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Snug but unsafe: your heater may be harming your health. What are your safest choices?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/christine-cowie-191638">Christine Cowie</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/bill-dodd-1280161">Bill Dodd</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> We now have a dizzying array of heating technologies to consider, besides the fire that warmed our ancestors. Salespeople will highlight any number of features and minor conveniences. You will be made aware of limited-offer discounts, product warranties, trends in certain Nordic countries, or their low cost (at least in the short-term). What you are less likely to read on the box is, well, the stuff that really matters: the long-term effects on your health and the health of your family, your neighbours and the environment. Yes, a heater should keep you warm affordably. After all, a warm home is vital for your health. But would you run a heater that you knew was increasing the likelihood of your child developing asthma, your partner developing lung cancer, and your neighbour or your grandparent suffering a stroke or heart attack? Many <a href="https://doi.org/10.1016/j.envint.2019.105429">peer-reviewed studies</a> have found domestic heating to be a major source of air pollution and of ill health in Australia. So which heaters are high-risk and which are low-risk? Let’s consider, firstly, the most dangerous heaters. <h2>Extreme-risk heaters</h2> Two rules reduce the risks: <ol> <li> never burn anything (wood, gas or other fuel) in your home without adequate ventilation such as a chimney, exhaust or flue </li> <li> never use an outdoor appliance (heater, cooker, barbecue) inside. </li> </ol> Concerningly, a 2022 <a href="https://asthma.org.au/wp-content/uploads/2022/11/AA2022_Housing-Survey-Report_full_v4.pdf">Asthma Australia survey</a> found 7% of Australians used an unflued gas heater. When gas or other fuel is burnt indoors it releases a range of <a href="https://search.informit.org/doi/abs/10.3316/informit.786585213635569">particles and toxic gases</a>. Most dangerous of all is <a href="https://www.dcceew.gov.au/environment/protection/npi/substances/fact-sheets/carbon-monoxide-0">carbon monoxide</a> (CO). This colourless, odourless gas can build up in unventilated homes, resulting in serious poisoning and death. A recent <a href="https://www.abc.net.au/news/2024-06-29/sydney-family-use-bbq-as-indoor-heater-inhale-carbon-monoxide/104039702">case of carbon monoxide intoxication</a> left three people unconscious in a Sydney home after an outdoor barbecue was used inside as a heater. Outdoor heaters, cookers and barbecues are especially potent sources of carbon monoxide and should never be brought inside. If you have a gas appliance in your home, even if it is ventilated, install a <a href="https://www.energysafe.vic.gov.au/industry-guidance/gas/gas-information-sheets/gis-36-carbon-monoxide-alarms-domestic-use">carbon monoxide alarm</a> for as little as $30. <h2>High-risk heaters</h2> <a href="https://www.sciencedirect.com/science/article/pii/S0048969724012087">The evidence</a> is now very clear: wood heater smoke is a potent source of air pollution and significant cause of ill-health in Australia. The more often you burn, the greater the risk. One <a href="https://doi.org/10.1016/j.envint.2023.108128">large population study</a> found even infrequent wood heater use (30 days or more each year) increases the risk of lung cancer by 68%. Wood heaters spill smoke into the home when refuelling. They also suck smoke from outside back into the home as air is drawn up the chimney. If you can smell your wood heater, it is harming your health and exposing you to a toxic mix of particles and gases. For the wider community, the cumulative health impacts of wood heaters are significant. Less than <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Previousproducts/4602.0.55.001Main%20Features5Mar%202011?opendocument&tabname=Summary&prodno=4602.0.55.001&issue=Mar%202011&num=&view=">10% of Australian households</a> use a wood heater. Yet they are the largest source of particulate air pollution in most Australian cities and towns, including <a href="https://www.environment.nsw.gov.au/-/media/OEH/Corporate-Site/Documents/Air/sydney-air-quality-study-stage-2-program-report-220644.pdf">Sydney</a>, <a href="http://www.doi.org/10.1016/j.scitotenv.2024.171069">Melbourne</a>, <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.52176">Canberra</a>, <a href="http://www.doi.org/10.1016/j.scitotenv.2024.171069">Adelaide</a> and <a href="http://www.doi.org/10.3390/ijerph17093264">Hobart</a>. Even in temperate Sydney, wood heaters emit <a href="https://www.environment.nsw.gov.au/-/media/OEH/Corporate-Site/Documents/Air/sydney-air-quality-study-stage-2-program-report-220644.pdf">more of this pollution</a> than all the cars, trucks, boats and buses combined, and more than coal-fired power stations and industry. <a href="https://safeair.org.au/">Centre for Safe Air</a> researchers <a href="https://doi.org/10.1016/j.scitotenv.2024.171069">estimate</a> wood heaters cause between 558 and 1,555 excess deaths a year in Australia. That’s roughly equivalent to the <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">annual road toll</a>. Fine particles (2.5 microns or less in diameter – also known as PM2.5) are a major component of wood smoke. PM2.5 increases <a href="https://www.epa.gov/air-research/air-pollution-and-cardiovascular-disease-basics">rates of heart disease and stroke</a>, <a href="https://doi.org/10.3978%2Fj.issn.2072-1439.2016.01.19">lung disease</a>, <a href="https://doi.org/10.1016/j.scitotenv.2018.11.218">dementia and other neurological conditions</a> and <a href="https://asthma.org.au/about-us/advocacy/air-quality">asthma attacks</a>. Risks of <a href="https://doi.org/10.1371/journal.pmed.1003718">adverse pregnancy outcomes</a> and <a href="https://www.eea.europa.eu/publications/air-pollution-and-childrens-health">poorer learning outcomes in children</a> are also increased. <h2>Low-risk heaters</h2> Evidence suggests there is no “safe” level of air pollution, with health effects <a href="https://doi.org/10.1016/j.envint.2019.02.044">seen at very low levels</a>. Even ducted gas heating, where most of the toxins are ventilated, <a href="https://search.informit.org/doi/abs/10.3316/informit.786585213635569">can expose residents to low levels</a> of PM2.5, nitrogen dioxide (NO2), carbon monoxide and formaldehyde. Over time, this can have a range of <a href="https://safeair.org.au/the-health-impacts-of-gas-use-extraction/#gf_1">health impacts</a>, including worsening asthma and respiratory symptoms. Burning gas for heating also adds to greenhouse gas emissions. As Australia transitions to a zero-carbon society, some states and territories are phasing out installation of new wood heaters, such as <a href="https://www.abc.net.au/news/2023-08-24/canberra-to-phase-out-wood-heaters-by-2045/102769162">in the ACT</a>, and gas connections, such as <a href="https://www.planning.vic.gov.au/guides-and-resources/strategies-and-initiatives/victorias-gas-substitution-roadmap">in Victoria</a>. Subsidies to help people replace unhealthy heaters are excellent investments in the environment, public health and health equity. <h2>Healthy heaters</h2> Ultimately, heaters that do not rely on burning fuel inside the home are the safest, and often more affordable, heating option. A <a href="https://www.abc.net.au/news/2023-07-17/cleaning-filters-in-reverse-cycle-air-conditioner-to-save/102594652">well-maintained</a> reverse-cycle air conditioner, sometimes called a heat pump, actually cleans the air inside your home. These air conditioners have the additional benefit of cooling your home in summer. As heatwaves become more severe and frequent, efficient cooling is <a href="https://www.sciencedirect.com/science/article/pii/S0378778823004152">increasingly important for health</a>. As for affordability, an efficient reverse-cycle air conditioner can be up to <a href="https://www.climatechoices.act.gov.au/__data/assets/pdf_file/0005/1862663/Sustainable-Household-Scheme-A-guide-to-reverse-cycle-systems.pdf">seven times as efficient</a> as a gas wall heater in the energy it uses for a given amount of heat. There are many other <a href="https://www.choice.com.au/home-and-living/heating/electric-heaters/articles/which-electric-heater-type-is-best">electric heating technologies</a> – such as fan heaters, oil column heaters, panel heaters, or infrared heaters – that do not release toxins into the home. Heater manufacturers are often reluctant to talk about the health impacts of their products, and regulators are slow to catch up with the science. By thinking about heating in terms of health, you can make your home safer for yourself and the people around you. After all, there’s nothing cosier than a healthy home.<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/235102/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-cowie-191638">Christine Cowie</a>, Senior Research Fellow, Centre for Air Quality and Health Research and Evaluation, Woolcock Institute of Medical Research, University of Sydney; Senior Research Fellow, South West Sydney Clinical School, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/bill-dodd-1280161">Bill Dodd</a>, Knowledge Broker, Centre for Safe Air (NHMRC CRE), and Adjunct Researcher, Media School, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</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/snug-but-unsafe-your-heater-may-be-harming-your-health-what-are-your-safest-choices-235102">original article</a>. </div>

Home & Garden

Yes, blue light from your phone can harm your skin. A dermatologist explains

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michael-freeman-223922">Michael Freeman</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Social media is full of claims that everyday habits can harm your skin. It’s also full of recommendations or advertisements for products that can protect you. Now social media has blue light from our devices in its sights. So can scrolling on our phones really damage your skin? And will applying creams or lotions help? Here’s what the evidence says and what we should really be focusing on. <h2>Remind me, what actually is blue light?</h2> Blue light is part of the visible light spectrum. Sunlight is the strongest source. But our electronic devices – such as our phones, laptops and TVs – also emit it, albeit at levels <a href="https://melasmaclinic.com.au/wp-content/uploads/2024/01/Melasma-LEDS.pdf">100-1,000 times</a> lower. Seeing as we spend so much time using these devices, there has been some concern about the impact of blue light on our health, including <a href="https://theconversation.com/do-blue-light-glasses-really-work-can-they-reduce-eye-strain-or-help-me-sleep-213145">on our eyes and sleep</a>. Now, we’re learning more about the impact of blue light on our skin. <h2>How does blue light affect the skin?</h2> The evidence for blue light’s impact on skin is still emerging. But there are some interesting findings. 1. Blue light can increase pigmentation <a href="https://academic.oup.com/ced/article-abstract/46/5/934/6598472?redirectedFrom=fulltext&login=false">Studies</a> <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/srt.13401">suggest</a> exposure to blue light can stimulate production of melanin, the natural skin pigment that gives skin its colour. So too much blue light can potentially worsen hyperpigmentation – overproduction of melanin leading to dark spots on the skin – especially in people with darker skin. 2. Blue light can give you wrinkles Some research <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280109/">suggests</a> blue light might damage collagen, a protein essential for skin structure, potentially accelerating the formation of wrinkles. A laboratory <a href="https://pubmed.ncbi.nlm.nih.gov/29399830/">study suggests</a> this can happen if you hold your device one centimetre from your skin for as little as an hour. However, for most people, if you hold your device more than 10cm away from your skin, that would reduce your exposure <a href="https://en.wikipedia.org/wiki/Inverse-square_law">100-fold</a>. So this is much less likely to be significant. 3. Blue light can disrupt your sleep, affecting your skin If the skin around your eyes looks dull or puffy, it’s easy to blame this directly on blue light. But as we know blue light affects sleep, what you’re probably seeing are some of the visible signs of sleep deprivation. We know blue light is particularly good at <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.01413.2009?rss=1">suppressing</a> production of melatonin. This natural hormone normally signals to our bodies when it’s time for sleep and helps regulate our sleep-wake cycle. By suppressing melatonin, blue light exposure before bed disrupts this natural process, making it harder to fall asleep and potentially reducing the <a href="https://www.tandfonline.com/doi/abs/10.1080/07420528.2023.2173606">quality of your sleep</a>. The stimulating nature of screen content further disrupts sleep. Social media feeds, news articles, video games, or even work emails can keep our brains active and alert, hindering the transition into a sleep state. Long-term sleep problems can also <a href="https://academic.oup.com/ced/article-abstract/40/1/17/6621145?login=false">worsen</a> existing skin conditions, such as acne, eczema and rosacea. Sleep deprivation can elevate cortisol levels, a stress hormone that breaks down collagen, the protein responsible for skin’s firmness. Lack of sleep can also weaken the skin’s natural barrier, making it more susceptible to environmental damage and dryness. <h2>Can skincare protect me?</h2> The beauty industry has capitalised on concerns about blue light and offers a range of protective products such as mists, serums and lip glosses. From a practical perspective, probably only those with the more troublesome hyperpigmentation known as <a href="https://dermnetnz.org/topics/melasma">melasma</a> need to be concerned about blue light from devices. This condition requires the skin to be well protected from all visible light at all times. The only products that are totally effective are those that block all light, namely mineral-based suncreens or some cosmetics. If you can’t see the skin through them they are going to be effective. But there is a lack of rigorous testing for non-opaque products outside laboratories. This makes it difficult to assess if they work and if it’s worth adding them to your skincare routine. <h2>What can I do to minimise blue light then?</h2> Here are some simple steps you can take to minimise your exposure to blue light, especially at night when it can disrupt your sleep: <ul> <li> use the “night mode” setting on your device or use a blue-light filter app to reduce your exposure to blue light in the evening </li> <li> minimise screen time before bed and create a relaxing bedtime routine to avoid the types of sleep disturbances that can affect the health of your skin </li> <li> hold your phone or device away from your skin to minimise exposure to blue light </li> <li> use sunscreen. Mineral and physical sunscreens containing titanium dioxide and iron oxides offer broad protection, including from blue light. </li> </ul> <h2>In a nutshell</h2> Blue light exposure has been linked with some skin concerns, particularly pigmentation for people with darker skin. However, research is ongoing. While skincare to protect against blue light shows promise, more testing is needed to determine if it works. For now, prioritise good sun protection with a broad-spectrum sunscreen, which not only protects against UV, but also light.<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/233335/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-freeman-223922">Michael Freeman</a>, Associate Professor of Dermatology, <a href="https://theconversation.com/institutions/bond-university-863">Bond 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/yes-blue-light-from-your-phone-can-harm-your-skin-a-dermatologist-explains-233335">original article</a>. </div>

Body

Poor sleep is really bad for your health. But we found exercise can offset some of these harms

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Despite the well-known links between poor sleep and poorer health, getting enough good quality sleep has become a luxury in modern society. Many of us struggle to improve our sleep, while amid the COVID pandemic and recurring lock-downs, <a href="https://theconversation.com/were-sleeping-more-in-lockdown-but-the-quality-is-worse-155797">our sleep has deteriorated</a>. But <a href="https://doi.org/10.1136/bjsports-2021-104046">our new study</a>, published today in the British Journal of Sports Medicine, bears some encouraging news. We found doing enough physical activity (including exercise such as running or going to the gym) may counter some of the adverse health effects of unhealthy sleep patterns. Let us explain. <h2>Does poor sleep really harm our health?</h2> Unhealthy sleep patterns include: <ul> <li> not sleeping for long enough (less than seven hours per night for adults) </li> <li> sleeping for too long (more than nine hours per night for adults) </li> <li> snoring </li> <li> insomnia </li> <li> being a night owl, also known as “late chronotype”. This is people who naturally feel most awake and motivated in the evening, and are sluggish in the morning. </li> </ul> They are <a href="https://doi.org/10/ggjqrt">all associated</a> with poorer health. Recent research shows poor sleep may: <ul> <li> cause <a href="https://doi.org/10.1038/s41577-019-0190-z">inflammation</a> </li> <li> impair the metabolism of glucose (also known as blood sugar) and reduce the number of calories burned, thereby increasing the risk of <a href="https://theconversation.com/why-sleep-is-so-important-for-losing-weight-145058">obesity</a> </li> <li> increase the risk of <a href="https://doi.org/10/gg6x87">heart disease</a> and <a href="https://doi.org/10/ggnw5h">premature death</a>. </li> </ul> However, very few studies have examined how sleep and physical activity interact and impact our health. We set out to answer the question: if I have poor sleep but I do quite a lot of physical activity, can that offset some of the harms of my poor sleep in the long-term? Or would this not make any difference? <h2>What did we do?</h2> We analysed the information provided by 380,055 middle-aged adults in the UK Biobank study, recruited between 2006 and 2010. Participants reported their level of physical activity and five aspects of their sleep. We grouped people based on their sleep behaviour into healthy, intermediate or poor. We categorised people’s level of physical activity based on <a href="https://bjsm.bmj.com/content/54/24/1451">the World Health Organization (WHO) guidelines</a>. People who met the upper bounds of the guidelines did 300 minutes of moderate intensity physical activity a week, or 150 minutes of vigorous exercise, or a combination of both. Those who met the lower bound did 150 minutes of moderate intensity exercise a week, or 75 minutes of vigorous exercise, or a combination. Moderate intensity physical activity usually makes you slightly out of breath if sustained for a few minutes and includes brisk walking or cycling at a leisurely pace. Vigorous exercise usually makes you breath hard and can include running, swimming, and playing sports like tennis, netball, soccer or footy. <figure class="align-center "><img src="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=409&fit=crop&dpr=1 600w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=409&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=409&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=515&fit=crop&dpr=1 754w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=515&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=515&fit=crop&dpr=3 2262w" alt="" /><figcaption>Doing at least 150 minutes of moderate intensity physical activity a week, or 75 minutes of vigorous exercise, can offset some of the health harms of poor sleep. <a class="source" href="https://apps.who.int/iris/bitstream/handle/10665/336656/9789240015128-eng.pdf?sequence=1&isAllowed=y">World Health Organization, CC BY-NC-SA 3.0 IGO</a></figcaption></figure> <h2>What did we find?</h2> We followed up with the participants after 11 years. By May 2020, 15,503 participants had died, of which 4,095 died from heart disease and 9,064 died from cancer. <a href="https://doi.org/10.1136/bjsports-2021-104046">We found</a> that, compared to healthy sleepers, people with poor sleep had a 23% higher risk of premature death, a 39% higher risk of dying from heart disease, and a 13% higher risk of dying from cancer. We then compared the data of people who slept well with those who slept poorly, and how much they exercised. We found people who had the highest risk of dying from heart disease and cancer were those who had poor sleep and didn’t meet the WHO physical activity guidelines. On the other hand, those who had poor sleep but did enough physical activity to meet the WHO guidelines didn’t have as high a risk of dying from heart disease or cancer, compared to those who slept poorly and didn’t meet the physical activity guidelines. For example, let’s look at the risk of dying from cancer. Those who had poor sleep and did no physical activity had a 45% higher risk of dying from cancer compared to those who had healthy sleep and exercised a lot. But among those who met the physical activity guidelines, despite poor sleep, they didn’t really have a higher risk of dying from cancer any more. We found physical activity levels which met at least the bottom threshold of the WHO guidelines could reduce or eliminate some of the health harms of poor sleep. So people who did at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week were to some extent protected against the detrimental health effects of poor sleep. Those who had both poor sleep and did no moderate-to-vigorous intensity physical activity had the highest risks of premature death. Our study wasn’t designed to find out how and why physical activity may counteract some of the bad physiological impacts of poor sleep. But other research provides theories. For example, adequate physical activity may <a href="https://doi.org/10.1249/MSS.0000000000001179">reduce inflammation, help maintain a healthy glucose metabolism</a>, and <a href="https://doi.org/10.1016/j.pcad.2018.07.014">increase the number of calories burned</a>. It’s important to note our study was what’s called an “observational study”. It shows an association between adequate physical activity and reduced harms from poor sleep, but we must be careful in interpreting causation. It can’t conclusively say adequate physical activity causes the reduction of harms from poor sleep, though there’s strong evidence for an association in the right direction. Our study offers a hopeful message, that even if you haven’t been able to improve your sleep, you can still offset some of the health harms by doing enough exercise. <a href="https://www.sciencedirect.com/science/article/abs/pii/S009174352030339X">Our previous research</a> has also shown physical activity may help improve poor sleep patterns, which are a serious health problem across the world. In addition to combating some of the negative outcomes of poor sleep, physical activity can also provide many other health benefits and extend our lives. For example, a 2019 study found people who met WHO’s physical activity target above <a href="https://doi.org/10.1186/s12916-019-1339-0">lived three years longer on average</a> than those who didn’t. During lockdowns, access to parks, gyms, and swimming pools might be limited in many places. But there are still many ways to <a href="https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine">to stay fit and active at home during the coronavirus</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/163270/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: 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/poor-sleep-is-really-bad-for-your-health-but-we-found-exercise-can-offset-some-of-these-harms-163270">original article</a>. </div>

Body

Taking more than 5 pills a day? ‘Deprescribing’ can prevent harm – especially for older people

<a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> People are living longer and with more <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-functioning/health-disability-status">chronic health conditions</a> – including heart disease, diabetes, arthritis and dementia – than ever before. As societies continue to grow older, one pressing concern is the use of multiple medications, a phenomenon known as <a href="https://www.who.int/docs/default-source/patient-safety/who-uhc-sds-2019-11-eng.pdf">polypharmacy</a>. About <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50244">1 million older Australians</a> experience polypharmacy and this group is increasing. They may wake up in the morning and pop a pill for their heart, then another one or two to control blood pressure, a couple more if they have diabetes, a vitamin pill and maybe one for joint pain. Polypharmacy is usually <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.1_polypharmacy_75_years_and_over.pdf">defined</a> as taking five or more different medications daily. In aged care homes, <a href="https://doi.org/10.1016/j.archger.2022.104849">90% of residents</a> take at least five regular medications every single day. That can put their health at risk with increased costs for them and the health system. <h2>Adding up over time</h2> As people age, the effects of medications can change. Some medications, which were once beneficial, might start to do more harm than good or might not be needed anymore. About <a href="https://www.psa.org.au/wp-content/uploads/2020/02/Medicine-Safety-Aged-Care-WEB-RES1.pdf">half of older Australians</a> are taking a medication where the likely harms outweigh the potential benefits. While polypharmacy is sometimes necessary and helpful in managing multiple health conditions, it can lead to unintended consequences. <a href="https://www.nps.org.au/living-with-multiple-medicines/costs">Prescription costs</a> can quickly add up. Taking multiple medications can be difficult to manage particularly when there are specific instructions to crush them or take them with food, or when extra monitoring is needed. There is also a risk of <a href="https://www.nps.org.au/consumers/understanding-drug-interactions">drug interactions</a>. Medications bought “over the counter” without a prescription, such as vitamins, herbal medications or pain relievers, can also cause <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja11.10698">problems</a>. Some people might take an over-the-counter medication each day due to previous advice, but they might not need it anymore. Just like prescription medications, over-the-counter medications add to the overall burden and cost of polypharmacy as well as drug interactions and side effects. Unfortunately, the more medications you take, the more likely you are to have <a href="https://www.nps.org.au/consumers/managing-your-medicines#risks-of-taking-multiple-medicines">problems with your medications</a>, a reduced quality of life and increased risk of falls, hospitalisation and death. Each year, <a href="https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf">250,000 Australians</a> are admitted to hospital due to medication-related harms, many of which are preventable. For example, use of multiple medications like sleeping pills, strong pain relievers and some blood pressure medications can cause drowsiness and dizziness, potentially resulting in a <a href="https://betterhealthwhileaging.net/preventing-falls-10-types-of-medications-to-review/">fall</a> and broken bones. <h2>Prescribing and deprescribing are both important</h2> Ensuring safe and effective use of medications involves both prescribing, and <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/silver-book/part-a/deprescribing">deprescribing</a> them. <a href="https://www.australiandeprescribingnetwork.com.au/474-2/">Deprescribing</a> is a process of stopping (or reducing the dose of) medications that are no longer required, or for which the risk of harm outweighs the benefits for the person taking them. The process involves reviewing all the medications a person takes with a health-care professional to identify medications that should be stopped. Think of deprescribing as spring cleaning your medicine cabinet. Just like how you tidy up your house and get rid of objects that are causing clutter without being useful, deprescribing tidies up your medication list to keep only the ones truly required. <h2>But care is needed</h2> The process of deprescribing requires close monitoring and, for many medications, slow reductions in dose (tapering). This helps the body adjust gradually and can prevent sudden, unpleasant changes. Deprescribing is often done on a trial basis and medication can be restarted if symptoms come back. Alternatively, a safer medication, or non-drug treatment may be started in its place. Studies show deprescribing is a safe process when managed by a health-care professional, both for people living at <a href="https://link.springer.com/article/10.1007/s11606-020-06089-2">home</a> and those in <a href="https://doi.org/10.1016/j.jamda.2018.10.026">residential aged care</a>. You should always talk with your care team before stopping any medications. Deprescribing needs to be a team effort involving the person, their health-care team and possibly family or other carers. Shared decision-making throughout the process empowers the person taking medications to have a say in their health care. The team can work together to clarify treatment goals and decide which medications are still serving the person well and which can be safely discontinued. If you or a loved one take multiple medications you might be eligible for a free visit from a pharmacist (<a href="https://www.nps.org.au/assets/NPS/pdf/NPSMW2390_Anticholinergics_HMR_Factsheet.pdf">a Home Medicines Review</a>) to help you get the best out of your medications. <h2>What’s next?</h2> Health care has traditionally focused on prescribing medications, with little focus on when to stop them. Deprescribing is not happening as often as it should. <a href="https://www.australiandeprescribingnetwork.com.au/">Researchers</a> are working hard to develop tools, resources and service models to support deprescribing in the community. Health-care professionals may think older adults are not open to deprescribing, but about <a href="https://academic.oup.com/biomedgerontology/article/77/5/1020/6352400">eight out of ten people</a> are willing to stop one or more of their medications. That said, of course some people may have concerns. If you have been taking a medication for a long time, you might wonder why you should stop or whether your health could get worse if you do. These are important questions to ask a doctor or pharmacist. We need more <a href="https://shpa.org.au/news-advocacy/MedsAware">public awareness</a> about polypharmacy and deprescribing to turn the tide of increasing medication use and related harms. <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/211424/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, Senior Research Fellow in the Centre for Medicine Use and Safety , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, Enterprise Fellow, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, PhD student, Clinical Pharmacology and Toxicology, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</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/taking-more-than-5-pills-a-day-deprescribing-can-prevent-harm-especially-for-older-people-211424">original article</a>.

Body

Australia has a strong hand to tackle gambling harm. Will it go all in or fold?

<a href="https://theconversation.com/profiles/charles-livingstone-2724">Charles Livingstone</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> A ban on all gambling advertising within three years has attracted the <a href="https://www.theguardian.com/australia-news/2023/jun/28/ads-for-online-gambling-should-be-banned-in-australia-within-three-years-inquiry-recommends">most attention</a> of the <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Social_Policy_and_Legal_Affairs/Onlinegamblingimpacts/Report/List_of_recommendations">31 recommendations</a> made by the Australian parliamentary inquiry into online gambling, which reported this week. But equally significant are the recommendations to adopt public health principles to prevent gambling harm, to appoint a national online regulator, and for Australian to lead the development of international agreements that “aim to reduce gambling harm and protect public policy and research from gambling industry interference”. If implemented, the recommendations will advance gambling regulation by several orders of magnitude. <a href="https://link.springer.com/article/10.1007/s10389-020-01437-2">Preventing harm</a> is a better goal than the current practice of ignoring harms until they become overwhelming. Building a fence at the top of the cliff, rather than providing a fleet of ambulances at the bottom, seems sensible. Many countries are grappling with regulating unlicensed <a href="https://researchportal.helsinki.fi/en/publications/blocking-measures-against-offshore-online-gambling-a-scoping-revi">online gambling operators</a> registered in places like Curaçao and the Isle of Man. The only way to effectively address this is via <a href="https://www.coe.int/en/web/pompidou/-/the-recording-of-the-webinar-on-behavioural-addictions-facilitated-by-information-and-communication-technologies-risks-and-perspectives-is-now-availab">international agreements</a>. And as with many other harmful commodity industries, gambling operators <a href="https://www.lisbonaddictions.eu/lisbon-addictions-2022/presentations/5-ways-gambling-industry-pursues-influence-policymakers">advance their interests</a> through political influence. They have enthusiastically utilised the tactics honed by the tobacco industry – <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2010.03137.x">lobbying</a>, <a href="https://www.abc.net.au/news/2021-10-14/how-the-gambling-industry-cashed-in-on-political-donations/100509026">political donations</a> and influencing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434195/">research outcomes</a> through funding. All these aspects need addressing. For example, the inquiry recommends imposing a levy on the gambling industry to fund research. <h2>Phasing out advertising</h2> The proposals to prohibit all inducements to gamble come in four phases. The first would ban all social media and online advertising. Radio advertising during school drop-off times would also be prohibited. In the second phase, broadcast advertising for an hour either side of sporting broadcasts would be banned (as Opposition Leader <a href="https://www.theguardian.com/australia-news/2023/may/13/peter-dutton-cranks-up-pressure-on-labor-to-further-restrict-gambling-ads">Peter Dutton has argued for</a>). The third stage would prohibit all broadcast advertising for gambling between 6am and 10pm. Finally, three years on, all gambling advertising would be gone from our screens. Not many people will miss it. A 2022 survey by the <a href="https://australiainstitute.org.au/post/polling-research-give-junk-food-gambling-ads-the-punt/">Australia Institute</a> found 70% support for such restrictions. The evidence suggests this would be beneficial to young people, since exposure to advertising increases the likelihood of gambling as adults, <a href="https://www.theguardian.com/society/2020/mar/27/children-more-likely-to-become-gamblers-due-to-high-volume-of-betting-ads">with significant harm</a> for some. <h2>Important precedents</h2> The recommendations would set important precedents that can be readily applied to other forms of gambling. These include the principle of establishing a public health-oriented harm prevention policy, a national regulatory system, and enhancing consumer protections to potentially include a universal pre-commitment system. If online gambling can be better regulated – and it can – why not casinos and pokies? Casino inquiries in <a href="https://www.parliament.nsw.gov.au/la/papers/Pages/tabled-paper-details.aspx?pk=79129">New South Wales</a>, <a href="https://www.rccol.vic.gov.au/">Victoria</a>, <a href="https://www.justice.qld.gov.au/initiatives/external-review-qld-operations-star-entertainment-group">Queensland</a> and <a href="https://www.wa.gov.au/government/publications/perth-casino-royal-commission-final-report">Western Australia</a> have certainly demonstrated the need. So has the <a href="https://www.crimecommission.nsw.gov.au/inquiry-into-money-laundering-in-pubs-and-clubs">NSW Crime Commission</a>’s 2022 inquiry into money laundering in pubs and clubs. Notably, poker machines are estimated to be responsible for <a href="https://akjournals.com/view/journals/2006/12/1/article-p182.xml">51% to 57% of the total problems</a> arising from gambling. Race and sports wagering account for 20%. <h2>Industry will resist</h2> The <a href="https://www.abc.net.au/radio/programs/pm/gambling-ads-ban-called-an-over-reach-/102538120">online gambling industry</a> will do all it can to thwart these initiatives, along with <a href="https://www.smh.com.au/business/companies/wagering-tv-bodies-slam-proposed-gambling-ads-ban-afl-wary-of-impact-20230628-p5dk4j.html">broadcasters</a> and some <a href="https://www.theage.com.au/sport/afl/scourge-of-the-gambling-epidemic-teal-mp-attacks-afl-over-gambling-ads-20230302-p5coym.html">sports</a> businesses. Certainly Australia’s unenviable record of being world leaders in <a href="https://www.abc.net.au/news/2018-11-20/australians-worlds-biggest-gambling-losers/10495566">gambling losses</a> will be threatened if the recommendations are implemented. The report <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Social_Policy_and_Legal_Affairs/Onlinegamblingimpacts/Report/Chapter_2_-_A_national_strategy_on_online_gambling_harm_reduction">acknowledges</a> wagering service providers have “successfully framed the issue of gambling harm around personal responsibility while diminishing industry and government responsibility”. "There is too much potential for the gambling industry to be involved in the development of gambling regulation and policy in Australia." Submissions from the gambling industry reflected this. For example, <a href="https://responsiblewagering.com.au/">Responsible Wagering Australia</a>, which represents wagering companies such as Bet365, Betfair, Entain, Sportsbet, Pointsbet and Unibet, suggested the <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Social_Policy_and_Legal_Affairs/Onlinegamblingimpacts/Submissions">industry was focused on limiting harm</a>, and mindful of the risks of “problem gambling”. Indeed, the inquiry’s original terms of reference were about “online gambling and its impacts on problem gamblers”. The committee changed this to the “impacts on those experiencing gambling harm”. Its report reflects this change, and the majority of submissions and evidence given in <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Social_Policy_and_Legal_Affairs/Onlinegamblingimpacts/Report/B_Public_hearings">13 public hearings</a> overwhelmingly in favour of improved regulation of online gambling product In the report’s forward, chair Peta Murphy writes: "I am proud to say this Committee has delivered a unanimous report that says, ‘enough is enough’." Gambling harm imposes <a href="https://responsiblegambling.vic.gov.au/resources/publications/the-social-cost-of-gambling-to-victoria-121/">enormous costs</a> on the community, and on those affected, including families. Examples of these effects are prominent in the committee’s report. Many are harrowing. There is some way to go before Australia joins Italy, Spain, Belgium and The Netherlands in taking action against gambling interests. But delay means more harm to more people. The Australian government now has an excellent road map to demonstrate its commitment to the health and wellbeing of Australians. Adopting the inquiry’s recommendations should be a high priority.<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/208749/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/charles-livingstone-2724">Charles Livingstone</a>, Associate Professor, School of Public Health and Preventive Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australia-has-a-strong-hand-to-tackle-gambling-harm-will-it-go-all-in-or-fold-208749">original article</a>.

Money & Banking

‘Psychological debriefing’ right after an accident or trauma can do more harm than good – here’s why

<a href="https://theconversation.com/profiles/richard-bryant-161">Richard Bryant</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> The recent <a href="https://www.abc.net.au/news/2023-06-18/hunter-valley-wedding-bus-crash-survivors-remain-in-hospital/102487630">tragic bus accident</a> in the New South Wales Hunter Valley has again raised the issue of how we address the potential psychological effects of traumatic events. It is interesting we revisit the same debate after each disaster, and few lessons have apparently been learned after decades of research. After the Hunter Valley accident, immediate psychological counselling was <a href="https://www.theguardian.com/australia-news/2023/jun/15/hunter-valley-bus-crash-company-issued-with-defect-notices-after-police-raid">offered to those affected</a>. While we can’t say what form of counselling was offered, the traditional approach is known as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118833/">psychological debriefing</a>”. This typically involves counsellors providing trauma survivors with a single counselling intervention within days of the event. Although the content of the intervention can vary, it usually involves education about stress reactions, encouragement to disclose their memories of the experience, some basic stress-coping strategies and possibly referral information. But the evidence shows this approach, however well-meaning, may not help – or worse, do harm. <h2>The belief that feelings must be shared</h2> The encouragement of people to discuss their emotional reactions to a trauma is the result of a long-held notion in psychology (dating back to the classic writings of Sigmund Freud) that disclosure of one’s emotions is invariably beneficial for one’s mental health. Emanating from this perspective, the impetus for psychological debriefing has traditionally been rooted in the notion trauma survivors are vulnerable to psychological disorders, such as post-traumatic stress disorder (PTSD), if they do not “talk through their trauma” by receiving this very <a href="https://journals.sagepub.com/doi/full/10.1177/1529100610387086">early intervention</a>. The scenario of trauma counsellors appearing in the acute aftermath of traumatic events has been commonplace for decades in Australia and elsewhere. Following the 9/11 terrorist attacks in New York City in 2001, up to 9,000 counsellors were mobilised and more than <a href="https://www.nytimes.com/2002/07/22/nyregion/finding-cure-for-hearts-broken-sept-11-is-as-difficult-as-explaining-the-cost.html">US$200 million</a> was projected to meet a surge in mental health needs. But fewer people than expected sought help under this program and $90 million remained <a href="https://theconversation.com/9-11-anniversary-a-watershed-for-psychological-response-to-disasters-2975">unspent</a>. <h2>What do we know about psychological reactions to disasters?</h2> The overwhelming evidence indicates the majority of people will <a href="http://www.psychologicalscience.org/publications/journals/pspi/weighing-the-costs-of-disaster.html">adapt</a> to traumatic events without any psychological intervention. Long-term studies indicate approximately 75% of trauma survivors will not experience any long-term distress. Others will experience short-term distress and subsequently adapt. A minority (usually about 10%) will <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086">experience chronic psychological problems</a>. This last group are the ones who require care and attention to reduce their mental health problems. Experts now agree other trauma survivors can rely on their own <a href="https://www.rcpsych.ac.uk/mental-health/problems-disorders/coping-after-a-traumatic-event">coping resources and social networks</a> to adapt to their traumatic experience. The finding across many studies that most people adapt to traumatic experiences <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086">without formal mental health interventions</a> has been a major impetus for questioning the value of psychological debriefing in the immediate aftermath of disasters. In short, the evidence tells us universal interventions – such as psychological debriefing for everyone involved in a disaster – that attempt to prevent PTSD and other psychological disorders in trauma survivors are not indicated. These attempts <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086#bibr448-1529100610387086">do not prevent</a> the disorder they are targeting. <h2>Not a new conclusion</h2> In the aftermath of the 2004 Indian Ocean earthquake and tsunami, the World Health Organization listed a warning (which <a href="https://www.who.int/teams/mental-health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/other-significant-emotional-and-medical-unexplained-somatic-complaints/psychological-debriefing-in-people-exposed-to-a-recent-traumatic-event">still stands</a>) that people should not be given single-session psychological debriefing because it is <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086#bibr448-1529100610387086">not supported</a> by evidence. Worse than merely being ineffective, debriefing can be <a href="https://www.jenonline.org/article/S0099-1767(19)30453-2/fulltext#:%7E:text=It%20is%20for%20these%20reasons,%2C%20anxiety%20or%20depressive%20symptoms.%E2%80%9D">harmful for some people</a> and may increase the risk of PTSD. The group of trauma survivors that are most vulnerable to the toxic effects of debriefing are those who are more distressed in the acute phase right after the trauma. This group of people have worse mental health outcomes if they are provided with early debriefing. This may be because their trauma memories are over-consolidated as a result of the emotional disclosure so shortly after the event, when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/#:%7E:text=Brain%20areas%20implicated%20in%20the,norepinephrine%20responses%20to%20subsequent%20stressors.">stress hormones</a> are still highly active. In normal clinical practice a person would be assessed in terms of their suitability for any psychological intervention. But in the case of universal psychological debriefing there is no prior assessment. Therefore, there’s no assessment of the risks the intervention may pose for the person. <h2>Replacing debriefing</h2> Most international bodies have shifted away from psychological debriefing. Early intervention might now be offered as “<a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/psychological-first-aid">psychological first aid</a>”. This newer approach is meant to provide <a href="https://www.who.int/publications/i/item/9789241548205">fundamental support and coping strategies</a> to help the person manage the immediate aftermath of adversity. One of the most important differences between psychological first aid and psychological debriefing is that it does not encourage people to disclose their emotional responses to the trauma. But despite the increasing popularity of psychological first aid, it is difficult to assess its effectiveness as it does not explicitly aim to prevent a disorder, such as PTSD. <h2>Wanting to help</h2> So if there is so much evidence, why do we keep having this debate about the optimal way to assist psychological adaptation after disasters? Perhaps it’s because it’s human nature to want to help. The evidence suggests we should monitor the most vulnerable people and target resources towards them when they need it – usually some weeks or months later when the dust of the trauma has settled. Counsellors might want to promote their activities in the acute phase after disasters, but it may not be in the best interest of the trauma survivors. In short, we need to develop better strategies to ensure we are meeting the needs of the survivors, rather than the counsellors. <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<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/208139/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/richard-bryant-161">Richard Bryant</a>, Professor & Director of Traumatic Stress Clinic, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/psychological-debriefing-right-after-an-accident-or-trauma-can-do-more-harm-than-good-heres-why-208139">original article</a>.

Caring

Gastro or endometriosis? How your GP discusses uncertainty can harm your health

You wake with stomach pain that worsens during the day and decide to see your doctor. You describe your symptoms and your doctor examines you. Then the doctor says, “From what I hear, I think you could just have a stomach bug. Rest and come back in three days.” This might be a less definitive answer than you’re after. But doctors can’t always be sure of a diagnosis straight away. As <a href="https://link.springer.com/article/10.1007/s11606-022-07768-y">my review</a> shows, doctors use various ways of communicating such uncertainty. Sometimes there is a mismatch between what doctors say when they’re uncertain and how patients interpret what they say, which can have harmful consequences. <h2>Why does uncertainty matter?</h2> Doctors <a href="https://link.springer.com/article/10.1007/s11606-017-4164-1">cannot always explain</a> what your health problem is or what caused it. Such diagnostic uncertainty is a normal and <a href="https://doi.org/10.1001/jama.2022.2141">ever-present part</a> of the processes leading to a diagnosis. For instance, doctors often have to rule out other possible diagnoses before settling on one that’s most likely. While doctors ultimately get the diagnosis right <a href="http://dx.doi.org/10.1136/bmjqs-2012-001615">in 85-90%</a> of cases, diagnostic uncertainty can lead to diagnostic delays and is a huge contributor to harmful or even deadly misdiagnoses. Every year, <a href="https://www.mja.com.au/system/files/issues/213_07/mja250771.pdf">an estimated</a> 21,000 people are seriously harmed and 2,000-4,000 people die in Australia because their diagnosis was delayed, missed or wrong. That could be because the wrong treatment was provided and caused harm, or the right treatment was not started or given after the condition had already considerably progressed. More than <a href="https://www.mja.com.au/system/files/issues/213_07/mja250771.pdf">80% of diagnostic errors</a> could have been prevented. Three medical conditions – infections, cancer and major vascular events (such as strokes or heart attacks) – are the so-called “<a href="https://doi.org/10.1515/dx-2019-0019">Big Three</a>” and cause devastating harm if misdiagnosed. In my review, the top three symptoms – fever, chest pain and abdominal pain – were most often linked to diagnostic uncertainty. In other words, most of us will have had at least one of these very common symptoms and thus been at risk of uncertainty and misdiagnosis. Some groups are less likely to be diagnosed correctly or without inappropriate delay than others, leading to <a href="https://doi.org/10.1001/jama.2022.7252">diagnostic inequities</a>. This may be the case for <a href="https://www.liebertpub.com/doi/10.1089/whr.2022.0052">women</a>, and other groups marginalised because of their <a href="https://onlinelibrary.wiley.com/doi/10.1111/acem.14142">race or ethnicity</a>, <a href="https://doi.org/10.1016/j.socscimed.2020.113609">sexual orientation or gender identity</a>, or <a href="https://doi.org/10.1001/jama.2022.7252">language proficiency</a>. <h2>How often do you hear ‘I don’t know’?</h2> My research showed doctors often make diagnostic uncertainty clear to patients by using explicit phrases such as: “I don’t know.” But doctors can also keep quiet about any uncertainty or signal they’re uncertain in more subtle ways. When doctors believe patients prefer clear answers, they may only share the most likely diagnosis. They say: “It’s a stomach bug” but leave out, “it could also be constipation, appendicitis or endometriosis”. Patients leave thinking the doctor is confident about the (potentially correct or incorrect) diagnosis, and remain uninformed about possible other causes. This can be especially frustrating for patients with chronic symptoms, where such knowledge gaps can lead to lengthy diagnostic delays, as reported for <a href="https://doi.org/10.1016/j.ajog.2018.12.039">endometriosis</a>. Subtle ways of communicating uncertainty include hedging with certain words (could, maybe) or using introductory phrases (my guess, I think). Other implicit ways are consulting a colleague or the Internet, or making follow-up appointments. If patients hear “I think this could be a stomach bug” they may think there’s some uncertainty. But when they hear “come back in three days” the uncertainty may not be so obvious. Sharing uncertainty implicitly (rather than more directly), can leave patients unaware of new symptoms signalling a dangerous change in their condition. <h2>What can you do about it?</h2> 1. Ask about uncertainty Ask your doctor to share any <a href="http://dx.doi.org/10.1515/dx-2021-0086">uncertainty and other diagnostic reasoning</a>. Ask about alternative diagnoses they’re considering. If you’re armed with such knowledge, you can better engage in your care, for example asking for a review when your symptoms worsen. 2. Manage expectations together Making a diagnosis can be an evolving process rather than a single event. So ask your doctor to outline the diagnostic process to help manage any <a href="http://dx.doi.org/10.1136/ebm.14.3.66">mismatched expectations</a> about how long it might take, or what might be involved, to reach a diagnosis. Some conditions need time for symptoms to evolve, or further tests to exclude or confirm. 3. Book a long appointment When we feel sick, we might get anxious or find we experience heightened levels of fear and other emotions. When we hear our doctor isn’t certain about what’s causing our symptoms, we may get even more anxious or fearful. In these cases, it can take time to discuss uncertainty and to learn about our options. So book a long appointment to give your doctor enough time to explain and for you to ask questions. If you feel you’d like some support, you can ask a close friend or family member to attend the appointment with you and to take notes for you. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/gastro-or-endometriosis-how-your-gp-discusses-uncertainty-can-harm-your-health-196943" target="_blank" rel="noopener">The Conversation</a>.

Caring

Did COVID harm my immune system?

So you’ve had COVID and have now recovered. You don’t have ongoing symptoms and luckily, you don’t seem to have developed <a href="https://theconversation.com/long-covid-how-researchers-are-zeroing-in-on-the-self-targeted-immune-attacks-that-may-lurk-behind-it-169911" target="_blank" rel="noopener">long COVID</a>. But what impacts has COVID had on your overall immune system? It’s early days yet. But growing evidence suggests there are changes to your immune system that may put you at risk of other infectious diseases. Here’s what we know so far. <h2>A round of viral infections</h2> Over this past winter, many of us have had what seemed like a <a href="https://theconversation.com/why-do-i-and-my-kids-get-so-many-colds-and-with-all-this-covid-around-should-we-be-isolating-too-179302" target="_blank" rel="noopener">continual round</a> of viral illness. This may have included COVID, <a href="https://www.who.int/health-topics/influenza-seasonal#tab=tab_1" target="_blank" rel="noopener">influenza</a> or infection with <a href="https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098" target="_blank" rel="noopener">respiratory syncytial virus</a>. We may have recovered from one infection, only to get another. Then there is the re-emergence of infectious diseases globally such as <a href="https://theconversation.com/we-need-to-talk-about-monkeypox-without-shame-and-blame-188295" target="_blank" rel="noopener">monkeypox</a> or <a href="https://theconversation.com/the-latest-polio-cases-have-put-the-world-on-alert-heres-what-this-means-for-australia-and-people-travelling-overseas-188989" target="_blank" rel="noopener">polio</a>. Could these all be connected? Does COVID somehow weaken the immune system to make us more prone to other infectious diseases? There are <a href="https://www.sciencedirect.com/science/article/pii/B9780128009475000168?via%3Dihub" target="_blank" rel="noopener">many reasons</a> for infectious diseases to emerge in new locations, after many decades, or in new populations. So we cannot jump to the conclusion COVID infections have given rise to these and other viral infections. But evidence is building of the negative impact of COVID on a healthy individual’s immune system, several weeks after symptoms have subsided. <h2>What happens when you catch a virus?</h2> There are three possible outcomes after a viral infection: 1) your immune system clears the infection and you recover (for instance, with <a href="https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Rhinovirus-Infections.aspx" target="_blank" rel="noopener">rhinovirus</a> which causes the common cold) 2) your immune system fights the virus into “latency” and you recover with a virus dormant in our bodies (for instance, <a href="https://www.healthdirect.gov.au/chickenpox" target="_blank" rel="noopener">varicella zoster virus</a>, which causes chickenpox) 3) your immune system fights, and despite best efforts the virus remains “chronic”, replicating at very low levels (this can occur for <a href="https://www.who.int/news-room/fact-sheets/detail/hepatitis-c" target="_blank" rel="noopener">hepatitis C virus</a>). Ideally we all want option 1, to clear the virus. In fact, most of us <a href="https://biosignaling.biomedcentral.com/articles/10.1186/s12964-022-00856-w" target="_blank" rel="noopener">clear SARS-CoV-2</a>, the virus that causes COVID. That’s through a complex process, using many different parts of our immune system. But international evidence suggests changes to our immune cells after SARS-CoV-2 infection may have other impacts. It may affect our ability to fight other viruses, as well as other pathogens, such as bacteria or fungi. <h2>How much do we know?</h2> An <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02228-6" target="_blank" rel="noopener">Australian study</a> has found SARS-CoV-2 alters the balance of immune cells up to 24 weeks after clearing the infection. There were changes to the relative numbers and types of immune cells between people who had recovered from COVID compared with healthy people who had not been infected. This included changes to cells of the <a href="https://www.khanacademy.org/test-prep/mcat/organ-systems/the-immune-system/a/innate-immunity" target="_blank" rel="noopener">innate immune system</a> (which provides a non-specific immune response) and the <a href="https://www.ncbi.nlm.nih.gov/books/NBK21070/" target="_blank" rel="noopener">adaptive immune system</a> (a specific immune response, targeting a recognised foreign invader). <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1009742" target="_blank" rel="noopener">Another study</a> focused specifically on <a href="https://www.immunology.org/public-information/bitesized-immunology/cells/dendritic-cells" target="_blank" rel="noopener">dendritic cells</a> – the immune cells that are often considered the body’s “first line of defence”. Researchers found fewer of these cells circulating after people recovered from COVID. The ones that remained were less able to activate white blood cells known as <a href="https://www.britannica.com/science/T-cell" target="_blank" rel="noopener">T-cells</a>, a critical step in activating anti-viral immunity. Other studies have found different impacts on T-cells, and other types of white blood cells known as <a href="https://askabiologist.asu.edu/b-cell" target="_blank" rel="noopener">B-cells</a> (cells involved in producing antibodies). After SARS-CoV-2 infection, one study <a href="https://doi.org/10.1172/JCI140491" target="_blank" rel="noopener">found evidence</a> many of these cells had been activated and “exhausted”. This suggests the cells are dysfunctional, and might not be able to adequately fight a subsequent infection. In other words, sustained activation of these immune cells after a SARS-CoV-2 infection may have an impact on other inflammatory diseases. <a href="https://www.nature.com/articles/s41392-021-00749-3#citeas" target="_blank" rel="noopener">One study</a> found people who had recovered from COVID have changes in different types of B-cells. This included changes in the cells’ metabolism, which may impact how these cells function. Given B-cells are critical for producing antibodies, we’re not quite sure of the precise implications. Could this influence how our bodies produce antibodies against SARS-CoV-2 should we encounter it again? Or could this impact our ability to produce antibodies against pathogens more broadly – against other viruses, bacteria or fungi? The study did not say. <h2>What impact will these changes have?</h2> One of the main concerns is whether such changes may impact how the immune system responds to other infections, or whether these changes might worsen or cause other chronic conditions. So more work needs to be done to understand the long-term impact of SARS-CoV-2 infection on a person’s immune system. For instance, we still don’t know how long these changes to the immune system last, and if the immune system recovers. We also don’t know if SARS-CoV-2 triggers other chronic illnesses, such as <a href="https://www.healthdirect.gov.au/chronic-fatigue-syndrome-cfs-me" target="_blank" rel="noopener">chronic fatigue syndrome</a> (myalgic encephalomyelitis). Research into this is ongoing. What we do know is that having a healthy immune system and being vaccinated (when a vaccine has been developed) is critically important to have the best chance of fighting any infection. This article originally appeared on <a href="https://theconversation.com/ive-had-covid-and-am-constantly-getting-colds-did-covid-harm-my-immune-system-am-i-now-at-risk-of-other-infectious-diseases-188899" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

Research shows it’s harmful to smack your child, so what should parents do instead?

Today, if a parent smacks a child mid-tantrum in the supermarket, they are likely to get looks of disapproval from other shoppers. Smacking is not as socially acceptable as it used to be. Recent <a href="https://www.australianchildmaltreatmentstudy.org/the-prevalence-of-corporal-punishment-in-australia/" target="_blank" rel="noopener">research</a> shows only 15% of people aged 16-24 view physical discipline as necessary to properly raise children. This compares with 38% of people over 65. But it still happens – and it is very harmful to children. So we need to help parents find alternative methods of discipline. <h2>It is more common than you might think</h2> In 2017, the royal commission into child sexual abuse recommended a national study on how common child abuse is in Australia. Early findings <a href="https://www.australianchildmaltreatmentstudy.org/the-prevalence-of-corporal-punishment-in-australia/" target="_blank" rel="noopener">released last month</a> revealed 61% of those aged 16-24 said they were physically hit for discipline four or more times during their childhood. The research also found those who were hit had almost double the risk of depression and anxiety. This partly because those who had been smacked as a child may have also experienced other forms of mistreatment, such as harsh parental reactions, neglect or insufficient support. This fits with other research showing negative consequences if children are smacked or hit. A 2016 <a href="https://doi.org/10.1037/fam0000191" target="_blank" rel="noopener">review</a> of more than 70 international studies showed it was linked to reduced compliance with parents’ instructions over time, children having increased aggression and antisocial behaviour, mental health problems, and lower self-esteem. In adulthood, it is also linked to antisocial behaviour and being either a victim or perpetrator of intimate partner violence. <h2>What does the law say?</h2> Currently, the use of reasonable force for the purpose of discipline in the home remains lawful under <a href="https://aifs.gov.au/resources/resource-sheets/physical-punishment-legislation" target="_blank" rel="noopener">criminal law provisions</a> or common law principles made by courts. This is despite the fact it is illegal in most Australian states and territories in other settings such as schools, or between adults – where it is classed as assault. Many countries are changing their laws because they understand the harms and because it is a violation of <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child" target="_blank" rel="noopener">children’s right</a> to live a life free from violence. Already, <a href="https://endcorporalpunishment.org/countdown/" target="_blank" rel="noopener">63 countries</a> have banned corporal punishment for children, including New Zealand, Sweden, Denmark, South Korea, Wales, Scotland, France and Japan. Parenting and family researchers have <a href="https://theconversation.com/lets-talk-about-making-smacking-children-illegal-16399" target="_blank" rel="noopener">long been pushing</a> for an end to corporal punishment <a href="https://www.3aw.com.au/growing-calls-to-make-smacking-children-illegal-as-england-considers-move/" target="_blank" rel="noopener">in Australia</a> as well. <h2>Parenting is stressful</h2> But this is not just about law reform. Raising kids can be challenging at the best of times. Kids misbehave or may not be in control of their emotions, and parents need to provide guidance to their children about what is appropriate behaviour. The good news is there are <a href="https://rdcu.be/cEvhu" target="_blank" rel="noopener">evidence-based alternatives</a> to smacking. These are <a href="https://www.bbc.com/future/article/20220607-what-should-you-do-when-a-child-misbehaves" target="_blank" rel="noopener">strategies</a> that aim to help children understand what behaviours are expected, teach them to work through their feelings and learn how to repair a situation or solve a problem. These approaches lead to much better outcomes for parents and children, including more realistic expectations on the part of the parent and a better relationship between the parent and child. They also improve a child’s well-being and mental health. <h2>So, what are the alternatives to smacking?</h2> Here are some approaches to consider with your child: 1. Give clear and consistent limits about what you expect Children need to know how you want them to behave and for this to be clear. An example might be: “It’s not OK to hit your brother” or “You can’t take lollies off the supermarket shelves without asking me first.” 2. Manage your own emotions Anger is contagious, so try not to lose your temper in front of your kids. Instead, pause before you react: take three deep breaths, have a cold drink of water, or step outside for a moment. 3. Be a good role model for your child when you don’t manage situations well Parents need to show how they manage their own emotions - or make amends when they act in less-than-ideal ways. Parents should be brave enough to say “I’m sorry I got angry and shouted at you. I wasn’t very patient.” 4. Explore the emotions behind behaviour Kids can be uncertain or confused by their emotions. So, try and help them understand their feelings. This could include saying something like “I can see you felt left out and jealous”. Also validate their emotions because this helps them feel accepted by you while learning to understand and manage their feelings. For example, say “It’s difficult when this happens”. When they are calmer, you could explore other feelings behind their actions. This is about separating feelings (jealousy, frustration) from behaviour (hitting). All feelings are okay, but not all behaviours. 5. Resolve problems when everyone is calm No one can think, talk or listen properly if they are upset. Take time to do some breathing or something soothing with your child. Or perhaps they need a run around to release strong feelings. 6. Support children to make amends When everyone is calmer, help them work out the solution or next step. This teaches them how to resolve situations, repair relationships and take responsibility for their behaviour. You might say something like, “It can be embarrassing saying sorry to someone you’ve been angry with. What do you think might help?” 7. Explore natural consequences If something is broken, children might need to fix it, use pocket money to replace it, or explore what might make the situation better. Children need family rules about behaviour and it can be useful to discuss what should happen if these are broken. Getting discipline right is not easy as a parent, grandparent or carer. And this can be especially difficult if you were brought up with smacking (and have older relatives telling you it is “fine”). It’s worth remembering a <a href="https://www.childmatters.org.nz/downloads/CUB.pdf" target="_blank" rel="noopener">slogan</a> frequently used when we talk about an end to smacking: “children are unbeatable”. They deserve the same protection from violence as adults. This article originally appeared in <a href="https://theconversation.com/research-shows-its-harmful-to-smack-your-child-so-what-should-parents-do-instead-186739" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Legal

Why over-cleansing can do more harm than good

As we all know, taking off your makeup and sunscreen at the end of the day is a vital part of anyone’s skincare routine.This process not only helps you feel fresh and relaxed to get a good night’s sleep, but is also an essential step to remove dirt, oil and dead skin cells that can lead to skin feeling congested, breakouts and lasting dullness. While most people opt for a makeup remover, such as wipes or cleansing serums, it turns out this process could be doing more harm than good - especially with ageing skin. According to Dr Mike Bell, Head of Science and Research for the holy grail UK skincare brand No7, “The over-cleansing of skin - sometimes with harsh high surfactant foaming cleansers or high alcohol-based toners - can be as harmful as the over-use of make-up or ineffective removal of make-up.” “The skin’s essential barrier can become stripped of important ceramides and lipids, leaving it more sensitive and vulnerable to the environment."Dr Bell’s solution? Turn to a cleanser that gets the job done, without all the harsh ingredients. "Effective removal does rely on cleansers with mild but effective surfactants as well as the right type of emollient oils that together can dissolve even the most stubborn make-up.”“Branched ester emollients like isononyl isononanoate are particularly effective as is dimethicone for dissolving some of the higher waterproof make-ups. These are combined with olive oil-based emulsifiers to take your make-up off seamlessly without harming the skin," he says. Luckily, No7 offers a huge range of cleansers for all skin types, with tested formulas that will help remove makeup with ease, and not damage your skin in the process. <a href="https://www.priceline.com.au/no7-biodegradable-cleansing-wipes-30-wipes">No7 Biodegradable Cleansing Wipes</a> are a tested favourite, with the soft and gentle wipes helping to clear pores and banish all traces of impurity with ease. <img src="https://oversixtydev.blob.core.windows.net/media/2022/02/cleansing-No7.jpg" alt="" width="1280" height="720" />Image credit: Supplied - No7For a gentle eye makeup remover that won’t leave behind traces of your favourite mascara, look no further than <a href="https://www.priceline.com.au/brand/no7/no7-radiant-results-revitalising-eye-make-up-remover-100-ml">No7 Radiant Results Revitalising Eye Make-Up Remover</a>.<img src="https://oversixtydev.blob.core.windows.net/media/2022/02/eye-No7.jpg" alt="" width="1280" height="720" />Image credit: Supplied - No7A gentle pre-cleanse is essential for any deep clean, with<a href="https://www.priceline.com.au/no7-radiant-results-revitalising-micellar-cleansing-water-200-ml"> No7 Radiant Results Revitalising Micellar Cleansing Water</a> working to capture make-up, impurities and pollutants, drawing them away from the skin in an instant. <img src="https://oversixtydev.blob.core.windows.net/media/2022/02/micellar-No7.jpg" alt="" width="1280" height="720" />Image credit: Supplied - No7Available at <a href="https://www.priceline.com.au/brand/no7">Priceline</a>, these three holy grail products are available for under $20 each, making them a must have to everyone’s skincare regime. Image credits: Getty Images / No7

Beauty & Style

7 harmful beauty product ingredients that you should swap out

How harmful are your beauty products? A study found there are as many as 126 potentially harmful ingredients in the average adult’s daily beauty routine. From synthetics in your shampoo to chemicals in your concealer, find out which ingredients you should swap out and why. Fragrance “If you only change one thing in your beauty routine, the ingredient you should avoid is fragrance,” says Lindsay Coulter, the David Suzuki Foundation’s resident green living expert. Fragrance isn’t just in colognes or perfumes; in fact, it’s added to everything from body wash to shampoo to face creams. Even unscented products can contain fragrance compounds that act as masking agents. “It shows up as one word [on the ingredients label], but it can be a concoction of hundreds of different ingredients,” Coulter explains. According to research published by the Canadian Cosmetic, Toiletry and Fragrance Association, these anonymous chemical compounds can trigger allergies and asthma, cause hormone disruption, and in many cases, are harmful to fish and other wildlife after they get washed down the drain. Not ready to give up smelling pretty? There are still plenty of green alternatives, says naturopath Jen Newell. “I recommend that people opt for products with essential oils or other natural scents,” Newell says. Parabens Parabens are preservatives that can be found in everything from makeup to moisturisers to fragrances. Problem is, numerous studies have shown that these chemicals – which are easily absorbed through the skin – have the potential to interfere with hormone function and have been linked with breast cancer. How do you rid your beauty routine of this particularly harmful ingredient? Keep an eye out for products that are labelled “paraben-free,” and study the ingredient list carefully, as these pesky preservatives can be listed in different ways, including “methylparaben” or “propylparaben.” Triclosan Triclosan is an antibacterial agent that can be found in antibacterial soaps, body washes, hand sanitisers, toothpaste and mouthwash. The issue with triclosan, Coulter says, is that it kills all bacteria – good and bad. Although this ingredient is not yet regulated in Australia, the Food and Drug Administration in the United States banned its use in September 2016 on the grounds that it could pose health risks, including bacterial resistance and hormonal effects. The good news? It’s easy to steer clear of this harmful ingredient, as triclosan is listed on product labels. For an alternative to triclosan, Coulter suggests alcohol-based sanitisers or old-fashioned castile soap and water. Sodium lauryl sulphate Sodium lauryl sulphate (SLS, sometimes also known as SLES) is a chemical additive that makes super-foamy bubbles and suds. It’s often listed as a main ingredient in soap, shampoo, face wash and dish soaps, says Coulter. The reason that SLS should be avoided is that it can be contaminated with ethylene oxide, which the International Agency for Research on Cancer lists as a known human carcinogen (cancer-causing chemical). Check your soaps for this ingredient before purchasing and don’t fret if the SLS-free product you try doesn’t produce a rich lather like your old shampoo or body wash. A lack of suds doesn’t mean it’s not doing its job, says Coulter; it simply means you’re skipping out on a harmful chemical. Phthalates Phthalates are commonly found in fragrance compounds, says Newell. Research suggests they can disrupt hormones during critical periods of human development (such as a baby’s development in utero) and they’ve also been associated with male infertility. If you’re having trouble identifying which products might contain harmful ingredients such as phthalates, Newell recommends downloading the Think Dirty App to your smartphone. It allows you to scan the bar codes of the products in your daily beauty regimen, and then assesses their degree of safety. Oxybenzone Oxybenzone is the active ingredient in many popular sunscreens, but Newell recommends avoiding it when possible – and for good reason. According to a study published in the International Journal of Andrology, oxybenzone has been linked to skin reactions and it may even disrupt hormones. There have also been studies indicating that when oxybenzone is exposed to sunlight it can form free radicals that cause skin cell damage. This doesn’t mean you should skip sunscreen altogether, of course. It’s easy to avoid this chemical if you stick with mineral-based zinc or titanium oxide sunscreens. Petrolatum Petrolatum or petroleum jelly is often used in moisturisers, lip balms and hair products because it acts as a moisture barrier and creates a sheen. The David Suzuki Foundation lists petrolatum as one of its “Dirty Dozen” harmful ingredients to avoid, as it can be contaminated with polycyclic aromatic hydrocarbons (PAHs), which the European Union lists as a carcinogen. If you want to skip petrolatum just to be on the safe side, try organic coconut oil or shea butter to moisturise your skin. If you’re feeling overwhelmed when it comes to “greening” your beauty routine, begin the transition slowly. “Start with the products you use most often and then eventually replace those items that you only use every once in a while,” recommends Newell. Image credits: Getty Images This article originally appeared on <a rel="noopener" href="https://www.readersdigest.com.au/healthsmart/beauty/7-harmful-beauty-product-ingredients-that-you-should-swap-out" target="_blank">Reader's Digest</a>.

Beauty & Style

Nutrient supplements do no good, may do harm

<div class="copy">The only vitamins that help are the ones you get from food, a new study suggests.</div> <div class="copy"> Researchers at Tufts University in the US find that vitamin and mineral supplements are at best a waste of money, and at worst are correlated with increased mortality rates. </div> <div class="copy"> The study, led by nutrition specialist Fang Fang Zhang and <a href="https://dx.doi.org/10.7326/M18-2478">published</a> in the journal Annals of Internal Medicine, finds that adequate intakes of vitamin K and magnesium are associated with lower all-cause mortality rates, but the findings hold true only for intake from food sources, not from vitamin supplements. On the other hand, excess calcium intake, including from supplements, was linked to a higher rate of cancer mortality. Vitamin D supplement intake for individuals with no vitamin D deficiency was linked to higher all-cause mortality rates. “As potential benefits and harms of supplement use continue to be studied, some studies have found associations between excess nutrient intake and adverse outcomes, including increased risk of certain cancers,” Zhang says. “It is important to understand the role that the nutrient and its source might play in health outcomes, particularly if the effect might not be beneficial.” The study is based on data from 27,725 adults who had answered a range of health and nutrition questions and completed at least one 24-hour food log for the US National Health and Nutrition Examination Survey between 2006 and 2011. More than half of the participants had used at least one dietary supplement within the previous 30 days, with over 38% using a multivitamin or mineral product. Supplement users were more likely than the rest of the population to get nutrients through their food. They were also disproportionately older, wealthier, whiter, more educated, physically active, and female. They were less likely to smoke, drink heavily, or be obese. In other words, they were people with the resources and inclination to take care of their bodies. “Our results support the idea that, while supplement use contributes to an increased level of total nutrient intake, there are beneficial associations with nutrients from foods that aren’t seen with supplements,” said Zhang. “This study also confirms the importance of identifying the nutrient source when evaluating mortality outcomes.” Image credit: Shutterstock This article was originally published on <a rel="noopener" href="https://cosmosmagazine.com/health/nutrient-supplements-do-no-good-may-do-harm/" target="_blank">cosmosmagazine.com</a> and was written by Samantha Page. </div>

Retirement Life

Spanking does more harm than good, study finds

A review of 69 studies from across the world has found physical punishment doesn’t appear to improve a child’s behaviour of social competence in the long run. The review was published in The Lancet, one of the world’s oldest and best-known medical journals. Elizabeth Gershoff, a professor in human development and family science at The University of Texas at Austin and senior author of the review, said physical punishments such as spanking are “harmful to children’s development and well-being”. “Parents hit their children because they think doing so will improve their behaviour,” Professor Gershoff said. “Unfortunately for parents who hit, our research found clear and compelling evidence that physical punishment does not improve children’s behaviour and instead makes it worse.” In their research on the impact of spanking and other physical punishments parents might choose to use to discipline a child, the review excluded verbal and “severe” types of punishment that would be classified as child abuse. Though some studies included in the review found mixed results - where some positive and negative effects were associated with physical punishment - the majority showed a significant negative impact across a child’s life and behaviours. In 13 of 19 independent studies, the most consistent finding was that spanking and other forms of punishment created external problem behaviours over time, Professor Gershoff said, such as “increased aggression, increased antisocial behaviour, and increased disruptive behaviour in school.” The review also found that children who were physically punished acted out no matter their sex, race, or ethnicity. One study included in the review, conducted in Colombia in South America, found that physically-punished young children gained “fewer cognitive skills” than those who were not. Seven of the studies the team reviewed examined the association between a child’s negative behaviour and the frequency of punishment over time, with five finding a “dose-response effect”. “In other words, as physical punishment increased in frequency, so did its likelihood of predicting worse outcomes over time,” Professor Gershoff said. Other studies in the review found that conduct problems and signs of oppositional defiant disorder - characterised by temper tantrums, argumentative and defiant behaviour, spitefulness, and vindictiveness - were increased by physical punishment. In addition to these findings, the review also saw that four of the five studies that considered the influence of parenting styles found that an overall warm and positive parenting style “did not buffer the effect of physical punishment on an increase in behaviour problems.” Alternatives to spanking The American Academy of Pediatrics recommends a variety of alternative methods of discipline, which depend on the child’s age. “During the first year what infants need is love while they discover new abilities such as crying and making messes,” Dr Robert Sege, a professor and medical doctor who specialises in the study of child abuse, said in an earlier interview. “So parents should distract, by giving them other things to do that are less disruptive or picking them up and moving them to a different place. That’s all they can do.” As they become toddlers and continue doing things you don’t want them to, Dr Sege said the best technique is to tap into their need for attention. “Toddlers crave their parent’s attention, so use that to your advantage,” he said. “Pay attention to the things your children do that are wonderful; reward them for those with praise. Then when they do something you don’t like, put them in time-out and take the attention away. Use that. That’s how time-outs work.” As they get older, he suggests letting children learn the natural consequences of their behaviour. “Instead of shielding, help them learn the lesson, as long as they are not in danger,” he said. “Things like, ‘You didn’t put your toys away, so instead of playing, you have to clean them up before we can play.’ It takes parents out of the loop.” Teens also need to learn how to take responsibility for their actions, he said. “And you do that by calling them out on their behaviour and its consequences and then help them figure out how to resolve those consequences. “It’s hard, because it requires, at least at first, a level of mindfulness and thought on what you are doing as a parent,” Dr Sege said. “Parenting isn’t easy. The good thing is that our children excuse us for the mistakes we make.”

Mind

Could taking hydroxychloroquine for coronavirus be more harmful than helpful?

A <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">paper published in The Lancet</a> has cast fresh controversy on the use of the malaria drug hydroxychloroquine as a potential treatment for COVID-19. The study’s authors reported they were “unable to confirm a benefit” of using the drug, while also finding COVID-19 patients in hospital treated with hydroxychloroquine were more likely to die or suffer life-threatening heart rhythm complications. The publication prompted the World Health Organisation to <a href="https://www.abc.net.au/news/2020-05-26/who-pauses-trial-of-hydroxychloroquine-for-coronavirus-patients/12285652">suspend its testing of hydroxychloroquine to treat COVID-19</a>, while a <a href="https://www.ascot-trial.edu.au/blogs/news/statement-on-the-status-of-australasian-covid-19-trial-ascot">similar Australian trial</a> has paused recruitment. A bit of background Hydroxychloroquine has been used since the 1940s to treat malaria, but has been making headlines as a <a href="https://www.nps.org.au/media/hydroxychloroquine-and-covid-19">potential treatment for COVID-19</a>. US President Donald Trump recently declared <a href="https://theconversation.com/donald-trump-is-taking-hydroxychloroquine-to-ward-off-covid-19-is-that-wise-139031">he was taking it daily</a>, while Australian businessman and politician Clive Palmer <a href="https://www.sbs.com.au/news/the-feed/clive-palmer-has-bought-30-million-doses-of-an-anti-malaria-drug-to-fight-covid-19-but-experts-warn-this-may-not-be-the-cure-all">pledged to create a national stockpile</a> of the drug. The drug alters the human immune system (it’s an <a href="https://www.nps.org.au/hcq-and-covid-19">immunomodulator, not an immunosuppressant</a>) and has an important role in helping people with rheumatoid arthritis and lupus. It does have a range of serious <a href="https://www.tga.gov.au/alert/new-restrictions-prescribing-hydroxychloroquine-covid-19">possible side-effects</a>, including eye damage and altered heart rhythm, which require monitoring. <a href="https://www.nature.com/articles/s41421-020-0156-0">Laboratory studies</a> suggest hydroxychloroquine may disrupt replication of the SARS-CoV-2 virus that causes COVID-19. It’s also possible hydroxychloroquine could reduce “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161506/">cytokine storm</a>” – the catastrophic immune system overreaction that happens in some people with severe COVID-19. A huge global effort is underway to investigate whether hydroxychloroquine is safe and effective for preventing or treating COVID-19, especially to improve recovery and reduce the risk of death. Previous studies have been inconclusive as they were anecdotal, observational or small randomised trials. Doubts about hydroxychloroquine’s effectiveness have been increasing, with a large observational study from New York <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2012410">showing it had no benefit</a> in treating people with COVID-19. The new <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">Lancet study</a>, published last week, has found it could increase the risk of death among COVID-19 patients in hospital. But there’s more to the story. What did the new study do? The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">Lancet study</a> collected real-world data on more than 96,000 hospitalised patients with COVID-19 from more than 600 hospitals across six continents. About 15,000 patients were treated with hydroxychloroquine (or a closely related drug, chloroquine) alone or in combination with an antibiotic. Using a global registry the researchers investigated the safety of these treatments. They looked at whether people died in hospital, as well as the risk of developing life-threatening heart rhythm problems (called ventricular arrhythmias). What did the study find? Treatment with hydroxychloroquine was associated with increased rates of death in people with COVID-19, even after the researchers adjusted for other factors (age, other health conditions, suppressed immune system, smoking, and severity of the COVID-19 infection) that might increase the risk of death. About 18% of people who received hydroxychloroquine died in hospital, compared with 9% of people with COVID-19 who did not receive these treatments. The risk of death was even higher (24%) in people receiving hydroxychloroquine in combination with either of the antibiotics azithromycin or clarithromycin. Hydroxychloroquine (6%) and chloroquine (4%) treatment was also associated with more cases of dangerous heart rhythm problems when compared with untreated people with COVID-19 (0.3%). Any evidence of benefit, while not the focus of this study, was unclear. How can we interpret the results? This was an observational study, so it can only explore the association between treatments and death – rather than telling us hydroxychloroquine caused these patients to die. It is <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31174-0/fulltext">unclear</a> why the death rate for patients treated with hydroxychloroquine and chloroquine was double that of those who weren’t, as the cause of death was not reported in this study. Importantly, the study cannot account for all the factors that might contribute to death in these hospitalised patients and how these factors interact with each other. However, the researchers did a good job of “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144483/">matching</a>” the characteristics of people who were receiving hydroxychloroquine with those who were not receiving the drug, which makes the results more reliable. But there may still be other factors, or medicines, that contributed to these findings. So there remains uncertainly about whether hydroxychloroquine causes, or even contributes to, the death of people with COVID-19. Further, it was not possible to have careful control over the hydroxychloroquine dose people received – or other medicines people might be taking such as antivirals or other medicines for heart conditions (which potentially interact in sick hospitalised patients). The average dose of hydroxychloroquine in this study was at the upper end of the regular recommended dose range for rheumatoid arthritis and lupus. But the wide range of hydroxychloroquine (and chloroquine) doses in this study makes interpretation of the findings difficult, especially when we know <a href="https://www1.racgp.org.au/ajgp/coronavirus/hydroxychloroquine-use-during-the-covid-19-pandemi">harmful effects</a> are associated with larger doses. Broader implications This study provides important information about the safety of hydroxychloroquine in treating vulnerable people with COVID-19 receiving hospital care. While the implications for using hydroxychloroquine to treat COVID-19 in the community or for prevention of COVID-19 remain unclear, if nothing else this study highlights the need to carefully monitor people receiving the drug. Some hydroxychloroquine trials are continuing, such as the very large <a href="https://www.recoverytrial.net/for-site-staff/site-staff/#alert">RECOVERY trial</a> in the UK. This new information must be considered when balancing harm and potential benefit of these trials and will likely result in renewed safety monitoring. We’ll need to see results from <a href="https://www.mja.com.au/journal/2020/clinical-trials-prevention-and-treatment-coronavirus-disease-2019-covid-19-current">ongoing</a> high-quality randomised controlled trials to truly know if hydroxychloroquine is effective and safe in treating or preventing COVID-19. Further questions about what dose should be used, and which patients will benefit most, are topics under active investigation. You <a href="https://www.tga.gov.au/alert/new-restrictions-prescribing-hydroxychloroquine-covid-19">should not take hydroxychloroquine</a> for COVID-19 unless you’re part of a clinical trial. – Andrew McLachlan and Ric Day Blind peer review This is a fair and reasonable review of the Lancet paper, its relationship to previous studies, and its impact on ongoing clinical trials. As stated in the review the Lancet article adds to the body of knowledge, including recent substantial studies in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2012410">New England Journal of Medicine</a> and the <a href="https://www.bmj.com/content/369/bmj.m1849">British Medical Journal</a>, that hydroxychloroquine is without significant effect in treatment trials. The high death rate is concerning but not unprecedented, given that a clinical trial in Brazil was <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765499">halted</a> because of adverse effects on the heart. However, recent <a href="https://www.theguardian.com/science/2020/may/28/questions-raised-over-hydroxychloroquine-study-which-caused-who-to-halt-trials-for-covid-19?CMP=share_btn_tw">media reports</a> suggest the data may have to be revised due to <a href="https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-update/">misclassification</a> of the participating hospitals. – Ian Musgrave <hr /> Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.<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; text-shadow: none !important;" src="https://counter.theconversation.com/content/139309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/ric-day-14406">Ric Day</a>, Professor of Clinical Pharmacology, <a href="https://theconversation.com/institutions/unsw-1414">UNSW</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/could-taking-hydroxychloroquine-for-coronavirus-be-more-harmful-than-helpful-139309">original article</a>.

Body

Turn off the porch light: 6 easy ways to stop light pollution from harming our wildlife

As winter approaches, marine turtle nesting in the far north of Australia <a href="https://www.environment.gov.au/system/files/resources/2eb379de-931b-4547-8bcc-f96c73065f54/files/national-light-pollution-guidelines-wildlife.pdf">will peak</a>. When these baby turtles hatch at night, they crawl from the sand to the sea, using the relative brightness of the horizon and the natural slope of the beach as their guide. But when artificial lights outshine the moon and the sea, these hatchlings become disorientated. This leaves them vulnerable to predators, exhaustion and even traffic if they head in the wrong direction. Baby turtles are one small part of the larger, often overlooked, story of how light pollution harms wildlife across the <a href="https://theconversation.com/getting-smarter-about-city-lights-is-good-for-us-and-nature-too-69556">land</a> and <a href="https://theconversation.com/bright-city-lights-are-keeping-ocean-predators-awake-and-hungry-68965">underwater</a>. Green Turtle’s Battle For Survival | Planet Earth | BBC Earth. Today, more than 80% of people – and 99% of North American and European human populations – <a href="https://advances.sciencemag.org/content/2/6/e1600377">live under light-polluted skies</a>. We have transformed the night-time environment over substantial portions of the Earth’s surface in a very short time, relative to evolutionary timescales. Most wildlife hasn’t had time to adjust. In January, Australia released the <a href="https://www.environment.gov.au/biodiversity/publications/national-light-pollution-guidelines-wildlife">National Light Pollution Guidelines for Wildlife</a>. These guidelines provide a framework for assessing and managing the impacts of artificial light. The guidelines also identify practical solutions that can be used globally to manage light pollution, both by managers and practitioners, and by anyone in control of a light switch. The guidelines outline six easy steps anyone can follow to minimise light pollution without compromising our own safety. Although light pollution is a global problem and true darkness is hard to come by, we can all do our part to reduce its impacts on wildlife by changing how we use and think about light at night. 1. Start with natural darkness. Only add light for a specific purpose Natural darkness should be the default at night. Artificial light should only be used if it’s needed for a specific purpose, and it should only be turned on for the necessary period of time. This means it’s okay to have your veranda light on to help you find your keys, but the light doesn’t need to stay on all night. Similarly, indoor lighting can also contribute to light pollution, so turning lights off in empty office buildings at night, or in your home before you go to sleep, is also important. 2. Use smart lighting controls Advances in smart control technology make it easy to manage how much light you use, and adaptive controls make meeting the goals of Step 1 more feasible. Investing in smart controls and LED technology means you can remotely manage your lights, set timers or dimmers, activate motion sensor lighting, and even control the colour of the light emitted. These smart controls should be used to activate artificial light at night only when needed, and to minimise light when not needed. 3. Keep lights close to the ground, directed and shielded Any light that spills outside the specific area intended to be lit is unnecessary light. Light spilling upward contributes directly to artificial sky glow – the glow you see over urban areas from cumulative sources of light. Both sky glow and light spilling into adjacent areas on the ground can disrupt wildlife. Installing <a href="https://www.ledlightexpert.com/Light-Shields-Explained--Outdoor-Parking-Lot-Light-Shielding_b_42.html">light shields</a> allow you to direct the light downward, which significantly reduces sky glow, and to direct the light towards the specific target area. Light shields are recommended for any outdoor lighting installations. 4. Use the lowest intensity lighting When deciding how much light you need, consider the intensity of the light produced (lumens), rather than the energy required to make it (watts). LEDs, for example, are often considered an “environmentally friendly” option because they’re relatively energy efficient. But because of their energy efficiency, LEDs produce between two and five times as much light as incandescent bulbs for the same amount of energy consumption. So, while LED lights save energy, the increased intensity of the light can lead to greater impacts on wildlife, if not managed properly. 5. Use non-reflective, dark-coloured surfaces. Sky glow has been shown to <a href="https://www.nature.com/articles/srep01722">mask lunar light rhythms</a> of wildlife, interfering with the celestial navigation and migration of <a href="https://science.sciencemag.org/content/313/5788/837">birds</a> and <a href="https://www.nature.com/articles/424033a">insects</a>. Highly polished, shiny, or light-coloured surfaces – such as structures painted white, or polished marble – are good at reflecting light and so contribute more to sky glow than darker, non-reflective surfaces. Choosing darker coloured paint or materials for outdoor features will help reduce your contribution to light pollution. 6. Use lights with reduced or filtered blue, violet and ultra-violet wavelengths Most animals are sensitive to short-wavelength light, which creates blue and violet colours. These short wavelengths are known to suppress melatonin production, which is known to disrupt sleep and interfere with circadian rhythms of many animals, <a href="https://www.mdpi.com/2071-1050/11/22/6400/htm">including humans</a>. Choosing lighting options with little or no short wavelength (400-500 nanometres) violet or blue light will help to avoid unintended harmful effects on wildlife. For example, compact fluorescent and LED lights have a high amount of short wavelength light, compared low or high-pressure sodium, metal halide, and halogen light sources. Written by Emily fobert, Katherine Dafforn and Mariana Mayer-Pinto. Republished with permission of <a href="https://theconversation.com/turn-off-the-porch-light-6-easy-ways-to-stop-light-pollution-from-harming-our-wildlife-132595">The Conversation.</a>

Cruising

DIY coronavirus masks: Are they doing more harm than good?

The coronavirus pandemic has changed the way civilians protect themselves and over the course of a month we have seen a rise in DIY face masks. However there is concern surrounding whether it is necessary for healthy people to wear face masks despite advice via the United States government telling it’s citizens not to bother if they are healthy. With the thousands of videos popping up online teaching people how to make nonmedical face masks with paper towels, men’s underwear and even bras. But which one is best for you, and should you even be wearing a DIY mask? Medical experts and health professions across the globe say a homemade face mask or even a bandana may just prove to be helpful in protecting people from transmitting and getting the virus. Among the supports includes <a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/24229526" target="_blank">a 2013 study</a> published in the journal Disaster Medicine and Public Health Preparedness which found well-fitting homemade face masks made from cotton T-shirts will provide protection from droplet transmission. Epidemiologist and doctor at the University of New South Wales, Raina MacIntyre told <a rel="noopener noreferrer" href="https://www.washingtonpost.com/lifestyle/wellness/masks-diy-coronavirus/2020/04/01/20830f5e-7420-11ea-85cb-8670579b863d_story.html" target="_blank">The Washington Post</a> there is “no evidence” pointing towards one type.” The health professions has completed research on the effectiveness of face masks. “These are all just common-sense approaches people are trying.” Here are the basic tips people should follow when deciding what face mask they should wear: <ul> <li>A mask should provide good coverage for your face – reaching above the bridge of the nose and below the chin.</li> <li>A mask should be snug, not spacious, and it is noted fabric ties could work better than an elastic band.</li> <li>Rewash face masks after every use</li> <li>Layering a face mask at least three times is recommended to make an effective mask and it is helpful to include a small pocket or pouch so a filter may be inserted.</li> <li>Sunlight is “germicidal” MacIntyre noted, so hang the mask outside if possible.</li> <li>Cotton and cotton blends are highly recommended over cloth materials as cloth retains moisture and therefore can be harmful.</li> <li>Non-woven fabrics is also a recommended material to make a face mask, Peter Tsai, the creator of the highest quality of masks recommends.</li> <li>Non-woven fabrics are made of individual fibres that are bound together mechanically, thermally or chemically.</li> <li>Car shop towels are recommended as they filter droplets better than cloths.</li> </ul>

Home & Garden

Why cashless welfare cards do more harm than good

The Australian government touts compulsory income management as a way to stop welfare payments being spent on alcohol, drugs or gambling. The Howard government introduced the <a href="https://www.servicesaustralia.gov.au/individuals/services/centrelink/basicscard">BasicsCard</a> more than a decade ago. About 22,500 welfare recipients now use it, mostly in the Northern Territory. Now the Coalition government has big plans for a more versatile <a href="https://www.dss.gov.au/families-and-children/programmes-services/welfare-conditionality/cashless-debit-card-overview">Cashless Debit Card</a>, trialled on about 12,700 people in four regional communities in Western Australia, South Australia and Queensland. These trials aren’t complete, nor the findings compiled, but a string of senior ministers, including <a href="https://www.smh.com.au/politics/federal/scott-morrison-eyes-long-term-cashless-debit-card-roll-out-20190907-p52oxb.html">Prime Minister Scott Morrison</a>, have indicated they are already sold on expanding the program. <a href="https://www.incomemanagementstudy.com/blog/hiddencosts">Our research</a>, however, <a href="https://theconversation.com/theres-mounting-evidence-against-cashless-debit-cards-but-the-government-is-ploughing-on-regardless-123763">adds to the evidence</a> that compulsory income-management policies do as much harm as good. Financial (in)stability Over the past year we have conducted the first <a href="https://www.incomemanagementstudy.com/">independent, multisite study</a> of compulsory income management in Australia. It has involved 114 in-depth interviews at four sites: Playford (BasicsCard) and Ceduna (Cashless Debit Card) in South Australia; Shepparton (BasicsCard) in Victoria; and the Bundaberg and Hervey Bay region (Cashless Debit Card) in Queensland. We also collected 199 survey responses from around Australia. Proponents of compulsory income management champion its potential to “provide a stabilising factor in the lives of families with regard to financial management and to encourage safe and healthy expenditure of welfare dollars”, as the then social services minister, Paul Fletcher, <a href="https://www.paulfletcher.com.au/portfolio-speeches/speech-to-sydney-institute-welfare-personal-responsibility-and-the-cashless">said in March</a> last year. Our study found some individuals experience these benefits. But most face extra financial challenges. These include not having enough cash for essential items, being unable to shop at preferred outlets, being unable to buy second-hand goods, and cards being declined even when they are supposed to work. <hr /> <a href="https://images.theconversation.com/files/316964/original/file-20200224-24690-153xr6u.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/316964/original/file-20200224-24690-153xr6u.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /></a> Survey respondents reported a range of challenges related to compulsory income management. Hidden Costs: An Independent Study into Income Management in Australia <hr /> In Playford, Jacob* told us about being on the BasicsCard, which can only be used with merchants that have agreed to not allow cardholders to buy excluded goods. The limits on where he could shop made it harder for him to manage his finances. “I couldn’t make decisions about saving money,” he told us. He and his wife used to catch the train to shop at the Adelaide markets, for example, but vendors there couldn’t take the BasicsCard. The Cashless Debit Card is intended to overcome the limitations of the BasicsCard. It’s like a debit card except it can’t be used to withdraw cash or at businesses that sell prohibited items. But Emma*, a single mother in the Bundaberg and Hervey Bay area, told of her struggles to make basic purchases using the card. It often failed – even at businesses that purportedly accepted it – and her family went without. She also felt excluded from the markets and second-hand retailers where she used to shop. Her greatest stress, however, was rent. Emma* said she had always been on time with rental payments until the Cashless Debit Card. She described one occasion when, two days after paying the rent, the money “bounced back” into her account. When she rang the card’s administrator (card payment company <a href="https://www2.indue.com.au/">Indue</a>), she was told: “It’s just a minor teething issue, just keep trying.” The extra stress from “worrying about which payments were going to get paid” was considerable. Others shared similar experiences. Social (dis)integration Supporters of compulsory income management claim it brings people back into the community by combating addiction and encouraging pro-social behaviour and economic contribution. As federal Attorney-General <a href="https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;db=CHAMBER;id=chamber%2Fhansardr%2F5d1aabc6-2984-42d1-bf5e-3f493db56d60%2F0048;orderBy=customrank;page=0;query=Cashless%20debit%20card%20SearchCategory_Phrase%3A%22house%20of%20representatives%22%20Dataset_Phrase%3A%22hansardr%22%20Speaker_Phrase%3A%22pitt,%20keith,%20mp%22;rec=1;resCount=Default">Christian Porter said in 2018</a>: “The cashless debit card can help to stabilise the lives of young people in the new trial locations by limiting spending on alcohol, drugs and gambling and thus improving the chances of young Australians finding employment or successfully completing education or training.” However, our study found the card can also stigmatise and infantilise users – pushing people without these problems further to the margins. One of the problems is that compulsory income management is routinely applied based on where a person lives and their payment type, and not on any history of problem behaviour. The large majority of our respondents indicated they did not have alcohol, drug or gambling issues. <hr /> <a href="https://images.theconversation.com/files/316963/original/file-20200224-24676-1jamv1d.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/316963/original/file-20200224-24676-1jamv1d.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /></a> The majority of survey respondents had been managing finances well before compulsory income management. Hidden Costs: An Independent Study into Income Management in Australia <hr /> But as Ray* in Ceduna explained, having the card meant others viewed him as a problem citizen. <blockquote> I’m embarrassed every time I have to use it at the supermarket, which is about the only place I do use it. I sort of look around and see who’s behind me in the queue. I don’t want anybody to see me using it. </blockquote> This was a common experience across the interview sites. Maryanne* in Shepparton told about being judged for shopping for groceries with her BasicsCard. <blockquote> I got called a junkie and I said: ‘I’m not a junkie, do you see any marks or anything?’ They were like: ‘No, but you have a BasicsCard.’ I said: ‘What’s that got to do with it? Centrelink gave it to me. I can’t do nothing.’ </blockquote> <hr /> <img src="https://images.theconversation.com/files/316965/original/file-20200224-24664-asok53.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /> Stigma was a common concern among survey participants. Hidden Costs: An Independent Study into Income Management in Australia <hr /> A path forward The overwhelming finding from our study is that compulsory income management is having a disabling, not an enabling, impact on many users’ lives. As the policy has been extended, more and more Australians <a href="https://www.vinnies.org.au/page/Publications/National/Factsheets_and_policy_briefings/The_Cashless_Debit_Card/">with no pre-existing problems</a> have been caught up in its path. This does not mean a genuine voluntary scheme could not be maintained, but it would need to sit alongside evidence-based measures to tackle poverty. Addressing the <a href="https://raisetherate.org.au/">inadequacy of income support payments</a>, ensuring <a href="https://theconversation.com/these-job-snob-claims-dont-match-the-evidence-121429">decent employment and training opportunities</a>, and providing accessible social services and secure and affordable <a href="https://theconversation.com/supportive-housing-is-cheaper-than-chronic-homelessness-67539">housing</a> would be a better starting point for creating healthy lives and flourishing communities. <hr /> Names have been changed to protect individuals’ privacy.<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; text-shadow: none !important;" src="https://counter.theconversation.com/content/132341/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/greg-marston-737150">Greg Marston</a>, Head of School, School of Social Science, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/phillip-mendes-101820">Phillip Mendes</a>, Associate Professor, Director Social Inclusion and Social Policy Research Unit, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/zoe-staines-426110">Zoe Staines</a>, Research fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-dont-want-anybody-to-see-me-using-it-cashless-welfare-cards-do-more-harm-than-good-132341">original article</a>.

Retirement Income

Why celebrity concern about bushfires could do more harm than good

From Australian superstars such as Cate Blanchett, Russell Crowe, Chris Hemsworth and Nicole Kidman to Hollywood heavyweights including Ellen DeGeneres and Bette Midler, a lengthening list of celebrities are helping to shine a spotlight on Australia’s bushfires. Some have donated <a href="https://www.businessinsider.com.au/aussie-celebrities-and-sports-stars-are-pledging-big-donations-to-bushfire-relief-efforts-2020-1">large sums of money </a>and used social media to publicise their donations, encouraging fans to follow suit. Some have used their profile and platforms such as the Golden Globes awards to draw attention to the fires. Others are donating items for auction or appearing in charity events. For attracting attention and money to a cause, celebrity-driven attention is hard to beat. But there’s also a downside. If that interest is superficial and fleeting, it may actually hinder recovery efforts in disaster-ravaged regions. Our research into <a href="https://espace.library.uq.edu.au/view/UQ:263209">disaster recovery efforts for Victoria’s Gippsland region</a> after the deadly “Black Saturday” fires in 2009 suggests celebrities’ best contribution needs to be in the weeks and months to come – and requires them putting “boots on the ground”. Negative implications Studies confirm the influence of messages from celebrities, be it <a href="https://espace.library.uq.edu.au/view/UQ:227015">brand choice</a>, <a href="https://www.researchgate.net/publication/235261651_If_Kate_voted_Conservative_would_you_The_role_of_celebrity_endorsements_in_political_party_advertising">political opinion</a> or <a href="https://news.rutgers.edu/news-release/celebrity-endorsements-lead-increases-charitable-donations-public/20130926#.Xh5oEFczaUk">charitable giving</a>. It’s great that celebrities want to use their influence for good causes. Not all celebrity advocacy, though, should be applauded uncritically. One study has suggested it is <a href="https://journals.sagepub.com/doi/pdf/10.1177/1367877914528532">less effective than sometimes supposed</a> for development causes, and can simplify a complex issue to a single outcome – usually giving money. This fails to address how people can make an ongoing difference in other ways. In terms of natural disasters, a very practical way to help communities recover is the resumption of tourism. Perceptions play a big part in this, and celebrities can play a big part in <a href="https://www.tandfonline.com/doi/pdf/10.1300/J073v02n02_12">forming images</a>. It’s why they have long featured in tourism campaigns, from Paul Hogan in the 1980s to Kylie Minogue and others in the humorously idealised imagery presented by Tourism Australia to Britons a few weeks ago. <div class="embed-responsive embed-responsive-16by9"><iframe class="embed-responsive-item" src="https://www.youtube.com/embed/QMAq8F8N2Fg"></iframe></div> Now these images are being replaced by the message globally that Australia is “<a href="https://www.nbcnews.com/science/environment/australia-fire-literally-so-are-its-climate-politics-n1104351">on fire, literally</a>”, and that much of the country is an “<a href="https://www.greenqueen.com.hk/australia-is-literally-on-fire-because-of-climate-change-so-why-wont-more-governments-act/">apocalyptic nightmare</a>”. Tourism effects Even if celebrities have the best of intentions, their emotional appeals and shared of images of red skies and smoke-filled cities along with heartbreaking images of devastation and loss can contribute to fans cancelling holidays plans, even while they’re donating to bushfire appeals. <a href="https://www.sbs.com.au/news/tourism-industry-suffers-as-bushfire-images-scare-off-international-travellers">There are already reports</a>, for example, of tourists aborting plans for visits months away. The <a href="https://qualitytourismaustralia.com/">Australian Tourism Industry Council</a> says cancelled bookings in towns unaffected by the bushfires <a href="https://www.smh.com.au/politics/federal/tourism-industry-takes-1b-hit-as-australians-cancel-their-holidays-20200115-p53rr1.html">are up to 60%</a>. The <a href="https://www.atec.net.au/">Australian Tourism Export Council</a> estimates the loss of international bookings will cost the nation <a href="https://www.afr.com/companies/tourism/tourism-loses-4-5b-to-bushfires-as-overseas-visitors-cancel-20200116-p53s0s">at least A$4.5 billion</a> in 2020, hurting regional areas the most. It doesn’t help when <a href="https://www.abc.net.au/news/2020-01-08/misleading-fire-maps-go-viral-during-australian-bushfire-crisis/11850948">misleading information</a> is spread, as the American singer Rihanna inadvertently did when she <a href="https://www.abc.net.au/news/2020-01-08/misleading-fire-maps-go-viral-during-australian-bushfire-crisis/11850948">shared an image on Twitter</a> that exaggerated the size of the bushfires. This image suggested huge swathes of Australia were no-go zones. Ellen Degeneres did something similar in telling her audience “<a href="https://www.youtube.com/watch?v=gSWveTGTMBA">nearly a third of their habitat has been destroyed</a>”. This was an exaggerated misstatement of Australia’s environment minister saying <a href="https://www.abc.net.au/radio/programs/am/govt-is-working-to-address-threats-to-native-species:-ley/11828480">a third of koala habitat in New South Wales</a> had been destroyed. <a href="https://www.sciencedirect.com/science/article/pii/S1447677016300626">Our research confirms</a> the further someone is from a destination in crisis, the more likely they are to be confused about the location and think a greater area is affected. Fires in the Blue Mountains area of New South Wales, for example, were called “the "Sydney fires” elsewhere in Australia. Overseas they were referred to as the “Australian bushfires”, confusing domestic and international tourists. Where celebrities can really help So while celebrities might have the very best of motivations, their contribution in generating donations in the short term might be offset by the longer-term effect of amplifying the misconception that Australia is not safe for tourists. This is demonstrated by past experience. After Victoria’s 2009 Black Saturday fires, the Gippsland region experienced a major tourism downturn, despite just 5% of the region being directly affected. But celebrites can also use their mass-pull to aid tourism recovery. <a href="https://www.tandfonline.com/doi/abs/10.1080/10548408.2012.638565">Our research</a> suggests their star power is unmatched as a means to encourage tourists back to regions recovering from disaster. In the case of Gippsland, <a href="https://www.tandfonline.com/doi/full/10.1080/10548408.2012.638565">we surveyed 691 people</a> with nine different advertising messages. Themes included solidarity, community readiness and even short-term discounts. We found celebrity endorsement made the greatest impression, with test subjects indicating it made them more likely to visit the region. In the months after the Black Saturday bushfires, former Miss Universe Jennifer Hawkins and legendary cricketer Shane Warne <a href="https://thenewdaily.com.au/news/national/2019/02/07/black-saturday-media-moments/">visited affected towns</a>. These highly publicised events sent the message these towns were ready to welcome visitors again. So celebrities can definitely help in the coming weeks and months. They can share positive stories about local communities’ resilience, and maybe even visit. This is likely to do more for recovery efforts in the long term than helping to spruik for donations.<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; text-shadow: none !important;" src="https://counter.theconversation.com/content/129627/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gabrielle-walters-159430">Gabrielle Walters</a>, Associate Professor, School of Business, <a href="http://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/judith-mair-11132">Judith Mair</a>, Associate Professor, <a href="http://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/monica-chien-933029">Monica Chien</a>, Senior lecturer, <a href="http://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/celebrity-concern-about-bushfires-could-do-more-harm-than-good-to-help-they-need-to-put-boots-on-the-ground-129627">original article</a>.

Travel Trouble

Before you hit ‘share’ on that cute animal photo – consider the harm it can cause

Limbani the chimpanzee has about 650,000 Instagram followers. In recent months the account has featured viral photos and videos of the captive young ape playing the guitar, bouncing on a trampoline and wearing a giant banana costume. Fans are also offered real-life encounters with the chimp at a Miami facility, paying US$700 for a ten-minute session. Experts, including renowned primatologist <a href="https://news.janegoodall.org/2019/04/25/inappropriate-videos-on-social-media-are-hurting-chimpanzees/">Dr Jane Goodall</a>, have raised <a href="http://primatesanctuaries.org/wp-content/uploads/2018/07/Limbani-Chimp-Video-Letter-1.pdf">concerns about Limbani’s care</a>. They question why he is not in the company of other chimpanzees, and say his exposure to humans could cause stress and other health issues. So before you click on or share wildlife content online, it’s worth considering how you might affect a species’ welfare and conservation in the wild. Smiling chimps are actually stressed <a href="https://www.tandfonline.com/doi/abs/10.1080/08927936.2018.1406197">Chimpanzees</a> are frequently depicted in greeting cards, advertisements, film, television and internet images. They are often clothed, in human-like poses and settings. These performing animals <a href="https://www.janegoodall.org.au/great-apes/#eluid6c5879d2">are usually taken from their mothers</a> as infants, physically disciplined in training, and can spend their retirement in poorly regulated roadside attractions or breeding facilities. For example the chimpanzee, who appeared with Leonardo DiCaprio in The Wolf of Wall Street <a href="https://www.thesun.co.uk/news/4451790/chance-the-chimp-who-starred-in-wolf-of-wall-street-with-leonardo-dicaprio-tethered-in-a-roadside-zoo-and-yanked-round-by-the-neck/">has reportedly</a> since been kept in a roadside zoo, dragged around by the neck and forced to perform circus tricks. Primates are complex social animals, and the trauma they suffer when forced to perform is often clear. <a href="https://www.taylorfrancis.com/books/9781351243131/chapters/10.4324/9781351243131-12">Research has shown</a> the “cheeky chimp grins” we associate with happiness are actually a sign of fear or submission. But it’s not just primates who are suffering. Earlier this year US banking giant JPMorgan Chase s<a href="https://www.mediapost.com/publications/article/338072/jpmorgan-chase-pulls-elephant-ads.html">uspended an advertising campaign</a> featuring captive elephants. The move followed an outcry from conservationists, <a href="https://www.thedrum.com/news/2019/07/12/jp-morgan-axes-campaign-filmed-with-captive-elephants">who explained</a> that elephants are often trained “using harsh and cruel methods” to perform unnatural behaviours and interact directly with people. Endangered in the wild Images of wildlife in human-like poses and environments can also skew public perception about their status in the wild. For example, the International Union for Conservation of Nature <a href="https://www.iucnredlist.org/species/15933/129038584">classifies chimpazees as endangered</a>. In the last century their numbers have decreased from some <a href="https://www.worldchimpanzeeday.org/">1-2 million to as few as 350,000.</a> However research has shown that the prevalence of chimpanzees in media and entertainment can lull viewers into believing wild populations are thriving. This undermines both the need and urgency for in-situ conservation. A 2008 article published in <a href="https://science.sciencemag.org/content/319/5869/1487">Science</a> reported on the findings of two surveys where participants were asked to identify which of three great apes were endangered. In the first, 66% of respondents thought chimpanzees were endangered (compared with 95% for gorillas, and 91% for orangutans). In the second, 72% believed chimpanzees to be endangered (compared with 94% for gorillas and 92% for orangutans). Participants in both studies said the prevalence of chimpanzees in television, advertisements and movies meant they must not be in jeopardy in the wild. A PETA video objecting to a chimp appearing in the film Wolf of Wall Street. Suitability as pets Images of animals in close proximity with humans also affects their perceived desirability as exotic pets. Such images include <a href="https://d31j74p4lpxrfp.cloudfront.net/sites/default/files/ca_-_en_files/amazon_selfies_report_-_canada.pdf">“wildlife selfies”</a> shared on social media by tourists, pet collectors and celebrities. The demand for exotic pets drives the illicit trade in live animals. In Japan, unprecedented demand for otters as pets <a href="https://www.otterspecialistgroup.org/osg-newsite/wp-content/uploads/2018/10/otter-alert-vfinal-web-100-1.pdf">is likely fuelled by an increase</a> in the visibility of pet otters in social and mass media. The pet trade has been identified as <a href="https://d2ouvy59p0dg6k.cloudfront.net/downloads/otter_report_060618_1.pdf">a pressing threat to the survival of otters</a>. Social media provides an easy way for traffickers and buyers to connect. Over six weeks in 2017 in France, Germany, Russia and the UK, the <a href="https://d1jyxxz9imt9yb.cloudfront.net/resource/223/attachment/regular/disrupt-wildlife-cybercrime.pdf">International Fund for Animal Welfare</a> identified more than 11,000 protected wildlife specimens for sale via more than 5,000 advertisements and posts. They included live otters, tortoises, parrots, owls, primates and big cats. <a href="https://www.cnbc.com/2018/04/10/facebook-puts-ads-on-pages-illegally-selling-animal-parts.html">Facebook is also allegedly</a> profiting from advertisements on pages illicitly selling parts and derivatives of threatened animals, including elephant ivory, rhino horn and tiger teeth. Slow progress Social media giants have gone some way to recognising the harmful impact of their wildlife content. Facebook and Instagram are partners of the <a href="https://www.endwildlifetraffickingonline.org/">Coalition to End Wildlife Trafficking Online</a> which aims to reduce wildlife trafficking online by 80% by 2020. Both platforms also banned the sale of animals in 2017 – however it is not well policed, and the advertisements persist. In 2017, Instagram <a href="https://www.nationalgeographic.com/news/2017/12/wildlife-watch-instagram-selfie-tourism-animal-welfare-crime/">encouraged users</a> not to harm plants or animals in pursuit of a selfie, and consider the potential animal abuse behind photo opportunities with exotic animals. But there are <a href="https://news.mongabay.com/2019/10/holding-social-media-companies-accountable-for-facilitating-illegal-wildlife-trade-commentary/">persistent claims</a> these measures aren’t proactive or effective enough. There is cause for cautious optimism. Researchers and social media platforms are collaborating to develop <a href="https://theconversation.com/how-machine-learning-can-help-fight-illegal-wildlife-trade-on-social-media-115021">artificial intelligence to help in wildlife trafficking investigations</a> and <a href="https://www.bbc.com/news/science-environment-46945302">facial recognition</a> technology is being used to track individual animals. Social media users are also key in promoting respect and safety for wildlife. To find out more, you can access resources on <a href="https://www.forbes.com/sites/michaelshiels/2016/09/07/deadly-virtual-postcards-lead-poachers-to-rare-endangered-trophy-animals/#592c765e23ad">“responsible tagging”</a>, <a href="https://www.worldanimalprotection.us/wildlife-selfie-code">“wildlife selfie codes”</a>, <a href="https://www.nationalgeographic.com/animals/2019/07/ethical-wildlife-photography/">ethically sourcing footage</a>, and <a href="https://www.wildcru.org/research/wildlife-tourism/">how to research wildlife attractions</a>. Written by Zara Bending. Republished with permission of <a href="/Limbani%20the%20chimpanzee%20has%20about%20650,000%20Instagram%20followers.%20In%20recent%20months%20the%20account%20has%20featured%20viral%20photos%20and%20videos%20of%20the%20captive%20young%20ape%20playing%20the%20guitar,%20bouncing%20on%20a%20trampoline%20and%20wearing%20a%20giant%20banana%20costume.">The Conversation.</a>

Retirement Life

Are you a frequent flyer? Solar storm radiation can be harmful

Space weather <a href="https://theconversation.com/solar-eruption-could-help-earth-prepare-for-technology-melt-down-18747">impacts</a> many modern-day technologies. But one of the most concerning – and least reported – space weather effects is the increased radiation exposure to passengers on commercial long-distance flights during so-called “<a href="http://www.spaceweather.com/glossary/srs.html">solar radiation storms</a>”. The NASA-funded Nowcast of Atmospheric Ionizing Radiation System (<a href="http://sol.spacenvironment.net/~nairas/">NAIRAS</a>) is the computer system tasked with providing a real-time data-driven climatology of the aviation radiation environment. Recently, a series of papers published in the journal [Space Weather] estimate that when NAIRAS was turned off during the US government shutdown last year – which went into effect just as a solar radiation storm began – <a href="http://onlinelibrary.wiley.com/doi/10.1002/2013SW001015/abstract">500,000 people</a> received increased radiation doses. It has also been estimated that this event is likely to eventually result in four cancer-related deaths. What is a solar radiation storm? Disturbances on the surface of the sun are commonly the cause of geomagnetic disturbances here on Earth; such as power grid faults/failures and increased errors in GPS navigation and positioning. Associated with some of these solar disturbances is the ejection of extremely fast plasma into the solar wind that, when aimed directly towards the Earth, causes the onset of increased geomagnetic and ionospheric activity. The Earth-bound solar energetic particles ejected into the solar wind eventually penetrate into the Earth’s magnetosphere. When inside the magnetosphere, they orbit the planet across the Earth’s magnetic field lines until they are scattered by various complicated magnetospheric processes and interactions. Once scattered, these solar particles then travel down the magnetic field lines until they impact the Earth’s upper atmosphere, where they are effectively absorbed. The penetration depth of these particles primarily depends on their kinetic energy, which is governed by their mass and velocity. The less energetic particles are stopped by the Earth’s atmosphere typically between 100 and 400km altitude, causing the well-known <a href="http://spaceweathergallery.com/aurora_gallery.html">aurora</a> in the northern and southern high-latitude regions. The atmosphere increases in density exponentially as the particle falls. This normally prevents particles penetrating to lower altitudes where they are harmful to living organisms. The more energetic particles, called “solar energetic particles”, caused by these solar disturbances can <a href="http://www.dartmouth.edu/~barrel/index.html">penetrate</a> to below 10km, near of commercial flights. During such events, the danger posed by the increased radiation levels is easily averted by decreasing the cruising altitudes of the aircraft. Pilots can also divert their flight paths to areas less affected by the increased radiation levels (more equatorward latitudes). Several chest X-rays worth of radiation The aviation radiation monitoring performed in real-time by computer systems such as NAIRAS can effectively be used to issue such warnings to aircraft. This will help remove the threat posed to hundreds of thousands of people across the globe during such space weather events. The geomagnetic activity levels associated with the solar radiation storm that occurred during the US government shutdown were only minor (a minimum <a href="https://theconversation.com/solar-eruption-could-help-earth-prepare-for-technology-melt-down-18747">Dst</a> of -54nT). This means the technologies normally classified as being <a href="https://theconversation.com/divert-power-to-shields-the-solar-maximum-is-coming-11228">vulnerable</a> to extreme space weather events are not likely to have been significantly affected. The solar energetic particle levels observed by <a href="http://www.ngdc.noaa.gov/stp/satellite/goes/index.html">geostationary satellites</a> classifies this as an <a href="http://www.spaceweather.com/glossary/srs.html">S2</a>solar radiation storm. It lasted more than 24 hours, and took about four days to fully subside (see video below). Some controversy exists around the exact method used by the scientists of the first <a href="http://onlinelibrary.wiley.com/doi/10.1002/2013SW001015/abstract">study</a>into this event. There has been doubt around the estimation of the number of eventual cancer fatalities related to this solar radiation storm. Even though the radiation levels air travellers were exposed to during this event are much higher than they might have been had an appropriate warning been issued, they were still comparatively low – on par with the dose that one would receive from a number of chest X-rays. Arguments put forward by some <a href="http://onlinelibrary.wiley.com/doi/10.1002/2014SW001074/abstract">researchers</a> err on the side of caution. They indicate that some people who would be considered more vulnerable to increased radiation exposure (such as frequent flyers and unborn children) should have access to this radiation monitoring information. This would enable them to make educated decisions about appropriate air travel times in much the same way that non-urgent X-rays may be postponed during pregnancy. <a href="http://onlinelibrary.wiley.com/doi/10.1002/2014SW001061/abstract">Other researchers</a> have erred on the opposite side, with the view that the radiation doses during this event were too small to be considered a serious threat. Independent of whether or not this particular space weather event exposed air travellers to dangerous levels of radiation, these studies are in clear agreement that increasing radiation monitoring is a must in the future. This is especially important for the aviation industry, and the provision of such information must not be hindered by short-term political partisan interests. Written by Brett Carter. Republished with permission of <a href="https://theconversation.com/are-you-a-frequent-flyer-solar-storm-radiation-can-be-harmful-28775">The Conversation</a>.

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