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COVID vaccines saved millions of lives – linking them to excess deaths is a mistake

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p>A recent <a href="https://bmjpublichealth.bmj.com/content/2/1/e000282">study</a> has sparked another <a href="https://nypost.com/2024/06/06/us-news/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths-since-pandemic-study/">round of</a> <a href="https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/">headlines</a> <a href="https://www.gbnews.com/health/covid-vaccine-side-effects-deaths">claiming</a> that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of <a href="https://x.com/DrAseemMalhotra/status/1797922073798717524">I-told-you-sos</a> on social media.</p> <p>Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">The Conversation</a> pointing this out and suggesting some reasons. But has anything changed?</p> <p>The authors of the new study, published in BMJ Public Health, used publicly available data from <a href="https://ourworldindata.org/COVID-vaccinations">Our World in Data</a> to determine which countries had “statistically significant” excess deaths – in other words, excess deaths that couldn’t be explained by mere random variation.</p> <p>They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text – and indeed widely interpreted as such by certain newspapers.</p> <p>There is no doubt that a few deaths were associated with <a href="https://journals.sagepub.com/doi/full/10.1177/25166026211053485">the COVID vaccines</a>, but could the vaccination programme explain the large number of excess deaths – 3 million in 47 countries – that have been reported?</p> <p>Based on <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">death certificates</a>, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022">exceeded COVID deaths</a>.</p> <p>If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">Office for National Statistics (ONS)</a>. In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated “age-standardised death rates” to account for age differences between those vaccinated and those not.</p> <p>What the ONS found was that in all months from April 2021 to May 2023, the death rate <a href="https://www.ons.gov.uk/redir/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpbmRleCI6MSwicGFnZVNpemUiOjEwLCJwYWdlIjoxLCJ1cmkiOiIvcGVvcGxlcG9wdWxhdGlvbmFuZGNvbW11bml0eS9iaXJ0aHNkZWF0aHNhbmRtYXJyaWFnZXMvZGVhdGhzL2RhdGFzZXRzL2V4Y2Vzc2RlYXRoc2luZW5nbGFuZGFuZHdhbGVzIiwibGlzdFR5cGUiOiJyZWxhdGVkZGF0YSJ9.Cot-XDe8Rr07paGllBNnVVz1nTqnXfVafn2woA3tk0c">from all causes was higher</a> in the unvaccinated than in people who had been vaccinated at least once.</p> <p>That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492612/">protective effect of vaccines</a> against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months.</p> <p>Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic.</p> <h2>Possible causes</h2> <p>If the vaccine is not the cause of the excess deaths, what was?</p> <p>The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries.</p> <p>Possible <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">explanations</a> for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath.</p> <p>We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/covid-vaccines-saved-millions-of-lives-linking-them-to-excess-deaths-is-a-mistake-231776">original article</a>.</em></p> </div>

Body

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Why it’s still a scientific mystery how some can live past 100 – and how to crack it

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/richard-faragher-224976">Richard Faragher</a>, <a href="https://theconversation.com/institutions/university-of-brighton-942">University of Brighton</a> and <a href="https://theconversation.com/profiles/nir-barzilai-1293752">Nir Barzilai</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <p>A 35-year-old man <a href="https://pubmed.ncbi.nlm.nih.gov/18544745/">only has a 1.5% chance of dying in the next ten years</a>. But the same man at 75 has a 45% chance of dying before he reaches 85. Clearly, ageing is bad for our health. On the bright side, we have made unprecedented progress in understanding the fundamental mechanisms that control ageing and late-life disease.</p> <p>A few tightly linked biological processes, sometimes called the <a href="https://pubmed.ncbi.nlm.nih.gov/23746838/">“hallmarks of ageing”</a>, including our supply of stem cells and communication between cells, act to keep us healthy in the early part of our lives – with <a href="https://theconversation.com/the-secret-to-staying-young-scientists-boost-lifespan-of-mice-by-deleting-defective-cells-54068">problems arising as these start to fail</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/34699859/">Clinical trials are ongoing</a> to see if targeting some of these hallmarks can improve <a href="https://pubmed.ncbi.nlm.nih.gov/31542391/">diabetic kidney disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29997249/">aspects of</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33977284/">immune function</a> and age-related <a href="https://pubmed.ncbi.nlm.nih.gov/30616998/">scarring of the lungs</a> among others. So far, so good.</p> <p>Unfortunately, big, unanswered questions remain in the biology of ageing. To evaluate what these are and how to address them, the <a href="https://www.afar.org/">American Federation For Aging Research</a>, a charity, recently convened a series of <a href="https://www.afar.org/imported/AFAR_GeroFuturesThinkTankReport_November2021.pdf">meetings for leading scientists and doctors</a>. The experts agreed that understanding what is special about the biology of humans who survive more than a century is now a key challenge.</p> <p>These centenarians <a href="https://www.statista.com/chart/18826/number-of-hundred-year-olds-centenarians-worldwide/">comprise less than 0.02% of the UK population</a> but have exceeded the life expectancy of their peers by almost 50 years (babies born in the 1920s typically had a life expectancy of less than 55). How are they doing it?</p> <p>We know that centenarians live so long because they are unusually healthy. They remain in good health for about 30 years longer than most normal people and when they finally fall ill, they are only sick for a very short time. This <a href="https://pubmed.ncbi.nlm.nih.gov/27377170/">“compression of morbidity”</a> is clearly good for them, but also benefits society as a whole. In the US, the medical care costs for a centenarian in their last two years of life <a href="https://www.cdc.gov/nchs/data/series/sr_10/sr10_198.pdf">are about a third of those of someone who dies in their seventies</a> (a time when most centenarians don’t even need to see a doctor).</p> <p>The children of centenarians are also much healthier than average, indicating they are inheriting something beneficial from their parents. But is this genetic or environmental?</p> <h2>Centenarians aren’t always health conscious</h2> <p>Are centenarians the poster children for a healthy lifestyle? For the general population, watching your weight, not smoking, drinking moderately and eating at least five servings of fruit and vegetables a day can <a href="https://pubmed.ncbi.nlm.nih.gov/27296932/">increase life expectancy by up to 14 years</a> compared with someone who does none of these things. This difference <a href="https://publications.parliament.uk/pa/ld5801/ldselect/ldsctech/183/18305.htm#_idTextAnchor012">exceeds that seen</a> between the least and most deprived areas in the UK, so intuitively it would be expected to play a role in surviving for a century.</p> <p>But astonishingly, this needn’t be the case. <a href="https://pubmed.ncbi.nlm.nih.gov/21812767/">One study</a> found that up to 60% of Ashkenazi Jewish centenarians have smoked heavily most of their lives, half have been obese for the same period of time, less than half do even moderate exercise and under 3% are vegetarians. The children of centenarians appear no more health conscious than the general population either.</p> <p>Compared to peers with the same food consumption, wealth and body weight, however, <a href="https://pubmed.ncbi.nlm.nih.gov/29050682/">they have half the prevalence of cardiovascular disease</a>. There is something innately exceptional about these people.</p> <h2>The big secret</h2> <p>Could it be down to rare genetics? If so, then there are two ways in which this could work. Centenarians might carry unusual genetic variants that extend lifespan, or instead they might lack common ones that cause late-life disease and impairment. Several studies, including our own work, <a href="https://pubmed.ncbi.nlm.nih.gov/32860726/">have shown</a> that centenarians have just as many bad genetic variants as the general population.</p> <p>Some even carry two copies of the largest known common risk gene for Alzheimer’s disease (APOE4), but still don’t get the illness. So a plausible working hypothesis is that centenarians carry rare, beneficial genetic variations rather than a lack of disadvantageous ones. And the best available data is consistent with this.</p> <p>Over 60% of centenarians have genetic changes that alter the genes which regulate growth in early life. This implies that these remarkable people are human examples of a type of lifespan extension observed in other species. Most people know that <a href="https://pubmed.ncbi.nlm.nih.gov/28803893/">small dogs tend to live longer than big ones</a> but fewer are aware that this is a general phenomenon across the animal kingdom. <a href="https://pubmed.ncbi.nlm.nih.gov/26857482/">Ponies can live longer than horses</a> and many strains of laboratory mice with dwarfing mutations <a href="https://pubmed.ncbi.nlm.nih.gov/29653683/">live longer than their full-sized counterparts</a>. One potential cause of this is reduced levels of a growth hormone called IGF-1 – although human centenarians <a href="https://pubmed.ncbi.nlm.nih.gov/28630896/">are not necessarily shorter than the rest of us</a>.</p> <p>Obviously, growth hormone is necessary early on in life, but there is increasing evidence that high levels of IGF-1 in mid to late life <a href="https://pubmed.ncbi.nlm.nih.gov/18316725/">are associated with increased late-life illness</a>. The detailed mechanisms underlying this remain an open question, but even among centenarians, women with the lowest levels of growth hormone <a href="https://pubmed.ncbi.nlm.nih.gov/24618355/">live longer than those with the highest</a>. They also have better cognitive and muscle function.</p> <p>That doesn’t solve the problem, though. Centenarians are also different from the rest of us in other ways. For example, they tend to have good cholesterol levels – hinting there may several reasons for their longevity.</p> <p>Ultimately, centenarians are “natural experiments” who show us that it is possible to live in excellent health even if you have been dealt a risky genetic hand and chose to pay no attention to health messages – but only if you carry rare, poorly understood mutations.</p> <p>Understanding exactly how these work should allow scientists to develop new drugs or other interventions that target biological processes in the right tissues at the right time. If these become a reality perhaps more of us than we think will see the next century in. But, until then, don’t take healthy lifestyle tips from centenarians.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/172020/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/richard-faragher-224976">Richard Faragher</a>, Professor of Biogerontology, <a href="https://theconversation.com/institutions/university-of-brighton-942">University of Brighton</a> and <a href="https://theconversation.com/profiles/nir-barzilai-1293752">Nir Barzilai</a>, Professor of Medicine and Genetics, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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-its-still-a-scientific-mystery-how-some-can-live-past-100-and-how-to-crack-it-172020">original article</a>.</em></p> </div>

Retirement Life

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Cost of living: if you can’t afford as much fresh produce, are canned veggies or frozen fruit just as good?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180"><em>University of South Australia</em></a></em></p> <p>The cost of living crisis is affecting how we spend our money. For many people, this means tightening the budget on the weekly supermarket shop.</p> <p>One victim may be fresh fruit and vegetables. Data from the <a href="https://www.abs.gov.au/media-centre/media-releases/australians-consuming-fewer-vegetables-fruit-and-less-milk#:%7E:text=Paul%20Atyeo%2C%20ABS%20health%20statistics,278%20to%20267%20to%20grams.%E2%80%9D">Australian Bureau of Statistics</a> (ABS) suggests Australians were consuming fewer fruit and vegetables in 2022–23 than the year before.</p> <p>The cost of living is likely compounding a problem that exists already – on the whole, Australians don’t eat enough fruit and vegetables. <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Australian dietary guidelines</a> recommend people aged nine and older should consume <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/fruit">two</a> serves of fruit and <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/vegetables-and-legumes-beans">five</a> serves of vegetables each day for optimal health. But in 2022 the <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/dietary-behaviour/latest-release">ABS reported</a> only 4% of Australians met the recommendations for both fruit and vegetable consumption.</p> <p>Fruit and vegetables are crucial for a healthy, balanced diet, providing a range of <a href="https://theconversation.com/were-told-to-eat-a-rainbow-of-fruit-and-vegetables-heres-what-each-colour-does-in-our-body-191337">vitamins</a> and minerals as well as fibre.</p> <p>If you can’t afford as much fresh produce at the moment, there are other ways to ensure you still get the benefits of these food groups. You might even be able to increase your intake of fruit and vegetables.</p> <h2>Frozen</h2> <p>Fresh produce is often touted as being the most nutritious (think of the old adage “fresh is best”). But this is not necessarily true.</p> <p>Nutrients can decline in transit from the paddock to your kitchen, and while the produce is stored in your fridge. Frozen vegetables may actually be higher in some nutrients such as <a href="https://pubmed.ncbi.nlm.nih.gov/25526594/">vitamin C and E</a> as they are snap frozen very close to the time of harvest. Variations in transport and storage can affect this slightly.</p> <p><a href="https://pubs.acs.org/doi/10.1021/jf504890k">Minerals</a> such as calcium, iron and magnesium stay at similar levels in frozen produce compared to fresh.</p> <p>Another advantage to frozen vegetables and fruit is the potential to reduce food waste, as you can use only what you need at the time.</p> <p>As well as buying frozen fruit and vegetables from the supermarket, you can freeze produce yourself at home if you have an oversupply from the garden, or when produce may be cheaper.</p> <p>A <a href="https://www.growveg.com.au/guides/freezing-vegetables-and-herbs-the-garden-foodie-version/">quick blanching</a> prior to freezing can improve the safety and quality of the produce. This is when food is briefly submerged in boiling water or steamed for a short time.</p> <p>Frozen vegetables won’t be suitable for salads but can be eaten roasted or steamed and used for soups, stews, casseroles, curries, pies and quiches. Frozen fruits can be added to breakfast dishes (with cereal or youghurt) or used in cooking for fruit pies and cakes, for example.</p> <h2>Canned</h2> <p>Canned vegetables and fruit similarly often offer a cheaper alternative to fresh produce. They’re also very convenient to have on hand. The <a href="https://nchfp.uga.edu/how/can#gsc.tab=0">canning process</a> is the preservation technique, so there’s no need to add any additional preservatives, including salt.</p> <p>Due to the cooking process, levels of heat-sensitive nutrients <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jsfa.2825">such as vitamin C</a> will decline a little compared to fresh produce. When you’re using canned vegetables in a hot dish, you can add them later in the cooking process to reduce the amount of nutrient loss.</p> <p>To minimise waste, you can freeze the portion you don’t need.</p> <h2>Fermented</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723656/">Fermentation</a> has recently come into fashion, but it’s actually one of the oldest food processing and preservation techniques.</p> <p>Fermentation largely retains the vitamins and minerals in fresh vegetables. But fermentation may also enhance the food’s nutritional profile by creating new nutrients and allowing existing ones to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352655/">absorbed more easily</a>.</p> <p>Further, fermented foods contain probiotics, which are beneficial for our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051273/">gut microbiome</a>.</p> <h2>5 other tips to get your fresh fix</h2> <p>Although alternatives to fresh such as canned or frozen fruit and vegetables are good substitutes, if you’re looking to get more fresh produce into your diet on a tight budget, here are some things you can do.</p> <p><strong>1. Buy in season</strong></p> <p>Based on supply and demand principles, buying local seasonal vegetables and fruit will always be cheaper than those that are imported out of season from other countries.</p> <p><strong>2. Don’t shun the ugly fruit and vegetables</strong></p> <p>Most supermarkets now sell “ugly” fruit and vegetables, that are not physically perfect in some way. This does not affect the levels of nutrients in them at all, or their taste.</p> <p><strong>3. Reduce waste</strong></p> <p>On average, an Australian household throws out <a href="https://www.ozharvest.org/food-waste-facts/">A$2,000–$2,500</a> worth of food every year. Fruit, vegetables and bagged salad are the <a href="https://www.ozharvest.org/food-waste-facts/">three of the top five foods</a> thrown out in our homes. So properly managing fresh produce could help you save money (and benefit <a href="https://endfoodwaste.com.au/why-end-food-waste/">the environment</a>).</p> <p>To minimise waste, plan your meals and shopping ahead of time. And if you don’t think you’re going to get to eat the fruit and vegetables you have before they go off, freeze them.</p> <p><strong>4. Swap and share</strong></p> <p>There are many websites and apps which offer the opportunity to swap or even pick up free fresh produce if people have more than they need. Some <a href="https://www.charlessturt.sa.gov.au/environment/sustainable-lifestyles/community-fruit-and-vege-swaps">local councils are also encouraging</a> swaps on their websites, so dig around and see what you can find in your local area.</p> <p><strong>5. Gardening</strong></p> <p>Regardless of how small your garden is you can always <a href="https://www.gardeningaustraliamag.com.au/best-vegies-grow-pots/">plant produce in pots</a>. Herbs, rocket, cherry tomatoes, chillies and strawberries all grow well. In the long run, these will offset some of your cost on fresh produce.</p> <p>Plus, when you have put the effort in to grow your own produce, <a href="https://mdpi-res.com/sustainability/sustainability-07-02695/article_deploy/sustainability-07-02695.pdf?version=1425549154">you are less likely to waste it</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229724/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250"><em>Evangeline Mantzioris</em></a><em>, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/cost-of-living-if-you-cant-afford-as-much-fresh-produce-are-canned-veggies-or-frozen-fruit-just-as-good-229724">original article</a>.</em></p> </div>

Food & Wine

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Dad forced to live in tent amid housing crisis

<p>An Aussie dad is the latest to fall victim to the housing crisis, with soaring rent and low vacancy rates forcing him to live in a tent. </p> <p>Peter Woodforde, 58, has been forced to live makeshift gazebo wrapped in tarps that's set up in an Adelaide park, and while his children know that he is doing it tough, they don't know that he is homeless and living in a tent. </p> <p>The father has yet to tell his kids, who live with their mother, that he's unable to find a suitable place to live as he said that they would be distraught if they found out. </p> <p>He admitted his 15-year-old daughter once told him that it "hurt her" to know her dad was struggling to find a comfortable place to live - but she doesn't know the extent of it. </p> <p>Speaking to <em>7News</em>, Woodforde said it's been difficult not being able to offer his kids a place to sleep. </p> <p>“Every parent wants to give their kids everything they possibly can and wants to give them the best chance of having a good life,” he told the publication. </p> <p>“What I say to them is that this is only temporary, Dad will get back on his feet.</p> <p>“(But) you’re missing out on some golden years ... I help where I can, I might pick them up and drop them off from school, but now they’re too far for me to do that,” he added. </p> <p>"I have to get myself off the street. I have to get my family into a house." </p> <p>Woodforde is sharing his story because he believes that homelessness is in a “state of emergency”,  especially with winter approaching. </p> <p>He is also unsure about whether his makeshift tent will collapse when heavier rain hits, and hopes that more could be done to help these people facing desperate circumstances. </p> <p>“We’re coming into the colder months - what’s the bill going to be for all the health problems that are going to arise out of this?" he said. </p> <p><em>Images: 7News</em></p> <p> </p>

Money & Banking

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What happens if you want access to voluntary assisted dying but your nursing home won’t let you?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/charles-corke-167297">Charles Corke</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>Voluntary assisted dying is now lawful in <a href="https://theconversation.com/voluntary-assisted-dying-will-soon-be-legal-in-all-states-heres-whats-just-happened-in-nsw-and-what-it-means-for-you-183355">all Australian states</a>. There is also <a href="https://nationalseniors.com.au/uploads/VAD-Report-correct-month-12.8.21.pdf">widespread community support</a> for it.</p> <p>Yet some residential institutions, such as hospices and aged-care facilities, are obstructing access despite the law not specifying whether they have the legal right to do so.</p> <p>As voluntary assisted dying is implemented across the country, institutions blocking access to it will likely become more of an issue.</p> <p>So addressing this will help everyone – institutions, staff, families and, most importantly, people dying in institutions who wish to have control of their end.</p> <h2>The many ways to block access</h2> <p>While voluntary assisted dying legislation recognises the right of doctors to <a href="https://theconversation.com/was-take-on-assisted-dying-has-many-similarities-with-the-victorian-law-and-some-important-differences-121554">conscientiously object</a> to it, the law is generally silent on the rights of institutions to do so.</p> <p>While the institution where someone lives has no legislated role in voluntary assisted dying, it can refuse access in various ways, including:</p> <ul> <li> <p>restricting staff responding to a discussion a resident initiates about voluntary assisted dying</p> </li> <li> <p>refusing access to health professionals to facilitate it, and</p> </li> <li> <p>requiring people who wish to pursue the option to leave the facility.</p> </li> </ul> <h2>Here’s what happened to ‘Mary’</h2> <p>Here is a hypothetical example based on cases one of us (Charles Corke) has learned of via his role at Victoria’s <a href="https://www.safercare.vic.gov.au/about/vadrb">Voluntary Assisted Dying Review Board</a>.</p> <p>We have chosen to combine several different cases into one, to respect the confidentiality of the individuals and organisations involved.</p> <p>“Mary” was a 72-year-old widow who moved into a private aged-care facility when she could no longer manage independently in her own home due to advanced lung disease.</p> <p>While her intellect remained intact, she accepted she had reached a stage at which she needed significant assistance. She appreciated the help she received. She liked the staff and they liked her.</p> <p>After a year in the facility, during which time her lung disease got much worse, Mary decided she wanted access to voluntary assisted dying. Her children were supportive, particularly as this desire was consistent with Mary’s longstanding views.</p> <p>Mary was open about her wish with the nursing home staff she felt were her friends.</p> <p>The executive management of the nursing home heard of her intentions. This resulted in a visit at which Mary was told, in no uncertain terms, her wish to access voluntary assisted dying would not be allowed. She would be required to move out, unless she agreed to change her mind.</p> <p>Mary was upset. Her family was furious. She really didn’t want to move, but really wanted to continue with voluntary assisted dying “in her current home” (as she saw it).</p> <p>Mary decided to continue with her wish. Her family took her to see two doctors registered to provide assessments for voluntary assisted dying, who didn’t work at the facility. Mary was deemed eligible and the permit was granted. Two pharmacists visited Mary at the nursing home, gave her the medication and instructed her how to mix it and take it.</p> <p>These actions required no active participation from the nursing home or its staff.</p> <p>Family and friends arranged to visit at the time Mary indicated she planned to take the medication. She died peacefully, on her own terms, as she wished. The family informed the nursing home staff their mother had died. Neither family nor staff mentioned voluntary assisted dying.</p> <h2>Staff are in a difficult position too</h2> <p>There is widespread community support for voluntary assisted dying. In a 2021 survey by National Seniors Australia, <a href="https://nationalseniors.com.au/uploads/VAD-Report-correct-month-12.8.21.pdf">more than 85%</a> of seniors agreed it should be available.</p> <p>So it’s likely there will be staff who are supportive in most institutions. For instance, in a survey of attitudes to voluntary assisted dying in a large public tertiary hospital, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/imj.15285">88% of staff</a> supported it becoming lawful.</p> <p>So a blanket policy to refuse dying patients access to voluntary assisted dying is likely to place staff in a difficult position. An institution risks creating a toxic workplace culture, in which clandestine communication and fear become entrenched.</p> <h2>What could we do better?</h2> <p><strong>1. Institutions need to be up-front about their policies</strong></p> <p>Institutions need to be completely open about their policies on voluntary assisted dying and whether they would obstruct any such request in the future. This is so patients and families can factor this into deciding on an institution in the first place.</p> <p><strong>2. Institutions need to consult their stakeholders</strong></p> <p>Institutions should consult their stakeholders about their policy with a view to creating a “<a href="https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-021-00891-3">safe</a>” environment for residents and staff – for those who want access to voluntary assisted dying or who wish to support it, and for those who don’t want it and find it confronting.</p> <p><strong>3. Laws need to change</strong></p> <p>Future legislation should define the extent of an institution’s right to obstruct a resident’s right to access voluntary assisted dying.</p> <p>There should be safeguards in all states (as is already legislated <a href="https://documents.parliament.qld.gov.au/tp/2021/5721T707.pdf">in Queensland</a>), including the ability for individuals to be referred in sufficient time to another institution, should they wish to access voluntary assisted dying.</p> <p>Other states should consider whether it is reasonable to permit a resident, who does not wish to move, to be able to stay and proceed with their wish, without direct involvement of the institution.</p> <hr /> <p><em>The opinions expressed in this article are those of the authors and do not necessarily reflect the views of Victoria’s Voluntary Assisted Dying Review Board.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/183364/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/charles-corke-167297">Charles Corke</a>, Associate Professor of Medicine, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-if-you-want-access-to-voluntary-assisted-dying-but-your-nursing-home-wont-let-you-183364">original article</a>.</em></p> </div>

Caring

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People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/ben-white-15387">Ben White</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/casey-haining-1486290">Casey Haining</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>Dementia is the <a href="https://www.dementia.org.au/about-dementia">second leading cause of death</a> for Australians aged over 65. More than 421,000 Australians <a href="https://www.dementia.org.au/about-dementia">currently live with dementia</a> and this figure is expected to almost double in the next 30 years.</p> <p>There is ongoing public <a href="https://www.mja.com.au/journal/2024/220/9/should-voluntary-assisted-dying-victoria-be-extended-encompass-people-dementia">discussion</a> about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">now lawful in all six states</a>, but is not available for a person living with dementia.</p> <p>The Australian Capital Territory has <a href="https://www.canberratimes.com.au/story/8631104/marisa-paterson-to-consult-on-voluntary-assisted-dying-amendments/?cs=14329">begun debating</a> its voluntary assisted dying bill in parliament but the government has <a href="https://www.legislation.act.gov.au/DownloadFile/es/db_68610/current/PDF/db_68610.PDF">ruled out</a> access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to <a href="https://www.legislation.act.gov.au/b/db_68609/">revisit the issue</a> in three years.</p> <p>The Northern Territory is also considering reform and <a href="https://www.theaustralian.com.au/subscribe/news/1/?sourceCode=TAWEB_WRE170_a_GGL&amp;dest=https%3A%2F%2Fwww.theaustralian.com.au%2Fnation%2Fpolitics%2Fconcerning-territory-nt-surveys-public-support-on-euthanasia-for-mentally-ill%2Fnews-story%2F4e45111bb293af4cf32ac3c6df058869&amp;memtype=anonymous&amp;mode=premium&amp;v21=GROUPA-Segment-2-NOSCORE&amp;V21spcbehaviour=append">has invited views</a> on access to voluntary assisted dying for dementia.</p> <p>Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, <a href="https://www.abc.net.au/listen/programs/melbourne-drive/voluntary-assisted-dying-dementia-victoria/103467864">called for the law to be widened</a> to allow access.</p> <p>Others <a href="https://www.smh.com.au/national/voluntary-assisted-dying-should-not-be-available-to-dementia-patients-20230607-p5deqo.html">argue</a> permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.</p> <h2>Australian laws exclude access for dementia</h2> <p>Current Australian voluntary assisted dying laws <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">exclude access</a> for people who seek to qualify because they have dementia.</p> <p>In New South Wales, the <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2022-017">law specifically states</a> this.</p> <p>In the other states, this occurs through a <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2022/04/Issue-451-White-et-al.pdf">combination of the eligibility criteria</a>: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.</p> <p>This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.</p> <h2>What happens internationally?</h2> <p>Voluntary assisted dying laws in some other countries allow access for people living with dementia.</p> <p>One mechanism, used in the Netherlands, is through <a href="https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16692">advance directives or advance requests</a>. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.</p> <p>Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “<a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2022/04/Issue-451-White-et-al.pdf">ten minutes to midnight</a>” approach.</p> <h2>But these approaches have challenges</h2> <p>International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are <a href="https://link.springer.com/article/10.1186/1472-6939-16-7">reluctant</a> to act on advance directives.</p> <p>Particularly challenging are <a href="https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0401-y">scenarios</a> where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.</p> <p>Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.</p> <p>Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.</p> <p>Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.</p> <h2>More thought is needed before changing our laws</h2> <p>There is <a href="https://www.parliament.qld.gov.au/Documents/TableOffice/TabledPapers/2020/5620T490.pdf">public demand</a> to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation <a href="https://www.publish.csiro.au/ah/pdf/AH23005">present an opportunity</a> to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.</p> <p>The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “<a href="https://www.legislation.qld.gov.au/view/pdf/asmade/act-2021-017">must include a review of the eligibility criteria</a>”. And the ACT bill requires the review to <a href="https://www.legislation.act.gov.au/b/db_68609/">consider</a> “advanced care planning”.</p> <p>Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.</p> <p>This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.</p> <p>This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.</p> <p>Any future law reform should be <a href="https://www.publish.csiro.au/AH/AH19201">evidence-based</a> and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224075/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/ben-white-15387"><em>Ben White</em></a><em>, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/casey-haining-1486290">Casey Haining</a>, Research Fellow, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, Postdoctoral research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/people-with-dementia-arent-currently-eligible-for-voluntary-assisted-dying-should-they-be-224075">original article</a>.</em></p> </div>

Caring

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“These are people’s lives”: Calls for gambling reform after fatal cruise ship plunge

<p>The shocking death of a 50-year-old father who went overboard on a P&O Cruise has caused widespread outrage, with many questioning who is to blame for his untimely passing. </p> <p>Shane Dixon had racked up $5,000 of gambling debt while onboard the Elvis-themed voyage, which his mother, who was also travelling with him, helped him to repay. </p> <p>The next day, Dixon went back to the cruise ship's casino where he racked up another $4,000 in debt, before he plunged to his death while the vessel was on its way into Sydney Harbour. </p> <p>While questions have arisen about the circumstances surrounding his death, the CEO of the Alliance for Gambling Reform Carol Bennett said the cruise ship operator had failed to provide Shane with an adequate duty of care, and encouraged him to keep gambling. </p> <p>"It's really concerning that when a ship sails 12 nautical miles off the coast it can then allow anything and everything to happen," she told <em><a href="https://www.dailymail.co.uk/news/article-13414919/Anti-gambling-Shane-Dixon-cruise-ship-casino.html" target="_blank" rel="noopener">Daily Mail Australia</a></em>.  </p> <p>"The rules that might apply on land no longer seem to apply and yet you would expect this cruise line would have some kind of duty of care to ensure that people are not plied with inducements, promotions and advertisements that are pushing them to gamble to extremely harmful levels."</p> <p>"It is just beyond belief that there is not an expectation that when a cruise ship leaves a dock that the rules of that jurisdiction apply."</p> <p>"But clearly that's not the case and we leave it all in the hands of the cruise line operator who may or may not apply the responsible service of gambling."</p> <p>Ms Bennett said it was "fundamental" that gamblers were able to set spend limits, self-exclude themselves and be in an environment free of inducements: all of which are required by law when it comes to casinos on Australian soil. </p> <p>"This is just basic harm reduction that any provider or organisation that is providing gambling services should be complying with," she said. </p> <p>"And if they're not, we need to really seriously think about what governments need to do to address this problem because you do wonder how widespread this is. This could be just the tip of the iceberg."</p> <p>Ms Bennett said Australia loses an estimated $25billion on legal forms of gambling each year, with the consequences spreading far beyond the impact on the economy. </p> <p>"It leads to everything from domestic and family violence to health and mental health issues, anxiety, depression, financial distress, right through to suicide," she said. </p> <p>"It is a huge and to some degree hidden problem in Australia, which is why we need stronger enforcement of safeguards and guardrails around gambling that don't see people led into a situation where they see no other way out but suicide."</p> <p>"These are peoples lives. For every person who gambles, there are six people around them who are going to be directly impacted."</p> <p>Labor backbencher Graham Perrett said the British cruise line most likely operated under the UK's gambling laws.</p> <p>"My understanding is that the UK gambling laws are not dissimilar to ours in terms of marketing and advertising," he said. </p> <p>"It's not just a gambling free-for-all, even if they are outside our territorial seas they still have to follow the laws of the UK."</p> <p><em>Image credits: Facebook / Shutterstock</em></p>

Cruising

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Family of eight forced to live in tent amid rental crisis

<p>A family of eight have been forced to live in a tent for over six months as they wait to find suitable accommodation after their last rental lease ended. </p> <p>Cameron and Tameka Fletcher and their six children, aged between one and 10, have been living in a tent and have had to move from campsite to campsite since September. </p> <p>The couple claimed that the government can't support them because they have "too many children", and are waiting for public housing, but they might not meet the criteria to be eligible for it. </p> <p>They were reportedly staying in a makeshift tent city in a suburban park north of Brisbane.</p> <p>"We've always had a house, we've never done this," Cameron Fletcher told <em>Nine News</em>. </p> <p>"Everyone here is going through the same thing. But it's the only way to get help."</p> <p>“We can only do what’s best for our kids, to keep a roof over their heads,” his wife added. </p> <p>One of the couple's daughters is due to start school next year, and they have been struggling to enrol her as the family doesn't have a permanent address. </p> <p>The family said they are also struggling with day-to-day activities like finding breakfast, washing their clothes and getting the kids ready for school, and are using solar camping showers purchased from Kmart to clean themselves.</p> <p>According to <em>Nine News</em>, the family would be happy with a three-bedroom home but were told by state housing officials that they can only be offered a five-bedroom home to avoid overcrowding, but there are currently none available. </p> <p>In a statement issued to <em>Yahoo News</em>, a spokesperson for Department of Housing said it “has been working with the family since September last year, including providing accommodation which they chose to leave”.</p> <p>"As we’ve been assisting them to find longer-term options, they have declined further offers of accommodation," the spokesperson said.</p> <p>"With regards to social housing, there are eligibility factors that need to be met, including income thresholds. However, the department continues to work with the family to find a private rental and give any other support they might need."</p> <p>This comes as new <a href="https://www.news.com.au/finance/real-estate/rent-shock-what-youll-be-paying-in-every-australian-suburb-in-2024/news-story/10b67da9ebe170a2e2d37caa7e66bf40" target="_blank" rel="noopener">PropTrack</a> data, released in March, revealed that rent has increased by 17 per cent over the past 12 months, across all the capital cities in Australia. </p> <p>More than half of Queenslanders who have applied for social housing are reportedly homeless and have had to wait for over two years amid a lack of supply and increased demands.</p> <p>Earlier this year, the Queensland government announced it was aiming to build another 53,500 social homes by 2046, with a $3.1 billion funding boost to deliver one million homes. </p> <p><em>Images: Nine News</em></p>

Money & Banking

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Do optimists really live longer? Here’s what the research says

<p><em><a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, <a href="https://theconversation.com/institutions/durham-university-867">Durham University</a></em></p> <p>Do you tend to see the glass as half full, rather than half empty? Are you always looking on the bright side of life? If so, you may be surprised to learn that this tendency could actually be good for your health.</p> <p>A <a href="https://content.apa.org/record/2020-71981-001">number of studies</a> have shown that optimists enjoy higher levels of wellbeing, better sleep, lower stress and even better cardiovascular health and immune function. And now, <a href="https://pubmed.ncbi.nlm.nih.gov/35674052/">a recent study</a> has shown that being an optimist is linked to longer life.</p> <p>To conduct their study, researchers tracked the lifespan of nearly 160,000 women aged between 50 to 79 for a period of 26 years. At the beginning of the study, the women completed a <a href="https://local.psy.miami.edu/people/faculty/ccarver/availbale-self-report-instruments/lot-r/">self-report measure of optimism</a>. Women with the highest scores on the measure were categorised as optimists. Those with the lowest scores were considered pessimists.</p> <p>Then, in 2019, the researchers followed up with the participants who were still living. They also looked at the lifespan of participants who had died. What they found was that those who had the highest levels of optimism were more likely to live longer. More importantly, the optimists were also more likely than those who were pessimists to live into their nineties. Researchers refer to this as “exceptional longevity”, considering the average lifespan for women is about 83 years in developed countries.</p> <p>What makes these findings especially impressive is that the results remained even after accounting for other factors known to predict a long life – including education level and economic status, ethnicity, and whether a person suffered from depression or other chronic health conditions.</p> <p>But given this study only looked at women, it’s uncertain whether the same would be true for men. However, <a href="https://www.pnas.org/doi/abs/10.1073/pnas.1900712116">another study</a> which looked at both men and women also found that people with the highest levels of optimism enjoyed a lifespan that was between 11% and 15% longer than those who were the least optimistic.</p> <h2>The fountain of youth?</h2> <p>So why is it that optimists live longer? At first glance it would seem that it may have to do with their healthier lifestyle.</p> <p>For example, <a href="https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.117.310828">research from several studies</a> has found that optimism is linked to eating a healthy diet, staying physically active, and being less likely to smoke cigarettes. These healthy behaviours are well known to improve heart health and <a href="https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases">reduce the risk</a> for cardiovascular disease, which is a <a href="https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)">leading cause of death</a> globally. Adopting a healthy lifestyle is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857242/">important for reducing the risk</a> of other potentially deadly diseases, such as diabetes and cancer.</p> <p>But having a healthy lifestyle may only be part of the reason optimists live a longer than average life. This latest study found that lifestyle only accounted for 24% of the link between optimism and longevity. This suggests a number of other factors affect longevity for optimists.</p> <p>Another possible reason could be due to the way optimists manage stress. When faced with a stressful situation, optimists tend to deal with it head-on. They <a href="https://pubmed.ncbi.nlm.nih.gov/16859439/">use adaptive coping strategies</a> that help them resolve the source of the stress, or view the situation in a less stressful way. For example, optimists will problem-solve and plan ways to deal with the stressor, call on others for support, or try to find a “silver lining” in the stressful situation.</p> <p>All of these approaches are well-known to reduce feelings of stress, as well as the biological reactions that occur when we feel stressed. It’s these <a href="https://www.apa.org/topics/stress/body">biological reactions to stress</a> –- such as elevated cortisol (sometimes called the “stress hormone”), increased heart rate and blood pressure, and impaired immune system functioning –- that can take a toll on health over time and increase the risk for developing <a href="https://www.sciencedirect.com/science/article/pii/S0889159115004316?via%3Dihub">life-threatening diseases</a>, such as cardiovascular disease. In short, the way optimists cope with stress may help protect them somewhat against its harmful effects.</p> <h2>Looking on the bright side</h2> <p>Optimism is typically viewed by researchers as a relatively stable personality trait that is determined by both <a href="https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/sex-differences-in-the-genetic-architecture-of-optimism-and-health-and-their-interrelation-a-study-of-australian-and-swedish-twins/58F21AA11943D44B4BA4C63A966E6AC7">genetic</a> and early childhood influences (such as having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541423/">secure and warm relationship</a> with your parents or caregivers). But if you’re not naturally prone to seeing the glass as half full, there are some ways you can increase your <a href="https://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1221122?journalCode=rpos20">capacity to be optimistic</a>.</p> <p>Research shows optimism can change over time, and can be cultivated by engaging in simple exercises. For example, visualising and then writing about your “<a href="https://www.psychologytoday.com/us/blog/what-matters-most/201303/what-is-your-best-possible-self">best possible self</a>” (a future version of yourself who has accomplished your goals) is a technique that studies have found can <a href="https://www.tandfonline.com/doi/full/10.1080/17439760.2016.1221122">significantly increase optimism</a>, at least temporarily. But for best results, the goals need to be both positive and reasonable, rather than just wishful thinking. Similarly, simply <a href="https://www.tandfonline.com/doi/abs/10.3200/SOCP.149.3.349-364">thinking about positive future events</a> can also be effective for boosting optimism.</p> <p>It’s also crucial to temper any expectations for success with an accurate view of what you can and can’t control. Optimism is reinforced when we experience the positive outcomes that we expect, and <a href="https://psycnet.apa.org/record/1970-20680-001">can decrease</a> when these outcomes aren’t as we want them to be. Although more research is needed, it’s possible that regularly envisioning yourself as having the best possible outcomes, and taking realistic steps towards achieving them, can help develop an optimistic mindset.</p> <p>Of course, this might be easier said than done for some. If you’re someone who isn’t naturally optimistic, the best chances to improve your longevity is by <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003332">living a healthy lifestyle</a> by staying physically active, eating a healthy diet, managing stress, and getting a good night’s sleep. Add to this cultivating a more optimistic mindset and you might further increase your chances for a long life.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/184785/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, Professor in Social &amp; Health Psychology, <a href="https://theconversation.com/institutions/durham-university-867">Durham University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/do-optimists-really-live-longer-heres-what-the-research-says-184785">original article</a>.</em></p>

Caring

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People in the world’s ‘blue zones’ live longer – their diet could hold the key to why

<p><em><a href="https://theconversation.com/profiles/justin-roberts-1176632">Justin Roberts</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a>; <a href="https://theconversation.com/profiles/joseph-lillis-1505087">Joseph Lillis</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a>, and <a href="https://theconversation.com/profiles/mark-cortnage-438941">Mark Cortnage</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>Ageing is an inevitable part of life, which may explain our <a href="https://time.com/4672969/why-do-people-want-to-live-so-long/">strong fascination</a> with the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726954">quest for longevity</a>. The allure of <a href="https://pubmed.ncbi.nlm.nih.gov/26566891/">eternal youth</a> drives a <a href="https://www.alliedmarketresearch.com/longevity-and-anti-senescence-therapy-market-A14010">multi-billion pound industry</a> ranging from anti-ageing products, supplements and <a href="https://www.everydayhealth.com/diet-nutrition/longevity-diet">diets</a> for those hoping to extend their lifespan.</p> <p>f you look back to the turn of the 20th century, average life expectancy in the UK was around 46 years. Today, it’s closer to <a href="https://population.un.org/wpp/">82 years</a>. We are in fact <a href="https://pubmed.ncbi.nlm.nih.gov/27706136/">living longer than ever before</a>, possibly due to medical advancements and improved <a href="https://www.health.org.uk/publications/reports/mortality-and-life-expectancy-trends-in-the-uk">living and working conditions</a>.</p> <p>But living longer has also come at a price. We’re now seeing higher rates of <a href="https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death">chronic and degenerative diseases</a> – with heart disease consistently topping the list. So while we’re fascinated by what may help us live longer, maybe we should be more interested in being healthier for longer. Improving our “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632858/">healthy life expectancy</a>” remains a global challenge.</p> <p>Interestingly, certain locations around the world have been discovered where there are a high proportion of centenarians who display remarkable physical and mental health. The <a href="https://pubmed.ncbi.nlm.nih.gov/15489066/">AKEA study of Sardinia, Italy</a>, as example, identified a “blue zone” (named because it was marked with blue pen), where there was a higher number of locals living in the central-eastern mountainous areas who had reached their 100th birthday compared with the wider Sardinian community.</p> <p>This longevity hotspot has since been expanded, and now includes several other areas around the world which also have greater numbers of longer-living, healthy people. Alongside Sardinia, these blue zones are now <a href="https://www.netflix.com/gb/title/81214929">popularly recognised</a> as: Ikaria, Greece; Okinawa, Japan; Nicoya, Costa Rica; and Loma Linda, California.</p> <p>Other than their long lifespans, people living in these zones also appear to share certain other commonalities, which centre around being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874460">part of a community</a>, having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224996/">life purpose</a>, eating <a href="https://pubmed.ncbi.nlm.nih.gov/33514872/">nutritious, healthy foods</a>, keeping <a href="https://www.nature.com/articles/s41398-021-01735-7">stress levels</a> low and undertaking purposeful daily <a href="https://pubmed.ncbi.nlm.nih.gov/30202288/">exercise or physical tasks</a>.</p> <p>Their longevity could also relate to their <a href="https://pubmed.ncbi.nlm.nih.gov/9010380/">environment</a>, being mostly rural (or less polluted), or because of <a href="https://pubmed.ncbi.nlm.nih.gov/22253498/">specific longevity genes</a>.</p> <p>However, studies indicate genetics may only account for <a href="https://pubmed.ncbi.nlm.nih.gov/8786073">around 20-25% of longevity</a> – meaning a person’s lifespan is a complex interaction between lifestyle and genetic factors, which contribute to a long and healthy life.</p> <h2>Is the secret in our diet?</h2> <p>When it comes to diet, each blue zone has its own approach – so one specific food or nutrient does not explain the remarkable longevity observed. But interestingly, a diet rich in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288">plant foods</a> (such as locally-grown vegetables, fruits and legumes) does appear to be reasonably consistent across these zones.</p> <p>For instance, the Seventh-day Adventists of Loma Linda are <a href="https://pubmed.ncbi.nlm.nih.gov/10641813/">predominately vegetarian</a>. For centenarians in Okinawa, <a href="https://pubmed.ncbi.nlm.nih.gov/20234038/">high intakes of flavonoids</a> (a chemical compound typically found in plants) from purple sweet potatoes, soy and vegetables, have been linked with <a href="https://pubmed.ncbi.nlm.nih.gov/11710359/">better cardiovascular health</a> – including lower cholesterol levels and lower incidences of stroke and heart disease.</p> <p>In Nicoya, consumption of locally produced rice and beans has been associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34444746/">longer telomere length</a>. Telomeres are the structural part at the end of our chromosomes which protect our genetic material. Our telomeres get shorter each time a cell divides – so get progressively shorter as we age.</p> <p>Certain <a href="https://pubmed.ncbi.nlm.nih.gov/21102320/">lifestyle factors</a> (such as smoking and poor diet) can also shorten telomere length. It’s thought that telomere length acts as a <a href="https://pubmed.ncbi.nlm.nih.gov/31728493/">biomarker of ageing</a> – so having longer telomeres could, in part, be linked with longevity.</p> <p>But a plant-based diet isn’t the only secret. In Sardinia, for example, meat and fish is consumed in moderation in addition to locally grown vegetables and <a href="https://journalofethnicfoods.biomedcentral.com/articles/10.1186/s42779-022-00152-5">traditional foods</a> such as acorn breads, pane carasau (a sourdough flatbread), honey and soft cheeses.</p> <p>Also observed in several blue zone areas is the inclusion of <a href="https://www.jacc.org/doi/10.1016/j.jacc.2021.10.041">olive oil</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/33669360/">wine</a> (in moderation – around 1-2 glasses a day), as well as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830687/">tea</a>. All of these contain powerful antioxidants which may help <a href="https://ncbi.nlm.nih.gov/pmc/articles/PMC10049696/">protect our cells</a> from damage <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273542/">as we age</a>.</p> <p>Perhaps then, it’s a combination of the protective effects of various nutrients in the diets of these centenarians, which explains their exceptional longevity.</p> <p>Another striking observation from these longevity hot spots is that meals are typically <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232892">freshly prepared at home</a>. Traditional blue zone diets also don’t appear to contain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538973/">ultra-processed foods</a>, fast foods or sugary drinks which may <a href="https://pubmed.ncbi.nlm.nih.gov/32330232/">accelerate ageing</a>. So maybe it’s just as important to consider what these longer-living populations are not doing, as much as what they are doing.</p> <p>There also appears to be a pattern of eating until 80% full (in other words partial <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9036399/">caloric reduction</a>. This could be important in also supporting how our cells deal with damage as we age, which could mean a longer life.</p> <p>Many of the factors making up these blue zone diets – primarily plant-based and natural whole foods – are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/35706591/">lower risk of chronic diseases</a> such as <a href="https://pubmed.ncbi.nlm.nih.gov/28728684/">heart disease</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/37589638/">cancer</a>. Not only could such diets contribute to a <a href="https://pubmed.ncbi.nlm.nih.gov/37836577/">longer, healthier life</a>, but could support a more <a href="https://pubmed.ncbi.nlm.nih.gov/33397404/">diverse gut microbiome</a>, which is also associated with healthy ageing.</p> <p>Perhaps then we can learn something from these remarkable centenarians. While diet is only one part of the bigger picture when it comes to longevity, it’s an area we can do something about. In fact, it might just be at the heart of improving not only the quality of our health, but the quality of how we age.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221463/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/justin-roberts-1176632">Justin Roberts</a>, Professor of Nutritional Physiology, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a>; <a href="https://theconversation.com/profiles/joseph-lillis-1505087">Joseph Lillis</a>, PhD Candidate in Nutritional Physiology, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a>, and <a href="https://theconversation.com/profiles/mark-cortnage-438941">Mark Cortnage</a>, Senior Lecturer in Public Health and Nutrition, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/people-in-the-worlds-blue-zones-live-longer-their-diet-could-hold-the-key-to-why-221463">original article</a>.</em></p>

Food & Wine

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"Worst experience of our lives": Aussies break silence after being stranded by cruise ship

<p>An Australian couple have spoken out about how their dream holiday turned into a nightmare after they were abandoned by their cruise ship and left stranded in Africa. </p> <p>Violetta and Doug Sanders were two of eight travellers on the Norwegian Dawn cruise ship who took off on a private tour not organised by the cruise while they were docked on the small African island of São Tomé. </p> <p>After their <a href="https://oversixty.com.au/travel/travel-trouble/the-key-decision-that-led-to-cruise-passengers-being-abandoned-by-ship" target="_blank" rel="noopener">private tour ran late</a>, the Aussie pensioners and their fellow travellers were unable to rejoin the cruise as the ship was ready to disembark from the port, and were left stranded. </p> <p>Doug and Violetta are still attempting to rejoin the cruise in Senegal to be reunited with valuables such as their passports to finish out their journey. </p> <p>The couple spoke to <em>Sunrise</em> on Wednesday, detailing their nightmarish experience in the foreign country. </p> <p>“It’s been the worst experience of our lives to be abandoned like that in a strange country, can’t speak the language — Portuguese or an African (language),” Violeta said.</p> <p>“We have no money, our credit cards aren’t accepted.”</p> <p>The group of stranded travellers have been racing through six African countries to get to where the ship is docking in Senegal in time, but US travellers Jill and Jay Campbell have cast doubt on whether they will re-board the ship.</p> <p>“We believe that it was a basic duty of care that they have forgotten about — although there are a set of rules, they have followed them too rigidly,” Jill told US media overnight.</p> <p>The group, which included four elderly people, a pregnant woman, a quadriplegic and a person with a heart condition, were set to rejoin the ship last Sunday in The Gambia, however, low-tide meant the ship couldn’t dock at the African port.</p> <p>The Campbells have been using their credit card to look after the entire group, spending more than $5,000 USD so far.</p> <p>Norwegian Cruise Lines has said it is up to guests to be back on time.</p> <p>“Guests are responsible for ensuring they return to the ship at the published time, which is communicated broadly over the ship’s intercom, in the daily communication and posted just before exiting the vessel,” it said.</p> <p>The cruise line later said it was in contact with passengers and had been “working closely with authorities” to allow the guests to re-join the ship.</p> <p><em>Image credits: Sunrise </em></p>

Travel Trouble

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Undernourished, stressed and overworked: cost-of-living pressures are taking a toll on Australians’ health

<p><em><a href="https://theconversation.com/profiles/nicole-black-103425">Nicole Black</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/anthony-harris-7148">Anthony Harris</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/danusha-jayawardana-1406565">Danusha Jayawardana</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/david-johnston-1126643">David Johnston</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>For the past few years, it has been impossible to escape the impact of inflation. Meeting our most basic needs – such as food, housing and health care – now costs significantly more, and wage increases <a href="https://futurework.org.au/post/for-most-workers-wages-are-still-failing-to-keep-up-with-inflation/">haven’t kept up</a>.</p> <p>There are signs relief could be on the horizon. Inflation has fallen to its <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/consumer-price-index-australia/latest-release">lowest levels</a> since January 2022.</p> <p>But Australia now also finds itself in the midst of an <a href="https://theconversation.com/prepare-to-hear-about-an-official-recession-unofficially-weve-been-in-one-for-some-time-224963">economic downturn</a>, putting further pressure on households.</p> <p>Rising prices have an obvious negative impact on our financial health. But they can also have a profound effect on our physical and mental wellbeing, which is often overlooked.</p> <p>Australians may continue to feel the health effects of high inflation for quite some time.</p> <h2>It’s costing more to live well</h2> <p>Between March 2021 and March 2023, the price of goods and services <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/consumer-price-index-australia/jun-quarter-2023">rose substantially</a>, marking a period of high <a href="https://www.rba.gov.au/education/resources/explainers/inflation-and-its-measurement.html">inflation</a>.</p> <p><iframe id="5vFeh" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/5vFeh/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Worryingly, the prices of basic needs that are important for staying healthy – nutritious food, health care, housing and utilities – rose between 11% and 36%.</p> <h2>Who is affected the most?</h2> <p>Higher prices on essentials are virtually impossible to dodge, but they impact certain groups of people more than others.</p> <p>Wealthier households have managed their higher expenses by <a href="https://www.rba.gov.au/publications/fsr/2023/oct/pdf/financial-stability-review-2023-10.pdf">cutting back on discretionary spending and dipping into savings</a>.</p> <p>However, lower income households spend <a href="https://www.rba.gov.au/publications/fsr/2023/oct/household-business-finances-in-australia.html#:%7E:text=Lower%20income%20households%2C%20including%20many,than%20households%20on%20higher%20incomes.">a much larger portion of their income</a> on housing and other essentials.</p> <p>Without a savings buffer, these households experience severe financial strain and poor health outcomes.</p> <h2>Financial stress affects our health</h2> <p>Our research shows that high inflation has <a href="https://www.vichealth.vic.gov.au/resources/resource-download/high-inflation-and-implications-for-health">a range of effects</a> on people’s health.</p> <p>These effects fall into three main groups: material hardship, psychosocial, and behavioural.</p> <p><strong>1. Material hardship</strong></p> <p>People facing material hardship can’t meet their basic needs because they can’t afford to pay for them.</p> <p>Material hardship can present itself in a variety of ways:</p> <ul> <li><a href="https://theconversation.com/how-many-australians-are-going-hungry-we-dont-know-for-sure-and-thats-a-big-part-of-the-problem-195360">food insecurity</a> – not getting adequate nutrition</li> <li><a href="https://theconversation.com/1-in-4-households-struggle-to-pay-power-bills-here-are-5-ways-to-tackle-hidden-energy-poverty-204672">energy poverty</a> – struggling to pay for electricity and gas</li> <li>deferred health care – putting off medical treatment</li> <li>housing insecurity – struggling to find a stable place to live.</li> </ul> <p>Between August 2022 and February 2023, when inflation hit its highest levels in 33 years, over half (53%) of surveyed Australians reported <a href="https://melbourneinstitute.unimelb.edu.au/data/taking-the-pulse-of-the-nation-2022/2023/australians-face-challenging-budgetary-constraints">struggling to afford</a> their basic needs.</p> <p>Finding ourselves in this situation can have far-reaching implications for our health.</p> <p>For example, food insecurity is linked to <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">an increased risk of poor nutrition, obesity and chronic illness</a>, as households facing cost-of-living pressures shift towards cheaper, lower-quality food options.</p> <p>Energy poverty is linked to <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">physical and mental health problems</a> as people struggle to keep warm in wintertime, and cool in the summer.</p> <p>Delaying health care <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">increases</a> the risk of facing severe health problems, staying in hospital for longer, and being admitted to the emergency department. This isn’t just worse for individuals, it’s also far more costly for our health care system.</p> <p><strong>2. Psychosocial effects</strong></p> <p>Psychosocial effects are the ways in which cost-of-living pressures impact our mind and social relationships.</p> <p>Difficulties in meeting our basic needs are strongly associated with <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">increased levels of psychological distress</a>, including symptoms of anxiety and depression.</p> <p>This impact can worsen over time if individuals experience sustained financial stress.</p> <p>By undermining our ability to work well, the psychosocial effects of prolonged financial stress can initiate a “vicious cycle”, leading to reduced productivity and lower earnings.</p> <p>Financial stress can also have a detrimental impact on spousal relationships, which can affect the mental health of other household members such as children.</p> <p><strong>3. Behavioural effects</strong></p> <p>Cost-of-living pressures can also cause a number of changes in the way we behave.</p> <p>For many, these pressures have become a reason to work longer hours and gain additional income.</p> <p>Last year, Australians collectively worked 4.6% longer, an <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia/aug-2023">extra 86 million hours</a>.</p> <p>But working longer hours <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">reduces people’s overall health</a>, especially among parents of young children facing greater time constraints.</p> <p>It also leaves less time for activities that help to keep people healthy, such as getting regular exercise and cooking healthy meals.</p> <h2>How can policymakers respond?</h2> <p>In theory, the Reserve Bank of Australia’s primary tool for combating inflation – raising interest rates – should help. By reducing aggregate spending in the economy, it is designed to put downward pressure on prices.</p> <p>But by bluntly increasing the cost of borrowing, it also puts significant short-term financial pressure on both lower-income mortgage holders and renters.</p> <p>Better acknowledgement of this fact, and of inflation’s broader impact on people’s physical and mental health, would be a great start.</p> <p>When formulating policy responses to high inflation, governments could factor health and wellbeing impacts into their assessment of the trade-offs between alternative policy responses.</p> <p>This could help minimise any policy’s long-term negative health consequences and its impact on the health care system.</p> <p>Policymakers could also focus on making sure affordable and timely access to health care, especially mental health support, is made available to those most vulnerable to cost-of-living pressures.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223625/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nicole-black-103425">Nicole Black</a>, Associate Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/anthony-harris-7148">Anthony Harris</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/danusha-jayawardana-1406565">Danusha Jayawardana</a>, Research Fellow in Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/david-johnston-1126643">David Johnston</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/undernourished-stressed-and-overworked-cost-of-living-pressures-are-taking-a-toll-on-australians-health-223625">original article</a>.</em></p>

Money & Banking

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Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<p><em><a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January.</p> <p>Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”.</p> <p>The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate.</p> <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”.</p> <p>Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively.</p> <h2>What is cancer?</h2> <p>Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one.</p> <p>We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide.</p> <p>However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced.</p> <p>In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell.</p> <h2>What exactly are mutations?</h2> <p>Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix.</p> <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions.</p> <p>These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>.</p> <p>Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required.</p> <h2>How is cancer treated?</h2> <p>Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy.</p> <p>Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&amp;gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&amp;gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically.</p> <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence).</p> <p>Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally.</p> <p>Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients.</p> <p>Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&amp;text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history.</p> <h2>What you should do</h2> <p>Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to:</p> <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> <p>The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.</em></p>

Caring

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Millions of Aussies set for power bill relief

<p>Millions of Aussies are set for some financial relief, with electricity costs set to drop by up to 7 per cent in the coming months. </p> <p>The Australian Energy Regulator (AER) and Victoria's Essential Services Commission (ESC) both released their draft default market offers - the maximum energy retailers are allowed to charge customers - for the 2024-25 financial year. </p> <p>Under the AER draft, residents in Sydney, Newcastle and the Hunter on the default offer will pay between 3 and 3.4 per cent less for electricity starting from July 1. </p> <p>The biggest drop is set for Victoria, with the ESC proposing a 6.4 per cent decrease. </p> <p>Those in Western Sydney, the Illawarra, and South Coast, will see their electricity bills decrease by 1.9 to 7.1 per cent. </p> <p>South Australians will receive a drop between 0.5 and 2.5 per cent. </p> <p>A number of small business customers will also benefit from lower power bill costs with 9.7 per cent for Sydney, Newcastle and the Hunter; 4.4 per cent for Western Sydney and the South Coast; 0.3 per cent for South-East Queensland; 8.2 per cent for South Australia; and 7 per cent for Victoria.</p> <p>Energy Minister Chris Bowen welcomed the news of lower power bill costs, but acknowledged that it will continue to play a part in the cost of living challenges faced by many Australians. </p> <p>"This is encouraging news," he said.</p> <p>"Encouraging for those small businesses and families who will receive lower energy bills as a result.</p> <p>"But nobody should suggest that there aren't real cost of living pressures around the world and in Australia, and energy prices are of course part of that and will continue to be."</p> <p>Not everyone will see a drop, with customers in the rest of regional NSW to get a small increase of 0.9 per cent, while the default offer for South East Queensland will increase by up to 2.7 per cent.</p> <p>While not all households are on the default offer, Bowen said that the AER's decision will also affect those not on the offer. </p> <p>"This either impacts directly or indirectly your energy bill," he said.</p> <p>"Directly for those on the default market offer. For those who aren't on the direct market offer, indirectly - the energy companies have to benchmark themselves against this, tell their consumers how they compare to this, and it provides very real pressure on them to match it.</p> <p>"If they don't, consumers will know about it and will make choices accordingly.</p> <p>"It's partly about those on the default market offer, but it actually impacts on all our bills indirectly."</p> <p>AER chair Clare Savage said that the cost of living crisis was the main contributor for their draft decision. </p> <p>"We know that economic conditions have put pressure on many Australians and the increases in electricity prices over the last two years has made energy less affordable for many households," she said. </p> <p>"In light of this, the AER has, in this decision, placed increased weight on protecting consumers." </p> <p>The draft decision is not final, with both the AER and ESC to receive consultation and feedback from stakeholders before confirming their default market offers in May.</p> <p><em>Image: Getty</em></p>

Money & Banking

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Millions of eligible Aussies about to receive financial boost

<p>Starting this Wednesday, millions of Australians relying on Centrelink benefits will see a welcome increase in their payments. With indexation kicking in, fortnightly boosts ranging from $14 to $30 will be allocated to eligible recipients, depending on their specific circumstances and the type of payment they receive.</p> <p>This adjustment will not only benefit current beneficiaries but also extend support to more individuals, with an additional 77,000 parents now qualifying for higher payment rates. The eligibility criteria for certain payments have been expanded, particularly for parents whose youngest child is under 14, a significant extension from the previous threshold of under eight.</p> <p>Income and assets limits tied to these payments will also experience an uptick in line with the indexation process, offering further relief to recipients. But how exactly will these increments manifest across different categories of payments?</p> <p>For single parents, the fortnightly payment will see a boost of $17.50, while partnered parents will witness an increase of $12.30 individually. Moreover, the income free area will rise to $1,345 for each person, an enhancement of $20 per fortnight.</p> <p>Jobseekers with children or those aged over 55 will receive an additional $14.40 fortnightly. Single JobSeeker recipients without children and individuals aged over 22 on ABSTUDY will enjoy a $13.50 increase per fortnight, with couples receiving an extra $12.30 each.</p> <p>Rent assistance, however, will see relatively modest increments, ranging from $2.27 to $3.40, depending on the recipient's family situation.</p> <p>For those on the age pension, disability support pension, and carer payment, the increase is more substantial, with singles receiving an extra $19.60 and couples combined receiving $29.40 each fortnight. This brings the maximum rate of the pension to $1116.30 for singles and $1682.80 for couples, including pension and energy supplements.</p> <p>Amanda Rishworth, the Social Services Minister, explains that indexation plays a crucial role in ensuring that welfare recipients can cope with inflation and the rising cost of living – and that addressing these pressures remains a top priority for the government.</p> <p>This increase in Centrelink payments comes at a critical time when many Australians are grappling with economic uncertainty due to various factors, including the ongoing pandemic. While these adjustments may seem modest to some, they can make a significant difference for those relying on welfare support to make ends meet.</p> <p>It's essential for eligible individuals to stay informed about these changes and ensure they receive the full benefits they're entitled to. For those who may be unsure about their eligibility or how to navigate the system, seeking assistance from Centrelink or relevant support services can provide valuable guidance.</p> <p>As the cost of living continues to evolve, initiatives like indexation serve as vital mechanisms for maintaining the welfare safety net and supporting vulnerable members of society. By keeping pace with economic realities, these adjustments strive to provide meaningful relief to those who need it most, contributing to a more equitable and inclusive society for all Australians.</p> <p><em>Image: Getty </em></p>

Money & Banking

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Restaurant sparks outrage for "ridiculous" fee

<p>As inflation rates continue to rise it is not surprising that restaurants are charging extra fees, but one disgruntled customer was particularly shocked to see this "ridiculous" fee on their bill. </p> <p>The customer, who dined at restaurant and cocktail bar in Georgia, USA shamed the restaurant for charging their customers a $20 fee for “live band entertainment”.</p> <p>They shared their complaints on Reddit with a copy of their receipt and an unexpected fee at the bottom which read: “Two Live Band Entertainment Fee — $20”.</p> <p>Most people in the comments were equally annoyed and called the fee "ridiculous". </p> <p>“This is one of those leave money on the table, hand the waiter a tip and leave, sorry but if I didn’t order it, I’m not paying for it,” one wrote. </p> <p>“Great way to not have repeat customers,” said another.</p> <p>“This will backfire for them, just be honest and upfront," a third added. </p> <p>Other commenters were less sympathetic and did not understand why the customer was complaining when it looked like they could afford it. </p> <p>“When you’re paying seven dollars for a bottle of water, you really don’t get to complain about ‘unexpected costs.’ You knew what you signed up for," one commenter wrote. </p> <p>“Imagine a live band getting paid, huh,” another added. </p> <p>“They’re buying $7 bottles of water, they can probably afford it,” added a third.</p> <p><em>Image: Getty/ Reddit</em></p> <p> </p>

Money & Banking

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"What a life lived!": Fashion icon dies age 102

<p>New York designer and style icon Iris Apfel has passed away aged 102. </p> <p>Her death was confirmed by her commercial agent, Lori Sale, who called Apfel "extraordinary", although no cause of death was given. </p> <p>Apfel, who was born on August 29, 1921, was known for her eccentric outfits, oversized black-rimmed glasses, bright red lipstick and short white hair. </p> <p>Her death was also announced on the fashion icon's official Instagram page, on Friday US time, just one day after she celebrated her 102nd-and-a-half birthday. </p> <p>"Working alongside her was the honour of a lifetime. I will miss her daily calls, always greeted with the familiar question: 'What have you got for me today?'" Sale said in a statement.</p> <p>"She was a visionary in every sense of the word. She saw the world through a unique lens — one adorned with giant, distinctive spectacles that sat atop her nose."</p> <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/C3_geMFu15Y/?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/C3_geMFu15Y/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Iris Apfel (@iris.apfel)</a></p> </div> </blockquote> <p> </p> <p>Apfel was an expert on textiles and antique fabrics. She and her husband Carl owned textile manufacturing company, Old World Weavers, which specialised in restoration work, including projects at the White House under six different US presidents.</p> <p>Apfel first rose to fame in 2005 when the curator of the Metropolitan Museum of Art’s Costume Institute hosted a show about her called "Rara Avis". Latin for "rare bird".  </p> <p>They showcased the personal collection of vintage and designer accessories which were style on mannequins dressed in clothes Apfel would wear, and the exhibit became an instant success.</p> <p>Following the exhibit Apfel was awarded several opportunities including featuring in a 2007 coffee table book, a 2012 MAC Cosmetics campaign, and a 2014 documentary about her life, which was nominated for an Emmy award three years later. </p> <p>Apfel was also gained popularity among the younger generation, with over 3 million followers on Instagram, and over 250,000 on TikTok. </p> <p>"More is more & Less is a Bore," the bio read across her social media platforms. </p> <p>Despite her age, Apfel never retired, and told <em>Today</em>: "I think retiring at any age is a fate worse than death. Just because a number comes up doesn't mean you have to stop."</p> <p>Tributes have poured in from fans across the world. </p> <p>"What a life lived! What an example set! What footsteps you have left behind! Rest peacefully, icon!" one wrote. </p> <p>"She inspired so many women to be bold, and brave and truly authentic….to ignore the number of years we have lived and view age as an opportunity to shine. What a beautiful legacy," another added. </p> <p>"What a blessing to live that long and look that fabulous doing it," wrote a third. </p> <p>The style icon was married to Carl Apfel for 67 years until his death in 2015. They had no children. </p> <p><em>Images: Instagram</em></p> <p> </p>

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Supermarkets, airlines and power companies are charging ‘exploitative’ prices despite reaping record profits

<p><em><a href="https://theconversation.com/profiles/sanjoy-paul-1141384">Sanjoy Paul</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p>Australians have been hit by large rises in grocery, energy, transport, child and aged care prices, only adding to other cost of living pressures.</p> <p>While extreme weather and supply delays have contributed to the increases, an inquiry into what’s causing the hikes has confirmed what commentators and consumers suspected - many sectors are resorting to dodgy price practices and confusing pricing.</p> <p>Headed by the former Australian Consumer and Competition Commission (ACCC) boss, Allan Fels, on behalf of the ACTU, the inquiry found inflation, questionable pricing practices, a lack of price transparency and regulations, a lack of market competition, supply chain problems and unrestricted price setting by retailers are to blame for fuelling the increases.</p> <p>The inquiry, which released its <a href="https://www.actu.org.au/wp-content/uploads/2024/02/InquiryIntoPriceGouging_Report_web9-1.pdf">final report</a> on Wednesday, is one of four examining price rises. The other three are being undertaken by a Senate committee, the Queensland government and the ACCC, which has been given extra powers by the government.</p> <h2>Prices vs inflation</h2> <p>The inflation rate in Australia peaked at <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/consumer-price-index-australia/latest-release">7.8%</a> in December 2022 and has been gradually dropping since then.</p> <p>While the inquiry found higher prices contributed to inflation, it reported that businesses claimed it was inflation that caused price rises - making it a chicken-or-egg kind of problem.</p> <p>However, many businesses made enormous <a href="https://theconversation.com/amid-allegations-of-price-gouging-its-time-for-big-supermarkets-to-come-clean-on-how-they-price-their-products-219316">profits</a> in 2022-23, which the inquiry said contributed to rising prices and inflation. In most cases, post-pandemic profit margins were much higher than before the pandemic.</p> <h2>How prices are set</h2> <p>Business pricing strategies had a big impact on product prices.</p> <p>In Australia, businesses often provided partial and misleading pricing information which differed from the actual price. For example, supermarkets were “<a href="https://www.afr.com/politics/federal/accc-warns-supermarkets-about-discount-claims-20240114-p5ex1s">discounting</a>” products by raising prices beforehand.</p> <p>These practices helped raise prices and were “exploitative”, the inquiry found.</p> <p>A lack of transparent pricing information caused a poor understanding by consumers of how prices were set. This was significantly worsened by a lack of competition. While market concentration was a major issue, the inquiry found prices in Australia are way higher than in many other less competitive markets.</p> <p>Large price increases occurred across many sectors:</p> <p><strong>AVIATION</strong></p> <p>While it is free to set any price for airfares, Australia’s largest and highest profile aviation company, Qantas, has been <a href="https://www.thenewdaily.com.au/life/2023/12/28/qantas-deceptive-conduct-accc">accused</a> of price gouging since the pandemic.</p> <p>According to the inquiry report, Qantas made a profit of $1.7 billion in 2023 - 208% higher than in 2019. At the same time, its reputation has been badly damaged by unreliable timetables, lost baggage and so-called <a href="https://www.9news.com.au/national/qantas-files-legal-defence-refutes-accc-case-and-ghost-flight-claims/9a6296c9-9238-4053-9f36-cc3cbf1f8a55">“ghost” flights</a> (selling tickets for a flight that’s been cancelled or doesn’t exist).</p> <p>Despite its huge profits and poorer service, Qantas passed on extra expenses to consumers in the form of higher airfares, the inquiry found.</p> <p><strong>BANKING</strong></p> <p>The banking industry has a long history of being tardy in passing on the Reserve Bank’s cash rate cuts to consumers. However, when the reserve raised the cash rates, banks immediately increased their standard variable rates and passed them on to customers. This practice keeps the bank’s profit margin higher.</p> <p>According to the inquiry report, the major banks’ average profit margins have been higher since May 2022 than in the 15 years before the pandemic. For 2022-23, the four big Australian banks’ profit margins were 35.5%, compared to an average of 32.4% from 2005 to 2020.</p> <p><strong>CHILDCARE</strong></p> <p>Australian households spent a good portion of their income on childcare, and for many of them, it was <a href="https://www.vu.edu.au/sites/default/files/mitchell-institute-assessing-childcare-affordability-in-Australia.pdf">unaffordable</a>.</p> <p>In Australia, the lack of availability and difficulty in switching services makes it even harder for working parents to find alternative options. This indicates parents are forced to pay more if the service providers raise prices.</p> <p>The inquiry found the childcare sector increased fees by 20% to 32% from 2018 to 2022. Accordingly, Australian households’ out-of-pocket expenses for childcare increased more than the rate of wage growth. For-profit childcare businesses have higher margins than not-for-profit centres.</p> <p><strong>ELECTRICITY</strong></p> <p>In recent years, electricity price increases have impacted all Australian households. The inquiry found both wholesale and retail electricity pricing strategies were responsible for these increased prices.</p> <p>It reported that wholesale price increases were mainly responsible for an estimated 9% to 20% increase in electricity bills in 2022-23.</p> <p>The report noted the “price bidding system” was largely responsible for increasing wholesale electricity prices.</p> <p>The inquiry was critical of the profit margin of AGL, a leading electricity retailer:</p> <blockquote> <p>It would seem that AGL needs to explain why consumers are paying $60.10/MWh more than seems to be justified by cost differentials. That is, for every consumer bill of $1,000 there is an apparent excess to be explained of $205.61 relative to prices charged to large business customers and not accounted for by genuine cost differences.</p> </blockquote> <p><strong>SUPERMARKETS</strong></p> <p>Supermarket prices have received the most attention recently with the main providers being accused of price gouging.</p> <p>As has occurred in other sectors, profit margins were well above pre-COVID levels. In 2023, the margin was more than 3.5% compared to less than 3% in 2017 and 2018.</p> <p>In Australia, <a href="https://www.smh.com.au/politics/federal/not-happy-little-vegemites-food-prices-rising-faster-than-inflation-20230522-p5da9w.html">food prices</a> also increased well above the inflation rate.</p> <p>According to the inquiry, the price increases for groceries between March 2021 and September 2023 varied between 19.2% and 27.3% for different categories, including cheese, bread, milk, eggs, dairy products and breakfast cereals.</p> <p>Farmers recently <a href="https://www.news.com.au/finance/business/retail/aussie-farmer-shipping-beautiful-melons-to-japan-rather-than-deal-with-coles-and-woolworths/news-story/bd685cd91f934f31c02c764097f496ae">accused</a> supermarkets of making too much profit from their crops.</p> <p>This was backed by the inquiry, which found the disproportionate market power held by supermarkets and food processors was of significant concern.</p> <p>The report noted that supermarkets increased prices when there was a shortage or cost increase, but the opposite did not happen easily when supplies were plentiful and prices were cheaper.</p> <h2>Issues common to all sectors</h2> <p>Among the issues common to all sectors were weak competition, a lack of price transparency, the difficulty consumers face switching between suppliers and providers, a lack of pricing policies and a lack of consumer awareness.</p> <p>While the price rises imposed by service providers and retailers were <a href="https://www.accc.gov.au/business/pricing/setting-prices-whats-allowed">not unlawful</a>, the increases in all sectors were significant and were hurting everyday Australians.</p> <h2>Fels’ recommendations</h2> <p>Many of the recommendations were sector-specific, but the one that applied to all areas related to the lack of regulation and pricing policies.</p> <p>The ACCC should be empowered to investigate, monitor and regulate prices for the child and aged care, banking, grocery and food sectors, the inquiry found. This was necessary to ensure businesses used fair and transparent pricing.</p> <p>A review of all existing policies was also recommended. For example, the government should use the current aviation review to remove international and domestic restrictions on competition. It was important aviation stakeholders, such as airlines and airports, were involved in the process.</p> <p>The report suggested the grocery <a href="https://www.accc.gov.au/business/industry-codes/food-and-grocery-code-of-conduct">code of conduct</a> should be mandatory for the food and grocery sector, and a price register for farmers should be created. This should be a government priority to protect farmers from unfair pricing by major supermarkets and food processors.</p> <h2>Change is needed</h2> <p>The current pricing practices for all business sectors must improve for greater transparency and to protect Australian consumers from unfair pricing.</p> <p>The inquiry report’s findings and recommendations are helpful in ensuring fair and transparent pricing policies and improving the current regulations for price settings.</p> <p>Implementing the recommendations will improve fair and transparent pricing practices and may help Australians get relief from the cost of living pressure in future.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222755/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/sanjoy-paul-1141384"><em>Sanjoy Paul</em></a><em>, Associate Professor, UTS Business School, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/supermarkets-airlines-and-power-companies-are-charging-exploitative-prices-despite-reaping-record-profits-222755">original article</a>.</em></p>

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How do I handle it if my parent is refusing aged care? 4 things to consider

<p><em><a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>It’s a shock when we realise our parents aren’t managing well at home.</p> <p>Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed.</p> <p>You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what?</p> <p>Here are four things to consider.</p> <h2>1. Start with more help at home</h2> <p>Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move.</p> <p>Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both.</p> <p>Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety.</p> <p>Call <a href="https://www.myagedcare.gov.au/">My Aged Care</a> to discuss your options.</p> <h2>2. Be prepared for multiple conversations</h2> <p>Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made.</p> <p>Ideally, the older person feels supported rather than attacked during these conversations.</p> <p>Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice.</p> <p>Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”.</p> <h2>3. Understand the options when help at home isn’t enough</h2> <p>If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be <a href="https://academic.oup.com/gerontologist/article/60/8/1504/5863160">considering a nursing home</a> (also known as residential aged care in Australia).</p> <p>Every person has a legal right to <a href="https://humanrights.gov.au/our-work/9-your-right-choose-where-you-live">choose where we live</a> (unless they have lost capacity to make that decision).</p> <p>This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”.</p> <p>It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational).</p> <p>Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else?</p> <p>Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space.</p> <p>Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826495/">Research</a> suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control.</p> <p>Mum and Dad should be involved in the decision-making process about where they live, and when they might move.</p> <p>Some families start looking “just in case” as it often takes some time to <a href="https://www.abc.net.au/everyday/questions-to-ask-when-choosing-an-aged-care-home-for-a-loved-one/10302590">find the right nursing home</a> and there can be a wait.</p> <p>After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule.</p> <p>We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions.</p> <p>For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”.</p> <p>Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead.</p> <h2>4. Understand the options if a parent has lost capacity to make decisions</h2> <p>If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests.</p> <p>If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity.</p> <p>Mum or Dad may have appointed an <a href="https://www.tag.nsw.gov.au/wills/appoint-enduring-guardian/what-enduring-guardian">enduring guardian</a> to make decisions about their health and lifestyle decisions when they are not able to.</p> <p>An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves.</p> <p>If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can <a href="https://www.tag.nsw.gov.au/guardianship/information-about-guardianship">appoint</a> that person a private guardian (usually a family member, close friend or unpaid carer).</p> <p>If no such person is available to act as private guardian, a public official may be appointed as public guardian.</p> <h2>Deal with your own feelings</h2> <p>Families often feel <a href="https://link.springer.com/article/10.1007/s12144-023-04538-9">guilt and grief</a> during the decision-making and transition process.</p> <p>Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221210/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lee-fay-low-98311"><em>Lee-Fay Low</em></a><em>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-handle-it-if-my-parent-is-refusing-aged-care-4-things-to-consider-221210">original article</a>.</em></p>

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