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How to prevent back pain on long trips

<p>Travel is exciting, but it can also take a toll on your body. The long periods of sitting in cars, trains or planes can put your back in agony with no clear remedy. But before you decide to give in and bear the discomfort, there are things you can do before and during the trip to help alleviate the pain.</p> <p><strong>Sit right</strong></p> <p>Changing your posture or position can help make the journey more comfortable. To reduce the amount of strain on your back, you can place a pillow between your lower back and the seat or under your buttocks.</p> <p><strong>Get up and stretch</strong></p> <p>If possible, move around for five minutes per hour to keep your muscles active. Physiotherapist Adrian Traeger advised keeping your back moving. “In terms of specific stretches, there’s not one golden stretch,” he told the <span><a href="/But%20getting%20up%20and%20walking%20around%20…%20doing%20some%20bending%20backward,%20bending%20forward,%20those%20kind%20of%20general%20movements%20can%20certainly%20help"><em>ABC</em></a></span>. “But getting up and walking around … doing some bending backward, bending forward, those kinds of general movements can certainly help.”</p> <p><strong>Stay hydrated</strong></p> <p>The dry environment of airplane cabins and cars can dehydrate the body, including the spinal discs – which makes them more vulnerable to stress, bulging or tearing, according to Talal W Khan, MD, director of pain management at the University of Kansas Medical Center.</p> <p>“Start hydrating several days before your trip,” Dr Khan told <span><a href="https://www.cntraveler.com/stories/2016-04-15/how-to-avoid-back-pain-on-a-plane"><em>Conde Nast Traveler</em></a></span>. “Dehydration can make joint stiffness and back issues worse.”</p>

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When laser surgery turns into a nightmare

<p>It will soon be a year since Jessica Starr, a popular weatherperson on Detroit TV, took her own life. Her husband said she did so because of complications related to <a href="https://www.today.com/health/smile-surgery-husband-meteorologist-who-took-her-own-life-speaks-t151062">her recent laser refractive surgery</a>.</p> <p>Such complications are not as rare as people think. <a href="https://www.nytimes.com/2018/06/11/well/lasik-complications-vision.html">The <em>New York Times</em></a> warned in 2018 of the potential effects on some patients. More recently, and closer to home, <a href="https://www.ctvnews.ca/health/lasik-md-patients-allege-nerve-damage-file-class-action-lawsuit-1.4697069">a class-action lawsuit was filed across the country</a> against Québéc-based company Lasik MD. It is accused of failing to properly warn its clients of the risks associated with vision correction surgery.</p> <p>Does this mean that the dream of getting rid of glasses while still improving vision should be forgotten?</p> <p><strong>Improved technology</strong></p> <p>Refractive laser surgery aims to change the profile of the cornea, the front and clear part of the eye, to correct common vision problems: nearsightedness, farsightedness and astigmatism. The idea is to eliminate the need for glasses.</p> <p>Introduced in 1983 in Germany, the first North American procedure <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=kugler+wang+laser+applied+optics">was performed in 1985</a>. Since then, millions have been done. At that time, laser surgery was an advantageous alternative to <a href="https://www.ncbi.nlm.nih.gov/pubmed/2686058">a more imprecise technique, radial keratotomy </a>(KR).</p> <p>The first laser technologies led to better, more stable, and more predictable results, but they were also associated <a href="https://www.ncbi.nlm.nih.gov/pubmed/31819355">with a number of complications</a>: intense pain during the procedure and in the days that followed, off-centre treatment leading to the perception of halos and glare, under- or over-correction requiring the need for retouching or a return to wearing glasses, permanent corneal fog or delayed healing of the corneal surface with increased potential for infection.</p> <p>In order to improve this profile, and especially the patient’s comfort, a technique called LASIK (laser <em>in situ</em> keratomileusis) was developed in the 1990s. This time, the laser is applied once a flap of tissue, generated by incising the cornea with a small planer equipped with a blade, is lifted. The flap is then replaced without the need for sutures.</p> <p><strong>Complications remain</strong></p> <p>All surgery carries risks. Serious incidents after <a href="https://www.newswire.ca/news-releases/protegez-vous-fevrier-2016---la-chirurgie-des-yeux-au-laser-sous-enquete-565633031.html">LASIK occur in only 0.1 per cent of cases</a>. But various complications affect between 10 and 30 per cent of patients undergoing surgery, compared to 7.7 per cent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777802/">after cataract surgery</a>.</p> <p>While the majority of complications are minor and do not result in permanent consequences, a number of patients experience chronic, severe post-operative pain and/or visual problems, to the point where Morris Waxler, a former Food and Drug Administration expert, <a href="https://www.cbsnews.com/news/lasik-eye-surgery-retired-fda-adviser-says-procedure-should-be-taken-off-market/">is calling for a recall and suspension of its use pending further safety investigations</a>.</p> <p>Regarding LASIK, <a href="https://www.canada.ca/en/health-canada/services/medical-procedures/laser-eye-surgery.html">Health Canada lists several potentially serious effects</a> that must be taken into account.</p> <p><strong>A nightmare case</strong></p> <p>Following laser surgery, the cornea is traumatized and must recover to restore normal function. In the case of LASIK, the cornea is cut at the level of the sensory nerves. These nerves protect the eye but also provide the feedback (biofeedback) necessary for the production of new tears.</p> <p>In the absence of this feedback, the eye dries out and its surface can deteriorate. In the majority of cases, the cut nerves will return to normal function within four to six months. But for a number of patients, the episode turns into a nightmare.</p> <p>Karen (not her real name) is one such patient I recently met. As a young, dynamic executive, she had opted for surgery for practical (work, sports activities) and esthetic reasons. Attracted by promotions and a tempting price, she went to a laser centre and was quickly examined by the staff. Even more quickly, she was given an appointment for surgery — the next day! Without thinking too much, she proceeded.</p> <p>In the days and weeks that followed, her eyes began to hurt more and more —intense pain that felt like knives in her eyes, redness and sensitivity to light requiring her to wear sunglasses even indoors. She had difficulty sleeping.</p> <p>The staff at the centre tried to reassure her, saying it would be temporary, that she is the only one to whom this happened, and that it would heal by itself. Weeks went by, without improvement. She asked to see the surgeon again.</p> <p>The surgeon told her that her eye was healed and that nothing more could be done for her. His tone and attitude left Karen in great despair. She had feelings of rejection, of denial of what she was experiencing, of incomprehension. The situation affected her work. She began to consult other professionals, always being told that her eyes were perfect. No one seemed to understand.</p> <p><strong>A puzzling condition</strong></p> <p>Karen actually suffers from neuropathy. It is a disorder of the peripheral nerves that causes symptoms but is not associated with any visible pathology. Following LASIK, the nerves in the cornea remain permanently damaged, like bare electrical wires, or they regenerate but make poor connections. In either case, the nerves send a constant signal of pain to the brain.</p> <p>After a few weeks/months, the pain becomes internalized (like pain emanating from a phantom limb) and the brain is therefore involved in making the symptoms chronic. Because no one really understands this condition, patients are dismissed and depression sets in as the condition worsens.</p> <p>The lack of understanding of this case stems from the fact that it is a new field in ocular medicine that is poorly documented in the scientific literature. Treatments are complex and time-consuming. It is, in fact, necessary to create new normal nerve connections while breaking the bad ones, using medication such as cortisone, drops of autologous serum and dressing lenses made of amniotic membrane, etc.</p> <p>The internalized stimulation must also be addressed, using oral medication prescribed by a specialized pain clinic. Antidepressants may also be helpful, but they usually have the effect of increasing dryness of the eyes, which is counterproductive. Psychotherapy is essential, with a professional trained in the treatment of chronic pain. Cannabis oil could help, in theory, but <a href="https://www.ncbi.nlm.nih.gov/pubmed/29513392">this approach is controversial</a>.</p> <p>Karen lost her job due to frequent absenteeism and loss of productivity. Her treatments are expensive and are eating into her savings. The financial stress increases as the months go by and the light at the end of the tunnel is not always clear. The situation put great pressure on her marriage and her spouse has found it difficult to cope with the circumstances.</p> <h2>What to know before deciding to have surgery</h2> <p>To avoid an outcome like Karen’s, certain precautions can be taken.</p> <p>First of all, it’s best to avoid making decisions on a whim. Get information from your own eye-care professional, the one who has known your eyes for a long time. Then, get at least two opinions — in different centres — before proceeding, and assess those interactions and the level of trust you feel.</p> <p>Certain risk factors can reduce the effectiveness of the procedure. For example, many patients opt for surgery because they become intolerant to contact lenses, with uncomfortable and dry eyes at the end of the day. If this is the case, it is because the eye is already prone to dryness and surgery will only increase it. It is therefore necessary to consult your optometrist in order to treat this dryness <em>before</em> the operation, and wait until the surface of the eye is ready for surgery.</p> <p>Patients with chronic inflammatory diseases should avoid refractive surgery. These diseases include fibromyalgia, irritable bowel syndrome, Crohn’s disease, lupus and rheumatoid arthritis. Similarly, people with diabetes or severe and chronic migraines <a href="https://www.aafp.org/afp/2017/0515/p637.html">are considered poor candidates</a>. Finally, <a href="https://www.ncbi.nlm.nih.gov/pubmed/22081153">people with obsessive-compulsive disorders should also abstain</a>. For example, they may have the reflex to rub their eyes violently, which can dislodge the tissue flap.</p> <p>Patients with severe myopia (&gt;8D) as well as patients with large pupils (black part of the eye larger than five millimetres) are prone to the continuous perception of halos and glare after surgery.</p> <p><strong>After the operation</strong></p> <p>Once the operation has been performed, it’s important to ensure adequate professional followup. Demand to see an optometrist or ophthalmologist at every opportunity. Assistance personnel, even properly trained, are not legally authorized to diagnose your condition (saying that everything is fine is a diagnosis in itself).</p> <p>It’s also important to never neglect regular eye health checkups. A severely near-sighted person, even after surgery, is still at risk of having a torn retina.</p> <p>Laser surgery is performed successfully in more than 95 per cent of cases. To avoid chronic problems, it is important to be well assessed and well informed.</p> <p>You only have two eyes and they are not replaceable. So take every precaution to ensure laser surgery is safe for you.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/130518/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/langis-michaud-647069">Langis Michaud</a>, Professeur Titulaire. École d'optométrie. Expertise en santé oculaire et usage des lentilles cornéennes spécialisées, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/when-laser-surgery-turns-into-a-nightmare-the-toll-can-be-enormous-130518">original article</a>.</em></p>

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How Gwyneth Paltrow’s The Goop Lab whitewashes traditional health therapies for profit

<p>In Gwyneth Paltrow’s new Netflix series, <a href="https://www.imdb.com/title/tt11561206/?ref_=fn_al_tt_1"><em>The Goop Lab</em></a>, Paltrow explores a variety of wellness management approaches, from “energy healing” to psychedelic psychotherapy.</p> <p>Goop has long been criticised for making unsubstantiated health claims and advancing pseudoscience, but the brand is incredibly popular. It was <a href="https://fortune.com/2018/03/30/gwyneth-paltrow-goop-series-c-valuation-250-million/">valued at over US$250 million</a> (A$370 million) in 2019.</p> <p>The alternative health industry is worth <a href="https://my-ibisworld-com.ezproxy.uow.edu.au/au/en/industry/x0015/industry-at-a-glance">A$4.1 billion</a> in Australia alone – and projected to grow.</p> <p>A key driver of the industry is increased health consciousness. With easier access to information, better health literacy, and open minds, consumers are increasingly seeking alternatives to managing their well-being.</p> <p>Goop has capitalised on the rise in popularity of alternative health therapies – treatments not commonly practised under mainstream Western medicine.</p> <p style="text-align: center;"><iframe width="440" height="260" src="https://www.youtube.com/embed/MunlAm7IGsE?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p>Health systems in countries such as Australia are based on Western medicine, eschewing traditional and indigenous practices. These Western systems operate on measurable and objective indicators of health and well-being, ignoring the fact <a href="https://www.emerald.com/insight/content/doi/10.1108/JSOCM-08-2017-0049/full/html">subjective assessments</a> – such as job satisfaction and life contentment – are just as important in evaluating quality of life.</p> <p>This gap between objective measures and subjective assessments creates a gap in the marketplace brands can capitalise on – not always for the benefit of the consumer.</p> <p><em>The Goop Lab</em> fails to engage with the cultural heritage of traditional health and well-being practices in any meaningful way, missing an important opportunity to forward the holistic health cause.</p> <p>The uncritical manner in which these therapies are presented, failure to attribute their traditional origins, absence of fact-checking, and lack of balanced representation of the arguments for and against these therapies only serve to set back the wellness cause.</p> <p><strong>New to the West, not new to the world</strong></p> <p>Many of the historical and cultural origins of the therapies in <em>The Goop Lab</em> are not investigated, effectively <a href="https://dictionary.cambridge.org/dictionary/english/whitewashing">whitewashing</a> them.</p> <p>The first episode, The Healing Trip, explores psychedelic psychotherapy, suggesting this is a new and novel approach to managing mental health.</p> <p>In reality, psychedelics have been used in non-Western cultures for <a href="https://www.rcpsych.ac.uk/docs/default-source/members/sigs/spirituality-spsig/ben-sessa-from-sacred-plants-to-psychotherapy.pdf?sfvrsn=d1bd0269_2">thousands of years</a>, only recently enjoying a re-emergence in the Western world.</p> <p>In the second episode, Cold Comfort, the “<a href="https://www.wimhofmethod.com/">Wim Hof Method</a>” (breathing techniques and cold therapy) is also marketed as a novel therapy.</p> <p>The meditation component of Hof’s method ignores its Hindu origins, documented in <a href="https://www.ancient.eu/The_Vedas/">the Vedas</a> from around 1500 BCE. The breathing component closely resembles <em>prāṇāyāma</em>, a yogic breathing practice. The “Hof dance” looks a lot like <a href="http://www.taichisociety.net/tai-chi.html">tai chi</a>, an ancient Chinese movement practice.</p> <p>Whitewashing these alternative therapies represents a form of colonisation and commodification of non-Western practices that have existed for centuries.</p> <p>The experts showcased are usually white and from Western cultures, rather than people of the cultures and ethnicities practising these therapies as part of their centuries-old traditions.</p> <p>Rather than accessing these therapies from authentic, original sources, often the consumer’s only option is to turn to Western purveyors. Like Paltrow, these purveyors are business people capitalising on consumers’ desire and pursuit of wellness.</p> <p><strong>Only the rich?</strong></p> <p>Paltrow describes Goop as a resource to help people “optimise the self”. But many of these therapies are economically inaccessible.</p> <p>In The Health-Span Plan, Paltrow undergoes the five-day “Fast Mimicking Diet” by <a href="https://prolonfmd.com/">ProLon</a> – a diet designed to reap the health benefits of fasting while extremely restricting calories. The food for the treatment period costs US$249 (A$368) (but shipping is free!). The average Australian household spends just over <a href="https://www.budgetdirect.com.au/home-contents-insurance/research/average-grocery-bill-statistics.html">A$250</a> on groceries weekly.</p> <p>Paltrow also undergoes a “vampire facial”, where platelet-rich plasma extracted from your own blood is applied to your skin. This facial is available at one Sydney skin clinic for between A$550 and A$1,499.</p> <p>These therapies commodify wellness – and health – as a luxury product, implying only the wealthy deserve to live well, and longer.</p> <p>This sits in stark odds with the goals of the <a href="https://www.who.int/about/who-we-are/constitution">World Health Organisation</a>, which views health as a fundamental human right “without distinction of race, religion, political belief, economic, or social condition”.</p> <p><strong>A right to live well</strong></p> <p>Companies like Goop have a responsibility to explain the science and the origins of the methods they explore.</p> <p>Given their profit-driven motive, many absolve themselves of this responsibility with an easy disclaimer their content is intended to “entertain and inform – not provide medical advice”. This pushes the burden of critically researching these therapies onto the consumer.</p> <p>Governments should seek to fund public health systems, such as Medicare, to integrate traditional health practices from other cultures through consultation and working in collaboration with those cultures.</p> <p>Perhaps this will give everyone access to a wellness system to help us live well, longer. This way, citizens are less likely to be driven towards opportunists such as Goop seeking to capitalise on our fundamental human right to live well.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/130287/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/nadia-zainuddin-944436"><em>Nadia Zainuddin</em></a><em>, Senior Lecturer, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></span></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/marketing-not-medicine-gwyneth-paltrows-the-goop-lab-whitewashes-traditional-health-therapies-for-profit-130287">original article</a>.</em></p>

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Melbourne girl swallows needle allegedly hidden in Woolworths apple

<p>A 14-year-old Melbourne girl is undergoing x-rays after swallowing what she believes was part of a needle in a bag of apples from Woolworths.</p> <p>Shelby Pewhairangi was on Tuesday eating her lunchtime snack, purchased from Hoppers Crossing Woolworths, when she felt a sudden stabbing pain.</p> <p>Her friend pointed out that a needle was hanging from her mouth, she told <em><a href="https://7news.com.au/lifestyle/woolworths/needle-allegedly-found-in-woolworths-apple-leaves-melbourne-girl-injured-c-694124">7News</a></em>.</p> <p>The needle was broken and Pewhairangi is now in hospital undergoing x-rays to locate the missing half.</p> <p>“The doctor told us the 24 hours after the accident were crucial,” the girl’s mother Seimone said.</p> <p>Woolworths said it is investigating the case. “We’ve seen the customer’s report and we’re looking into the matter in line with established procedures,” a Woolworths spokesperson said.</p> <p>“We stand ready to assist authorities in any way we can.</p> <p>“While this appears to be an isolated case, we’ve conducted precautionary checks on our stock in the store and found no issues.”</p> <p>More than 180 cases of needles in fruit reported since the nationwide contamination crisis emerged in September 2018.</p> <p>In response to the scare, the Australian government <a href="https://uk.reuters.com/article/uk-australia-strawberries-contamination/strawberries-spook-australia-into-raising-jail-terms-for-food-tampering-idUKKCN1M00OO">in 2018 increased the maximum jail term</a> for anyone convicted of contaminating foodstuffs from 10 years to 15 years.</p>

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Adele shows off stunning weight loss after losing 20kgs

<p>A TV star has called Adele unrecognisable after her shocking weight loss of 20kgs.</p> <p>The 31-year-old looked stunning in a high-neck long-sleeved leopard print dress as she partied at Chateau Marmont in Los Angeles.</p> <p><img style="width: 500px; height:281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7834519/adele-weight-loss.jpg" alt="" data-udi="umb://media/abdcb559d18b46698faed91abc97bb79" /></p> <p>Adele attended Jay Z and Beyonce’s Oscar’s party when she bumped into Polish TV presenter Kinga Rusin, who posted a photo of their encounter on Instagram.</p> <p>According to Rusin, Adele struck up a conversation after she noticed that Rusin wasn’t wearing the slippers provided at the door as she preferred to keep her heels on instead.</p> <p>“Honestly, I didn’t recognise her because she is so thin now,” Rusin wrote.</p> <p>There were reportedly 200 people at the party and despite the photo ban, Rusin snagged a photo with Adele.</p> <p>Adele’s weight loss has been a hot topic as of late as the singer split from her husband Simon Konecki. She has found a “new lease of life” after starting reformer pilates.</p> <p>“Adele has been out enjoying herself and she sees that as her priority at the moment, along with being a mum to Angelo.” The source told<span> </span><a rel="noopener noreferrer" href="https://www.thesun.co.uk/tvandshowbiz/9324836/adele-reformer-pilates-ayda-field-loses-stone-marriage-split/" target="_blank">The Sun</a>.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B6bUG27gnWs/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B6bUG27gnWs/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Adele (@adele)</a> on Dec 23, 2019 at 11:32am PST</p> </div> </blockquote> <div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>“It’s a bonus that she has shifted some weight. Her mates are glad she’s letting loose and there’s nothing but good feelings towards her. She’s got a new lease of life.”</p> <p>Farnham Pilates owner, Hannah Louise Epps, explains how her reformer classes work: “It works in a slow, precise way, focusing on the core muscles and helping to build up heat and sweat to help you lose weight. It streamlines and tones muscles and helps align imbalances in posture.”</p> </div> </div> </div>

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Why some people overeat when they're upset

<p>The idea of eating a tub of ice cream to cope with being upset has become a bit cliche. Though some might not need a tub of chocolate swirl to help perk themselves up again, there do seem to be systematic differences in the way that people cope with <a href="https://link.springer.com/content/pdf/10.1007/s11892-018-1000-x.pdf">upsetting events</a>, with some more likely to find solace in food than others.</p> <p>This matters because when eating to cope with negative feelings is part of a broader tendency to overeat, it is likely to be <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-789X.2007.00426.x">associated with obesity and being overweight</a>. More people than ever are now overweight and obese, with <a href="https://www.obesityday.worldobesity.org/world-obesity-day-2017">recent estimates</a> suggesting that by 2025, 2.7 billion adults worldwide will be affected by obesity, risking health issues such as cardiovascular disease, type 2 diabetes and cancer.</p> <p>So why do some people manage their emotions with food while others don’t? One psychological concept that helps to explain this difference is <a href="http://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-0167.47.3.283">adult attachment orientation</a>. Depending on the extent to which we fear abandonment by those we love, adults fall somewhere on the dimension of “attachment anxiety”. Where we fall on this dimension (high or low) determines a set of expectations about how we and others behave in personal relationships. These are developed as a response to the care we received as an infant and this can characterise your attachment style.</p> <p>A recent <a href="https://www.sciencedirect.com/science/article/pii/S0195666317303525">meta-analysis</a> – a study bringing together the results of many other studies – showed that the higher a person’s attachment anxiety, the more they engage in unhealthy eating behaviours, with <a href="https://www.nature.com/articles/ijo201072">a knock-on effect on body mass index (BMI)</a>. Two other studies have also shown that patients undergoing weight loss surgery are likely to have <a href="https://link.springer.com/article/10.1007/s11695-017-2796-1">higher attachment anxiety</a> scores than a comparable lean population, and it is thought that this difference is <a href="https://www.nature.com/articles/ijo2017157">partly explained by the tendency to overeat</a>.</p> <p><strong>Understanding attachment anxiety</strong></p> <p>For a long time, <a href="http://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-3514.75.2.420">we have known</a> that people who are have high attachment anxiety are more likely to both notice upsetting things and find it harder to manage their emotions when upset. This is because of how attachment orientations come about in the first place. The dynamics and feelings relating to our most important long-term relationships, including in early life, act as a templates that guide our behaviour in subsequent relationships and in stressful situations.</p> <p>If we receive consistent care from a caregiver, which includes helping us to cope with problems in life, we develop a secure attachment orientation. For people high in security, when a negative life event occurs, they are able to seek support from others or soothe themselves by thinking about the sorts of things that their caregiver or other significant person would say to them in that situation.</p> <p>However, inconsistent care – where the caregiver sometimes responds to another’s needs but at other times does not – leads to attachment anxiety and a fear that our needs won’t be met. When negative life events occur, support from others is sought but perceived as unreliable. People with high attachment anxiety are also less able to self-soothe than people with a secure attachment.</p> <p>We <a href="https://www.sciencedirect.com/science/article/pii/S0195666317318378">recently tested</a> whether this poor emotional management could explain why people with attachment anxiety are more likely to overeat. Importantly, we found that for people high in attachment anxiety it was harder to disengage from whatever was upsetting them and to get on with what they were supposed to be doing. These negative emotions were managed with food and this related to a higher BMI.</p> <p>It is important to note, however, that this is only one factor among many that can influence overeating and BMI. We cannot say that attachment anxiety causes overeating and weight gain. It might be that overeating and weight gain influences our attachment orientation, or it could be a bit of both.</p> <p><strong>Managing eating behaviour</strong></p> <p>There are two approaches that appear promising for attachment anxious individuals seeking to manage their eating behaviour. These involve targeting the specific attachment orientation itself and/or improving emotion regulation skills in general.</p> <p>To target attachment orientation, one possibility is a psychological technique called “<a href="https://www.sciencedirect.com/science/article/pii/S2352250X1830037X">security priming</a>” designed to make people behave like “secures”, who cope well with negative life events. It results in beneficial effects more generally, such as engaging in more pro-social behaviours. <a href="http://journals.sagepub.com/doi/abs/10.1177/0265407512468371">One study</a> showed that priming is related to snack intake. When people are asked to reflect on secure relationships in their life they eat less in a later snacking episode than when asked to reflect on anxious relationships in their life (though this work is very preliminary and needs replicating and extending).</p> <p>Looking at emotion regulation, a <a href="https://link.springer.com/content/pdf/10.1007/s11892-018-1000-x.pdf">recently published paper</a> highlighted the importance of emotional eaters focusing on skills such as coping with stress rather than calorie restriction, when seeking to lose weight. This study did not look solely at those with attachment anxiety, however, so further work is needed explore this further.</p> <p>Of course, in an ideal world everybody would have relationship experiences that helped them to develop high attachment security, and perhaps this is a hidden third approach – facilitating better caregiving and interpersonal relationships for all.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/105872/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><em><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/laura-wilkinson-583732">Laura Wilkinson</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/swansea-university-2638">Swansea University</a>; <a href="https://theconversation.com/profiles/angela-rowe-256122">Angela Rowe</a>, Reader in Social Cognitive Psychology, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a>, and <a href="https://theconversation.com/profiles/charlotte-hardman-109457">Charlotte Hardman</a>, Lecturer in Appetite and Obesity, <a href="https://theconversation.com/institutions/university-of-liverpool-1198">University of Liverpool</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-some-people-overeat-when-theyre-upset-105872">original article</a>.</em></p>

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Why mosquitoes prefer to bite some people over others

<p>It’s always you, isn’t it? The person busy swatting away buzzing backyard mosquitoes or nursing an arm full of itchy red lumps after a weekend camping trip.</p> <p>You’re not imagining it – mosquitoes really are attracted to some people more than others.</p> <p><strong>Why do mosquitoes need blood?</strong></p> <p>Only female mosquitoes bite. They do it for the nutrition contained in blood, which helps develop their eggs.</p> <p>Mosquitoes don’t just get blood from people. They’re actually far more likely to get it from biting animals, <a href="https://theconversation.com/how-australian-wildlife-spread-and-suppress-ross-river-virus-107267">birds</a>, <a href="https://www.abc.net.au/news/2016-08-18/australian-geographic-nature-photographer-of-the-year-winners/7753248">frogs</a> and reptiles. They even <a href="https://www.nature.com/articles/s42003-018-0096-5">bite earthworms</a>.</p> <p>But some mosquitoes specifically target people. One of the worst culprits is the <em>Aedes aegypti</em> species, which spreads <a href="https://www.cdc.gov/dengue/index.html">dengue</a> and <a href="https://www.cdc.gov/yellowfever/">yellow fever</a> viruses.</p> <p>Another that prefers humans are the <em>Anopheles</em> mosquitoes, responsible for spreading the parasites that cause <a href="https://www.who.int/malaria/en/">malaria</a>.</p> <p><strong>How do mosquitoes find us?</strong></p> <p>Most mosquitoes will get their blood from whatever is around and don’t necessarily care if they’re biting one person or another.</p> <p>Although it’s our blood they’re after, there is no strong indicator they prefer a particular blood type over another. Some studies have <a href="https://academic.oup.com/jme/article/41/4/796/885285">suggested they prefer people with type O blood</a> but that’s unlikely to be the case for all types of mosquitoes.</p> <p>Whether we’re picked out of a crowd may come down to heavy breathing and skin smell.</p> <p>When they need blood, mosquitoes can pick up on the <a href="https://www.cambridge.org/core/journals/bulletin-of-entomological-research/article/role-of-carbon-dioxide-in-hostfinding-by-mosquitoes-diptera-culicidae-a-review/2506B86EF63852B2D02EC3FCEE1E3B8B">carbon dioxide</a> we exhale. Around the world, carbon dioxide is one of the most common “baits” used to attract and collect mosquitoes. If you’re exhaling greater volumes of carbon dioxide, you’re probably an easier target for mosquitoes.</p> <p>When the mosquito gets closer, she is <a href="https://www.sciencedirect.com/science/article/pii/S2214574517300342">responding to a range of stimuli</a>.</p> <p>Perhaps it’s <a href="https://www.sciencedirect.com/science/article/abs/pii/S1471492210002618">body heat and sweat</a>: exercise that increases body temperature and perspiration can attract mosquitoes.</p> <p>Perhaps it’s body size: studies indicate <a href="https://academic.oup.com/trstmh/article/96/2/113/1909983">pregnant women are more likely to be bitten</a> by mosquitoes.</p> <p>How hairy are you? Mosquitoes may have a tough job finding a path through to your skin if there is an abundance of body hair.</p> <p>More than anything else, though, it’s about the smell of your skin. Hundreds of chemicals are sweated out or emitted by our body’s bacteria. The <a href="https://www.sciencedirect.com/science/article/pii/S2214574517300536">cocktail of smells they create</a> will either attract or deter mosquitoes.</p> <p><strong>It’s not just who they bite but where</strong></p> <p>Mosquitoes could also have a preference for different parts of the body.</p> <p>One study showed mosquitoes are more attracted to hands and feet <a href="https://www.nature.com/articles/srep27141">than armpits</a>, but that just turned out to be because of deodorant residues.</p> <p>Mosquitoes may also be more attracted to our feet: studies have shown cheese sharing similar bacteria to that <a href="https://www.ncbi.nlm.nih.gov/pubmed/15275226">found between our toes</a> attracts mosquitoes!</p> <p><strong>Who is to blame for this misery?</strong></p> <p>It’s not your diet. There is no evidence that what you eat or drink will prevent mosquito bites. Some food or drink may subtly change how many mosquitoes are likely to bite you but it won’t make that much difference.</p> <p><a href="https://www.mdpi.com/2075-4450/9/4/129">Eating bananas</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832015/">drinking beer</a> has been shown to marginally increase the attraction of mosquitoes but the results aren’t enough to suggest any dietary change will reduce your mosquito bites. That’s why our supermarket shelves aren’t full of “mozzie repellent” pills.</p> <p>Your irresistibility to mosquitoes may not be your fault. Blame your parents. Studies have shown the chemicals responsible for the “<a href="https://europepmc.org/article/med/2230769">skin smell</a>” that attracts mosquitoes has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406498/">a high level of heritability</a> when twins are exposed to biting mosquitoes.</p> <p><strong>What can you do about it?</strong></p> <p>We have to be careful about generalisations. There are thousands of types of mosquitoes around the world and all will have a different preference for what or who to bite. And the attraction of individuals and the scenario that plays out in one part of the world may be much different in another.</p> <p>Remember, it only takes one mosquito bite to transmit a pathogen that could make you sick. So whether you’re a mosquito magnet or feeling a little invisible because you’re not bitten so often, don’t be complacent and <a href="https://theconversation.com/the-best-and-worst-ways-to-beat-mosquito-bites-70274">use insect repellents</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/128788/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><em><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, Clinical Lecturer and Principal Hospital Scientist, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/feel-like-youre-a-mozzie-magnet-its-true-mosquitoes-prefer-to-bite-some-people-over-others-128788">original article</a>.</em></p>

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How to cut back or quit alcohol

<p>It’s February and many people are starting to put into place their New Year’s resolution to drink less alcohol.</p> <p>Events like <a href="https://febfast.org.au/">FebFast</a> can encourage and support these good intentions. But <a href="https://www.vichealth.vic.gov.au/-/media/ResourceCentre/PublicationsandResources/alcohol-misuse/Evaluation-of-febfast-participation_Full-Report.pdf">around 30%</a> of people who start FebFast don’t get through the whole month alcohol-free.</p> <p>Relying on intention and willpower to stop drinking, even for a short period, is not usually enough. <a href="https://www.memoirsofanaddictedbrain.com">Resisting temptation</a> takes up a lot of brain power and eventually your brain <a href="https://nypost.com/2015/07/12/addiction-is-not-a-disease-and-were-treating-drug-and-alcohol-addicts-wrong/">gets tired</a> and gives in.</p> <p>So what are the best strategies to take a break from drinking?</p> <p><strong>Monitor your drinking</strong></p> <p>Before your planned break from alcohol, spend a week or two <a href="https://www.rethinkingdrinking.niaaa.nih.gov/tools/Interactive-worksheets-and-more/Track-what-you-drink/drinking-Tracker-Cards.aspx">monitoring</a> the amount you drink and when.</p> <p>You might be surprised at how much or how often you’re drinking, and in what contexts. There may be certain people, places or emotions that increase or decrease your alcohol consumption.</p> <p>Understanding this can be a helpful motivator to make changes. It can also help you plan for situations where you’d usually be drinking.</p> <p><strong>Get clear on your goals and your motivation</strong></p> <p>Will you cut back or quit? If cutting back, will you drink less frequently or a lower quantity? For how long? What happens afterwards?</p> <p>It’s easier to stick to your <a href="http://www.drugs.ie/alcohol_info/tips_tools/goal_setting/">goals</a> if they’re clear and achievable.</p> <p>Think about why you are making changes to your drinking – to <a href="https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301643">lose weight</a>, <a href="https://www.healthdirect.gov.au/how-alcohol-affects-your-health">feel healthier</a>, <a href="https://www.smh.com.au/money/saving/giving-up-drinking-saved-me-4000-a-year-20170528-gwez3y.html">save money</a>, <a href="https://www.sleepfoundation.org/articles/how-alcohol-affects-quality-and-quantity-sleep">sleep better</a>, or prevent that Sunday morning <a href="https://theconversation.com/what-causes-hangovers-blackouts-and-hangxiety-everything-you-need-to-know-about-alcohol-these-holidays-127995">hangover</a>.</p> <p>Try to keep these reasons in mind when you have the inevitable periods of doubt!</p> <p><strong>Set a quit date</strong></p> <p>Setting a <a href="https://academic.oup.com/her/article/25/4/698/576515">quit date</a> is linked to success in sticking to your plan. It helps you prepare and reflect on the <a href="https://www.tandfonline.com/doi/abs/10.1080/0887044022000004911">reasons</a> making a change is worthwhile, which can improve your commitment to change.</p> <p>It also gives you time to get everything you need in place – preparing how you will tell others, thinking about how to decline a drink when offered, and working out which situations you might need to avoid or be cautious about, at least initially.</p> <p><strong>Get a support network</strong></p> <p>Having a friend also take up the challenge can make it a little easier. People trying to quit who have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714832/">social support</a> are more likely to reduce their drinking.</p> <p>If you’re taking part in an event like FebFast, encourage your friends and family to sponsor you. Not only will it be good for the charity you are supporting, but it can make you more accountable.</p> <p>It’s also a good way to communicate to your friends your choice to quit drinking, so they can better support you.</p> <p><a href="https://www.hellosundaymorning.org">Hello Sunday Morning</a> has a large online support community of more than 100,000 people, and offers a range of <a href="https://www.hellosundaymorning.org/daybreak/">resources</a> to help people who want to cut down or quit drinking. It’s a free service, funded by the Australian government and a range of philanthropic organisations.</p> <p>Recent evaluations of their Daybreak program – which includes one-on-one chats with health coaches – shows it leads to significant <a href="https://www.hellosundaymorning.org/wp-content/uploads/2019/11/Daybreak-journal-article.pdf">reductions in drinking</a>, and improvements in <a href="https://www.vichealth.vic.gov.au/-/media/ResourceCentre/PublicationsandResources/alcohol-misuse/Hello-Sunday-Morning-Summary.pdf">physical and mental health</a>.</p> <p><strong>Be kind to yourself</strong></p> <p>You might hear psychologists refer to something called the “rule violation effect”. This is when you’re working hard to not drink, but one day give in and have a glass of wine or two, then give up on your goals altogether.</p> <p>Changing any behaviour is difficult. Don’t give up at the first mistake or slip up: get back on the horse and keep going.</p> <p>Instead of thinking “bugger it, I might as well keep on drinking now,” try saying something like: “It’s going to take time. It was just a slip up. I can pick up where I left off.”</p> <p><strong>Find alternatives to drinking</strong></p> <p>In our alcohol-centric society, it sometimes feels uncomfortable when everyone around you is drinking and your own hands are empty. Choose a healthier alternative like sparkling water, soft drink or a <a href="https://www.bbcgoodfood.com/recipes/collection/non-alcoholic-cocktail">mocktail</a>.</p> <p>As well as existing non-alcoholic beer and wine, a range of non-alcoholic spirits is also emerging in the market. You could ask for it to be served in a spirit or cocktail glass – you might be less likely to be asked why you’re not drinking.</p> <p>It can also be helpful to focus on activities that don’t usually involve alcohol. Encourage your friends to meet up in the morning for breakfast, for example, or suggest healthy activities where alcohol is less likely to be present.</p> <p>If you suddenly have a craving for alcohol, try doing some vigorous exercise or doing something you love instead. These things release the same feel-good chemicals in your brain as alcohol. They won’t make you feel intoxicated like alcohol but they may make you feel happier and more relaxed.</p> <p><a href="https://www.blackdoginstitute.org.au/docs/default-source/psychological-toolkit/7-mindfulnessineverydaylife-(with-gp-notes).pdf?sfvrsn=2">Mindfulness</a> practice has also been shown to help drinkers to <a href="https://www.washingtonpost.com/news/inspired-life/wp/2018/01/05/i-tried-mindfulness-to-quit-drinking-it-worked/">change their drinking</a>.</p> <p><strong>Are there downsides to taking a break from alcohol?</strong></p> <p>For most people, participating in month-long challenges will provide a range of benefits and little downside, even over the longer term.</p> <p>Some people worry about “rebound effects”. But evaluations show, regardless of successful completion, taking up a month-long challenge to quit alcohol is linked to reductions in alcohol consumption <a href="https://psycnet.apa.org/record/2015-57039-001">six months</a> and up to <a href="https://www.vichealth.vic.gov.au/media-and-resources/publications/evaluation-of-the-impact-of-febfast-participation">a year</a> later.</p> <p>However, keep in mind that these programs are aimed at social drinkers. Dependent drinkers may experience <a href="https://www.uptodate.com/contents/management-of-moderate-and-severe-alcohol-withdrawal-syndromes">withdrawal symptoms</a> when they suddenly stop drinking, which can be dangerous if not monitored. So if you think you might be <a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/TR.097.pdf">dependent</a> on alcohol seek advice from a GP first.</p> <p><strong>Maintaining the benefits</strong></p> <p>New <a href="https://www.nhmrc.gov.au/sites/default/files/documents/attachments/draft-aus-guidelines-reduce-health-risks-alcohol.pdf">draft Australian alcohol guidelines</a> recommend healthy men and women should consume no more than ten standard drinks per week and no more than four standard drinks on any one day.</p> <p>The less you drink, the lower your risk of <a href="https://theconversation.com/four-ways-alcohol-is-bad-for-your-health-92578">alcohol-related harm</a>.</p> <p>Use the strategies that worked for you during your alcohol break to stick to these guidelines. You’ll need to understand how much a <a href="https://www.health.gov.au/health-topics/alcohol/about-alcohol/standard-drinks-guide#what-are-standard-drinks">standard drink</a> is – it’s probably less than you think!<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/130952/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nicole-lee-81635">Nicole Lee</a>, Professor at the National Drug Research Institute (Melbourne), <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/brigid-clancy-908017">Brigid Clancy</a>, PhD Candidate (Psychiatry) &amp; Research Assistant, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/thinking-about-taking-a-break-from-alcohol-heres-how-to-cut-back-or-quit-130952">original article</a>.</em></p>

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What can go wrong in the blood?

<p>While blood is essential for human life, there are many things that can go wrong. And as it travels around the body and flows through every organ, problems in the blood can have wide-ranging implications for our health. There are countless problems that can occur in this vital fluid; here, we’ll have a look at the most common - bleeding disorders, clotting disorders and blood cancers.</p> <p><strong>Bleeding disorders</strong></p> <p>If our blood vessels are damaged in some way, the blood contains platelets and many clotting factors (or proteins) that will form a clot in order to stem blood loss from our veins. If the number or function of these platelets or clotting proteins is reduced, this will lead to a “<a href="http://journals.lww.com/anesthesia-analgesia/Fulltext/2007/05000/Hemostasis_and_Thrombosis__Basic_Principles_and.93.aspx">bleeding disorder</a>”.</p> <p>Platelets are produced by the marrow in our bones, and clotting factors by our liver. Both are affected by our individual genetic makeup. Therefore genetic abnormalities that adversely affect the function of either organ can result in bleeding disorders. Major trauma to blood vessels can also cause excessive bleeding that requires surgery.</p> <p>Patients with disorders of their platelets typically present with bruises, fine spots on the limbs or trunk, or recurrent nose or gum bleeds (called “muco-cutaneous bleeding”).</p> <p>Those with <a href="http://journals.lww.com/anesthesia-analgesia/Fulltext/2007/05000/Hemostasis_and_Thrombosis__Basic_Principles_and.93.aspx">deficiencies in clotting factors</a> may have joint, muscle or critical organ bleeds such as an intracranial haemorrhage (a bleed inside the skull). Women can present with excessive menstrual bleeding. Patients with a hereditary bleeding disorder often have a family history of excessive bleeding. Those patients with milder forms of bleeding disorders might present with excessive bleeding for the first time only after surgical procedures or major trauma.</p> <p>The diagnosis of bleeding disorders is complex and requires a careful assessment for an excessive bleeding history, the presence (or absence) of a family history, and extensive laboratory evaluation of the platelet and clotting factors by a blood specialist, called a haematologist.</p> <p style="text-align: center;"><iframe width="440" height="260" src="https://www.youtube.com/embed/5ZMuPciBVy8?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p style="text-align: center;"><span class="caption">The journey of blood.</span></p> <p>A bleeding disorder you’ve probably heard of is haemophilia. This is a bleeding disorder caused when someone has less than 40% of the normal level of clotting factors (specifically, factor VIII). This is relatively rare, with about one in 10,000 people (<a href="https://www.haemophilia.org.au/about-bleeding-disorders/haemophilia">0.01% of Australians</a>) suffering from the disorder. Haemophilia is associated with joint and muscle bleeds, and sufferers need this clotting factor to be replaced in their blood for the rest of their lives.</p> <p>The treatment of bleeding disorders depends on the diagnosis and severity. Those with a deficiency in a clotting factor can receive a factor concentrate replacement, the frequency of which depends on its severity. Treatment of platelet defects is complex, but can include platelet transfusion. Tranexamic acid is a drug that can also be used to help prevent bleeding.</p> <p>Patients with hereditary bleeding disorders can bleed significantly (and to death) if not given the correct treatment to stop the bleeding or prevent bleeding prior to surgeries.</p> <p><strong>Clotting disorders</strong></p> <p>While it’s necessary for our blood to be able to form clots, if clots form inside blood vessels when no injury has occurred, this can have significant consequences. “Thrombosis” refers to the formation of a blood clot inside a blood vessel, impeding blood flow.</p> <p>A part of the clot can break off and travel further around the body, a process called “embolism”. Thrombosis can develop in the arteries (vessels transporting blood from the heart to the organs) or the veins (vessels transporting blood from the organs to the heart).</p> <p>A blockage in the arteries (arterial thrombosis) blocks the blood supply, causing a shortage of oxygen and glucose that are required to keep our tissues alive. Venous thrombosis (blockages in the veins) impede the blood flow from the organs to the heart. In both instances, embolism can occur.</p> <p>A common clotting condition that involves the veins is “venous thromboembolism” or VTE, which includes both deep vein thrombosis (DVT - a blood clot in a deep vein, often in the legs) and pulmonary embolism (PE - a blockage in the lungs). This is where the blood clot moves from a deep vein to the lungs.</p> <p>Surgery, major trauma or prolonged immobility can all be causes of venous thromboembolism. But there are <a href="http://onlinelibrary.wiley.com/store/10.1111/j.1469-8749.2001.tb00151.x/asset/j.1469-8749.2001.tb00151.x.pdf;jsessionid=93B25B0BD5D0ACE9DC814B8DB020722E.f02t03?v=1&amp;t=j352g66p&amp;s=18324c10bf11174a27dc7d92977219be455d4c56">other risk factors</a> that alter the constituents of the blood, to promote thrombosis. These include the oestrogen oral contraceptive pill, pregnancy, inflammatory bowel disease, heritable thrombophilia (an inherited abnormality making clots more likely to form), and several others.</p> <p>Deep vein thrombosis causes leg pain, swelling and redness, while pulmonary embolisms cause chest pain, shortness of breath, coughing up blood (haemoptysis) or collapse. All of these symptoms can be caused by other things, so thorough investigations are needed to confirm the diagnosis.</p> <p>The treatment for these conditions is principally to rebalance the coagulation system using anticoagulants. Until recently, the only oral anticoagulant was warfarin, a drug that can have significant food and drug interactions, hence requiring frequent blood testing to monitor its control. But new and superior anticoagulants (such as apixaban and rivaroxaban) have been created that don’t require regular blood tests.</p> <p>They also appear to be <a href="https://www.ncbi.nlm.nih.gov/pubmed/24963045">safer with a lower risk</a> of major bleeding, including intracranial haemorrhage. Antidotes exist in case the patient bleeds (needs surgery or is in an accident) and needs clotting.</p> <p>Clots in the arteries can lead to myocardial infarction (a blockage in the heart), and ischaemic strokes (a blockage in the brain) – both are part of cardiovascular disease. Smoking, high blood pressure, high blood cholesterol, diabetes, obesity and a family history <a href="http://journals.lww.com/anesthesia-analgesia/Fulltext/2007/05000/Hemostasis_and_Thrombosis__Basic_Principles_and.93.aspx">can increase the risk of clots</a> in the arteries. Heart attacks can lead to heart failure, while strokes can lead to loss of function and sensation of limbs, and both can lead to death.</p> <p>So it’s important to address the risk factors to minimise the risk of these occurring. If they do develop, antiplatelet medications (such as aspirin) and others can be prescribed to prevent it from happening again. Some patients have to have stents placed where the blockage occurred to prevent it from recurring.</p> <p><strong>Blood cancers</strong></p> <p>Blood cancers occur when there is an uncontrolled growth of blood cells, which can infiltrate tissues and cause disease. The main types of blood cancer are leukaemia, lymphoma and myeloma. A haematologist also treats these types of cancers.</p> <p>The symptoms of blood cancer differ depending on the type of blood cell that has turned malignant, and where they are present.</p> <p>Leukaemia is a cancer of immature white blood cells that accumulate in the bone marrow and often spill out into the blood. Leukaemias are categorised as acute or chronic depending on how fast they grow.</p> <p>Acute leukaemias are aggressive cancers that require intensive chemotherapy in hospital. For many patients, the only chance of cure is through bone marrow transplant, essentially replacing their entire blood cells and immune systems with that of another person, either a relative (usually a sibling) or even an unrelated but genetically compatible donor.</p> <p>Acute leukaemia is the most common childhood cancer, and can often be cured. But in adults with increasing age, and particularly over 70, it becomes more difficult to cure.</p> <p>Chronic leukaemias tend to only occur in adults. They are slow growing and some types have no symptoms, meaning treatment isn’t necessary. If the cancer is progressing or causing symptoms, therapy is given as an outpatient (meaning they don’t have to stay in hospital).</p> <p>Lymphomas are a group of blood cancers that arise in a type of blood cell called lymphocytes (a type of small white blood cell found in the immune system). It causes swellings in the glandular or “lymphatic” system that fights infections and removes toxins from the body. Lymphomas are the <a href="http://www.leukaemia.org.au/blood-cancers">most common type</a> of blood cancer.</p> <p>There are two main types of lymphoma, characterised by the presence (or lack of) an abnormal cell called the Reed-Sternberg cell. If the cell is present it’s referred to as Hodgkin Lymphoma - named after the British physician who discovered it. Hodgkin lymphoma occurs mainly in adolescents and young adults and makes up about 10% of cases.</p> <p><a href="http://www.aihw.gov.au/cancer/lymphoma/">About 90% of lymphomas</a> are “non-Hodgkin lymphoma”, which mainly arise in the elderly. Treatment is usually chemotherapy and sometimes radiotherapy. While survival rates for Hodgkin Lymphoma are over 80%, there are many different subtypes of non-Hodgkin lymphoma, and outcomes vary considerably between subtypes.</p> <p>Myeloma is a cancer of mature white blood cells and affects the bone. It usually occurs in those over the age of 60, and is treatable with chemotherapy and, increasingly, newer and less toxic medications. However it remains generally incurable.</p> <p><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/maher-gandhi-135558"><em>Maher Gandhi</em></a><em>, Professor of Blood Cancer Research, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/huyen-tran-365198">Huyen Tran</a>, Adjunct associate professor, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></span></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-can-go-wrong-in-the-blood-a-brief-overview-of-bleeding-clotting-and-cancer-76400">original article</a>.</em></p>

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What does your heart rate number really mean?

<p>The rise of <a href="https://theconversation.com/us/topics/wearable-technology-5180">wearable fitness trackers</a> has increased the number of people monitoring their heart rate, both throughout the day and during exercise.</p> <p>Whether you’re an athlete trying to gain the <a href="https://theconversation.com/wearable-technologies-help-olympians-achieve-top-performance-91721">competitive edge</a>, a weekend warrior tracking progress or someone who is just trying to improve your health, consider heart rate a valuable tool in understanding the work of your amazing body as it achieves those first steps, that next 5K or even Olympic gold.</p> <p>Heart rate is one of your body’s most basic vital signs, yet many people have questions about what heart rate really tells them. What should your target heart rate be during exercise? Does it even matter?</p> <p><strong>1. What is your heart rate?</strong></p> <p>First, the basics: Your <a href="https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/all-about-heart-rate-pulse">heart rate</a>, also sometimes called your pulse rate, is the number of times your heart contracts per minute.</p> <p><a href="https://scholar.google.com/citations?user=uXcM0scAAAAJ&amp;hl=en&amp;oi=ao">Physiologists like me</a> focus on the contractions of the left ventricle, the chamber of the heart that generates pressure to drive blood out through the aorta and on to the entire body. The heart’s pumping capacity directly relates to its ability to deliver oxygen to the body’s organs.</p> <p>If you’re running up the stairs or hauling something heavy, your muscles and organs are going to need more oxygen to help power your actions. And so your heart beats faster.</p> <p><strong>2. How do you measure heart rate?</strong></p> <p>The easiest way to measure heart rate is <a href="https://www.healthline.com/health/how-to-check-heart-rate#target-heart-rates">to find your pulse</a> and count the number of pulses felt over the course of one minute.</p> <p>In adults, the best places to feel for a pulse are large arteries that are near the surface of the skin, such as the carotid at the side of your neck or the radial on the underside of your wrist. If feeling for the carotid pulse, don’t press hard enough to disrupt blood flow to and from the head.</p> <p>More recently, watches and other wrist-based fitness monitors have incorporated optical sensors to track heart rate. These <a href="https://support.apple.com/en-us/HT204666">wearable devices</a> use technology called <a href="https://doi.org/10.1088/0967-3334/28/3/R01">photoplethysmography</a>, which has been around since the <a href="https://iopscience.iop.org/article/10.1088/0031-9155/19/3/003">mid-1970s</a>. Each beat of your heart sends a little surge of blood through your veins. The monitor detects this by shining green light onto your skin and then analyzing the light that gets refracted back by the <a href="https://theconversation.com/blood-in-your-veins-is-not-blue-heres-why-its-always-red-97064">red blood flowing underneath</a>.</p> <p>This kind of heart-rate monitoring is popular, but it has <a href="https://theconversation.com/some-heart-rate-monitors-give-less-reliable-readings-for-people-of-colour-121007">shortcomings for people with dark skin</a>.</p> <p>Some exercisers rely on chest straps that measure electrical activity and then transmit that signal to a watch or other display device. This technique depends on picking up the electrical signals within your body that direct your heart to beat.</p> <p>For the most part, the two techniques are <a href="https://doi.org/10.1186/s13102-018-0098-0">about equally accurate</a>.</p> <p><strong>3. What controls your heart rate?</strong></p> <p>Your autonomic nervous system is mostly in charge of your heart rate. That’s the portion of the nervous system that runs without your even thinking about it.</p> <p>In <a href="https://doi.org/10.1136/hrt.2005.079400">healthy hearts</a>, as someone begins to exercise, the autonomic nervous system does two things. First, it removes the “brake” that keeps your heart beating slowly and steadily under normal conditions. And then it “hits the gas” to actively stimulate the heart to beat faster.</p> <p>In addition, the amount of blood ejected from the left ventricle with each heart beat – called the stroke volume – increases, particularly during the initial stages of exercise.</p> <p>Together, higher stroke volume and more beats per minute mean the amount of blood delivered by the heart increases to match the increased oxygen demand of exercising muscles.</p> <p><strong>4. How does heart rate relate to exercise intensity?</strong></p> <p>As your exercise session becomes more intense and more work is done, your heart beats faster and faster. This relationship means you can use heart rate as a surrogate measure for the intensity of exertion, relative to one’s maximal heart rate.</p> <p>Your maximum heart rate is the fastest your heart can functionally beat. So how do you know what your number actually is?</p> <p>In order to determine your maximum heart rate, you could do increasingly difficult exercise, like walking on a treadmill and increasing the grade each minute, until you can no longer keep up. But it’s much more common (and often safer!) to estimate it. Many studies have identified that <a href="https://www.ncbi.nlm.nih.gov/pubmed/2188839">maximal heart rate goes down with age</a>, and thus age is included in all estimation equations.</p> <p>The most common and simplest prediction equation is: Maximal heart rate is equal to 220 minus your age. From that number, you can calculate a percentage of maximum to provide <a href="https://www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates">target heart rate ranges</a> in the moderate (50%-70%) or vigorous (70%-85%) categories of exercise, important in terms of meeting the <a href="https://www.cdc.gov/physicalactivity/basics/index.htm">recommended levels of exercise</a> for overall health benefits.</p> <p><iframe id="nRCoQ" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/nRCoQ/4/" height="400px" width="100%" style="border: none;" frameborder="0"></iframe></p> <p>Interestingly, this equation, while perhaps most common, <a href="https://www.researchgate.net/publication/237258265_The_surprising_history_of_the_HRmax220-age_equation">wasn’t based upon empirical research</a> and is not as accurate as others you can try, like <a href="https://doi.org/10.1016/S0735-1097(00)01054-8">your age multiplied by 0.7 and then subtracted from 208</a>.</p> <p>As with any prediction equation, there is always some individual variability. To accurately know your max heart rate at your current age, you’d need to measure it during maximal exercise.</p> <p><strong>5. Why is exercise intensity important?</strong></p> <p>In addition to helping you to know whether you’re meeting general recommendations for exercise, knowing the intensity of a given workout session can be of benefit in other ways.</p> <p>First, the body uses different primary sources of energy to fuel exercise of different relative intensities. During lower-intensity exercise, a greater proportion of the energy you’re using comes from fat sources in your body. During higher-intensity exercise, more of the energy utilized comes from carbohydrate sources.</p> <p>But don’t slow that treadmill down just yet if you’re hoping to drop pounds of fat. Lower-intensity exercise also requires less energy overall. So, to burn the same amount of calories with lower-intensity exercise, you’ll need to exercise for longer than you would at a higher intensity.</p> <p>Secondly, the intensity of a set amount of work – like a particular speed/grade combo on the treadmill, or a certain wattage on a rowing ergometer – reflects your overall fitness. Once you can complete the same amount of work at a lower relative intensity – like if you can run a mile in the same amount of time but with your heart beating slower than it did in the past – you know you’ve gained fitness. And increased fitness is associated with a <a href="https://doi.org/10.1001/jamanetworkopen.2018.3605">decrease in death from any cause</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/124066/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/anne-r-crecelius-663313">Anne R. Crecelius</a>, Associate Professor of Health and Sport Science, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/tracking-your-heart-rate-5-questions-answered-about-what-that-number-really-means-124066">original article</a>.</em></p>

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4 things to help treat constipation

<p>Chronic constipation is incredibly common. Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/30364088">one in four people</a> worldwide report symptoms, while in Australia and New Zealand, it’s around <a href="https://www.ncbi.nlm.nih.gov/pubmed/18269746">one in seven</a>.</p> <p>Lots of things can trigger <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation">constipation</a>: being out of your usual routine (think holidays, illness or injury), <a href="https://www.ncbi.nlm.nih.gov/pubmed/31292358">having a low fibre intake, not drinking enough water</a> and <a href="https://www.health.harvard.edu/diseases-and-conditions/common-causes-of-constipation">inactivity</a>.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/29382180">Certain medications</a> can also cause constipation including iron supplements, painkillers, diuretics (to help you get rid of sodium and water), and other drugs to treat heart disease, mental health conditions and allergies.</p> <p>Constipation is more common in <a href="https://www.ncbi.nlm.nih.gov/pubmed/16342852">older adults</a> and in <a href="https://www.ncbi.nlm.nih.gov/pubmed/10805262">women</a>, due to hormonal changes that slow bowel motility – the time it takes for your body to digest food and expel the waste products (stools or bowel motions). <a href="https://www.ncbi.nlm.nih.gov/pubmed/25803402">Pregnant</a> women are particularly prone to constipation.</p> <p><strong>How do you know you’re constipated?</strong></p> <p>Symptoms include:</p> <ol> <li><a href="https://www.continence.org.au/pages/bristol-stool-chart.html">lumpy or hard stools</a></li> <li>feeling that your bowels haven’t emptied completely or your <a href="https://www.webmd.com/digestive-disorders/picture-of-the-anus#1">anus</a> is blocked</li> <li>straining to pass a bowel motion</li> <li>manipulating your body position to try and pass a bowel motion</li> <li>having fewer than three bowel motions per week.</li> </ol> <p>If over a three-month period you answer yes to <a href="https://www.ncbi.nlm.nih.gov/pubmed/30364088">two or more of these symptoms</a> most weeks, then you have “constipation”.</p> <p>The good news is it can be treated and then prevented.</p> <p>If your bowels are so packed you can’t pass any bowel motions at all, see your GP. You may need treatment with specific laxatives to clear your bowels before you can start on a prevention plan.</p> <p>Here are four things that research shows improve bowel function, which refers to the time it takes for food to move through your digestive system and be expelled as a bowel motion (called gut transit time), the frequency and volume of bowel motions, and stool consistency.</p> <p><strong>1. High-fibre foods</strong></p> <p>Dietary fibres are <a href="https://www.ncbi.nlm.nih.gov/pubmed/28676135">complex carbohydrates that aren’t digested or absorbed</a> in the gut.</p> <p>Different types of dietary fibres improve bowel function through the following processes:</p> <ul> <li> <p>the fermentation of fibre in the colon produces water and other molecules. These make stools <a href="https://www.ncbi.nlm.nih.gov/pubmed/27170558">softer and easier to pass</a></p> </li> <li> <p>absorption of water into stools stimulates the gut to contract and makes bowel motions softer</p> </li> <li> <p>a higher fibre intake creates bigger stools, which pass more quickly, resulting in more regular bowel motions.</p> </li> </ul> <p>A good source of fibre is psyllium. It forms a viscous gel, which gets fermented in the colon, leading to softer bowel motions. Psyllium is the main ingredient in Metamucil, which is commonly used to treat constipation.</p> <p>A review <a href="https://www.ncbi.nlm.nih.gov/pubmed/31764399">comparing the effect of psyllium to wheat bran</a> in people with chronic constipation found psyllium was 3.4 times more effective at increasing the amount of stool passed.</p> <p>This is important because having a bigger bowel motion waiting in the colon to be passed sends signals to your gut that it’s time to expel the stool – and it helps the gut contract to do just that.</p> <p>The review found <a href="https://www.ncbi.nlm.nih.gov/pubmed/31764399">both psyllium and coarse wheat bran had a stool-softening effect</a>, but finely ground wheat bran had a stool-hardening effect.</p> <p>Other foods rich in fermentable carbohydrates include dark rye bread and <a href="https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/food-and-food-products/legumes-what-are-they-and-how-can-i-use-them/">legumes</a> (chickpeas, lentils, four-bean mix, red kidney beans, baked beans); while <a href="https://nomoneynotime.com.au/hacks-myths-faqs/how-much-fibre-should-i-be-eating">wholemeal and wholegrain breads</a> and cereals are high in different types of dietary fibres.</p> <p><strong>2. Kiwi fruit</strong></p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/30706488">Kiwi fruit fibre</a> absorbs about three times its weight in water. This means it helps make stools softer and boosts volume by increasing the amount of water retained in bowel motions. This stimulates the gut to contract and moves the bowel motions along the gut to the anus.</p> <p>In a <a href="https://www.ncbi.nlm.nih.gov/pubmed/12074185">study of 38 healthy older adults</a>, researchers found adding two to three kiwi fruit per day to their diets for three weeks resulted in participants passing bowel motions more often. It also increased the size of their stools and made them softer and easier to pass.</p> <p>Kiwi fruit are also <a href="https://www.ncbi.nlm.nih.gov/pubmed/30706488">rich in the complex carbohydrate inulin</a> a type of <a href="https://en.wikipedia.org/wiki/Fructan">fructan</a>. Fructans are a <em>prebiotic</em> fibre, meaning they encourage growth of healthy bacteria in the colon.</p> <p>But fructans can also <a href="https://www.monashfodmap.com/ibs-central/i-have-ibs/">aggravate symptoms in some people with irritable bowel syndrome</a> (IBS). If you have IBS and constipation, check in with your GP before upping your fructan intake.</p> <p>If you don’t like kiwi fruit, other <a href="https://www.ncbi.nlm.nih.gov/pubmed/17625872">vegetables and fruit high in fructans</a> include spring onion, artichoke, shallots, leek, onion (brown, white and Spanish), beetroot, Brussels sprouts, white peaches, watermelon, honeydew melon and nectarines.</p> <p><strong>3. Prunes</strong></p> <p><a href="https://en.wikipedia.org/wiki/Prune">Prunes</a> are dried plums. They contain a large amount of sorbitol, a complex carbohydrate that passes undigested into the colon where bacteria ferment it. This produces gas and water, which triggers an increase in bowel movements.</p> <p>Eating prunes is even more effective than psyllium in improving stool frequency and consistency.</p> <p>One study of adults with constipation compared <a href="https://www.ncbi.nlm.nih.gov/pubmed/25109788">eating 100 grams (about ten) prunes</a> a day for three weeks to those who ate psyllium. The prune group passed an average of 3.5 separate bowel motions per week compared to 2.8 in the psyllium group.</p> <p>The prune group’s stools were also softer. They rated, on average, 3.2 on the <a href="https://en.wikipedia.org/wiki/Bristol_stool_scale">Bristol stool chart</a> compared to 2.8 for the psyllium group, meaning their bowel motions were more toward smooth to cracked sausage-shaped motions rather than lumpy ones.</p> <p><img src="https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /> <span class="caption"></span> <span class="attribution"><span class="source">The Conversation</span>, <a href="http://creativecommons.org/licenses/by-nd/4.0/" class="license">CC BY-ND</a></span></p> <p>If you don’t like prunes, <a href="https://www.ncbi.nlm.nih.gov/pubmed/19765364">other foods that contain sorbitol</a> include apples, pears, cherries, apricots, plums and “sugar-free” chewing gum and “sugar-free” lollies.</p> <p><strong>4. Water</strong></p> <p>Not drinking enough water is the <a href="https://www.ncbi.nlm.nih.gov/pubmed/27933718">strongest predictor of constipation</a>. When your body is a bit dehydrated, there’s less water for the fibre in your colon to absorb, meaning your bowel motions also become dehydrated and harder to pass.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/27933718">Aim for</a> around 1.5 to two litres of fluid per day, which can include liquids such as tea, coffee, soup, juice, and even jelly and the liquid from stewed fruit.</p> <p><strong>Putting it all together</strong></p> <p>Start by increasing the amount of water or other liquids you drink. You should be drinking enough that your urine is the colour of straw.</p> <p>Next, add in psyllium. Start with a tablespoon once a day with breakfast cereal.</p> <p>Psyllium forms a gel as soon as it comes into contact with liquids so to make psyllium more palatable, mix it with a small amount of stewed fruit or yoghurt and eat it straight away. If needed, increase psyllium to twice a day.</p> <p>At least once a day, have some prunes (either dried or canned) or kiwi fruit and a variety of other foods high in fibre, fructans, sorbitol and fermentable carbohydrate.</p> <p>If your bowel habits don’t improve, see your GP.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/123364/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/had-constipation-here-are-4-things-to-help-treat-it-123364">original article</a>.</em></p>

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Young Brisbane artist targeted by scammers after losing her legs

<div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>Brisbane artist Visaya Hoffie, 23, has spoken out about the scam that started after she lost both of her legs in a freak accident on the New York subway.</p> <p>It was a scam donation page that was set up on Donobox, falsely publicising itself as raising money for her treatment.</p> <p>“Do not donate to this page. It is a scam,” Visaya wrote, sharing a screenshot of the impostor page.</p> <p>Donorbox has since confirmed it has removed the fake fundraiser account. “Regarding the fake fundraiser, the page was taken down within a matter of hours of being created and the account was banned,” a spokeswoman told<span> </span><em><a rel="noopener noreferrer" href="https://www.dailymail.co.uk/news/article-7941713/Australian-artist-23-lost-legs-freak-New-York-subway-accident-dealt-cruel-blow.html" target="_blank">the Daily Mail</a></em>.</p> <p>Visaya was visiting a friend in New York when she tripped and fell onto the tracks. She was run over by a train and all seven of its carriages, but the shirt she was wearing saved her life as it was bright pink and spotted by another train driver.</p> <p>Her mother, Pat Hoffie, revealed in an emotional Facebook post just what happened to he daughter.</p> <div id="fb-root"></div> <div class="fb-post" data-href="https://www.facebook.com/photo.php?fbid=10156831928273671&amp;set=pcb.10156831931753671&amp;type=3&amp;theater" data-width="auto"> <blockquote class="fb-xfbml-parse-ignore">Posted by <a href="https://www.facebook.com/ArTcRedsN0tdEaD">Jo Diball</a> on <a href="https://www.facebook.com/photo.php?fbid=10156831928273671&amp;set=a.490550323670&amp;type=3">Tuesday, January 21, 2020</a></blockquote> </div> <p>“When the first train had rolled across her unconscious body 20 minutes earlier, her black puffy jacket and black jeans had made her invisible to the driver,” Ms Hoffie explained.</p> <p>“The bright pink colour of her top is what alerted the engine driver of the second train to the fact that someone was lying across the track.”</p> <p>Her mother said: “Visaya is now off breathing support, and has started to eat. She is sedated but is optimistic and has already muttered, ‘I’m going to have to deal with this’,”.</p> <p>“It’s difficult at the moment,” Ms Hoffie said from her daughter’s New York hospital bedside.</p> <p>“But we are in the best possible medical home but we just have to put our heads together and work through it.</p> <p>“We’re in the middle of a very trying time.”</p> </div> </div> </div>

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The real reason women live longer than men

<p>Ask your smartphone how to drive from Copenhagen to Berlin and it will give you an estimate of how long the trip will take, based on current traffic. If there is a traffic jam in Hamburg, say, the extra time this traffic jam takes will be included in the estimate. But, of course, you are not at all the points of your journey now. Rather, you’ll be in Copenhagen first, then at Odense, then Kolding, and so forth. By the time you get to Hamburg, there may no longer be a traffic jam. The estimate your smartphone gave you will be off. Life expectancy is calculated in much the same way.</p> <p>Life expectancy in 2019 is calculated using the chances of survival for all ages in 2019: those who turned 70 in 2019, those who turned 69 in 2019, those who turned 71 … you get the point. But nobody actually has all their birthdays in 2019. People have at most one birthday a year (less than one for some of those who died that year and those born on February 29). Since I turned 35 in 2019, why should the 2019 chances of survival for a 70-year-old matter to me? By the time I turn 70, the world will have changed. The estimate will be off.</p> <p>But your smartphone also tells you something like “31 minutes extra travel time due to a traffic jam”. With this information, you can guess how long the trip will take assuming that the traffic jam will be resolved by the time you get there: just subtract those 31 minutes. Every part of the journey has a travelling time and you can pick those pieces apart.</p> <p>Similarly, life expectancy is built up out of many small pieces, one for each age, and demographers can pick those pieces apart. We did that to answer questions such as: “what is the part of life expectancy lived between ages 50 and 85?” (which will be a number between 0 and 35). And “suppose that in 2015 no 70-year-old died of smoking (for example through lung cancer), what would that life expectancy have been?” And “how has the importance of smoking-related deaths been changing, and was that different for men and women?”</p> <p>Throw all that in the mixer and you get some interesting results, which my colleagues and I – a team from the University of Southern Denmark and University of Groningen – published in <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8148-4">BMC Public Health</a>.</p> <p>We studied the part of life expectancy lived between ages 50 and 85 for high-income North America, high-income Europe and high-income Oceania for the period 1950-2015. Around 1950, males lived about two and a half years less than females. Around 1980, this difference had increased to about four and a half years. Then the difference in life expectancy declined to new lows of about two years in 2015.</p> <p>All of that increase and subsequent decrease was due to smoking. Remove smoking and you get an almost flat line at only two years, which is what the difference in life expectancy between ages 50 and 85 would have been if nobody had smoked.</p> <p><strong>Long time coming</strong></p> <p>If smoking is so bad, why are we seeing all of these early deaths? Why aren’t people smarter? Well, if cigarettes killed you right away, nobody would touch them. The problem is that cigarettes do kill you – only decades later.</p> <p>Because, historically, men started smoking earlier and heavier than women, any effect of smoking on life expectancy shows in males first. While medical doctors were coming to the conclusion that smoking is bad – basing their conclusions on evidence from men – women decided it was time to take up smoking. Now, decades later, the effect of smoking (death) is declining in males but still increasing for older females who smoked in the past. This gives rise to a four-wave pattern dubbed “the smoking epidemic”: first men smoke, then men start dying from smoking at around the same time women start smoking, then women start dying from smoking.</p> <p>In the final phase of the smoking epidemic, people get smarter and stop smoking. This last part of the smoking epidemic, however, is the more difficult part. Unfortunately, people keep smoking (big tobacco is doing just fine).</p> <p>But our study also showed some good news. Recently, there was a big drop in smoking-related deaths for people of around 50 years old. While smoking is certainly not down and out, at least some people seem to get that tobacco is a killer.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/130142/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/maarten-wensink-941141">Maarten Wensink</a>, Assistant Professor, Epidemiology, Biostatistics and Biodemography, <a href="https://theconversation.com/institutions/university-of-southern-denmark-1097">University of Southern Denmark</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-real-reason-women-live-longer-than-men-new-study-130142">original article</a>.</em></p>

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29,000 cancers overdiagnosed in Australia in a single year

<p>Almost one in four cancers detected in men were overdiagnosed in 2012, according to our new research, published today in the <a href="https://www.mja.com.au/">Medical Journal of Australia</a>.</p> <p>In the same year, we found that approximately one in five cancers in women were overdiagnosed.</p> <p>Overdiagnosis is when a person is diagnosed with a “harmless” cancer that either never grows or grows very slowly. These cancers are sometimes called low or ultra-low-risk cancers and wouldn’t have spread or caused any problems even if left untreated.</p> <p>This level of overdiagnosis means Australian men are 17% more likely to be diagnosed with cancer in their lifetime than they were 30 years ago, while women are 10% more likely.</p> <p>Cancer overdiagnosis can result in people having unnecessary treatments, such as surgery, radiotherapy and hormone therapy. Being diagnosed with cancer and having cancer treatments can cause physical, psychological and financial harms.</p> <p><strong>How many cancers were overdiagnosed?</strong></p> <p>In 2012, 77,000 cancers were diagnosed among Australian men. We estimated that 24% of these (or 18,000 in total) were overdiagnosed, including:</p> <ul> <li>8,600 prostate cancers</li> <li>8,300 melanomas</li> <li>860 kidney cancers</li> <li>500 thyroid cancers.</li> </ul> <p>Some 55,000 cancers were diagnosed in women; 18% of them (11,000) were overdiagnosed. This includes:</p> <ul> <li>4,000 breast cancers</li> <li>5,600 melanomas</li> <li>850 thyroid cancers</li> <li>660 kidney cancers.</li> </ul> <p>These calculations are based on changes since 1982 in the lifetime risk of cancers, after adjusting for other causes of death and changing risk factors.</p> <p>Because they are more common, prostate and breast cancer and melanoma accounted for the greatest number of overdiagnosed cancers, even though larger percentages of thyroid cancers were overdiagnosed.</p> <p>In women, for example, 73% of thyroid cancers were overdiagnosed, while 22% of breast cancers were overdiagnosed.</p> <p>The harms to patients come from the unnecessary surgery, and other treatments, as well as the anxiety and expenses.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/29042396">Three in four patients with thyroid “cancers” that are overdiagnosed</a>, for example, will almost all have their thyroid completely removed, risk complications, and have to take replacement thyroid medication for the rest of their life.</p> <p>In addition, there are substantial costs to the health system, and delays in necessary surgery.</p> <p>Some “good news” is that overdiagnosis appears to be largely confined to the five main cancers mentioned above.</p> <p><strong>What causes cancer overdiagnosis?</strong></p> <p>The cause of overdiagnosis differs for each cancer.</p> <p>For prostate cancer, the cause is the quest for early detection of prostate cancer using the prostate specific antigen (PSA) blood test. A downside of PSA testing is the risk of detecting large numbers of low-risk prostate cancers which may be overtreated.</p> <p>For breast cancer, the cause is also early detection, through mammography screening which can detect low-risk cancers.</p> <p>Likewise, detection of low-risk melanoma accounted for most of the melanoma overdiagnosis we observed. Early detection activities again are the likely cause, with many times more skin biopsies being done today than 30 years ago.</p> <p>Overdiagnosis of kidney and thyroid cancer is due largely to “incidentalomas” – abnormalities found incidentally on imaging done for other reasons – or through over-investigation of mild thyroid problems.</p> <p><strong>What can we do about it?</strong></p> <p>Some level of overdiagnosis is unavoidable in a modern health-care system committed to screening to reduce the disease and death burden from cancer.</p> <p>We want to maximise the timely detection of high-risk cancers that allows the best chance of cure through early surgery and other treatments.</p> <p>But this is still possible while taking measures to prevent overdiagnosis and overtreatment of low-risk cancers that are better left undetected.</p> <p>Take South Korea, for example. Following the introduction of a screening program for thyroid cancer, the country saw a <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1507622?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%3Dpubmed">15-fold increase</a> in small, low-risk thyroid cancers. Then it cut back on early detection. This led to a major drop in thyroid cancer rates without any change in death rates.</p> <p>Rates of PSA testing in Australia are <a href="https://cancercouncil.com.au/wp-content/uploads/2015/03/World-Journal-of-Urology_2015_Prostate_mortality-AUS.pdf">among the highest in the world</a>. Countries where there is less PSA testing, such as the <a href="https://researchonline.nd.edu.au/cgi/viewcontent.cgi?article=1777&amp;context=med_article">United Kingdom</a>, detect less low-risk prostate cancer, and therefore have less overtreatment.</p> <p>Rather than simply accepting PSA testing, a wiser strategy is to <a href="https://www.bmj.com/content/362/bmj.k3581.full">make an informed decision whether to go ahead with it or not</a>. Tools to help you choose are available <a href="http://psatesting.org.au/info/?utm_source=pcfa&amp;utm_medium=redirect&amp;utm_campaign=pcam19">here</a> and <a href="https://www.racgp.org.au/download/Documents/Guidelines/prostate-cancer-screening-infosheetpdf.pdf">here</a>.</p> <p>A <a href="https://ses.library.usyd.edu.au/bitstream/2123/16658/1/2017%20updated%20breast%20screening%20DA%20%28Hersch%20et%20al%29.pdf">decision aid</a> is also available for Australian women to consider whether to go ahead with mammogram screening or not.</p> <p>Trials to wind back treatment of low-risk prostate cancer have resulted in <a href="https://www.nice.org.uk/guidance/ng131/chapter/Recommendations#localised-and-locally-advanced-prostate-cancer">clinical practice guidelines</a> which recommend men with low-risk prostate cancer be offered active surveillance as an alternative to immediate surgery or radiation therapy.</p> <p>Trials to evaluate less treatment for low-risk breast cancer are now under way and should help wind back breast cancer overtreatment one day.</p> <p>New screening tests that identify clinically important cancers, while leaving slow- and never-growing cancers undetected, are the holy grail. But they could be some time coming.</p> <p>In the meantime, health services need to be vigilant in <a href="https://annals.org/aim/fullarticle/2724039/recognizing-potential-overdiagnosis-high-sensitivity-cardiac-troponin-assays-example">monitoring new areas of overdiagnosis</a>, particularly when investing in new technologies with potential to further increase overdiagnosis.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/127791/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/alexandra-barratt-6143">Alexandra Barratt</a>, Professor of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, Associate in Clinical Epidemiology in the School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-jones-916410">Mark Jones</a>, Associate Professor, Biostatistician, Institute for Evidence-Based Healthcare, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>; <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>, and <a href="https://theconversation.com/profiles/thanya-pathirana-916412">Thanya Pathirana</a>, Senior Lecturer, School of Medicine, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/29-000-cancers-overdiagnosed-in-australia-in-a-single-year-127791">original article</a>.</em></p>

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Woman’s X-ray from car crash reveals dangers of common habit

<p>A UK police officer has released an X-ray of a car crash victim to warn other passengers against putting their feet on the dashboard.</p> <p>An unidentified woman had one of her hips broken and the other dislocated in a car accident while her feet were propped on the vehicle’s dashboard.</p> <p>Wales police sergeant Ian Price took to Twitter to share the X-ray initially posted by the Platinum Ambulance Service to warn other front-seat passengers against the habit.</p> <p>“Here is an X-ray of horrific injuries sustained to the front seat passenger who had their feet on the dashboard at the time of a collision,” he wrote. “If you see your passenger doing it stop driving and show them this.”</p> <blockquote class="twitter-tweet"> <p dir="ltr">Here is an X-ray of horrific injuries sustained to the front seat passenger who had their feet on the dashboard at the time of a collision. If you see your passenger doing it stop driving and show them this. <a href="https://t.co/f3XCT8ePvi">pic.twitter.com/f3XCT8ePvi</a></p> — 🏴󠁧󠁢󠁷󠁬󠁳󠁿 Sgt 121 Ian Price 🏴󠁧󠁢󠁷󠁬󠁳󠁿 (@DPGoSafeSkipper) <a href="https://twitter.com/DPGoSafeSkipper/status/1220030119735103489?ref_src=twsrc%5Etfw">January 22, 2020</a></blockquote> <p>According to trauma surgeon Dr John Crozier, putting up feet on the dashboard may in a crash cause <a href="https://www.mynrma.com.au/cars-and-driving/driver-training-and-licences/resources/feet-on-dash">death or serious injuries</a> such as a ruptured bowl, spinal cord damage and paralysis.</p> <p>In 2016, more than 400 people in Australia were admitted to hospital with injuries related to putting their feet up on the dashboard.</p>

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What is sepsis and how can it be treated?

<p>Sepsis, colloquially known as blood poisoning, occurs as a result of an infection, usually from bacteria. Bacteria can enter the blood stream via an open wound, from another part of the body after a surgical procedure, or even from a urinary tract infection.</p> <p>In Australia, more than <a href="https://www.australiansepsisnetwork.net.au/healthcare-providers/sepsis-epidemiology">15,700 new cases</a> of sepsis are reported each year. Of these, more than 5,000 people will die. Some who survive will need to have limbs amputated, and be left with lifelong disability.</p> <p>Each intensive care unit admission to treat sepsis costs <a href="https://www.australiansepsisnetwork.net.au/healthcare-providers/sepsis-epidemiology">close to A$40,000</a>.</p> <p>But according to <a href="https://www.georgeinstitute.org.au/sites/default/files/world-sepsis-day-2016-report.pdf">a recent Australian survey</a>, only 40 per cent of people have heard of sepsis. Even fewer know what the condition is.</p> <p>More and more people <a href="https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1914-8">are aware of sepsis globally</a>, but there’s still a long way to go. If more people know about it (health professionals included), we’re more likely to recognise the condition early and intervene early, which will lead to improved survival rates.</p> <p>Meanwhile, with the emergence of antibiotic resistant bacteria and the ageing population, the need to find a cure is becoming even more pressing. While a variety of treatments exist, rates of illness and death from sepsis haven’t dropped as they have for infectious diseases over recent decades.</p> <p><strong>Sepsis has two phases</strong></p> <p>The first phase occurs when an infection enters the bloodstream. This is called septicaemia. Our body’s immune system over-reacts – a process known as hyper inflammation, or septic shock – which leads to the failure of multiple organs. This phase normally lasts for seven to ten days, or longer, depending on the severity of infection.</p> <p>If the condition is not caught and successfully treated during this first stage, an immune paralysis phase follows. During this phase, the body is left with no functional immune system to fight off the infection. This second phase accounts for the vast majority of sepsis-related deaths.</p> <p>Sepsis can affect anyone, but is <a href="https://www.georgeinstitute.org.au/sites/default/files/world-sepsis-day-2016-report.pdf">most dangerous</a> in older adults, pregnant women, children younger than one year, and in those with a weakened immune system such as premature babies and people with chronic diseases like diabetes.</p> <p>Patients in intensive care units are especially vulnerable to developing infections, which can then lead to sepsis.</p> <p><strong>Symptoms and treatments</strong></p> <p>The pathogens causing sepsis can vary, with bacteria accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488423/">almost 80%</a> of the cases. Pathogenic fungi and viruses contribute to the rest. For this reason, the symptoms aren’t always identical; and they often overlap with other common infections.</p> <p>A person will be diagnosed with sepsis if they have a confirmed infection together with low systolic blood pressure (less than 100 mmHg), high fever (in some instances hypothermia), delirium and an increased breathing rate.</p> <p>Treatment often includes antibiotics as well as dialysis. This is because the kidneys are one of the organs often affected when someone gets sepsis.</p> <p>Other treatment methods such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303907/">blood purification</a> by removing endotoxins (bacterial cell wall products that trigger the immune response) have been trialled with little or no success. This is most likely because these methods fail to remove infectious agents hidden in the body’s tissue.</p> <p>Alternative treatments such as vitamin D have been reported but <a href="http://rcm.mums.ac.ir/article_3256.html">have not been proven</a> to offer any clinical benefits.</p> <p>Many doctors choose to treat with <a href="https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/corticosteroids">corticosteroids</a>, a type of steroid. Although treatment with steroids reduces the time patients spend in intensive care units, it’s shown <a href="https://www.georgeinstitute.org/media-releases/study-ends-debate-over-role-of-steroids-in-treating-septic-shock">no reduction</a> in mortality rates. Importantly, while corticosteroids reduce inflammation, they cause a steep reduction in the number of immune cells, which are needed to fight infection.</p> <p>In spite of intensive care treatments involving antibiotics, <a href="https://ccforum.biomedcentral.com/track/pdf/10.1186/cc5346">neither the prevalence of sepsis nor death rates from the condition have changed</a> in Australia over the last three decades. They both have actually risen slightly due to the emergence of drug-resistant bacteria and the ageing population.</p> <p><strong>Where to from here?</strong></p> <p>Australian experts have recently called for <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja2.50279">a national action plan</a> to reduce preventable death and disability from sepsis. This would be a positive step to bring more attention to the condition. But reducing the harm sepsis causes also relies on advances in treatment.</p> <p>Experimental drug therapies for sepsis are at a crossroads, with more than 100 drug trials around the world <a href="https://www.ncbi.nlm.nih.gov/pubmed/24581450">failing to show any benefit</a> over the last 30 years.</p> <p>The common thread among all these trials was these treatments targeted the initial inflammatory phase of sepsis. But this phase accounts for <a href="https://www.thoracic.org/patients/patient-resources/breathing-in-america/resources/chapter-22-sepsis.pdf">less than 15%</a> of all sepsis-related deaths.</p> <p>And it’s the inflammation that alerts our immune system to an infection. If you completely block this response (for example, by using steroids), the body will not recognise there is an infection.</p> <p>Researchers have now switched their efforts to identifying the molecular mechanisms that lead to the immune-paralysis phase of sepsis. Understanding this better will hopefully lead to the development of new immunotherapies to target the second phase of the condition.</p> <p>The time is ripe for measuring the success of sepsis treatment by the number of lives saved rather than the cost saved by reducing the time patients spend in intensive care units.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/121508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/hamsa-puthalakath-797779">Hamsa Puthalakath</a>, Associate Professor, Biochemistry, <a href="http://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-sepsis-and-how-can-it-be-treated-121508">original article</a>.</em></p>

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How to help babies stay a healthy weight

<p>How babies are fed is often a topic of hot discussion. It’s known that babies should be introduced gradually to solid foods <a href="https://www.nhs.uk/conditions/pregnancy-and-baby/solid-foods-weaning/">at around six months old</a>. But in recent years, another question has arisen: should parents be spoon-feeding babies special pureed baby foods or could they just join in <a href="https://www.theguardian.com/commentisfree/2012/feb/08/baby-led-weaning">with the family and feed themselves</a> from the very start?</p> <p>Known as <a href="http://www.babyledweaning.com">baby-led weaning</a>, parents who follow the method believe it has lots of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1740-8709.2011.00360.x">benefits for their baby</a>, such as encouraging them to eat a range of foods and stay a healthy weight. Research suggests that babies who feed themselves are <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.2047-6310.2013.00207.x">less likely to be fussy</a> and more likely to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/jhn.12616">eat a wider variety of food</a>. But what about their weight?</p> <p>Research examining this so far <a href="https://link.springer.com/article/10.1007/s13668-017-0201-2">has been mixed</a>. But in <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.12941">our new study</a> of 269 babies, we found that when babies were breastfed, there was no difference in weight for those who were spoon-fed or self-fed. But when babies were bottle fed, those who were spoon-fed were heavier than those who self-fed.</p> <p>This is potentially because as long as babies have some opportunity to be “in charge” of how much they eat, they may be better able to eat according to what they need rather than how much food a caregiver might encourage them to eat.</p> <p><strong>Milk matters too</strong></p> <p>Previous research into the impact of solid foods and weight has not really explored how the other part of a baby’s diet – their milk feeds – might play a role.</p> <p>Indeed, solid foods should only be part of a baby’s diet. Babies who are between six and 12 months should still be getting lots of energy <a href="https://www.unicef.org/parenting/food-nutrition/feeding-your-baby-6-12-months">from breast or formula milk</a>. In fact, at six to eight months old, babies only need <a href="https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5ceed06a15fcc07f8822270b/1559154825802/Eating_well_first_year_April19_for_web.pdf">less than 200 calories a day</a> from solid foods.</p> <p>Research with older children shows that using a “<a href="http://www.aijcrnet.com/journals/Vol_7_No_2_June_2017/9.pdf">responsive feeding style</a>”, where lots of healthy options are offered but parents don’t put too much pressure on how much children eat, is associated with <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01849">a healthier weight and more varied diet</a>. Children are better able to listen to their own hunger cues and don’t crave foods that are “banned” so much – meaning they are less likely to overeat.</p> <p>Research with younger babies shows that <a href="https://kellymom.com/ages/newborn/bf-basics/importance-responsive-feeding/">being “responsive” during milk feeds</a> also matters. For example, bottle fed babies who are fed responsively – with parents looking for cues they are full – <a href="https://www.ncbi.nlm.nih.gov/pubmed/3572635">drink less than those who are encouraged to finish a bottle</a>.</p> <p>Breastfeeding might <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0083893">make responsive feeding easier</a> as you cannot see how much a baby has drunk, so you have to trust they will feed if they are hungry. It’s also difficult to persuade a baby who doesn’t want to breastfeed to do so. But if you are bottle feeding you can see how much is left and might worry that baby <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-277X.2010.01145.x">needs to finish the bottle</a>.</p> <p>This might explain why babies who are breastfed are more likely to be able <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.2047-6310.2012.00071.x">to control their appetite</a> as toddlers and are <a href="https://www.tandfonline.com/doi/abs/10.3109/17477160902763309">less likely to be overweight</a>.</p> <p><strong>Feeding your baby responsively</strong></p> <p><a href="http://orca.cf.ac.uk/91927/">Decisions around feeding babies are complicated</a> and some mothers <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jan.12832">might face challenges breastfeeding</a> or <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/mcn.12166">worry about giving their baby solid foods</a>. But the good news is that most babies, unless there is a particular medical worry about their growth, should be able to have opportunity to be “in charge” of how much they eat.</p> <p>If you are bottle feeding, try not to worry too much about when and how much your baby feeds. Instead, try <a href="https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/bottle-feeding-resources/infant-formula-responsive-bottle-feeding-guide-for-parents/">“paced” or “responsive” feeding</a>, where smaller amounts of milk are made up and you watch carefully for signs your baby is full.</p> <p>To do this gently, offer your baby the bottle by stroking their lip and wait for them to show they are ready –- they will open their mouth if they are hungry. Pause regularly and stop when your baby starts to show signs of being full, such as turning their head or pushing the bottle out. Don’t try to encourage them to finish the bottle.</p> <p>If you are spoon-feeding, <a href="https://www.nhs.uk/conditions/pregnancy-and-baby/solid-foods-weaning/">let your baby set the pace of the meal</a>. Offer them small spoonfuls and, again, pause in between, looking for signs they have had enough such as turning their head or pushing lots back out. Don’t try to persuade them to finish a jar or eat too quickly.</p> <p>Remember, guidelines suggest that however you feed your baby you <a href="https://www.nhs.uk/conditions/pregnancy-and-baby/solid-foods-weaning/">can give them finger foods from the start of weaning</a>. Try foods such as soft cooked sticks of parsnip, broccoli or yam, flakes of fish or toast fingers. Cut food into pieces large enough for them to pick up, so that the food sticks out of the top of their fist. But make sure you avoid foods that could snap off in your baby’s mouth such as hard apple slices or raw carrot sticks or small hard foods such as nuts or popcorn.</p> <p>Some babies might not eat much at first when they self-feed, but don’t worry. Remember, the <a href="https://link.springer.com/article/10.1007/s13679-018-0297-8">experience of learning to eat is important too</a>. Letting babies play with food, feeling its texture and learning how it tastes is all part of their development – just put a mat down and try not to worry too much about the mess!<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/129961/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sara-wyn-jones-379117">Sara Wyn Jones</a>, PhD researcher in Public Health, <a href="http://theconversation.com/institutions/swansea-university-2638">Swansea University</a>; <a href="https://theconversation.com/profiles/amy-brown-279356">Amy Brown</a>, Professor of Child Public Health, <a href="http://theconversation.com/institutions/swansea-university-2638">Swansea University</a>, and <a href="https://theconversation.com/profiles/michelle-lee-602893">Michelle Lee</a>, Professor of Psychology, <a href="http://theconversation.com/institutions/swansea-university-2638">Swansea University</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/let-babies-be-in-charge-of-how-much-they-eat-it-could-help-them-stay-a-healthy-weight-129961">original article</a>.</em></p>

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Do blind people have better hearing?

<p>The sensation of sound occurs when the vibrations from sounds enter our ear and cause little hairlike structures – called hair cells – within our inner ear to move back and forth. The hair cells transform this movement into an electrical signal that the brain can use.</p> <p>How well a person can hear largely depends on how intact these hair cells are. Once lost, they don’t grow back – and this is no different for blind people. So blind people can’t physically hear better than others.</p> <p>Yet blind people often outperform sighted people in hearing tasks such as <a href="https://www.sciencedirect.com/science/article/pii/S0378595515300174">locating the source of sounds</a>. The reason for this emerges when we look beyond the sensory organs, at what is happening with the brain, and how the sensory information is processed by it.</p> <p>Perception occurs when the brain interprets signals that our sensory organs provide, and different parts of the brain respond to the information arriving from different sensory organs. There are areas that process visual information (the visual cortex) and areas that process sound information (the auditory cortex). But when a sense like vision is lost, the brain does something remarkable: it <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898172/">reorganises the functions of these brain areas</a>.</p> <p>In blind people, the visual cortex gets a bit “bored” without visual input and starts to “rewire” itself, becoming more responsive to information from the other remaining senses. So blind people may have lost their vision, but this leaves a larger brain capacity for processing the information from other senses.</p> <p>The extent of reorganisation in the brain depends on when someone loses their sight. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898172/">brain can reorganise itself at any point in life</a>, including adulthood, but during childhood the brain is more able to adapt to change. This is because during childhood the brain is still developing and the new organisation of the brain does not have to compete with an existing one. As a result, people who have been blind from a very early age show a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898172/">much greater level of reorganisation in the brain</a>.</p> <p>People who become blind early in life tend to outperform sighted people, as well as those who became blind later in life, in <a href="https://www.nature.com/articles/430309a">hearing</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0960982203009849">touch</a> perceptual tasks.</p> <p><strong>Echolocation</strong></p> <p>The reorganisation in the brain also means that blind people are sometimes able to learn how to use their remaining senses in interesting ways. For example, some blind people learn to sense the location and size of objects around them using <a href="https://community.dur.ac.uk/lore.thaler/thaler_goodale_echo_review2016.pdf">echolocation</a>.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/2IKT2akh0Ng?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p>By producing clicks with their mouths and listening for the echoes, blind people can locate objects in their surroundings. This ability is tightly linked with the <a href="https://community.dur.ac.uk/lore.thaler/thaler_goodale_echo_review2016.pdf">brain activity in the visual cortex</a>. In fact, the visual cortex in blind echolocators responds to sound information in almost the same way as it does to visual information in the sighted. In other words, in blind echolocators, hearing has replaced vision in the brain to a very large extent.</p> <p>But not every blind person is automatically an expert echolocator. Whether a blind person is able to develop a skill like echolocation depends on the time spent learning this task – <a href="https://www.sciencedirect.com/science/article/pii/S0378595514000185">even sighted people can learn this skill with enough training</a>, but blind people will probably benefit from their reorganised brain being more tuned towards the remaining senses.</p> <p>Blind people will also rely more on their remaining senses to do everyday tasks, which means that they train their remaining senses on a daily basis. The reorganised brain together with the greater experience in using their remaining senses are believed to be important factors in blind people having an edge over sighted people in hearing and touch.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/102282/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/loes-van-dam-543699">Loes van Dam</a>, Lecturer in Psychology, <a href="http://theconversation.com/institutions/university-of-essex-1291">University of Essex</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-blind-people-have-better-hearing-102282">original article</a>.</em></p>

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