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Outrage as Paralympian gets disqualified for "unfair" reason

Elena Congost, had just finished the T12/B2 run in third place, but was disqualified and had the bronze medal taken from her, for this one simple move. The 36-year-old was running in the vision-impaired category with guide Mia Carol Bruguera. When her guide faltered with a cramp in the final metres before the finish line, Congost instinctively helped him from falling over and let go of the rope that binds them together. This is not allowed within Paralympic rules as all runners must be connected to their guide via a tether. As a result, Japan’s Misato Michishita was elevated to the bronze medal after finishing fourth. In a heartbreaking interview after the race, a devastated Congost said: “It’s unfair, surreal.” “The next athlete was three minutes behind me. It was just a reflex action that any human being would have done – holding on to someone who is falling.” “But that doesn’t mean that there is any kind of benefit or help. In fact, it is clear that I stop dead. “I can’t find any explanation for this. It’s sad because, in addition, I had just been without a scholarship. And I’m not going to get one now. They will leave me out of everything again when I have shown everything I can do. “I have not been disqualified for cheating, but for being a person, for helping someone.” In a separate interview with Spanish outlet Marca, she said that despite being disqualified, she is proud of her actions. “I would like everyone to know that I have not been disqualified for cheating, but rather I have been disqualified for being a person and for an instinct that comes to you when someone is falling and is to help or support them,” she said. “I’m devastated, to be honest, because I had the medal. I’m super proud of everything I’ve done and in the end they disqualify me because 10 metres from the finish line I let go of the rope for a second because a person next to me fell face first to the ground and I grabbed the rope again and we crossed the finish line. “The next athlete is three minutes away from me, so it was a reflex action of any human being to hold on to a person who is falling next to you.” Fans around the world were outraged at the disqualification verdict and have called for officials to overturn it. “Shame on you. Give the medal back to Elena Congost,” one fan wrote on X, formerly Twitter. “Where is the Olympic spirit? Elena Congost was disqualified after running 42km and helping her guide not to fall to the ground. She has lost the bronze medal and her sports scholarship. Disgusting," another wrote. "Give the medal to Elena Congost. This decision ruins the paralympics. How can you be called inclusive if you can’t help a person from falling?” a third added. Image: X

Caring

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&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/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</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/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

Body

Strength training has a range of benefits for women. Here are 4 ways to get into weights

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment. This is more than just anecdotal. According to data from the <a href="https://app.powerbi.com/view?r=eyJrIjoiZGU1YWFhZDgtMmRhZi00YTgyLThhMzItYjc2ODk5NTg0MTg1IiwidCI6IjhkMmUwZjRjLTU1ZjItNGNiMS04ZWU3LWRhNWRkM2ZmMzYwMCJ9">Australian Sports Commission</a>, the number of women <a href="https://www.clearinghouseforsport.gov.au/research/ausplay/results#portal">participating in weightlifting</a> (either competitively or not) grew nearly five-fold between 2016 and 2022. Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles. <h2>Health benefits</h2> <a href="https://www.womenshealth.gov/a-z-topics/osteoporosis">Osteoporosis</a>, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">bone density</a>, a crucial factor for <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-47">preventing osteoporosis</a>, especially for women negotiating menopause. Strength training also improves <a href="http://link.springer.com/10.1007/s40279-015-0379-7">insulin sensitivity</a>, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better <a href="https://doi.org/10.1139/apnm-2020-0245">heart health</a> too. There’s a mental health boost as well. Strength training has been linked to reduced symptoms of <a href="https://doi.org/10.1001/jamapsychiatry.2018.0572">depression</a> and <a href="http://link.springer.com/10.1007/s40279-017-0769-0">anxiety</a>. <h2>Improved confidence and body image</h2> Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2019.1634127">conquer challenges</a>. This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S1755296623000194">recent study</a> found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym. Strength training also has the potential to positively impact <a href="https://journals.lww.com/nsca-jscr/abstract/2002/11000/Relations_of_Strength_Training_to_Body_Image_Among.25.aspx">body image</a>. In a world where women are often judged on appearance, lifting weights can shift the focus <a href="http://journals.sagepub.com/doi/10.1177/0193732502238256">to function</a>. Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success. Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative <a href="https://journals.humankinetics.com/view/journals/wspaj/aop/article-10.1123-wspaj.2022-0088/article-10.1123-wspaj.2022-0088.xml">research</a> I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us: <blockquote> I wanted something that would allow me to train that just didn’t have anything to do with how I looked. </blockquote> Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said: <blockquote> We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we? </blockquote> This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained: <blockquote> Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life. </blockquote> This newfound confidence often spills over into other areas of life. As one woman said: <blockquote> I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter. </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> 1. Take things slow Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">compound movements</a>, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient. 2. Prioritise proper form Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially. 3. Consistency is key Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else. 4. Find a community Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum. <h2>Are there any downsides?</h2> Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag. Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging. If you’re concerned about getting too “bulky”, it’s very difficult for <a href="https://journals.sagepub.com/doi/epub/10.1177/0031512520967610">women</a> to bulk up like male bodybuilders without pharmaceutical assistance. The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<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/221307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>. </div>

Body

Larry Emdur gets tattooed live on air

Larry Emdur has stayed true to his promise and tattooed the initials of the other Gold Logie nominees on his bum, live on The Morning Show. After being nominated for the coveted award, Emdur said last Thursday that he would get the <a href="https://oversixty.com.au/entertainment/tv/larry-emdur-s-crazy-pledge-ahead-of-logies" target="_blank" rel="noopener">tattoo</a>, saying: “I’m so confident I won’t win, I’ll happily get all the nominees’ name initials tattooed on my a*** on the show (The Morning Show) on Monday.” Emdur was up against Tony Armstrong, Andy Lee, Sonia Kruger, Robert Irwin, Julia Morris, and Asher Keddie for the highly-coveted award, but beat them all out to take home the accolade. On Monday, Emdur followed through with the outrageous promise, lazing on a massage bench in the studio. “Kylie, I can’t see what’s happening!” Larry said. <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-permalink="https://www.instagram.com/reel/C-1Q0KCvfpU/?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/C-1Q0KCvfpU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Morning Show On 7 (@morningshowon7)</a> </div> </blockquote> The design included the outline of a Logie, with the initials of all the other nominees in the plaque. Larry debuted the tattoo live on air after trying to keep cool during the tattoo process. During an interview on Sunrise earlier that morning, Emdur told Nat and Shirvo it was the “dumbest promise he was ever made” after his win, laughing off the challenge as he confirmed he would be going through with the ink. Reflecting on his Gold Logie speech, Larry said it was a “surreal” moment in his career. “I knew I needed to thank my work family and my family family — I knew I wanted to thank the other nominees,” Emdur said. “It was so surreal. I was standing up there just looking down at all these famous people. I was thinking it was really a moment. “I was so humbled, thrilled and honoured … you just go wow, all of TV is in this room. Everything I worked for and everything I wanted to be part of.” Image credits: The Morning Show

No, your aches and pains don’t get worse in the cold. So why do we think they do?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather. It’s a common idea, but a myth. When we looked at the evidence, <a href="https://www.sciencedirect.com/science/article/pii/S0049017224000337">we found</a> no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains. So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on. <h2>Weather can be linked to your health</h2> The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures <a href="https://pubmed.ncbi.nlm.nih.gov/27021573/">may worsen</a> asthma symptoms. Hot temperatures <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00117-6/fulltext">increase the risk</a> of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease. Many people are also convinced the weather is linked to their aches and pains. For example, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1479-8077.2004.00099.x?casa_token=jvpSbA4szqoAAAAA%3ATyHyGaqXmfevWyuJe6LW_3Pap3IPHC8HSMTl3RN63mFzNO0X7ozQjBb6Bi3yVFuPjqkrf-WlB-J5A1q1">two in every three</a> people with knee, hip or hand osteoarthritis <a href="https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-15-66">say</a> cold temperatures trigger their symptoms. Musculoskeletal conditions affect more than <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions-comorbidity-australia/summary">seven million Australians</a>. So we set out to find out whether weather is really the culprit behind winter flare-ups. <h2>What we did</h2> Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies. We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included. We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry). <h2>What we found</h2> We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis. The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain. In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis. It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather. The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions. Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up. <h2>Why do people blame the weather?</h2> The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain. For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know <a href="https://pubmed.ncbi.nlm.nih.gov/28700451/">prolonged sitting</a>, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. Likewise, changes in mood, often experienced in cold weather, trigger increases in both <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself. Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the <a href="https://link.springer.com/article/10.1186/s12891-018-1943-8">nocebo effect</a>. <h2>What to do about winter aches and pains?</h2> It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather). You can: <ul> <li> become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool </li> <li> lose weight if obese or overweight, as this is linked to <a href="https://jamanetwork.com/journals/jama/article-abstract/2799405">lower levels</a> of joint pain and better physical function </li> <li> keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep <a href="https://www.sciencedirect.com/science/article/pii/S0033350623003359">less well</a> in cold rooms </li> <li> maintain a healthy diet and <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">avoid smoking</a> or drinking high levels of alcohol. These are among <a href="https://ard.bmj.com/content/annrheumdis/82/1/48.full.pdf">key lifestyle recommendations</a> to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with <a href="https://pubmed.ncbi.nlm.nih.gov/36208321/">higher levels</a> of physical function.<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/235117/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, Rheumatologist and Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-your-aches-and-pains-dont-get-worse-in-the-cold-so-why-do-we-think-they-do-235117">original article</a>. </div>

Body

If Australia had an aviation ombudsman, passengers could get compensation for cancelled flights

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/justin-wastnage-489752">Justin Wastnage</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> The financial difficulties of <a href="https://www.abc.net.au/news/2024-08-02/rex-airlines-staff-notified-of-termination/104172020">Rex Airlines</a>, coming so soon after the bankruptcy of <a href="https://www.abc.net.au/news/2024-06-26/bonza-directors-accused-of-trading-while-insolvent/104022496">Bonza</a>, have brought into sharp focus one of the federal government’s key priorities for aviation: enhancing passenger rights. In each case, passengers were left with tickets for flights that did not fly. In the case of Rex, tickets were honoured by rivals Virgin Australia and Qantas, possibly trying to recapture the small toehold Rex had established in the Brisbane-Sydney-Melbourne golden triangle. The Bonza story was more complex as the fledgling airline, which collapsed in May, had sought to exploit under-serviced routes to smaller leisure-based cities including Maroochydore and Port Macquarie. In many cases, passengers were left out-of-pocket and stranded. <h2>Support for an ombudsman</h2> These failures will have emboldened the federal government’s plans to introduce stronger passenger protections and an airline ombudsman. The release of its <a href="https://www.infrastructure.gov.au/infrastructure-transport-vehicles/aviation/aviation-white-paper">policy white paper</a> is imminent. The paper covers aviation issues including competition between airports and airlines, the sector’s environmental impact and better mechanisms for consultation. After years of opposition, <a href="https://www.travelweekly.com.au/article/qantas-and-virgin-change-tune-on-aviation-ombudsman-ahead-of-white-paper-release/">Qantas and Virgin quietly fell in behind the idea in May</a>, signalling a deal is close to being announced. The ombudsman is designed to protect consumer rights in what is often monopolistic or quasi-monopolistic operating environments. With the exception of residents of southeast Queensland and the western suburbs of Melbourne, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0967070X18302063">most Australians only have one airport from which to fly.</a> This, coupled with an effective airline duopoly, can lead to higher prices and poorer service for consumers, the <a href="https://www.accc.gov.au/system/files/Airline%20competition%20in%20Australia%20-%20June%202023%20report.pdf">Australian Consumer and Competition Commission (ACCC)</a> has argued. The ACCC has been calling for better passenger rights for more than a decade. But its calls grew louder after it fined Qantas <a href="https://theconversation.com/qantas-has-finally-settled-its-ghost-flights-lawsuit-for-120-million-whats-next-229368">A$120 million for selling “ghost” flights in May</a>. Passengers did receive refunds, but the process was not easy compared to many overseas jurisdictions where compensation is automatic and based on distance travelled. Australia is rare among developed countries for not having automatic compensation if a flight is cancelled or delayed. <h2>The EU model</h2> The leader in air passenger rights, as in many areas of consumer protection, is the European Union. <a href="https://eur-lex.europa.eu/eli/reg/2004/261/oj">The EU Passenger Rights regulation</a> is 20 years old and now also applies to rail and bus passengers. The regulation favours the passenger and awards compensation <a href="https://www.airhelp.com/en-int/ec-regulation-261-2004/">of up to €600 (almost A$1,000) for delays or cancellations</a>. There are clauses for when a delay is unavoidable, but generally airlines have now built the scheme into their costs of doing business. The scheme is well publicised and in 2022, about <a href="https://schengen.news/8-million-passengers-affected-by-flight-cancellations-airport-strikes-are-eligible-for-compensation-of-up-to-e600/">eight million passengers were eligible for refunds</a>. Air passenger rights in the UK continued in the EU mould after Brexit and were even strengthened. But in a 2023 review into the UK scheme, <a href="https://www.gov.uk/government/consultations/reforming-aviation-consumer-policy-protecting-air-passenger-rights/outcome/response-to-the-aviation-consumer-policy-reform-consultation#chapter-3-compensation-for-delays-and-cancellations">some airlines argued</a> “private insurance was a better option for some passengers”, particularly those with disabilities. The same reasoning led to the removal of Australia’s previous consumer protection scheme for airline passengers, the <a href="https://www.travelmanagers.com.au/peaceofmind/#:%7E:text=The%20Travel%20Compensation%20Fund%20continued,and%20until%2030%20June%202014.">Travel Compensation Fund</a>, which refunded customers when airlines or travel agencies went bankrupt. The scheme was ended under the Abbott government in June 2014, with travellers told instead to take out their own travel insurance. Labor is expected to reintroduce an element of corporate responsibility for airline delays, not least since Brazil, Canada and Türkiye have also followed the EU’s lead. Brazil’s scheme is particularly generous, with up to R7,500 (A$1,950) available to passengers who have to pay for last minute accommodation if their flight is cancelled. Lawmakers there countered claims by airlines that low cost airline passengers could stay in cheaper hotels, by applying the compensation uniformly, regardless of travel class. <h2>Popular with voters</h2> Air passenger rights can be a vote winner, too. Before he withdrew his bid for reelection, US President Joe Biden trumpeted the <a href="https://www.transportation.gov/briefing-room/biden-harris-administration-announces-final-rule-requiring-automatic-refunds-airline">automatic airline compensation scheme</a> the US Department for Transportation will bring in this year. Until now, airline compensation was mandated by the states without coordinated processes meaning some airlines used vouchers, some credits and a few cash to compensate customers. Despite this, about <a href="https://www.transportation.gov/briefing-room/biden-harris-administration-announces-final-rule-requiring-automatic-refunds-airline">US$3 billion (A$4.6 billion)</a> in refunds have been issued to US passengers since 2020, including more than US$600 million to Southwest Airlines passengers alone. This was due to a serious scheduling crisis which forced the low-cost carrier to cancel almost 60% of its flights in the 2022 summer. By contrast, in Australia, air passengers have only had basic protections under <a href="https://consumer.gov.au/australian-consumer-law/legislation">consumer rights law</a> since deregulation in 2002. There is no guarantee of a seat or even flight the consumer purchased. This has led consumer advocates including <a href="https://www.choice.com.au/consumer-advocacy/policy/policy-submissions/2023/november/aviation-green-paper">Choice</a> to support calls for an airline ombudsman and automatic delay and cancellation compensation.<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/235679/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/justin-wastnage-489752">Justin Wastnage</a>, Adjunct Industry Fellow, Griffith Institute for Tourism, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-australia-had-an-aviation-ombudsman-passengers-could-get-compensation-for-cancelled-flights-235679">original article</a>. </div>

Travel Trouble

Readers response: What are you starting to like more as you get older?

As we age, we start to have a whole new appreciation for things we previously overlooked in our younger years. We asked our reader what of life's simple pleasures they are starting to enjoy more as they get older, and the response was overwhelming. Here's what you said. Wendy Turner - The beauty and companionship of dogs, the wildness of a garden, the treasured times between physical pain, and the love of family and treasured friends. SE Rosenberg - Being on my own away from people but hanging out with my cats. Lynette Miller - Taking time to enjoy sunrise and sunsets, smelling the roses and just little things that sometimes pass you by because you're too busy to enjoy them. Antoinette Devlin - Peace and quiet. Robert Edward Fleming - Not having to work for the man anymore. Janine Sarai George - Putting my feet up, a good book and my wildlife. Maureen Brown Montgomery - Finally starting not to mind living a solo life and enjoying my own company without drama. Liz Lewis - Not having to set the alarm but being able to wake up naturally and usually not having to be anywhere in a hurry. Roselyn Reincastle - Appreciating life more now that I have had the experience. Frances Bradshaw - Peace and hearing the birds sing. Margie Buckingham - Serenity, that my opinions matter, travelling, spare time & being a grandparent. Rob Anderson - Time with the grandchildren, and reflection. Wendy Hope - Travel and wonder at the diversity of people. Maya Richardson - Staying as far away from people as possible. Christine Tully - Not having to commit to anything if I don’t want to. Margaret Inglis - Doing what I want to do, although my 4 legged mate still wants to get me out of the house each morning. Image credits: Shutterstock

Retirement Life

"Get over yourself": Sports fans call out Aussie Olympian's "privileged" rant

Aussie sports fans have seemingly turned on swimming champion Ariarne Titmus after she called out the standard of living in the Olympic village. Titmus, who took home the gold medal in the 400m freestyle, labelled the conditions for athletes in Paris "ridiculous". "Living in the Olympic village makes it hard to perform," the 23-year-old said in an interview on Sunday. "It's definitely not made for high performance, so it's about who can really keep it together in the mind." Some sports fans haven't received her comments well, with many taking to social media to accuse the athlete of whinging. "Give me a break, why is it always the Aussies that make excuses?" one person fumed. Another posted, "Get over yourself, remember how privileged you are to be there ... to complain is really petty." Others argued that all the athletes in Paris are "in the same boat" so there is no point in complaining. "Our athletes are becoming a bunch of spoiled whining Australian representatives. If you don't like your situation just leave go home and find a job!" one person said. Another wrote, "I'm not very impressed if the competitors think that blaming their accommodation for their performance ... get over yourselves, and remember how privileged you are to have the chance to be there." Australian Swimming head coach Rohan Taylor has also spoken about the conditions of the Olympic village, but said being adaptable is crucial for competitors in France to succeed. "The Olympics has always been a challenge," he said. "Every Olympics I've been a part of, every Olympic Games that you see, is a test of athletes' ability to come here, compete and perform when it matters." "It's about how you manage yourself and whatever environments are presented, whatever the beds are, whatever the food is, everybody deals with it." "The Olympics has always been this way and that's the way it is. And that's the beauty of it." Image credits: Panoramic/SIPA/Shutterstock Editorial

Travel Trouble

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Migraine is many things, but one thing it’s not is “just a headache”. “Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided. Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function. Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&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/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands. In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect. <iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Aspirin For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication. Triptans For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”. Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack. However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers. <h2>What about preventing migraines?</h2> The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol. Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives. Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached. It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more. <hr /> <iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>‘Nothing works for me!’</h2> In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP. The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections. These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist. Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away. Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives. Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<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/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>. </div>

Body

You don’t need a doctor to get more physically active – here are 10 simple steps you can take by yourself

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> We all know physical activity has many <a href="https://www.nhs.uk/live-well/exercise/exercise-health-benefits/">health benefits</a>, including for mental health. It helps <a href="https://theconversation.com/exercise-can-reduce-stress-and-improve-sleep-particularly-for-women-with-breast-cancer-186144">manage stress</a>, ease joint or back pain, and boost energy levels. Exercise can also improve <a href="https://theconversation.com/exercise-and-the-brain-three-ways-physical-activity-changes-its-very-structure-150203">brain function</a> and <a href="https://theconversation.com/exercise-really-can-help-you-sleep-better-at-night-heres-why-that-may-be-192427">sleep</a>, and lift mood. In contrast, inactivity or spending too much time <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308180/">sedentary</a> is a leading factor in developing a range of diseases. The <a href="https://www.who.int/publications/i/item/9789240015128">World Health Organization</a> recommends we should do a weekly minimum of 150-300 minutes of moderate intensity physical activity, such as walking, or 75 minutes of vigorous physical activity, such as swimming, jogging or an exercise class – as well as <a href="https://theconversation.com/strength-training-could-be-the-answer-to-one-of-the-worlds-worst-killers-228665">regular strength training</a>. However, many people <a href="https://www.who.int/teams/health-promotion/physical-activity/global-status-report-on-physical-activity-2022">fail to meet these guidelines</a>. So what to do about this <a href="https://www.weforum.org/agenda/2022/12/lack-exercise-inactivity-preventable-diseases/">health crisis</a>? There is already <a href="https://www.bmj.com/content/376/bmj-2021-068465">evidence</a> that when GPs give patients guidance and continued support to increase physical activity, this encourages them to be more physically active – at least in the short term. However, we don’t yet know the best way for doctors to communicate with patients to help them sustain these increased activity levels so the current guidance and support on offer to patients isn’t as effective as it could be. <figure><iframe src="https://www.youtube.com/embed/vCCD1xHKpZc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For example, my <a href="https://www.bmj.com/content/386/bmj-2023-078713">latest research</a> examines the <a href="https://www.bmj.com/content/340/bmj.c1900">“motivational interviewing” (MI)</a> method GPs currently use to encourage patients to change their lifestyle. MI is a patient-centred, non-confrontational communication style that helps patients address any problem behaviour by exploring their ambivalence towards changing it. MI has been shown to help patients with a host of health problems, including <a href="https://pubmed.ncbi.nlm.nih.gov/25577724/">addiction issues</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/23001832/">eating disorders</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/25726920/">smokers</a> and those with <a href="https://pubmed.ncbi.nlm.nih.gov/33637368/">diabetes</a> to change their behaviour. However, I found that while MI programmes can help patients increase their total amount of physical activity – the benefits are only short term. <h2>Ten simple ways to be more physically active</h2> If you want more physical activity in your life, then, there are many self-directed things you can do to help yourself, without joining a programme or seeing your GP. Here are ten simple and effective ways to help you become – and stay – more physically active: 1) Don’t sit, stand We <a href="https://theconversation.com/sitting-is-bad-for-your-health-and-exercise-doesnt-seem-to-offset-the-harmful-effects-225056">sit a lot</a>. In fact, it’s likely you’re sitting right now – and you needn’t be. Sitting for long periods has been <a href="https://doi.org/10.1016/j.amepre.2010.05.024">linked</a> with many adverse health outcomes, so try to stand more. <figure><iframe src="https://www.youtube.com/embed/wUEl8KrMz14?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> 2) Take the stairs Being physically active needn’t mean expensive gym memberships. Try building physical activity into your daily routine. One easy way to do this is by swapping the lift or escalator for the stairs. 3) Make it fun If you like doing something, you’re <a href="https://theconversation.com/why-you-shouldnt-let-guilt-motivate-you-to-exercise-220342">more likely</a> to continue doing it. Why not try an activity you liked doing as a child, or even something new? Who knows, you might enjoy it. 4) Phone a friend Exercising <a href="https://theconversation.com/exercise-can-be-punishing-but-heres-how-to-stop-thinking-of-it-as-a-punishment-76167">with a friend</a> or loved one is a great way to stay motivated, and it can make physical activity more fun too. 5) Do less, more often <a href="https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-023-01272-8">“Snacktivity”</a> – a term for breaking up your activity into shorter <a href="https://theconversation.com/forget-the-gym-in-january-exercise-snacking-is-the-way-forward-69702">activity “snacks”</a> – can help you increase activity in convenient, manageable bursts while reaping the health benefits. 6) Track your progress Activity trackers aren’t a fad. There is <a href="https://doi.org/10.1016/S2589-7500(22)00111-X">evidence</a> that just using an activity tracker such as a pedometer to count steps or a smart watch that logs activity can help increase your activity levels, reduce body fat and increase muscle mass – and increase your overall physical fitness. 7) Get into a habit We know it takes about ten weeks to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/">form a habit</a>. Repetition is key – so stick with it and keep going. Once you’ve formed a physical activity habit, it will be <a href="https://www.psychologytoday.com/gb/basics/habit-formation#:%7E:text=Building%20healthy%20habits%20can%20involve,listening%20to%20music%20while%20exercising">hard to shake it off</a>.). 8) Hold still Try to incorporate <a href="https://en.wikipedia.org/wiki/Isometric_exercise">isometric exercises</a> like the plank or wall squats into your routine. These exercises, which need no equipment, require you to tighten muscles and hold still – and have been shown to <a href="https://bjsm.bmj.com/content/57/20/1317">lower your blood pressure</a>. 9) Set a goal Give yourself an achievable target to work towards – it will <a href="https://theconversation.com/three-tips-to-help-you-stay-motivated-to-keep-exercising-all-year-long-175868">motivate you</a> to reach your goal. 10) Reward yourself And don’t forget to reward yourself when you meet that goal. You can also build in rewards to mark your progress along the way. After all, who doesn’t like to treat themselves when they’ve done well?<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/231991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, Associate professor, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/you-dont-need-a-doctor-to-get-more-physically-active-here-are-10-simple-steps-you-can-take-by-yourself-231991">original article</a>. </div>

Body

Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Many people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">drinking less</a> sugary soft drink than in the past. This is a great win for public health, given the <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2749350">recognised risks</a> of diets high in sugar-sweetened drinks. But over time, intake of diet soft drinks has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">grown</a>. In fact, it’s so high that these products are now regularly <a href="https://www.sciencedirect.com/science/article/pii/S0160412020319188">detected in wastewater</a>. So what does the research say about how your health is affected in the long term if you drink them often? <h2>What makes diet soft drinks sweet?</h2> The World Health Organization (WHO) <a href="https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children">advises</a> people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.” But most regular soft drinks contain <a href="https://www.actiononsugar.org/surveys/2014/sugar-sweetened-beverages/">a lot of sugar</a>. A regular 335 millilitre can of original Coca-Cola contains at least <a href="https://www.coca-cola.com/ng/en/about-us/faq/how-much-sugar-is-in-cocacola-original-taste">seven</a> teaspoons of added sugar. Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources. Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness. Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight. But while surveys of Australian <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551593/">adults</a> and <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/adolescents-knowledge-and-beliefs-regarding-health-risks-of-soda-and-diet-soda-consumption/32F3E0FD6727F18F04C63F0390595131">adolescents</a> show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly. <h2>What does the research say about aspartame?</h2> The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the <a href="https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food">US</a> and <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame">Australia</a>. However, some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/">researchers</a> have raised concern about the long-term risks of consumption. People who drink diet soft drinks regularly and often are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446768/">more likely</a> to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks. The link was found even after accounting for other dietary and lifestyle factors (such as physical activity). In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “<a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">possibly carcinogenic to humans</a>” (carcinogenic means cancer-causing). Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally. <h2>Will diet soft drinks help manage weight?</h2> Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management. In 2022, the WHO conducted a <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">systematic review</a> (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management. Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners. But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity. In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">advising</a> artificial sweeteners should not be used to manage weight. <a href="http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30296-0">Studies</a> in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven. <h2>What about inflammation and dental issues?</h2> There is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10817473/">some early evidence</a> artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed. High amounts of diet soft drinks have <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17223-0">also been</a> linked with liver disease, which is based on inflammation. The consumption of diet soft drinks is also <a href="https://link.springer.com/article/10.1007/s40368-019-00458-0#:%7E:text=Diet%20soft%20drinks%20often%20have,2006">associated</a> with dental erosion. Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion. <h2>Moderation is key</h2> As with many aspects of nutrition, moderation is key with diet soft drinks. Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term. Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.<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/233438/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/cheeky-diet-soft-drink-getting-you-through-the-work-day-heres-what-that-may-mean-for-your-health-233438">original article</a>. </div>

Food & Wine

"They lied": Kerri-Anne Kennerley blasts I’m A Celeb

Kerri-Anne Kennerley has opened up on her dramatic appearance on I’m A Celebrity … Get Me Out Of Here! last year, claiming that she was "lied to" ahead of her decision to sign up. Speaking to Tammin Sursok on her podcast, The Sh*t Show, Kennerly alleged that Network Ten made promises they couldn't keep. “[Ten] came to me and promised me this, this and this … and I had nothing else to do at the time,” the TV veteran claimed. “I got promised a bunch of stuff and they lied. And so instead of being in there, the three weeks I committed to, I got out in three days. They lied.” Sursok asked her to elaborate on the promises they made, but Kennerley refused. “I don’t want to go into it now. History. And I’m even dumbfounded that I said to myself after I’ve gone, oh my God. I avoided exactly what happened for 10 years. “ … If I had thought about it for one more nanosecond and the things that were said to me were not said to me, I wouldn’t have done it in a heartbeat.” Kennerley tearfully quit I'm A Celebrity last year after clashing with MAFS star Domenica Calarco, who she claimed called her "the most self-centred b***h” she’d ever met during an eating challenge. The TV veteran added that going on the show was the "dumbest" decision she has ever made. “Comes out as absolutely number one dumb and as backed by several of my friends – especially straight after [I left IAC], them going, ‘You didn’t tell us, we would’ve locked you in a room if you had said you were going’,” she admitted. “But I don’t know … I’ve always thought I was pretty bulletproof, and then you get wounded and move on. But no … dumb, dumb, dumb – and lies. That’s what I put it down to.” Images: Ten

Ambulance ramping is getting worse in Australia. Here’s why – and what we can do about it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jonathan-karnon-290">Jonathan Karnon</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/andrew-partington-93821">Andrew Partington</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> We’ve seen countless <a href="https://www.heraldsun.com.au/leader/ballarat/ambulance-ramping-leaves-paramedics-unable-to-respond-to-emergencies-says-union/news-story/54b6fee380eb7b7f1c9b2784edf3d2cd">media reports</a> in recent days, weeks and months about the <a href="https://www.couriermail.com.au/news/queensland/qld-politics/worst-cases-of-ambulance-ramping-at-queensland-hospitals-revealed/news-story/bcf4833b5197774329cf983029d77cb4">ramping of ambulances</a> at <a href="https://thewest.com.au/news/health/ambulance-ramping-reaches-record-levels-in-june-as-hospitals-struggle-with-surging-winter-demand-c-15192504">hospital emergency departments</a> (EDs) around Australia. Ambulance ramping occurs when paramedics are made to wait at the hospital’s entrance and are unable to transfer their patient into the emergency department within an appropriate time frame – defined as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/our+performance/ambulance+waiting+times">30 minutes</a> in South Australia. Ramping is an indicator of hospital stress. It means patients are waiting longer to receive care in the emergency department, and patients requiring inpatient care are waiting longer to access a hospital bed. Research suggests <a href="https://www.mja.com.au/journal/2022/217/5/influence-ambulance-offload-time-30-day-risks-death-and-re-presentation-patients">ambulance ramping</a> and <a href="https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.13699">having to wait longer</a> for a hospital bed are associated with a greater risk of patients dying up to 30 days after their initial presentation. So why is ambulance ramping still a problem? And what can we do to fix it? <h2>Ramping is getting worse</h2> Available data indicate the problem has become worse over time. In <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/our+performance/ambulance+waiting+times">South Australia</a>, for example, ramping has been steadily increasing since 2017, from around 500 hours “ramped” per month to around 4,000 hours per month in 2024. This is the sum of the time ambulances spend waiting beyond 30 minutes after arriving at the hospital. In <a href="https://www.bhi.nsw.gov.au/data-portal">New South Wales</a>, we calculate the numbers of patients being ramped increased from around 44,000 patients per month in early 2022 to more than 50,000 in early 2024. <h2>What’s driving the increase in ramping?</h2> The ambulance ramping bottleneck reflects an imbalance between the number of people presenting at emergency departments and the capacity to treat patients and transfer those requiring inpatient care to a ward. Potential drivers of this imbalance are increased emergency department presentations and reduced availability of inpatient beds. The latter may reflect increased demand for beds, including longer hospital stays. Between the financial years 2018–19 and 2022–23 (the latest period for which figures are available), Australian Institute of Health and Welfare data show the numbers of more serious presentations (triage categories 1 to 3) increased by <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/emergency-department-care">almost 700,000</a> across Australia. Some 100,000 fewer patients who presented to an emergency department were <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">admitted as inpatients</a> during this period, but the additional presentations will nonetheless have contributed to more ramping. In the same period, admissions to inpatient beds that did not come through an emergency department increased by <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">almost 400,000</a> across the country. These include admissions for the management of chronic conditions (such as diabetes, heart disease, asthma and so on) and infections and viruses (COVID, flu, RSV and others). Further, COVID and other viruses are likely to have contributed to increased hospital stress via <a href="https://www.aihw.gov.au/reports/workforce/health-workforce">workforce shortages</a>. This has possibly led to delays in seeing patients in the emergency department and in discharging patients from hospital. There has not been a significant increase in <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">patients’ time in hospital</a> receiving required care, but there appear to be increasing numbers of patients waiting for placement in an aged care facility or for home care services after their treatment <a href="https://www.ama.com.au/sites/default/files/2023-02/Hospital%20exit%20block%20-%20a%20symptom%20of%20a%20sick%20health%20system_Final.pdf">has finished</a>. <h2>Many admissions may be preventable</h2> Increased vaccination rates could reduce the impact of viruses. For example, only <a href="https://www.aihw.gov.au/reports/australias-health/immunisation-and-vaccination">21% of Australians</a> aged 65 to 74 received the 2023 COVID booster recommended for their age group. We know there were significant increases in people delaying or avoiding seeing a GP <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">due to cost</a> in 2022–23, which can put extra pressure on hospitals. The government is trying to address this issue by increasing <a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments">incentives to GPs</a> to reduce costs to patients. Meanwhile, government health departments may not have been provided with enough funding to meet increasing demand for health care. Year on year the gap between supply and demand grows. <a href="https://www.theguardian.com/australia-news/article/2024/jun/27/victoria-hospitals-recruitment-freeze-cost-cuts-premier-jacinta-allan">Victorian hospitals</a> are reportedly scrambling to reduce spending in light of proposed budget cuts. <h2>What are the solutions?</h2> The creation of new hospital beds is not the only option for increasing capacity. Governments should design, implement and scale up services that free up hospital capacity by providing appropriate and cost-effective out-of-hospital care. For example, there is further scope to care for patients admitted to hospital in their own homes with the support of digital technologies. Programs such as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/services/hospitals/my+home+hospital/my+home+hospital">My Home Hospital</a> in South Australia aim to provide an alternative to inpatient care. Across Australia, such “hospital in the home” care was provided 150,000 times in 2022–23, compared to <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">6.8 million episodes of care</a> in public hospitals. Virtual ED services are a growing phenomenon across Australia, using <a href="https://theconversation.com/what-is-a-virtual-emergency-department-and-when-should-you-visit-one-228098">virtual consultations</a> to identify patients for whom urgent care can be provided outside hospital. The Victorian virtual ED service is targeting a capacity of <a href="https://www.afr.com/policy/health-and-education/meet-the-two-doctors-revolutionising-emergency-healthcare-20240415-p5fjud">1,000 consults</a> per day. Longer-term solutions require co-operation between state and territory governments and the federal government to prevent and better manage chronic conditions, such as diabetes and heart disease, outside hospital. This includes boosting access to GPs and improving communication between GPs and hospitals. Greater investment in well-designed policies and programs to support healthy ageing would also likely help, as well as improving access to required out-of-hospital aged care and disability services for patients waiting to leave hospital. All these measures could ease the pressure on hospitals and reduce the likelihood of patients waiting in an ambulance, unable to get inside and receive the care they need.<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/232720/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jonathan-karnon-290">Jonathan Karnon</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/andrew-partington-93821">Andrew Partington</a>, Research Fellow (Health Economics), <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ambulance-ramping-is-getting-worse-in-australia-heres-why-and-what-we-can-do-about-it-232720">original article</a>. </div>

Caring

Millions of older people don’t get enough nutrients – how to spot it and what to do about it

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a> By 2050, approximately a quarter of the UK population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/january2021">expected to be over the age of 65</a>. With this in mind, the World Health Organization (WHO) has put “<a href="https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_28">healthy ageing</a>” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years. Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat. Older adults are <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/research-report-2019--one-step-at-a-time.pdf">generally less physically active</a> than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older. This means we need to get more nutrients into less energy which can be tricky as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/#:%7E:text=The%20physiological%20changes%20that%20occur,can%20contribute%20to%20declining%20appetite.">older adults often have lower appetites</a>. This is why <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">scientists suggest</a> that it may be necessary to enrich the food of older people to maintain the nutrient intake. <h2>How to spot when someone isn’t eating enough?</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399049/">Several studies have shown</a> that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital. Being overweight, even obese, <a href="https://link.springer.com/article/10.1007/s40520-023-02650-1">does not protect</a> against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.892675/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Nutrition&id=892675">abilities to do daily tasks</a>. Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness <a href="https://www.sciencedirect.com/science/article/pii/S0195666319307603?casa_token=iU5UIdNwGDgAAAAA:I81EKDJ2T0oBsOsZunpPBk6uI-TcgiCr-5gPJE1tz4-Tq3w8pK4Yi_mv22AhVHHpRpiv1Bvz0RI">with good health</a>. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment. Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition. <h2>Getting more nutrients into less food</h2> If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK. Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy. <figure><iframe src="https://www.youtube.com/embed/kNu8auu3fuU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For older adults in particular, protein is a very important nutrient, because of muscle loss (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/#:%7E:text=Sarcopenia%20has%20been%20defined%20as,decade%20of%20life%20%5B1%5D.">sarcopenia)</a> which is a natural part of ageing. This could be slowed down or even reversed by <a href="https://www.medicalnewstoday.com/articles/could-a-higher-protein-intake-lead-to-healthier-eating">eating enough protein</a> at regular intervals throughout the day. A few ways to increase protein include: • Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato. • Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies). • Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals. • Look in the sports section of supermarkets to find <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/whey-powder#:%7E:text=Whey%20powders%20are%20characterized%20as,of%20products%20obtained%20from%20milk.">whey protein</a> powders. These are marketed to gym enthusiasts, but actually whey is one of the <a href="https://www.mdpi.com/2072-6643/15/15/3424">best proteins to stimulate muscle growth</a>. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking. <h2>Importance of physical activity and strength exercises</h2> Physical activity and nutrition go hand-in-hand – both are equally important. As we age, being physically active becomes <a href="https://link.springer.com/article/10.1007/s12603-021-1665-8?fbclid=IwAR3dJkeHjgcSrR9Xq5kBfN-HLrbpli8WcAnz7AeY5Nu9XcGCHEB07Sd2z1w">even more essential</a> as it helps to prevent disease, maintains independence, decreases risk of falls, improves cognitive function, mental health and sleep. Exercise can also <a href="https://academic.oup.com/ageing/article/48/4/476/5423796?login=false">combat isolation and loneliness</a> which has also been <a href="https://www.bda.uk.com/resource/loneliness-and-malnutrition.html">linked to decreased appetite</a> in older adults. Often strength training gets ignored when we think of being active but to keep independence and prevent falls, older adults should do varied physical activity that emphasises balance and strength training at moderate or greater intensity on three or more days a week. Ultimately, it’s essential to contact a doctor or dietician with any worries or concerns about malnutrition or unintentional weight loss. There are, however, <a href="https://www.futurelearn.com/courses/ageing-well-nutrition-and-exercise-for-older-adults">some excellent resources</a> to learn more about ageing healthily and maintaining a good quality of life in later years.<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/221380/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, Senior Lecturer in Human Nutrition, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, Sensory and Consumer Scientist, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/millions-of-older-people-dont-get-enough-nutrients-how-to-spot-it-and-what-to-do-about-it-221380">original article</a>. </div>

Body

If I’m diagnosed with one cancer, am I likely to get another?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health. Fear of cancer returning is one of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321869/">top health concerns</a>. And <a href="https://www.cancercouncil.com.au/cancer-information/living-well/after-cancer-treatment/fear-of-the-cancer-returning/managing-fear-of-recurrence/">managing this fear</a> is an important part of cancer treatment. But how likely is it to get cancer for a second time? <h2>Why can cancer return?</h2> While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms. This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">metastasis</a>. Actor Hugh Jackman has gone public about his <a href="https://www.skincancer.org/blog/is-basal-cell-carcinoma-serious/">multiple diagnoses</a> of basal cell carcinoma (a type of skin cancer) over the <a href="https://www.bbc.com/news/world-australia-65158945">past decade</a>. The exact reason why cancer returns differs depending on the cancer type and the treatment received. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486871/">Research</a> is <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.3408">ongoing</a> to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people. <h2>What are the chances of cancer returning?</h2> The risk of cancer returning differs between cancers, and between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019423/">sub-types</a> of the same cancer. New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2812113">31-68%</a>. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning. For most types of cancer, the highest risk of cancer returning is within the <a href="https://pubmed.ncbi.nlm.nih.gov/31231898/">first three years</a> after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning. Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed. <h2>What about second, unrelated cancers?</h2> Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) <a href="https://www.bbc.com/news/uk-68047608">shortly after</a> being treated for breast cancer. Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one. Australian research from <a href="https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-83">Queensland</a> and <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.31247">Tasmania</a> shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population. <h2>Who’s at risk of another, unrelated cancer?</h2> With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer. Reasons for such cancers <a href="https://www.cancer.net/survivorship/what-second-cancer">include</a> different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors. The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435077/">relatively small</a> when compared with the (sometimes lifesaving) benefits of these treatment and procedures. While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years. Similarly, in a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.30164">large US study</a> only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years). The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer. People diagnosed with cancer as a <a href="https://www.mja.com.au/journal/2020/212/3/second-primary-cancers-people-who-had-cancer-children-australian-childhood">child</a>, <a href="https://www.liebertpub.com/doi/10.1089/jayao.2022.0074">adolescent or young adult</a> also have a greater risk of a second, unrelated cancer. <h2>What can I do to lower my risk?</h2> Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment. <a href="https://www.lymphoma.org.au/lymphoma/treatments/maintenance-therapy/">Maintenance therapy</a> may be used to reduce the risk of some types of cancer returning. However, despite ongoing <a href="https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.15626">research</a>, there are no specific treatments against cancer recurrence or developing a second, unrelated cancer. But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21719">cancer returning</a> and <a href="https://www.cancer.net/survivorship/what-second-cancer">getting a second cancer</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/226386/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, Senior Lecturer in Cancer Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-im-diagnosed-with-one-cancer-am-i-likely-to-get-another-226386">original article</a>. </div>

Body

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

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

Travel Tips

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

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

Body

Woman fined after paid car park gets set up around her parked vehicle

Josephine Williams had been leaving her car in a gravel clearing at Westgate in Auckland, alongside other commuters to catch the bus into the city for months. The New Zealand woman was left with a "nasty surprise" when she returned from work on Monday to find a NZ $85 ($77) fine sitting on her windshield. "To my unfortunate surprise - and many others - I was greeted by an $85 parking ticket for a breach and a flyer from Wilson Parking saying paid parking had started that day," Williams told Stuff. "But what breach exactly was made? How was I supposed to know paid parking started that day when there was nothing at all displayed anywhere in the car park?" Williams claimed that the Wilson Parking car park had been set up around her already parked car, even providing dash cam footage that showed her pulling into the gravel clearing at 7.45am, with no paid parking signs or Wilson branding in sight. By 6pm, a large red and white Wilson sign had been put up at the entrance, with "12 hours for $4" written on it. "Wilson deliberately put their sign up sometime after 9am and then took it upon themselves to fine every single car that was already parked there from the morning," Williams said. "$85 is a lot of money - it would have been two weeks' worth of grocery shopping for me," she added. "I'm lucky that I know the law and my rights, but some other people might not. What about students or the elderly or people who don't know English well?" She estimated that there was usually around 50 and 100 cars in the gravel clearing. Wilson argued that the carpark was always there and they had just added more signage, but have since waived Williams' fine after she lodged a request to have it reviewed by Parking Enforcement Services. Wilson Parking also said that they had started to set up the car park and installed a "clear signage" on April 22. "It was not set up around parked cars on 29 April as suggested," a Wilson spokesperson said. "Several payments were made by customers via the Parkmate app from 22 April proving that signage on the site was clear and effective," they said. They added that on April 29 more signs were added to all entry points of the car park. "In acknowledgment of the increased signage added on the 29th at the entry we've made the decision to refund all payments made until 30 April and waive any breach notices issued up to this date." They also denied issuing any breach notices before the signs were put up. "Payment options were available and signed from 22 April - but no infringement notices were issued prior to the 29th." Images: Stuff

Legal

When is it a good idea to get a property appraisal?

In the fast-paced world of real estate, finding a space that truly reflects your essence and aspirations can feel like searching for a needle in a haystack. Enter <a href="https://go.linkby.com/PXROBQFZ" target="_blank" rel="noopener">Atlas by LJ Hooker</a>. At the heart of Atlas lies a profound understanding that a home is not merely a structure; it's a canvas upon which individuals paint their dreams and express their identities. This ethos is beautifully encapsulated in their brand message: "We understand that a home is so much more than real estate; it's a place to truly express yourself, to live the life you envision." What sets Atlas apart is its unwavering commitment to personalised service – especially when it comes to <a href="https://go.linkby.com/PXROBQFZ" target="_blank" rel="noopener">free property appraisals</a>. Unlike traditional real estate agencies, Atlas doesn't believe in a one-size-fits-all approach. Instead, they empower sellers to curate their own narrative, choosing elements of the brand that resonate with their unique lifestyle. Whether it's a sleek urban penthouse or a sprawling countryside estate, Atlas offers highly tailored marketing strategies that serve as a personal reflection of the property and its inherent allure. For those ready to embark on the journey of <a href="https://go.linkby.com/PXROBQFZ" target="_blank" rel="noopener">having their property appraised</a> – whether you're contemplating a sale, gauging investment opportunities, or simply curious about your net worth – Atlas offers a seamless pathway to success, as well as comprehensive advice on the potential benefits. At the core of any property appraisal lies a quest for insight into the local property market's heartbeat. Has your neighbourhood witnessed fluctuations in property values? Have recent renovations added significant value to your home? Are you considering upsizing, downsizing, or entering the investment realm? Or perhaps you're merely eager to unveil the hidden potential nestled within your property's walls. From the size of your property to the nuances of its structure and condition, every facet contributes to the appraisal process. Agents meticulously scrutinise elements such as property size, bedroom configurations, fixtures and fittings, offering valuable insights into your property's market positioning. Beyond tangible attributes, location exerts a profound influence on property values. Agents dissect the neighbourhood fabric, examining proximity to amenities, school catchments and transport accessibility. Additionally, factors like building structure, overall presentation and ease of access shape the appraisal narrative, underscoring the intricate interplay between tangible and intangible elements. The crucial distinction: Valuations vs. Appraisals It's imperative to <a href="https://go.linkby.com/PXROBQFZ/understanding-property-appraisals/" target="_blank" rel="noopener">discern between property valuations and appraisals</a>. While valuations offer an independent assessment of a property's value by certified valuers, appraisals provide a nuanced perspective shaped by local market dynamics and agent expertise. Embarking on the path to a property appraisal is easy. Simply <a href="https://go.linkby.com/PXROBQFZ" target="_blank" rel="noopener">book a consultation</a>, relax as they navigate through the intricacies of your property, and await their expert assessment. Armed with the insights garnered from your property appraisal, you're now equipped to chart your next course of action. Whether it's embarking on home improvements, contemplating a sale or recalibrating your financial portfolio, the appraisal serves as your guiding light. In a landscape defined by constant flux, the value of knowledge cannot be overstated. A property appraisal isn't merely a transactional ritual; it's a journey towards financial empowerment and informed decision-making. So, whether you're contemplating a sale or simply curious about your property's worth, take that pivotal step towards unlocking the true value of your home. After all, in the realm of real estate, knowledge is indeed power. For more information or to book your own <a href="https://go.linkby.com/PXROBQFZ" target="_blank" rel="noopener">free property appraisal, click here</a>.

Real Estate

Beyond the spin, beyond the handouts, here’s how to get a handle on what’s really happening on budget night

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Three weeks from now, some of us will be presented with a <a href="https://budget.gov.au/">mountain</a> of budget papers, and just about all of us will get to hear about them on radio, TV or news websites on budget night. The quickest way to find out what the budget is really doing will be to listen to the treasurer’s speech, or to peruse online the aptly-named “<a href="https://treasury.infoservices.com.au/page/budget2023">glossy</a>” – a document that last year was titled “<a href="https://archive.budget.gov.au/2023-24/overview/download/budget_overview.pdf">Stronger foundations for a better future</a>”. <figure class="align-right zoomable"><a href="https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=237&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=848&fit=crop&dpr=1 600w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=848&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=848&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=1066&fit=crop&dpr=1 754w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=1066&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/589444/original/file-20240422-23-vkinrm.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=1066&fit=crop&dpr=3 2262w" alt="Cover of 2023 budget glossy" /></a><figcaption>Glossies are used to make each budget attractive. <a class="source" href="https://archive.budget.gov.au/2023-24/overview/download/budget_overview.pdf">Commonwealth Treasury</a></figcaption></figure> But they will tell you exactly what the government wants you to hear, exactly as it wants you to hear it. If you are looking instead for the truth – what the government is actually trying to achieve and what it is holding itself and its officials to, I would suggest something else, tucked away on about page <a href="https://cdn.theconversation.com/static_files/files/3225/8787.pdf">87</a> of the main budget document. It is required by the <a href="https://www.legislation.gov.au/C2004A05333/latest/text">Charter of Budget Honesty Act</a> introduced in 1998 by Peter Costello, the treasurer under Prime Minister John Howard. On taking office in 1996, Costello set up a <a href="https://webarchive.nla.gov.au/awa/20101119021633/http://www.finance.gov.au/archive/archive-of-publications/ncoa/execsum.htm">National Commission of Audit</a> to examine the finances he had inherited from the Hawke and Keating governments, presumably with an eye to discovering they had been mismanaged. But the members of the commission weren’t much interested in that. Instead, they decided to deal with something more fundamental. <h2>Budget as you wish, but explain your strategy</h2> Governments were perfectly entitled to manage money in whatever way they wanted, and they were perfectly entitled to spend more money than they raised (which they usually do, it’s called a <a href="https://www.investopedia.com/terms/d/deficit.asp">budget deficit</a>). What the commission wanted was for governments to make clear what they were doing, and to spell out the strategy behind it. Only part of it was about being upfront with the public. The commission also wanted governments to be upfront with themselves – to actually develop frameworks for what they were doing, rather than doing whatever they felt like. The commission recommended a <a href="https://webarchive.nla.gov.au/awa/20101119021633/http://www.finance.gov.au/archive/archive-of-publications/ncoa/execsum.htm">Charter of Budget Honesty</a>, which among other things requires officials to prepare independent assessments of the finances before each election, requires budget updates six months after each budget, and requires <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BriefingBook45p/TaxExpenditures">tax expenditures</a> (tax breaks) to be accounted for like other expenditures. And it requires the publication and regular updating of a <a href="https://cdn.theconversation.com/static_files/files/3227/CBH_Fiscal_strategy.pdf">fiscal strategy statement</a>. <h2>Where treasurers hold themselves accountable</h2> The <a href="https://cdn.theconversation.com/static_files/files/3225/8787.pdf">fiscal strategy</a> can be thought of as an exam question set by the student who is being examined – something along the lines of “this is what you say you want your budget to achieve, please set out the means by which you plan to achieve it”. It turns out to have been exceptionally effective in getting governments to organise their thoughts, make budgets at least try to achieve something, and let the rest of us know what they are trying to achieve. Every few years, treasurers change the strategy, as is their right. Treasurer Jim Chalmers says he’ll change it again this budget, to de-emphasise the fight against inflation and to more greatly emphasise the need to <a href="https://ministers.treasury.gov.au/ministers/jim-chalmers-2022/transcripts/press-conference-washington-dc-0">support economic growth</a>. His statement will tell us what’s behind his actions in a way the glossy words in his brochure and speech might not. <h2>The strategy that has signposted 26 years</h2> Previous statements have signposted all the important turns in what the budget is trying to do. The first, in <a href="https://images.theconversation.com/files/589686/original/file-20240423-16-rncqg3.PNG">1998</a>, committed Costello and Howard to achieving a budget surplus on average over the economic cycle and whenever “growth prospects remain sound”. Making that commitment more difficult was another “not to introduce new taxes or raise existing taxes over the term of this parliament”. Two years later, after the government had won an election promising a new goods and services tax, that commitment was <a href="https://images.theconversation.com/files/589692/original/file-20240423-18-q843xn.PNG">changed</a> to “no increase in the overall tax burden from its 1996-97 level”, a condition met by calling the GST a state tax. <h2>Hockey and Morrison wound back spending</h2> The Labor budgets from 2008 <a href="https://images.theconversation.com/files/589702/original/file-20240423-18-mikx6f.PNG">loosened</a> the tax target to the average share of GDP below the reference year, which they changed to the higher-tax year of 2007-08. The first Coalition budget under Treasurer Joe Hockey in 2014 changed the target from tax to spending, pledging to bring down the ratio of <a href="https://images.theconversation.com/files/589705/original/file-20240423-16-9spkdy.PNG">payments to GDP</a>, and pledging a surplus of 1% of GDP by 2023-24. Any new spending would be more than offset by cuts elsewhere, and if the budget did receive a burst of unexpected revenue it would be “banked” rather than spent. In 2018 Treasurer Scott Morrison reintroduced tax as a target, that he spelled out precisely. Tax was not to increase beyond <a href="https://images.theconversation.com/files/589706/original/file-20240423-16-b7gj5d.PNG">23.9%</a> of GDP. <h2>During COVID, Frydenberg spent big</h2> In 2020, in the face of a COVID-induced recession and soaring unemployment, Finance Minister Mathias Cormann and Treasurer Josh Frydenberg pushed the old strategy to one side. They would spend big now to keep the economy afloat so they wouldn’t have to spend more bailing it out later, and they wouldn’t return to their old concern about the deficit until the unemployment rate was “<a href="https://cdn.theconversation.com/static_files/files/3228/fs2020.pdf">comfortably below 6%</a>”. So well did they succeed that in 2021 Frydenberg made the momentous decision to keep going, abandoning the promise to return to worrying about the deficit when unemployment fell below 6%. Instead he promised to keep spending big until unemployment was “<a href="https://images.theconversation.com/files/589709/original/file-20240423-16-9pmpaf.PNG">back to pre-crisis levels or lower</a>”. The decision propelled unemployment down to a 50-year low of <a href="https://www.datawrapper.de/_/wPfXO/">3.5%</a>. Along with high iron ore prices, that one change of strategy has probably helped deliver Chalmers two consecutive budget surpluses – the one he announced last year for 2022-23, and the one he is set to announce this year for 2023-24. More of us have been in jobs <a href="https://www.finance.gov.au/publications/commonwealth-monthly-financial-statements/2024/mfs-january">paying tax</a>, and fewer have been out of jobs <a href="https://theconversation.com/half-a-million-more-australians-on-welfare-not-unless-you-double-count-227342">on benefits</a>. It’s a powerful demonstration of the real-world difference budget decisions can make, and the way in which the <a href="https://cdn.theconversation.com/static_files/files/3225/8787.pdf">fiscal strategy</a> tells the story.<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/228387/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/beyond-the-spin-beyond-the-handouts-heres-how-to-get-a-handle-on-whats-really-happening-on-budget-night-228387">original article</a>. </div>

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Woman fined after paid car park gets set up around her parked vehicle

When is it a good idea to get a property appraisal?

Beyond the spin, beyond the handouts, here’s how to get a handle on what’s really happening on budget night

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Woman fined after paid car park gets set up around her parked vehicle

When is it a good idea to get a property appraisal?

Beyond the spin, beyond the handouts, here’s how to get a handle on what’s really happening on budget night

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