempts or more before you can say you “like” the food. </li> <li> <a href="https://www.sciencedirect.com/science/article/pii/S0950329302001106">mask bitterness</a> by eating it with other foods or ingredients that contain salt or sugar. For instance, you can pair bitter rocket with a sweet salad dressing. </li> <li> eat it repeatedly in a positive context. That could mean eating it after playing your favourite sport or with people you like. Alternatively, you could eat it with foods you already enjoy; if it’s a specific vegetable, try pairing it with your favourite protein. </li> <li> eat it when you’re hungry. In a hungry state you’ll be more willing to accept a taste you might not appreciate on a full stomach. </li> <li> remind yourself why you want to enjoy this food. You may be changing your diet for health reasons, or because you’ve moved countries and are struggling with the local cuisine. Your reason will help motivate you. </li> <li> start young (if possible). It’s easier for children to learn to like new foods as their tastes are less established. </li> <li> remember: the more foods you like, the easier it’ll become to learn to like others. </li> </ol> A balanced and varied diet is essential for good health. <a href="https://www.sciencedirect.com/science/article/pii/S0195666315003438?ref=pdf_download&fr=RR-2&rr=82a5fd5069821f63">Picky eating</a> can become a problem if it leads to vitamin and mineral deficiencies – especially if you’re avoiding entire food groups, such as vegetables. At the same time, eating too many tasty but energy-dense foods can increase your risk of chronic disease, including obesity. Understanding how your food preferences have formed, and how they can evolve, is a first step to getting on the path of healthier eating.<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/215999/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nicholas-archer-181464">Nicholas Archer</a>, Research Scientist, Sensory, Flavour and Consumer Sciences, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> and <a href="https://theconversation.com/profiles/astrid-poelman-1481227">Astrid Poelman</a>, Principal Researcher, Public Health & Wellbeing Group, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</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/taste-depends-on-nature-and-nurture-here-are-7-ways-you-can-learn-to-enjoy-foods-you-dont-like-215999">original article</a>.

Food & Wine

About 1 in 6 older Australians experiences elder abuse. Here are the reasons they don’t get help

<a href="https://theconversation.com/profiles/eileen-obrien-95332">Eileen O'Brien</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/catriona-stevens-1455614">Catriona Stevens</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>, and <a href="https://theconversation.com/profiles/loretta-virginia-baldassar-1485078">Loretta Virginia Baldassar</a> Each year, many older Australians experience abuse, neglect or financial exploitation, usually at the hands of their adult children or other close relatives. A recent <a href="https://aifs.gov.au/research/research-reports/national-elder-abuse-prevalence-study-final-report">national prevalence study</a> revealed one in six older Australians living at home experiences elder abuse. This may encompass various forms of abuse, such as emotional, financial, social, physical and sexual abuse, or neglect. Despite elder abuse being such a common problem, older people often don’t get the help they need. With the right responses, we can make it easier for those working with older people, and the wider community, to support them. Our <a href="https://www.wa.gov.au/system/files/2023-11/everyones_business_research_into_responses_to_the_abuse_of_older_in_wa_report.pdf">new research</a> reveals the key reasons older people experiencing harm do not receive the support they so desperately need. Our study included a survey of nearly 700 service providers throughout Western Australia. Respondents worked in diverse fields including healthcare, law, aged care, financial services and law enforcement. We found four key obstacles to people getting help with elder abuse. 1. Older people are too scared to report abuse. Older people are often afraid to report abuse because they fear repercussions both for themselves and for the perpetrator, usually an adult child or other close relative. These concerns can mean an older person endures abuse for a long time. They may only seek help when the situation escalates to an extreme level or when someone else notices the ongoing mistreatment. Equally important, they may fear other negative outcomes of reporting abuse. They may fear having to leave their home and enter residential care. They may fear increased isolation and loneliness, or that the abuse will get worse. All these fears combined create a formidable barrier to older people promptly reporting abuse and getting the help they need. <blockquote class="twitter-tweet"> <a href="https://twitter.com/hashtag/ElderAbuse?src=hash&ref_src=twsrc%5Etfw">#ElderAbuse</a> is more common than people realize. It can happen: In their own homes In hospitals In nursing homes or other kinds of long-term care facilities Learn more, including how to prevent elder abuse: <a href="https://t.co/CAkBHQO4gm">https://t.co/CAkBHQO4gm</a><a href="https://twitter.com/hashtag/Alzheimers?src=hash&ref_src=twsrc%5Etfw">#Alzheimers</a> <a href="https://twitter.com/hashtag/dementia?src=hash&ref_src=twsrc%5Etfw">#dementia</a> <a href="https://twitter.com/hashtag/aging?src=hash&ref_src=twsrc%5Etfw">#aging</a> <a href="https://twitter.com/hashtag/geriatrics?src=hash&ref_src=twsrc%5Etfw">#geriatrics</a> <a href="https://t.co/gO3Dc6Dy3Z">pic.twitter.com/gO3Dc6Dy3Z</a> — Ian Kremer (@LEAD_Coalition) <a href="https://twitter.com/LEAD_Coalition/status/1720567529200918550?ref_src=twsrc%5Etfw">November 3, 2023</a></blockquote> 2. Older people don’t know where to turn for help Elder abuse cases are often complex, involving long family histories and complicated relationships. Older people trying to improve their situation may need support from multiple service providers. The challenge of accessing the right services and acting on their advice can be daunting. Addressing complicated matters may require intensive support and advocacy for an extended time. In the words of one experienced advocate, <blockquote> People don’t need to know the next ten steps. They need to know one step, maybe two, and then see where they are at. </blockquote> Helping older people feel empowered to seek help requires simple, accessible channels of assistance, promoted through multiple formats and outreach efforts. 3. Government-funded responses to family violence are more focused on intimate partner violence and child protection, leaving elder abuse out of the picture Most programs targeting family violence prioritise intimate partner violence and child protection, inadvertently sidelining elder abuse. Services such as shelters and perpetrator programs are not always compatible with the distinct characteristics of elder abuse. Additionally, the gendered nature of family violence responses fails to address the diverse demographics of elder abuse, which includes older men. As a result, older people, regardless of gender, may struggle to access supports suited to their needs. A refuge manager explained: <blockquote> When a bed becomes available we have this awful job of deciding who’s more high-risk and who gets the bed. If an older person needs the bed, as opposed to a single mum with a newborn, unfortunately we would go with the mum. That really presents a barrier where there isn’t refuge accommodation specifically for older people. </blockquote> There is a pressing need for a shift in focus to better recognise elder abuse as a significant issue and tailor responses to meet the specific needs of older people. This includes creating safe and accessible refuge options and providing specialised support services to address the multifaceted nature of elder abuse. 4. There’s low public awareness about what elder abuse looks like or how to respond Awareness of elder abuse remains surprisingly low, hindering effective responses. Changing this requires clear public information campaigns and community-wide conversations about abuse. This includes greater awareness of the challenge for well-meaning adult children who might limit the choices of their older relatives, thinking they know best. This can result in unintended social isolation or even neglect. A society that speaks openly about elder abuse, without stigma, is better equipped to support victims and intervene. By building public knowledge and promoting a culture where such issues can be freely discussed, we lay the groundwork for reducing its incidence. We are living longer lives than ever before, meaning we can expect to spend more years in older age than previous generations. This is good news, but also means we need to do more work to support people to age well. Positive steps we can all take include tackling ageism when we see it and normalising conversations about abuse so older people can feel confident to seek help when it’s needed.<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/216827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/eileen-obrien-95332">Eileen O'Brien</a>, Professor of Law, Discipline of Law, Justice and Society, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/catriona-stevens-1455614">Catriona Stevens</a>, Forrest Prospect Fellow in Sociology and Anthropology, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>, and <a href="https://theconversation.com/profiles/loretta-virginia-baldassar-1485078">Loretta Virginia Baldassar</a>, Vice Chancellor Professorial Research Fellow, School of Arts and Humanities, Edith Cowan University 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/about-1-in-6-older-australians-experiences-elder-abuse-here-are-the-reasons-they-dont-get-help-216827">original article</a>.

Legal

“People don’t understand boundaries”: Woman ruins couple’s romantic proposal

A young couple has been left devastated and mortified after their marriage proposal was crashed by an inconsiderate “Karen” on the beach. Zenicca Llanza, a 24-year-old from the Philippines, shared a video of her boyfriend getting down on one knee at the beach and asking her to marry him. Her partner had arranged a romantic set up on the beach, complete with a tent, picnic table, proposal sign, a cake and rose petals. However, when the time came for him to pop the question, a beach goer began to interfere and rearrange the set up, interrupting the romantic moment. In the video posted to TikTok, Zenicca’s partner got down on one knee and began to recite a speech, as the unnamed woman walked into shot. <div><iframe title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7269928964536192298&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40warngwarng%2Fvideo%2F7269928964536192298&image=https%3A%2F%2Fp16-sign.tiktokcdn-us.com%2Fobj%2Ftos-useast5-p-0068-tx%2F80e87476646048bca323b002688ff427_1692662253%3Fx-expires%3D1692910800%26x-signature%3D2CX7o9uY0RsEB7creGyXnWP8mas%253D&key=5b465a7e134d4f09b4e6901220de11f0&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> She then moves the proposal sign before walking over to the couple to get a look at the ring, before Zenicca even got a chance to wear it. “How to quickly ruin a proposal,” Zenicca wrote on TikTok. “Please be mindful of other people's once in a lifetime event! You never know you're already ruining it,” she wrote. The video has racked up tens of thousands of views, with many people being outraged on Zenicca’s behalf. “You could excuse the first few seconds w good intentions but the rest I feel like we’re just really bad manners and not having any self awareness,” commented one person. “This made me physically ill. I'm so sorry omg,” added another. “Aw I could tell she had good intentions but was ignorant in the moment that she was slightly ruining something y’all would cherish forever,” commented a third. “Just tell her it’s a personal moment. Sometimes people don’t understand boundaries.” Image credits: TikTok

Relationships

You don’t have to be an economist to know Australia is in a cost of living crisis. What are the signs and what needs to change

<a href="https://theconversation.com/profiles/john-hawkins-746285">John Hawkins</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> This article is part of The Conversation’s series examining Australia’s cost of living crisis. <hr /> Every day the higher price of seemingly everything is mentioned in the news or in conversations with friends and acquaintances. The impact is clear as we are required to pay more for most things from our weekly shop and power bills, to filling the car and swimming lessons. So what is the cost of living and how is it measured? The “cost of living” refers to the prices people need to pay to meet their needs in their everyday lives. The most commonly cited measure is the <a href="https://www.abs.gov.au/websitedbs/d3310114.nsf/home/Consumer+Price+Index+FAQs">Consumer Price Index</a> compiled by the Australian Bureau of Statistics. This represents the price of a fixed basket of goods and services. The items in the basket reflect the spending of metropolitan households. Each item is given a weight corresponding to its share in the spending of these households. The CPI does not include the price of land or financial assets such as shares. The rate of change of prices is known as <a href="https://www.rba.gov.au/education/resources/explainers/inflation-and-its-measurement.html">inflation</a>. <hr /> <iframe id="WV21a" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/WV21a/1/" width="100%" height="400px" frameborder="0"></iframe> <hr /> Inflation rose sharply in the 1970s, especially after the oil price shocks. It took a long while to get it down. The Reserve Bank adopted an <a href="https://www.rba.gov.au/education/resources/explainers/australias-inflation-target.html">inflation target of 2-3%</a> in the <a href="https://www.tandfonline.com/doi/full/10.1080/10370196.2019.1615401">early 1990s</a> to keep inflation low over the medium term. After a long period of low inflation, it rose sharply again during 2022. It is now declining. A similar pattern is seen in comparable economies such as the United States and New Zealand. The supply bottlenecks caused by COVID have eased and economic activity is slowing in response to the increases in interest rates in most economies. <hr /> <iframe id="XtUKa" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/XtUKa/3/" width="100%" height="400px" frameborder="0"></iframe> <hr /> <h2>Not all prices rise at the same rate</h2> Some prices rise fairly smoothly in line with the overall CPI. Others, such as petrol and fresh food, are much more volatile. <hr /> <iframe id="XKmuL" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/XKmuL/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> Since 1972 the price of the CPI basket has increased almost 12-fold. But some prices have increased much more. Cigarettes cost almost 60 times as much (reflecting increased taxes). Labour-intensive hairdressing costs 20 times as much. Prices of other goods have gone up much less, especially after Australia cut tariffs and started importing more from low-cost producers. Over the past decade the prices of clothing and computers have fallen. People often believe inflation is higher than the CPI reports. Big price rises are more noticeable. You seldom see headlines about prices that have not changed. And when was the last time you heard a discussion about how clothing has been getting cheaper? House prices are now more than 50 times as high as in 1972, a much larger increase than the CPI. Some of this, however, represents quality changes rather than pure price changes. The average Australian house has roughly doubled in size and may now be the <a href="https://theconversation.com/size-does-matter-australias-addiction-to-big-houses-is-blowing-the-energy-budget-70271">largest in the world</a>. <h2>My inflation is not the same as yours</h2> The CPI reflects the prices faced by an average household. About half of households will have experienced a higher increase in the prices they pay, and half will have seen a lower increase. Different households consume different goods and services. Retirees tend to spend more on health care and less on childminding. A higher proportion of the spending of lower income households goes on necessities rather than luxuries. For the “average” household, almost 4% of spending is on tobacco. But of course non-smokers spend nothing while heavy smokers spend much more. So that large rise in cigarette prices affects some people significantly and others not at all. The ABS publishes some separate <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/selected-living-cost-indexes-australia/jun-2023">living cost indices</a>. The data get much less attention, partly because they are released after the CPI. These differ from the CPI in that they <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/6467.0Feature+Article1Mar+2017">include interest charges</a>. They are also prepared relating to different classes of people. Over the year to June 2023, the living costs of employees rose by 9.6% but those of self-funded retirees by 6.3% and age pensioners by 6.7%. The main reason for the difference was that interest rates increased and employees are more likely to have a mortgage than are retirees. <hr /> <iframe id="1OagU" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/1OagU/3/" width="100%" height="400px" frameborder="0"></iframe> <hr /> These compare to the <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/consumer-price-index-australia/latest-release">6% increase in the CPI</a> over the same period. <h2>Cost of living problem</h2> The cost of living becomes an increasing problem when incomes, notably wages, fail to keep up with it. Over long periods of time, wages tend to grow faster than prices. The economy becomes more productive over time and the gains flow to both workers and companies. But over shorter periods, this may not be the case. Last week’s <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/wage-price-index-australia/jun-2023">data</a> show wages grew by only 3.6% over the year to the June quarter. This is well below the current inflation rate of 6%. But it is around the growth in prices <a href="https://www.rba.gov.au/publications/smp/2023/aug/pdf/05-economic-outlook.pdf">forecast</a> by the Reserve Bank for the coming year. As well as an income for workers, wages are a major cost for businesses. So if wages grow too fast, and particularly were they to accelerate, there is a risk of a wage-price spiral. The 3.6% annual wage increase for the June quarter is slightly less than the 3.7% recorded in the March quarter. The quarterly growth rate has been steady at 0.8% for the past three quarters. If labour productivity grows close to its medium-term average, this size of wage increase should not be a concern. If business starts to expect raw material and input prices, and prices charged by their competitors, to keep growing strongly, they will be likely to keep increasing their own prices a lot. This risks a <a href="https://www.axios.com/2023/05/18/once-a-fringe-theory-greedflation-gets-its-due">price-price spiral</a>. <hr /> <iframe id="dfh40" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/dfh40/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The Reserve Bank is trying to steer the economy along what it calls a narrow path. It hopes it has raised interest rates enough to slow the economy and return inflation to its 2-3% target within a reasonable time frame. But it hopes it has not raised them too far, which would push the economy into a recession and lead to a large rise in unemployment. The bank’s goal is to have the cost of living rising by around 2-3% per year and incomes a bit more than this, so living standards steadily improve for all Australians over time.<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/210373/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/john-hawkins-746285">John Hawkins</a>, Senior Lecturer, Canberra School of Politics, Economics and Society, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/you-dont-have-to-be-an-economist-to-know-australia-is-in-a-cost-of-living-crisis-what-are-the-signs-and-what-needs-to-change-210373">original article</a>.

Money & Banking

“You really don’t age!”: Michelle Pfeiffer stuns in make-up free update

Michelle Pfeiffer has stunned fans and celebrity pals alike as she shared a make-up free selfie to celebrate hitting 3 million followers on Instagram. The 65-year-old actress proved that she can look good with or without make up, as fans were obsessed with her ageless look in a casual photo of her relaxing on the lounge. “3M followers. Thank you all for hanging out with me here!!” she captioned the photo. The Scarface star's celebrity pals took to the comments to celebrate the follower milestone with her. "Authenticity is magnetic," commented her Ant-man and The Wasp co-star Evangeline Lilly. “I remember when you first showed up here … and it was like finding ruby slippers! You are solid gold,” the First Lady actress Selma Blair commented. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CwEXzWVRjmK/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CwEXzWVRjmK/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Michelle Pfeiffer (@michellepfeifferofficial)</a> </div> </blockquote> “You are SO beautiful. Always so jazzed that I once played your mother!” American actress Holland Taylor commented, in reference to their shared screen-time on One Fine Day. Christina Ricci, known for her role as Wednesday Addams in The Addam's Family called Pfeiffer an “Icon Queen,” while Chelsea Handler wrote “Yeah, girl yeah”. My Big Fat Greek Wedding actress Rita Wilson commented “love you.” Pfeiffer's fans also took to the comments to compliment her beauty both "inside and out". "I love when celebs do true makeup free selfies. Michelle is gorgeous - and lovely - at every age," wrote one fan. “You really don’t age!” commented another. "I love how natural and YOU you are! Absolutely refreshing and warm and beautiful," wrote a third. Image: Getty

Beauty & Style

Don’t believe the hype. Menopausal women don’t all need to check – or increase – their testosterone levels

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Ever heard “low testosterone” blamed for low mood, brain fog and loss of vitality? Despite all evidence to the contrary, social media influencers are increasingly promoting testosterone therapy as an elixir for women experiencing troubling symptoms of menopause. In a series of documentaries and <a href="https://www.dailymail.co.uk/health/article-11792553/Davina-McCall-effect-sparks-menopause-testosterone-treatment-rush-putting-women-risk.html">social media posts</a> about menopause in 2021 and 2022, British TV presenter Davina McCall promoted the use of testosterone therapy in addition to standard <a href="https://www.menopause.org.au/hp/information-sheets/combined-menopausal-hormone-therapy-mht">menopausal hormone therapy</a>. The “<a href="https://www.telegraph.co.uk/news/2023/02/17/davina-effect-fuels-surge-menopausal-women-using-testosterone/#:%7E:text=Chelsea%20Magazine%20Company-,'Davina%20effect'%20fuels%20surge%20in%20menopausal%20women%20using%20testosterone,NHS%20prescriptions%20for%20the%20hormone">Davina effect</a>” has helped fuel a <a href="https://pharmaceutical-journal.com/article/news/nhs-testosterone-prescribing-in-women-rises-ten-fold-in-seven-years#:%7E:text=The%20number%20of%20women%20in,The%20Pharmaceutical%20Journal%20has%20revealed">ten-fold increase</a> in prescribing of testosterone for women in the United Kingdom since 2015. Data isn’t available for Australia, but in my clinical practice, women are increasingly asking to have their testosterone level checked, and seeking testosterone to treat fatigue and brain fog. But while testosterone continues to be an important hormone before and after menopause, this doesn’t mean women should be having a blood test to get their testosterone levels checked – or taking testosterone therapy. <h2>What does testosterone do?</h2> Testosterone is an important hormone in women’s bodies, affecting the blood vessels, skin, muscle and bone, breast tissue and the brain. In both women and men, testosterone can act on its own or be converted into estrogen. Before menopause, testosterone is made in the ovaries, where it helps developing eggs grow and aids in estrogen production. The ovaries release both testosterone and estrogen into the bloodstream, and the levels of the two hormones in the blood peak around ovulation. Some of the testosterone measured in blood is also produced outside the ovaries, such as in fat, where it is made from “pre-hormones” secreted by the adrenal glands. This source of production of testosterone takes over after menopause. <h2>Do we have more testosterone before menopause?</h2> The claim is often made that pre-menopausal women have more testosterone in their bloodstream than estrogen, to justify the need for testosterone replacement after menopause. But, when sex hormones have been measured with precision, studies have shown this is not true. <a href="https://pubmed.ncbi.nlm.nih.gov/31390028/">Our research</a> found estrogen levels are higher than testosterone levels at all stages of the menstrual cycle. Blood testosterone levels <a href="https://pubmed.ncbi.nlm.nih.gov/31390028/">fall</a> by about 25% between the ages of 18 and 40 years in healthy women. The fall in testosterone coincides with the decline in eggs in the ovaries but whether this is a marker of the decline, a consequence, or a cause of the decline is not known. From around 40, the rate of decline slows and blood testosterone levels don’t change when <a href="https://www.menopause.org.au/hp/information-sheets/what-is-menopause">menopause</a> occurs naturally. Studies have not shown testosterone levels change meaningfully during the menopause transition. <h2>Can blood tests detect ‘low testosterone’?</h2> Some influencers claim to have a condition called “testosterone deficiency syndrome” or low levels of testosterone detected in blood tests. But there is no “normal” blood level below which a woman can be diagnosed as having “testosterone deficiency”. So there’s no such thing as having a testosterone deficiency or testosterone deficiency syndrome. This is also in part, because women have very low testosterone concentrations compared with men, and most commercial methods used to measure testosterone cannot separate normal from low levels in women with any certainty. Pre-menopausal women might also be told they have “low” testosterone if blood is drawn early in the menstrual cycle when it is normal for testosterone to be low. (However, it would only be clinically necessary to do this type of blood test to look for high testosterone, in someone with with excessive hair growth or severe acne, for example, not for low testosterone.) In post-menopausal women, much of the action of testosterone occurs in the tissues where it is made, after which testosterone is either converted to estrogen or broken down before it leaks back into the circulation. So blood testosterone concentrations are not a true reflection of tissue concentrations. Further complicating the picture is the enormous variability in the effects of testosterone. At a given blood level of testosterone, some women might have oily skin, acne, increased body hair growth or balding, while others will have no such effects. So, looking for a “low” blood testosterone in women is not helpful. <h2>Can testosterone improve sexual desire? What about other conditions?</h2> There is sound evidence that testosterone therapy may improve sexual desire in post-menopausal women who have developed low sexual desire that bothers them. This was <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2019.1637079">confirmed by</a> a <a href="https://pubmed.ncbi.nlm.nih.gov/31353194/">systematic review</a> of clinical trials comparing testosterone with a placebo or an alternative. These trials, all of which involved a treatment time of at least 12 weeks, showed testosterone therapy, overall, improved desire, arousal, orgasm and sexual satisfaction in post-menopausal women with low desire that caused them distress. Treatment is only indicated for women who want an improvement in sexual desire (after excluding other factors such as depression or medication side effects) and its success can only be determined by each woman’s personal self-reported response. But there is <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2019.1637079">not enough evidence</a> to show testosterone is beneficial for any other symptom or medical condition. The overall available data has shown no effect of testosterone on mood or cognition. As such, testosterone therapy <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2019.1637079">should not be used</a> to treat symptoms such as fatigue, low mood, muscle weakness and poor memory, or to prevent bone loss, dementia or breast cancer. However research continues to investigate these potential uses, including from my <a href="https://www.monash.edu/medicine/sphpm/units/womenshealth">research team</a>, which is investigating whether testosterone therapy can <a href="https://asbmr.onlinelibrary.wiley.com/doi/10.1002/jbmr.534">protect against bone density loss and muscle loss after menopause</a>. You can learn more about participating in one of our studies <a href="https://www.monash.edu/medicine/sphpm/units/womenshealth/join-a-study">here</a>. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/209516/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <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/dont-believe-the-hype-menopausal-women-dont-all-need-to-check-or-increase-their-testosterone-levels-209516">original article</a>.

Body

"We don't storm planes, this is not TV": Police respond to criticism of Sydney plane bomb threat

A 45-year-old man is facing charges following a prolonged standoff aboard an airplane, which culminated in an arrest at Sydney Airport. Malaysia Airlines flight MH122, carrying 199 passengers and 12 crew members, took off from Sydney Airport at 1.40pm on Monday August 14. However, the flight had to return to the airport's runway at 3.47pm, where it remained stationary for several hours as emergency vehicles stood by. The arrest followed an alleged disturbance caused by a passenger on board. Finally, at around 6.30pm, passengers were able to disembark from the aircraft. The Australian Federal Police have now revealed that the man had made claims of having explosives on the plane. The authorities charged the 45-year-old individual, a resident of Canberra, with making a false statement regarding threats to damage an aircraft of division three, and with failing to comply with safety instructions from cabin crew. Video footage captured within the plane reportedly showed the man, who was carrying a backpack, making threats towards fellow passengers and crew members. During the flight, passengers took to social media to share videos depicting the man raising his voice and displaying aggressive behaviour towards cabin crew and fellow travellers. One passenger named Velutha Parambath shared on social media that approximately 30 minutes after takeoff, the individual began behaving disruptively, even becoming physically confrontational with other passengers. Parambath noted that the man's actions escalated to include preaching about his religious beliefs. He added that the man had something in his hand, and his conversations with the crew were marked by statements like "I'm not afraid of dying" and "I've got things with me," which generated fear among those on board. In the immediate aftermath, criticism emerged from several passengers aboard MH122 regarding the duration it took for the Australian Federal Police to arrest and remove the man from the aircraft once it returned to Sydney. In response, the AFP stated that an evacuation was initiated once it was determined safe for passengers and crew, leading to the man's arrest. The Australian Federal Police took the lead in managing the situation, with the support of the New South Wales Police. NSW Police Commissioner Karen Webb defended the response, noting the volatile nature of the incident and the unpredictability of the situation. "Given it's a volatile situation and [it's] unpredictable we didn't know the severity of the incident and you have to deal with what we learn about the passenger," she said. "We didn't know if there was a bomb." "I praise the crew for what they did in keeping the passengers calm … to de-escalate the situation to the point that we got this matter resolved in three hours, I think three hours is pretty good. "The protocol in Australia is to negotiate, we don't storm planes, this is not TV, it's not the movies we want to protect the lives of all passengers." The incident caused significant disruptions to domestic travel at Sydney Airport, resulting in the cancellation of 32 flights and delays of up to 90 minutes. NSW Premier Chris Minns acknowledged the concerns about the AFP response and announced a review of the situation while highlighting that the resolution was achieved peacefully. Image: Twitter

Travel Trouble

Private health insurance is set for a shake-up. But asking people to pay more for policies they don’t want isn’t the answer

<a href="https://theconversation.com/profiles/yuting-zhang-1144393">Yuting Zhang</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nathan-kettlewell-903866">Nathan Kettlewell</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Private health insurance is <a href="https://consultations.health.gov.au/medical-benefits-division/consultation-on-phi-studies/">under review</a>, with proposals to overhaul everything from rebates to tax penalty rules. One <a href="https://consultations.health.gov.au/medical-benefits-division/consultation-on-phi-studies/supporting_documents/Finity%20Consulting%20MLS%20and%20PHI%20Rebate%20Final%20Report.pdf">proposal</a> is for higher-income earners who don’t have private health insurance to pay a larger <a href="https://www.ato.gov.au/Individuals/Medicare-and-private-health-insurance/Medicare-levy-surcharge/">Medicare Levy Surcharge</a> – an increase from 1.25% or 1.5%, to 2%. And if they want to avoid that surcharge, they’d need to take out higher-level hospital cover than currently required. Encouraging more people to take up private health insurance like this might seem a good way to take pressure off the public hospital system. But <a href="https://melbourneinstitute.unimelb.edu.au/publications/working-papers/search/result?paper=4682822">our research</a> shows these proposals may not achieve this. These may also be especially punitive for people with little to gain from buying private health insurance, such as younger people and those living in regional areas who do not have access to private hospitals. <h2>What is the Medicare Levy Surcharge?</h2> The Medicare Levy Surcharge was <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/FlagPost/2013/May/A_short_history_of_increases_to_the_Medicare_levy#:%7E:text=From%20July%201997%2C%20a%20surcharge,ancillary%20insurance%20cover%20was%20introduced">introduced in 1997</a> to encourage high-income earners to buy health insurance. People earning above the relevant thresholds need to buy “complying” health insurance, or pay the levy. This surcharge is in addition to the <a href="https://www.ato.gov.au/Individuals/Medicare-and-private-health-insurance/Medicare-levy/">Medicare levy</a>, which applies to most taxpayers. The surcharge varies depending on your income bracket, and the rate is <a href="https://www.ato.gov.au/Individuals/Medicare-and-private-health-insurance/Medicare-levy-surcharge/Medicare-levy-surcharge-income,-thresholds-and-rates/">different</a> for families. For instance, to avoid paying the surcharge currently, a single person living in Victoria earning A$108,001 can buy basic hospital cover. The lowest annual premium for someone under 65 is <a href="https://www.privatehealth.gov.au/dynamic/Search/">about $1,100</a>, after rebates. That varies slightly between states and territories. Not buying private health insurance and paying the Medicare Levy Surcharge instead would cost even more, at $1,350 (1.25% of $108,001). <h2>What is being proposed?</h2> The <a href="https://consultations.health.gov.au/medical-benefits-division/consultation-on-phi-studies/">report</a>, by Finity Consulting and commissioned by the federal health department, reviews a range of health insurance incentives. It recommends increasing the Medicare Levy Surcharge to 2% for those with an income above $108,001 for singles, and $216,001 for families. The definition of a “complying” private health insurance policy would also change. Rather than having basic hospital cover as is required now, someone would need to buy <a href="https://www.health.gov.au/resources/publications/private-health-insurance-reforms-gold-silver-bronze-basic-product-tiers-campaign-fact-sheet?language=en">silver or gold</a> cover to avoid the surcharge. Under the proposed changes, people who pay the 2% surcharge would also no longer receive any rebate, which currently reduces premiums by <a href="https://www.ato.gov.au/Individuals/Medicare-and-private-health-insurance/Private-health-insurance-rebate/Income-thresholds-and-rates-for-the-private-health-insurance-rebate/#Rebaterates1">about 8%</a> for people earning $108,001-$144,000. So, for a single person under 65, earning $108,001 and living in Victoria, the <a href="https://www.privatehealth.gov.au/dynamic/Search/">annual cost of buying</a> complying hospital cover would be at least $1,904 (without the rebate). Again, that varies slightly between states and territories. But the cost of not insuring and paying the Medicare Levy Surcharge instead would go up to $2,160 (2% of $108,001). <h2>Is this a good idea?</h2> However, <a href="https://melbourneinstitute.unimelb.edu.au/publications/working-papers/search/result?paper=4682822">our research</a>, out earlier this year, suggests increasing the Medicare Levy Surcharge will not meaningfully increase take-up of private health insurance. We’ve shown that people do not respond as strongly to the surcharge as theory would predict. For example, when the surcharge kicks in, we found the probability of insuring only increases modestly from about 70% to 73% for singles, and about 90% to 91% for families. It is generally cheaper to buy private health insurance than to pay the surcharge. However, we found about 15% of single people with an income of $108,001 or above don’t insure despite it being cheaper than paying the Medicare Levy Surcharge. We don’t know precisely why. Maybe people are not sure of the financial benefit due to changes in their income, or if they are, cannot be bothered, or do not have time, to explore their options. Maybe, as <a href="https://www.reddit.com/r/AusFinance/comments/x2909w/does_anyone_else_willingly_pay_the_medicare/">anecdotal reports suggest</a>, rather than buying private health insurance, some people would rather support the public system by paying the Medicare Levy Surcharge. The point is, people who are not buying private health insurance appear to be highly resistant to financial incentives. So stronger penalties might have little effect. Instead, we propose the Medicare Levy Surcharge be better targeted to true high-income earners. We can do that by increasing income thresholds for the surcharge to kick in, which are then indexed annually to reflect changes in earnings. <h2>How about needing more expensive cover?</h2> Requiring people to choose silver level cover or above would address criticisms about people buying “<a href="https://theconversation.com/getting-rid-of-junk-health-insurance-policies-is-just-tinkering-at-the-margins-of-a-much-bigger-issue-82749">junk</a>” private health insurance they never intend to use. However, people may be buying this type of product because private health insurance has little value to them. Requiring them to spend even more on a product they don’t want is a roundabout way of taking pressure off the public system. So we propose keeping the current level of hospital cover required to avoid the surcharge, rather than increasing it. <h2>Who loses?</h2> Taken together, the cost of these proposed changes would disproportionately fall on people with little to gain from private health insurance. These include younger people, those living in regional areas who do not have access to private hospitals, or those who prefer to support the public system directly. These groups are the least likely to use private insurance so have the least to gain from upgrading their cover. <h2>Where to next?</h2> The report also recommends keeping <a href="https://www.ato.gov.au/Individuals/Medicare-and-private-health-insurance/Private-health-insurance-rebate/">health insurance rebates</a> (a government contribution to your premiums), the <a href="https://www.ato.gov.au/Individuals/Medicare-and-private-health-insurance/Private-health-insurance-rebate/Lifetime-health-cover/">Lifetime Health Cover</a> loading (to encourage people to take out hospital cover while younger), as well as the Medicare Levy Surcharge. We also support keeping these three in the short to medium term. But we recommend gradually reducing public support for private health insurance. We believe the ultimate goal of reforming private health insurance is to optimise the overall efficiency of the health-care system (both public and private systems) and improve population health while saving taxpayers’ money. The goal should not be merely increasing the take-up of private health insurance, which is the focus of the current report. So, as well as our recommendation to better target the Medicare Levy Surcharge, we need to: <ul> <li> lower income thresholds for <a href="https://theconversation.com/the-private-health-insurance-rebate-has-cost-taxpayers-100-billion-and-only-benefits-some-should-we-scrap-it-181264">insurance rebates</a>, especially targeting those on genuinely low incomes. This means lower premiums only for the people who can least afford private health care </li> <li> remove rebates <a href="https://theconversation.com/private-health-insurance-premiums-should-be-based-on-age-and-health-status-122545">based on age</a> as higher rebates for older people <a href="https://www.tandfonline.com/doi/abs/10.1080/13504851.2017.1299094?journalCode=rael20">do not</a> encourage more to insure. Rebates should be tied to just income, which is a better indicator of financial means.<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/210981/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/yuting-zhang-1144393">Yuting Zhang</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nathan-kettlewell-903866">Nathan Kettlewell</a>, Chancellor's Postdoctoral Research Fellow, Economics Discipline Group, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/private-health-insurance-is-set-for-a-shake-up-but-asking-people-to-pay-more-for-policies-they-dont-want-isnt-the-answer-210981">original article</a>.

Money & Banking

6 reasons Australians don’t trust economists, and how we could do better

<a href="https://theconversation.com/profiles/peter-siminski-250958">Peter Siminski</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Economics is about organising markets in ways that contribute to social welfare, which means anyone interested in anything from inequality to housing affordability, to health and education systems, or climate change to gender gaps ought to be interested in it. But economists are far from the most trusted professionals. We are apparently among the <a href="https://kingcenter.stanford.edu/news/abhijit-banerjee-good-economics-hard-times">least-trusted</a> in the US and <a href="https://www.ipsos.com/en-uk/ipsos-veracity-index-2020-trust-in-professions">midway</a> down the ranking in the United Kingdom. In Australia, such surveys on our most trusted professions <a href="https://www.governanceinstitute.com.au/advocacy/ethics-index/">don’t include</a> <a href="https://www.roymorgan.com/findings/roy-morgan-image-of-professions-survey-2021-in-a-year-dominated-by-covid-19-health-professionals-including-nurses-doctors-and-pharmacists-are-the-most-highly-regarded-but-almost-all-professions-d">economists</a>, which itself is noteworthy. Nevertheless, it’s worth reflecting on why Australians may distrust economists, and the ways in which economics can better serve Australia. <h2>1: Weak diversity and reflexivity</h2> Diversity is imperative for a field that helps make decisions about the allocation of resources. At <a href="https://www.rba.gov.au/publications/bulletin/2020/jun/why-study-or-not-study-economics-a-survey-of-high-school-students.html">high school</a>, economics students are increasingly male, and concentrated in metropolitan and high socio-economic status locations. <hr /> <iframe id="Pdz6D" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/Pdz6D/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> Only 0.5% of Indigenous graduates identified economics or econometrics as their main discipline in the 2021 census. Two-thirds of the Australians employed as economists are <a href="https://labourmarketinsights.gov.au/occupation-profile/economists?occupationCode=2243">male</a>, and although university economics departments have improved recently, they are still notoriously <a href="https://genderinstitute.anu.edu.au/gess/academic-appointments-in-economics-in-Australia">male-dominated</a>. Compounding this is that – unlike other social sciences – mainstream economics is not a tradition where <a href="https://medicine.unimelb.edu.au/school-structure/medical-education/research/qualitative-journey/themes/reflexivity">reflexivity</a> is encouraged. Reflexivity involves reflecting on one’s background and environment. Nor are economists often encouraged to reflect on the role of power in the promotion of the ideas they and others espouse, including in the media. <h2>2: The media and conflicts of interest</h2> Economists span academia, government, private and not-for-profit sectors. <figure class="align-right zoomable"><figcaption></figcaption></figure> But those appearing in the media appear to come disproportionately from banks, other financial institutions, management consultancies and think tanks. Particularly worrying is that some think tanks do not disclose the identity of their donors. The media seems uninterested in holding them to account for this. In contrast, all reputable academic journals (and <a href="https://images.theconversation.com/files/541221/original/file-20230804-21-4t1zo2.png">The Conversation</a>) require authors to declare any potential conflicts of interest as a condition of publication. Also worrying is that some think tanks seem particularly ideologically driven. In my view, the media should be much more critical and discerning in its engagement with economists and potential conflicts of interest. And more space should be made for academic and public-sector economists. Choices as to who is quoted should be guided by informed attempts to identify genuine expertise, as well as by diversity considerations. The opposite approach, sensationalism, is irresponsible and detrimental to the public good. And it contributes to distrust in economists. Equally, academic economists should strive to contribute more to national economic debates. A realignment of incentives within universities would help. <h2>3: Efficiency preferred to equity</h2> Decisions made by governments usually affect both the “size of the pie” (loosely, what economists call efficiency) and how it is shared (equity). How to balance this trade-off is a question of values, about which economists have no special insight. But we are well placed to summarise the likely distributional implications of policies. It is true that many economists are at the forefront of research on <a href="https://wid.world/">inequality</a>, but it is also true that economists often focus too much on efficiency. It is rare for economists to explicitly discuss the implications of government decisions for both. Recent examples are debates about increases to the minimum wage and to JobKeeper payments in the context of containing inflation. <h2>4: A heavy international focus</h2> Most of our best and most prominent economists were trained overseas, which is a double-edged sword. We should continue to help top students to study at the world’s best institutions, and continue to recruit top economists globally. But we should accept that this can come with the price of reduced interest and engagement in Australian issues. In my view we should balance this by also creating a truly world-class Australian postgraduate training system, perhaps through cross-institutional collaboration, drawing on strengths and creating economies of scale. Such programs <a href="https://tinbergen.nl/graduate-program">run</a> <a href="https://www.parisschoolofeconomics.eu/en/teaching/phd-program-pse/">successfully</a> in Europe. This has been discussed many times by academics in Australia, but it requires government resolve to happen. <h2>5: Declining economics training</h2> It’s also hard to trust economics if you don’t understand it. Year 12 enrolments in economics have fallen by about <a href="https://www.rba.gov.au/publications/bulletin/2020/jun/pdf/why-study-or-not-study-economics-a-survey-of-high-school-students.pdf">70%</a> since the 1990s. In New South Wales at least, economics has been mostly replaced by “business studies”. <hr /> <iframe id="ANlgw" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/ANlgw/1/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The study of economics has also declined strikingly compared to other fields at universities. Census data shows that only 1% of university graduates under 40 specialised in economics, compared to 2.5% of those now in their 70s. <hr /> <iframe id="tE4bE" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/tE4bE/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> Management and commerce degrees are much more popular, producing 23% of graduates across all ages. While these degrees do include some economics, it is usually in only one or two compulsory units. <h2>6: Overconfidence</h2> While it was once said that every two economists had at least <a href="https://quotefancy.com/quote/939837/Winston-Churchill-If-you-put-two-economists-xin-a-room-you-get-two-opinions-unless-one-of">three opinions</a>, reflecting the inherent uncertainties in the discipline, economists seem very sure of themselves in the media. A large dose of humility would help, and it would help build trust. The media and consumers of the media should seek out the voices that acknowledge the necessary uncertainties.<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/208833/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-siminski-250958">Peter Siminski</a>, Professor of Economics, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/6-reasons-australians-dont-trust-economists-and-how-we-could-do-better-208833">original article</a>.

Money & Banking

"I don't want to talk about it": John Cleese shuts down Waleed Aly

John Cleese has butted heads with Waleed Aly in an awkward interview on The Project, with the Monty Python star refusing to answer a question and mocking Waleed's name. The 83-year-old comedic legend appeared on the show to promote his new Australian tour, An Evening with the Late John Cleese, when Waleed asked him what had brought him Down Under for the show. Cleese simply quipped, "Money." The interview turned sour when Waleed began to ask Cleese about his iconic 1970s sitcom Fawlty Towers, before he was shut down. <blockquote class="twitter-tweet"> .<a href="https://twitter.com/JohnCleese?ref_src=twsrc%5Etfw">@JohnCleese</a> is 83 years old, but he doesn't fear death; in fact, he says he's already dead. <a href="https://t.co/2uHTp1w1oX">pic.twitter.com/2uHTp1w1oX</a> — The Project (@theprojecttv) <a href="https://twitter.com/theprojecttv/status/1681961238731825152?ref_src=twsrc%5Etfw">July 20, 2023</a></blockquote> “We can’t let you go without talking about Fawlty Towers – at least I can’t, because I think it’s one of the greatest shows …” Aly began, before Cleese interjected. “I don’t want to talk about Fawlty Towers,” he said. “Yeah but, you know what – it’s not all about you, is it? I mean, I can ask you about Fawlty Towers?” Aly asked. “You can talk about Fawlty Towers,” Cleese told him, before turning his back and facing away from his hosts to take a sip of water, which earned him a round of applause from the panel. After making his point, Cleese turned back to the hosts, and asked: “What kind of a name is Waleed, anyway? Is it an anagram?” “No. It’s just Arabic. I take it your Arabic’s not great?” Waleed replied. “No. I tried to learn it once. There’s about four h’s and two k’s or something.” “Do you know what John is in Arabic? Yahya. I bet you can’t say that either,” said Aly. Cleese remarked that it was a “more interesting” topic to discuss than Fawlty Towers, but Aly persisted, asking whether he could see the show’s imprint in any recent comedy series. Despite his reluctance to talk about the show, Cleese conceded that it was, in fact, “a very interesting question.” As the interview wrapped, Cleese joked that as his original family surname is actually Cheese, he could be known as “Yahya Cheese.” Image credits: The Project <div class="AV62af35d851923c62777207b4" style="box-sizing: inherit; margin: 0px auto; width: 712.1875px; background-color: white; height: 1px;"> </div>

What happens when doctors don’t act as they should? And what’s the ruling against neurosurgeon Charlie Teo?

<a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> After several years of controversy, and both praise and blame for his willingness to perform high-risk surgeries, neurosurgeon Charlie Teo has been subject to <a href="http://www.austlii.edu.au/cgi-bin/viewdoc/au/cases/nsw/NSWMPSC//2023/2.html">practice restrictions</a> by a special committee of the Medical Council of New South Wales. <blockquote class="twitter-tweet"> Charlie Teo was fighting two complaints of unprofessional conduct from the families of two different women, who say they were not properly warned about the risk of death before consenting to surgery. <a href="https://t.co/gvhiQdWnRF">https://t.co/gvhiQdWnRF</a> — ABC News (@abcnews) <a href="https://twitter.com/abcnews/status/1678952850238349312?ref_src=twsrc%5Etfw">July 12, 2023</a></blockquote> So how does the process of restricting doctors’ medical practice work? And what did this mean for Teo? <h2>How are health practitioners regulated in Australia?</h2> Health practitioner regulators in Australia aren’t generally empowered to make punitive decisions about health professionals’ conduct. Instead, Australia’s health practitioner regulations (the so-called “national law”) require decision-makers to exercise their powers to protect patients. They operate in what is often called a “<a href="https://www.mcnsw.org.au/sites/default/files/case_note_-_legal_case_note_-_medical_council_v_lee_-_concerning_stay_applications.pdf">protective jurisdiction</a>”. And though the regulator may sometimes impose fines, it is rare. That’s because it may do so only <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2009-86a#sec.146C">when</a> it is “satisfied there is no other order, or combination of orders, that is appropriate in the public interest”. In all state <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2009-86a#sec.3A">versions</a> of the national law, regulators may <a href="https://www.legislation.qld.gov.au/view/html/inforce/current/act-2009-hprnlq#sec.3A">restrict doctors’ medical practices</a> only if it’s “necessary to ensure health services are provided safely and of an appropriate quality”. But the NSW national law includes additional wording. In all its decisions, the regulator <a href="https://legislation.nsw.gov.au/view/whole/html/inforce/current/act-2009-86a#sec.3A">must regard</a> the “health and safety of the public” as the “paramount consideration.” This can have unusual effects. As the <a href="https://www.ama.com.au/sites/default/files/2022-03/Ahpra---Regulatory-guide---a-full-guide.PDF">Australian Health Practitioners Regulation Agency (AHPRA)</a> acknowledges, requirements to protect the public may sometimes result in “a determination that is harsher on the practitioner than if punishment were the sole purpose”. <h2>What happened in the Teo case?</h2> In late 2022, proceedings commenced against Teo via two complaints by the New South Wales <a href="https://www.hccc.nsw.gov.au/">Health Care Complaints Commission</a> (HCCC). The complaints concerned two brain surgeries on two patients. Both involved “radical resections” (“en bloc” removals) of these patients’ brain tumours. Tragically, neither patient regained consciousness after the operations and both patients died – one just ten days after. In legal terms, the complaints were based on a provision of the national law that defines certain categories of wrongdoing as <a href="https://legislation.nsw.gov.au/view/whole/html/inforce/current/act-2009-86a#sec.139B">unsatisfactory professional conduct</a>. The HCCC alleged Teo had engaged in two categories of this wrongdoing: conduct below the standard reasonably expected of a doctor of his training and experience, and unethical conduct. The HCCC alleged Teo’s decisions to operate were inappropriate and substandard because the risks of “neurological morbidity” (so-called brain death) outweighed the (potential) benefits of the interventions. There was no allegation that Teo’s surgical skills were substandard. The surgeries were also unethical, it was alleged, as informed consent had not been obtained from the patients and one patient was required to pay an expensive upfront fee in circumstances of clear vulnerability. <h2>What were the findings and consequences for Teo?</h2> The HCCC Professional Standards Committee, made up of an experienced judge, two expert neurosurgeons and a lay member, applied the civil standard of proof – the balance of probabilities – to the evidence. Though the committee is not legally bound to <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2009-86a#sch.5D-sec.2">apply the rules of evidence</a> applied in criminal courts, it decided, broadly for procedural fairness reasons, to receive and consider all of Teo’s unchallenged evidence. In a decision of more than 100 pages, the committee found Teo guilty of unsatisfactory professional conduct. It determined to “reprimand” Teo (this means a <a href="https://www.medicalboard.gov.au/sitecore/content/Home/Registration/Monitoring-and-compliance/Removal-of-reprimands.aspx">record of “reprimand” is</a> noted on the public copy of his practitioner licence) and to impose four conditions on his practice. Three conditions involve increased oversight of his practice records. But a more restrictive condition will require Teo to obtain written support from a neurosurgeon approved by the Medical Council of New South Wales for any neurosurgery involving “recurring malignant tumours in the brain or brain stem”. While this order was hotly contested in the proceedings, the committee determined that, for reasons including Teo’s evidenced “isolation from his peers”, the condition was “necessary to protect the health and safety of the public”. <h2>What about patient autonomy or clinical freedom?</h2> Difficult ethical questions arise in medical regulation. Here, the committee had to balance the practitioner’s right to practise medicine against the paramount consideration of patient health and safety and against the patient’s right to exercise autonomy. This last right is sometimes seen as a patient’s <a href="https://jme.bmj.com/content/40/5/293">moral right to be wrong</a>. On these considerations, the committee relied on accepted evidence from ethical experts that proposed that, as a matter of ethics, "a surgeon does not have a licence to undertake any conceivable procedure even with the agreement or acquiescence of the patient." <h2>Is medical regulation strict in Australia and NSW?</h2> Many <a href="https://www.ahpra.gov.au/News/2016-08-10-Independent-review-on-chaperoning.aspx">reviews</a> and <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3668054">academic</a> <a href="https://pubmed.ncbi.nlm.nih.gov/34907681/">studies</a> find the national law to be fair and appropriate, or not strict enough. However, some scholars and representative groups including the Australian Medical Association (AMA) find some aspects <a href="https://www.ama.com.au/ama-rounds/16-july-2021/articles/upholding-natural-justice-doctors">are</a> too <a href="https://www.ama.com.au/media/law-change-threatens-doctors-hard-earned-reputations-and-risks-their-mental-health">strict</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/36763016/">unsympathetic</a> to practitioners. But a potted history of NSW medical history showcases how successive medical scandals have tended to drive strong regulatory reform. In 1984, when the tragic impacts of the shocking and unethical treatment at <a href="https://piac.asn.au/legal-help/public-interest-cases/deep-sleep-tragedy/">Chelmsford psychiatric hospital</a> were <a href="http://www5.austlii.edu.au/au/journals/ALRCRefJl/1988/77.pdf">coming to light</a>, NSW was the first jurisdiction globally to establish a complaints body for health consumers. Known as the Complaints Unit, this body is now the HCCC. Another milestone occurred in the early 2000s following several scandals, including the so-called “Butcher of Bega” episode. An <a href="https://www.parliament.nsw.gov.au/ladocs/inquiries/2112/Final%20Report%20on%20Graeme%20Reeves.pdf">inquiry</a> into these events prompted the NSW government to introduce laws permitting medical practitioners to be immediately suspended if the regulator considered it was in the “public interest”. This was the first power of its kind in Australia and was only adopted into the broader national law of other states in <a href="https://doi.org/10.1071/AH19293">2018</a>. <h2>What next for Teo?</h2> Teo may appeal the orders of the committee to the NSW Civil and Administrative Tribunal or seek a review of the conditions. But as the conditions are not subject to an end date, it appears they will otherwise continue indefinitely.<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/209612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Instagram 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-happens-when-doctors-dont-act-as-they-should-and-whats-the-ruling-against-neurosurgeon-charlie-teo-209612">original article</a>.

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Weight loss: why you don’t just lose fat when you’re on a diet

<a href="https://theconversation.com/profiles/adam-collins-1179004">Adam Collins</a>, <a href="https://theconversation.com/institutions/university-of-surrey-1201">University of Surrey</a> When you go on a diet, you don’t just lose fat – you lose muscle too. This can have many repercussions – not only on your fitness and strength, but on your metabolism. To lose weight (body fat), you need to be in a calorie deficit. This means consuming fewer calories than your body uses, or exercising to burn more calories than you consume. During the first few days in a calorie deficit, the body uses up its small reservoir of <a href="https://pubmed.ncbi.nlm.nih.gov/1615908/">glycogen stores</a> for energy. Glycogen is a string of glucose (sugar) that comes from the carbohydrates you eat. Since carbs are the body’s main energy source, this is why any glucose the body doesn’t immediately use is stored to use for energy later. But as carbohydrate molecules bind with water, this means that when the body stores glycogen, it also stores water in the muscles. As these glycogen stores are used up, the body also releases a significant amount of water. This is often called “water weight”, and explains why some may feel they lose considerable weight early in their diet. Given you only have days’ worth of glycogen stores, this is why the body uses fat to store extra calories for when you need it. Once the glycogen stores are used up, the body shifts to metabolising fat to get the energy it needs to function. But not all tissues can use fat for energy – such as the brain. This is why the body needs to metabolise your muscles when you’re in a calorie deficit. Protein (from the food you eat) is stored in your muscles. The body can convert this stored protein into glucose for energy. But this means you subsequently lose the muscle tissue itself when that happens. This has significant consequences – including <a href="https://pubmed.ncbi.nlm.nih.gov/35103583/">slowing the metabolism</a>, which may ultimately drive weight regain after losing weight. <h2>Muscle loss</h2> Many factors can affect how much muscle you lose while in a calorie deficit. While it was once thought that the more fat you had, the <a href="https://pubmed.ncbi.nlm.nih.gov/10673906/">less muscle you lost</a> in a calorie deficit, this has since been disproved – with both <a href="https://pubmed.ncbi.nlm.nih.gov/3066619/">lean</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/17367567/">obese people</a> losing significant rates of muscle when dieting. <a href="https://pubmed.ncbi.nlm.nih.gov/29957829/">Ethnicity</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32734691/">genetics</a> may, however, play a role – with studies showing black people tend to lose more muscle mass in a calorie deficit than white people do. Some research also suggests that genetic variants may make some people more susceptible to <a href="https://pubmed.ncbi.nlm.nih.gov/32734691/">certain dietary changes</a>, which may determine how much muscle mass they end up losing. Muscle loss will also happen regardless of whether you lose weight <a href="https://pubmed.ncbi.nlm.nih.gov/30925026/">gradually or quickly</a>. A better determinant of how much muscle you’ll lose depends on <a href="https://pubmed.ncbi.nlm.nih.gov/30925026/">how much weight you end up losing</a>. If a person loses 10% of their body weight, typically around 20% of this is fat-free mass (the proportion of body mass that isn’t fat – such as muscle). This can equate to several kilograms of muscle. Many people also think that what you eat while losing weight may determine how much muscle you lose, with it commonly believed that if you eat plenty of protein you’re less likely to lose muscle mass. This is <a href="https://pubmed.ncbi.nlm.nih.gov/19246357/">debatable</a>, with research showing people lose as much muscle on high-protein weight loss diets as people who followed other types of diets. Low-carb diets have also been claimed to promote more fat loss. But studies comparing <a href="https://pubmed.ncbi.nlm.nih.gov/22258266/">different types of diets</a> have found that low-fat high-carb diets seem to offer <a href="https://pubmed.ncbi.nlm.nih.gov/28193517/">the same, if not better, fat loss</a> than low-carb, high-fat diets – with no differences in muscle loss. <h2>Protein and exercise</h2> Given all that has been said, the only way to prevent muscle loss somewhat while losing weight is to combine exercise (particularly <a href="https://pubmed.ncbi.nlm.nih.gov/18356845/">resistance exercise</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/28507015/">endurance exercise</a>) with a diet higher in protein. This is because exercise stimulates muscle growth – but this process can only happen if you have an adequate supply of protein. It’s suggested adults normally aim to consume <a href="https://pubmed.ncbi.nlm.nih.gov/34371981/">0.8g of protein per kilogram of body weight</a> per day to maintain muscle mass. But given the extra demand exercise places on the muscles, a person will probably need to consume 1.2-1.5g of protein per kilogram of body weight to preserve muscle during weight loss. People who exercise a lot may need to increase that to more than <a href="https://pubmed.ncbi.nlm.nih.gov/28642676/">2g per kilogram of body weight</a> when losing weight. <a href="https://pubmed.ncbi.nlm.nih.gov/22221216/">Older people</a> may also need to consume more protein than average. Just be wary of consuming too much protein (more than 2.5g per kilogram of body weight) as eating more than your body uses could have an <a href="https://pubmed.ncbi.nlm.nih.gov/28507015/">adverse effect</a> on your metabolism by potentially making the body less able to draw upon glucose for energy. It may also put greater pressure on the kidneys and liver – which could lead to serious <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460905/#:%7E:text=High%20dietary%20protein%20intake%20can,a%20role%20in%20kidney%20health.">health issues</a>, such as liver and kidney damage. Even if you prevent muscle loss when losing weight, other metabolic changes still happen that promote weight regain – such as changes in your metabolic rate (the minimum amount of calories your body needs to survive) and <a href="https://pubmed.ncbi.nlm.nih.gov/21677272/">increases in appetite and hunger</a>. This is why, when trying to lose weight, the most important thing to consider is how sustainable your diet and lifestyle changes are. The easier these are to maintain, the better chances you have of keeping the weight off.<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/209258/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-collins-1179004">Adam Collins</a>, Principal Teaching Fellow, Nutrition, <a href="https://theconversation.com/institutions/university-of-surrey-1201">University of Surrey</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/weight-loss-why-you-dont-just-lose-fat-when-youre-on-a-diet-209258">original article</a>.

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