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Independent you: preventing, and recovering from, elder abuse

<p>From implementing safeguards to stop it from beginning to taking back control if it does, there is a lot of power in your hands to avoid elder abuse.</p> <p>Previously, we explored the warning signs of elder abuse and how <a href="https://www.oversixty.com.au/finance/retirement-income/are-you-a-victim-of-elder-abuse-without-even-realising-it">it is possible to be a victim without even realising it</a>.</p> <p>And with more wealth owned by people over 60 now than ever before, the potential for abuse only continues to grow.</p> <p>So, how can you prevent elder abuse happening to you? And if you are already experiencing it, what can you do to regain control over your finances, independence and wellbeing? </p> <p><strong>Prevention better than cure</strong></p> <p>The best way to avoid the impacts of elder abuse is to protect yourself against it beginning in the first place.</p> <p>Awareness is the first step, so having <a href="https://www.oversixty.com.au/finance/retirement-income/are-you-a-victim-of-elder-abuse-without-even-realising-it">read this article and knowing the warning signs</a>, you’re already ahead of the game!</p> <p>Other preventative actions include:</p> <ul> <li>Maintaining contact: social interactions are important not just for warding off loneliness but providing access to other points of view and avenues for support. </li> <li>External advisers: engage your own advisers – don’t simply employ who someone tells you to. They should be an impartial, qualified set of eyes to monitor things for you and point out anything that doesn’t seem right. This includes a financial advisor, lawyer, accountant, doctor and so on. A support person attending appointments with you may give you extra assurance.</li> <li>Power of attorney/guardianship: nominate multiple people, so that no one individual has all the say. It can be useful to include someone who is not a relative for impartiality, such as a trusted friend or your lawyer. </li> <li>Superannuation beneficiaries: super is separate from your will, but beneficiary nominations can only be spouse, child, dependent or interdependent otherwise it will go to you Will. In your Will you can direct to other people or charities. Some beneficiaries lapse, so will need to be renewed.</li> <li>Wills: review your will to ensure it reflects YOUR wishes, not someone else’s. People can jostle over not only their own inheritance but may try to influence you to leave others out. </li> <li>Documenting everything: keep a written record, especially where money is concerned – such as acting as Bank of Mum and Dad for adult kids to purchase property. Outline how much is given, what if any interest/repayments are expected and when, and what happens if their relationship subsequently breaks down.</li> <li>Encouraging independence: people who have come to expect handouts can become abusive if those handouts stop or requests for more are denied. Support and encourage others, especially your kids, to be financially independent and self-sufficient.</li> </ul> <p><strong>Taking back control</strong></p> <p>Sadly, prevention is no longer an option for an <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/population-groups/older-people?xd_co_f=YjAzZDU4YTUtYzA5YS00YTNkLWJkNDQtNjdiZTM5ZmY5ZjQx#abuse">estimated 598,000 Australians</a> already experiencing elder abuse. However, it is still possible to break the cycle.</p> <p>Don’t be embarrassed or stick your head in the sand hoping things will improve. You have done nothing wrong. You are entitled to enjoy your retirement years.</p> <p>To take back control over your affairs, your wellbeing and your independence:</p> <ul> <li>Ensure your physical safety first and foremost.</li> <li>Seek medical attention for your physical and mental health (the latter is crucial for making good decisions around the other points on this list).</li> <li>Get support from another relative, close friend, neighbour, or other trusted person. Don’t be alone.</li> <li>Secure a roof over your head. Having a stable place to live gives you the security and focus to tackle other concerns.</li> <li>Freeze access to your money – bank accounts, credit cards etc. This will stop (further) unauthorised withdrawals or purchases being charged to you.</li> <li>Seek professional advice. Your financial adviser, tax accountant and lawyer will be able to guide you through protecting your home, money, guardianship and estate planning matters.</li> <li>Make informed changes. Don’t do anything rashly – make necessary changes once you have sought independent advice and considered your options. This may involve making changes to your power of attorney, will, superannuation, bank accounts, even your phone number in extreme cases.</li> <li>Consider counselling. Your abuser may not realise the severity of their actions. An independent counsellor may be able to help them see this and change their ways, and ultimately salvage your relationship.</li> </ul> <p>If you or someone you know is experiencing elder abuse, seek help straight away. Speak to a trusted relative or friend. Seek independent legal and financial advice about your affairs. Or call the government’s free elder abuse line on 1800 353 374. And if your life is in danger, call triple zero (000) immediately.</p> <p><strong><em>Helen Baker is a licensed Australian financial adviser and author of On Your Own Two Feet: The Essential Guide to Financial Independence for all Women. Helen is among the 1% of financial planners who hold a master’s degree in the field. Proceeds from book sales are donated to charities supporting disadvantaged women and children. Find out more at <a href="http://www.onyourowntwofeet.com.au/">www.onyourowntwofeet.com.au</a></em></strong></p> <p><strong><em>Disclaimer: The information in this article is of a general nature only and does not constitute personal financial or product advice. Any opinions or views expressed are those of the authors and do not represent those of people, institutions or organisations the owner may be associated with in a professional or personal capacity unless explicitly stated. Helen Baker is an authorised representative of BPW Partners Pty Ltd AFSL 548754.</em></strong></p> <p><em>Image credits: Getty Images </em></p>

Caring

Allan Border's desperate plea to PM

<p>Allan Border has joined Parkinson’s Australia chief executive Olivia Nassaris in a plea for the Federal Government to provide more funding and research into the condition. </p> <p>The 68-year-old cricket legend is one of over 150,000 Australians living with Parkinson’s, after being diagnosed with the neurodegenerative disorder back in 2016. </p> <p>A new report from the organisation revealed that there are 19,500 new cases every year, with one Australian diagnosed with the condition every 27 minutes.</p> <p>“A lot of people know the disease but they don’t know the impact that it has — 150,000 people in Australia have the disease, it does present in different ways,” Border said. </p> <p>“When I was told I was suffering, my first image was of (boxer) Muhammad Ali and the Olympic torch, I just thought people suffered from a tremor.</p> <p>“But there’s about 100,000 different ways of it presenting.”</p> <p>Border joined the Parkinson’s Australia chief executive on April 11 to raise awareness for World Parkinson’s Day.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Nassaris </span>estimated that the number of Australians impacted by Parkinson’s would almost triple by 2050.</p> <p>“At the moment we don’t have a cause or cure, so it is frightening that a disease like this is going to almost triple in numbers,” she said.</p> <p>Responding to the cricketer’s plea, the Prime Minister described Border as a “great Australian” and hinted at a potential boost to government support in providing more resources into the condition. </p> <p>“Our heart goes out to him,” the PM said on Thursday. </p> <p>“I will have a word with the Health Minister about what more we can do. We have contributed over $100m to research into Parkinson’s.</p> <p>“There’s also a pilot program for nurses about people suffering from Parkinson’s at the moment. There’s some $6.5m being used for that pilot program. We want to wait and see what the assessment of that is.”</p> <p><em>Images: Getty</em></p>

Caring

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&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&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&gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&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&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&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.<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" /></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

Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

<p><a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.”</p> <p>“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video.</p> <p>No further details have been released about the Princess of Wales’ treatment.</p> <p>But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment.</p> <h2>It’s not the same as preventing cancer</h2> <p>To <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">prevent cancer developing</a>, lifestyle changes such as diet, exercise and sun protection are <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">recommended</a>.</p> <p>Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at <a href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353">high risk of breast cancer</a>.</p> <p>Aspirin <a href="https://www.cancer.gov/about-cancer/causes-prevention/research/aspirin-cancer-risk">can also be used</a> for those at high risk of bowel and other cancers.</p> <h2>How can chemotherapy be used as preventive therapy?</h2> <p>In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning.</p> <p>If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer.</p> <p>If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate <a href="https://www.healthline.com/health/cancer/metastatic-cancer">around the body</a> .</p> <p>The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer <a href="https://www.verywellhealth.com/adjuvant-therapy-5198903">coming back</a>. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later.</p> <p>With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back.</p> <p>If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer.</p> <h2>How effective is preventive therapy?</h2> <p>The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy.</p> <p>Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564362/">first chemotherapy tested</a> improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%.</p> <p>Preventive chemotherapy is usually given for three to six months.</p> <h2>How does chemotherapy work?</h2> <p>Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations.</p> <p>Chemotherapy is not selective for cancer cells. It kills any dividing cells.</p> <p>But cancers consist of a higher proportion of dividing cells than the normal body cells. A <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment/chemotherapy/how-does-chemotherapy-work#:%7E:text=Chemotherapy%20works%20by%20killing%20cells%20that%20are%20rapidly,cells%20can%20repair%20the%20damage%20and%20can%20recover.">greater proportion of the cancer is killed</a> with each course of chemotherapy.</p> <p>Normal cells can recover between courses, which are usually given three to four weeks apart.</p> <h2>What are the side effects?</h2> <p>The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells.</p> <p>The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection.</p> <p>Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance.</p> <p>Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet.</p> <p>There are also generalised symptoms such as <a href="https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html">fatigue</a>.</p> <p>Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.<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/226461/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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/kate-middleton-is-having-preventive-chemotherapy-for-cancer-what-does-this-mean-226461">original article</a>.</em></p>

Body

Victorian man rides lawn mower for 800km to speak to the PM

<p>You know the saying: mow big or mow home. And one man risked it all in hopes of scoring a meeting with Prime Minister Anthony Albanese.</p> <p>In an incredible 11-day journey Warren "Woz" Acott made the 800km journey from Central Victoria to Canberra to try and speak with the Prime Minister about motor neurone disease (MND). </p> <p>He left his home in Toolleen in Central Victoria on March 11, with no guarantee that anyone was going to meet him at the end of his journey. But his efforts have been fruitful, because by the time he arrived in Canberra this morning, he had a booking with the PM. </p> <p>"I've shuffled my schedule around to fit him in. I'd better go see him," Woz joked when he was told he had a meeting with the PM</p> <p>Albanese met met Woz in the Prime Minister's courtyard, and a crowd of families affected by MND were also waiting outside parliament to welcome Woz. </p> <p>"I'm overwhelmed. But it's not about me. It's about MND and the families and the carers and everybody else," Woz told <em>A Current Affair</em>.</p> <p>Woz, who lives with MND, wants the condition to be added to the National Notifiable Disease Surveillance System (NNDSS). </p> <p>This is because NNDSS conditions "a threat to public health in Australia" and are given additional funding for research." </p> <p>"We'll give consideration to all these things. You're a champion, mate," Albanese said.</p> <p>"It's all over my head. I mean, I'm a truck driver at the end of the day. But I know that if (MND is added to the NNDSS), it's more trackable, more funding, and everything else," Woz said.</p> <p>Robyn Sneddon, who lost her husband Ian to MND, praised Woz for his effort. </p> <p>"The effort he has made has been incredible. He is just a champion," she told <em>A Current Affair</em>. </p> <p>"I'm very proud of him," Snedden added.</p> <p><em>Images: A Current Affair</em></p>

Caring

"What a legend": Michael J Fox receives emotional standing ovation

<p>Michael J Fox, who has Parkinson's disease, made a surprise appearance at the BAFTA Awards in London. </p> <p><em>The Back to the Future</em> actor came onstage in a wheelchair, but he insisted on standing up at the podium to present the Best Film award. </p> <p>The star-studded audience all rose to their feet and gave the actor a standing ovation. </p> <p>When presenting the award, Fox described cinema as "magic" which can "change your life".</p> <p>"Five films were nominated in this category tonight and all five have something in common. They are the best of what we do," he said. </p> <p>He added that films can bring people together "no matter who you are or where you're from".</p> <p>"There's a reason why they say movies are magic because movies can change your day.</p> <p>"It can change your outlook. Sometimes it can change your life."</p> <p>Fox, who was diagnosed with Parkinson's in the 1990s, rarely makes public appearances. </p> <p>Many fans were pleasantly surprised at his appearance as he presented the night’s biggest award, Best Film, to <em>Oppenheimer</em>.</p> <p>"I was in tears the moment Michael J Fox came on the stage," one fan wrote on X, formerly known as Twitter.</p> <p>"THE MAN IS A LEGEND"</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">i was in tears the moment Michael J Fox came on the stage 😥😥😥</p> <p>THE MAN IS A LEGEND <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://twitter.com/hashtag/BAFTA2024?src=hash&ref_src=twsrc%5Etfw">#BAFTA2024</a> <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> <a href="https://t.co/Uud368S9gb">pic.twitter.com/Uud368S9gb</a></p> <p>— RanaJi🏹 (@RanaTells) <a href="https://twitter.com/RanaTells/status/1759323180060299726?ref_src=twsrc%5Etfw">February 18, 2024</a></p></blockquote> <p>"Michael J Fox. Absolute hero. What a legend," wrote another. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Michael J Fox. Absolute hero. What a legend. <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://t.co/62lxpCy3mn">pic.twitter.com/62lxpCy3mn</a></p> <p>— Jules 🌼 (@JulesItsjules) <a href="https://twitter.com/JulesItsjules/status/1759320058583568638?ref_src=twsrc%5Etfw">February 18, 2024</a></p></blockquote> <p>"All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend," added a third. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend. <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a></p> <p>— Declan Cashin (@Tweet_Dec) <a href="https://twitter.com/Tweet_Dec/status/1759319831696855281?ref_src=twsrc%5Etfw">February 18, 2024</a></p></blockquote> <p>"He's a total legend and wonderful human," wrote a fourth. </p> <p>The actor has spoken <a href="https://www.oversixty.com.au/health/caring/i-m-not-gonna-be-80-michael-j-fox-s-tragic-admission" target="_blank" rel="noopener">candidly</a> about his experience with Parkinson's over the years, and has said that he has made peace with the degenerative nature of the disease. </p> <p>In a previous interview with AARP magazine profile, the actor admitted that he did not fear death. </p> <p>“I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all," he told the publication. </p> <p><em>Images: Getty</em></p>

What happens to teeth as you age? And how can you extend the life of your smile?

<p><em><a href="https://theconversation.com/profiles/arosha-weerakoon-792707">Arosha Weerakoon</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>A healthy smile <a href="https://pubmed.ncbi.nlm.nih.gov/37314011/">helps us</a> live long, well and happy lives. But just <a href="https://pubmed.ncbi.nlm.nih.gov/37436910/">like our bodies</a>, our teeth succumb to age-related changes.</p> <p>So what happens to teeth as you age? And what can you do to ensure your smile lasts the distance?</p> <h2>First, what are teeth made of?</h2> <p>The tooth crown is covered by a hard enamel coat that surrounds softer, brown dentine, which protects a centrally located pulp.</p> <p>Enamel is a complex weave of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584618/">brittle</a>, honeycomb-clustered strands that interact with light to make teeth appear opalescent (a pearly, milky iridescence).</p> <p><a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1601-1546.2012.00269.x">Dentine under enamel</a> forms most of the tooth crown and root, and is made of collagen, mineral, water and proteins. Collagen strands are <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib12">woven</a> to stretch and spring back, to <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib12">prevent teeth</a> from cracking and breaking when we grind and chew.</p> <p>The pulp has blood vessels and nerves that communicate with the rest of your body.</p> <p>Enmeshed in the dentine mineral and collagen are small, <a href="https://pubmed.ncbi.nlm.nih.gov/8809302/">interconnected tubules</a> formed by specialised cells called <a href="https://www.sciencedirect.com/science/article/abs/pii/S1047847799940960">odontoblasts</a> that settle around the pulp, once our teeth completely form.</p> <p>Each tooth contains a <a href="https://pubmed.ncbi.nlm.nih.gov/23803461/">finite number of odontoblasts</a>, unlike the constantly replenished special bone cells that renew.</p> <h2>How do our teeth change as we age?</h2> <p>Unable to renew, our teeth <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib19">become brittle</a>, and prone to fracture as dentine loses its spring.</p> <p>This is <a href="https://www.sciencedirect.com/science/article/pii/S0002817714613532?casa_token=1K9Y6CJXmsAAAAAA:t6y_b_Iy02AWpUGaiz4H8Fk0Kdfx6z1ypHiGOEjFqFNlU1jvSRCVjfYOyysgIErJvgCzh33c2hfX">more common</a> in teeth with existing crack lines, large fillings or root canal treatments.</p> <p>With time, the outer surface of enamel <a href="https://www.sciencedirect.com/science/article/abs/pii/S0022391305004348?casa_token=xXfdecXrLaoAAAAA:YE_0swAFtT3RyCUeJmPwciixQ0hwL-foLyC2RGtnlyUSJ9O-pPLQz0B8XNd4Gq1AMtCN2BgnCrqo">thins</a> to reveal the relatively opaque dentine that darkens as we age.</p> <p>The dentine darkens because the collagen weave <a href="https://www.sciencedirect.com/science/article/abs/pii/S1047847722000697">stiffens and shrinks</a>, and the fluid in the tubules <a href="https://www.sciencedirect.com/science/article/pii/S2590152422000010?via%3Dihub">fills with mineral</a>.</p> <p>The odontoblasts continue to form dentine inside the tooth to reduce the translucent pulp space. The increase in dentine makes our teeth appear <a href="https://www.sciencedirect.com/science/article/abs/pii/S0003996913003294">opaque</a> and insulates from hot and cold sensations. This is why <a href="https://www.sciencedirect.com/science/article/pii/S0300571215000494?casa_token=iiLtoxOZOYQAAAAA:RfaGR7lrq9dgWuO_nh6hLETzVUiIWdu-mB-Ev019vZH5t6meVyAHs3YpZzcu9FNrDBYQL6OExu6j">X-rays</a> are useful to detect cavities we may not feel.</p> <p>Food and drink particles fill micro-gaps and age-related fine crack lines that run up and down enamel to <a href="https://www.researchgate.net/profile/Yash-Kapadia/publication/322509199_Tooth_staining_A_review_of_etiology_and_treatment_modalities/links/5b4cd922a6fdcc8dae245b7d/Tooth-staining-A-review-of-etiology-and-treatment-modalities.pdf">discolour and stain</a>. These stains are easily managed by <a href="https://www.sciencedirect.com/science/article/pii/S2772559622000207">tooth whitening</a>.</p> <p>How else can you extend the life of your teeth and brighten your smile? Here are seven tips to avoid dental decline:</p> <h2>1. Avoid unnecessary forces</h2> <p>Avoid <a href="https://www.nature.com/articles/sj.bdj.2012.722">using</a> your teeth to hold things such as working tools or to open packaging.</p> <p>Take measures to avoid forces such as <a href="https://www.sciencedirect.com/science/article/pii/S1882761622000059">grinding or clenching</a> by wearing a night guard.</p> <p>If you have <a href="https://www.sciencedirect.com/science/article/pii/S0109564122002421">large fillings</a> or <a href="https://www.sciencedirect.com/science/article/pii/S0109564122001579?casa_token=kQPjGNgU2iQAAAAA:ytMnT5MLV8aRehNyyWD7qC7FXSBE5xpPCxnzZ2ryKsuyJePq1jHisue1udtN0Cs6NDYJ37xYHy_5">root canal-treated</a> teeth, speak to your dentist about <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/aej.12002?casa_token=RwMhhwmgjwwAAAAA%3AGCWVA9vjFX68S2DdKbCFl4jwTAjMeqVDoT3GtXTSjA7SMEc3ksktOMCUSz9ArikD4XhBM5v08nGCvmVF0g">specific filling materials or crowns</a> that can protect your teeth from cracking or breaking.</p> <h2>2. Share the load</h2> <p>If you are missing molars or premolars, distribute chewing forces evenly to prevent overloading your remaining teeth.</p> <p>Replace missing teeth with <a href="https://www.sciencedirect.com/science/article/pii/S010956411100858X?casa_token=4vrj3ssj0PEAAAAA:UODaFxNDCKmQ_lQs1faL6lh0xIeIfSFrRQBq-s0KF1ZvUJd6ytbXX37TVaiHLRzJPJaSDF_2aVmL">bridges</a>, <a href="https://aap.onlinelibrary.wiley.com/doi/full/10.1902/jop.2008.080188?casa_token=uA0r7imcRbUAAAAA%3AeXGszI5-Dcu4oKi33FCrRRviiAj0uyoP7V5wApIRQD1-1Zu-rkLAcoLhKMAJYVnC9tEnxj33UdNJIndEBA">implants</a> or well-fitted <a href="https://www.mdpi.com/1660-4601/18/13/6776">dentures</a> to support your bite. Get your dentures <a href="https://www.sciencedirect.com/science/article/pii/S0022391320301554">checked regularly</a> to ensure they fit and support adequately, and replace them at least every ten years.</p> <h2>3. Preserve your enamel</h2> <p>Reduce <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12330?casa_token=W2Ib34A77-QAAAAA%3AnLZtwwqZuueyHf1CMX0K9MERSW_Pvc3w0KlpArFT1KNusuopjEUcWmGd8pDUA7fQcj6DMkcS-JnXISFV1w">further enamel and dentine loss</a> by selecting soft-bristled <a href="https://www.tandfonline.com/doi/full/10.1080/00016350802195041?casa_token=E-ErdP543QUAAAAA%3A0Wz5AWwQxntBIc3UndFX_5nVbAYoPDx-PX1tg7Umxjr_QepX3CSIFVXYcrrxWV9iTx99Afk8c_zff-o">tooth brushes and non-abrasive toothpastes</a>.</p> <p>Certain whitening toothpastes can be abrasive, which can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874033/">roughen and wear</a> the tooth surfaces. If you are unsure, stick with toothpastes that are labelled “sensitive”.</p> <p>Reduce your exposure to <a href="https://www.nature.com/articles/sj.bdj.2012.722">acid</a> in food (think lemons or apple cider vinegar) or illness (reflux or vomiting) where possible to maintain enamel and prevent erosion.</p> <h2>4. Enhance your saliva</h2> <p><a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jtxs.12356?casa_token=1moXbwnrDQIAAAAA%3AHz3Im9lmR3h75TmG8FSUQH-8_0UGnQ9TNkgaPL79LlrCmwC3kzZZJaAB2mSZHf4X7PX5y3GKaVoY5cm5JA">Saliva</a> protects against acid attacks, flushes our teeth, and has antibacterial properties to reduce erosion and decay (holes forming).</p> <p>Saliva is also important to help us chew, swallow and speak.</p> <p>But our saliva quality and quantity reduces because of age-related changes to our salivary glands as well as certain medications prescribed to <a href="https://pubmed.ncbi.nlm.nih.gov/19392837/">manage chronic illnesses</a> such as depression and high blood pressure.</p> <p>Speak to your doctor about other medication options to improve your saliva or manage reflux disease to prevent erosion.</p> <h2>5. Treat gum disease</h2> <p>Aesthetically, <a href="https://pubmed.ncbi.nlm.nih.gov/37358230/">treating gum disease (periodontitis)</a> reduces gum shrinkage (recession) that typically exposes the relatively darker tooth roots that are more <a href="https://journals.sagepub.com/doi/abs/10.1177/00220345231166294">prone to developing holes</a>.</p> <h2>6. Manage and prevent senescence</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/36908187/">Cellular senescence</a> is the process that changes DNA in our cells to reduce our ability to withstand physical, chemical or biological damage.</p> <p>Cellular senescence enhances new cancer formation, the spread of existing cancers and the onset of chronic illnesses such as Alzheimer’s disease, diabetes, osteoporosis and heart disease.</p> <p>You can prevent cell damage by managing lifestyle factors such as smoking, uncontrolled diabetes and chronic infections such as gum disease.</p> <h2>7. Adapt and ask for help</h2> <p><a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jan.15769?casa_token=SC-LouFQThsAAAAA%3A4jcvLRuJ56dGEm7ttvMad65hvUoZ7V5nvILg5sLFVZo8jxyQGR6YFeTcfM8sByTbdVrCWR1O5ytI3Z_crA">Ageing</a> can affect our cognition, hand dexterity and eyesight to prevent us from cleaning our teeth and gums as effectively as we once could.</p> <p>If this describes you, talk to your dental care team. They can help clean your teeth, and <a href="https://www.magonlinelibrary.com/doi/full/10.12968/bjon.2020.29.9.520?casa_token=_rol0NXx9c8AAAAA%3Aq8zgxiMSASwF1MRQZnZzfzmttn2x7FfGwsiIv71C_s_PTTmGD9JOIbqqtLNXa0oF9ogOjOCZwwpwB94">recommend products and tools</a> to fit your situation and abilities.<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/215786/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/arosha-weerakoon-792707"><em>Arosha Weerakoon</em></a><em>, Senior Lecturer, School of Dentistry, The University of Queensland and General Dentist., <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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-to-teeth-as-you-age-and-how-can-you-extend-the-life-of-your-smile-215786">original article</a>.</em></p>

Body

"I’m not going to be cured". How breast cancer awareness and support sidelines people with metastatic disease

<p><em><a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>There have been incredible <a href="https://www.cancer.gov/types/breast/research">advances</a> in breast cancer diagnosis and treatment in recent years. And stories about celebrities who have “beaten” breast cancer continue to be a source of inspiration for many people.</p> <p>However, this emphasis on fighting, beating and surviving cancer shuts out the voices of those who will not survive. That is, the many people diagnosed with incurable, life-limiting metastatic breast cancer, <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">which kills nine Australians every day</a> or nearly <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">3,300 people</a> a year. Yet an <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">estimated 10,000</a> Australians are living with the diagnosis.</p> <p>Being diagnosed with metastatic breast cancer, as one of the authors has been, means ongoing treatment to live as long, and as well, as possible. It also means an ongoing need for emotional and practical support.</p> <p>However, society, health-care professionals, cancer advocacy organisations, even a patient’s closest family and friends, can struggle to understand what it is like to live with an incurable and life-limiting cancer and how best to provide support.</p> <h2>Why is there so little awareness?</h2> <p><a href="https://www.breastcancer.org/types/metastatic">Metastatic breast cancer</a>, also called stage four breast cancer, is the most serious form of breast cancer. Unlike early breast cancer that is contained within the breast or nearby lymph nodes, metastatic breast cancer has spread to other parts of the body, most often the bones, lungs, liver, or brain.</p> <p>There is no cure for metastatic breast cancer despite decades of advocacy, funding and research. Treatment continues for as long as it helps to control the cancer and is tolerated by the patient. Median survival is <a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.51687">two to three years</a>, although newer, novel treatments mean some patients are living much longer.</p> <p>As a society, we can be uncomfortable <a href="https://theconversation.com/before-you-go-are-you-in-denial-about-death-34056">talking about and facing death</a>. When it comes to cancer, we usually prefer focusing on good news stories. These narratives are often perceived to be better for fundraising and are reassuring for people newly diagnosed. But they fail to <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">represent</a> the diversity and reality of cancer experiences.</p> <p>Despite considerable research into people with non-metastatic breast cancer, <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">relatively little</a> is known about Australians with metastatic breast cancer.</p> <h2>Feeling silenced and unsupported</h2> <p>Through our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">research</a> we wanted to better understand people’s experiences of metastatic breast cancer. We interviewed 38 participants from around Australia with diverse experiences of metastatic breast cancer. Participants were recruited through breast cancer and community organisations.</p> <p>We found messages and public campaigns about cancer survivorship, which emphasise hope and positivity, drowned out the voices of those with metastatic breast cancer. The focus on “success stories” about surviving breast cancer made some people feel like it was their responsibility to “beat” cancer. If they didn’t, it was their own fault. </p> <p>As one interviewee told us: "I react quite badly to all the, ‘we’ve had breast cancer and we beat it and we’ve survived. Aren’t we fantastic.’ There’s almost a feeling if you haven’t beaten your breast cancer you haven’t tried hard enough."</p> <p>Silence around metastatic breast cancer was common in research participants’ experiences. It prevented many from connecting with others and to the support they needed. It even affected relationships with those closest to them leaving them feeling misunderstood: "They don’t realise I’ve got to be on treatment forever. I’m not going to be cured. I think society thinks everything can be fixed; metastatic breast cancer actually can’t be fixed."</p> <p>Sharing deep fears and worries about their life expectancy can leave people with metastatic breast cancer feeling drained rather than supported. Many participants reported having to support and shield family, friends, acquaintances and work colleagues from the reality of their terminal diagnosis.</p> <p>"You hide how you feel because you don’t want to be avoided […] You put on that big, happy face. But like an onion if you peeled the layers away, you’d find out what’s going on."</p> <p>While many participants wanted to join a community of people with metastatic breast cancer, they struggled to know how to find one. Those who did, emphasised how invaluable it had been: "Being able to identify with and know that these people really get me is a huge relief and it reduces the isolation."</p> <p>These findings echo <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">previous research</a> demonstrating people with metastatic breast cancer have higher support needs than those with non-metastatic breast cancer. And these needs are <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">less likely to be met</a> by <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08269-8">health care, support services</a>, family or friends.</p> <h2>A new path</h2> <p>Being diagnosed with metastatic breast cancer can be terrifying, lonely and create significant support needs. It is essential people with metastatic breast cancer have their <a href="https://ascopubs.org/doi/10.1200/OP.20.00183">voices listened to</a> and their needs met.</p> <p>Next steps should include:</p> <ul> <li> <p><a href="https://bcna-dxp.azureedge.net/media/d32bhdzf/bcna_making-metastatic-breast-cancer-count_2022.pdf">improving data collection by cancer registries</a> so we know exactly how many people in Australia have metastatic breast cancer</p> </li> <li> <p>increasing representation of people with metastatic breast cancer in advocacy, support organisations and research</p> </li> <li> <p>nationwide access to peer-to-peer programs and professionally led metastatic breast cancer support groups.</p> </li> </ul> <p>We must ensure people with metastatic breast cancer are the ones to speak to their experience and needs. As a colleague with metastatic breast cancer said: "I read an article written by an early-stage breast cancer ‘survivor’. It felt like someone describing winter when they had only ever experienced autumn."</p> <p>If you or someone you know has metastatic breast cancer, these organisations may be able to support you or connect you with others with the same diagnosis:</p> <ul> <li> <p><a href="https://www.bcna.org.au">Breast Cancer Network Australia</a> for information and support</p> </li> <li> <p><a href="https://www.mcgrathfoundation.com.au/">McGrath Foundation</a> for information about access to metastatic breast care nurses.</p> </li> </ul> <hr /> <p><em>The authors would like to thank the members of Breast Cancer Network Australia’s Metastatic Breast Cancer Lived Experience Reference Group for their review of this article.</em><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/215458/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, Senior Lecturer, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, Research fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <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/im-not-going-to-be-cured-how-breast-cancer-awareness-and-support-sidelines-people-with-metastatic-disease-215458">original article</a>.</em></p>

Caring

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<p><em><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>.</p> <p>Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease.</p> <p>Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link?</p> <h2>What the study did and found</h2> <p>This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period.</p> <p>Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia.</p> <p>During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease.</p> <h2>Important considerations</h2> <p>In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk.</p> <p>Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively.</p> <p>These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable.</p> <p>Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves.</p> <p>This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association.</p> <h2>What does other evidence say?</h2> <p><a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both.</p> <p>High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too.</p> <p>For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life.</p> <h2>Why the link?</h2> <p>There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia.</p> <p>Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline.</p> <p>Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>.</p> <p>We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<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/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <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/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.</em></p>

Mind

Demands for "killer product" to be dropped from Bunnings over fatal disease links

<p>Bunnings Warehouse is being urged in the strongest possible terms to pull a popular item off their shelves amid concerns it could be linked to a fatal disease.</p> <p>A particular range of trendy kitchen countertops have been linked to an incurable disease that the national construction union says has been harming tradies.</p> <p>The Construction, Forestry, Maritime, Mining and Energy Union (CFMMEU) have taken their demands for the recall directly to the hardware giant’s chief executive Michael Schneider, warning it was “unconscionable” to keep the engineered stone benchtops on Bunnings’ product line up.</p> <p>“Bunnings has unique market power and a unique place in Australian society. If you were to remove this killer product from your shelves, it would send a powerful message,” CFMEU boss Zach Smith wrote.</p> <p>The engineered benchtops, which have become a feature in many modern day Australian kitchens and bathrooms, contain a high concentration of crystalline silica.</p> <p>When cutting the benchtops, silica dust is released into the air, which can lead to the potentially deadly and incurable disease of silicosis, as well as lung cancer.</p> <p>In his letter, Mr Smith called for the product to be removed “effective immediately”.</p> <p>“I am disappointed that, despite all this information being in the public sphere, Bunnings is still advertising and selling high-silica engineered stone products in your stores nationwide,” he said.</p> <p>“Conversely, it is unconscionable for Bunnings to continue promoting and selling this killer product when there is no need to do so."</p> <p>“There are many, many alternatives to engineered stone as a benchtop material. The business costs of removing these products are insignificant when we are faced with the prospect of more deaths.”</p> <p>It has been estimated that up to 103,000 tradies will be diagnosed in their lifetime with silicosis as a result of exposure to silica dust at work, while more than 10,000 will develop lung cancer.</p> <p>In response to the concerns raised, Jen Tucker, the Director of Merchandise at Bunnings, acknowledged that the hardware giant is aware of the issue at hand and emphasised their commitment to keeping a close watch on and adhering to guidance from regulatory authorities. However, Ms. Tucker did not explicitly endorse the request made by the CFMEU.</p> <p>She went on to clarify that the majority of benchtops available in their stores are made from laminate or timber materials. However, for the engineered stone benchtops that they offer, these are pre-cut to precise dimensions before reaching a customer's location.</p> <p>Furthermore, these engineered stone benchtops are exclusively supplied and installed by specialist providers who hold valid engineered stone licenses. These providers strictly adhere to rigorous safety standards, prioritising the well-being of their production and installation teams, all in accordance with the stipulations of their licenses.</p> <p>Ms Tucker underscored Bunnings' unwavering commitment to the safety of their staff and customers, underscoring its profound importance to the company. She also acknowledged that safety is a broader concern within the industry and noted that the federal government is presently conducting a review on this matter.</p> <p>In this regard, Bunnings expressed its support for new legislation and the establishment of consistent standards and licensing procedures across various states and territories, all in pursuit of enhancing safety within the industry.</p> <p><em>Image credits: Getty Images</em></p>

Legal

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

<p><em><a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies.</p> <p>While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low.</p> <p>But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections.</p> <h2>What diseases can pets carry?</h2> <p>Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people.</p> <p>Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs.</p> <p>Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water.</p> <p>Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms.</p> <p>Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva.</p> <p>Dogs also commonly carry <em>Capnocytophaga</em> bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>.</p> <p>Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray.</p> <p>Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium <em>Bartonella henselae</em>.</p> <p>Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium <em>Staphylococcus aureus</em></a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission.</p> <h2>Birds, turtles and fish can also transmit disease</h2> <p>But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to <em>Salmonella</em> infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis.</p> <p>Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink.</p> <p>Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to <em>Pasteurella multicoda</em> infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats.</p> <p>Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets.</p> <p>Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed.</p> <p>For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>.</p> <h2>What should I do if I’m worried about catching a disease from my pet?</h2> <p>There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include:</p> <ul> <li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li> <li>not allowing your pets to lick your face or open wounds</li> <li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li> <li>wearing gloves when changing litter trays or cleaning aquariums</li> <li>wetting bird cage surfaces when cleaning to minimise aerosols</li> <li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)</li> <li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments</li> <li>seeking veterinary care if you think your pet is unwell.</li> </ul> <p>It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.<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/210898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, Lecturer in environmental health, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Getty </em><em>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/is-it-okay-to-kiss-your-pet-the-risk-of-animal-borne-diseases-is-small-but-real-210898">original article</a>.</em></p>

Family & Pets

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

<p><em><a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>People are living longer and with more <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-functioning/health-disability-status">chronic health conditions</a> – including heart disease, diabetes, arthritis and dementia – than ever before. As societies continue to grow older, one pressing concern is the use of multiple medications, a phenomenon known as <a href="https://www.who.int/docs/default-source/patient-safety/who-uhc-sds-2019-11-eng.pdf">polypharmacy</a>.</p> <p>About <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50244">1 million older Australians</a> experience polypharmacy and this group is increasing. They may wake up in the morning and pop a pill for their heart, then another one or two to control blood pressure, a couple more if they have diabetes, a vitamin pill and maybe one for joint pain.</p> <p>Polypharmacy is usually <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.1_polypharmacy_75_years_and_over.pdf">defined</a> as taking five or more different medications daily. In aged care homes, <a href="https://doi.org/10.1016/j.archger.2022.104849">90% of residents</a> take at least five regular medications every single day. That can put their health at risk with increased costs for them and the health system.</p> <h2>Adding up over time</h2> <p>As people age, the effects of medications can change. Some medications, which were once beneficial, might start to do more harm than good or might not be needed anymore. About <a href="https://www.psa.org.au/wp-content/uploads/2020/02/Medicine-Safety-Aged-Care-WEB-RES1.pdf">half of older Australians</a> are taking a medication where the likely harms outweigh the potential benefits.</p> <p>While polypharmacy is sometimes necessary and helpful in managing multiple health conditions, it can lead to unintended consequences.</p> <p><a href="https://www.nps.org.au/living-with-multiple-medicines/costs">Prescription costs</a> can quickly add up. Taking multiple medications can be difficult to manage particularly when there are specific instructions to crush them or take them with food, or when extra monitoring is needed. There is also a risk of <a href="https://www.nps.org.au/consumers/understanding-drug-interactions">drug interactions</a>.</p> <p>Medications bought “over the counter” without a prescription, such as vitamins, herbal medications or pain relievers, can also cause <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja11.10698">problems</a>. Some people might take an over-the-counter medication each day due to previous advice, but they might not need it anymore. Just like prescription medications, over-the-counter medications add to the overall burden and cost of polypharmacy as well as drug interactions and side effects.</p> <p>Unfortunately, the more medications you take, the more likely you are to have <a href="https://www.nps.org.au/consumers/managing-your-medicines#risks-of-taking-multiple-medicines">problems with your medications</a>, a reduced quality of life and increased risk of falls, hospitalisation and death. Each year, <a href="https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf">250,000 Australians</a> are admitted to hospital due to medication-related harms, many of which are preventable. For example, use of multiple medications like sleeping pills, strong pain relievers and some blood pressure medications can cause drowsiness and dizziness, potentially resulting in a <a href="https://betterhealthwhileaging.net/preventing-falls-10-types-of-medications-to-review/">fall</a> and broken bones.</p> <h2>Prescribing and deprescribing are both important</h2> <p>Ensuring safe and effective use of medications involves both prescribing, and <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/silver-book/part-a/deprescribing">deprescribing</a> them.</p> <p><a href="https://www.australiandeprescribingnetwork.com.au/474-2/">Deprescribing</a> is a process of stopping (or reducing the dose of) medications that are no longer required, or for which the risk of harm outweighs the benefits for the person taking them.</p> <p>The process involves reviewing all the medications a person takes with a health-care professional to identify medications that should be stopped.</p> <p>Think of deprescribing as spring cleaning your medicine cabinet. Just like how you tidy up your house and get rid of objects that are causing clutter without being useful, deprescribing tidies up your medication list to keep only the ones truly required.</p> <h2>But care is needed</h2> <p>The process of deprescribing requires close monitoring and, for many medications, slow reductions in dose (tapering).</p> <p>This helps the body adjust gradually and can prevent sudden, unpleasant changes. Deprescribing is often done on a trial basis and medication can be restarted if symptoms come back. Alternatively, a safer medication, or non-drug treatment may be started in its place.</p> <p>Studies show deprescribing is a safe process when managed by a health-care professional, both for people living at <a href="https://link.springer.com/article/10.1007/s11606-020-06089-2">home</a> and those in <a href="https://doi.org/10.1016/j.jamda.2018.10.026">residential aged care</a>. You should always talk with your care team before stopping any medications.</p> <p>Deprescribing needs to be a team effort involving the person, their health-care team and possibly family or other carers. Shared decision-making throughout the process empowers the person taking medications to have a say in their health care. The team can work together to clarify treatment goals and decide which medications are still serving the person well and which can be safely discontinued.</p> <p>If you or a loved one take multiple medications you might be eligible for a free visit from a pharmacist (<a href="https://www.nps.org.au/assets/NPS/pdf/NPSMW2390_Anticholinergics_HMR_Factsheet.pdf">a Home Medicines Review</a>) to help you get the best out of your medications.</p> <h2>What’s next?</h2> <p>Health care has traditionally focused on prescribing medications, with little focus on when to stop them. Deprescribing is not happening as often as it should. <a href="https://www.australiandeprescribingnetwork.com.au/">Researchers</a> are working hard to develop tools, resources and service models to support deprescribing in the community.</p> <p>Health-care professionals may think older adults are not open to deprescribing, but about <a href="https://academic.oup.com/biomedgerontology/article/77/5/1020/6352400">eight out of ten people</a> are willing to stop one or more of their medications. That said, of course some people may have concerns. If you have been taking a medication for a long time, you might wonder why you should stop or whether your health could get worse if you do. These are important questions to ask a doctor or pharmacist.</p> <p>We need more <a href="https://shpa.org.au/news-advocacy/MedsAware">public awareness</a> about polypharmacy and deprescribing to turn the tide of increasing medication use and related harms. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211424/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, Senior Research Fellow in the Centre for Medicine Use and Safety , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, Enterprise Fellow, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, PhD student, Clinical Pharmacology and Toxicology, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></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/taking-more-than-5-pills-a-day-deprescribing-can-prevent-harm-especially-for-older-people-211424">original article</a>.</em></p>

Body

“Invisible suffering”: Bella Hadid opens up about painful health battle

<p dir="ltr">Bella Hadid has shared a raw update to her fans, giving them further insight into her “painful” health battle with Lyme disease.</p> <p dir="ltr">On Sunday, the model took to Instagram to share a series of photos of her ongoing health battle, including photos of her medical records.</p> <p dir="ltr">“The little me that suffered would be so proud of grown me for not giving up on myself,” she began in the caption.</p> <p dir="ltr">She then thanked her mum, Yolanda Hadid, "for keeping all of my medical records, sticking by me, never leaving my side, protecting, supporting, but most of all, believing me through all of this”.</p> <p dir="ltr">She then continued to say that since contracting Lyme, her symptoms have gotten worse over time and it’s taken a toll on her in ways that are difficult for her to explain, but remained positive despite it.</p> <p dir="ltr">“To be that sad and sick with the most blessings/privilege/opportunity/love around me was quite possibly the most confusing thing ever,” she added before reassuring fans not to worry and that she is “okay”.</p> <p dir="ltr">The model also noted that despite her painful health battle, she “wouldn’t change anything for the world” and would go through it all again, as it has shaped who she is.</p> <p dir="ltr">“The universe works in the most painful and beautiful ways but I need to say that if you are struggling- it will get better,” she added.</p> <p dir="ltr">Bella also said that despite “almost 15 years of invisible suffering” she is grateful for the experience, and has so much “gratitude for and perspective on life” that has made her able to spread ”love from a full cup” and “truly” be herself.</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/Cvmz8ilAcxx/?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/Cvmz8ilAcxx/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bella 🦋 (@bellahadid)</a></p> </div> </blockquote> <p dir="ltr">“I tried to pick the most positive pictures I could because as painful as this experience was, the outcome was the most enlightening experience of my life filled with new friends, new visions and a new brain,” she added before thanking everyone who has supported her throughout this journey.</p> <p dir="ltr">“I’ll be back when I’m ready, I miss you all so much, I love you all so much,” she concluded.</p> <p dir="ltr">The model shared a few photos of herself getting treatment with IVs sticking out of her arm.</p> <p dir="ltr">In a few other photos, the model can be seen resting on the couch as she gets a blood transfusion, with her loyal pup, “Petunia aka Beans,” never leaving her side.</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/Cvm1ImkA-89/?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/Cvm1ImkA-89/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bella 🦋 (@bellahadid)</a></p> </div> </blockquote> <p dir="ltr">This is the model’s first health update after she revealed she was taking time off from modelling due to a flare-up in her Lyme disease.</p> <p dir="ltr"><em>Images: Instagram</em></p> <p dir="ltr"> </p>

Caring

Daily aspirin doesn’t prevent strokes in older, healthy people after all

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The daily use of <a href="https://www.nps.org.au/australian-prescriber/articles/drugs-in-secondary-stroke-prevention">low dose aspirin</a> has been a mainstay of preventing strokes for decades. While there has always been a risk of bleeding associated with aspirin use, the benefits were thought to outweigh the risk.</p> <p>Now <a href="https://dx.doi.org/10.1001/jamanetworkopen.2023.25803">new research</a> led by Monash University has shown daily, low-dose aspirin doesn’t prevent strokes in relatively healthy people aged over 70. And it increases their risk of bleeding on the brain after falls or other injuries.</p> <p>But if you’re taking aspirin, it doesn’t mean you should abruptly stop. It may still have a role to play in treating people at high risk of stroke. Or, after talking to your doctor, there might be better options available.</p> <h2>Why has aspirin been used to prevent strokes?</h2> <p>Aspirin is an anti-platelet medicine, which is commonly known as a blood-thinner. <a href="https://www.lifeblood.com.au/blood/learn-about-blood/platelets">Platelets</a> are the component of blood primarily responsible for its clotting action. They are what stop you from continuously bleeding any time you have a cut or scrape on your skin.</p> <p>A <a href="https://strokefoundation.org.au/about-stroke/learn/what-is-a-stroke">stroke</a> is when oxygen can’t get into the brain because of a burst or blocked blood vessel. A blockage can occur when platelets in the bloodstream form a clot and it gets stuck in the artery.</p> <p>Because aspirin acts on platelets, it can help prevent the clots that can lead to a stroke.</p> <p>But because aspirin acts on platelets, it can also increase the risk of <a href="https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/daily-aspirin-therapy/art-20046797#:%7E:text=While%20daily%20aspirin%20can%20help,of%20developing%20a%20stomach%20ulcer.">unwanted bleeding</a>, usually in the stomach. It can also increase your risk of bleeding more when you have another injury, like hitting your head.</p> <p>Aspirin isn’t just used for the prevention of strokes. It is also the first aid treatment for someone undergoing a <a href="https://www.nps.org.au/australian-prescriber/articles/acute-myocardial-infarction-early-treatment">heart attack</a>.</p> <h2>Findings of the Monash trial</h2> <p>New <a href="https://dx.doi.org/10.1001/jamanetworkopen.2023.25803">research from Australia and the United States</a> reports results from the Aspirin in Reducing Events in the Elderly (ASPREE) trial.</p> <p>The researchers examined the protective use of daily low-dose aspirin (100 mg) in nearly 2,000 people who were aged 70 years and older and had no history of heart disease or stroke and whose blood pressure and cholesterol were well managed.</p> <p>When compared with placebo, aspirin didn’t reduce or increase the risk of stroke. Of the participants who took the aspirin, 195 or 4.6% had a stroke. Of those who took the placebo, 203 people or 4.7% had a stroke.</p> <p>But it did statistically increase the rate of non-stroke bleeding in the participants’ brains, for example when they injured their head. Those on aspirin showed a rate of bleeding in the brain of 1.1% (108 participants) compared with 0.8% (79 people) for those on placebo. This is a relatively, low but serious, risk.</p> <p>These findings are not entirely new. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1800722?query=featured_home">Research</a> published five years ago based on the same ASPREE trial showed a similar result: a higher rate of bleeding among those taking low-dose aspirin compared with placebo.</p> <p>However as the study authors note, aspirin continues to be widely used for the prevention of stroke.</p> <h2>What are the study’s limitations?</h2> <p>The researchers examined aspirin in mostly people of white European heritage.</p> <p>So we don’t know whether the results are translatable to people with different ethnic backgrounds. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594139/">Genetics and ethnicity</a> can significantly impact the efficacy and safety of some drugs.</p> <p>The clinical trial only included people who were not significantly at risk of a stroke, and had no history of heart disease.</p> <p>Younger age groups were not studied either, so we cannot make any conclusions about their use of low dose aspirin to prevent stroke.</p> <p>It’s also possible the potential benefits and risks are different for those who have underlying heart problems or who have previously had a stroke and are therefore at higher risk of another stroke.</p> <h2>I’m taking aspirin, what should I do?</h2> <p>If you’re taking daily low-dose aspirin and are concerned by the results of the study, it’s important you don’t just stop taking your medicine. Speak to your doctor or pharmacist.</p> <p>For people who are at high risk of having a stroke, or have previously had one, low-dose aspirin may remain their treatment of choice despite the slight bleeding risk.</p> <p>If you’re at high risk of bleeding, for example because of falls and other accidents due to advanced age, frailty, or another underlying condition, your doctor may be able to reduce the amount of aspirin you take by adding in <a href="https://www.nps.org.au/australian-prescriber/articles/dipyridamole">dipyridamole</a> or prescribing a different medicine completely, such as <a href="https://www.nps.org.au/australian-prescriber/articles/clopidogrel">clopidogrel</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210388/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty </em><em>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/daily-aspirin-doesnt-prevent-strokes-in-older-healthy-people-after-all-210388">original article</a>.</em></p>

Body

Why understanding how spiders spin silk may hold clues for treating Alzheimer’s disease

<p><a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em></p> <p>Really, we should envy spiders. Imagine being able to make silk like they do, flinging it around to get from place to place, always having a <a href="https://pubs.acs.org/doi/10.1021/acsmacrolett.8b00678">strong-as-steel safety line</a> or spinning a comfy hammock whenever they need a rest.</p> <p>The fascinating properties of spider silk make it no wonder that scientists have been trying to unravel its secrets for decades.</p> <p>If we could understand and recreate the spinning process, we could produce artificial spider silk for a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0141813021021292">range of medical applications</a>. For example, artificial silk can help <a href="https://doi.org/10.1016/j.biomaterials.2021.120692">regenerate the nerves that connect our brain and limbs</a>, and can shuttle <a href="https://doi.org/10.1021/acs.biomac.0c01138">drug molecules directly into the cells where they are needed</a>.</p> <figure><iframe src="https://www.youtube.com/embed/zNtSAQHNONo?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Spider silk is made of <a href="https://www.sciencedirect.com/topics/engineering/spidroins">proteins called spidroins</a>, which the spider stores in a silk gland in its abdomen. There are several types of spidroin for spinning different sorts of silk. Spiders <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673682/">store them as a liquid</a> that resembles oil droplets.</p> <p>But one of the questions that has eluded scientists so far is how spiders turn these liquid droplets into silk. We decided to investigate why the spidroins form droplets, to get us closer to replicating a spider’s spinning process.</p> <h2>Weaving a web</h2> <p>The trick that spiders use to speed up their spinning process can be used to spin better artificial silk, or even develop new spinning processes.</p> <p>In 2017, we learned to <a href="https://www.nature.com/articles/ncomms15504">make synthetic silk fibres</a> by emulating the silk gland, but we did not know how things work inside the spider. Now we know that forming droplets first <a href="https://pubmed.ncbi.nlm.nih.gov/37084706/">speeds up the conversion to these fibres</a>.</p> <p>An important clue to how the droplets and fibres are related came from an unexpected area of our research – on <a href="https://pubmed.ncbi.nlm.nih.gov/23013511/">Alzheimer’s and Parkinson’s diseases</a>. Proteins that are involved in these diseases, called <a href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/alpha-synuclein#:%7E:text=%CE%B1%2DSynuclein%20is%20a%20highly,linked%20to%20familial%20Parkinson%20disease.">alpha-synuclein</a> and <a href="https://www.alz.org/media/Documents/alzheimers-dementia-tau-ts.pdf">tau</a>, can assemble into tiny, oil-like droplets in human cells.</p> <p>Tau is a protein that helps stabilise the internal skeleton of nerve cells (neurons) in the brain. This internal skeleton has a tube-like shape through which nutrients and other essential substances travel to reach different parts of the neuron.</p> <p>In Alzheimer’s disease, an abnormal form of tau builds up and clings to the normal tau proteins, creating “tau tangles”.</p> <p>Alpha-synuclein is found in large quantities in <a href="https://www.webmd.com/mental-health/what-is-dopamine">dopamine-producing nerve cells</a>. Abnormal forms of this protein are linked to Parkinson’s disease.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Beautiful spider web with water drops close-up" /></a><figcaption><span class="caption">The trick spiders use to speed up their spinning process can be used to spin better artificial silk.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/beautiful-spider-web-water-drops-close-155560781">Aastels/Shutterstock</a></span></figcaption></figure> <p>Oil droplets of either one of these proteins form in humans when they become entangled, like boiled spaghetti on a plate. At first, the proteins are flexible and elastic, much like spidroin oil droplets.</p> <p>But if the proteins remain entangled, they get stuck together which alters their shape, changing them into rigid fibres. These can be toxic to human cells – for example, in neurodegenerative conditions such as Alzheimer’s.</p> <p>However, <a href="https://pubmed.ncbi.nlm.nih.gov/33148640/">spidroins can form droplets</a> too. This left us wondering if the same mechanism that causes neurodegeneration in humans could help the spider to convert liquid spidroins into rigid silk fibres.</p> <p>To find out, we used a <a href="https://www.nature.com/articles/nchembio.2269">synthetic spidroin called NT2RepCT</a>, which can be produced by bacteria. Under the microscope, we could see that this synthetic spidroin formed liquid droplets when it was dissolved in phosphate buffer, a type of salt found in the spider’s silk gland. This allowed us to replicate spider silk spinning conditions in the lab.</p> <h2>Silky science</h2> <p>Next, we studied how the spidroin proteins act when they form droplets. To answer this question, we turned to an analysis technique <a href="https://www.britannica.com/science/mass-spectrometry">called mass spectrometry</a>, to measure how the weight of the proteins changed when they formed droplets. To our surprise, we saw that the spidroin proteins, which normally form pairs, instead split into single molecules.</p> <p>We needed to do more work to find out how these protein droplets help spiders spin silk. Previous research has shown spidroins have different parts, called domains, with separate functions.</p> <p>The end part of the spidroin, called c-terminal domain, makes it form pairs. The c-terminal also starts <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1001921">fibre formation when it comes into contact with acid</a>.</p> <p>So, we made a spidroin which contained only the c-terminal domain and tested its ability to form fibres.</p> <p>When we used phosphate buffer to entangle the proteins into droplets, they turned into rigid fibre instantly. When we added acid without first making droplets, fibre formation took much longer.</p> <p>This makes sense since the spidroin molecules must find each other when forming a fibre. Entangling the spidroins like spaghetti helps them rapidly assemble into silk.</p> <p>This finding tells us how the spider can instantly convert its spidroins into a solid thread. It also uncovered how nature uses the same mechanism that can make brain proteins toxic to create some of its most amazing structures.</p> <p>The surprising parallel between spider silk spinning and fibres toxic to humans could one day lead to new clues about how to fight neurodegenerative disorders.</p> <p>Scientists may use spider silk research, including what we have learned about the spider silk domains, to keep human proteins from sticking together – to stop them from becoming toxic. If spiders can learn how to keep their sticky proteins in check, perhaps so can we.<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/205857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, Researcher, Department of Microbiology, Tumor and Cell Biology, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></em> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, Researcher in Veterinary medicine biochemistry, <em><a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a></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-understanding-how-spiders-spin-silk-may-hold-clues-for-treating-alzheimers-disease-205857">original article</a>.</em></p> <p><em>Images: Getty</em></p>

Body

How to prevent travel-related deep vein thrombosis

<p>No matter your transportation of choice, sitting motionless for long periods of time puts people at increased risk of deep vein thrombosis (DVT).</p> <p>DVT refers to blood clots that form deep in your veins, usually in the calf or leg, and results in the sensation of a swollen, painful limb. If you’ve been susceptible to DVT in your past travels, there are a few simple things to do to combat the problem.</p> <ul> <li>Stand up and walk around at least every hour to keep blood flowing</li> <li>Exercise your calf muscles by standing on tip-toes a few times</li> <li>If you can’t walk around, exercise legs by stretching them, flexing feet and curling or pressing toes frequently</li> <li>Drink lots of fluids, especially water, to prevent dehydration</li> <li>Reduce alcohol and coffee consumption, which contributes to dehydration</li> <li>Avoid crossing your legs when seated or at least for long periods of time</li> <li>Wear compression stockings that put on gentle pressure on leg muscles.</li> <li>Don’t wear regular socks that are right or have tight elastic bands at top</li> <li>Skip the aspirin; there’s no evidence that it’s effective as a preventative measure</li> </ul> <p><em>Image credits: Getty Images</em></p>

Travel Tips

Here’s how a new AI tool may predict early signs of Parkinson’s disease

<p>In 1991, the world was shocked to learn actor <a href="https://www.theguardian.com/film/2023/jan/31/still-a-michael-j-fox-movie-parkinsons-back-to-the-future">Michael J. Fox</a> had been diagnosed with Parkinson’s disease. </p> <p>He was just 29 years old and at the height of Hollywood fame, a year after the release of the blockbuster <em>Back to the Future III</em>. This week, documentary <em><a href="https://www.imdb.com/title/tt19853258/">Still: A Michael J. Fox Movie</a></em> will be released. It features interviews with Fox, his friends, family and experts. </p> <p>Parkinson’s is a debilitating neurological disease characterised by <a href="https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055">motor symptoms</a> including slow movement, body tremors, muscle stiffness, and reduced balance. Fox has already <a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">broken</a> his arms, elbows, face and hand from multiple falls. </p> <p>It is not genetic, has no specific test and cannot be accurately diagnosed before motor symptoms appear. Its cause is still <a href="https://www.apdaparkinson.org/what-is-parkinsons/causes/">unknown</a>, although Fox is among those who thinks <a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">chemical exposure may play a central role</a>, speculating that “genetics loads the gun and environment pulls the trigger”.</p> <p>In research published today in <a href="https://pubs.acs.org/doi/10.1021/acscentsci.2c01468">ACS Central Science</a>, we built an artificial intelligence (AI) tool that can predict Parkinson’s disease with up to 96% accuracy and up to 15 years before a clinical diagnosis based on the analysis of chemicals in blood. </p> <p>While this AI tool showed promise for accurate early diagnosis, it also revealed chemicals that were strongly linked to a correct prediction.</p> <h2>More common than ever</h2> <p>Parkinson’s is the world’s <a href="https://www.who.int/news-room/fact-sheets/detail/parkinson-disease">fastest growing neurological disease</a> with <a href="https://shakeitup.org.au/understanding-parkinsons/">38 Australians</a>diagnosed every day.</p> <p>For people over 50, the chance of developing Parkinson’s is <a href="https://www.parkinsonsact.org.au/statistics-about-parkinsons/">higher than many cancers</a> including breast, colorectal, ovarian and pancreatic cancer.</p> <p>Symptoms such as <a href="https://www.apdaparkinson.org/what-is-parkinsons/symptoms/#nonmotor">depression, loss of smell and sleep problems</a> can predate clinical movement or cognitive symptoms by decades. </p> <p>However, the prevalence of such symptoms in many other medical conditions means early signs of Parkinson’s disease can be overlooked and the condition may be mismanaged, contributing to increased hospitalisation rates and ineffective treatment strategies.</p> <h2>Our research</h2> <p>At UNSW we collaborated with experts from Boston University to build an AI tool that can analyse mass spectrometry datasets (a <a href="https://www.sciencedirect.com/topics/neuroscience/mass-spectrometry">technique</a> that detects chemicals) from blood samples.</p> <p>For this study, we looked at the Spanish <a href="https://epic.iarc.fr/">European Prospective Investigation into Cancer and Nutrition</a> (EPIC) study which involved over 41,000 participants. About 90 of them developed Parkinson’s within 15 years. </p> <p>To train the AI model we used a <a href="https://www.nature.com/articles/s41531-021-00216-4">subset of data</a> consisting of a random selection of 39 participants who later developed Parkinson’s. They were matched to 39 control participants who did not. The AI tool was given blood data from participants, all of whom were healthy at the time of blood donation. This meant the blood could provide early signs of the disease. </p> <p>Drawing on blood data from the EPIC study, the AI tool was then used to conduct 100 “experiments” and we assessed the accuracy of 100 different models for predicting Parkinson’s. </p> <p>Overall, AI could detect Parkinson’s disease with up to 96% accuracy. The AI tool was also used to help us identify which chemicals or metabolites were likely linked to those who later developed the disease.</p> <h2>Key metabolites</h2> <p>Metabolites are chemicals produced or used as the body digests and breaks down things like food, drugs, and other substances from environmental exposure. </p> <p>Our bodies can contain thousands of metabolites and their concentrations can differ significantly between healthy people and those affected by disease.</p> <p>Our research identified a chemical, likely a triterpenoid, as a key metabolite that could prevent Parkinson’s disease. It was found the abundance of triterpenoid was lower in the blood of those who developed Parkinson’s compared to those who did not.</p> <p>Triterpenoids are known <a href="https://www.sciencedirect.com/topics/neuroscience/neuroprotection">neuroprotectants</a> that can regulate <a href="https://onlinelibrary.wiley.com/doi/10.1002/ana.10483">oxidative stress</a> – a leading factor implicated in Parkinson’s disease – and prevent cell death in the brain. Many foods such as <a href="https://link.springer.com/article/10.1007/s11101-012-9241-9#Sec3">apples and tomatoes</a> are rich sources of triterpenoids.</p> <p>A synthetic chemical (a <a href="https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html">polyfluorinated alkyl substance</a>) was also linked as something that might increase the risk of the disease. This chemical was found in higher abundances in those who later developed Parkinson’s. </p> <p>More research using different methods and looking at larger populations is needed to further validate these results.</p> <h2>A high financial and personal burden</h2> <p>Every year in Australia, the average person with Parkinson’s spends over <a href="https://www.hindawi.com/journals/pd/2017/5932675/">A$14,000</a>in out-of-pocket medical costs.</p> <p>The burden of living with the disease can be intolerable.</p> <p>Fox acknowledges the disease can be a “nightmare” and a “living hell”, but he has also found that “<a href="https://www.cbsnews.com/video/michael-j-fox-on-parkinsons-and-maintaining-optimism">with gratitude, optimism is sustainable</a>”. </p> <p>As researchers, we find hope in the potential use of AI technologies to improve patient quality of life and reduce health-care costs by accurately detecting diseases early.</p> <p>We are excited for the research community to try our AI tool, which is <a href="https://github.com/CRANK-MS/CRANK-MS">publicly available</a>.</p> <p><em>This research was performed with Mr Chonghua Xue and A/Prof Vijaya Kolachalama (Boston University).</em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/heres-how-a-new-ai-tool-may-predict-early-signs-of-parkinsons-disease-205221" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Mind

Bindi Irwin breaks down on camera about health condition

<p>Bindi Irwin has shown her vulnerable side in an emotional new video shared with fans about a personal ordeal.</p> <p>The 24-year-old spoke candidly to the camera for 15 minutes with guest appearances from husband Chandler Powell and their daughter Grace Warrior.</p> <p>In the video, Irwin recalled the “insurmountable” pain she experienced due to endometriosis before finally <a href="https://www.oversixty.com.au/health/caring/how-did-you-live-with-this-much-pain-bindi-irwin-hospitalised" target="_blank" rel="noopener">undergoing surgery</a>.</p> <p>The wildlife warrior announced her diagnosis in March 2023, but the new video explains her symptoms - which started when she was just 14 - that left her with “extreme fatigue, nausea and pain”.</p> <p>“I had pain every single day of my life. No matter where we went, where we were going, I would be falling asleep. I felt like I constantly had the flu,” she said.</p> <p>The conservationist confessed she tried everything to solve the issue, undergoing CT scans, MRIs and ultrasounds.</p> <p>“I was always in pain. We tried for a year, and finally a doctor told me it was just part of being a woman.”</p> <p>Irwin said it was that comment from a doctor that led her to suffer in silence.</p> <p>However, after giving birth to her daughter in 2021, the pain “magnified” to a point where it was “out of this world”.</p> <p>“I remember countless times of Grace needing me, and me crawling to her cot at night,” she revealed, becoming emotional.</p> <p>“I can remember being with Grace and lying on the floor in agony. I had a stabbing pain in my side, I couldn’t get up or I would throw up, and I was scared I would pass out.</p> <p>“I was so scared because I was worried if I was alone with Grace, something would happen to me, and she would be on her own.”</p> <p>Irwin dubbed the pain “insurmountable” and something that “would knock me over”.</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/reel/Cr31hQDANTp/?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/reel/Cr31hQDANTp/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bindi Irwin (@bindisueirwin)</a></p> </div> </blockquote> <p>She said that after returning to new doctors, she was diagnosed with irritable bowel syndrome and chronic fatigue.</p> <p>It was not until she spoke to a friend, Leslie Mosier, who recently had endometriosis surgery that she realised they shared similar symptoms.</p> <p>“Leslie said the only way to diagnose for sure is through exploratory surgery.”</p> <p>Irwin said she decided to undergo surgery in the US as her daughter would have Powell’s parents, who live in Florida, nearby for support while she recovered.</p> <p>At this point in her video, Grace woke up and joined her mum on camera.</p> <p>“Mama went for surgery and they found 37 lesions and a chocolate cyst on my ovary,” she said in a child-like tone for the sake of her daughter.</p> <p>“Ovary!” Grace chirped.</p> <p>“After surgery mama feels a lot better hey? I had to recover for quite a while, and mama feels so much better, and she can run around with you!”</p> <p>Irwin went on to share what she has learned being a part of the endometriosis community.</p> <p>She revealed that excision surgery is considered the “gold standard” for the disease, where lesions and cysts are removed.</p> <p>“Everyone says we need to educate the public, but there also needs to be a shift in health care. Doctors need more information because endometriosis has myriad symptoms. Doctors need the right tools to diagnose.”</p> <p>She explained that her own endometriosis has been classified as severe, which means she may have to undergo more surgeries in the future to keep symptoms at bay.</p> <p>“I feel like. I got a second chance at life... I feel like a new woman.”</p> <p>In a final message of encouragement, Irwin said, “If you’re in pain, it’s so hard to get up every day and forge ahead.</p> <p>“Keep searching for those answers and never give up on you.”</p> <p><em>Image credit: Instagram</em></p>

Body

“I’m not gonna be 80": Michael J. Fox's tragic admission

<p>Beloved actor Michael J. Fox is acknowledging how difficult his more than 30-year battle with Parkinson’s disease has become.</p> <p>“I’m not gonna be 80,” the Back to the Future star said in a preview for an upcoming episode of the American current affairs program <em>CBS Sunday Mornin</em>g, according to <em>Page Six</em>.</p> <p>In the clip, Journalist Jane Pauley tells Fox that he has “not squandered” but that his condition will eventually “make the call” as to when it’s his time to go.</p> <p>“Yeah, it’s, it’s banging on the door,” the actor said.</p> <p>“I’m not gonna lie. It’s gettin’ hard, it’s gettin’ harder. It’s gettin’ tougher. Every day it’s tougher.”</p> <p>Fox revealed that he had surgery to remove a benign tumour on his spine, but the procedure “messed up” his walking and so he started to “break” other parts of his body, including his arm, elbow, face and hand.</p> <p>He added that the “big killer” of Parkinson’s disease is “falling” and can also be “aspirating food and getting pneumonia”, pointing out that it is “all these subtle ways that gets you.”</p> <p>You don’t die from Parkinson’s. You die with Parkinson’s,” he said. “So – so I’ve been – I’ve been thinking about the mortality of it.”</p> <p>The actor was diagnosed with the brain disorder at just 29. He has since become a leading advocate for research on the condition, with the launch of the Michael J. Fox Foundation in 2000 to help educate the public and fund studies.</p> <p>He has previously revealed that he does not fear death.</p> <p>“I’m really blunt with people about cures. When they ask me if I will be relieved of Parkinson’s in my lifetime, I say, ‘I’m 60 years old, and science is hard. So, no,’” he admitted in an AARP magazine profile in December 2021.</p> <p>“I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all.”</p> <p><em>Image credit: Instagram</em></p>

Caring

“Game-changer”: Michael J Fox shares huge medical news

<p dir="ltr">Michael J Fox has shared news of a medical breakthrough into Parkinson’s disease.</p> <p dir="ltr">The 61-year-old – who was diagnosed with the disease in 1991 – was thrilled to share the news, despite suffering a “terrible year”.</p> <p dir="ltr">Fox told <a href="https://www.statnews.com/2023/04/12/michael-j-fox-parkinsons-biomarker/" target="_blank" rel="noopener"><em>Stat News</em></a> that he had broken multiple bones after a fall, including some in his hand and face, but has said that in some ways he is “feeling better”.</p> <p dir="ltr">Despite his own personal battle, the <em>Back to the Future</em> star was overjoyed to share the breakthrough in Parkinson’s research.</p> <p dir="ltr">The study – funded by Fox’s charity organisation that aims to find a cure for Parkinson’s – found that a key Parkinson's pathology can now be identified by examining spinal fluid from living patients, allowing earlier intervention.</p> <p dir="ltr">“It’s all changed. It can be known and treated early on. It’s huge,” he said</p> <p dir="ltr">“This is the thing. This is the big reward. This is the big trophy.”</p> <p dir="ltr">The findings, published in <em>The Lancet Neurology</em>, are the result of a 1,123-person study that Fox’s foundation has put hundreds of millions of dollars into since it began in 2010.</p> <p dir="ltr">An editorial in the medical journal has also called this research “a game-changer in Parkinson’s disease diagnostics, research, and treatment trials”.</p> <p dir="ltr">In late 2022 the actor opened up about his struggle with Parkinson’s in his emotional acceptance speech for the <a href="https://www.oversixty.com.au/health/caring/michael-j-fox-reveals-more-details-about-his-struggle-with-parkinson-s" target="_blank" rel="noopener">Jean Hershel Humanitarian Award</a>.</p> <p dir="ltr">In the speech he said that the hardest part “was grappling with the certainty of the diagnosis and the uncertainty of the situation,” but has since felt relieved after an “outpouring of support” from the public and his peers.</p> <p><em>Image: Frazer Harrison for Getty Images</em></p>

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