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Beyond the spin, beyond the handouts, here’s how to get a handle on what’s really happening on budget night

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Three weeks from now, some of us will be presented with a <a href="https://budget.gov.au/">mountain</a> of budget papers, and just about all of us will get to hear about them on radio, TV or news websites on budget night. The quickest way to find out what the budget is really doing will be to listen to the treasurer’s speech, or to peruse online the aptly-named “<a href="https://treasury.infoservices.com.au/page/budget2023">glossy</a>” – a document that last year was titled “<a href="https://archive.budget.gov.au/2023-24/overview/download/budget_overview.pdf">Stronger foundations for a better future</a>”. <figure class="align-right zoomable"><a href="https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=237&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=848&fit=crop&dpr=1 600w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=848&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=848&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=1066&fit=crop&dpr=1 754w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=1066&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=1066&fit=crop&dpr=3 2262w" alt="Cover of 2023 budget glossy" /></a><figcaption>Glossies are used to make each budget attractive. <a class="source" href="https://archive.budget.gov.au/2023-24/overview/download/budget_overview.pdf">Commonwealth Treasury</a></figcaption></figure> But they will tell you exactly what the government wants you to hear, exactly as it wants you to hear it. If you are looking instead for the truth – what the government is actually trying to achieve and what it is holding itself and its officials to, I would suggest something else, tucked away on about page <a href="https://cdn.theconversation.com/static_files/files/3225/8787.pdf">87</a> of the main budget document. It is required by the <a href="https://www.legislation.gov.au/C2004A05333/latest/text">Charter of Budget Honesty Act</a> introduced in 1998 by Peter Costello, the treasurer under Prime Minister John Howard. On taking office in 1996, Costello set up a <a href="https://webarchive.nla.gov.au/awa/20101119021633/http://www.finance.gov.au/archive/archive-of-publications/ncoa/execsum.htm">National Commission of Audit</a> to examine the finances he had inherited from the Hawke and Keating governments, presumably with an eye to discovering they had been mismanaged. But the members of the commission weren’t much interested in that. Instead, they decided to deal with something more fundamental. <h2>Budget as you wish, but explain your strategy</h2> Governments were perfectly entitled to manage money in whatever way they wanted, and they were perfectly entitled to spend more money than they raised (which they usually do, it’s called a <a href="https://www.investopedia.com/terms/d/deficit.asp">budget deficit</a>). What the commission wanted was for governments to make clear what they were doing, and to spell out the strategy behind it. Only part of it was about being upfront with the public. The commission also wanted governments to be upfront with themselves – to actually develop frameworks for what they were doing, rather than doing whatever they felt like. The commission recommended a <a href="https://webarchive.nla.gov.au/awa/20101119021633/http://www.finance.gov.au/archive/archive-of-publications/ncoa/execsum.htm">Charter of Budget Honesty</a>, which among other things requires officials to prepare independent assessments of the finances before each election, requires budget updates six months after each budget, and requires <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BriefingBook45p/TaxExpenditures">tax expenditures</a> (tax breaks) to be accounted for like other expenditures. And it requires the publication and regular updating of a <a href="https://cdn.theconversation.com/static_files/files/3227/CBH_Fiscal_strategy.pdf">fiscal strategy statement</a>. <h2>Where treasurers hold themselves accountable</h2> The <a href="https://cdn.theconversation.com/static_files/files/3225/8787.pdf">fiscal strategy</a> can be thought of as an exam question set by the student who is being examined – something along the lines of “this is what you say you want your budget to achieve, please set out the means by which you plan to achieve it”. It turns out to have been exceptionally effective in getting governments to organise their thoughts, make budgets at least try to achieve something, and let the rest of us know what they are trying to achieve. Every few years, treasurers change the strategy, as is their right. Treasurer Jim Chalmers says he’ll change it again this budget, to de-emphasise the fight against inflation and to more greatly emphasise the need to <a href="https://ministers.treasury.gov.au/ministers/jim-chalmers-2022/transcripts/press-conference-washington-dc-0">support economic growth</a>. His statement will tell us what’s behind his actions in a way the glossy words in his brochure and speech might not. <h2>The strategy that has signposted 26 years</h2> Previous statements have signposted all the important turns in what the budget is trying to do. The first, in <a href="https://images.theconversation.com/files/589686/original/file-20240423-16-rncqg3.PNG">1998</a>, committed Costello and Howard to achieving a budget surplus on average over the economic cycle and whenever “growth prospects remain sound”. Making that commitment more difficult was another “not to introduce new taxes or raise existing taxes over the term of this parliament”. Two years later, after the government had won an election promising a new goods and services tax, that commitment was <a href="https://images.theconversation.com/files/589692/original/file-20240423-18-q843xn.PNG">changed</a> to “no increase in the overall tax burden from its 1996-97 level”, a condition met by calling the GST a state tax. <h2>Hockey and Morrison wound back spending</h2> The Labor budgets from 2008 <a href="https://images.theconversation.com/files/589702/original/file-20240423-18-mikx6f.PNG">loosened</a> the tax target to the average share of GDP below the reference year, which they changed to the higher-tax year of 2007-08. The first Coalition budget under Treasurer Joe Hockey in 2014 changed the target from tax to spending, pledging to bring down the ratio of <a href="https://images.theconversation.com/files/589705/original/file-20240423-16-9spkdy.PNG">payments to GDP</a>, and pledging a surplus of 1% of GDP by 2023-24. Any new spending would be more than offset by cuts elsewhere, and if the budget did receive a burst of unexpected revenue it would be “banked” rather than spent. In 2018 Treasurer Scott Morrison reintroduced tax as a target, that he spelled out precisely. Tax was not to increase beyond <a href="https://images.theconversation.com/files/589706/original/file-20240423-16-b7gj5d.PNG">23.9%</a> of GDP. <h2>During COVID, Frydenberg spent big</h2> In 2020, in the face of a COVID-induced recession and soaring unemployment, Finance Minister Mathias Cormann and Treasurer Josh Frydenberg pushed the old strategy to one side. They would spend big now to keep the economy afloat so they wouldn’t have to spend more bailing it out later, and they wouldn’t return to their old concern about the deficit until the unemployment rate was “<a href="https://cdn.theconversation.com/static_files/files/3228/fs2020.pdf">comfortably below 6%</a>”. So well did they succeed that in 2021 Frydenberg made the momentous decision to keep going, abandoning the promise to return to worrying about the deficit when unemployment fell below 6%. Instead he promised to keep spending big until unemployment was “<a href="https://images.theconversation.com/files/589709/original/file-20240423-16-9pmpaf.PNG">back to pre-crisis levels or lower</a>”. The decision propelled unemployment down to a 50-year low of <a href="https://www.datawrapper.de/_/wPfXO/">3.5%</a>. Along with high iron ore prices, that one change of strategy has probably helped deliver Chalmers two consecutive budget surpluses – the one he announced last year for 2022-23, and the one he is set to announce this year for 2023-24. More of us have been in jobs <a href="https://www.finance.gov.au/publications/commonwealth-monthly-financial-statements/2024/mfs-january">paying tax</a>, and fewer have been out of jobs <a href="https://theconversation.com/half-a-million-more-australians-on-welfare-not-unless-you-double-count-227342">on benefits</a>. It’s a powerful demonstration of the real-world difference budget decisions can make, and the way in which the <a href="https://cdn.theconversation.com/static_files/files/3225/8787.pdf">fiscal strategy</a> tells the story.<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/228387/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/beyond-the-spin-beyond-the-handouts-heres-how-to-get-a-handle-on-whats-really-happening-on-budget-night-228387">original article</a>. </div>

Money & Banking

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes. So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex. <h2>The study</h2> Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade. The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk. As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets. Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category. The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours. One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less. Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations. <h2>Why might short sleep increase diabetes risk?</h2> In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body. We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes. Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>. This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses. These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours. While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes. Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase. The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>. <h2>Good sleep, healthy diet</h2> Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes. Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle. While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health. The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk. In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> 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/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>. </div>

Body

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

Days are getting shorter and colder. 6 tips for sticking to your fitness goal

<a href="https://theconversation.com/profiles/juliana-s-oliveira-709434">Juliana S. Oliveira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/anne-tiedemann-409380">Anne Tiedemann</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/cathie-sherrington-561141">Cathie Sherrington</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/leanne-hassett-1497197">Leanne Hassett</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Daylight saving ends this weekend. The days are shorter and getting colder. It’s less appealing to cycle to work, walk after dinner, or wake up early to hit the gym. But we all know daily physical activity is essential for our health and wellbeing. Physical activity releases feel-good neurotransmitters in our brains, which help to alleviate <a href="https://bjsm.bmj.com/content/57/18/1203">stress, anxiety, and depression</a>. It also helps <a href="https://www.cdc.gov/chronicdisease/resources/infographic/physical-activity.htm#:%7E:text=Regular%20physical%20activity%20helps%20improve,depression%20and%20anxiety%2C%20and%20dementia.">prevent diseases</a> such as diabetes, heart disease and some cancers. Regular physical activity can prolong life and improve overall quality of life. However, many of us find it difficult to achieve the <a href="https://bjsm.bmj.com/content/54/24/1451">recommended 150 minutes of moderate intensity physical activity</a> each week. In fact, three out of ten Australians and half of Australians aged 65 and over are <a href="https://www.aihw.gov.au/reports/physical-activity/physical-activity">inactive</a>. So, what can you do to stay motivated and keep moving regularly through the darker months? Here are some tips. <h2>1. Nail those goals</h2> Goals can provide us with a sense of purpose, meaning and direction. But just aiming to “get fit” is less likely to cut it than goals that are SMART: specific, measurable, achievable, realistic and time-bound. Specific goals are based on an observable behaviour or activity, such as step count, yoga, or competing in an event. Measurable goals can be tracked, so you can easily tell whether you have ticked them off. Achievable goals are realistic and based on your current fitness and abilities. But they can and should still be challenging. If you’ve only ever run 5 kilometres, it won’t be realistic to aim for a half marathon in the next month. But you could aim for 10 kilometres. Relevant goals hold personal meaning for you. Articulating why it’s important will help motivate you to do it. Time-bound goals include a target date for achieving them. You can always revisit your deadline if you’re ahead of schedule or if it’s too unrealistic. An example of a SMART goal could be: “I will walk 10,000 steps every weekday within a month.” Then you can break it down into short-term goals to make it more achievable. If you currently walk 6,000 steps each day, you can increase steps by 1,000 every week to reach 10,000 by the end of the month. <h2>2. Keep track</h2> More than <a href="https://www.deloitte.com/au/en/Industries/tmt/blogs/digital-consumer-trends-who-is-purchasing-what-now.html">90% of Australians own a smartphone</a> and more than <a href="https://www.deloitte.com/au/en/Industries/telecom-media-entertainment/blogs/digital-consumer-trends-touch-less-healthier-wiser.html">two in ten own a fitness tracker or a smartwatch</a>. These devices can help you track your goals and activity, keep you accountable and increase your motivation. A 2021 systematic review suggests fitness trackers and smartphone apps <a href="https://bjsm.bmj.com/content/55/8/422">can assist people</a> to increase their step count by up to 2,000 steps per day. <a href="https://bjsm.bmj.com/content/54/20/1188">Our research</a> demonstrated fitness trackers can also be helpful in increasing physical activity among older people. If you don’t have a fitness tracker, you can buy low-cost pedometers or track your activity times using paper and pen. <h2>3. Plan for success but prepare for barriers</h2> Take some time to think about the potential barriers that could prevent you from being active and plan solutions to overcome them. For example, if the cost of physical activity is too high for you, try to find options that are free, such as walking or running. You can also consider free online programs or streaming videos. If you find it difficult to fit exercise into your busy schedule, try exercising early in the morning before you start your day and laying out your workout clothes the night before. You could consider joining a gym with flexible timetables. A good strategy is to try to fit physical activity into your daily routine, such as walking or cycling to work. If you are living with a chronic health condition or disability, consider seeking guidance from a health professional such as an <a href="https://www.essa.org.au/Public/SearchAEP.aspx?WebsiteKey=44cfee74-3fc3-444e-bb5f-77729c390872">exercise physiologist</a> or <a href="https://choose.physio/find-a-physio">physiotherapist</a>. Start slow and gradually increase your activity and find something you enjoy so you are more likely to keep doing it. <h2>4. Team up with a workout friend</h2> Physical activity can be more fun when you do it with someone else. Studies show <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167494322002953?via%253Dihub&sa=D&source=docs&ust=1712015093947627&usg=AOvVaw1XGQBMDMFspL5YrQtKo3h">working out with friends can be more motivating and enjoyable</a>. It can also help with accountability, as some people are more likely to show up when they have a workout partner. So, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60407-9/fulltext">find a friend</a> who supports your goal of being more active or maintaining your current activity levels. <h2>5. Plan yourself a little treat</h2> Make an appointment with yourself in your diary to exercise. Approach it as just as important as meeting a friend or colleague. One idea is to delay something you’d rather do and make it a reward for sticking to your activity appointment. If you really want to go out for coffee, do a hobby, or watch something, go for a walk first. Research shows <a href="https://www.nature.com/articles/s41746-019-0164-3">incentives can dramatically increase physical activity levels</a>. <h2>6. Find a coach</h2> If you want more support, <a href="https://bjsm.bmj.com/content/51/19/1425">health coaching</a> might be an option. Trained professionals work one-on-one with people, sometimes via telehealth, to find out what’s reducing their motivation to make healthier choices, such as exercise. Then they employ behaviour change techniques to help them meet their health goals. Our recent research suggests health coaching can improve physical activity in <a href="https://bjsm.bmj.com/content/58/7/382">older people</a> and those with <a href="https://www.sciencedirect.com/science/article/pii/S183695532400002X">chronic pain</a>. In <a href="https://www.gethealthynsw.com.au/#:%7E:text=About%20the%20Get%20Healthy%20Service&text=Delivered%20by%20NSW%20Health%2C%20the,and%20achieve%20your%20health%20goals">New South Wales</a>, <a href="https://lifeprogram.org.au/">Victoria</a> and <a href="https://www.myhealthforlife.com.au/">Queensland</a>, these sessions are government-subsidised or free.<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/226619/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/juliana-s-oliveira-709434">Juliana S. Oliveira</a>, Postdoctoral Research Fellow, Physical Activity, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/anne-tiedemann-409380">Anne Tiedemann</a>, Professor of Physical Activity and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/cathie-sherrington-561141">Cathie Sherrington</a>, Professor, Institute for Musculoskeletal Health, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/leanne-hassett-1497197">Leanne Hassett</a>, Associate Professor in Physiotherapy, <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/days-are-getting-shorter-and-colder-6-tips-for-sticking-to-your-fitness-goals-226619">original article</a>.

Body

There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people. Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020. It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year. Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>. <h2>What goes into a flu vaccine?</h2> Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus. Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains. All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future. <h2>What’s different about new flu vaccines?</h2> There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad). Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely. However, there have been several enhancements to influenza vaccines in recent years. Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people. An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people. Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future. <h2>What should I do this year?</h2> Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life. Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>. In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need. <h2>Are there side effects?</h2> All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines. As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines. Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<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/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a> COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others. So how much stress is too much, and what can you do about it? I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues. I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.” A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging. <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit. Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.” The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface. When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions. For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors. <h2>‘Treating’ stress</h2> Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan. Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure. Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>. Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress. Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses. <h2>Suffering from toxic stress</h2> Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood. Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be. And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all. Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress. <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Exercise, meditation and a healthy diet help fight toxic stress.</figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>. The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate. Adopting these lifestyle changes is not quick or easy, but it works. The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits. There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.

Mind

Announcing Kate Middleton’s cancer diagnosis should have been simple. But the palace let it get out of hand

<a href="https://theconversation.com/profiles/victoria-fielding-236389">Victoria Fielding</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/saira-ali-1522239">Saira Ali</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> The British royal family is famous for its carefully curated media image. That’s why it was a surprise to see them lose control of the narrative in the wake of what we now know is a serious health crisis befalling Catherine, Princess of Wales (or Kate Middleton as she’s popularly known). It is clear the nearly 1,000-year-old institution of the monarchy and its tradition of “<a href="https://news.northeastern.edu/2024/03/14/kate-middleton-photo-pr-crisis/">never complain, never explain</a>” is being tested by social media and its power to spread rumours and misinformation. The palace’s public relations team has underestimated how difficult it is to manage relationships with social media audiences. Their reactive attempts to rein in speculation has turned Catherine’s health challenge into a PR disaster. Social media, with its lax regulations and freer environment, offers a more open forum for users to say whatever they like about the royals. It’s served as a hotbed for Catherine conspiracies, particularly on TikTok. These theories are as wild as they are ridiculous, from Catherine being a prisoner in the palace to her hiding in <a href="https://www.prdaily.com/kate-middleton-stanley-alabama-retail/">Taylor Swift’s London home</a>. What should have been a simple announcement to a sympathetic public about a popular royal having cancer turned into a spider’s web of competing conspiracy theories across social media. How did it all go so terribly wrong? <h2>I’ve lost track, what happened?</h2> All was well with the Prince and Princess of Wales when they were filmed attending church on Christmas Day. As usual when royals are out in public, the scene was picture perfect with everyone dutifully smiling for the cameras in “<a href="https://www.harpersbazaar.com/celebrity/latest/a46227698/kate-middleton-royal-blue-christmas-day-church-service-prince-william-kids/">co-ordinated</a>” outfits. Two weeks later, Kensington Palace announced Catherine had undergone planned abdominal surgery, with <a href="https://abcnews.go.com/GMA/Culture/princess-kate-hospitalized-after-planned-abdominal-surgery-palace/story?id=106441561">palace sources</a> telling media the surgery had been “successful” and she would need two weeks to recover. On January 29, the palace announced Catherine had returned home to recuperate. <a href="https://www.townandcountrymag.com/society/tradition/a46569739/king-charles-discharged-from-hospital/">Unlike King Charles</a> when he released news of his cancer diagnosis on February 5, Catherine was not photographed leaving hospital. This was the first PR misstep. She had appeared outside hospital soon after giving birth to her three children, but this time she remained uncharacteristically out of the public eye. Almost a month later, when Prince William <a href="https://au.lifestyle.yahoo.com/prince-william-pulls-memorial-godfather-211406977.html?amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAG6tOzuXsqZXP6G2nLLd-lnWzZhYKHVJ5TJ-w5XCCfgMjerRrR8v1R8unjtcoQTbvPDsVt3mtTcZ_g0os6zwOuEFfMKCh0kfEExvz-dB2FG0uqcy6-GoryjvG99TEhMli66hNZLjLENmMhq1mwoV7GmM0AYezMDsZtZVtONH9C1b&guccounter=2">unexpectedly withdrew</a> from his godfather’s memorial citing “personal reasons”, social media users started asking “Where is Princess Kate?”. Used to a steady stream of content about the royal family, the public were unsurprisingly questioning if there was more to Catherine’s abdominal surgery than they were being told. In a rare reactive move, the palace tried to quell questions about Catherine’s whereabouts by releasing a <a href="https://people.com/palace-responds-kate-middleton-conspiracy-theories-online-surgery-recovery-rare-statement-8602191">statement</a> reiterating that she would not be returning to public duties until Easter. On March 4, US outlet <a href="https://www.tmz.com/2024/03/04/kate-middleton-seen-spotted-public-first-time-mystery-hospitalization/">TMZ published</a> a paparazzi photo of Catherine driving with her mother. Social media audiences asked if it really was Catherine. Over the next week, conspiracy theories about Catherine’s absence reached frenzied levels. To show everything was fine, Kensington Palace released a <a href="https://twitter.com/KensingtonRoyal/status/1766750995445387393?s=20">Mother’s Day photo</a> of Catherine and her children on their social media accounts. Social media users spotted apparently edited flaws and global news agencies announced “<a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">kill orders</a>”, saying the image had been manipulated. The next day, Catherine <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised</a> on social media for editing the photo. Although royals have been <a href="https://www.townandcountrymag.com/society/tradition/a60191061/royal-photoshop-history/">editing their pictures</a> for centuries, it seems particularly digitally naive of the palace’s PR team to release such an obviously edited image into an already cynical social media environment, creating fodder for more conspiracy theories. Mainstream news outlets then joined social media users in asking questions about Catherine’s absence. Although this media attention did not legitimise wild conspiracies, in some ways it fuelled them. Days later, TMZ <a href="https://www.youtube.com/watch?v=erWJNmbrECs">published footage</a> of Catherine and William shopping. At this point in the media chaos, many social media users claimed it was fake. This intense public speculation finally ended on March 23, when Catherine <a href="https://twitter.com/KensingtonRoyal/status/1771235267837321694?s=20">released a video</a> explaining her extended absence after abdominal surgery was caused by the surgeons discovering cancer. During a crisis, the public crave transparency, authenticity, honesty and reassurance. These elements were missing in the royal PR team’s carefully worded statements made directly to mainstream media along with reactive, overly curated social media posts. By providing scant details, the palace seemed to believe they could control public perception. But public image is increasingly difficult to control. <h2>The double-edged sword of social media</h2> After Princess Diana’s death in a paparazzi-chase car accident, privacy laws and <a href="https://time.com/4914324/princess-diana-anniversary-paparazzi-tabloid-media/">media regulations</a> forbade the most invasive breaches of the royal family’s privacy, particularly for her children, princes William and Harry. However, tabloid appetite for uncontrolled access soon returned once the princes became adults. Recently, Harry and his wife Meghan have been involved in <a href="https://www.reuters.com/world/uk/prince-harry-his-many-lawsuits-against-press-2023-12-15/">several lawsuits</a> against media companies over breaches of privacy, including phone hacking. The rise of social media has typically been viewed as a tool that gives royals more control over their image through the curation of their own personal content. Previously, the fact Catherine was the one <a href="https://www.businessinsider.com/kate-middleton-cutest-family-photos-2018-5">taking photos</a> of her children was seen as a sign of authenticity and being down to earth (as much as a princess could be). Yet, social media is both a blessing and a curse for the management of public reputations. The perpetuation of contested facts and theories on social media in the wake of Princess Catherine’s unexplained absence shows how difficult it is to curate a controlled image using social media. Lack of verified information in mainstream media helps fuel speculative flames. While <a href="https://www.thedrum.com/news/2024/03/22/where-the-palace-lost-the-plot-and-what-we-can-learn-about-pr-and-empathy-kategate">PR experts</a> believe it is understandable and appropriate for Catherine and her family to have privacy during this time, more timely, direct and honest communication would have gone a long way to prevent relentless gossip. Once rumours and conspiracies gained momentum, the palace perhaps thought the less information provided, the better. However, silence during a crisis just fuels more speculation because the lack of information makes it look like there is something to hide. Catherine’s personal video announcing her cancer diagnosis helped end the social media frenzy. This shows a simple, clear statement posted by Kensington Palace to social media weeks ago would likely have avoided the PR disaster and provided Catherine the privacy she so clearly needs. The palace is now <a href="https://www.sheknows.com/entertainment/articles/2986509/kate-middleton-cancer-pr-disaster/">being criticised</a> for complicating a situation that was relatively simple in retrospect. Many social media users are also upset Catherine took public blame for the photoshopping incident. Any organisation that deals with the media to maintain positive reputations, including the British monarchy, has no choice but to adapt to all kinds of media, including social media. The long-time practice of keeping calm and carrying on amid controversy and the 24-hour gossip cycle doesn’t work in the era of TikTok, X and YouTube. In the absence of trusted information, social media will do what it does best: take mostly innocuous online chatter and amplify it until it goes viral.<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/226490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/victoria-fielding-236389">Victoria Fielding</a>, Lecturer, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/saira-ali-1522239">Saira Ali</a>, Senior Lecturer in Media, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/announcing-kate-middletons-cancer-diagnosis-should-have-been-simple-but-the-palace-let-it-get-out-of-hand-226490">original article</a>.

Caring

Summer’s over, so how much sun can (and should) I get?

<a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a> As we slide of out summer, you might be wondering how careful you need to be about sun exposure. Excessive exposure causes <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/skin-cancer-statistics-and-issues/uv-radiation">skin cancer</a>, but sun exposure also has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">benefits</a>. How do you balance the two? A new <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">position statement</a> from cancer, bone health and other experts <a href="https://www.assc.org.au/wp-content/uploads/2023/01/Sun-Exposure-Summit-PositionStatement_V1.9.pdf">aims to help</a> Australians balance the good and bad effects of sun exposure by taking into account their skin colour, risk of skin cancer, and where they live. <h2>What are the benefits of sunlight?</h2> Ultraviolet (UV) radiation (the wavelengths in sunlight that cause skin cancer) also leads to vitamin D production. <a href="https://dermnetnz.org/topics/vitamin-d">Vitamin D</a> is very important for maintaining strong bones, and is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">multiple other health benefits</a>. But vitamin D probably isn’t the whole story. Sunshine, including UV radiation, is thought to affect health in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">other ways</a> such as improving our mood and reducing the risk of autoimmune diseases and infections. So for many people, avoiding the sun and taking a vitamin D supplement may not be the best approach. <h2>How much time does it take to make vitamin D?</h2> It’s complicated, but for most people and most of the year across most of Australia, it’s a lot less than you think. The <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">amount of time needed</a> depends on the amount of skin covered by clothing and the intensity of UV radiation (indicated by the UV index). More skin exposed and higher UV index equate to less time needed. Both the UV index and the amount of the year that UV radiation is high increase as you get closer to the equator. In summer, all of Australia is bathed in sunshine. But in winter, opposite ends of the country have <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">very different exposures</a>. In summer, everybody except those with deeply pigmented skin can make enough vitamin D in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">just five minutes</a> between 9am and 3pm, anywhere in Australia, provided they are wearing shorts and a T-shirt. In winter it’s a different story. In <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Darwin and Brisbane</a>, 5–10 minutes between 10am and 3pm will do the trick, but in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Hobart</a>, factoring in winter clothing, it will take nearly an hour in the middle of the day. Hover your mouse over the lines below to see the length of exposure needed at specific times of day. <iframe id="X5szQ" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/X5szQ/" width="100%" height="400px" frameborder="0"></iframe> Staying out for longer than needed doesn’t necessarily make more vitamin D, but it <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib25">does cause skin damage</a>. <h2>Hang on, what about those with darker skin?</h2> People with deeply pigmented, brown to black skin accumulate both vitamin D and DNA damage at a much slower rate than people with lighter skin tones. When UV radiation hits a DNA strand, it causes the DNA to become distorted. If the distortion isn’t fixed, it will cause a mistake when the DNA is copied for a new cell, causing a permanent mutation that sometimes leads to cancer. Melanin, the brown pigment in the skin, absorbs UV photons before that can happen, and the high melanin content in the darkest skin tones provides <a href="https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.201701472R">60 times</a> as much UV protection as the small amount in very fair skin. The flip side is the risk of vitamin D deficiency is much higher than the risk of skin cancer. The new statement accounts for this by putting people into <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">three groups</a> based on their risk of skin cancer, with specialised advice for each group. <h2>Highest skin cancer risk</h2> This includes people with very pale skin that burns easily and tans minimally, but also people with darker white or olive skin who can tan easily but have extra skin cancer risk factors because they: <ul> <li>have had skin cancer before</li> <li>have a family history of melanomas</li> <li>have many moles</li> <li>are taking immunosuppressant medications.</li> </ul> For these people, the harms of sun exposure almost certainly <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">outweigh the benefits</a>. These people should wear sunscreen every day the <a href="https://www.arpansa.gov.au/our-services/monitoring/ultraviolet-radiation-monitoring/ultraviolet-radiation-index">UV index</a> is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, and use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">five sunsmart steps</a> whenever the UV index is above three: <ul> <li>slip on clothing covering as much of the body as possible</li> <li>slop on SPF30+ sunscreen on areas that can’t be covered up</li> <li>slap on a hat</li> <li>seek shade</li> <li>slide on sunglasses.</li> </ul> They shouldn’t spend time outdoors deliberately to make vitamin D, but should discuss vitamin D supplements with their doctor. <h2>Intermediate skin cancer risk</h2> This means people with dark white/olive skin that sometimes burns but tans easily, and who don’t have other skin cancer risk factors. These people should still apply sunscreen as part of their usual routine on all days when the UV index is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, but they can spend enough time outdoors to get a “dose” of vitamin D on most days of the week. Once the time needed for their vitamin D dose is up, they should also use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> steps to avoid accumulating DNA damage. If they’re unable to do this because of health or lifestyle factors, like being housebound, working night shifts, or always covering up with clothing, they should see their doctor about whether they need vitamin D supplements. <h2>Lowest skin cancer risk</h2> This covers people with deeply pigmented brown to black skin that rarely or never burns. These people can <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib14">safely spend enough time outdoors</a> to make vitamin D and get the other benefits of sunshine. But because more time is needed, it can be difficult, particularly when the weather is cold. Vitamin D supplements might be needed. They don’t need to routinely protect their skin, but might need to <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> if they are outdoors for more than two hours. <h2>How do I get the feel-good effects of sunshine?</h2> Spending time outdoors in the early morning is the best way to get the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">feel-good effects</a> of sunshine. An early morning walk is a great idea for all of us, but it won’t make vitamin D.<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/224144/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, PhD Candidate, Dermatology Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, Principal research fellow, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/summers-over-so-how-much-sun-can-and-should-i-get-224144">original article</a>.

Body

Only walking for exercise? Here’s how to get the most out of it

<a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> We’re living longer than in previous generations, with <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile">one in eight</a> elderly Australians now aged over 85. But the current <a href="https://pubmed.ncbi.nlm.nih.gov/26561272/">gap</a> between life expectancy (“lifespan”) and health-adjusted life expectancy (“healthspan”) is about ten years. This means many of us live with significant health problems in our later years. To increase our healthspan, we need planned, structured and regular physical activity (or exercise). The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization recommends</a> 150–300 minutes of moderate-intensity exercise – such as brisk walking, cycling and swimming – per week and muscle strengthening twice a week. Yet few of us meet these recommendations. <a href="https://doi.org/10.1186/s12966-019-0797-2">Only 10%</a> meet the strength-training recommendations. <a href="https://pubmed.ncbi.nlm.nih.gov/32488898/">Lack of time</a> is one of the most common reasons. Walking is cost-effective, doesn’t require any special equipment or training, and can be done with small pockets of time. <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">Our preliminary research</a>, published this week, shows there are ways to incorporate strength-training components into walking to improve your muscle strength and balance. <h2>Why walking isn’t usually enough</h2> Regular walking <a href="http://theconversation.com/health-check-in-terms-of-exercise-is-walking-enough-78604">does not appear</a> to work as muscle-strengthening exercise. In contrast, exercises consisting of “eccentric” or muscle-lengthening contractions <a href="http://theconversation.com/its-ok-to-aim%20lower-with-your-new-years-exercise-resolutions-a-few-minutes-a-day-can-improve-your-muscle-strength-193713">improve</a> muscle strength, <a href="https://pubmed.ncbi.nlm.nih.gov/31130877/">prevent muscle wasting</a> and improve other functions such as balance and flexibility. Typical eccentric contractions are seen, for example, when we sit on a chair slowly. The front thigh muscles lengthen with force generation. <h2>Our research</h2> Our <a href="https://pubmed.ncbi.nlm.nih.gov/31055678/">previous research</a> found body-weight-based eccentric exercise training, such as sitting down on a chair slowly, improved lower limb muscle strength and balance in healthy older adults. We also <a href="https://pubmed.ncbi.nlm.nih.gov/28291022/">showed</a> walking down stairs, with the front thigh muscles undergoing eccentric contractions, increased leg muscle strength and balance in older women more than walking up stairs. When climbing stairs, the front thigh muscles undergo “concentric” contractions, with the muscles shortening. It can be difficult to find stairs or slopes suitable for eccentric exercises. But if they could be incorporated into daily walking, lower limb muscle strength and balance function could be improved. This is where the idea of “eccentric walking” comes into play. This means inserting lunges in conventional walking, in addition to downstairs and downhill walking. <figure><iframe src="https://www.youtube.com/embed/wAI7z3XdY9o?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Eccentric walking means incorporating deep lunges into your movement.</figcaption></figure> In our <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">new research</a>, published in the European Journal of Applied Physiology, we investigated the effects of eccentric walking on lower limb muscle strength and balance in 11 regular walkers aged 54 to 88 years. The intervention period was 12 weeks. It consisted of four weeks of normal walking followed by eight weeks of eccentric walking. The number of eccentric steps in the eccentric walking period gradually increased over eight weeks from 100 to 1,000 steps (including lunges, downhill and downstairs steps). Participants took a total of 3,900 eccentric steps over the eight-week eccentric walking period while the total number of steps was the same as the previous four weeks. We measured the thickness of the participants’ front thigh muscles, muscle strength in their knee, their balance and endurance, including how many times they could go from a sitting position to standing in 30 seconds without using their arms. We took these measurements before the study started, at four weeks, after the conventional walking period, and at four and eight weeks into the eccentric walking period. We also tested their cognitive function using a digit symbol-substitution test at the same time points of other tests. And we asked participants to complete a questionnaire relating to their activities of daily living, such as dressing and moving around at home. Finally, we tested participants’ blood sugar, cholesterol levels and complement component 1q (C1q) concentrations, a potential <a href="https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fj.14-262154">marker of sarcopenia</a> (muscle wasting with ageing). <h2>What did we find?</h2> We found no significant changes in any of the outcomes in the first four weeks when participants walked conventionally. From week four to 12, we found significant improvements in muscle strength (19%), chair-stand ability (24%), balance (45%) and a cognitive function test (21%). Serum C1q concentration decreased by 10% after the eccentric walking intervention, indicating participants’ muscles were effectively stimulated. The sample size of the study was small, so we need larger and more comprehensive studies to verify our findings and investigate whether eccentric walking is effective for sedentary people, older people, how the different types of eccentric exercise compare and the potential cognitive and mental health benefits. But, in the meantime, “eccentric walking” appears to be a beneficial exercise that will extend your healthspan. It may look a bit eccentric if we insert lunges while walking on the street, but the more people do it and benefit from it, the less eccentric it will become. <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/224159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, Professor of Exercise and Sports Science, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/only-walking-for-exercise-heres-how-to-get-the-most-out-of-it-224159">original article</a>.

Body

Why our voices change as we get older

<a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> Sir Elton John set a record at this year’s Glastonbury, becoming the <a href="https://www.independent.co.uk/arts-entertainment/music/news/elton-john-glastonbury-viewing-record-b2364260.html">most-watched headliner</a> in the festival’s history, with more than 7 million people tuning in live to the BBC to watch his last ever UK performance. The 76-year-old singer certainly delivered all his characteristic showmanship. But many who have followed his music over the decades will have noticed how much his voice has changed during his career – and not only because of the <a href="https://www.billboard.com/music/music-news/a-qa-with-elton-john-65620/">surgery he had</a> in the 1980s to <a href="https://ultimateclassicrock.com/elton-john-throat-surgery/">remove polyps</a> from his vocal cords. Equally, it’s not all down to the process of ageing. While it’s no mystery that this affects every part of our body, it isn’t the only reason that a person’s voice – even a professional singer like Sir Elton – can sound quite different over the years. <h2>The sound of your voice</h2> The vocal cords are what produce the sound of your voice. They are located in the <a href="https://www.ncbi.nlm.nih.gov/books/NBK538202/">larynx</a>, a part of the respiratory system that allows air to pass from your throat to your lungs. When air passes out of the lungs and through the larynx, it causes the vocal cords to vibrate – <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412481/">producing sound</a>. The vocal cords are composed of <a href="https://www.kenhub.com/en/library/anatomy/vocal-cords">three main parts</a>: the vocalis muscle, vocal ligament, and a mucous membrane (containing glands) to cover them. This keeps the surface moist and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810851/">protects them from damage</a>. There are also approximately <a href="https://radiopaedia.org/articles/intrinsic-muscles-of-the-larynx?lang=gb">17 other muscles</a> in the larynx that can alter vocal cord position and tension – thus changing the sound produced. Pre-puberty, there’s very little difference in the sound the vocal cords produce. But during puberty, hormones begin exerting their effects. This changes the structure of the larynx – making the “Adam’s apple” more prominent in men – and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0018506X16301271?via%3Dihub">length of the vocal cords</a>. After puberty, they’re around 16mm in length in men, and 10mm in women. Women’s vocal cords are also <a href="https://pubs.aip.org/asa/jasa/article/82/S1/S90/719336/Physiology-of-the-female-larynx">20-30%</a> thinner after puberty. These shorter, thinner vocal cords are the reason why women typically have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306615">higher voices</a> than men. Even after puberty, hormones can affect the voice. For instance, a woman’s voice may sound different depending on the stage of her menstrual cycle – with the <a href="https://www.jvoice.org/article/S0892-1997(08)00169-0/fulltext">best voice quality</a> being in the ovulatory phase. This is because the glands produce most mucous during this phase, giving the vocal cords their best functional ability. Research also shows that women taking the contraceptive pill show <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199717304940">less variation in voice quality</a> because the pill halts ovulation. On the other hand, hormonal changes during the premenstrual phase impede the vocal cords, making them stiffer. This may explain why opera singers would be offered “<a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199717301133">grace days</a>” in the 1960s to ensure they didn’t damage their vocal cords. And, because <a href="https://www.asha.org/practice-portal/clinical-topics/voice-disorders/#collapse_1">women’s vocal cords</a> are thinner, they may also be more likely to <a href="https://pubmed.ncbi.nlm.nih.gov/15157130/">suffer damage</a> from overuse. <h2>Everything ages</h2> As with almost every other part of the body, vocal cords age. But these changes might not be as <a href="https://www.sciencedirect.com/science/article/pii/S0892199721000011">noticeable for everyone</a>. As we get older, the larynx begins increasing its <a href="https://www.sciencedirect.com/science/article/abs/pii/S1752928X21001840">mineral content</a>, making it stiffer and more like bone than cartilage. This change can begin happening as early as <a href="https://meridian.allenpress.com/angle-orthodontist/article/75/2/196/57743/Ossification-of-Laryngeal-Cartilages-on-Lateral">your thirties</a> – especially in men. This makes the vocal cords less flexible. The muscles that allow the vocal cords to move also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166195/">begin wasting</a> (as do our other muscles) as we age. The ligaments and tissues that support the vocal cords also <a href="https://pubmed.ncbi.nlm.nih.gov/11800365/">lose elasticity</a>, becoming <a href="https://pubmed.ncbi.nlm.nih.gov/25645525/">less flexible</a>. There’s also a decrease in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695176/">pulmonary muscle function</a>, reducing the power of the air expelled from the lungs to create the sound. The number of glands that produce the protective mucus also decrease, alongside a reduction in the ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156980/">control the larynx</a>. <h2>Lifestyle is a factor</h2> While vocal cords age at largely the same rate in most people, many lifestyle factors can increase the risk of damage to them – and so can change the way your voice sounds. Smoking, for example, causes <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918293/">localised inflammation</a>, increased <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824943/">mucous production</a>, but can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557797/">dry out</a> the mucosal surfaces. Alcohol has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166195/">similar effect</a>. Over time, these factors can damage the vocal cords and alter the voice’s sound. Some over-the-counter and prescription drugs can also alter the voice – such as <a href="https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/482932">steroid inhalers used for laryngitis</a>. Blood thinners may also <a href="https://pubmed.ncbi.nlm.nih.gov/10875579/">damage the vocal cords</a> and can cause polyps to form, making the voice sound raspy or hoarse. <a href="https://pubmed.ncbi.nlm.nih.gov/7395839/">Muscle relaxants</a>, too, can lead to irritation and vocal cord damage due to the drug allowing stomach acid to wash back into the larynx. Thankfully, the irritation and changes caused by these medications typically disappears after stopping use. One other lifestyle factor can be overuse, which is typically seen in singers and other people who use their voice a lot <a href="https://pubmed.ncbi.nlm.nih.gov/15157130/">during work</a>, such as teachers and fitness instructors. This can lead to an uncommon condition called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392404/">Reinke’s oedema</a>, which can also be caused by smoking. Reinke’s oedema causes fluid to swell in the vocal cords, changing the pitch of the voice – often <a href="https://www.cuh.nhs.uk/patient-information/reinkes-oedema/">making it deeper</a>. In extreme cases of Reinke’s oedema, <a href="https://link.springer.com/article/10.1007/s00405-022-07377-9">surgery is needed</a> to drain the fluid. But in most cases, rest and avoiding irritants (smoking and alcohol) is beneficial, while speech and language therapy can also address the <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1460-6984.1995.tb01660.x">change in sound</a>. <h2>Maintaining our vocal quality</h2> While we can’t help some of the age-related changes that happen to our vocal cords, we can maintain some of our vocal quality and ability through continued use. This may explain why, in many cases, singers show <a href="https://pubmed.ncbi.nlm.nih.gov/27049451/">significantly less vocal change</a> with age than their non-singing counterparts. Singing or <a href="https://www.aarp.org/health/healthy-living/info-2014/improve-aging-voice.html">reading out</a> loud daily can give the vocal cords sufficient exercise to slow their decline. <a href="https://www.nidcd.nih.gov/health/taking-care-your-voice">Looking after</a> your vocal cords is also important. Staying hydrated and limiting intake of <a href="https://www.cuh.nhs.uk/patient-information/presbyphonia/">alcohol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069957/">tobacco</a> can help prevent high rates of decline and damage.<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/208640/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-our-voices-change-as-we-get-older-208640">original article</a>.

Body

Why do I need to get up during the night to wee? Is this normal?

<a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> It can be normal to wake up once or even twice during the night to wee, especially as we get older. One in three adults over 30 makes <a href="https://pubmed.ncbi.nlm.nih.gov/30085529">at least two</a> trips to the bathroom every night. Waking up from sleep to urinate on a regular basis is called <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">nocturia</a>. It’s one of the most commonly reported <a href="https://pubmed.ncbi.nlm.nih.gov/32249998/">bothersome urinary symptoms</a> (others include urgency and poor stream). So what causes nocturia, and how can it affect wellbeing? <h2>A range of causes</h2> Nocturia can be caused by a variety of <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">medical conditions</a>, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an <a href="https://www.nature.com/articles/s41598-023-44916-8">overactive bladder</a>, or gastrointestinal issues. Other causes include pregnancy, <a href="https://onlinelibrary.wiley.com/doi/10.1002/nau.24839">medications</a> and consumption of alcohol or caffeine before bed. While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055528/">insomnia</a>, can also cause nocturia. When we sleep, an antidiuretic hormone is released that slows down the rate at which our <a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">kidneys produce urine</a>. If we lie awake at night, less of this hormone <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00025.2023">is released</a>, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night. Stress, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153377/">anxiety</a> and watching television <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987">late into the night</a> are common causes of insomnia. <h2>Effects of nocturia on daily functioning</h2> The recommended amount of sleep for adults is between <a href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep">seven and nine hours</a> per night. The more times you have to get up in the night to go to the bathroom, the more this impacts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602727/#:%7E:text=Nocturia%20is%2C%20however%2C%20an%20important,(QoL)%20and%20general%20health.">sleep quantity and quality</a>. Decreased sleep can result in increased <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1251-5">tiredness</a> during the day, poor concentration, forgetfulness, changes in mood and impaired <a href="https://pubmed.ncbi.nlm.nih.gov/28425062/">work performance</a>. If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life. In more severe cases, nocturia has been compared to having a similar impact on <a href="https://www.racgp.org.au/getattachment/b43c05ba-e29e-47c3-b816-ec47ceeafe97/Nocturia-a-guide-to-assessment-and-management.aspx">quality of life</a> as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts. Nocturia not only upsets sleep, but also increases the risk of <a href="https://www.auajournals.org/doi/10.1097/JU.0000000000000459">falls</a> from moving around in the dark to go to the bathroom. Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed. <h2>Can you have a ‘small bladder’?</h2> It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is <a href="https://youtu.be/blVmyrBPves">smaller</a> relative to your other organs. If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often. <figure><iframe src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Can you have a small bladder?</figcaption></figure> If you find you are going to the bathroom quite a lot during the day and evening (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903463/">more than eight times</a> in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate. If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP. There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night. <h2>A happy and healthy bladder</h2> Here are some tips to maintain a happy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/">healthy</a> bladder, and reduce the risk you’ll be up at night: <ul> <li> make your <a href="https://theconversation.com/what-position-should-i-sleep-in-and-is-there-a-right-way-to-sleep-189873">sleep environment comfortable</a>, with a suitable mattress and sheets to suit the temperature </li> <li> get to bed early, and limit <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">screens</a>, or activites before bed </li> <li> limit foods and drinks that irritate the bladder, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811496/">coffee or alcohol</a>, especially before bedtime </li> <li> sit in a <a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">relaxed position</a> when urinating, and allow time for the bladder to completely empty </li> <li> practice <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor muscle exercises</a> </li> <li> drink an adequate amount of fluids during the day, and avoid becoming <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">dehydrated</a> </li> <li> maintain a healthy lifestyle, eat <a href="https://journals.physiology.org/doi/full/10.1152/advan.00052.2023">nutritious foods</a> and do not do anything harmful to the body such as smoking or using illicit drugs </li> <li> review your medications, as the time you take some <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">pharmaceuticals</a> may affect urine production or sleep </li> <li> if you have <a href="https://pubmed.ncbi.nlm.nih.gov/28675633/">swollen legs</a>, raise them a few hours before bedtime to let the <a href="https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management">fluid drain</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/224160/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, Associate Professor of Science & Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, Senior Teaching Fellow, Medical Program, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-get-up-during-the-night-to-wee-is-this-normal-224160">original article</a>.

Body

Millions of Aussies to get cash boost in weeks

Millions of Australians are set to receive more money when payments are indexed. On March 20, those on the age pension, disability support pension and carer payment will be pocketing extra money. Single people on the pension and carer payment can expect an extra $19.60, with maximum amount increasing to $1116.30. For couples, the rate will go up $29.40 per fortnight, with the maximum being $1682.80. People on rent assistance, JobSeeker, single parenting payments and ABSTUDY will also benefit from payment increases, with single parenting payment going up by $17.50 a fortnight. Single JobSeeker recipients with no kids, and people over 22 on ABSTUDY, will get an extra $13.50 per fortnight, while each member of a couple will get an additional $12.30 per fortnight. The government has also changed the eligibility criteria for parents seeking welfare payments, with the last budget revealing that 77,000 parents will receive benefits for the youngest child up to the age of 14 instead of eight. The income and assets limits will also be increased in line with indexation in March. Social Services Minister Amanda Rishworth said that these changes will be implemented to ensure that Centrelink recipients would be able to have more money in their accounts, with the rise in cost-of-living. “Our number one priority is addressing inflation and cost of living pressures,” Rishworth said. Image: Getty

Money & Banking

Sam Mac gets emotional as he shares major family news

Sam Mac has teared up as he announced the exciting news that he is soon to become a father of two. The Sunrise weatherman took to Instagram on Saturday to share a snap of him, his fiancée Rebecca, and their one-year-old daughter Margot, as Rebecca showed off her growing baby bump while Sam held an ultrasound photo. He captioned the photo, "Baby Mac (the sequel) premiering this August 2024 🍿Starring Margot as The Big Sister." On Monday morning's episode of Sunrise, hosts Nat Barr and Matt Shirvington congratulated Sam on the joyous news, who was crossing in live from Taronga Zoo. “Sam, you have some very exciting family news,” Matt asked Sam, who looked overjoyed as he shared the news with viewers. <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/C3tSo1KyGJE/?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/C3tSo1KyGJE/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Sam Mac (@sammacinsta)</a> </div> </blockquote> “Thank you, we shared this photo over the weekend — I hope you appreciate it, it took 147 takes to get that photo,” Sam said as he became emotional talking about his growing family. He went on to mention his mother, Loretta, who had been campaigning for a second grandchild from the couple since the birth of their first. “Shout-out to my mum, Loretta, who has been the biggest campaigner for a second child,” Sam said. “She started the campaign while in the delivery ward for Margot. Everything is on track — 16 weeks,” he laughed. “Baby is due in August, team. Very exciting time.” Nat Barr quickly jumped in to say congratulations to the growing family. “Congratulations to all three of you,” Nat said. “That’s wonderful news,” Shirvo added. Image credits: Instagram

Family & Pets

Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial. UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom. Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year. They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area. Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments. <h2>Why are chronic UTIs so hard to treat?</h2> Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach. The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments. This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective. Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted. But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead. Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria. Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions. The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence. For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur. Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role. Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>. <h2>What treatments might we see in the future?</h2> Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu. Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus. Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves. Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response. Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<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/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.

Body

How people get sucked into misinformation rabbit holes – and how to get them out

<a href="https://theconversation.com/profiles/emily-booth-715018">Emily Booth</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/marian-andrei-rizoiu-850922">Marian-Andrei Rizoiu</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> As misinformation and radicalisation rise, it’s tempting to look for something to blame: the internet, social media personalities, sensationalised political campaigns, religion, or conspiracy theories. And once we’ve settled on a cause, solutions usually follow: do more fact-checking, regulate advertising, ban YouTubers deemed to have “gone too far”. However, if these strategies were the whole answer, we should already be seeing a decrease in people being drawn into fringe communities and beliefs, and less misinformation in the online environment. We’re not. In new research <a href="https://doi.org/10.1177/14407833241231756">published in the Journal of Sociology</a>, we and our colleagues found radicalisation is a process of increasingly intense stages, and only a small number of people progress to the point where they commit violent acts. Our work shows the misinformation radicalisation process is a pathway driven by human emotions rather than the information itself – and this understanding may be a first step in finding solutions. <h2>A feeling of control</h2> We analysed dozens of public statements from newspapers and online in which former radicalised people described their experiences. We identified different levels of intensity in misinformation and its online communities, associated with common recurring behaviours. In the early stages, we found people either encountered misinformation about an anxiety-inducing topic through algorithms or friends, or they went looking for an explanation for something that gave them a “bad feeling”. Regardless, they often reported finding the same things: a new sense of certainty, a new community they could talk to, and feeling they had regained some control of their lives. Once people reached the middle stages of our proposed radicalisation pathway, we considered them to be invested in the new community, its goals, and its values. <h2>Growing intensity</h2> It was during these more intense stages that people began to report more negative impacts on their own lives. This could include the loss of friends and family, health issues caused by too much time spent on screens and too little sleep, and feelings of stress and paranoia. To soothe these pains, they turned again to their fringe communities for support. Most people in our dataset didn’t progress past these middle stages. However, their continued activity in these spaces kept the misinformation ecosystem alive. When people did move further and reach the extreme final stages in our model, they were doing active harm. In their recounting of their experiences at these high levels of intensity, individuals spoke of choosing to break ties with loved ones, participating in public acts of disruption and, in some cases, engaging in violence against other people in the name of their cause. Once people reached this stage, it took pretty strong interventions to get them out of it. The challenge, then, is how to intervene safely and effectively when people are in the earlier stages of being drawn into a fringe community. <h2>Respond with empathy, not shame</h2> We have a few suggestions. For people who are still in the earlier stages, friends and trusted advisers, like a doctor or a nurse, can have a big impact by simply responding with empathy. If a loved one starts voicing possible fringe views, like a fear of vaccines, or animosity against women or other marginalised groups, a calm response that seeks to understand the person’s underlying concern can go a long way. The worst response is one that might leave them feeling ashamed or upset. It may drive them back to their fringe community and accelerate their radicalisation. Even if the person’s views intensify, maintaining your connection with them can turn you into a lifeline that will see them get out sooner rather than later. Once people reached the middle stages, we found third-party online content – not produced by government, but regular users – could reach people without backfiring. Considering that many people in our research sample had their radicalisation instigated by social media, we also suggest the private companies behind such platforms should be held responsible for the effects of their automated tools on society. By the middle stages, arguments on the basis of logic or fact are ineffective. It doesn’t matter whether they are delivered by a friend, a news anchor, or a platform-affiliated fact-checking tool. At the most extreme final stages, we found that only heavy-handed interventions worked, such as family members forcibly hospitalising their radicalised relative, or individuals undergoing government-supported deradicalisation programs. <h2>How not to be radicalised</h2> After all this, you might be wondering: how do you protect yourself from being radicalised? As much of society becomes more dependent on digital technologies, we’re going to get exposed to even more misinformation, and our world is likely going to get smaller through online echo chambers. One strategy is to foster your critical thinking skills by <a href="https://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(23)00198-5">reading long-form texts from paper books</a>. Another is to protect yourself from the emotional manipulation of platform algorithms by <a href="https://guilfordjournals.com/doi/10.1521/jscp.2018.37.10.751">limiting your social media use</a> to small, infrequent, purposefully-directed pockets of time. And a third is to sustain connections with other humans, and lead a more analogue life – which has other benefits as well. So in short: log off, read a book, and spend time with people you care about. <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/223717/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-booth-715018">Emily Booth</a>, Research assistant, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/marian-andrei-rizoiu-850922">Marian-Andrei Rizoiu</a>, Associate Professor in Behavioral Data Science, <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/how-people-get-sucked-into-misinformation-rabbit-holes-and-how-to-get-them-out-223717">original article</a>.

Mind

The art of ‘getting lost’: how re-discovering your city can be an antidote to capitalism

<a href="https://theconversation.com/profiles/stephen-dobson-1093706">Stephen Dobson</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Do you remember what it was like to discover the magic of a city for the first time? Do you remember the noises, smells, flashing lights and pulsating crowds? Or do you mostly remember cities through the screen of your phone? In 1967, French philosopher and filmmaker Guy Debord <a href="https://files.libcom.org/files/The%20Society%20of%20the%20Spectacle%20Annotated%20Edition.pdf">publicised the need</a> to move away from living our lives as bystanders continually tempted by the power of images. Today, we might see this in a young person flicking from one TikTok to the next – echoing the hold images have on us. But adults aren’t adverse to this window-shopping experience, either. Debord notes we have a tendency to observe rather than engage. And this is to our detriment. Continually topping-up our image consumption leaves no space for the unplanned – the reveries to break the pattern of an ordered life. Debord was a member of a group called the <a href="https://www.britannica.com/topic/Situationist-International">Situationist International</a>, dedicated to new ways we could reflect upon and experience our cities. Active for about 15 years, they believed we should experience our cities as an act of resistance, in direct opposition to the (profit-motivated) capitalistic structures that demand our attention and productivity every waking hour. More than 50 years since the group dissolved, the Situationists’ philosophy points us to a continued need to attune ourselves – through our thoughts and senses – to the world we live in. We might consider them as early eco-warriors. And through better understanding their philosophy, we can develop a new relationship with our cities today. <h2>Understanding the ‘situation’</h2> The Situationist International movement was <a href="https://www.jstor.org/stable/j.ctt183p61x">formed</a> in 1957 in Cosio di Arroscia, Italy, and became active in several European countries. It brought together radical artists inspired by spontaneity, experimentalism, intellectualism, protest and hedonism. Central figures included Danish artist <a href="https://museumjorn.dk/en/">Asger Jorn</a>, French novelist <a href="https://mitpress.mit.edu/author/michele-bernstein-10219/">Michèle Bernstein</a> and Italian musician and composer <a href="https://en.wikipedia.org/wiki/Walter_Olmo">Walter Olmo</a>. The Situationists were driven by a <a href="https://encyclopedia.pub/entry/34141">libertarian form of Marxism</a> that resisted mass consumerism. One of the group’s early terms was “unitary urbanism”, which sought to join avant-garde art with the critique of mass production and technology. They rejected “urbanism’s” conventional emphasis on function, and instead thought about art and the environment as inexorably interrelated. By rebelling against the invasiveness of consumption, the Situationists proposed a turn towards artistically-inspired individuality and creativity. <h2>Think on your own two feet</h2> According to the 1960 <a href="https://hts3.files.wordpress.com/2010/12/situationist-international-manifesto.pdf">Situationist Manifesto</a> we are all to be artists of our own “situations”, crafting independent identities as we stand on our own two feet. They believed this could be achieved, in part, through “<a href="https://www.tate.org.uk/art/art-terms/p/psychogeography#:%7E:text=Psychogeography%20describes%20the%20effect%20of,emotions%20and%20behaviour%20of%20individuals">psychogeography</a>”: the idea that geographical locations exert a unique psychological effect on us. For instance, when you walk down a street, the architecture around you may be deliberately designed to encourage a certain kind of experience. Crossing a vibrant city square on a sunny morning evokes joy and a feeling of connection with others. There’s also usually a public event taking place. The Situationists valued drift, or dérive in French. This alludes to unplanned movement through a landscape during journeys on foot. By drifting aimlessly, we unintentionally redefine the traditional rules imposed by private or public land owners and property developers. We make ourselves open to the new unexpected and, in doing so, are liberated from the shackles of everyday routine. In <a href="https://link.springer.com/book/10.1007/978-981-10-8100-2">our research</a>, my colleagues and I consider cities as places in which “getting lost” means exposing yourself to discovering the new and taken-for-granted. <h2>Forge your own path</h2> By understanding the Situationists – by looking away from our phones and allowing ourselves to get lost – we can rediscover our cities. We can see them for what they are beneath the blankets of posters, billboards and advertisements. How might we take back the image and make it work for us? The practise of geo-tagging images on social media, and sharing our location with others, could be considered close to the spirit of the Situationists. Although it’s often met with claims of <a href="https://www.nationalgeographic.com/travel/article/when-why-not-to-use-geotagging-overtourism-security">over-fuelling tourism</a> (especially regarding idyllic or otherwise protected sites), geo-tagging could <a href="https://www.melaninbasecamp.com/trip-reports/2019/5/1/five-reasons-why-you-should-keep-geotagging">inspire us</a> to actively seek out new places through visiting the source of an image. This could lead to culturally respectful engagement, and new-found respect for the rights of traditional custodians as we experience their lands in real life, rather than just through images on our phones. Then there are uniquely personal and anarchistic forms of resistance, wherein we can learn about the world around us by interweaving ourselves with our histories. In doing so we offer a new meaning to a historical message, and a new purpose. The Situationists called this process <a href="https://www.theartstory.org/movement/situationist-international/">détournement</a>, or hijacking. For instance, from my grandfather I inherited a biscuit tin of black and white photographs I believe were taken in the 1960s. They showed images of parks and wildlife, perhaps even of the same park, and cityscapes of London with people, streets and buildings. I have spent many hours wandering the London streets tracking down the exact places these images were snapped. I was juxtaposing past with present, and experiencing both continuity and change in the dialogues I had with my grandfather. In this way, I used images to augment (rather than replace) my lived experience of the material world. Urban art installations can also be examples of detournment as they make us re-think everyday conceptions. <a href="https://www.cityartsydney.com.au/artwork/forgotten-songs/">Forgotten Songs</a> by Michael Hill is one such example. A canopy of empty birdcages commemorates the songs of 50 different birds once heard in central Sydney, but which are now lost due to habitat removal as a result of urban development. There are also a number of groups, often with a strong environmental or civic rights focus, that partake in detournment. <a href="https://popularresistance.org/dancing-revolution-how-90s-protests-used-rave-culture-to-reclaim-the-streets/">Reclaim the Streets</a> is a movement with a long history in Australia. The group advocates for communities having ownership of and agency within public spaces. They may, for instance, “invade” a highway to throw a “<a href="https://pasttenseblog.files.wordpress.com/2022/02/road-rave.pdf">road rave</a>” as an act of reclamation. <figure><iframe src="https://www.youtube.com/embed/bUL0C_T-Sqk?wmode=transparent&start=999" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> As French avant-garde philosopher <a href="https://www.themarginalian.org/2014/07/24/the-poetics-of-reverie-gaston-bachelard/">Gaston Bachelard</a> might have put it, when we’re bombarded by images there is no space left to daydream. We lose the opportunity to explore and question the world capitalism serves us through images. Perhaps now is a good time to set down the phone and follow in the Situationists’ footsteps. <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/221606/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephen-dobson-1093706">Stephen Dobson</a>, Professor and Dean of Education and the Arts, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-art-of-getting-lost-how-re-discovering-your-city-can-be-an-antidote-to-capitalism-221606">original article</a>.

Travel Tips

Pickle, anyone? 3 possible reasons women get cravings during pregnancy

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/katelyn-barnes-1238606">Katelyn Barnes</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> From pickles and french fries to oranges and ice cream, women and other people who are pregnant report craving a range of foods while they’re expecting. A <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2015.00021/full">food craving</a> is a strong urge to eat a specific food. The intense desire to eat is not necessarily related to hunger and can be difficult to ignore or resist. Think: “I must have this now!”. Food cravings during pregnancy are common, with studies reporting anywhere between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/">50% and 90%</a> of pregnant women experience a food craving at least once during their pregnancy. Most women who experience food cravings will do so in their second trimester (from week 13 to 27), and the cravings may also be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/">most intense</a> at this time. Let’s delve into the science of food cravings and what it means for the health of mum and bub. <h2>What are some typical cravings, and why do they happen?</h2> There’s an old wives’ tale which implies food cravings can predict the sex of the baby, with sweet foods being associated with a girl, and savoury foods indicating a boy. This isn’t backed by science. In reality, food cravings during pregnancy are highly individual, though they <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/">typically include</a> carbohydrate-dense and protein-dense foods. Commonly reported cravings include biscuits, bananas, nuts, pickles, ice cream and potatoes. We don’t know exactly why pregnant women experience food cravings, but there are a few possible reasons. 1. Changes in nutritional needs Growing a baby takes a lot of work, and unsurprisingly, increases womens’ requirements for energy and specific nutrients such as iron, folic acid, magnesium and calcium. In addition, a woman’s blood volume <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928162/#:%7E:text=Maternal%20blood%20volume%20increases%20by,falls%20by%2010%20mosmol%2Fkg.">increases significantly during pregnancy</a>, meaning a greater demand for water and electrolytes (in particular sodium and potassium). Some studies suggest women experiencing nutrient deficiencies are <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0276079">more likely</a> to have food cravings. This might mean women crave foods high in energy and specific nutrients based on their needs. However, this link is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054961/">not consistently seen</a>, and many women experience food cravings without being deficient in any nutrients. 2. Changes in hunger and taste Hormonal changes that occur throughout pregnancy may change how hungry women feel. A specific hormone called neuropeptide Y has been <a href="https://doi.org/10.1006/appe.1996.0060">shown</a> to increase during pregnancy and is associated with increased hunger. Also, many women report foods and drinks taste different during pregnancy. Most commonly, women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/">report</a> an increased taste of bitter flavours such as those in vegetables or coffee, and a heightened sense of sweetness from fruits. Changes in how foods taste combined with increased feelings of hunger may create food cravings, particularly for sweet foods such as fruits. However, studies have not been able to consistently link hormone levels in blood with reported taste changes, suggesting hormones may not be solely responsible for food cravings. 3. Social and cultural influences Pregnant women in different parts of the world report different food cravings. For example, the most commonly reported food cravings among pregnant women in Nigeria is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/#B113">fruits and vegetables</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/#B83">Rice</a> is the most common craving among all women in Japan, while in the United States, women seem to crave <a href="https://pubmed.ncbi.nlm.nih.gov/16831486/">chocolate</a> the most. These differences may be due to what foods are available, and what foods are familiar. Popular commentary around pregnancy food cravings, and even the notion of “eating for two”, imply a biological need for pregnant women to indulge their food cravings. These sentiments make eating different, strange, or large amounts of food more socially acceptable. Also, food cravings may normalise eating foods which may be less healthy, such as chocolates or cake. Normalising a food choice that may usually be considered a special treat can then <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/#B76">lead to increased urges</a> for and consumption of those foods during pregnancy. Some women can struggle with food cravings they know are not healthy, but cannot resist. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/">lead to</a> shame and negative relationships with food during pregnancy. <h2>Cravings aren’t a big cause for concern</h2> People may think food cravings lead to excess weight gain in pregnancy, which can be related to poor health outcomes for mothers. But studies to date have shown that while women who experience food cravings in pregnancy have a slightly higher energy intake than those who don’t, there’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172095/#B167">no consistent link</a> between food cravings and diet quality, changes in body weight or size, or development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054961/">pregnancy complications</a> such as gestational diabetes. Some people have also suspected food cravings in pregnancy might influence the baby while it’s growing. However, studies haven’t found <a href="https://www.sciencedirect.com/science/article/pii/S1658361218301070">a link</a> between the mother’s food cravings during pregnancy, the size of baby at birth, the baby’s taste preferences, or behaviours of developing children. Overall, it seems food cravings have little to modest impact on the health of mothers or their babies. <h2>When to seek help</h2> While all women should feel comfortable to eat foods they desire, moderation is still key. Resolving sweet food cravings with nutritious options such as fruits, dairy and wholegrains may be beneficial, as well as limiting less healthy cravings such as chocolates, lollies and chips. Particular cravings, such soil or ice, can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635104/">indicate</a> underlying health conditions that warrant treatment. If you or a loved one is concerned about food cravings or any aspect of food intake during pregnancy, make an appointment with an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited dietitian</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/221755/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/katelyn-barnes-1238606">Katelyn Barnes</a>, Postdoctoral Research Fellow, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/pickle-anyone-3-possible-reasons-women-get-cravings-during-pregnancy-221755">original article</a>.

Body

Yes, it’s getting more humid in summer. Here’s why

<a href="https://theconversation.com/profiles/steven-sherwood-272">Steven Sherwood</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Has Sydney felt more like Cairns lately? You’re not imagining it – millions of Australians up and down the east coast have sweltered through exceptionally high humidity in recent weeks. It’s due to normal weather patterns combined with a boost from global warming. Right now, the temperature of the sea surface is <a href="http://www.bom.gov.au/products/IDYOC052.Aus.SSTAnomaly.shtml">1–3°C above normal</a> for this time of year up and down the east coast. It’s particularly hot around the Queensland-New South Wales border and Tasmania’s east coast. When we have high ocean temperatures, we get more water evaporating. This is taken up by the air, which can hold more moisture when the air is hotter. This moist air is then carried to us by winds, and the sweating begins. <h2>Where does humidity come from?</h2> Humidity is just gaseous water held in the air after evaporating from liquid water or ice. It is called a vapour because it condenses into rain — the more humid, the more likely rain is. Higher humidity makes us feel hotter in warm weather, and slows the drying of laundry on a clothesline or of plants in the garden. How do we measure it? Two common ways are the “dew point” and “relative humidity”. At any given air temperature, there’s a limit to how much vapour the air will retain. Any vapour above this limit will just condense out. But the limit roughly doubles with every 10°C of warming; the dew point is the temperature where the vapour would hit the limit. The less vapour there is in the air, the colder the dew point. Relative humidity is the ratio of how much vapour the air has compared to the maximum it would retain. If you’re in Tasmania and see that relative humidity is at 100%, you might be confused. But this measure essentially tracks how “full” the air is. At 100% relative humidity, the dew point matches the actual temperature and no more vapour can be added. If the dew point is 10°C below the actual temperature, relative humidity is about 50%. How do we measure it? The dew point can be measured directly using a chilled mirror and a laser to detect condensation. More often it’s calculated from measurements of relative humidity and temperature. Relative humidity determines whether material exposed to the air will moisten or dry out. That’s why relative-humidity sensors use cheap water-absorbing materials (early ones used a strand of human hair!). <h2>What does a changing climate mean for humidity?</h2> The world’s higher ocean temperatures are unambiguously attributable to global warming, largely from the greenhouse gases we have added by burning fossil fuels. To date, more than 90% of all the extra heat thereby trapped has gone into the oceans. The amount of water vapour over the oceans has increased by roughly 5% since the industrial era began, in lockstep with global warming. Global warming will continue until we stop it. That means the atmosphere will keep getting more humid. If the world manages to keep global warming below 2°C, we should avoid the worst health outcomes from more humidity. But even then, we would expect up to another 5% increase in peak water vapour. Right now, we are seeing higher-than-normal temperatures in most of our surrounding oceans, with only a few exceptions. The areas hit hardest by rising humidity are mostly those that are already humid, like Queensland and the Northern Territory. Although peak dew points are rising, you may be confused to hear average relative humidity is actually <a href="https://www.pnas.org/doi/full/10.1073/pnas.1722312115">falling over land</a>. That’s because the land is warming so fast the average dew points aren’t quite keeping up with temperature, lowering the ratio. That means, alas, that Australia faces a double whammy: increasing water stress and bushfire risk as well as sweatier summers. <h2>Humidity can be very dangerous</h2> Our natural cooling system in hot weather is evaporation of sweat. Sweat forms on your skin, and the air evaporates it, taking the heat with it. But this only works to a point. When the dew point is higher, our self-cooling methods get less and less effective. How important this is depends on how hot you feel. On a moderate but muggy day, you might feel fine until you need to climb four flights of stairs and end up sweaty and exhausted. On a hotter but less muggy day you’d feel the heat at the outset, but would more easily handle the stairs. The Bureau of Meteorology uses something called “<a href="https://media.bom.gov.au/social/blog/1153/apparent-feels-like-temperature/">apparent temperature</a>” to capture the combined effect of temperature and humidity, although this assumes you’re not exerting yourself. How you feel with more exertion can be captured by other measures, such as the “wet bulb globe temperature” now being used at sporting events such as the Australian Open. The Bureau has recently begun providing <a href="http://www.bom.gov.au/places/nsw/sydney/forecast/detailed/">humidity and apparent temperature forecasts</a> as a beta product, which is great for activity planning. This type of information will become more important as the heat builds. As humidity increases during peak humid heat episodes, it makes heat stress worse and moves us toward our body’s physical limits. <a href="https://www.pnas.org/doi/10.1073/pnas.2316003120">Recent research</a> has shown the combination of humidity and heat could make parts of the planet unlivable if Paris Agreement targets are not met, beginning in India and spreading elsewhere in the tropics – including the Top End of Australia. We need to prepare now for increasing heat, while doing everything we can to stop the routine burning of fossil fuels as soon as possible to maintain a margin of safety for humanity.<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/221748/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steven-sherwood-272">Steven Sherwood</a>, Professor of Atmospheric Sciences, Climate Change Research Centre, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-its-getting-more-humid-in-summer-heres-why-221748">original article</a>.

Domestic Travel

I have COVID. How likely am I to get long COVID?

<a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> EG.5 or the Eris COVID variant is dominant in parts of <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20231202.pdf">Australia</a>. Eris, along with other circulating strains, are descendants of Omicron. While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains. So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID? <h2>When COVID becomes ‘long COVID’</h2> For most people, long COVID means not getting better after a COVID infection. The World Health Organization <a href="https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">defines long COVID</a> as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis. The most <a href="https://link.springer.com/article/10.1007/s10654-022-00962-6">common symptoms</a> include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience <a href="https://www.sciencedirect.com/science/article/pii/S1684118222001864?via%3Dihub">a wide range</a> of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems. <h2>How common is long COVID?</h2> Australian data on long COVID <a href="https://www.mja.com.au/journal/2023/218/10/long-covid-australia-achieving-equitable-access-supportive-health-care">remains limited</a> compared to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">international data</a>, and estimates of its prevalence have varied. A report from Australia’s parliamentary inquiry into long COVID, <a href="https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf">published in April</a>, suggested 2%-20% of people may develop long COVID following an infection. A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants <a href="https://doi.org/10.3390/ijerph20186756">saw 10% of people</a> who caught COVID develop long COVID. Another recent study, yet to be peer-reviewed, found <a href="https://www.medrxiv.org/content/10.1101/2023.08.06.23293706v1">18.2%</a> of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods. The risk is lower in children. One Australian study indicated persistent symptoms in <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext">8% of children</a> who had COVID in 2020, while <a href="https://www.medrxiv.org/content/10.1101/2023.03.14.23287239v1">preliminary research</a> points to a slightly lower risk among children infected in 2021. But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway <a href="https://www.apprise.org.au/broad-research-area/insights-into-long-covid/">in Australia</a> to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes. Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will <a href="https://doi.org/10.1001/jamainternmed.2023.0750">increase a person’s chance</a> of getting long COVID. <h2>What’s different this time?</h2> Research shows COVID vaccines offer <a href="https://www.mdpi.com/1660-4601/19/19/12422">protection</a> against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially <a href="https://theconversation.com/could-antivirals-reduce-your-risk-of-long-covid-where-the-research-is-up-to-on-prevention-and-treatment-216529">less long COVID</a> than we saw earlier in the pandemic. But while the Omicron waves may lead to <a href="https://www.smh.com.au/national/newer-virus-strains-less-likely-to-cause-long-covid-20231123-p5emag.html">fewer cases of long COVID</a> than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">repeat infection</a> presents a new risk of prolonged symptoms. <h2>Long COVID can affect all aspects of life</h2> Long COVID can <a href="https://doi.org/10.1093/ije/dyad033">impact</a> a person’s life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks. Many people with long COVID submitted evidence to the recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report/Chapter_4_-_Lived_experiences_of_long_COVID">parliamentary inquiry</a> that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals. Evidence suggests many symptoms <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-77622200250-2/fulltext">will improve</a> in most people over <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00138-4/fulltext">12 to 18 months</a>, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to <a href="https://www.nature.com/articles/s41579-022-00846-2">resolve sooner than others</a>, such as cognitive symptoms. <h2>I think I have long COVID, what can I expect from my doctor?</h2> Long COVID is the kind of challenge Australia’s <a href="https://dx.doi.org/10.5694/mja2.51950">health system finds most difficult</a>. GPs are stretched and the small number of specialist <a href="https://www.abc.net.au/news/2023-12-12/long-covid-clinics-are-closing-as-us-clinic-expands/103186272">long COVID clinics</a> are struggling to maintain funding. Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition. As a result, support for long COVID in Australia is <a href="https://doi.org/10.3389/phrs.2023.1606084">hard to access</a>, expensive and patchy. However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should: <ul> <li> validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear </li> <li> diagnose and treat any other health conditions that are part of the picture </li> <li> support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue. </li> </ul> These steps are not a cure but they may improve a person’s ability to function in their day-to-day life, at work and to fulfil their caring responsibilities. <h2>We still need to focus on reducing COVID transmission</h2> The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means: <ul> <li> getting vaccinated or boosted, if you’re eligible </li> <li> staying home if you feel unwell </li> <li> wearing a mask to protect yourself and vulnerable community members </li> <li> testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve. </li> </ul> Long COVID is not going away, but we all have a role to play in preventing and responding to it. Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, Professor of Allied Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, Senior Research Fellow, ANU College of Health and Medicine, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, Professor, Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, Associate Professor, Child and Adolescent Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">original article</a>.

Body

Top 80s songs to get you moving

While the fashion from the 1980s might only come out of the closet for dress up parties these days, the music is still considered some of the best of our time. Especially for music to get you moving. From dance and pop hits to a little rap and rock, it’s got to be one of the most diverse, eclectic and extravagant decades in recent cultural history. Here, we have been busy rifling through the tracks to whittle down a decade of music into 40 of the best tracks to move to. From dancing to exercise, if you want to get up off that couch, these are the songs to hit play on. 1. “Girls Just Want to Have Fun” by Cindy Lauper (1983) 2. “Hit Me with Your Best Shot” by Pat Benatar (1980) 3. “Eye of the Tiger” by Survivor (1982) 4. “Love Shack” by The B-52's (1989) 5. “Beat It” by Michael Jackson (1982) 6. “Manic Monday” by The Bangles (1986) 7. “Let's Dance” by David Bowie (1983) 8. “Livin' on a Prayer” by Bon Jovi (1986) 9. “I Love Rock N' Roll” by Joan Jett & The Blackhearts (1982) 10. “Thriller” by Michael Jackson (1982) 11. “Faith” by George Michael (1987) 12. “Jump” by Van Halen (1984) 13. “Don't Stop Believin’" by Journey (1982) 14. “Walking on Sunshine” by Katrina & The Waves (1983) 15. “Kiss” by Prince (1986) 16. “Holiday” by Madonna (1983) 17. “Celebration” by Kool and the Gang (1980) 18. “Billie Jean” by Michael Jackson (1982) 19. “Love is a Battlefield” by Pat Benatar (1983) 20. “Sweet Dreams (Are Made of This)” by Eurythmics (1983) 21. “White Wedding” by Billy Idol (1982) 22. “Take on Me” by a-ha (1985) 23. “Video Killed the Radio Star” by The Buggles (1981) 24. “Karma Chameleon” by Culture Club (1983) 25. “The Tide is High” by Blondie (1980) 26. “Wake Me Up Before You Go-Go” by Wham (1984) 27. “Let's Hear It for the Boy” by Deniece Williams (1984) 28. “A Little Respect” by Erasure (1988) 29. “Sweet Child O' Mine” by Guns N' Roses (1987) 30. “Footloose” by Kenny Loggins (1984) 31. “Wild Thing” by Tone-Loc (1989) 32. “Tainted Love” by Soft Cell (1981) 33. “Borderline” by Madonna (1983) 34. “I Wanna Dance With Somebody” by Whitney Houston (1987) 35. “Just Can't Get Enough” by Depeche Mode (1981) 36. “Never Gonna Give You Up” by Rick Astley (1987) 37. “Always Something There to Remind Me” by Naked Eyes (1983) 38. “You Got It (The Right Stuff)” by New Kids on the Block (1988) 39. “It Takes Two” by Rob Base (1988) 40. “Down Under” by Men at Work (1981) Image: Getty

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