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Can you control your image? Gina Rinehart, King Charles and ‘moral portraits'

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/roger-benjamin-119535">Roger Benjamin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> “She’s no oil painting”. Those were the unkind words of a colleague commenting on the subject of Vincent Namatjira’s acrylic painting, Gina. Every one of the prominent Australians and cultural heroes in Namatjira’s ensemble <a href="https://theconversation.com/vincent-namatjiras-paintbrush-is-his-weapon-with-an-infectious-energy-and-wry-humour-nothing-is-off-limits-217361">Australia in Colour</a> (2021) is subject to his trademark distortions. When the painter gets to work interpreting the press photographs that his main source, resemblance is always stretched. No one comes out unscathed: Tony Abbott looks just as scary as Angus Young from AC/DC; a grimacing Queen Elizabeth as grisly as a roaring Cathy Freeman. Indeed, in the <a href="https://thamesandhudson.com.au/product/vincent-namatjira/">2023 volume on Namatjira</a> there are no fewer than four paintings of Gina Rinehart – and they look like four different people. Do we expect a portrait to be a moral <a href="https://en.wikipedia.org/wiki/Physiognomy">physiognomy</a>, the ancient pseudoscience that assumes the way someone has lived their life shapes their features and appearance? Roman emperors were shown to be ideal types: the heroic portrait. Who knows what these men actually looked like? In the case of King Charles III, whose <a href="https://www.bbc.com/news/entertainment-arts-68981200">new portrait</a> by Jonathon Yeo was unveiled this week, we can compare his likeness to the myriad photographic and filmic images. Newspaper caricature, <a href="https://firstamendmentmuseum.org/exhibits/virtual-exhibits/art-politics-300-years-of-political-cartoons/political-cartoons-part-1-1720-1800/">popular since the 1700s</a>, works hard to point out imperfections, posit animal likenesses, and exaggerate specific facial features to satirise public figures. Namatjira brushes with caricature even when depicting himself. <h2>Can you control your image?</h2> I think Rinehart should be flattered to be one of Namatjira’s favourites. The wits in the twittersphere have in the past 24 hours shown several more of his Ginas, and it turns out there are also at least half a dozen colour portraits of her by other artists. They range from <a href="https://scottmarsh.com.au/products/mothers-milk">Scottie Marsh’s mural</a> on a Sydney wall of a matronly Rinehart giving the breast to infant Barnaby Joyce (with apologies to Raphael), to Xavier Ghazi’s demonic hard-hatted Gina <a href="https://citynews.com.au/2023/bald-archy-prize-heading-for-immortality/">giving Australians the finger</a> – it’s in newspaper caricature mode, his entry in the Bald Archies competition for 2023. Although Rinehart has reportedly called for Namatjira’s painting to be taken down, the initiative <a href="https://www.theage.com.au/culture/art-and-design/gold-medallist-led-campaign-to-take-down-gina-rinehart-portrait-20240516-p5je1y.html">apparently comes</a> from members of the Australian swimming team and their former coach (Rinehart is that sport’s major private sponsor). I suspect their discomfort comes from reading Namatjira’s Gina as a moral portrait; that is, ugliness of appearance projects an ugly spirit (whereas for them she is the epitome of generosity). It’s an interesting idea that the fresh-faced teenage daughter of Lang Hancock in <a href="https://www.smh.com.au/entertainment/tv-and-radio/abcs-australian-story-focuses-on-gina-rineharts-bond-with-father-lang-hancock-20150706-gi6h1f.html">old news photos</a> has changed not just because times takes beauty away (as we all know), but because of the impact of things she inherited from her father: not just the extreme wealth and the jawline, but the conservative views, and the ways she has used her money and power. Her control of vast tracts of (unceded) grazing land across western and central Australia give reason to reflect on what Western Aranda man Namatjira might think of her. <h2>And yet what about commissions?</h2> When can a sitter control their portrait image? Only when they commission the work. Art history has plenty of cases in which a sitter has rejected their portrait. Monet in the 1860s painted his brother Leon, who so disliked the canvas he locked it in an attic, from which it emerged 150 years later. Portrait paintings have had to be altered, payment refused, or be paid for then destroyed. The commissioned portrait, it’s assumed, must flatter the sitter or at least offer a fair and non-judgemental likeness. The British royal family has historically been very forgiving about portraits, and has the sophistication to know it is futile to protest a likeness. Doing so invokes the perverse “<a href="https://en.wikipedia.org/wiki/Streisand_effect">Streisand effect</a>”, as we see happening with Namatjira’s Gina. There are dozens of depictions of Elizabeth II and Charles III in Namatjira’s pantheon – including one of the late queen alongside Rinehart in Australia in Colour. Namatjira has a family link to Elizabeth and Prince Philip, who met Albert Namatjira (the painter’s great grandfather) on their 1954 tour of Australia. But no one is asking for Queen Bess to be removed from the National Gallery of Australia. As a mark of noblesse oblige, King Charles has accepted the newly unveiled commissioned portrait of himself by Jonathon Yeo. It is an absolute shocker, and he should have sent it back. The King, de-aged by 20 years, looks pleasantly out at us from a floor-to-ceiling fog of strawberry- and cerise-coloured paint that covers his dress uniform. The joke, of course, is that the red colouration can be read as a reference to “<a href="https://time.com/6226657/crown-charles-camilla-tampongate/">tampongate</a>”, the product of an infamous case of tabloid phone-hacking in 1993. It’s a case of a portrait generating an unintended consequence – just as Namatjira surely did not expect to provoke international headlines today with his Gina, whom he’s been depicting for years. Fittingly, wise heads have rejected calls for the gallery to remove the canvas, starting with director Nick Mitzevich’s <a href="https://amp.smh.com.au/culture/art-and-design/portrait-gina-rinehart-doesn-t-want-you-to-see-mogul-demands-national-gallery-remove-her-image-20240513-p5jd59.html">measured statement</a>, seconded by the National Association for the Visual Arts whose <a href="https://visualarts.net.au/news-opinion/2024/nava-defends-vincent-namatjiras-artistic-freedom-amid-demands-removal-nga/">press release</a> insists on freedom of expression. Finally, late yesterday, Namatjira, resisting myriad calls for interviews, issued a statement in the pithy mode of his book texts. Let him have the last word: <blockquote> I paint people who are wealthy, powerful, or significant – people who have had an influence on this country, and on me personally, whether directly or indirectly, whether for good or for bad. Some people might not like it, other people might find it funny, but I hope people look beneath the surface and see the serious side too.<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/230297/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </blockquote> <a href="https://theconversation.com/profiles/roger-benjamin-119535">Roger Benjamin</a>, Professor in Art History, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: X (Twitter) This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-you-control-your-image-gina-rinehart-king-charles-and-moral-portraits-230297">original article</a>. </div>

Art

5 reasons art therapy is great for your mental health as you age

We know how important it is to look after our <a style="color: blue;" href="https://www.betterhealth.vic.gov.au/health/servicesandsupport/healthy-and-active-ageing">physical health</a> as we age, but our mental health is equally important. <a style="color: blue;" href="https://aifs.gov.au/resources/short-articles/normalising-mental-illness-older-adults-barrier-care">Studies have shown</a> that besides the immediate impact on wellbeing, older people with untreated mental ill health are at risk of poorer overall health, increased hospital admissions, and an earlier transition into aged care. Art therapy is an excellent way to boost our mental wellbeing. In a nutshell, this type of therapy is when visual art, such as drawing, sculpting, or collage, is used in a <a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/">therapeutic context</a>. And don’t be put off if you haven’t picked up a paintbrush since you were a kid. Art therapy is not about creating works of beauty but about the process. It’s a completely <a style="color: blue;" href="https://cata.org.au/faqs-myth-busters/#:~:text=The%20focus%20of%20Creative%20Art,%2C%20growth%20and%20self%2Dawareness.&text=Reality%3A%20Creative%20Art%20Therapy%20does,to%20affect%20change%20and%20growth.">judgement free zone</a>! Emotional release: Growing up, many of us were never taught that it was okay to express how we’re feeling, especially emotions like anger and sadness. In that way, art therapy can be ideal us older folks who often feel stuck when it comes to expressing ourselves. Art therapy provides the opportunity to express our <a style="color: blue;" href="https://creativityintherapy.com/2017/06/expressing-emotions-creativity-6-step-art-process/">inner experiences</a> in a visual way. Through the act of creation, we can release pent-up feelings, reduce stress, and experience emotional release. Another challenging emotion that art therapy can help with is grief. As we age, we are more likely to experience the <a style="color: blue;" href="https://www.nari.net.au/the-impact-of-prolonged-grief-in-older-people">loss of a loved one</a> and we don’t get ‘used to it’. The hole it leaves in our hearts is just as dark. Through <a style="color: blue;" href="https://www.vivianpaans.com.au/blog/healing-through-art-how-art-therapy-can-help-with-grief-and-wellbeing">creating art</a> we can explore the feelings of grief and sadness in a safe, judgement-free space. It can also foster a sense of self-compassion and when we have more compassion for ourselves, it becomes easier to accept our emotions. Stress relief: <a style="color: blue;" href="https://www.sane.org/information-and-resources/facts-and-guides/facts-mental-health-issues">Anxiety, depression, and past traumas</a> can heavily impact on our daily lives. Risk factors over our lifespans may change but they don’t magically disappear once we hit a certain age. Illness, grief, financial stress, social isolation, and life transitions such as menopause can all be <a style="color: blue;" href="https://www.healthdirect.gov.au/older-people-and-mental-health">contributing factors</a> of poor mental health for older adults. Creating art can ease symptoms as we refocus on what we’re creating and move thoughts away from overthinking and worry. Creating art releases <a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/">dopamine,</a> the chemical responsible for allowing us to feel pleasure and satisfaction. This further reduces bothersome symptoms of anxiety and depression. Also, participating in art therapy leads to a more creative brain. A creative brain is better equipped to create stress-relieving techniques for other areas of our lives. Through creating art, we draw the fears that are inside our minds. This takes them out of our heads and places them away from us, helping us feel more in control. Recovering from <a style="color: blue;" href="https://www.interrelate.org.au/news-media/blogs/november-2021/how-art-can-heal-trauma">trauma</a> can be a lifelong process for many, and it’s important for someone dealing with it to find tools that will help this process. Art therapy can be one of those as it can give a sense of agency and self-understanding through the ability to express feelings symbolically. This can give <a style="color: blue;" href="https://anzacata.org/About-CAT">new perspectives</a> of ourselves and our worldview which is essential in the recovery process. It can also help connect with deeply stored emotions and help process them. Self-discovery: When we are younger we are often so busy working, socialising, and raising a family many of us never get a chance to take the time out for <a style="color: blue;" href="https://www.visionpsychology.com/starting-the-process-of-self-discovery/">self-discovery</a>. Self-discovery is important in our lives as it gives us a clearer sense of purpose and direction in life. In turn, this leads to making better decisions that lead to our overall happiness. Some of us see our kids leave home and suddenly we’re left wondering, who am I when I don’t have a family to care for? Creating art can help us acknowledge and recognise feelings that have been suppressed in our subconscious. Through learning to use different techniques of art our minds open up to thinking more freely. Self-discovery comes from both the finished product we create as well as the process of making it. Self-esteem: As we age, it’s easy to look in the mirror and struggle to recognise the person we see. Our bodies are changing, and it can often feel like society doesn’t value us as much as when we were young. It can be a major shift in the way we view ourselves and lead to poor self-esteem. Art therapy teaches us how to use a variety of media to create something new. We can develop talents and see strengths as we master new materials and see the completion of projects. This sense of accomplishment can be a big leg up to our <a style="color: blue;" href="https://artbusinessnews.com/2022/01/benefits-of-art-therapy/">self-esteem.</a> A sense of community: <a style="color: blue;" href="https://likefamily.com.au/blog/what-is-loneliness-and-how-does-it-affect-someone/">Loneliness</a> is a big contributor to poor mental health. <a style="color: blue;" href="https://www.psychiatrist.com/news/study-why-older-people-feel-so-lonely/">Studies</a> show two groups of people are most at risk: young adults and older people. With factors at our age such as children leaving home, not working as much or at all, living alone, and chronic illness, it’s easy to see how loneliness can creep into our lives. Group art therapy is a wonderful way to connect with others. We share a space with those who have similar interests, and it gives us a sense of belonging. For those who can't make a session in person due to distance or illness, some therapists offer <a style="color: blue;" href="https://www.artandplaytherapytraining.com.au/art_therapy">online group art therapy</a>. You don’t need to see an art therapist to get the mental health benefits of creating art. But the advantage of that is they have the skills to work out what best suits your needs. They’ll also work with you through any tough emotions that may arise from your art therapy. So maybe it’s time to hide those new coloured pencils from the little ones, crack them open, and enjoy them yourself! If you’d like to find out more about art therapy sessions, the links below are helpful. They offer online, in person and group sessions. <a style="color: blue;" href="https://www.zevaarttherapy.com/" target="_blank" rel="noopener">https://www.zevaarttherapy.com/</a> <a style="color: blue;" href="https://www.alliedarttherapy.com.au/" target="_blank" rel="noopener">https://www.alliedarttherapy.com.au/</a> <a style="color: blue;" href="https://www.solacecreativetherapies.com.au/" target="_blank" rel="noopener">https://www.solacecreativetherapies.com.au/</a> <a style="color: blue;" href="https://cata.org.au/programs-ndis/online-creative-art-therapy/" target="_blank" rel="noopener">https://cata.org.au/programs-ndis/online-creative-art-therapy/</a> And for some more ideas on dabbling in art therapy on your own (or with a friend), check out Shelley Klammer’s amazing resources. She is US-based but has some online workshops that are also amazing: <a style="color: blue;" href="https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/" target="_blank" rel="noopener">https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/</a> Article written by Kylie Carberry Image: Shutterstock

Mind

Do red bags get loaded onto a plane first? Travel hack goes viral

One TikTok user has racked up over 75 million views for their hack which warns travellers against buying red suitcases. The reason behind it? He claims that red suitcases are always loaded onto a plane first - meaning that they will be the last ones to come out at the baggage carousel. The <a href="https://www.tiktok.com/@airportlife_/video/7359248989134327072" target="_blank" rel="noopener">viral video</a> showed a plane's cargo being loaded, with all the red bags being loaded first. Many commenters have shared their theories on why this might be the case. "If the red are at the back then they are less likely to get left behind when unloading," one wrote. "So that it's easier to check if there is any bag left at end corner of loading area and prevent missing out black bags at dark corners, maybe," another added. However, a spokesperson for KLM Royal Dutch Airlines has debunked this theory and claimed that the video is "nonsense" and "was made purposefully to mislead or provide false information". They also said that there was simply not enough time for their baggage handlers to sort suitcases out by colour. The question of "Do red bags get loaded onto a plane first?" also made its way to Reddit, after the video went viral, and one user who claimed to be a ramp worker denied the theory. "If we had taken the time and brain power to load bags based on colour I'd still be loading flights from 2015." Image: TikTok

Travel Tips

Longer appointments are just the start of tackling the gender pain gap. Here are 4 more things we can do

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Ahead of the federal budget, health minister Mark Butler <a href="https://www.abc.net.au/news/2024-05-10/endometriosis-australia-welcomes-govt-funding-for-endometriosis/103830392">last week announced</a> an investment of A$49.1 million to help women with endometriosis and complex gynaecological conditions such as chronic pelvic pain and polycystic ovary syndrome (PCOS). From July 1 2025 <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/historic-medicare-changes-for-women-battling-endometriosis">two new items</a> will be added to the Medicare Benefits Schedule providing extended consultation times and higher rebates for specialist gynaecological care. The Medicare changes <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">will subsidise</a> $168.60 for a minimum of 45 minutes during a longer initial gynaecologist consultation, compared to the standard rate of $95.60. For follow-up consultations, Medicare will cover $84.35 for a minimum of 45 minutes, compared to the standard rate of $48.05. Currently, there’s <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=104&qt=item&criteria=104">no specified time</a> for these initial or subsequent consultations. But while reductions to out-of-pocket medical expenses and extended specialist consultation times are welcome news, they’re only a first step in closing the gender pain gap. <h2>Chronic pain affects more women</h2> Globally, research has shown chronic pain (generally defined as pain that persists for <a href="https://www.healthdirect.gov.au/chronic-pain">more than three months</a>) disproportionately affects <a href="https://academic.oup.com/bja/article/111/1/52/331232?login=false">women</a>. Multiple biological and psychosocial processes likely contribute to this disparity, often called the gender pain gap. For example, chronic pain is frequently associated with conditions influenced by <a href="https://www.sciencedirect.com/science/article/abs/pii/S0304395914003868">hormones</a>, among other factors, such as endometriosis and <a href="https://theconversation.com/adenomyosis-causes-pain-heavy-periods-and-infertility-but-youve-probably-never-heard-of-it-104412">adenomyosis</a>. Chronic pelvic pain in women, regardless of the cause, can be debilitating and <a href="https://www.nature.com/articles/s41598-020-73389-2">negatively affect</a> every facet of life from social activities, to work and finances, to mental health and relationships. The gender pain gap is both rooted in and compounded by gender bias in medical research, treatment and social norms. The science that informs medicine – including the prevention, diagnosis, and treatment of disease – has traditionally focused on men, thereby <a href="https://www.theguardian.com/lifeandstyle/2015/apr/30/fda-clinical-trials-gender-gap-epa-nih-institute-of-medicine-cardiovascular-disease">failing to consider</a> the crucial impact of sex (biological) and gender (social) factors. When medical research adopts a “male as default” approach, this limits our understanding of pain conditions that predominantly affect women or how certain conditions affect men and women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921746/">differently</a>. It also means intersex, trans and gender-diverse people are <a href="https://www.deakin.edu.au/about-deakin/news-and-media-releases/articles/world-class-centre-tackles-sex-and-gender-inequities-in-health-and-medicine">commonly excluded</a> from medical research and health care. Minimisation or dismissal of pain along with the <a href="https://www.hindawi.com/journals/ecam/2016/3467067/">normalisation of menstrual pain</a> as just “part of being a woman” contribute to significant delays and misdiagnosis of women’s gynaecological and other health issues. Feeling dismissed, along with perceptions of stigma, can make women less likely <a href="https://link.springer.com/article/10.1186/s12905-024-03063-6">to seek help</a> in the future. <h2>Inadequate medical care</h2> Unfortunately, even when women with endometriosis do seek care, many <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.15494?saml_referrer">aren’t satisfied</a>. This is understandable when medical advice includes being told to become pregnant to treat their <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02794-2">endometriosis</a>, despite <a href="https://academic.oup.com/humupd/article/24/3/290/4859612?login=false">no evidence</a> pregnancy reduces symptoms. Pregnancy should be an autonomous choice, not a treatment option. It’s unsurprising people look for information from other, often <a href="https://www.mdpi.com/2227-9032/12/1/121">uncredentialed</a>, sources. While online platforms including patient-led groups have provided women with new avenues of support, these forums should complement, rather than replace, <a href="https://journals.sagepub.com/doi/full/10.1177/1460458215602939">information from a doctor</a>. Longer Medicare-subsidised appointments are an important acknowledgement of women and their individual health needs. At present, many women feel their consultations with a gynaecologist are <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">rushed</a>. These conversations, which often include coming to terms with a diagnosis and management plan, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/">take time</a>. <h2>A path toward less pain</h2> While extended consultation time and reduced out-of-pocket costs are a step in the right direction, they are only one part of a complex pain puzzle. If women are not listened to, their symptoms not recognised, and effective treatment options not adequately discussed and provided, longer gynaecological consultations may not help patients. So what else do we need to do? 1. Physician knowledge Doctors’ knowledge of women’s pain requires development through both practitioner <a href="https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00815-4/tables/2">education and guidelines</a>. This knowledge should also include dedicated efforts toward understanding the <a href="https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain">neuroscience of pain</a>. Diagnostic processes should be tailored to consider gender-specific symptoms and responses to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00137-8/fulltext">pain</a>. 2. Research and collaboration Medical decisions should be based on the best and most inclusive evidence. Understanding the complexities of pain in women is essential for managing their pain. Collaboration between health-care experts from different disciplines can facilitate comprehensive and holistic pain research and management strategies. 3. Further care and service improvements Women’s health requires multidisciplinary treatment and care which extends beyond their GP or specialist. For example, conditions like endometriosis often see people presenting to emergency departments in <a href="https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia/contents/treatment-management/ed-presentations">acute pain</a>, so practitioners in these settings need to have the right knowledge and be able to provide support. Meanwhile, pelvic ultrasounds, especially the kind that have the potential to visualise endometriosis, take longer to perform and require a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0015028223020757/">specialist sonographer</a>. Current rebates do not reflect the time and expertise needed for these imaging procedures. 4. Adjusting the parameters of ‘women’s pain’ Conditions like PCOS and endometriosis don’t just affect women – they also impact people who are gender-diverse. Improving how people in this group are treated is just as salient as addressing how we treat women. Similarly, the gynaecological health-care needs of culturally and linguistically diverse and Aboriginal and Torres Strait islander women may be even <a href="https://www.mdpi.com/1660-4601/20/13/6321">less likely to be met</a> than those of women in the general population. <h2>Challenging gender norms</h2> Research suggests one of the keys to reducing the gender pain gap is challenging deeply embedded <a href="https://pubmed.ncbi.nlm.nih.gov/29682130/">gendered norms</a> in clinical practice and research. We are hearing women’s suffering. Let’s make sure we are also listening and responding in ways that close the gender pain gap.<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/229802/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, Senior Lecturer, School of Business, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, PhD candidate, health communication and health sociology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, Affiliate Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, Associate Professor at NICM Health Research Institute, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney 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/longer-appointments-are-just-the-start-of-tackling-the-gender-pain-gap-here-are-4-more-things-we-can-do-229802">original article</a>. </div>

Body

"I am so lost without you": Sam Rubin's son speaks out

Sam Rubin’s son has delivered an emotional on-air tribute to his late dad just days after his <a href="https://oversixty.com.au/health/caring/legendary-today-show-reporter-dies-unexpectedly" target="_blank" rel="noopener">passing</a>. The entertainment reporter died unexpectedly at the age of 64, after reportedly suffering a heart attack in his Los Angeles home last Friday. He worked for LA TV station KTLA as their entertainment reporter, and was a regular guest on Aussie programs like Today and Today Extra. Colby Rubin, the youngest of the reporter's four children, joined KTLA 5 Morning News on Monday to reflect on his father's death. “Hi dad. I wrote this under the desk in your cubicle – only you weren’t there to wake me up this time. Dad, I can’t believe you’re gone,” the 16-year-old began. “I love you so much. On the day you died, I hope you heard me say that. You were the kindest soul, the light in every room. I can’t imagine my life without you... You were always there.” He said he idolised his father calling him his hero, and said: “I never got to tell you that, and I’m so sorry dad.” Colby then shared some of their private texts showing how encouraging his father was when he was unsure of himself, telling him: "You can do this,” and "you have every gift. Respect your own talent." At this point, Colby was overwhelmed with emotion, with the hosts telling him he could take a break but the teen powered on. “I can’t believe I’ve lost you. I had more of a father in 16 years than some people get in their entire lives, and I’m so grateful. "You are a beautiful human and you will never be forgotten. Dad I love you. I am so lost without you, I’ll miss you every day. I hope you know how loved you are.” Colby's tribute left his father's colleagues in tears with one co-host telling him simply: “He knew.” “He would be so proud of you. All of us are parents, we all can say – that is the most beautiful thing I’ve ever heard,” another said as she fought back tears. Viewers praised Colby for his “strength and composure” in delivering such an emotional tribute just days after losing his father. “Amazing how Colby was able to do this with such grace, strength, and composure. You can tell Sam was an amazing father through Colby’s tribute,” TV anchor Stephanie Myers wrote on X. Sam is survived by his wife Leslie and four children: Perry, 28, Rory, 23, Darcy, 18, and Colby. Image: KTLA/ X

Family & Pets

Everything you need to know about tipping in the US

There are few social customs in the US more confusing to travellers than tipping. To most Americans, gratuities are normal, like adding sales tax at the register. To foreign visitors, though, the very idea can induce anxiety or panic. We're notoriously poor tippers. Partly this is accidental ignorance, but partly it is self-righteous rejection of an institution many of us see as unfair. I once had a meal in New York with a woman from Brisbane who refused to tip "on principle." I nodded in agreement ... and then tipped for both of us. The truth is, federal minimum wage for adults in the US is just US$7.25 an hour. In industries where tipping is routine, employers are legally allowed to pay wages as low as US$2.13 an hour. So while travellers may stage a quiet rebellion, refusing to tip, the bereaved party is never going to be the restaurant owners (who earns their profit through the itemised bill), but the poor waiters. Until the US government raises minimum wages to Australian levels (something that will probably never happen), tipping is here to stay. Which means travellers need to accept it, then learn the rules. First rule: After clearing immigration get your hands on a stack of "singles" (US$1 bills). You're going to need them. Getting around In theory, tips should only go to people who are helpful; the more helpful, the more bountiful their reward. In reality, tips are par for the course, and to "stiff" somebody is tantamount to slapping them in the face. If a airport porter helps you with your bags, give them US$1-2 per bag. If they meet you at the gate with a wheelchair, give them US$3-5. For most travellers, the first real test comes with transports away from the airport. If you're lucky enough to have a hotel worker collect you from Arrivals, give them US$10-15 for the effort. If you take a taxi, a little more thought will be required. Many taxis now have seat-back displays that offer "default tipping" amounts at the end of a journey: in New York, 20, 25, and 30 per cent. You should only really tip 30 per cent if the taxi turns out to be the Batmobile, getting you to your destination in record time. Even 20 per cent can sometimes feels a little high. Tipping is subjective: I often manually override the default, leaving 15-20 per cent, or a few extra dollars if I'm paying in cash. If you hire a car and take advantage of valet (all but mandatory in Los Angeles), be prepared to tip the worker US$3-5 upon pick-up, depending on how ritzy the establishment is. A quick rule of thumb: more ritz equals more tip. Hotels If you arrive at the hotel and somebody opens the door for you, that's on the house. If they carry your bags, that is not on the house. Give them US$2-3 a bag. If the hotel has a concierge, their friendliness isn't contingent on your generosity. But if they perform a service for you - book a trip, hire a car, charter a private jet to the Bahamas - acknowledge this effort with US$10-20 at the end of your stay, presented with a handshake. One case where tipping can have a direct impact on the quality of service you receive is housekeeping. Each morning, leave US$2-5 on your pillow with a thank you note. This ensures different cleaners get their due, and it also means cleaners will be extra diligent for the rest of your stay. If you think this is a little rich, keep in mind that these people are picking up your dirty towels, so spare change for a cup of coffee is the least you can do. One point of confusion with hotel tipping is the in-room dining. Some hotels include a default tip on their dining bills; some include a "service charge," which goes to the hotel, and should not be treated as a tip. If there's no obvious tip included on the bill, slip the server 15-20 per cent when they knock on your door. Dining and drinking Nobody can force you to tip in a restaurant, though they can try to counteract your miserliness by stating on the menu that tips are automatically added to the final charge. This is increasingly common in areas catering to large numbers of foreign travellers; it's also pretty standard when your table has more than six people. If tips have been added by the time you come to hand over your card, no further gratuity is needed. If no tip has been included, you might need to leave some money on the table. How much exactly depends on what kind of table it is. If it is a fast food table, no tip. If it is a table at a restaurant ranging from modest diner to upmarket eatery, 15-20 per cent for the waiter is standard (err on the high side in major cities like New York and San Francisco). If you leave less than 15 per cent, staff will assume you weren't happy with their service. If you leave two pennies on top of the bill - a code - they will know you were very unhappy, and feel bad even as they silently loathe you for being a Scrooge. It is almost never okay to withhold a tip; if you're considering doing that, you should also be considering complaining to the manager. If it is a very fancy restaurant, perhaps one with Michelin stars, prepare to hand over 25 per cent of the bill (before tax) to the waiter, who will divide it up among his or her support staff. You should also tip the sommelier if they suggest wine, and perhaps the maitre'd, if they gave you a fabulous table. Always, without exception, tip a bartender a dollar for every drink; bigger tips can mean stronger second cocktails in my experience. As for coffee shops, despite the increasing prevalence of tip jars, and "suggested tips" when paying with a card, this is cheekiness and should only be taken seriously if the barista goes out of their way, like the man who once drew Darth Vader in my cappuccino crema. Everything else This guide covers the most common situations a traveller will have to contend when in the US, though the list is not exhaustive. For example, do you tip a massage therapist? Yes, 10-20 per cent. A hairdresser? Same. Tour guide or hiking leader? 15-20 per cent of the total charge, depending on their performance. That Elvis impersonator who officiated your wedding in a Las Vegas chapel? Same. Tip anyone, in fact, that provides you with a service: 15 per cent is a good default to keep in mind. Just remember, nobody is affronted by the offer of a gratuity, so you shouldn't feel bashful about giving one. Written by Lance Richardson. First appeared on <a href="http://Stuff.co.nz" target="_blank" rel="noopener">Stuff.co.nz</a>. Image credits: Shutterstock

International Travel

10 questions you must ask before booking a tour

A tour can be a memorable experience, for the right and wrong reasons. Here are 10 questions you must ask yourself before booking one on your next holiday. 1. Are there minimum or maximum group sizes? This applies for two reasons. Firstly, you need to decide how many people you’d like to travel with. Small group tours will have no more than a dozen or so while larger tours could be up to 50. The size will drastically impact your tour experience, affecting everything from the mode of transport to the type of meals. Secondly, you need to know if there’s a minimum group size needed for the tour to run. If you’re the only one who books you may find it cancelled. 2. What is your cancellation/refund policy? As a rule of thumb, you should ask this question about any kind of travel you book before you hand over your cash. With a tour, make sure you find out their policies around inclement weather, too few passengers or if you need to cancel. And as always, travel insurance is your best friend. 3. Are you available for support throughout? One of the good things about travelling with a tour is that you’ll have the services of at least one guide. It’s also good to know if the tour office itself is available for assistance when you’re on the road. This comes in handy if you have to make changes, get sick or are unhappy with the experience. 4. Do you have any reviews I can read? If you can’t find the tour company on TripAdvisor or a similar review site, ask the company if they have any testimonials from previous customers. Before you make your final decision, it’s nice to know what other people have said about the tour and its style. 5. What experience/qualifications do the guides have? Many tour companies now pride themselves on using locals or people who have lived in a country for many years to guide tours. You don’t want to be stuck with someone who just reads from a guidebook – you can do that yourself for half the price. Find out what they know before you go. 6. How active is it? There is a huge spectrum when it comes to tours, ranging from coach journeys with very little walking to active treks where you cover hard ground every day. Make sure you find out exactly what will be involved and if that suits your abilities and fitness level. And be realistic – you and the tour group will suffer otherwise. 7. What is the demographic? You don’t want to get stuck on a tour with a bunch of 25 year olds who are just looking for the pub. Most people prefer to travel with people around their own age and in similar demographics (such as solo travellers, seniors, families etc), so make sure you find out who is likely to be in your group before you book. 8. Is everything included or will I have to pay for extras? You should be able to get a detailed break down of exactly what is – and what isn’t – included in the price. What looked like a good deal can quickly become very expensive if you have to pay for day excursions, admission fees, alcohol or other surprises. 9. How much time do you spend in each place? Are you looking to tick many famous sites off your list or do you want to have the time to immerse yourself in a destination? When you’re looking at an itinerary, ask questions about how long you will actually be spending at each place to ensure that you get enough time to really enjoy it. 10. Will I get any free time on my own? After many days as part of a group, it’s nice to have some time on your own. You can explore sites that aren’t on your itinerary, try a new restaurant or just have a well deserved nap. Find out how rigid the schedules are and if there will be some time to do your own thing. Image credits: Shutterstock

Travel Tips

Technology is alienating people – and it’s not just those who are older

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/carolyn-wilson-nash-1255329">Carolyn Wilson-Nash</a>, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> and <a href="https://theconversation.com/profiles/julie-tinson-277507">Julie Tinson</a>, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> We take it for granted that technology brings people closer together and improves our access to essential products and services. If you can’t imagine life without your smartphone, it’s easy to forget that people who can’t or don’t want to engage with the latest technology are being left behind. For example, there have recently been reports that <a href="https://www.express.co.uk/life-style/cars/1618497/parking-poll-results-cashless-car-parks-card-smartphone-app-only-elderly-drivers-spt">cashless payment systems</a> for car parking in the UK are seeing older drivers unfairly hit with fines. This has led to calls for the <a href="https://www.dailymail.co.uk/news/article-10851103/Esther-Rantzen-tells-ministers-pensioners-not-use-apps-pay-parking.html">government to intervene</a>. Age is one of the biggest predictors of <a href="https://ageing-better.org.uk/sites/default/files/2020-08/landscape-covid-19-digital.pdf">digital exclusion</a>. Only 47% of those aged <a href="https://www.ons.gov.uk/businessindustryandtrade/itandinternetindustry/bulletins/internetusers/2019">75 and over</a> use the internet regularly. And out of the 4 million who have never used the internet in the UK, only 300,000 people are <a href="https://ageing-better.org.uk/sites/default/files/2020-08/landscape-covid-19-digital.pdf">under 55</a>. But older people are not the only ones who feel shut out by new technology. For example, research shows vulnerable people, such as those with disabilities, are also disengaging with e-services and being <a href="https://www.tandfonline.com/doi/full/10.1080/0267257X.2012.691526">“locked out” of society</a>. <h2>The digital transition</h2> From train tickets to vaccine passports, there is a growing expectation that consumers should embrace technology to participate in everyday life. This is a global phenomenon. Out in front, Sweden predicts its economy will be <a href="https://sweden.se/life/society/a-cashless-society">fully cashless</a> by March 2023. Shops increasingly use QR codes, virtual reality window displays and self-service checkouts. Many of these systems require a smart device, and momentum is building for QR codes to be integrated into <a href="https://www.thegrocer.co.uk/technology-and-supply-chain/the-time-has-finally-arrived-for-electronic-shelf-labels-heres-why/661068.article">digital price tags</a> as they can give customers extra information such as nutritional content of food. Changing paper labels is a labour intensive process. Technology pervades all aspects of consumer life. Going on holiday, enjoying the cinema or theatre, and joining sport and social clubs all make people feel part of society. But many popular artists now use online queues to sell tickets to their shows. Social groups use WhatsApp and Facebook to keep their members updated. When it comes to booking a holiday, there is a <a href="https://www.statista.com/statistics/919811/number-of-travel-agents-united-kingdom-uk/#:%7E:text=Overall%2C%20there%20were%203%2C710%20retail,as%20TUI%20and%20Hays%20Travel.">decreasing number</a> of in-person travel agents. This limits the social support to make the best choice, which is particularly important for those with specific needs such as people with health issues. And once travelling, aircrew expect flight boarding passes and COVID passports to be available on smartphones. Essential services such as healthcare, which can already <a href="https://www.tandfonline.com/doi/full/10.1080/0267257X.2022.2078861">be difficult</a> for older and other people to navigate, are also moving online. Patients are increasingly expected to use the GP website or email to request to see a doctor. Ordering prescriptions online is encouraged. <h2>Not just older people</h2> <a href="https://www.gov.uk/government/publications/digital-lifeline-a-qualitative-evaluation/digital-lifeline-a-qualitative-evaluation">Not everyone can afford</a> an internet connection or smart technology. Some regions, particularly rural ones, struggle for phone signal. The UK phone network’s plans for a <a href="https://www.bbc.co.uk/news/uk-england-shropshire-61377944">digital switchover</a> by 2025, which would render traditional landlines redundant, could cut off people who rely on their landlines. Concerns about privacy can also stop people using technology. Data collection and security breaches impact people’s confidence in organisations. A 2020 survey into <a href="https://www.mckinsey.com/business-functions/risk-and-resilience/our-insights/the-consumer-data-opportunity-and-the-privacy-imperative">consumers’ trust</a> in businesses showed no industry reached a trust rating of 50% for data protection. The majority of respondents (87%) said they would not do business with a company if they had concerns about its security practices. Some people view “forced” digitisation as a symbol of consumer culture and will limit their technology use. Followers of the <a href="https://www.researchgate.net/publication/228310981_The_Voluntary_Simplicity_Movement_Reimagining_the_Good_Life_Beyond_Consumer_Culture">simple living movement</a>, which gained momentum in the 1980s, try to minimise their use of technology. Many people take a “less is more” <a href="https://www.emerald.com/insight/content/doi/10.1108/JCM-04-2020-3749/full/html">approach to technology</a> simply because they feel it offers a more meaningful existence. One of the most common reasons for digital exclusion, however, <a href="https://www.iriss.org.uk/resources/esss-outlines/digital-inclusion-exclusion-and-participation">is poverty</a>. When the <a href="https://www.local.gov.uk/parliament/briefings-and-responses/tackling-digital-divide-house-commons-4-november-2021">pandemic hit in March 2020</a>, 51% of households earning between £6,000 to £10,000 had home internet access, compared with 99% of households with an income over £40,000. Limited access to tablets, smartphones and laptops can result in feelings of isolation. Many older consumers have developed strategies to manage and overcome the <a href="https://www.tandfonline.com/doi/full/10.1080/0267257X.2021.1945662">digital challenges</a> presented by these devices. But those unable to <a href="https://theconversation.com/how-older-people-are-mastering-technology-to-stay-connected-after-lockdown-165562">engage with technology</a> remain excluded if their family and friends don’t live close by. <h2>Smart change</h2> The solution is not simply to give devices to those without smart technology. While there is a need to provide affordable internet access and technology, and offer support in learning new skills, we need to recognise diversity in society. Services should provide non-digital options that embrace equality. For example, cash systems should not be abolished. There might be a demand for services to become digital, but service providers need to be aware of the people who will be isolated by this transition. Retailers, local councils, health providers and businesses in tourism, entertainment and leisure should try to understand more about the diversity of their consumers. They need to develop services that cater for the needs of all people, especially those without access to technology. We live in a diverse world and diverse consumers need choice. After all, access to and inclusion in society is a human right.<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/184095/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/carolyn-wilson-nash-1255329">Carolyn Wilson-Nash</a>, Lecturer, Marketing and Retail, Stirling Management School, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> and <a href="https://theconversation.com/profiles/julie-tinson-277507">Julie Tinson</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</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/technology-is-alienating-people-and-its-not-just-those-who-are-older-184095">original article</a>. </div>

Technology

Too many Australians aren’t getting a flu vaccine. Why, and what can we do about it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/holly-seale-94294">Holly Seale</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Australia’s childhood immunisation program gets very good uptake every year – <a href="https://www.health.gov.au/topics/immunisation/immunisation-data/childhood-immunisation-coverage">almost 94% of five-year-olds</a> have had all their routine vaccinations. But our influenza vaccine coverage doesn’t get such a good report card. Looking back over <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/historical-national-influenza-vaccination-coverage-end-year-age">recent years</a>, for kids aged six months to five years, we saw a peak in flu vaccine coverage at the beginning of the COVID pandemic at 46%, which then declined to 30% by the 2023 season. While we’re still relatively early in the 2024 flu season, only <a href="https://ncirs.org.au/influenza-vaccination-coverage-data">7% of children</a> under five have received their flu shot this year so far. Although young children are a particular concern, flu vaccination rates appear to be lagging for the population as a whole. Reports indicate that <a href="https://www.abc.net.au/news/2024-05-07/calls-to-vaccinate-young-children-against-flu-as-season-begins/103783508">from March 1 to April 28</a>, 16% fewer people were vaccinated against the flu compared with the same period last year. So what’s going on, and what can we do to boost uptake? <h2>Why do we vaccinate kids against the flu?</h2> Last year, <a href="https://www.health.gov.au/sites/default/files/2023-12/aisr-2023-national-influenza-season-summary.pdf">reported cases of flu</a> were highest in children aged five to nine, followed by those aged zero to four. This is not a new trend – we record a high number of flu cases and hospital admissions in kids every year. So far <a href="https://nindss.health.gov.au/pbi-dashboard/">this year</a> children aged zero to four have had the highest number of infections, marginally ahead of five- to nine-year-olds. While kids are more likely to catch and spread the flu, they’re also <a href="https://theconversation.com/kids-are-more-vulnerable-to-the-flu-heres-what-to-look-out-for-this-winter-117748">at greater risk</a> of getting very sick from it. This particularly applies to children under five, and the flu vaccine is available for free for this age group. The flu vaccine isn’t perfect – it may not prevent infections entirely – but it’s definitely our best chance of protection. Research has shown influenza-related visits to the GP were <a href="https://pubmed.ncbi.nlm.nih.gov/27577556/">more than halved</a> in vaccinated children compared with unvaccinated children. <h2>So why are kids not receiving the vaccine?</h2> Often, it comes down to misunderstandings about who is eligible for the vaccine or whom it’s recommended for. But we can address this issue by nudging people via <a href="https://www.annfammed.org/content/15/6/507?sf174332549=1">a text message reminder</a>. Some parents <a href="https://www.sciencedirect.com/science/article/pii/S0264410X17318285">report concerns</a> about the vaccine, including the old dogma that it can cause the flu. The flu vaccine <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/flu-influenza-immunisation">can’t give you the flu</a> because it doesn’t contain live virus. Unfortunately, that myth is really sticky. For <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.15235">some parents</a>, the challenge can be forgetting to book or accessing an appointment. <h2>It’s not just kids at higher risk</h2> Adults aged 65 and over are also <a href="https://theconversation.com/im-over-65-and-worried-about-the-flu-which-vaccine-should-i-have-204810">more vulnerable</a> to the flu, and can receive a <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">free vaccine</a>. For this group, we usually get around <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/historical-national-influenza-vaccination-coverage-end-year-age">65% vaccinated</a>. So far this year, <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/national-influenza-vaccination-coverage-all-people-age-group">around 35%</a> of over-65s have received their flu vaccine. Aboriginal and Torres Strait Islander people are likewise eligible for a free flu vaccine. While previously coverage rates were higher among Aboriginal and Torres Strait Islander peoples compared to the overall population, this gap has narrowed. There’s even some movement backwards, especially <a href="https://ncirs.org.au/influenza-vaccination-coverage-data/historical-national-influenza-vaccination-coverage-end-year-age">in younger age groups</a>. The flu vaccine is also free for pregnant women and anyone who has <a href="https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/immunisation-for-people-with-medical-risk-conditions">a medical condition</a> such as heart disease, chronic lung disease, diabetes or kidney disease. Past studies have found flu vaccine coverage <a href="https://www.phrp.com.au/wp-content/uploads/2022/06/PHRP31232111.pdf">for pregnant women</a> varies around the country from 39% to 76% (meaning in some jurisdictions up to 60% of pregnant women are not getting vaccinated). When it comes to adults with chronic health conditions, we don’t have a good sense of how many people receive the vaccine. The reasons adults don’t always get the flu vaccine overlap with the reasons for children. Often <a href="https://www.tandfonline.com/doi/full/10.1080/08870446.2021.1957104">concerns about side effects</a> are cited as the reason for not getting vaccinated, followed by time constraints. We also know <a href="https://www.aihw.gov.au/reports/primary-health-care/coordination-of-health-care-experiences-barriers/summary">accessing medical services</a> can be difficult for some people, such as those living in rural areas or experiencing financial hardship. <h2>Filling the gaps</h2> In Australia, GPs offer flu vaccines for all ages, while flu vaccination is also available at pharmacies, generally from age five and up. While some people make a conscious decision not to get themselves or their children vaccinated, for many people, the barriers are related to access. Programs offering vaccination outside the doctor’s office are increasing globally, and may assist in <a href="https://www.tandfonline.com/doi/full/10.1080/14760584.2019.1698955">filling gaps</a>, especially among those who don’t have regular access to a GP. For some people, their only point of contact with the <a href="https://pubmed.ncbi.nlm.nih.gov/34272104/">medical system</a> may be during emergency department visits. Others may have more regular contact with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046372/">specialist</a> who coordinates their medical care, rather than a GP. Offering vaccine education and programs <a href="https://journals.sagepub.com/doi/10.1177/0009922810374353">in these settings</a> has been shown to improve immunisation rates and may play a pivotal role in filling access gaps. Outside medical and pharmacy settings, the workplace is the most common place for Australian adults to receive their flu vaccine. A <a href="https://www.sciencedirect.com/science/article/pii/S1326020023004272">survey</a> showed Australian adults find workplace vaccination convenient and cost-effective, especially where free or subsidised vaccines are offered. Expanding vaccination settings, such as with <a href="https://journals.sagepub.com/doi/10.1177/19375867221087360?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">drive-through</a> and mobile clinics, can benefit groups who have unique access barriers or are under-served. Meanwhile, offering vaccination through faith-based organisations has been shown to improve uptake among <a href="https://pubmed.ncbi.nlm.nih.gov/37013523/">racial and ethnic minority groups</a>. Eleftheria Lentakis, a masters student at the School of Population Health at UNSW Sydney, contributed to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229477/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/holly-seale-94294">Holly Seale</a>, Associate Professor, School of Population Health, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/too-many-australians-arent-getting-a-flu-vaccine-why-and-what-can-we-do-about-it-229477">original article</a>. </div>

Body

"I love you all": Social media star announces her own death

Social media star Kimberley Nix has passed away at the age of 31 after a gruelling battle with cancer, and has announced the news of her own death to her dedicated followers. The TikTok star, who has amassed a following of 143,000 people as she documented her cancer journey, spoke candidly in a pre-filmed video that was posted to her page, letting her followers know that her "journey here is over". Kimberley, who was also a doctor in training, told her fans that if they were seeing the heartbreaking clip, that she had "passed", before sharing that they had made her "so happy". She captioned the viral video, which has so far amassed more than 5.1 million views, "My journey here is over and I can't thank each and every one of you enough. You have all made me so happy and your comments and support are more than enough to have gotten anyone through anything!" "If you wish, please donate through my link in bio to sarcoma cancer research and follow my husband [Michael MacIsaac] in his updates." At the beginning of the clip, Kimberley said, "Hello followers, if you're seeing this clip, I have passed away peacefully. " Holding back tears, she said that she had a "very beautiful life" that she was "so proud" of. "Those who know me, know I love my pets, my husband, and makeup. And though being a doctor is a big part of my identity, those are the things that matter," she said during the heartbreaking clip. Kim went on to note that in 2021 she got the "opportunity to start making TikTok videos", admitting that she "never thought anything would come of it". "I shared about love, joy, and gratitude because in this journey, I was grateful for the people and the little moments." "Those little parts of your day, like that warm first sip of tea in the morning or how it feels when snow is fresh on your face, those are the most beautiful [moments]." At the end of the clip, she thanked her followers for helping her and said that they meant the world to her. "I can't thank you enough, I will miss you TikTok. I love you all. Thank you for this amazing opportunity, I am in happy tears because I have found so much purpose in the end of my life," she said. "Thank you from the bottom of my heart, goodbye." Kimberley was diagnosed with metastatic sarcoma, which is known as cell cancer, at just 28 years old, and she was finishing up her final year of her internal medicine core residency when she got the diagnosis. She is survived by her husband Michael, who she married in February. Image credits: TikTok

Caring

Not all ultra-processed foods are bad for your health, whatever you might have heard

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/gary-sacks-3957">Gary Sacks</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-backholer-10739">Kathryn Backholer</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-bradbury-1532662">Kathryn Bradbury</a>, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a>, and <a href="https://theconversation.com/profiles/sally-mackay-1532685">Sally Mackay</a>, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a> In recent years, there’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036430/">increasing</a> <a href="https://theconversation.com/ultra-processed-foods-heres-what-the-evidence-actually-says-about-them-220255#:%7E:text=Hype%20around%20ultra%2Dprocessed%20food,or%20worry%20about%20their%20health.">hype</a> about the potential health risks associated with so-called “ultra-processed” foods. But new evidence published <a href="https://www.bmj.com/content/385/bmj-2023-078476">this week</a> found not all “ultra-processed” foods are linked to poor health. That includes the mass-produced wholegrain bread you buy from the supermarket. While this newly published research and associated <a href="https://www.bmj.com/content/385/bmj.q793">editorial</a> are unlikely to end the wrangling about how best to define unhealthy foods and diets, it’s critical those debates don’t delay the implementation of policies that are likely to actually improve our diets. <h2>What are ultra-processed foods?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">Ultra-processed foods</a> are industrially produced using a variety of processing techniques. They typically include ingredients that can’t be found in a home kitchen, such as preservatives, emulsifiers, sweeteners and/or artificial colours. Common examples of ultra-processed foods include packaged chips, flavoured yoghurts, soft drinks, sausages and mass-produced packaged wholegrain bread. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719194/#CR13">many other countries</a>, ultra-processed foods make up a large proportion of what people eat. A <a href="https://pubmed.ncbi.nlm.nih.gov/31676952/">recent study</a> estimated they make up an average of 42% of total energy intake in Australia. <h2>How do ultra-processed foods affect our health?</h2> Previous <a href="https://pubmed.ncbi.nlm.nih.gov/33167080/">studies</a> have linked increased consumption of ultra-processed food with poorer health. High consumption of ultra-processed food, for example, has been associated with a <a href="https://pubmed.ncbi.nlm.nih.gov/38418082/">higher risk</a> of type 2 diabetes, and death from heart disease and stroke. Ultra-processed foods are typically high in energy, added sugars, salt and/or unhealthy fats. These have long been <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">recognised</a> as risk factors for a range of diseases. It has also been suggested that structural changes that happen to ultra-processed foods as part of the manufacturing process <a href="https://pubmed.ncbi.nlm.nih.gov/31105044/">may</a> lead you to eat more than you should. Potential explanations are that, due to the way they’re made, the foods are quicker to eat and more palatable. It’s also <a href="https://pubmed.ncbi.nlm.nih.gov/35952706/">possible</a> certain food additives may impair normal body functions, such as the way our cells reproduce. <h2>Is it harmful? It depends on the food’s nutrients</h2> The <a href="https://www.bmj.com/content/385/bmj-2023-078476">new paper</a> just published used 30 years of data from two large US cohort studies to evaluate the relationship between ultra-processed food consumption and long-term health. The study tried to disentangle the effects of the manufacturing process itself from the nutrient profile of foods. The study found a small increase in the risk of early death with higher ultra-processed food consumption. But importantly, the authors also looked at diet quality. They found that for people who had high quality diets (high in fruit, vegetables, wholegrains, as well as healthy fats, and low in sugary drinks, salt, and red and processed meat), there was no clear association between the amount of ultra-processed food they ate and risk of premature death. This suggests overall diet quality has a stronger influence on long-term health than ultra-processed food consumption. When the researchers analysed ultra-processed foods by sub-category, mass-produced wholegrain products, such as supermarket wholegrain breads and wholegrain breakfast cereals, were not associated with poorer health. This finding matches another recent <a href="https://pubmed.ncbi.nlm.nih.gov/38417577/">study</a> that suggests ultra-processed wholegrain foods are not a driver of poor health. The authors concluded, while there was some support for limiting consumption of certain types of ultra-processed food for long-term health, not all ultra-processed food products should be universally restricted. <h2>Should dietary guidelines advise against ultra-processed foods?</h2> Existing national <a href="https://www.eatforhealth.gov.au/sites/default/files/2022-09/n55_australian_dietary_guidelines.pdf">dietary</a> <a href="https://www.health.govt.nz/system/files/documents/publications/eating-activity-guidelines-new-zealand-adults-updated-2020-oct22.pdf">guidelines</a> have been developed and refined based on decades of nutrition evidence. Much of the recent evidence related to ultra-processed foods tells us what we already knew: that products like soft drinks, alcohol and processed meats are bad for health. Dietary guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/35184508/">generally</a> already advise to eat mostly whole foods and to limit consumption of highly processed foods that are high in refined grains, saturated fat, sugar and salt. But some nutrition researchers have <a href="https://www.bmj.com/content/384/bmj.q439">called</a> for dietary guidelines to be amended to recommend avoiding ultra-processed foods. Based on the available evidence, it would be difficult to justify adding a sweeping statement about avoiding all ultra-processed foods. Advice to avoid all ultra-processed foods would likely unfairly impact people on low-incomes, as many ultra-processed foods, such as supermarket breads, are relatively affordable and convenient. Wholegrain breads also provide important nutrients, such as fibre. In many countries, bread is the <a href="https://www.health.govt.nz/system/files/documents/publications/a-focus-on-nutrition-ch3_0.pdf">biggest contributor</a> to fibre intake. So it would be problematic to recommend avoiding supermarket wholegrain bread just because it’s ultra-processed. <h2>So how can we improve our diets?</h2> There is strong <a href="https://www.foodpolicyindex.org.au/_files/ugd/7ee332_a2fa1694e42f423195caf581044fccf1.pdf">consensus</a> on the need to implement evidence-based policies to improve population diets. This includes legislation to restrict children’s exposure to the marketing of unhealthy foods and brands, mandatory Health Star Rating nutrition labelling and taxes on sugary drinks. These policies are underpinned by <a href="https://pubmed.ncbi.nlm.nih.gov/37659696/">well-established systems</a> for classifying the healthiness of foods. If new evidence unfolds about mechanisms by which ultra-processed foods drive health harms, these classification systems can be updated to reflect such evidence. If specific additives are found to be harmful to health, for example, this evidence can be incorporated into existing nutrient profiling systems, such as the <a href="http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/content/home">Health Star Rating</a> food labelling scheme. Accordingly, policymakers can confidently progress food policy implementation using the tools for classifying the healthiness of foods that we already have. Unhealthy diets and obesity are among the <a href="https://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-study-2018-key-findings/contents/key-findings">largest contributors</a> to poor health. We can’t let the hype and academic debate around “ultra-processed” foods delay implementation of globally recommended policies for improving population diets.<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/229493/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gary-sacks-3957">Gary Sacks</a>, Professor of Public Health Policy, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-backholer-10739">Kathryn Backholer</a>, Co-Director, Global Centre for Preventive Health and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-bradbury-1532662">Kathryn Bradbury</a>, Senior Research Fellow in the School of Population Health, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a>, and <a href="https://theconversation.com/profiles/sally-mackay-1532685">Sally Mackay</a>, Senior Lecturer Epidemiology and Biostatistics, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</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/not-all-ultra-processed-foods-are-bad-for-your-health-whatever-you-might-have-heard-229493">original article</a>. </div>

Food & Wine

Yes, adults can develop food allergies. Here are 4 types you need to know about

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> If you didn’t have food allergies as a child, is it possible to develop them as an adult? The short answer is yes. But the reasons why are much more complicated. Preschoolers are about <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">four times more likely to have a food allergy</a> than adults and are more likely to grow out of it as they get older. It’s hard to get accurate figures on adult food allergy prevalence. The Australian National Allergy Council reports <a href="https://nationalallergycouncil.org.au/about-us/our-strategy">one in 50 adults</a> have food allergies. But a US survey suggested as many as <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">one in ten adults</a> were allergic to at least one food, with some developing allergies in adulthood. <h2>What is a food allergy</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">Food allergies</a> are immune reactions involving <a href="https://www.aaaai.org/tools-for-the-public/allergy,-asthma-immunology-glossary/immunoglobulin-e-(ige)-defined">immunoglobulin E (IgE)</a> – an antibody that’s central to triggering allergic responses. These are known as “IgE-mediated food allergies”. Food allergy symptoms that are not mediated by IgE are usually delayed reactions and called <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">food intolerances or hypersensitivity</a>. Food allergy symptoms can include hives, swelling, difficulty swallowing, vomiting, throat or chest tightening, trouble breathing, chest pain, rapid heart rate, dizziness, low blood pressure or <a href="https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines?highlight=WyJhbmFwaHlsYXhpcyJd">anaphylaxis</a>. IgE-mediated food allergies can be life threatening, so all adults need an <a href="https://allergyfacts.org.au/allergy-management/newly-diagnosed/action-plan-essentials">action management plan</a> developed in consultation with their medical team. Here are four IgE-mediated food allergies that can occur in adults – from relatively common ones to rare allergies you’ve probably never heard of. <h2>1. Single food allergies</h2> The most <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">common IgE-mediated food allergies</a> in adults in a US survey were to: <ul> <li>shellfish (2.9%)</li> <li>cow’s milk (1.9%)</li> <li>peanut (1.8%)</li> <li>tree nuts (1.2%)</li> <li>fin fish (0.9%) like barramundi, snapper, salmon, cod and perch.</li> </ul> In these adults, about 45% reported reacting to multiple foods. This compares to <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">most common childhood food allergies</a>: cow’s milk, egg, peanut and soy. Overall, adult food allergy prevalence appears to be increasing. Compared to <a href="https://pubmed.ncbi.nlm.nih.gov/14657884/">older surveys published in 2003</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/15241360/">2004</a>, peanut allergy prevalence has increased about three-fold (from 0.6%), while tree nuts and fin fish roughly doubled (from 0.5% each), with shellfish similar (2.5%). While new <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">adult-onset food allergies are increasing</a>, childhood-onset food allergies are also more likely to be retained into adulthood. Possible reasons for both <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">include</a> low vitamin D status, lack of immune system challenges due to being overly “clean”, heightened sensitisation due to allergen avoidance, and more frequent antibiotic use. <h2>2. Tick-meat allergy</h2> Tick-meat allergy, also called α-Gal syndrome or mammalian meat allergy, is an allergic reaction to galactose-alpha-1,3-galactose, or α-Gal for short. <a href="https://pubmed.ncbi.nlm.nih.gov/33529984/">Australian immunologists first reported</a> links between α-Gal syndrome and tick bites in 2009, with cases also reported in the United States, Japan, Europe and South Africa. The <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">US Centers for Disease Control estimates</a> about 450,000 Americans <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm">could be affected</a>. The α-Gal contains a carbohydrate molecule that is bound to a <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">protein</a> molecule in <a href="https://alphagalinformation.org/what-is-a-mammal/">mammals</a>. The IgE-mediated allergy is triggered after repeated bites from ticks or <a href="https://www.insectshield.com/pages/chiggers">chigger mites</a> that have bitten those mammals. When tick saliva crosses into your body through the bite, antibodies to α-Gal are produced. When you subsequently eat foods that contain α-Gal, the allergy is triggered. These triggering foods include meat (lamb, beef, pork, rabbit, kangaroo), dairy products (yoghurt, cheese, ice-cream, cream), <a href="https://en.wikipedia.org/wiki/Gelatin">animal-origin gelatin</a> added to gummy foods (jelly, lollies, marshmallow), prescription medications and over-the counter supplements containing gelatin (<a href="https://www.drugs.com/inactive/gelatin-57.html">some antibiotics, vitamins and other supplements</a>). Tick-meat allergy reactions can be hard to recognise because they’re usually delayed, and they can be severe and include anaphylaxis. Allergy <a href="https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq">organisations produce management guidelines</a>, so always discuss management with your doctor. <h2>3. Fruit-pollen allergy</h2> Fruit-pollen allergy, called pollen food allergy syndrome, is an <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">IgE-mediated allergic reaction</a>. In susceptible adults, pollen in the air provokes the production of IgE antibodies to antigens in the pollen, but these antigens are similar to ones found in some fruits, vegetables and herbs. The problem is that <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">eating those plants</a> triggers an allergic reaction. The <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">most allergenic tree pollens</a> are from birch, cypress, Japanese cedar, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/latex-allergy">latex</a>, grass, and ragweed. Their pollen can cross-react with <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">fruit and vegetables</a>, including kiwi, banana, mango, avocado, grapes, celery, carrot and potato, and some herbs such as caraway, coriander, fennel, pepper and paprika. Fruit-pollen allergy is not common. Prevalence <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">estimates are between 0.03% and 8%</a> depending on the country, but it can be life-threatening. Reactions range from itching or tingling of lips, mouth, tongue and throat, called <a href="https://pubmed.ncbi.nlm.nih.gov/20306812/">oral allergy syndrome</a>, to mild <a href="https://www.allergy.org.au/patients/skin-allergy/urticaria-hives">hives</a>, to anaphylaxis. <h2>4. Food-dependent, exercise-induced food allergy</h2> During heavy exercise, the stomach produces less acid than usual and gut permeability increases, meaning that small molecules in your gut are more likely to escape across the membrane into your blood. These include food molecules that trigger an IgE reaction. If the person already has IgE antibodies to the foods eaten before exercise, then the risk of triggering food allergy reactions is increased. This allergy is called <a href="https://pubmed.ncbi.nlm.nih.gov/37893663/">food-dependent exercise-induced allergy</a>, with symptoms ranging from hives and swelling, to difficulty breathing and anaphylaxis. <a href="https://pubmed.ncbi.nlm.nih.gov/30601082/">Common trigger foods include</a> wheat, seafood, meat, poultry, egg, milk, nuts, grapes, celery and other foods, which could have been eaten many hours before exercising. To complicate things even further, allergic <a href="https://pubmed.ncbi.nlm.nih.gov/33181008/">reactions can</a> occur at lower levels of trigger-food exposure, and be more severe if the person is simultaneously taking non-steroidal inflammatory medications like aspirin, drinking alcohol or is sleep-deprived. Food-dependent exercise-induced allergy is extremely rare. Surveys have estimated prevalence as between <a href="https://www.sciencedirect.com/science/article/pii/S1555415517300259">one to 17 cases per 1,000 people worldwide</a> with the highest prevalence between the teenage years to age 35. Those affected often have other allergic conditions such as hay fever, asthma, allergic conjunctivitis and dermatitis. <h2>Allergies are a growing burden</h2> The <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">burden on physical health, psychological health</a> and health costs due to food allergy is increasing. In the US, this <a href="https://pubmed.ncbi.nlm.nih.gov/38393624/">financial burden was estimated as $24 billion per year</a>. Adult food allergy needs to be taken seriously and those with severe symptoms should wear a medical information bracelet or chain and carry an <a href="https://www.healthdirect.gov.au/how-to-use-an-adrenaline-autoinjector-epipen-anapen">adrenaline auto-injector pen</a>. Concerningly, surveys suggest only <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">about one in four adults</a> with food allergy have an adrenaline pen. If you have an IgE-mediated food allergy, discuss your management plan with your doctor. You can also find more information at <a href="https://allergyfacts.org.au/">Allergy and Anaphylaxis Australia</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/223342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <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/yes-adults-can-develop-food-allergies-here-are-4-types-you-need-to-know-about-223342">original article</a>. </div>

Body

Vitamins and supplements: what you need to know before taking them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neelaveni-padayachee-1018709">Neelaveni Padayachee</a>, <a href="https://theconversation.com/institutions/university-of-the-witwatersrand-894">University of the Witwatersrand</a> and <a href="https://theconversation.com/profiles/varsha-bangalee-1253468">Varsha Bangalee</a>, <a href="https://theconversation.com/institutions/university-of-kwazulu-natal-1941">University of KwaZulu-Natal</a> If you were to open your medicine cabinet right now, there’s a fair chance that you’d find at least one bottle of vitamins alongside the painkillers, plasters and cough syrup. After all, people are definitely buying vitamins: in 2020, the global market for complementary and alternative medicines, which includes multivitamin supplements, had an estimated value of <a href="https://www.grandviewresearch.com/industry-analysis/complementary-alternative-medicine-market">US$82.27 billion</a>. The use of natural health products such as minerals and amino acids has <a href="https://journals.lww.com/nutritiontodayonline/Abstract/2007/03000/Why_People_Use_Vitamin_and_Mineral_Supplements.4.aspx">increased</a> – and continues to rise, partly driven by consumers’ buying habits during the COVID-19 pandemic. People <a href="https://www.businesslive.co.za/bd/companies/healthcare/2021-02-08-native-sales-of-sas-vitamins-and-nutritional-supplements-boom/">sought out</a> vitamins C and D, as well as zinc supplements, as potential preventive measures against the virus – even though the <a href="https://www.health.harvard.edu/blog/do-vitamin-d-zinc-and-other-supplements-help-prevent-covid-19-or-hasten-healing-2021040522310">evidence</a> for their efficacy was, and <a href="https://pubmed.ncbi.nlm.nih.gov/35888660/#:%7E:text=Concluding%2C%20available%20data%20on%20the,trials%20(RCTs)%20are%20inconsistent">remains</a>, inconclusive. Multivitamins and mineral supplements are easily accessible to consumers. They are often marketed for their health claims and benefits – sometimes unsubstantiated. But their potential adverse effects are not always stated on the packaging. Collectively, vitamins and minerals are known as micronutrients. They are essential elements needed for our bodies to function properly. Our bodies can only produce micronutrients in small amounts or not at all. We get the bulk of these nutrients <a href="https://www.iprjb.org/journals/index.php/IJF/article/view/1024">from our diets</a>. People usually buy micronutrients to protect against disease or as dietary “insurance”, in case they are not getting sufficient quantities from their diets. There’s a common perception that these supplements are harmless. But they can be dangerous at incorrect dosages. They provide a false sense of hope, pose a risk of drug interactions – and can delay more effective treatment. <h2>Benefits</h2> Vitamins are beneficial if taken for the correct reasons and as prescribed by your doctor. For example, folic acid supplementation in pregnant women has been shown to prevent neural tube defects. And individuals who reduce their intake of red meat without increasing legume consumption require a vitamin B6 supplement. But a worrying trend is increasing among consumers: intravenous vitamin therapy, which is often punted by celebrities and social media marketing. Intravenous vitamins, nutrients and fluids are administered at pharmacies as well as beauty spas, and more recently “<a href="https://www.health.harvard.edu/blog/drip-bar-should-you-get-an-iv-on-demand-2018092814899">IV bars</a>”. Users believe these treatments can quell a cold, slow the effects of ageing, brighten skin, fix a hangover or just make them feel well. Intravenous vitamin therapy was previously only used in medical settings to help patients who could not swallow, needed fluid replacements or had an electrolyte imbalance. However, the evidence to support other benefits of intravenous vitamin therapy is limited. No matter how you choose to get additional vitamins, there are risks. <h2>Warning bells</h2> Most consumers use multivitamins. But others take large doses of single nutrients, especially vitamin C, iron and calcium. As lecturers in pharmacy practice, we think it’s important to highlight the potential adverse effects of commonly used vitamins and minerals: <ul> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-a/">Vitamin A/retinol</a> is beneficial in maintaining good eye health. But it can cause toxicity if more than 300,000IU (units) is ingested. Chronic toxicity (hypervitaminosis) has been <a href="https://www.ncbi.nlm.nih.gov/books/NBK532916/">associated</a> with doses higher than 10,000IU a day. Symptoms include liver impairment, loss of vision and intracranial hypertension. It can cause birth defects in pregnant women. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/niacin-vitamin-b3/">Vitamin B3</a> is beneficial for nervous and digestive system health. At moderate to high doses it can cause peripheral vasodilation (widening or dilating of the blood vessels at the extremities, such as the legs and arms), resulting in skin flushing, burning sensation, pruritis (itchiness of the skin) and hypotension (low blood pressure). </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-b6/">Vitamin B6</a> is essential for brain development and in ensuring that the immune system remains healthy. But it can result in damage to the peripheral nerves, such as those in the hands and feet (causing a sensation of numbness and often referred to as pins and needles) at doses over 200mg/daily. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-c/">Vitamin C</a> is an antioxidant and assists in the repair of body tissue. Taken in high doses it can cause kidney stones and interactions with drugs, such as the oncology drugs doxorubicin, methotrexate, cisplatin and vincristine. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-d/">Vitamin D</a> is essential for bone and teeth development. At high doses it can cause hypercalcaemia (calcium level in the blood is above normal) that results in thirst, excessive urination, seizures, coma and death. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/calcium/#:%7E:text=Calcium%20is%20a%20mineral%20most,heart%20rhythms%20and%20nerve%20functions">Calcium</a> is essential for bone health, but can cause constipation and gastric reflux. High doses can cause hypercalciuria (increased calcium in the urine), kidney stones and secondary hypoparathyroidism (underactive parathyroid gland). It can have drug interactions with zinc, magnesium and iron. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/magnesium/">Magnesium</a> is important for muscle and nerve functioning. At high doses it can cause diarrhoea, nausea and abdominal cramping, and can interact with tetracyclines (antibiotics). </li> <li> Zinc <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781367/">can impair</a> taste and smell, and doses over 80mg daily have been <a href="https://link.springer.com/article/10.1007/s10654-022-00922-0#:%7E:text=Zinc%20supplementation%20of%20more%20than,zinc%20supplements%20among%20adult%20men.">shown</a> to have adverse prostate effects. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/selenium/">Selenium</a> can cause hair and nail loss or brittleness, lesions of the skin and nervous system, skin rashes, fatigue and mood irritability at high doses. </li> <li> <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364#:%7E:text=Expert%20guidelines%20for%20oral%20iron%20supplementation&text=Traditionally%2C%20the%20recommended%20daily%20dose,iron%20(Brittenham%2C%202018).">Iron</a> at 100-200mg/day can cause constipation, black faeces, black discoloration of teeth and abdominal pain. </li> </ul> <h2>Recommendations</h2> People need to make <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377299/">informed decisions</a> based on evidence before consuming health products. Regular exercise and a well-balanced diet are more likely to do us good, as well as being lighter on the pocket. Seeking advice from a healthcare professional before consuming supplements can reduce the risk of adverse effects. Be aware of the potential adverse effects of vitamins and seek a healthcare professional’s guidance if you have symptoms.<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/198345/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neelaveni-padayachee-1018709">Neelaveni Padayachee</a>, Senior Lecturer, Department of Pharmacy and Pharmacology, <a href="https://theconversation.com/institutions/university-of-the-witwatersrand-894">University of the Witwatersrand</a> and <a href="https://theconversation.com/profiles/varsha-bangalee-1253468">Varsha Bangalee</a>, Associate Professor, Pharmaceutical Sciences, <a href="https://theconversation.com/institutions/university-of-kwazulu-natal-1941">University of KwaZulu-Natal</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/vitamins-and-supplements-what-you-need-to-know-before-taking-them-198345">original article</a>. </div>

Body

Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/diny-thomson-1519736">Diny Thomson</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”. Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members. Since as early as the <a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">19th century</a>, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals. It is estimated <a href="https://pubmed.ncbi.nlm.nih.gov/20010032/">43% of people</a> who experience this brief lucidity die within 24 hours, and 84% within a week. Why does this happen? <h2>Terminal lucidity or paradoxical lucidity?</h2> In 2009, researchers Michael Nahm and Bruce Greyson coined the term “<a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">terminal lucidity</a>”, since these lucid episodes often occurred shortly before death. But not all lucid episodes indicate death is imminent. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13667">One study</a> found many people with advanced dementia will show brief glimmers of their old selves more than six months before death. Lucidity has also been <a href="https://www.sciencedirect.com/science/article/pii/S0167494311001865?via%3Dihub">reported</a> in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury. Moments of lucidity that do not necessarily indicate death are sometimes called <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12579">paradoxical lucidity</a>. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia. But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease. <h2>Why does terminal lucidity happen?</h2> Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that <a href="https://psywb.springeropen.com/articles/10.1186/s13612-014-0024-5">music can sometimes improve lucidity</a>. But many episodes of lucidity do not have a distinct trigger. <a href="https://www.sciencedirect.com/science/article/pii/S0300957223002162">A research team from New York University</a> speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost. Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger. And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred. Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife. <h2>Why is it important to know about terminal lucidity?</h2> People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person. Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person. For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.<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/202342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/diny-thomson-1519736">Diny Thomson</a>, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, <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/terminal-lucidity-why-do-loved-ones-with-dementia-sometimes-come-back-before-death-202342">original article</a>. </div>

Mind

7 things you need to know about fear

Fear is an emotion that can be debilitating and unsettling. But it is a natural part of life and we are hardwired to experience it. 1. Fear can protect you Experiencing fear elicits responses from your brain to your limbs. It is the body’s natural way of protecting itself. For our ancestors the fear was often more physical – such as being chased by a lion. Modern fear can range from physical danger (such as a spider or an intruder) or even from perceived danger (such as the worry that something will happen to our partner or child). Feeling fear doesn’t make you a weak person. In fact, not feeling any fear could mean that there are neurological issues present. 2. There are many levels of fear Not everything that we fear is intense and paralysing. It can range from low levels of fear (such as worry about being robbed), to medium levels of fear (say if a loved one is in hospital) to high levels of fear (you are being chased by an attacker). Fear can also become stronger when we hear about events such as a terrorist attack or a natural disaster. It all relates back to how much the scary event will impact our lives. 3. Fear is not just instinctive We become fearful due to three main factors: instinct, learning, and teaching. An example of instinctual fear is pain – we learn to be fearful of things that hurt us. Learned fear comes from being exposed to unpleasant or uncomfortable things and wanting to avoid them in the future. For instance, having a relative die in a car crash could make you fearful of driving in the future. Other fears are taught to us by our family, friends and even society. For example, some religions teach us to be fearful of other religions or customs. 4. Fear can arise without a real threat of danger Fear can also be imagined, so it can be felt even when there is no danger present. If we feel this all the time it can lead to anxiety and depression. It’s important to think about whether the thing you are fearful of is real or likely to happen before you give it too much airtime. 5. Fear produces fear If you are already in a state of fear, your response to more fear is heightened. For instance if you are watching a scary movie, a small noise from the next room could make you jump and scream. Your senses are on red alert, primed to act if the need arises. 6. Fear leads to action Depending on the individual and the level of fear they are experiencing, there tend to be four main types of action as a result of fear: freeze, fight, flight, or fright. When you freeze it means you don’t move while you decide what to do (for instance you see a snake in your garden). From there you choose either fight (grab a shovel) or flight mode (walk away). If the fear is too much you might experience fright, where you do nothing and take no action (stand there screaming or worrying). 7. Real threats can lead to heroic actions Imagined threats can cause us to live in a permanent state of fear and stress. But often we will do nothing about it (for instance being worried about sharks attacking us in the ocean). Compare this to the threat from a real and identifiable source, which will make you spring into action almost immediately. Often we don’t even make the decision to act, it just happens automatically (such as moving a child out of the way of an approaching car). Image credits: Getty Images

Mind

How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a> People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">good sleep is imperative</a>. However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health? <a href="https://link.springer.com/article/10.1007/s00125-024-06145-0">Our research</a> attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each. <iframe id="dw4bx" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/dw4bx/" width="100%" height="400px" frameborder="0"></iframe> <h2>Finding the right balance</h2> Current health guidelines recommend you stick to a <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">sensible regime</a> of moderate-to vigorous-intensity physical activity 2.5–5 hours per week. However <a href="https://doi.org/10.1016/j.jacc.2019.02.031">mounting evidence</a> now <a href="https://doi.org/10.2337/dc14-2073">suggests</a> how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping. Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours. At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model. Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity. When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk. <h2>You’re doing more physical activity than you think</h2> We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise. Our experimental evidence shows that <a href="https://diabetesjournals.org/care/article/39/6/964/29532/Benefits-for-Type-2-Diabetes-of-Interrupting">interrupting our sitting</a> regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch. While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk. It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies. The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time. <h2>Australia’s adult physical activity guidelines need updating</h2> Australia’s <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">physical activity guidelines</a> currently only recommend exercise intensity and time. A <a href="https://www.uow.edu.au/media/2023/why-adults-need-to-move-more-stop-sitting-and-sleep-better-.php">new set of guidelines</a> are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements. While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night. Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening. It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.<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/228894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, Postdoctoral research fellow at Swinburne University, Centre for Urban Transitions, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-time-should-you-spend-sitting-versus-standing-new-research-reveals-the-perfect-mix-for-optimal-health-228894">original article</a>. </div>

Body

What are heart rate zones, and how can you incorporate them into your exercise routine?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537749/">Heart rate zones</a> reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute. But what are the different heart rate zones, and how can you use these zones to optimise your workout? <h2>The three-zone model</h2> While there are several models used to describe heart rate zones, the most common model in the scientific literature is the <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">three-zone model</a>, where the zones may be categorised as follows: <ul> <li> zone 1: 55%–82% of maximum heart rate </li> <li> zone 2: 82%–87% of maximum heart rate </li> <li> zone 3: 87%–97% of maximum heart rate. </li> </ul> If you’re not sure what your maximum heart rate is, it can be calculated using <a href="https://www.jacc.org/doi/full/10.1016/S0735-1097%2800%2901054-8">this equation</a>: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute. There are also other models used to describe heart rate zones, such as the <a href="https://journals.humankinetics.com/view/journals/ijspp/14/8/article-p1151.xml">five-zone model</a> (as its name implies, this one has five distinct zones). These <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">models</a> largely describe the same thing and can mostly be used interchangeably. <h2>What do the different zones involve?</h2> The three zones are based around a person’s <a href="https://link.springer.com/article/10.2165/00007256-200939060-00003">lactate threshold</a>, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic. Aerobic exercise <a href="https://www.healthline.com/health/fitness-exercise/difference-between-aerobic-and-anaerobic">uses oxygen</a> to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time. On average your lactate threshold tends to sit around <a href="https://www.tandfonline.com/doi/full/10.2147/OAJSM.S141657">85% of your maximum heart rate</a>, although this varies from person to person, and can be <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00043.2013">higher in athletes</a>. In the three-zone model, each zone loosely describes <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2015.00295/full">one of three types of training</a>. Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace. Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences. Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3. <h2>Striking a balance</h2> To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout. While zone 3 is thought to produce the largest improvements in <a href="https://www.sciencedirect.com/science/article/pii/S1440244018309198">maximal oxygen uptake</a> – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much. Training in different heart rate zones improves <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=38c07018c0636422d9d5a77316216efb3c10164f">slightly different physiological qualities</a>, and so by spending time in each zone, you ensure a <a href="https://link.springer.com/article/10.1007/bf00426304">variety of benefits</a> for performance and health. <h2>So how much time should you spend in each zone?</h2> Most <a href="https://www.frontiersin.org/articles/10.3389/fspor.2023.1258585/full">elite endurance athletes</a>, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3. Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate <a href="https://journals.humankinetics.com/view/journals/ijsnem/22/5/article-p392.xml?content=pdf">more than 250 kilometres per week</a>, which would be impossible to recover from if it was all performed in zone 2 or 3. Of course, most people are not professional athletes. The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization</a> recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week. If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines. <h2>What if I don’t have a heart rate monitor?</h2> If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training. The three heart rate zones discussed in this article can also be prescribed based on feel using a simple <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2004.00418.x">10-point scale</a>, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce. With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10. Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.<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/228520/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, Lecturer in Exercise Science, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-heart-rate-zones-and-how-can-you-incorporate-them-into-your-exercise-routine-228520">original article</a>. </div>

Body

Australians lose $5,200 a minute to scammers. There’s a simple thing the government could do to reduce this. Why won’t they?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> What if the government was doing everything it could to stop thieves making off with our money, except the one thing that could really work? That’s how it looks when it comes to <a href="https://www.scamwatch.gov.au/types-of-scams">scams</a>, which are attempts to trick us out of our funds, usually by getting us to hand over our identities or bank details or transfer funds. Last year we lost an astonishing <a href="https://www.accc.gov.au/media-release/scam-losses-decline-but-more-work-to-do-as-australians-lose-27-billion">A$2.74 billion</a> to scammers. That’s more than $5,200 per minute – and that’s only the scams we know about from the 601,000 Australians who made reports. Many more would have kept quiet. If the theft of $5,200 per minute seems over the odds for a country Australia’s size, a comparison with the United Kingdom suggests you are right. In 2022, people in the UK lost <a href="https://www.ukfinance.org.uk/system/files/2023-05/Annual%20Fraud%20Report%202023_0.pdf">£2,300</a> per minute, which is about A$4,400. The UK has two and a half times Australia’s population. It’s as if international scammers, using SMS, phone calls, fake invoices and fake web addresses are targeting Australia, because in other places it’s harder. If we want to cut Australians’ losses, it’s time to look at rules about to come into force in the UK. <h2>Scams up 320% since 2020</h2> The current federal government is doing a lot – almost everything it could. Within a year of taking office, it set up the <a href="https://www.accc.gov.au/national-anti-scam-centre">National Anti-Scam Centre</a>, which coordinates intelligence. Just this week, the centre reported that figure of $2.74 billion, which is down 13% on 2022, but up 50% on 2021 and 320% on 2020. It’s planning “<a href="https://treasury.gov.au/consultation/c2023-464732">mandatory industry codes</a>” for banks, telecommunication providers and digital platforms. But the code it is proposing for banks, set out in a <a href="https://treasury.gov.au/sites/default/files/2023-11/c2023-464732-cp.pdf">consultation paper</a> late last year, is weak when compared to overseas. <h2>Banks are the gatekeepers</h2> Banks matter, because they are nearly always the means by which the money is transferred. Cryptocurrency is now much less used after the banks agreed to limit payments to high risk exchanges. Here’s an example of the role played by banks. A woman the Consumer Action Law Centre is calling <a href="https://consumeraction.org.au/wp-content/uploads/2024/02/Joint-submission-CALC-CHOICE-ACCAN-31012024-Scams-Mandatory-code-treasury-consultA.pdf">Amelia</a> tried to sell a breast pump on Gumtree. The buyer asked for her bank card number and a one-time PIN and used the code to whisk out $9,100, which was sent overseas. The bank wouldn’t help because she had provided the one-time PIN. Here’s another. A woman the Competition and Consumer Commission is calling <a href="https://www.accc.gov.au/system/files/Targeting%20scams%202022.pdf">Niamh</a> was contacted by someone using the National Australia Bank’s SMS ID. Niamh was told her account was compromised and talked through how to transfer $300,000 to a “secure” account. After she had done it, the scammer told her it was a scam, laughed and said “we are in Brisbane, come find me”. <h2>How bank rules protect scammers</h2> And one more example. Former University of Melbourne academic <a href="https://www.researchgate.net/publication/377766055_Scams_Blaming_the_Victims">Kim Sawyer</a> (that’s his real name, he is prepared to go public) clicked on an ad for “St George Capital” displaying the dragon logo of St. George Bank. He was called back by a man using the name of a real St. George employee, who persuaded him to transfer funds from accounts at the AMP, Citibank and Macquarie to accounts he was told would be in his and his wife’s name at Westpac, ANZ, the Commonwealth and Bendigo Banks. They lost <a href="https://www.afr.com/wealth/personal-finance/i-lost-2-5m-of-my-super-to-scammers-20240423-p5flzp">$2.5 million</a>. Sawyer says none of the banks – those that sent the funds or those that received them – would help him. Some cited “<a href="https://www.choice.com.au/money/financial-planning-and-investing/stock-market-investing/articles/st-george-capital-investment-scam">privacy</a>” reasons. The Consumer Action Law Centre says the banks that transfer the scammed funds routinely tell their customers “it’s nothing to do with us, you transferred the money, we can’t help you”. The banks receiving the funds routinely say “you’re not our customer, we can’t help you”. That’s here. Not in the UK. <h2>UK bank customers get a better deal</h2> In Australia in 2022, only <a href="https://download.asic.gov.au/media/mbhoz0pc/rep761-published-20-april-2023.pdf">13%</a> of attempted scam payments were stopped by banks before they took place. Once scammed, only 2% to 5% of losses (depending on the bank) were reimbursed or compensated. In <a href="https://www.psr.org.uk/information-for-consumers/app-fraud-performance-data/">the UK</a>, the top four banks pay out 49% to 73%. And they are about to pay out much more. From October 2024, reimbursement will be compulsory. Where authorised fast payments are made “because of deception by fraudsters”, the banks will have to reimburse <a href="https://www.thomsonreuters.com/en-us/posts/investigation-fraud-and-risk/app-fraud-uk">the lot</a>. Normally the bills will be split <a href="https://www.psr.org.uk/news-and-updates/latest-news/news/psr-confirms-new-requirements-for-app-fraud-reimbursement/">50:50</a> between the bank transferring the funds and the bank receiving them. Unless there’s a need for further investigations, the payments must be made within five days. The <a href="https://www.psr.org.uk/media/as3a0xan/sr1-consumer-standard-of-caution-guidance-dec-2023.pdf">only exceptions</a> are where the consumer seeking reimbursement has acted fraudulently or with gross negligence. The idea behind the change – pushed through by the Conservative government now led by UK Prime Minister Rishi Sunak – is that if scams are the banks’ problem, if they are costing them millions at a time, they’ll stop them. <a href="https://www.thepost.co.nz/business/350197309/banks-given-fraud-ultimatum">New Zealand</a> is looking at doing the same thing, <a href="https://www.biocatch.com/blog/mas-shared-responsibility-fraud-losses">as is Singapore</a>. But here, the treasury’s discussion paper on its mandatory codes mentions reimbursement <a href="https://treasury.gov.au/sites/default/files/2023-11/c2023-464732-cp.pdf">only once</a>. That’s when it talks about what’s happening in the UK. Neither treasury nor the relevant federal minister is proposing it here. <h2>Australia’s approach is softer</h2> Assistant Treasurer Stephen Jones is in charge of Australia’s rules. Asked why he wasn’t pushing for compulsory reimbursement here, Jones said on Monday <a href="https://ministers.treasury.gov.au/ministers/stephen-jones-2022/transcripts/interview-mark-gibson-abc-perth">prevention was better</a>. <blockquote> I think a simplistic approach of just saying, ‘Oh, well, if any loss, if anyone incurs a loss, then the bank always pay’, won’t work. It’ll just make Australia a honeypot for these international crime gangs, because they’ll say, well, ‘Let’s, you know, focus all of our activity on Australia because it’s a victimless crime if banks always pay’. </blockquote> Telling banks to pay would certainly focus the minds of the banks, in the way they are about to be focused in the UK. The <a href="https://www.ausbanking.org.au/submissions/">Australian Banking Association</a> hasn’t published its submission to the treasury review, but the <a href="https://consumeraction.org.au/scams-mandatory-industry-codes-consultation-paper/">Consumer Action Law Centre</a> has. It says if banks had to reimburse money lost, they’d have more of a reason to keep it safe. In the UK, they are about to find out. If Jones is right, it might be about to become a honeypot for scammers. If he is wrong, his government will leave Australia even further behind when it comes to scams – leaving us thousands more dollars behind per day.<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/228867/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australians-lose-5-200-a-minute-to-scammers-theres-a-simple-thing-the-government-could-do-to-reduce-this-why-wont-they-228867">original article</a>. </div>

Money & Banking

7 items you should never put in your dryer

There are just some items that can’t take the dryer’s heat. To avoid shrinking and more these are the ones you should never put in the dryer. 1. Bathing suits The dryer will leave the spandex of bathing suits brittle and broken. 2. Pantyhose The delicate material of pantyhose will shrink in the heat of the dryer and the tumbling motion can cause stockings to get tangled. 3. Rubber-backed rugs They may be small enough to fit in your dyer but the rubber-back of these mats might crumble in the heat of the dryer. 4. Bras The heat of the dryer can damage bra’s elasticity and shape. 5. Clothes with embellishments Embellishments can easily snag in a dryer – and also snag other items in the process. 6. Anything that warns against dryers Double-check the care tag of your item of clothing before chucking it in the dryer. If it warns against using the dryer, it’s for good reason. It will help your clothes look new for longer and prevent shrinking and more. 7. Running shoes The heat can ruin the cushioning, weaken adhesive and shrink the rubber. Image credits: Getty Images

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If you have money anxiety, knowing your financial attachment style can help

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ylva-baeckstrom-1463175">Ylva Baeckstrom</a>, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a> The number of people struggling with money in Britain is at a <a href="https://www.theguardian.com/money/2024/mar/18/record-numbers-of-uk-people-in-debt-warns-charity">record high</a>. Financial charities say that people are contacting them for help with debt, paying bills and insolvency. The campaign group Debt Justice found in a <a href="https://debtjustice.org.uk/wp-content/uploads/2024/03/WalnutOmnibus-Debt-Justice-Policy-Development-Weighted.xlsx">survey</a> that 29% of 18- to 24-year-olds and 25% of 25- to 34-year-olds had missed three or more bill payments in the last six months. A majority (65%) of people don’t think they can survive on their savings for three months without <a href="https://www.money.co.uk/savings-accounts/savings-statistics">borrowing money</a>. Statistics from the UK’s financial markets regulator show that more than one-third of UK adults have less than £1,000 in savings. And a survey by Money.co.uk found that 30% of Brits aged 25-64 do not save at all <a href="https://www.pensionsage.com/pa/Nearly-one-third-of-Brits-are-not-saving-for-retirement.php">for retirement</a>. With figures like that, is it any wonder that 75% of people in the UK feel <a href="https://www.mentalhealth.org.uk/about-us/news/financial-strain-driving-uks-anxiety#:%7E:text=Almost%20three%2Dquarters%20of%20the,cited%20job%20insecurity%20or%20unemployment">anxious about money</a>? The current state of the economy is particularly scary for young people. Unless you were born with a trust fund (not most people), you are likely part of the first generation to be financially worse off than <a href="https://edition.cnn.com/2020/01/11/politics/millennials-income-stalled-upward-mobility-us/index.html">your parents</a>. Retirement seems like an impossibility, and you’re unlikely to own your own home. Eighty percent of people in their early 20s worry about <a href="https://www.youngminds.org.uk/parent/parents-a-z-mental-health-guide/money-and-mental-health/#Thelinksbetweenmoneyandmentalhealth">not earning enough</a>. It is important to start planning for your financial future early in your career, but you may find it overwhelming. The good news is, there are ways to overcome this. <h2>Finding your financial attachment style</h2> As a psychotherapist and finance researcher, I work with people to help them to increase their financial confidence and find the motivation to start planning. This often starts with understanding what influences their relationship with money. <a href="https://www.cambridge.org/core/journals/behavioral-and-brain-sciences/article/bowlbyainsworth-attachment-theory/6D35C7A344107195D97FD7ADAE06C807">Attachment theory</a> is a psychological concept introduced in the late 1950s. Your attachment style – which can be, for example, secure, anxious or avoidant – explains how you approach creating emotionally intimate relationships with other people. Some people feel secure building relationships, while others are extremely anxious. Some avoid close relationships altogether. Attachment style can also apply to your finances. If you feel confident and safe when it comes to money, you are secure in your relationship to saving and spending. But if the thought of opening an ISA or filling out a tax return, let alone planning for retirement, fills you with dread and panic, you may be anxiously attached. And if you if you push money worries to the back of your mind, you are likely avoidant. Attachment theorists and psychotherapists like me think that attachment styles are shaped by childhood experiences – for example, how well you were looked after by your parents or carers, and how safe and loved you felt. The way money was handled in your family growing up is likely to have set the blueprint for your <a href="https://www.sciencedaily.com/releases/2020/02/200225114410.htm">financial attachment style</a>. Outside influences like education or work experiences may shape this too. Although financial education is part of the <a href="https://maps.org.uk/en/work-with-us/financial-education-in-schools">school curriculum</a> in the UK, 76% of children leave school without sufficient <a href="https://maps.org.uk/en/media-centre/press-releases/2024/hundreds-of-thousands-leaving-school-without-money-skills#:%7E:text=In%20its%20poll%20of%201%2C012,knowledge%20they%20need%20for%20adulthood">financial knowledge</a> to manage their lives. Similarly, financial services like banks have done a poor job helping people establish secure financial relationships. Complex and <a href="https://www.pwmnet.com/private-view-blog-time-for-the-financial-industry-to-jettison-the-jargon">off-putting language</a> has placed a barrier between those who know about money and those who need to learn. If you feel unable to keep up with financial terms, or that you don’t understand money, this is likely to hurt your confidence in your financial planning abilities and fuel a more avoidant attachment style. Identifying your attachment style can help you nurture a better relationship with money. You will be able to understand and predict how and why you react to finances in certain ways. And, it can provide confidence by reminding you that money struggles are not necessarily your fault. <h2>Getting over financial anxiety</h2> Some of the recent financial trends spreading on social media may give an insight into your attachment style. Are you <a href="https://www.cnbc.com/select/what-is-loud-budgeting-trend-can-it-work/">“loud budgeting”</a> (being vocal about why you aren’t spending money)? This could be a sign of financial confidence and that you have secure financial attachment. Or are you “doom spending” (spending money you don’t have instead of creating a <a href="https://www.theguardian.com/lifeandstyle/2024/jan/31/are-you-loud-budgeting-or-doom-spending-finance-according-to-gen-z">nest egg</a> for the future)? You may be avoidant. Healthy relationships with <a href="https://www.nhs.uk/every-mind-matters/lifes-challenges/maintaining-healthy-relationships-and-mental-wellbeing/#:%7E:text=People%20with%20healthy%2C%20positive%20and,such%20as%20stress%20and%20anxiety">people</a> and <a href="https://www.nhs.uk/every-mind-matters/lifes-challenges/money-worries-mental-health/#:%7E:text=Our%20mental%20health%20might%20be,earning%20enough%20or%20currently%20unemployed">money</a> are both critical for our survival and mental health. As an adult, you have the power to improve these relationships. But because attachment patterns were formed early on, they are difficult to change. Therapy and other support can help you adopt healthier habits, as can increasing your financial knowledge. If you want to change your relationship with money, you should try to be mindful of what may be influencing you. While financial advice on social media may be useful and help young people feel more empowered to <a href="https://www.forbes.com/advisor/investing/financial-advisor/adults-financial-advice-social-media/">talk about money</a>, it can also <a href="https://www.mcleanhospital.org/essential/it-or-not-social-medias-affecting-your-mental-health">increase anxiety further</a> and be <a href="https://theconversation.com/if-you-get-your-financial-advice-on-social-media-watch-out-for-misinformation-222196">full of misinformation</a>. A good place to start for accurate and helpful information is the government’s <a href="https://www.moneyhelper.org.uk/en">Money Helper website</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/225243/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ylva-baeckstrom-1463175">Ylva Baeckstrom</a>, Senior Lecturer in Finance, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</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/if-you-have-money-anxiety-knowing-your-financial-attachment-style-can-help-225243">original article</a>. </div>

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Australians lose $5,200 a minute to scammers. There’s a simple thing the government could do to reduce this. Why won’t they?

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If you have money anxiety, knowing your financial attachment style can help

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Australians lose $5,200 a minute to scammers. There’s a simple thing the government could do to reduce this. Why won’t they?

7 items you should never put in your dryer

If you have money anxiety, knowing your financial attachment style can help

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