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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Ahead of the federal budget, health minister Mark Butler <a href="https://www.abc.net.au/news/2024-05-10/endometriosis-australia-welcomes-govt-funding-for-endometriosis/103830392">last week announced</a> an investment of A$49.1 million to help women with endometriosis and complex gynaecological conditions such as chronic pelvic pain and polycystic ovary syndrome (PCOS). From July 1 2025 <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/historic-medicare-changes-for-women-battling-endometriosis">two new items</a> will be added to the Medicare Benefits Schedule providing extended consultation times and higher rebates for specialist gynaecological care. The Medicare changes <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">will subsidise</a> $168.60 for a minimum of 45 minutes during a longer initial gynaecologist consultation, compared to the standard rate of $95.60. For follow-up consultations, Medicare will cover $84.35 for a minimum of 45 minutes, compared to the standard rate of $48.05. Currently, there’s <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=104&qt=item&criteria=104">no specified time</a> for these initial or subsequent consultations. But while reductions to out-of-pocket medical expenses and extended specialist consultation times are welcome news, they’re only a first step in closing the gender pain gap. <h2>Chronic pain affects more women</h2> Globally, research has shown chronic pain (generally defined as pain that persists for <a href="https://www.healthdirect.gov.au/chronic-pain">more than three months</a>) disproportionately affects <a href="https://academic.oup.com/bja/article/111/1/52/331232?login=false">women</a>. Multiple biological and psychosocial processes likely contribute to this disparity, often called the gender pain gap. For example, chronic pain is frequently associated with conditions influenced by <a href="https://www.sciencedirect.com/science/article/abs/pii/S0304395914003868">hormones</a>, among other factors, such as endometriosis and <a href="https://theconversation.com/adenomyosis-causes-pain-heavy-periods-and-infertility-but-youve-probably-never-heard-of-it-104412">adenomyosis</a>. Chronic pelvic pain in women, regardless of the cause, can be debilitating and <a href="https://www.nature.com/articles/s41598-020-73389-2">negatively affect</a> every facet of life from social activities, to work and finances, to mental health and relationships. The gender pain gap is both rooted in and compounded by gender bias in medical research, treatment and social norms. The science that informs medicine – including the prevention, diagnosis, and treatment of disease – has traditionally focused on men, thereby <a href="https://www.theguardian.com/lifeandstyle/2015/apr/30/fda-clinical-trials-gender-gap-epa-nih-institute-of-medicine-cardiovascular-disease">failing to consider</a> the crucial impact of sex (biological) and gender (social) factors. When medical research adopts a “male as default” approach, this limits our understanding of pain conditions that predominantly affect women or how certain conditions affect men and women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921746/">differently</a>. It also means intersex, trans and gender-diverse people are <a href="https://www.deakin.edu.au/about-deakin/news-and-media-releases/articles/world-class-centre-tackles-sex-and-gender-inequities-in-health-and-medicine">commonly excluded</a> from medical research and health care. Minimisation or dismissal of pain along with the <a href="https://www.hindawi.com/journals/ecam/2016/3467067/">normalisation of menstrual pain</a> as just “part of being a woman” contribute to significant delays and misdiagnosis of women’s gynaecological and other health issues. Feeling dismissed, along with perceptions of stigma, can make women less likely <a href="https://link.springer.com/article/10.1186/s12905-024-03063-6">to seek help</a> in the future. <h2>Inadequate medical care</h2> Unfortunately, even when women with endometriosis do seek care, many <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.15494?saml_referrer">aren’t satisfied</a>. This is understandable when medical advice includes being told to become pregnant to treat their <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02794-2">endometriosis</a>, despite <a href="https://academic.oup.com/humupd/article/24/3/290/4859612?login=false">no evidence</a> pregnancy reduces symptoms. Pregnancy should be an autonomous choice, not a treatment option. It’s unsurprising people look for information from other, often <a href="https://www.mdpi.com/2227-9032/12/1/121">uncredentialed</a>, sources. While online platforms including patient-led groups have provided women with new avenues of support, these forums should complement, rather than replace, <a href="https://journals.sagepub.com/doi/full/10.1177/1460458215602939">information from a doctor</a>. Longer Medicare-subsidised appointments are an important acknowledgement of women and their individual health needs. At present, many women feel their consultations with a gynaecologist are <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">rushed</a>. These conversations, which often include coming to terms with a diagnosis and management plan, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/">take time</a>. <h2>A path toward less pain</h2> While extended consultation time and reduced out-of-pocket costs are a step in the right direction, they are only one part of a complex pain puzzle. If women are not listened to, their symptoms not recognised, and effective treatment options not adequately discussed and provided, longer gynaecological consultations may not help patients. So what else do we need to do? 1. Physician knowledge Doctors’ knowledge of women’s pain requires development through both practitioner <a href="https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00815-4/tables/2">education and guidelines</a>. This knowledge should also include dedicated efforts toward understanding the <a href="https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain">neuroscience of pain</a>. Diagnostic processes should be tailored to consider gender-specific symptoms and responses to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00137-8/fulltext">pain</a>. 2. Research and collaboration Medical decisions should be based on the best and most inclusive evidence. Understanding the complexities of pain in women is essential for managing their pain. Collaboration between health-care experts from different disciplines can facilitate comprehensive and holistic pain research and management strategies. 3. Further care and service improvements Women’s health requires multidisciplinary treatment and care which extends beyond their GP or specialist. For example, conditions like endometriosis often see people presenting to emergency departments in <a href="https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia/contents/treatment-management/ed-presentations">acute pain</a>, so practitioners in these settings need to have the right knowledge and be able to provide support. Meanwhile, pelvic ultrasounds, especially the kind that have the potential to visualise endometriosis, take longer to perform and require a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0015028223020757/">specialist sonographer</a>. Current rebates do not reflect the time and expertise needed for these imaging procedures. 4. Adjusting the parameters of ‘women’s pain’ Conditions like PCOS and endometriosis don’t just affect women – they also impact people who are gender-diverse. Improving how people in this group are treated is just as salient as addressing how we treat women. Similarly, the gynaecological health-care needs of culturally and linguistically diverse and Aboriginal and Torres Strait islander women may be even <a href="https://www.mdpi.com/1660-4601/20/13/6321">less likely to be met</a> than those of women in the general population. <h2>Challenging gender norms</h2> Research suggests one of the keys to reducing the gender pain gap is challenging deeply embedded <a href="https://pubmed.ncbi.nlm.nih.gov/29682130/">gendered norms</a> in clinical practice and research. We are hearing women’s suffering. Let’s make sure we are also listening and responding in ways that close the gender pain gap.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229802/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, Senior Lecturer, School of Business, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, PhD candidate, health communication and health sociology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, Affiliate Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, Associate Professor at NICM Health Research Institute, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/longer-appointments-are-just-the-start-of-tackling-the-gender-pain-gap-here-are-4-more-things-we-can-do-229802">original article</a>. </div>

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“We need a donor”: Parents' desperate plea to save young daughter

The heartbroken parents of five-year-old Addison Kemp have made a desperate plea to save their young daughter. Addison suffers from a rare health condition called severe Aplastic anaemia, which means that her body’s bone marrow does not produce enough new blood cells to carry out vital tasks like carry oxygen, control infections or heal after an injury. This means that even a simple nosebleed can be catastrophic for the young girl, as she's forced to spend days in hospital getting blood transfusions to stay alive. Her parents Bianca and Daniel have spoken about her condition in an interview with A Current Affair and explained how without a bone-marrow transplant, the condition could mean death for their young daughter. “She wouldn’t live,” Ms Kemp said. “We need a donor.” The couple first found out about their daughter's condition after she returned home from school with bruises all over her body. Addison was taken to the doctor for a blood test, and they found out about the devastating condition a day later and were told to immediately take her to Queensland Children’s Hospital. “I was gutted, I was devastated. Getting a phone call from the doctor saying you need to rush your little girl to the hospital. That wasn’t a phone call that I wanted,” Mr Kemp said. Addison now has to stay in hospital until she can be matched with a donor. Her little sister Crimson, misses her every day that they are apart. “She gets a bit upset every day that they are not home,” Mr Kemp said. The family said that their bone-marrow did not match up with Addison, and no registered Australian donors had matched up with her either. However, not all hope is lost as any regular Australian could help save a life. Lisa Smith, from bone marrow donation charity Strength to Give, said that the donation process is similar to donating blood which involves a short course of injections before the operation. “The vast majority of time, it is you sitting in a chair, having your blood filtered, while you are watching Netflix," Smith said. Ms Kemp begged Australians to sign up as donors. “I really want to put the message out there that if you can, do,” she said. “You could be saving a life, that’s the biggest thing you could do in the world.” Image: A Current Affair

Caring

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

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

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To tackle gendered violence, we also need to look at drugs, trauma and mental health

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged <a href="https://ministers.pmc.gov.au/gallagher/2024/helping-women-leave-violent-partner-payment">more than A$925 million</a> over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships. However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues. <h2>Why is this crucial?</h2> The World Health Organization estimates <a href="https://iris.who.int/bitstream/handle/10665/341604/WHO-SRH-21.6-eng.pdf?sequence=1">30% of women</a> globally have experienced intimate partner violence, gender-based violence or both. In Australia, <a href="https://www.abs.gov.au/statistics/people/crime-and-justice/partner-violence/latest-release#key-statistics">27% of women</a> have experienced intimate partner violence by a co-habiting partner; <a href="https://pubmed.ncbi.nlm.nih.gov/37004184/">almost 40%</a> of Australian children are exposed to domestic violence. By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members. These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators. <h2>What’s the link with mental health, trauma and drugs?</h2> The relationships between mental illness, drug use, traumatic experiences and violence are complex. When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there <a href="https://theconversation.com/bondi-attacker-had-mental-health-issues-but-most-people-with-mental-illness-arent-violent-227868">is evidence</a> people with serious mental illness can be more likely to become violent. The use of alcohol and other drugs also <a href="https://theconversation.com/alcohol-and-drug-use-exacerbate-family-violence-and-can-be-dealt-with-69986">increases the risk</a> of domestic violence, including intimate partner violence. About <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/understanding-fdsv/factors-associated-with-fdsv">one in three</a> intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/">using alcohol or other drugs</a>. It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00075-0/fulltext">high rates</a> of trauma among people who become violent. For example, experiences of childhood trauma (such as witnessing physical abuse) <a href="https://www.sciencedirect.com/science/article/pii/S1359178915000828?via%3Dihub">can increase the risk</a> of perpetrating domestic violence as an adult. Early traumatic experiences can affect the brain and body’s <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0895-4">stress response</a>, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress. This response to stress increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675346/">alcohol and drug problems</a>, developing <a href="https://pubmed.ncbi.nlm.nih.gov/30798897/">PTSD</a> (post-traumatic stress disorder), and <a href="https://psycnet.apa.org/record/2015-17349-001">increases the risk</a> of perpetrating intimate partner violence. <h2>How can we address these overlapping issues?</h2> We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors. The early intervention and treatment of <a href="https://doi.org/10.1186/s12905-019-0728-z">mental illness</a>, <a href="https://doi.org/10.1177/1541204020939645">trauma</a> (including PTSD), and <a href="https://doi.org/10.1016/j.avb.2015.06.001">alcohol and other drug use</a>, could help reduce violence. So extra investment for these are needed. We also need more investment to <a href="https://www.sciencedirect.com/science/article/pii/S2212657023000508">prevent mental health issues</a>, and preventing alcohol and drug use disorders from developing in the first place. <a href="https://www.sciencedirect.com/science/article/pii/S074937972200023X?via%3Dihub">Preventing trauma</a> from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. <a href="https://journals.sagepub.com/doi/10.1177/070674371105600505">Safe and supportive</a> environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships. We also need to acknowledge the widespread <a href="https://store.samhsa.gov/product/practical-guide-implementing-trauma-informed-approach/pep23-06-05-005">impact of trauma</a> and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals. <h2>How about programs for perpetrators?</h2> Most existing standard intervention programs for perpetrators <a href="https://journals.sagepub.com/doi/10.1177/1524838018791268">do not consider</a> the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have <a href="https://psycnet.apa.org/doi/10.1037/a0012718">little</a> or <a href="https://doi.org/10.1016/j.cpr.2021.101974">mixed effects</a> on the behaviour of perpetrators. But we could improve these programs with a <a href="http://rcfv.archive.royalcommission.vic.gov.au/MediaLibraries/RCFamilyViolence/Reports/RCFV_Full_Report_Interactive.pdf">coordinated approach</a> including treating mental illness, drug use and trauma at the same time. Such “<a href="https://www.sciencedirect.com/science/article/pii/S014976341930449X?via%3Dihub">multicomponent</a>” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work. <h2>What needs to happen next?</h2> Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late. We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined. We also need to look more widely at preventing intimate partner violence and gendered violence. We need developmentally appropriate <a href="https://theconversation.com/4-things-our-schools-should-do-now-to-help-prevent-gender-based-violence-228993">education and skills-based programs</a> for adolescents to prevent the emergence of unhealthy relationship patterns before they become established. We also need to address the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278040/">social determinants of health</a> that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options. All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors. <hr /> The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229182/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/to-tackle-gendered-violence-we-also-need-to-look-at-drugs-trauma-and-mental-health-229182">original article</a>. </div>

Caring

Why are adults without kids hooked on Bluey? And should we still be calling it a ‘kids’ show’?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jessica-balanzategui-814024">Jessica Balanzategui</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> and <a href="https://theconversation.com/profiles/djoymi-baker-1269345">Djoymi Baker</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> “Bluey mania” shows no sign of abating. Bluey’s season finale, The Sign, was the <a href="https://tvtonight.com.au/2024/04/the-sign-breaks-abc-iview-records.html">most viewed ABC program</a> of all time on iView. A “hidden” follow-up episode, aptly named The Surprise, created a storm of <a href="https://www.dailymail.co.uk/tvshowbiz/article-13338251/Bluey-fans-wild-mystery-ending-surprise-episode-meaning.html">headlines</a> around the world, many of which <a href="https://mashable.com/article/bluey-surprise-baby-who-is-the-father">have a decidedly adult tone</a>. As highlighted in social media fan communities <a href="https://www.washingtonpost.com/arts-entertainment/2023/02/08/bluey-adult-fandom-tiktok/">and</a> <a href="https://gizmodo.com/bluey-disney-plus-bbc-australian-animation-adult-fans-1850426890">articles</a>, the show has struck a chord with adults, many of whom aren’t parents. What do they get from a show that is ostensibly “for kids”? <h2>Parents love Bluey (sometimes more than kids)</h2> Our <a href="https://www.infrastructure.gov.au/sites/default/files/documents/pfpp--australian-children%27s-television-cultures-actc.pdf">research</a> with <a href="https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiDjeXNluuFAxW2bmwGHf2aDvoQFnoECA8QAQ&url=https%3A%2F%2Fwww.aph.gov.au%2FDocumentStore.ashx%3Fid%3Dec6900b5-42b0-4c3d-b200-5c05ae895fec%26subId%3D751969&usg=AOvVaw2BpyYjP_6i62kXdJqyrplx&cshid=1714522763110954&opi=89978449">children aged 7-9</a> and their parents provides evidence of how enraptured adults are by Bluey. Our findings also suggest it’s the parents who often drive household Bluey obsessions. As one mum told us: "If we could tell the Australian TV gods something that we’d like to have on Australian TV, it would be more Bluey, don’t get rid of Bluey. […] Bluey is loved by mums a lot." Another explained how the show provided learning for parents: "It’s the gentle parenting, kindness, empathy for the children, the humour […] And helping kids [and] families work through real life situations with kindness and compassion." When one eight-year-old and his mum told us about their favourite shows, the following exchange took place: <blockquote> Mum:: What about Bluey? Son: I sometimes [watch it]… Mum: You don’t want to say. He doesn’t want to say he watches Bluey. Bluey’s fantastic. Son: I sometimes- Mum: He wants to be a big boy. […] Everyone in this room probably loves Bluey. It’s not just for kids. Son: Enough about that. </blockquote> Beyond families, Bluey has also attracted teen and adult fans without kids – in part thanks to a <a href="https://www.washingtonpost.com/arts-entertainment/2023/02/08/bluey-adult-fandom-tiktok/">vibrant TikTok community</a> (aka <a href="https://www.tiktok.com/search?lang=en&q=blueytok&t=1714526488575">#blueytok</a>). While some commentary suggests this adult fandom <a href="https://slate.com/culture/2024/04/bluey-the-sign-episode-ending-parents-adults-kids-disney-plus.html">is “weird”</a>, Bluey is only the latest in a long line of “children’s” shows with a passionate adult fanbase. <h2>Shifting barriers in television</h2> The distinction between “children’s” and “adult” television has long been crucial to our cultural understandings of what separates a child from an adult. In the 1950s, <a href="https://journals.sagepub.com/doi/10.1177/1749602020911359">academics were concerned</a> children were watching TV content that was too mature for them, turning them into “adultised children”, and that adults watching kids’ shows were becoming “infantile adults”. The industry took note. In 1957, a reduction in children’s TV production in the United States made space for so-called “kidult” shows designed for both age groups. Since then, the boundaries between children’s and adult television have continually shifted. In television’s early days, science fiction was associated with child audiences (which is why many initially assumed Star Trek was <a href="https://www.bloomsbury.com/au/to-boldly-go-9781838609733/">a kids’ show</a>). These boundaries were also influenced by television scheduling. Warner Bros’ early animation shorts were initially all-ages theatrical releases, but in 1960 were packaged into the Bugs Bunny Show – pitched for kids and aired on Saturday mornings. As a result, by 1967 animation was considered <a href="https://web.mit.edu/sp.778/www/Documents/From_Saturday_morning_to_---elevision_cartoons.pdf">kids’ fare</a>. The boundaries shifted again in the 1980s as adult Japanese anime such as Akira (1988) became popular in the West. In 1989, The Simpsons debuted on TV. Our research reveals even today there is confusion regarding the show’s suitability for young children. Some of our seven-to-nine-year-old participants described secretly watching it without their parents’ knowledge. <h2>Childhood healing</h2> Bluey’s adult appeal is credited to the show’s playful <a href="https://www.forbes.com/sites/paultassi/2024/04/14/disneys-giant-new-bluey-episode-the-sign-is-making-parents-cry/?sh=3c4a664f6234">yet emotionally complex</a> content. One reason adults tune into today’s kids’ TV is because it’s far more diverse than the shows they could access growing up. Take 19-year-old Bluey fan <a href="https://www.wired.com/story/bluey-internet-fandom/">Darby Rose</a>, who points to an episode in which a Jack Russell terrier has ADHD. “As a neurodivergent person myself, this representation makes me ecstatic,” Rose says. This is also true of many teen programs, with the queer-friendly high-school romance Heartstopper attracting a large <a href="https://time.com/6301556/heartstopper-netflix-season-2-fans/">adult following</a>. It’s not just <a href="https://theconversation.com/beyond-bluey-why-adults-love-re-watching-australian-kids-tv-from-their-childhoods-169727">childhood nostalgia</a> that drives adults to kids’ shows (although <a href="https://www.reddit.com/r/bluey/comments/x1xgf9/what_trips_down_memory_lane_and_nostalgia_does/">this is one aspect</a>). Watching kids’ shows can be self-affirming for adults who missed out on seeing their identity onscreen growing up. Some adult fans <a href="https://www.huffpost.com/entry/bluey-adults_n_65e774c1e4b0f9d26cac99a7">even say</a> Bluey has helped them heal childhood wounds. <h2>Children’s television meets adult fan cultures</h2> Watching “adult” television enables kids to feel more grown-up. Conversely, adults can watch children’s television to embrace aspects of their personality they feel social pressure to repress. The latter is often the case for “Bronies” (a portmanteau for “bro” and “pony”): adult male fans of the animated kids’ show My Little Pony: Friendship is Magic (2010-20). The community has attracted much <a href="https://www.mirror.co.uk/tv/tv-previews/military-men-obsessed-little-pony-6498303">controversy</a>. But <a href="https://researchportal.tuni.fi/en/publications/its-ok-to-be-joyful-my-little-pony-and-brony-masculinity">research</a> has found the reasons behind being a Brony aren’t suspicious or bizarre, but are empowering in unexpected ways. As Bronies themselves have explained, the fandom allows them to rethink what masculinity means to them, with the support of other fans online and at events such as <a href="https://www.npr.org/2019/08/14/750595032/the-friends-we-made-along-the-way-after-9-years-bronycon-calls-it-quits">BronyCon</a>. Why can’t “manliness” include watching a cute show about ponies with friendship at its heart? <h2>The changing nature of children’s television</h2> The rise of streaming has led to yet another shift. On-demand viewing means freedom from the constraints of TV scheduling, which historically set the terms for “child” and “adult” viewing. As <a href="https://www.routledge.com/Netflix-Dark-Fantastic-Genres-and-Intergenerational-Viewing-Family-Watch-Together-TV/Baker-Balanzategui-Sandars/p/book/9781032121895">our book details</a>, Netflix has invested in the expansion of cultural expectations around what makes “child-appropriate” television. Netflix’s mega hit Stranger Things deliberately pushes at these boundaries to attract a wide audience, from children and teens, to families, to adults without kids. As co-creator <a href="https://www.empireonline.com/movies/features/stranger-things-duffer-brothers-share-secrets-hit-show/">Matt Duffer explains</a>, the aim was to get children hooked on the show, and then later in the season “scare the shit out of them. Then the parents can get mad.” Parents certainly aren’t mad about their children getting hooked on Bluey. They may even be the secret to its global success: to keep the children watching, get the adults hooked.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228610/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jessica-balanzategui-814024">Jessica Balanzategui</a>, Senior Lecturer in Media, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> and <a href="https://theconversation.com/profiles/djoymi-baker-1269345">Djoymi Baker</a>, Lecturer in Media and Cinema Studies, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Image credits: ABC This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-adults-without-kids-hooked-on-bluey-and-should-we-still-be-calling-it-a-kids-show-228610">original article</a>. </div>

"We are with you": Hero cop embraced at Bondi candlelight vigil

The victims of the Bondi Junction stabbing attack have been honoured at a candlelight vigil, with police officer Amy Scott, who ended the terror by shooting Joel Cauchi, stepping out for the first time. Hundred of tearful mourners fathered at Bondi on Sunday night, where Prime Minister Anthony Albanese, Opposition Leader Peter Dutton, NSW Minister Chris Minns also joined in the sombre event to pay their respects to those who died in the Bondi Junction Westfield one week ago. The community gathered to farewell Ashlee Good, 38, Dawn Singleton, 25, Jade Young, 47, Pikria Darchia, 55, Yixuan Cheng, 27, and Faraz Tahir, 30, who were all fatally stabbed by 40-year-old Joel Cauchi. Cauchi was shot dead by police officer Amy Scott, who greeted and embraced emotional mourners at the vigil. Scott's actions were praised by the Prime Minister and the NSW Premier, who recognised her bravery in protecting the crowds of innocent people at the shopping centre. Speaking to the crowd, Mr Minns condemned Cauchi’s actions and the fear he instilled in the city’s residents. “Every Australian woman deserves to feel safe in her community. This is your state and your city,” he told the emotional crowd. “This is your home you have every right to live your life as you choose – free from fear and violence.” “We will not be a state where a woman is forced to change their behaviour because of the feelings or anger of other people.” The NSW Premier reminded mourners that millions of Australians shared their grief over the violent incident and were “in (their) corner” in the months to come. “Grief can be a terrible burden, but it doesn’t have to be a lonely one,” he said. Prime Minister Anthony Albanese reinforced that all of Australia was grieving for “all that has been stolen from us”, including “all the possibility and potential, all the kindness and humanity, all the love and laughter of the six lives snatched away” last Saturday. He said the vigil was being held for those killed in the attack and for everyone affected, including the dozen people injured and the “survivors carrying the invisible scars of trauma and of fear.” “We think of everyone still trying to come to terms with a hole in their life where a loved one should be,” Mr Albanese said. “Every Australian is thinking of you. We are with you. " "As a community, as a country today, tomorrow and always made those we have lost rest in eternal peace forever in our hearts.” Image credits: Getty Images

Caring

Hospice nurse explains why we shouldn't be afraid to die

A hospice nurse has shared why we shouldn't be afraid to die, explaining all the ways in which our bodies "shut off" to make for a "peaceful" death. Julie McFadden, a nurse based in Los Angeles, has long been sharing videos and explanations about end of life care in an attempt to destigmatise the conversations and fear around death and dying. In her latest YouTube video, McFadden got candid with her followers as she confessed she isn't afraid to die and why no one else should be either. She went on to explain all the ways in which our bodies are supposed to "shut off" in our final moments, making for a "peaceful" and "natural" death. " "I'm not afraid of death and here's the science behind it, our body biologically helps us die, so here is what I've seen and learned as a hospice nurse over the years - our body is literally built to die," she said. The hospice nurse revealed that bodies began to slowly shut down in the six months leading up to death, explaining that a person nearing the end of their life would start "eating less, drinking less, and sleeping more." "Why is that happening? Because calcium levels in the body are going up and because calcium levels are going up the person is getting sleepier," Julie said. "Our brains have built in mechanisms to make us hungry and thirsty. Biologically, when the body knows it's getting towards the end of life those mechanisms shut off, so the person does not usually feel hungry and does not usually feel thirsty, which is helping the body slowly shut down." <iframe title="YouTube video player" src="https://www.youtube.com/embed/CJEkzA0gt6s?si=CIzcf3xchddKtf1D" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe> She put minds at ease by debunking a common concern, saying that while certain diseases could make death more uncomfortable, dying in itself wasn't painful. "There are times when the disease that the person is experiencing can cause symptoms and it's more difficult because they're dying from a certain disease, but the actual process that the body is going through to help it die is actually helping that person," Julie added. "There have been many times as a hospice nurse that I have watched someone slowly die on hospice and I have not needed to give them any medication because their disease was not causing any symptoms - no pain, no shortness of breath, they were just more tired and weren't eating or drinking." "They still did all of the things any other person on hospice would be doing, like they slowly go unconscious, they slowly stop eating and drinking. I didn't have to give them any medications. They were perfectly comfortable and died a very peaceful death." Julie explained that death was even "comforting" in a way because when you're about to take your last breath, your body released endorphins, making you feel euphoric in your final moments. "The body slowly goes into something called ketosis, which releases endorphins. In that person's body those endorphins dull pain, dull nerves, and they also give that person a euphoric sense, so they feel good," she said. "There are many reasons why I don't fear death. Yes, I have had some pretty crazy spiritual experiences as a hospice nurse that led me to not fear death, but there are also biological, metabolical, and physiological things that happen in the body that truly, truly comforted me." She concluded, "Our bodies are built to die. The less we mess with that, the more peaceful it will be." Image credits: YouTube / Instagram

Caring

Whooping cough is surging in Australia. Why, and how can we protect ourselves?

<a href="https://theconversation.com/profiles/laurence-don-wai-luu-1415508">Laurence Don Wai Luu</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Australia is facing a whooping cough outbreak. Some <a href="https://nindss.health.gov.au/pbi-dashboard/">2,799 cases</a> were recorded in the first three months of 2024. Cases are highest in Queensland and New South Wales, with more than 1,000 recorded in each state. The last time Queensland recorded more than 1,000 cases in three months was <a href="https://nindss.health.gov.au/pbi-dashboard/">the first quarter of 2013</a>. This was at the tail end of a significant outbreak that spanned 2008 until 2012 – Australia’s largest reported outbreak since the <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi2205-pdf-cnt.htm/$FILE/cdi2205c.pdf">widespread introduction</a> of whooping cough vaccines <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-annlrpt-oz_dis19_91.htm/$FILE/ozdis1917_91.pdf">in the 1950s</a>. More than 140,000 cases were recorded during this period, with the number peaking at 38,748 in 2011. There was a smaller outbreak between <a href="https://nindss.health.gov.au/pbi-dashboard/">2014 and 2017</a>, with more than 60,000 cases in these years. So what is whooping cough, why are cases rising now, and how can you protect yourself? <h2>It’s most dangerous for babies</h2> Whooping cough is a serious and <a href="https://www.healthdirect.gov.au/whooping-cough">highly contagious</a> respiratory disease. Also called pertussis, it’s caused by the bacteria Bordetella pertussis. The initial symptoms of whooping cough resemble other cold and flu-like symptoms. These include runny nose, sneezing, mild cough and fever. However, as the disease progresses into the second week, the coughing fits become worse and more frequent. After or between bouts of coughing, patients may gasp for air and produce the characteristic “whoop” noise. The disease is also sometimes called the “100-day cough” as it can last for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150027/">6–12 weeks</a>. It’s especially serious and can be life-threatening in newborns who are yet to receive their vaccinations. In older children who are fully vaccinated, as well as adolescents and adults, the disease is normally less severe. However, even in adults, the coughing can lead to <a href="https://www.nejm.org/doi/full/10.1056/NEJMicm1701940">fractured ribs</a>. Antibiotics are used to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/ebch.1845">treat whooping cough</a> but are most effective when given during the initial stages of the illness. The best protection in the first instance is <a href="https://www.healthdirect.gov.au/whooping-cough">vaccination</a>, which prevents most cases of serious illness, and reduces the spread of whooping cough in the community. It’s recommended children are given six doses of a whooping cough vaccine (which is combined with vaccines for other diseases) between the ages of roughly two months and 13 years. Vaccination is free under the <a href="https://www.health.gov.au/topics/immunisation/vaccines/whooping-cough-pertussis-immunisation-service">National Immunisation Program</a> for children and pregnant women. Vaccinating women against whooping cough during pregnancy protects newborns in their first months of life. Immunity from these vaccines wanes over time, so it’s also recommended adults receive a booster, particularly those who may come into frequent contact with babies. <h2>Why are cases rising now?</h2> Whooping cough outbreaks generally occur <a href="https://www.healthdirect.gov.au/whooping-cough">every 3–4 years</a>. Due to COVID measures such as border closures, social isolation and masks, the number of cases declined dramatically during 2020–23. If trends had followed the usual outbreak cycle, this might have been around the time we’d have seen another outbreak. Missed <a href="https://ncirs.org.au/ncirs-study-confirms-decline-childhood-vaccination-coverage-throughout-covid-19-pandemic">routine whooping cough vaccinations</a> at the height of the pandemic may mean Australia is more vulnerable now. Reduced immunity in the population could be one of the reasons we’re seeing a rise in whooping cough cases in Australia and other countries including the <a href="https://www.gov.uk/government/publications/pertussis-epidemiology-in-england-2024/confirmed-cases-of-pertussis-in-england-by-month">United Kingdom</a> and the <a href="https://www.nyc.gov/assets/doh/downloads/pdf/han/advisory/2024/han-advisory-5.pdf">United States</a>. In Australia, cases have been particularly high during this outbreak in children aged 10–14. <h2>A potential superbug</h2> Over the past two decades, whooping cough has been getting better at evading vaccines and antibiotics. Most vaccines used in Australia and other developed countries stimulate your immune system to recognise and target <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/pertussis-whooping-cough">three to five components</a> of the bacteria. Over time, the bacteria that causes whooping cough has been slowly acquiring mutations in these genes. These mutations make the bacteria look slightly different to the one used in the vaccine, helping it better hide from the immune system. Most of these changes were small. But in 2008, a new strain appeared in Australia that no longer produced <a href="https://wwwnc.cdc.gov/eid/article/20/4/13-1478_article">pertactin</a>, one of the components targeted by the vaccine. This means your immune system, like a detective, has one less clue to recognise the bacteria. This new strain rapidly increased from <a href="https://wwwnc.cdc.gov/eid/article/25/6/18-0240_article">5% of strains found in 2008</a>, to become the dominant strain in less than ten years, making up <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537726/">90% of strains</a> by 2017. This pertactin-negative strain was shown to survive better in <a href="https://pubmed.ncbi.nlm.nih.gov/26432908/">vaccinated mice</a> and may have contributed to the high number of cases in the 2008–12 outbreak. Worryingly, since 2013, <a href="https://www.cdc.gov/drugresistance/biggest-threats.html">antibiotic-resistant strains</a> of whooping cough have become <a href="https://www.tandfonline.com/doi/full/10.1080/22221751.2019.1587315">widespread in China</a>. While there are other antibiotics available, these are not recommended for infants <a href="https://www.health.nsw.gov.au/Infectious/whoopingcough/Pages/workers-managing-cases.aspx">younger than two months</a> (the age group at most risk of serious disease). These resistant strains are increasingly <a href="https://wwwnc.cdc.gov/eid/article/26/10/20-1035_article">spreading through Asia</a> but are not yet in Australia. <h2>What next?</h2> It’s too early to know how big this outbreak will be or what strains are responsible for it. Greater tracking of whooping cough strains, like we do with COVID, is needed to inform future vaccine design and treatments. Importantly, although the bacteria is evolving, current vaccines are still very effective at preventing serious disease and reducing transmission. They remain our best tool to limit this outbreak. To protect oneself, vulnerable newborns, and the wider community, everyone should ensure they are up-to-date with their <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/pertussis-whooping-cough">whooping cough vaccinations</a>. You can check this with your GP if you’re not sure. And anyone with cold or flu-like symptoms should <a href="https://ncirs.org.au/ncirs-fact-sheets-faqs/pertussis">stay away</a> from infants.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226918/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laurence-don-wai-luu-1415508">Laurence Don Wai Luu</a>, Lecturer and Chancellor's Research Fellow, School of Life Sciences, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whooping-cough-is-surging-in-australia-why-and-how-can-we-protect-ourselves-226918">original article</a>.

Body

Why we need to stop being so judgemental – and the 4 steps to do it

As a society, we've become increasingly judgmental. We tend to judge not only others but ourselves as well. From a person's physical appearance to their actions, we criticise and judge everything. Everyone is too fat, too thin, too old, or too young, creating an environment where nothing seems to be good enough. This constant pattern of judgment is now harming our mental, emotional, and physical well-being. When we judge, we compare ourselves to others, leaving us emotionally vulnerable. Through this judgement, we seek to establish a sense of security and control over our lives and surroundings, often without even realising it. However, by increasing our emotional resilience and sense of control, we become consciously aware of this behaviour and can take steps to change it. So, is it possible to become less judgemental? As an educator and researcher, I developed an Emotional Resilience language (ER). It introduces simple changes that can reduce judgment, foster empathy, compassion, and personal responsibility, and bolster emotional intelligence and resilience when integrated into everyday life. Using a driving metaphor, ER simplifies the intricate world of emotions, providing an innovative way to integrate emotional vocabulary into daily life. It enhances understanding and establishes new neural pathways and healthier thought patterns. The following outlines the initial steps of ER, which can effectively manage judgement towards yourself and others. Though the changes may appear simplistic, they are instrumental in establishing lasting transformation. 1. Removing judgement towards how you or others may feel: Instead of labelling emotions as good or bad, view them as rough or smooth emotional roads. Just as roads serve different purposes, so do emotions. Rough emotions build resilience, while smooth emotions promote well-being, removing the need to lift everyone off a rough road. This makes it easier to recognise and accept emotions without feeling like a failure when things aren't going smoothly. You don’t know why someone is on a rough road, so resist the temptation to judge them. 2: The metaphorical steering wheel in ER represents emotional control and the power of choice in navigating life's challenges. As in a car, you should be the only one controlling your emotional steering wheel. Rather than judging yourself and others, this logical approach empowers you to regain control over your focus, emotions, and destination. Just because someone else is on a rough road doesn’t mean you must join them, fostering resilience and responsibility. 3. Shifting judgement and blame to responsibility involves removing phrases such as "You are making me angry, " which inadvertently hands your emotional steering wheel to others. Replace it with, "I am choosing to feel angry in response to this situation." This subtle alteration, substituting "making" with "choosing," helps reclaim ownership of your steering wheel rather than relinquishing control to external factors. Assigning blame—"It's your fault, it's the government's fault, it's my partner’s fault"— leaves you feeling like a victim, and you then resort to judgement and retaliation to regain control. 4. The importance of taking control: Understanding that judgement cannot be contained nor emotional resilience built when you are out of control on either road is crucial. Out-of-control scenarios activate the amygdala, the brain's fight, flight or freeze mode, disabling the prefrontal cortex, which is responsible for thinking and creativity. It is only possible to discuss a situation once the involved parties have regained control and can access the thinking part of their brain. Therefore, regaining control is essential for reducing judgement, as then you can have productive discussions that help maintain emotional well-being. This includes your conversations with yourself, which can often be the harshest! ER helps reduce judgement by developing your emotional resilience. Awareness of the emotional state of yourself and others fosters emotional intelligence, while learning to regain control builds resilience. Recognising that navigating rough emotions is crucial for growth alleviates the pressure from always needing to be on a smooth road and judging yourself and others if they aren’t. It shifts focus from dwelling on challenges and comparing yourself to others to being able to understand and manage your responses. Incorporating language changes into daily life builds new neural pathways, creating new thought patterns that reduce judgment and blame. By avoiding the tendency to judge yourself or others, you take back control of your reactions to people and circumstances. This leads to better mental and emotional well-being and fosters positive relationships with yourself and others. Does this mean you will never judge again? Of course not. You’re human. It’s what you do with the judgment that can make all the difference. Dr Jane Foster is a leading educator, researcher, presenter and author of It’s In Your Hands; Your Steering Wheel, Your Choice. Combining her educational skills with neuroscience and positive psychology, Jane equips people with strategies to help build emotional resilience and manage their daily stresses, successfully changing perspective and creating new neural pathways. For more information, visit <a href="https://www.emotionalresiliencetraining.com.au/" target="_blank" rel="noopener">www.emotionalresiliencetraining.com.au</a> Image: Getty

Mind

Might we see child-free zones on flights?

Ah, the joys of air travel. The excitement of jetting off to exotic locales, the thrill of new adventures, and of course, the endless possibilities for unexpected entertainment. And what's more exhilarating than finding yourself seated next to a rowdy toddler or an inconsolable infant? It's the stuff of dreams, truly. Picture this: you're settling into your seat, envisioning a serene journey ahead, perhaps catching up on your favourite Netflix series or finally finishing that novel you've been meaning to read. But wait, what's this? A couple with a baby approaching your row. You can already hear the distant wails of despair echoing through the cabin. Your heart sinks as you realise that your peaceful flight just took a nosedive before it even began. Yes, it's the age-old dilemma of child-free travellers everywhere. Whether it's the cacophony of a crying baby or the rhythmic drumming of tiny feet on the back of your seat, flying with children nearby can be an experience like no other. And let's not forget the classic game of "Will they or won't they?" as you anxiously await to see if the parents will be able to tame their pint-sized companions or if chaos will reign supreme at 30,000 feet. But fear not, dear passengers, for there may be a solution on the horizon. Could child-free zones be the answer to our airborne woes? According to a <a href="https://travel.nine.com.au/latest/planes-should-there-be-child-free-zones/d463b299-5258-418f-831c-f5fb218f1d77" target="_blank" rel="noopener">recent poll conducted by Nine News</a>, a whopping 73 per cent of respondents were in favour of such a proposition. Finally, a sanctuary where one can escape the unpredictable antics of tiny humans and bask in the tranquility of uninterrupted inflight bliss. Of course, implementing such a scheme may prove to be a tad challenging. After all, how does we go about segregating the child-rearing masses from the child-free elite without inciting a riot at the boarding gate? It's a logistical nightmare that even the most seasoned airline execs would hesitate to tackle. So, for now, it seems we child-free flyers will have to make do with our trusty noise-cancelling headphones, our steadfast eye masks, and a healthy dose of empathy for our fellow passengers. After all, parenting is no easy feat, especially at 35,000 feet. Image: Getty

Travel Trouble

Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

<a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Rumours and conspiracies have been <a href="https://www.nytimes.com/2024/02/28/style/princess-kate-middleton-health.html">swirling</a> following the abdominal surgery and long recovery period of Catherine, Princess of Wales, earlier this year. They intensified on Monday when Kensington Palace released a photo of the princess with her three children. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a> </div> </blockquote> The photo had clear signs of tampering, and international wire services <a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">withdrew the image</a> amid concerns around manipulation. The princess later <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised for any confusion</a> and said she had “experimented with editing” as many amateur photographers do. Image editing is extremely common these days, and not all of it is for nefarious purposes. However, in an age of rampant misinformation, how can we stay vigilant around suspicious images? <h2>What happened with the royal photo?</h2> A close look reveals at least eight inconsistencies with the image. Two of these relate to unnatural blur. Catherine’s right hand is unnaturally blurred, even though her left hand is sharp and at the same distance from the camera. The left side of Catherine’s hair is also unnaturally blurred, while the right side of her hair is sharp. These types of edits are usually made with a blur tool that softens pixels. It is often used to make the background of an image less distracting or to smooth rough patches of texture. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=358&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=358&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=358&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=450&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=450&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=450&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>At least eight logical inconsistencies exist in the doctored image the Prince and Princess of Wales posted on social media. <a class="source" href="https://www.instagram.com/p/C4U_IqTNaqU/">Photo by the Prince of Wales/Chart by T.J. Thomson</a></figcaption></figure> Five of the edits appear to use the “clone stamp” tool. This is a Photoshop tool that takes part of the same or a different image and “stamps” it onto another part. You can see this with the repeated pattern on Louis’s (on the left) sweater and the tile on the ground. You can also see it with the step behind Louis’s legs and on Charlotte’s hair and sleeve. The zipper on Catherine’s jacket also doesn’t line up. The most charitable interpretation is that the princess was trying to remove distracting or unflattering elements. But the artefacts could also point to multiple images being blended together. This could either be to try to show the best version of each person (for example, with a smiling face and open eyes), or for another purpose. <blockquote class="twitter-tweet"> Like many amateur photographers, I do occasionally experiment with editing. I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother’s Day. C — The Prince and Princess of Wales (@KensingtonRoyal) <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616?ref_src=twsrc%5Etfw">March 11, 2024</a></blockquote> <h2>How common are image edits?</h2> Image editing is increasingly common as both photography and editing are increasingly becoming more automated. This sometimes happens without you even knowing. Take HDR (high dynamic range) images, for example. Point your iPhone or equivalent at a beautiful sunset and watch it capture the scene from the brightest highlights to the darkest shadows. What happens here is your camera makes multiple images and automatically stitches them together to make an image <a href="https://www.adobe.com/creativecloud/photography/hub/guides/what-is-hdr-photography.html">with a wider range of contrast</a>. While face-smoothing or teeth-whitening filters are nothing new, some smartphone camera apps apply them without being prompted. Newer technology like Google’s “Best Take” <a href="https://blog.google/products/photos/how-google-photos-best-take-works/">feature</a> can even combine the best attributes of multiple images to ensure everyone’s eyes are open and faces are smiling in group shots. On social media, it seems everyone tries to show themselves in their best light, which is partially why so few of the photos on our <a href="https://www.tandfonline.com/doi/abs/10.1080/15551393.2020.1862663">camera rolls</a> make it onto our social media feeds. It is also why we often edit our photos to show our best sides. But in other contexts, such as press photography, the <a href="https://www.ap.org/about/news-values-and-principles/telling-the-story/visuals">rules are much stricter</a>. The Associated Press, for example, bans all edits beyond simple crops, colour adjustments, and “minor adjustments” that “restore the authentic nature of the photograph”. Professional photojournalists haven’t always gotten it right, though. While the majority of lens-based news workers adhere to ethical guidelines like those published by the <a href="https://nppa.org/resources/code-ethics">National Press Photographers Association</a>, others have let deadline pressures, competition and the desire for exceptional imagery cloud their judgement. One such example was in 2017, when British photojournalist Souvid Datta admitted to <a href="https://time.com/4766312/souvid-datta/">visually plagiarising</a> another photographer’s work within his own composition. <blockquote class="twitter-tweet"> Photographer Souvid Datta appears to have plagiarized Mary Ellen Mark: <a href="https://t.co/iO1Lm8CowU">https://t.co/iO1Lm8CowU</a> <a href="https://t.co/jswHyApGNj">pic.twitter.com/jswHyApGNj</a> — PetaPixel (@petapixel) <a href="https://twitter.com/petapixel/status/859824132258537472?ref_src=twsrc%5Etfw">May 3, 2017</a></blockquote> Concerns around false or misleading visual information are at an all-time high, given advances in <a href="https://theconversation.com/nine-was-slammed-for-ai-editing-a-victorian-mps-dress-how-can-news-media-use-ai-responsibly-222382">generative artificial intelligence (AI)</a>. In fact, this year the World Economic Forum named the risk of misinformation and disinformation as the world’s greatest <a href="https://www.weforum.org/agenda/2024/01/ai-disinformation-global-risks/">short-term threat</a>. It placed this above armed conflict and natural disasters. <h2>What to do if you’re unsure about an image you’ve found online</h2> It can be hard to keep up with the more than <a href="https://theconversation.com/3-2-billion-images-and-720-000-hours-of-video-are-shared-online-daily-can-you-sort-real-from-fake-148630">3 billion photos</a> that are shared each day. But, for the ones that matter, we owe it to ourselves to slow down, zoom in and ask ourselves a few simple <a href="https://www.aap.com.au/factcheck-resources/how-we-check-the-facts/">questions</a>: 1. Who made or shared the image? This can give clues about reliability and the purpose of making or sharing the image. 2. What’s the evidence? Can you find another version of the image, for example, using a <a href="https://tineye.com/">reverse-image search engine</a>? 3. What do trusted sources say? Consult resources like <a href="https://www.aap.com.au/factcheck/">AAP FactCheck</a> or <a href="https://factcheck.afp.com/">AFP Fact Check</a> to see if authoritative sources have already weighed in.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225553/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, Senior Lecturer in Visual Communication & Digital Media, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-kate-middletons-photo-was-doctored-but-so-are-a-lot-of-images-we-see-today-225553">original article</a>. Hero image: The Conversation / X / Instagram

Technology

Everything we know about Samantha Murphy's accused killer

The disappearance of Samantha Murphy, a beloved mother-of-three, sent shockwaves through the quiet community of Ballarat. As details emerged, the focus shifted towards Patrick Orren Stephenson, a young man <a href="https://www.oversixty.com.au/finance/legal/new-details-emerge-in-samantha-murphy-murder-charge" target="_blank" rel="noopener">accused of the crime</a>, whose life story offers a complex juxtaposition of privilege, athletic ambition and now, alleged tragedy. Patrick Stephenson, now 22 years old, grew up in the shadow of his father, <a href="https://www.afl.com.au/news/118551/orrens-family-affair" target="_blank" rel="noopener">Orren Stephenson</a>, a prominent figure in the world of AFL. Orren's late-life draft into the AFL introduced Patrick to the glamorous world of professional sports at a young age. Patrick, often seen tagging along with his father, had a firsthand view of the prestige and camaraderie within the football clubs, an experience many boys would envy. The Stephenson family, well-regarded in the Ballarat community, seemed to exude an aura of positivity. However, perceptions of Patrick were mixed among locals. While a local newspaper once featured him advocating for road safety alongside his football friends, news of his arrest painted a different picture, depicting him as a troubled teenager. On a fateful Thursday, Patrick Stephenson was charged with the murder of Samantha Murphy, <a href="https://www.oversixty.com.au/health/caring/please-come-home-family-s-emotional-plea-to-missing-woman" target="_blank" rel="noopener">whose disappearance</a> had gripped the community since February 4. Despite initial suppression orders, <a href="https://www.oversixty.com.au/finance/legal/new-details-emerge-in-samantha-murphy-murder-charge" target="_blank" rel="noopener">details about the accused</a> began to surface, shedding light on his upbringing and associations. Patrick's childhood was steeped in football culture, mirroring his father's passion for the sport. Orren Stephenson's stint in the AFL provided the family with unique opportunities, including access to elite football circles. Patrick, enamoured with the lifestyle his father's career afforded, embraced the world of football wholeheartedly. Neighbours recall a seemingly happy home life for the Stephensons, with Patrick attending private schools known for their conservative values and strong sporting traditions. However, in recent years, Patrick's involvement with the local football scene had waned, signalling a potential shift in his priorities. <a href="https://www.oversixty.com.au/finance/legal/man-arrested-in-search-for-samantha-murphy" target="_blank" rel="noopener">The arrest of Patrick Stephenson</a> in Scotsburn, a rural hamlet near Ballarat, left the community in disbelief. Residents, unaware of any motive or connection to the accused, expressed shock at the unfolding events. Despite extensive searches and appeals for information from the police, the whereabouts of Samantha Murphy's body remains unknown, adding to the sense of unease gripping the region. As the Ballarat community grapples with the loss of Samantha Murphy, questions linger about the events leading to her tragic demise. Patrick Stephenson's life, once intertwined with the glamour of professional football, now stands at the centre of a harrowing investigation that in many was has only just begun. Images: Redan Football Club / Supplied.

Legal

Why our voices change as we get older

<a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> Sir Elton John set a record at this year’s Glastonbury, becoming the <a href="https://www.independent.co.uk/arts-entertainment/music/news/elton-john-glastonbury-viewing-record-b2364260.html">most-watched headliner</a> in the festival’s history, with more than 7 million people tuning in live to the BBC to watch his last ever UK performance. The 76-year-old singer certainly delivered all his characteristic showmanship. But many who have followed his music over the decades will have noticed how much his voice has changed during his career – and not only because of the <a href="https://www.billboard.com/music/music-news/a-qa-with-elton-john-65620/">surgery he had</a> in the 1980s to <a href="https://ultimateclassicrock.com/elton-john-throat-surgery/">remove polyps</a> from his vocal cords. Equally, it’s not all down to the process of ageing. While it’s no mystery that this affects every part of our body, it isn’t the only reason that a person’s voice – even a professional singer like Sir Elton – can sound quite different over the years. <h2>The sound of your voice</h2> The vocal cords are what produce the sound of your voice. They are located in the <a href="https://www.ncbi.nlm.nih.gov/books/NBK538202/">larynx</a>, a part of the respiratory system that allows air to pass from your throat to your lungs. When air passes out of the lungs and through the larynx, it causes the vocal cords to vibrate – <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412481/">producing sound</a>. The vocal cords are composed of <a href="https://www.kenhub.com/en/library/anatomy/vocal-cords">three main parts</a>: the vocalis muscle, vocal ligament, and a mucous membrane (containing glands) to cover them. This keeps the surface moist and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810851/">protects them from damage</a>. There are also approximately <a href="https://radiopaedia.org/articles/intrinsic-muscles-of-the-larynx?lang=gb">17 other muscles</a> in the larynx that can alter vocal cord position and tension – thus changing the sound produced. Pre-puberty, there’s very little difference in the sound the vocal cords produce. But during puberty, hormones begin exerting their effects. This changes the structure of the larynx – making the “Adam’s apple” more prominent in men – and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0018506X16301271?via%3Dihub">length of the vocal cords</a>. After puberty, they’re around 16mm in length in men, and 10mm in women. Women’s vocal cords are also <a href="https://pubs.aip.org/asa/jasa/article/82/S1/S90/719336/Physiology-of-the-female-larynx">20-30%</a> thinner after puberty. These shorter, thinner vocal cords are the reason why women typically have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306615">higher voices</a> than men. Even after puberty, hormones can affect the voice. For instance, a woman’s voice may sound different depending on the stage of her menstrual cycle – with the <a href="https://www.jvoice.org/article/S0892-1997(08)00169-0/fulltext">best voice quality</a> being in the ovulatory phase. This is because the glands produce most mucous during this phase, giving the vocal cords their best functional ability. Research also shows that women taking the contraceptive pill show <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199717304940">less variation in voice quality</a> because the pill halts ovulation. On the other hand, hormonal changes during the premenstrual phase impede the vocal cords, making them stiffer. This may explain why opera singers would be offered “<a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199717301133">grace days</a>” in the 1960s to ensure they didn’t damage their vocal cords. And, because <a href="https://www.asha.org/practice-portal/clinical-topics/voice-disorders/#collapse_1">women’s vocal cords</a> are thinner, they may also be more likely to <a href="https://pubmed.ncbi.nlm.nih.gov/15157130/">suffer damage</a> from overuse. <h2>Everything ages</h2> As with almost every other part of the body, vocal cords age. But these changes might not be as <a href="https://www.sciencedirect.com/science/article/pii/S0892199721000011">noticeable for everyone</a>. As we get older, the larynx begins increasing its <a href="https://www.sciencedirect.com/science/article/abs/pii/S1752928X21001840">mineral content</a>, making it stiffer and more like bone than cartilage. This change can begin happening as early as <a href="https://meridian.allenpress.com/angle-orthodontist/article/75/2/196/57743/Ossification-of-Laryngeal-Cartilages-on-Lateral">your thirties</a> – especially in men. This makes the vocal cords less flexible. The muscles that allow the vocal cords to move also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166195/">begin wasting</a> (as do our other muscles) as we age. The ligaments and tissues that support the vocal cords also <a href="https://pubmed.ncbi.nlm.nih.gov/11800365/">lose elasticity</a>, becoming <a href="https://pubmed.ncbi.nlm.nih.gov/25645525/">less flexible</a>. There’s also a decrease in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695176/">pulmonary muscle function</a>, reducing the power of the air expelled from the lungs to create the sound. The number of glands that produce the protective mucus also decrease, alongside a reduction in the ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156980/">control the larynx</a>. <h2>Lifestyle is a factor</h2> While vocal cords age at largely the same rate in most people, many lifestyle factors can increase the risk of damage to them – and so can change the way your voice sounds. Smoking, for example, causes <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918293/">localised inflammation</a>, increased <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824943/">mucous production</a>, but can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557797/">dry out</a> the mucosal surfaces. Alcohol has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166195/">similar effect</a>. Over time, these factors can damage the vocal cords and alter the voice’s sound. Some over-the-counter and prescription drugs can also alter the voice – such as <a href="https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/482932">steroid inhalers used for laryngitis</a>. Blood thinners may also <a href="https://pubmed.ncbi.nlm.nih.gov/10875579/">damage the vocal cords</a> and can cause polyps to form, making the voice sound raspy or hoarse. <a href="https://pubmed.ncbi.nlm.nih.gov/7395839/">Muscle relaxants</a>, too, can lead to irritation and vocal cord damage due to the drug allowing stomach acid to wash back into the larynx. Thankfully, the irritation and changes caused by these medications typically disappears after stopping use. One other lifestyle factor can be overuse, which is typically seen in singers and other people who use their voice a lot <a href="https://pubmed.ncbi.nlm.nih.gov/15157130/">during work</a>, such as teachers and fitness instructors. This can lead to an uncommon condition called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392404/">Reinke’s oedema</a>, which can also be caused by smoking. Reinke’s oedema causes fluid to swell in the vocal cords, changing the pitch of the voice – often <a href="https://www.cuh.nhs.uk/patient-information/reinkes-oedema/">making it deeper</a>. In extreme cases of Reinke’s oedema, <a href="https://link.springer.com/article/10.1007/s00405-022-07377-9">surgery is needed</a> to drain the fluid. But in most cases, rest and avoiding irritants (smoking and alcohol) is beneficial, while speech and language therapy can also address the <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1460-6984.1995.tb01660.x">change in sound</a>. <h2>Maintaining our vocal quality</h2> While we can’t help some of the age-related changes that happen to our vocal cords, we can maintain some of our vocal quality and ability through continued use. This may explain why, in many cases, singers show <a href="https://pubmed.ncbi.nlm.nih.gov/27049451/">significantly less vocal change</a> with age than their non-singing counterparts. Singing or <a href="https://www.aarp.org/health/healthy-living/info-2014/improve-aging-voice.html">reading out</a> loud daily can give the vocal cords sufficient exercise to slow their decline. <a href="https://www.nidcd.nih.gov/health/taking-care-your-voice">Looking after</a> your vocal cords is also important. Staying hydrated and limiting intake of <a href="https://www.cuh.nhs.uk/patient-information/presbyphonia/">alcohol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069957/">tobacco</a> can help prevent high rates of decline and damage.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208640/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-our-voices-change-as-we-get-older-208640">original article</a>.

Body

MH370 disappearance 10 years on: can we still find it

<a href="https://theconversation.com/profiles/charitha-pattiaratchi-110101">Charitha Pattiaratchi</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> It has been ten years since Malaysia Airlines passenger flight MH370 <a href="https://theconversation.com/lessons-to-learn-despite-another-report-on-missing-flight-mh370-and-still-no-explanation-100764">disappeared on March 8 2014</a>. To this day it remains one of the biggest aviation mysteries globally. It’s unthinkable that a modern Boeing 777-200ER jetliner with 239 people on board can simply vanish without any explanation. Yet multiple searches in the past decade have still not yielded the main wreckage or the bodies of the victims. At a remembrance event held earlier this week, the Malaysian transport minister announced <a href="https://www.reuters.com/world/asia-pacific/malaysia-says-mh370-search-must-go-10-years-after-plane-vanished-2024-03-03/">a renewed push for another search</a>. If approved by the Malaysian government, the survey will be conducted by United States seabed exploration firm Ocean Infinity, whose efforts were unsuccessful in 2018. <h2>What happened to MH370?</h2> The flight was scheduled to fly from Kuala Lumpur to Beijing. Air traffic control lost contact with the aircraft within 60 minutes into the flight over the South China Sea. Subsequently, it was tracked by military radar crossing the Malay Peninsula and was last located by radar over the Andaman Sea in the northeastern Indian Ocean. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579774/original/file-20240305-18-vdbysn.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" alt="A map of the region showing the initial search areas on 8-16 March." /></a><figcaption>The planned route, final route and initial search area for MH370 in Southeast Asia. <a class="source" href="https://en.wikipedia.org/wiki/Timeline_of_Malaysia_Airlines_Flight_370#/media/File:MH370_initial_search_Southeast_Asia.svg">Andrew Heenen/Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> Later, automated satellite communications between the aircraft and British firm’s Inmarsat telecommunications satellite indicated that the plane ended up in the southeast Indian Ocean <a href="https://hub.arcgis.com/datasets/4c94d33cfc144f7d8b78943dee56e29b/explore">along the 7th arc</a> (an arc is a series of coordinates). This became the basis for defining the initial search areas by the Australian Air Transport Safety Bureau. Initial air searches were conducted in the South China Sea and the Andaman Sea. To date, we still don’t know what caused the aircraft’s change of course and disappearance. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579749/original/file-20240305-25-p456o1.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Location of the 7th arc and the origin of debris locations for simulations undertaken by the University of Western Australia. Google Earth/Author provided</figcaption></figure> <h2>What have searches for MH370 found so far?</h2> On March 18 2014, ten days after the disappearance of MH370, a search in the southern Indian Ocean <a href="https://www.atsb.gov.au/publications/2014/considerations-on-defining-the-search-area-mh370">was led by Australia</a>, with participation of aircraft from several countries. This search continued until April 28 and covered an area of 4,500,000 square kilometres of ocean. No debris was found. Two underwater searches of the Indian Ocean, 2,800km off the coast of Western Australia, have also failed to find any evidence of the main crash site. The initial seabed search, led by Australia, covered 120,000 square kilometres and extended 50 nautical miles across the 7th arc. It took 1,046 days and was suspended on January 17 2017. A second search by Ocean Infinity in 2018 <a href="https://oceaninfinity.com/conclusion-of-current-search-for-malaysian-airlines-flight-mh370/">covered over 112,000 square kilometres</a>. It was completed in just over three months but also didn’t locate the wreckage. <h2>What about debris?</h2> While the main crash site still hasn’t been found, several pieces of debris have washed up in the years since the flight’s disappearance. In fact, in June 2015 officials from the Australian Air Transport Safety Bureau determined that debris might arrive in Sumatra, contrary to the ocean currents in the region. The strongest current in the Indian Ocean is the South Equatorial Current. It flows east to west between northern Australia and Madagascar, and debris would be able to cross it. Indeed, on July 30 2015 a large piece of debris – a <a href="https://en.wikipedia.org/wiki/Flaperon">flaperon</a> (moving part of a plane wing) – washed up on Reunion Island in the western Indian Ocean. It was later confirmed to belong to MH370. Twelve months earlier, using an oceanographic drift model, our University of Western Australia (UWA) modelling team had predicted that any debris originating from the 7th arc would end up in the western Indian Ocean. In subsequent months, additional aircraft debris was found in the western Indian Ocean in Mauritius, Tanzania, Rodrigues, Madagascar, Mozambique and South Africa. The UWA drift analysis accurately predicted where floating debris from MH370 would beach in the western Indian Ocean. It also guided American adventurer Blaine Gibson and others to directly recover several dozen pieces of debris, three of which <a href="https://www.newsweek.com/where-blaine-gibson-now-malaysia-airlines-mh370-debris-hunter-1787369">have been confirmed</a> to be from MH370, while several others <a href="https://www.airlineratings.com/news/mh370-debris-now-for-the-facts/">are deemed likely</a>. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=602&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=602&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=602&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=757&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=757&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579756/original/file-20240305-22-q62h9n.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=757&fit=crop&dpr=3 2262w" alt="A detailed satellite map showing locations of debris found on the shores of Africa and Madagascar." /></a><figcaption>Predicted locations of landfall from results of University of Western Australia drift modelling. The white dots indicate predicted landfall of the debris. The aggregation of many dots, particularly close to land, is an indication of the density of particles – higher probability of debris making landfall. These are highlighted by red circles. Charitha Pattiaratchi/UWA, Author provided</figcaption></figure> To date, these debris finds in the western Indian ocean are the only physical evidence found related to MH370. It is also independent verification that the crash occurred close to the 7th arc, as any debris would initially flow northwards and then to the west, transported by the prevailing ocean currents. These results are consistent with other drift studies undertaken by independent researchers globally. <h2>Why a new search for MH370 now?</h2> Unfortunately, the ocean is a chaotic place, and even oceanographic drift models cannot pinpoint the exact location of the crash site. The proposed new search by Ocean Infinity has significantly narrowed down the target area within latitudes 36°S and 33°S. This is approximately 50km to the south of the locations where UWA modelling indicated the release of debris along the 7th arc. If the search does not locate the wreckage, it could be extended north. Since the initial underwater searches, technology has tremendously improved. Ocean Infinity is using a fleet of autonomous underwater vehicles with improved resolution. The proposed search will also use remotely controlled surface vessels. In the area where the search is to take place, the ocean is around 4,000 metres deep. The water temperatures are 1–2°C, with low currents. This means that even after ten years, the debris field would be relatively intact. Therefore, there is a high probability that the wreckage can still be found. If a future search is successful, this would bring closure not just to the families of those who perished, but also the thousands of people who have been involved in the search efforts.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224954/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/charitha-pattiaratchi-110101">Charitha Pattiaratchi</a>, Professor of Coastal Oceanography, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/mh370-disappearance-10-years-on-can-we-still-find-it-224954">original article</a>.

Travel Trouble

We talked to dozens of people about their experience of grief. Here’s what we learned (and how it’s different from what you might think)

<a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Have you ever felt a sudden pang of sadness? A bird seems to stop and look you in the eye. A photo drops out of a messy drawer from long ago, in the mundanity of a weekend spring clean. Your day is immediately derailed, unsettled. You are pulled into something you thought was past. And yet, in being pulled back, you are grateful, reconnected, and grief-stricken all over again. “You’ll get over it”. “Give it time”. “You need time to move on”. These are common cultural refrains in the face of loss. But what if grief doesn’t play by the rules? What if grief is a different thing altogether? We talked to 95 people about their experiences of grief surrounding the loss of a loved one, and <a href="https://journals.sagepub.com/doi/10.1177/00380261241228412">their stories</a> provided a fundamentally different account of grief to the one often presented to us culturally. <h2>Disordered grief?</h2> Grief is often imagined as a time-bound period in which one processes the pain of loss – that is, adjusts to absence and works toward “moving on”. The bereaved are expected to process their pain within the confines of what society deems “normal”. The <a href="https://theconversation.com/explainer-what-is-the-dsm-and-how-are-mental-disorders-diagnosed-9568">DSM-5 psychiatric manual</a> says if grief drags on too long, in fact, it becomes a pathology (a condition with a medical diagnosis). “Prolonged grief disorder” is the name given to “persistent difficulties associated with bereavement that exceeded expected social, cultural, or religious expectations”. While there can be <a href="https://theconversation.com/why-prolonged-grief-should-be-listed-as-a-mental-disorder-4262">value</a> in clinical diagnostic categories such as this, the danger is they put artificial boundaries around emotions. The pathologisation of grief can be deeply alienating to those experiencing it, for whom the pressure to “move on” can be hurtful and counterproductive. The stories we gathered in our research were raw, complex and often fraught. They did not sit comfortably with commonsense understandings of how grief “should” progress. As bereaved daughter Barbara told us: "Grief is not in the little box, it doesn’t even come close to a little box." <h2>Grief starts early</h2> The tendency is to think of grief as something that happens post death. The person we love dies, we have a funeral, and the grief sets in. Then it slowly subsides with the steady march of time. In fact, grief often begins earlier, often in a clinical consultation where the words “terminal” or “nothing more we can do” are used. Or when a loved one is told “go home and get your life in order”. Grief can begin months or even years before bereavement. As the people we interviewed experienced it, loss was also cumulative. The gradual deterioration of a loved one’s health in the years or months before their death imposed other painful losses: the loss of chosen lifestyles, the loss of longstanding relational rhythms, the loss of shared hopes and anticipated futures. Many participants felt their loved ones – and, indeed, the lives they shared with them – slipping away long before their physical deaths. <h2>Living with the dead</h2> Yet the dead do not simply leave us. They remain with us, in memories, rituals and cultural events. From <a href="https://theconversation.com/what-ancient-cultures-teach-us-about-grief-mourning-and-continuity-of-life-86199">Mexico’s Dia de los Muertos</a> to <a href="https://theconversation.com/japans-obon-festival-how-family-commemoration-and-ancestral-worship-shapes-daily-life-179890">Japan’s Opon</a>, festivals of the dead play a key role in cultures around the world. In that way, remembering the dead remains a critical aspect of living. So too does <a href="https://theconversation.com/theres-not-always-closure-in-the-never-ending-story-of-grief-3096">the ongoing experience of grief</a>. Events of this kind are not merely celebratory. They are critical forms through which life and death, joy and grief, are brought together and integrated. The absence of remembering can hold its own trouble, as our participants’ accounts revealed. As bereaved wife Anna explained: "I just find it really frustrating and I do get quite angry and upset sometimes. I know that life goes on. I’d be talking to girlfriends and stuff like that and it’s like they’ve forgotten that I’ve lost my husband. They haven’t, but nothing really changed in their life. But for me, and my family, it has." Part of the problem, here, is the ambivalent role grief plays in advanced industrialised societies like ours. Many of our participants felt pressure to perform resilience or (in clinical terms) to <a href="https://journals.sagepub.com/doi/full/10.1177/1363459317724854">“recover” quickly after loss</a>. But whose interests does a swift recovery serve? An employer’s? Friends who just want to get on with a death-free life? And, even more importantly, mightn’t ongoing connections with the dead enable better living? Might bringing the dead along with us actually make for better deaths and better lives? Many of our participants felt their loved ones remained with them, and experienced their “absent presence” as a source of comfort. Grieving, in this context, involved spending time “with” the dead. Anna described her practice as follows: "I had a diary, so I just write stuff in it about how I’m feeling or something happened and I’ll say to [my deceased husband], it’s all to [my deceased husband], “Do you remember, blah, blah, blah.” I’ll just talk about that memory that I have of that particular time and I find that that helps." <h2>Caring for those who grieve</h2> Grief does not begin at death, but neither do relationships end there. To rush the bereaved through grief – to usher them towards “recovery” and the more comfortable territories of happiness and productivity – is to do them a disservice. And, perhaps more critically, ridding our lives of the dead and grief may, in the end, make for more limited and muted emotional lives.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223848/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, Research Fellow, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-talked-to-dozens-of-people-about-their-experience-of-grief-heres-what-we-learned-and-how-its-different-from-what-you-might-think-223848">original article</a>.

Caring

We looked at 700 plant-based foods to see how healthy they really are. Here’s what we found

<a href="https://theconversation.com/profiles/laura-marchese-1271636">Laura Marchese</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> If you’re thinking about buying plant-based foods, a trip to the supermarket can leave you bewildered. There are plant-based burgers, sausages and mince. The fridges are loaded with non-dairy milk, cheese and yoghurt. Then there are the tins of beans and packets of tofu. But how much is actually healthy? Our nutritional audit of more than 700 plant-based foods for sale in Australian supermarkets has just been <a href="https://www.sciencedirect.com/science/article/pii/S0889157524000516">published</a>. We found some products are so high in salt or saturated fat, we’d struggle to call them “healthy”. <h2>We took (several) trips to the supermarket</h2> In 2022, we visited two of each of four major supermarket retailers across Melbourne to collect information on the available range of plant-based alternatives to meat and dairy products. We took pictures of the products and their nutrition labels. We then analysed the nutrition information on the packaging of more than 700 of these products. This included 236 meat substitutes, 169 legumes and pulses, 50 baked beans, 157 dairy milk substitutes, 52 cheese substitutes and 40 non-dairy yoghurts. <h2>Plant-based meats were surprisingly salty</h2> We found a wide range of plant-based meats for sale. So, it’s not surprising we found large variations in their nutrition content. Sodium, found in added salt and which contributes to <a href="https://www.heartfoundation.org.au/bundles/healthy-living-and-eating/salt-and-heart-health">high blood pressure</a>, was our greatest concern. The sodium content varied from 1 milligram per 100 grams in products such as tofu, to 2,000mg per 100g in items such as plant-based mince products. This means we could eat our entire <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/salt">daily recommended sodium intake</a> in just one bowl of plant-based mince. An <a href="https://www.tandfonline.com/doi/full/10.1080/09637486.2022.2137786">audit</a> of 66 plant-based meat products in Australian supermarkets conducted in 2014 found sodium ranged from 316mg in legume-based products to 640mg in tofu products, per 100g. In a <a href="https://www.mdpi.com/2072-6643/11/11/2603">2019 audit</a> of 137 products, the range was up to 1,200mg per 100g. In other words, the results of our audit seems to show a consistent trend of plant-based meats <a href="https://www.tandfonline.com/doi/full/10.1080/09637486.2022.2137786">getting saltier</a>. <h2>What about plant-based milks?</h2> Some 70% of the plant-based milks we audited were fortified with calcium, a nutrient important for <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/calcium">bone health</a>. This is good news as a <a href="https://www.mdpi.com/2072-6643/12/5/1254">2019-2020 audit</a> of 115 plant-based milks from Melbourne and Sydney found only 43% of plant-based milks were fortified with calcium. Of the fortified milks in our audit, almost three-quarters (73%) contained the <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/milk-yoghurt-cheese-andor-their-alternatives-mostly-reduced-fat">recommended amount of calcium</a> – at least 100mg per 100mL. We also looked at the saturated fat content of plant-based milks. Coconut-based milks had on average up to six times higher saturated fat content than almond, oat or soy milks. <a href="https://www.mdpi.com/2072-6643/12/5/1254">Previous audits</a> also found coconut-based milks were much higher in saturated fat than all other categories of milks. <h2>A first look at cheese and yoghurt alternatives</h2> Our audit is the first study to identify the range of cheese and yoghurt alternatives available in Australian supermarkets. Calcium was only labelled on a third of plant-based yoghurts, and only 20% of supermarket options met the recommended 100mg of calcium per 100g. For plant-based cheeses, most (92%) were not fortified with calcium. Their sodium content varied from 390mg to 1,400mg per 100g, and saturated fat ranged from 0g to 28g per 100g. <h2>So, what should we consider when shopping?</h2> As a general principle, try to choose whole plant foods, such as unprocessed legumes, beans or tofu. These foods are packed with vitamins and minerals. They’re also high in dietary fibre, which is good for your gut health and keeps you fuller for longer. If opting for a processed plant-based food, here are five tips for choosing a healthier option. 1. Watch the sodium Plant-based meat alternatives can be high in sodium, so look for products that have <a href="https://www.eatforhealth.gov.au/eating-well/how-understand-food-labels/food-labels-what-look">around</a> 150-250mg sodium per 100g. 2. Pick canned beans and legumes Canned chickpeas, lentils and beans can be healthy and low-cost <a href="https://www.heartfoundation.org.au/getmedia/71522940-decf-436a-ba44-cd890dc18036/Meat-Free-Recipe-Booklet.pdf">additions to many meals</a>. Where you can, choose canned varieties with no added salt, especially when buying baked beans. 3. Add herbs and spices to your tofu Tofu can be a great alternative to meat. Check the label and pick the option with the highest calcium content. We found flavoured tofu was higher in salt and sugar content than minimally processed tofu. So it’s best to pick an unflavoured option and add your own flavours with spices and herbs. 4. Check the calcium When choosing a non-dairy alternative to milk, such as those made from soy, oat, or rice, check it is fortified with calcium. A good alternative to traditional dairy will have at least 100mg of calcium per 100g. 5. Watch for saturated fat If looking for a lower saturated fat option, almond, soy, rice and oat varieties of milk and yoghurt alternatives have much lower saturated fat content than coconut options. Pick those with less than 3g per 100g.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-marchese-1271636">Laura Marchese</a>, PhD Student at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-looked-at-700-plant-based-foods-to-see-how-healthy-they-really-are-heres-what-we-found-222991">original article</a>.

Food & Wine

"We want Sam home": Distraught husband speaks out

Samantha Murphy's distraught husband has issued a desperate plea to the community for knowledge about his wife's whereabouts, two weeks after she went missing. The 51-year-old mother from Ballarat took off for her daily run in the early hours of the morning of February 4th, and was never seen again. With Ms Murphy's disappearance now being labelled as "suspicious" by police investigators, Mick Murphy has shared an emotional message for the community to come forward with information about his wife. “We want Sam home please,” he told <a href="https://7news.com.au/news/samantha-murphys-husband-mick-murphy-speaks-out-as-police-continue-to-investigate-joggers-disappearance-two-weeks-on-c-13642464" target="_blank" rel="noopener">7News</a>. Mr Murphy told the outlet his family are “doing the best we can under the circumstances”. He has made several pleas to the public for anyone to come forward if they had information about the mother-of-three’s disappearance. “People just don’t vanish into thin air. Someone’s got to know something,” he told reporters on Thursday. On Wednesday, police officially labelled Samantha's disappearance as "suspicious", as their investigation continues. “Call it unusual, call it suspicious. But it certainly is of significant concern to us,” Chief Commissioner Shane Patton said on Wednesday. He went on to say that there were still no new leads in the investigation, headed by the Missing Persons Squad. “It’s certainly unusual when we haven’t been able to locate any trace of her or any other evidence within that period of time,” he said. “It’s suspicious, whether that means there’s foul play involved or not, I don’t know, but obviously detectives are investigating a matter where a woman’s been missing for a significant period of time.” Image credits: 9News

Family & Pets

Is Valentine’s Day worth the romantic investment? Here’s what we can learn from economics

<a href="https://theconversation.com/profiles/selma-wather-1510222">Selma Wather</a>, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a> Expressing affection can be expensive. Spending on heart-shaped gifts, romantic cards, chocolates and flowers (other gifts are available) to celebrate Valentine’s Day has reached <a href="https://www.statista.com/statistics/510981/valentines-day-total-spending-great-britain/#:%7E:text=In%20the%20United%20Kingdom%20%28UK%29%20alone%2C%20Valentine%E2%80%99s%20Day,increased%20by%20just%20over%20300%20million%20British%20pounds.">close to £1 billion</a> in the UK. So the value of Valentine’s to retailers seems clear enough. But just how valuable is the annual ritual to consumers? What return can you expect for the money you invest in that bouquet of roses or candle lit meal? Broadly speaking, and depending on your relationship status, buying into Valentine’s Day traditions suggests two possible scenarios. You might be sending a card or gift to a potential partner to inform them of your interest; or you might be giving something to your current partner to remind them of your continuing love. Research suggests that both options have intrinsic economic value. For those seeking to express interest, sending a card is like dipping your toe into what economists might refer to as the “marriage market” – the search for someone you like, who likes what you have to offer in return. This search can happen smoothly, with plenty of information about your potential match, or it can be paved with obstacles, where you may not know much about who is available, and <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1703310">learning about potential partners</a> takes time. So suppose you are searching for a partner, and comprehensive information about potential matches is not freely available. What do you do? One option might be to put all your hopes into meeting someone on your daily journey to work. You pray that one day, just like in the movies, you will simply bump into “the one”. A second option might be to focus your search on single work colleagues, or people you know socially, and send Valentine’s Day cards to those you are attracted to. The option with the highest chance of success is the second one. You are using reliable information – knowledge of who is single. And sending a card to them can provide them with important information about you – that you’re also single, and that you’re interested. This is why research suggests that sending a Valentine’s Day card can be a <a href="https://www.jstor.org/stable/2938374?origin=crossref">logical investment</a> of time and money. <h2>‘Match quality’</h2> Fast forward five years or so and imagine you are happily married to the recipient of one of those cards. Is it worth repeating the gesture now that you’re settled down together? Economists think of marriages or partnerships as having an inherent “<a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-2354.2006.00385.x">match quality</a>”, which reflects how good (or bad) your relationship is – and the likelihood of you breaking up. If match quality falls below the level of happiness you might expect to have if you were to leave, a <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2759255">separation may well follow</a>. But many studies also show that <a href="https://www.jstor.org/stable/2535409">match quality is malleable</a> – that it can change, for better and indeed for worse, over time. You can invest in trying to improve match quality in various ways. It might be starting a family, sharing hobbies and interests, or gestures such as cooking a special meal or exchanging gifts on the 14th day of February. Improving your match quality <a href="https://www.researchgate.net/publication/228431914_How_Does_the_Change_of_Marriage_Quality_Affect_Divorce_Decisions">directly reduces the probability</a> of a separation. Then there’s the question of commitment – the willingness to stay in a relationship rather than walking away. And again, gestures can make a difference. Imagine you have just started a new job, and your employer asks you to complete an intensive training session in your free time, for a skill that would only be useful for that particular role. If you expect to hold the job for a long period, you might happily invest your time. But if your employer is struggling financially and redundancy is on the cards, you are much less likely to agree to perform the task. Relationships work in a similar way. People are more prepared to invest in things like having children or buying a house together if they expect the relationship to last. Given that commitment is not guaranteed by a marriage certificate, people <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=950688">need to find other ways</a> to signal their continued devotion. Celebrating Valentine’s Day is one way of making such a signal. It can show faith in your shared commitment, signify that you wish to continue investing in the relationship and improve match quality, further stabilising the partnership. So even if deep down you think that Valentine’s Day has become over commercialised and meaningless, research suggests it makes good economic sense to send that card.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223128/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/selma-wather-1510222">Selma Wather</a>, Senior Lecturer in Economics, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-valentines-day-worth-the-romantic-investment-heres-what-we-can-learn-from-economics-223128">original article</a>.

Money & Banking

"We want answers": Furious cruise passengers stage protest after itinerary change

Passengers onboard a Norwegian Cruise Line voyage has expressed their outrage after their once in a lifetime trip to Antarctica changed course after the journey had already begun. Melbourne woman Helen Midler was one of hundreds of people onboard the cruise from Buenos Aires to mainland Antarctica, when staff informed all travellers that their itinerary had changed. Days into their journey, those onboard were told they would not be visiting Antarctica at all, but would be doing a "South America round trip" instead. Midler took to social media to share her frustrations, saying the communication between the cruise line and the passengers was very poor. She explained that she only found out about the change after checking the app a few days into the journey and noticed the name of the cruise had been changed. Passengers were later told the change of destination was for "operational reasons" after raising their concerns, however no further explanation was given. Those onboard were allegedly told the decision was made by the head office in the US to not visit Paradise Bay, on mainland Antarctica, before departure on January 31, and that all passengers were notified by email, and again at check-in. However, Midler claims this was not the case. "I can assure you that we never got any email and many of our friends here on board, and I'm talking hundreds of people we know, did not receive any email either," she said in a video posted online. "Until the cruise had commenced, most people on this ship were not aware of the change in the itinerary." Midler said "everyone was angry", with hundreds of passengers meeting at in the ship's foyer one morning in protest to demand further answers from the crew. "Customer service are refusing to acknowledge us, they sent a security officer out to calm us down," she said while standing in the noisy crowd. "We feel we're being cheated, being scammed". Midler said frustrated travellers, some of whom "spent their live savings" on the cruise that costs upwards of $4,000 per person, just "want answers, transparency and clarity" but claims they're being treated with "absolute disdain and disrespect" with little explanation given. "Everyone on this ship has paid a lot of money to cruise to Antarctica, not to do a round trip of South America at sea," she fumed. "We are being dismissed, ignored, refused answers. They're telling us we just have to accept it. "They think we're idiots. We're not idiots and we're not prepared to just accept this sitting down," she continued. "We may not get to Antarctica. The chances of this cruise now going to Antarctica are minimal. But we want answers." In the days after her initial post, Midler updated her online followers and said those onboard were trying to make the best of a bad situation, despite still not hearing any clear answers about the change of itinerary. "We saved and we booked this two years ago for the trip of a lifetime," she said. "We're feeling very disappointed and dejected about the outcomes here." "We'll never be able to afford to do this again. And we've lost that trip to the Antarctica mainland that we had all been hoping and waiting for, and that we'd paid for. But we're going to try and do our best to enjoy it." Image credits: TikTok

Legal

Why can’t WE do this?! UK company unveils "Grans Go Free" flights

EasyJet Holidays has unveiled their "first of its kind" offer allowing older relatives to travel for free on family bookings to popular European destinations, including Spain, Greece and Italy. The offer was announced during the final week of the easyJet Holidays Big Orange Sale last week, where customers could get up to £400 off. The move was made after a survey they conducted found that half of families have never holidayed abroad with grandparents. From the survey of 2,000 British adults, half of them said they regret not spending more time with grandparents and hoped to travel with them in their upcoming holidays. "We're proud to offer thousands of free kids' places, but we feel it's time to recognise the grandparents," easyJet Holidays Chief Operating Officer, Matt Callaghan said. "This research shows how important grandparent and grandchild relationships are and how much can be learned from making time for them." The tour operator hopes to encourage people in the UK to take a "3G" holiday - the term used for getaways with three or more generations. They found that seventy-seven per cent of the people surveyed agreed that the bond between grandparents and grandchildren is one of the most special relationships within a family. 73 percent of these people also said that they would use the holiday opportunity to learn more about their grandparents' lives, and almost half of them want to benefit from their grandparents' wisdom. The most popular destinations for multi-generational holidays abroad are Spain (18 per cent), Italy and France, which both sit at 13 per cent. Limited spaces for the offer were made available and to qualify, the grandparent had to travel as part of a family booking with at least one child, and provide proof of age and relation had to be provided upon arrival at the hotel. The offer ended on the 5th of February, but it does make us wonder, when will Australia follow in their footsteps? Image: EasyJet/ Getty

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

“We need a donor”: Parents' desperate plea to save young daughter

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

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Hospice nurse explains why we shouldn't be afraid to die

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Why we need to stop being so judgemental – and the 4 steps to do it

Might we see child-free zones on flights?

Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

Everything we know about Samantha Murphy's accused killer

Why our voices change as we get older

MH370 disappearance 10 years on: can we still find it

We talked to dozens of people about their experience of grief. Here’s what we learned (and how it’s different from what you might think)

We looked at 700 plant-based foods to see how healthy they really are. Here’s what we found

"We want Sam home": Distraught husband speaks out

Is Valentine’s Day worth the romantic investment? Here’s what we can learn from economics

"We want answers": Furious cruise passengers stage protest after itinerary change

Why can’t WE do this?! UK company unveils "Grans Go Free" flights

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Entertainment

Travel

Health

Lifestyle

Finance

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Information

Keep up to date

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

“We need a donor”: Parents' desperate plea to save young daughter

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

To tackle gendered violence, we also need to look at drugs, trauma and mental health

Why are adults without kids hooked on Bluey? And should we still be calling it a ‘kids’ show’?

"We are with you": Hero cop embraced at Bondi candlelight vigil

Hospice nurse explains why we shouldn't be afraid to die

Whooping cough is surging in Australia. Why, and how can we protect ourselves?

Why we need to stop being so judgemental – and the 4 steps to do it

Might we see child-free zones on flights?

Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

Everything we know about Samantha Murphy's accused killer

Why our voices change as we get older

MH370 disappearance 10 years on: can we still find it

We talked to dozens of people about their experience of grief. Here’s what we learned (and how it’s different from what you might think)

We looked at 700 plant-based foods to see how healthy they really are. Here’s what we found

"We want Sam home": Distraught husband speaks out

Is Valentine’s Day worth the romantic investment? Here’s what we can learn from economics

"We want answers": Furious cruise passengers stage protest after itinerary change

Why can’t WE do this?! UK company unveils "Grans Go Free" flights

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