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Here’s why having chocolate can make you feel great or a bit sick – plus 4 tips for better eating

<a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Australians are <a href="https://www.retail.org.au/media/sweet-spending-boon-predicted-for-easter-retail">predicted</a> to spend around A$1.7 billion on chocolates, hot cross buns and other special foods this Easter season. Chocolate has a long history of production and consumption. It is made from cacao beans that go through processes including fermentation, drying, roasting and grounding. What is left is a rich and fatty liquor that is pressed to remove the fat (cocoa butter) and the cacao (or “cocoa”) powder which will then be mixed with different ingredients to produce dark, milk, white and other types of chocolates. There are several health benefits and potential problems that come in these sweet chocolatey packages. <h2>The good news</h2> Cacao beans contain <a href="https://foodstruct.com/food/cocoa-bean">minerals</a> like iron, potassium, magnesium, zinc and phosphorus and some vitamins. They are also rich in beneficial chemicals called <a href="https://pubmed.ncbi.nlm.nih.gov/23150750/">polyphenols</a>. These are great antioxidants, with the potential to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465250/">improve heart health</a>, increase <a href="https://pubmed.ncbi.nlm.nih.gov/25164923/">nitric oxide</a> (which dilates blood vessels) and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488419/">reduce blood pressure</a>, provide food for gut microbiota and <a href="https://www.mdpi.com/2072-6643/12/7/1908">promote gut health</a>, boost the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465250/">immune system</a> and reduce inflammation. However, the concentration of polyphenols in the chocolate we eat depends largely on the cocoa solid amounts used in the final product. In general terms, the darker the chocolate, the more cocoa solids, minerals and polyphenols it has. For example, dark chocolates may have around <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2011.614984">seven times more polyphenols</a> compared to white chocolates and <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2011.614984">three times more polyphenols</a> compared to milk chocolates. <h2>But also some bad news</h2> Unfortunately, the <a href="https://theconversation.com/treat-or-treatment-chocolate-is-good-but-cocoa-is-better-for-your-heart-3084">health benefits of cocoa solids</a> are easily offset by the high sugar and fat content of modern-day chocolates. For example, milk and white chocolate eggs are on average 50% sugar, 40% fat (mostly saturated fats) – which means a lot of added kilojoules (calories). Also, there may be some side effects that come with ingesting chocolate. Cocoa beans include a compound called theobromine. While it has the anti-inflammatory properties responsible for some of the health benefits of chocolate, it is also a mild brain stimulant that acts in a similar way to caffeine. The mood boost it offers may also be partly responsible for how much we <a href="https://www.frontiersin.org/articles/10.3389/fphar.2015.00030/full?crsi=662496658&cicada_org_src=healthwebmagazine.com&cicada_org_mdm=direct">like chocolate</a>. Dark chocolate has higher theobromine compared to milk and white chocolate. But accordingly, overindulging in chocolate (and therefore theobromine) may lead to feeling restless, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/">headaches</a> and nausea. <h2>What else is in your chocolate?</h2> Milk and dairy-based chocolates may also cause stomach upset, abdominal pain and bloating in people with <a href="https://dietitiansaustralia.org.au/health-advice/lactose-intolerance">lactose intolerance</a>. This happens when we don’t produce enough lactase enzymes to digest milk sugar (lactose). People with lactose intolerance can usually tolerate up to 6 grams of lactose without showing symptoms. Milk chocolate can have around <a href="https://www.ncbi.nlm.nih.gov/books/NBK310258/">3 grams of lactose</a> per 40 grams (the size of a standard chocolate bar). So two chocolate bars (or the equivalent in milk chocolate eggs or bunnies) may be enough to cause symptoms. It’s worth noting that lactase enzyme activity dramatically declines as we age, with the highest activity in newborns and children. So lactose sensitivity or intolerance may not be such an issue for your kids and your symptoms may increase over time. Genetics also plays a major role in how sensitive people are to lactose. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815241/">Allergic reactions</a> to chocolate are usually due to the added ingredients or cross-contamination with potential allergens such as nuts, milk, soy, and some sweeteners used in the production of chocolate. Symptoms can be mild (acne, rashes and stomach pain) or more severe (swelling of the throat and tongue and shortness of breath). If you or your family members have known allergic reactions, make sure you read the label before indulging – especially in a whole block or basket of the stuff. And if you or your family members do experience symptoms of an allergic reaction after eating chocolate, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/allergic-reactions-emergency-first-aid">seek medical attention</a> immediately. <h2>4 take home tips</h2> So, if you are like me and have a weakness for chocolate there are a few things you can do to make the experience a good one.<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/202848/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <ol> <li>keep an eye out for the darker chocolate varieties with higher cocoa solids. You may notice a percentage on labelling, which refers to how much of its weight is from cocoa beans. In general, the higher this percentage, the lower the sugar. White chocolate has almost no cocoa solid, and mostly cocoa butter, sugar and other ingredients. Dark chocolate has 50–100% cocoa beans, and less sugar. Aim for at least 70% cocoa</li> <li>read the fine print for additives and possible cross-contamination, especially if allergies might be an issue</li> <li>the ingredients list and nutrition information panel should tell you all about the chocolate you choosing. Go for varieties with lower sugar and less saturated fat. Nuts, seeds and dried fruits are better ingredients to have in your chocolate than sugar, creme, syrup, and caramel</li> <li>finally, treat yourself – but keep the amount you have within sensible limits!</li> </ol> <a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, Postdoctoral Fellow of the National Heart Foundation & Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/heres-why-having-chocolate-can-make-you-feel-great-or-a-bit-sick-plus-4-tips-for-better-eating-202848">original article</a>.

Food & Wine

Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a> Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above. Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>. While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey. As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way. <h2>The science behind altitude sickness</h2> Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research. The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent. When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>. Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations. As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level. <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Tips for preventing or reducing the risk of altitude sickness.</figcaption></figure> <h2>The importance of gradual ascent</h2> High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness. This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>. People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed. Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>. <h2>Effective medications</h2> For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye. If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent. Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>. A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken. Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize. <h2>Unproven therapies and remedies are common</h2> As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend. Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective. <a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>. <a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness. Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective. Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness. The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<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/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</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/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.

Travel Trouble

From COVID to gastro, why are cruise ships such hotbeds of infection?

<a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Dual outbreaks of <a href="https://www.abc.net.au/news/2023-11-12/grand-princess-ship-adelaide-covid-19-gastroenteritis/103095704">gastro and COVID</a> on the Grand Princess cruise ship that docked in Adelaide on Monday <a href="https://www.theguardian.com/australia-news/2023/nov/13/grand-princess-cruise-ship-covid-gastro-outbreak-docks-adelaide-south-australia">have now been declared over</a> by the <a href="https://www.canberratimes.com.au/story/8421009/cruise-ship-doctor-declares-dual-virus-outbreaks-over/">doctor on board</a>. A spokesperson for Princess Cruises, which operates the ship, said a number of passengers had presented with symptoms <a href="https://www.9news.com.au/national/grand-princess-no-double-covid19-gastro-outbreak-on-ship-cruise-line-says/5d02d423-3289-4a2b-a580-1ed565b78027">on a previous voyage</a>. But the ship has since been disinfected and the number of people who were ill when the ship arrived into Adelaide was said to be in single digits. While this is positive news, reports of infectious outbreaks on cruise ships evoke a sense of deja vu. We probably all remember the high-profile COVID outbreaks that occurred on cruise ships in 2020. So what is it about cruise ships that can make them such hotspots for infection? <h2>First, what causes these outbreaks?</h2> Respiratory infectious outbreaks on cruise ships may be caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">a range of pathogens</a> including SARS-CoV-2 (the virus that causes COVID) and influenza viruses. These can be spread by <a href="https://www.pnas.org/doi/10.1073/pnas.2015482118">respiratory droplets and aerosols</a> released when people breathe, talk, laugh, cough and sneeze. Historically, <a href="https://jmvh.org/article/the-navy-and-the-1918-19-influenza-pandemic/">troop transport ships</a> also helped to spread the lethal 1918 flu virus between continents. Gastro outbreaks on cruise ships are similarly well documented. More than 90% of cruise ship gastro outbreaks are caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel#infectious">norovirus</a>, which is spread from person to person, and through contaminated objects or contaminated food or water. Gastro can also be caused by other pathogens such as <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">bacteria in contaminated food or water</a>. <h2>What is the risk?</h2> In 2020, around 19% of <a href="https://www.bmj.com/content/369/bmj.m1632">Diamond Princess</a> passengers and crew docked in Japan tested positive to COVID. Ultimately, nearly one in four <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">Ruby Princess</a> passengers and crew docked in Sydney tested positive. However, COVID generally presents a lesser risk nowadays, with most people having some level of immunity from vaccination or previous infection. The outbreak on the Grand Princess appears to have been much smaller in scale. A <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680">three-year study</a> before COVID of influenza-like illness (which includes fever), acute respiratory illness (which <a href="https://www.cdc.gov/flu/about/glossary.htm">doesn’t require fever</a> to be present) and gastro on cruise ships found these were diagnosed in 32.7%, 15.9% and 17% of ill passengers, and 10.9%, 80% and 0.2% of ill crew, respectively. An <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">analysis</a> of data from 252 cruise ships entering American ports showed the overall incidence of acute gastro halved between 2006 and 2019. Passenger cases decreased from 32.5 per 100,000 travel days to 16.9, and crew cases from 13.5 per 100,000 travel days to 5.2. This decline may be due to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">combination</a> of improved hygiene and sanitation standards. The risk of getting sick with gastro was significantly higher on <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">bigger ships and longer voyages</a>. This is because the longer you are in close contact with others, the greater the chance of exposure to an infectious dose of viruses or bacteria. <h2>Why are cruise ships infection hotspots?</h2> On cruise ships, people tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">crowd together</a> in confined spaces for extended periods. These include dining halls, and during social activities in casinos, bars and theatres. The risk goes up when the environment is noisy, as more droplets and aerosols are shed when people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">laughing, shouting or talking loudly</a>. Passengers may come from <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680?via%3Dihub">multiple countries</a>, potentially bringing variants from different parts of the world. Influenza, which is usually seasonal (late autumn to early spring) onshore, can occur at any time <a href="https://academic.oup.com/cid/article/31/2/433/295546">on a cruise ship</a> if it has international passengers or is calling at international ports. Human behaviour also contributes to the risk. Some passengers <a href="https://academic.oup.com/jtm/article/15/3/172/1821220">surveyed</a> following cruise ship gastro outbreaks indicated they were ill when they boarded the ship, or they became ill but didn’t disclose this because they didn’t want to pay for a doctor or be made to isolate, or they thought it wasn’t serious. Those who became ill were more likely than those who did not to think that hand hygiene and isolation were not effective in preventing infection transmission, and were less likely to wash their hands after using the toilet. Given <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/norovirus.aspx">faecal contamination</a> is a major source of norovirus transmission, this is concerning. While there are usually a la carte dining options on board, many people will choose a buffet option. From personal experience, food tongs are handled by multiple people, some of whom may not have cleaned their hands. <h2>What can help?</h2> The <a href="https://www.health.gov.au/news/ahppc-statement-advice-to-support-safe-cruising">Department of Health and Aged Care</a> recommends cruise companies encourage crew and passengers to be up-to-date with flu and COVID vaccinations, and encourage anyone who becomes ill to stay in their cabin, or at least avoid crowded spaces and wear a mask in public. They also recommend cruise ships have a plan to identify and contain any outbreaks, including testing and treatment capacity, and communicate to passengers and crew how they can reduce their transmission risk. All passengers and crew should report any signs of infectious illness, and practice good hand hygiene and <a href="https://www.cdc.gov/oralhealth/infectioncontrol/faqs/respiratory-hygiene.html">respiratory etiquette</a>, such as covering their mouth if coughing or sneezing, disposing of used tissues, and washing or sanitising hands after touching their mouth or nose. South Australia’s chief health officer has <a href="https://www.abc.net.au/news/2023-11-13/grand-princess-ship-covid-gastro-docks-in-adelaide/103096836">commended</a> the Grand Princess crew for their infection protection and control practices, and for getting the outbreak under control.<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/217534/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, Professor, Nursing, School of Nursing and Midwifery, <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/from-covid-to-gastro-why-are-cruise-ships-such-hotbeds-of-infection-217534">original article</a>.

Cruising

You’ve heard of long COVID, but did you know there might also be a long cold?

<a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> At least <a href="https://www.nature.com/articles/s41579-022-00846-2">10% of people</a> infected with SARS-CoV-2, the virus that causes COVID, have symptoms that last more than four weeks after the infection. With more than <a href="https://covid19.who.int/">770 million infections</a> to date, this translates to tens of millions of people living with the long-term consequences of COVID, known as “long COVID”. <a href="https://www.nature.com/articles/s41579-022-00846-2">More than 200 symptoms</a> of long COVID have been studied, with some of the most common being fatigue, breathlessness and cognitive difficulties, such as memory problems or “brain fog”. The condition can be debilitating – many people have to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00387-5/fulltext">reduce their working hours</a> or are <a href="https://ifs.org.uk/publications/long-covid-and-labour-market">unable to work entirely</a>. But COVID may not be alone in causing long-lasting symptoms. In a <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext">new paper</a>, my colleagues and I report the findings of a study comparing long-term symptoms reported by people who experienced different types of acute respiratory infection. We asked more than 10,000 people to report on 16 symptoms commonly found in long COVID, such as fatigue, breathlessness, aches and pains, and dizziness. We then compared how common these symptoms were among three groups: people who had reported COVID, those who had reported another acute respiratory infection (but had tested negative for COVID), and those who had not reported either infection. We focused on long-term symptoms by only including people who had been infected more than four weeks earlier. We also took into account people’s general health before they were infected, and whether they had any existing respiratory conditions. Our study showed that all the symptoms considered were more common in people with previous COVID than in people with no infections, regardless of whether they reported long COVID. But this finding wasn’t unique to COVID. Almost all the symptoms we looked at were also more common in people with non-COVID respiratory infections than in those with no infection. In other words, our findings hinted towards the existence of a “long cold”: long-lasting health effects from other respiratory infections, such as colds, flu, or pneumonia, that are currently going unrecognised. Some of the most common symptoms of the long cold include coughing, stomach pain, and diarrhoea. These symptoms were reported an average of 11 weeks after the infection. While a severe initial infection seems to increase the risk of long-term symptoms, our research does not yet tell us why some people suffer extended symptoms while others do not. <h2>Important differences</h2> Importantly, we have no evidence that symptoms of the long cold have the same severity or duration as long COVID. In fact, we saw some important differences in the symptoms reported in the two groups, with those recovering from COVID more likely to experience light-headedness or dizziness and problems with taste and smell. These findings shine a light not only on the impact of long COVID on people’s lives, but also other respiratory infections. A lack of awareness, or even the lack of a common term, such as “long cold” or “long flu”, prevents both reporting and diagnosis of these conditions. And people who do report their long cold may still struggle to get a diagnosis, owing to the wide range of symptoms and <a href="https://www.nature.com/articles/s41591-022-01810-6">lack of diagnostic tests</a>. Long-lasting symptoms after respiratory infections are not a new phenomenon. Studies in survivors of two previous coronavirus outbreaks – the severe acute respiratory syndrome (Sars) pandemic and the Middle East respiratory syndrome (Mers) outbreak – have found long-term impacts on <a href="https://www.rcpjournals.org/content/clinmedicine/21/1/e68">lung function, quality of life and mental health</a>. And some people hospitalised with influenza A have experienced <a href="https://www.nature.com/articles/s41598-017-17497-6">respiratory and psychological problems</a> at least two years after being discharged from hospital. But most of the research so far has focused on people with severe disease, often severe enough to be hospitalised. Little is known about the long-term effects respiratory infections might have among people whose acute disease episode is less severe. Long COVID has bucked this trend, being studied in people with all levels of severity of the initial infection. This is in large part due to <a href="https://www.sciencedirect.com/science/article/pii/S0277953620306456">strong patient advocacy</a>, showing that it can affect even those with mild initial symptoms. In demanding recognition of their condition, people with long COVID have cast a much-needed spotlight on post-infection syndromes more generally. Now is the time to improve our understanding, diagnosis and treatment of these conditions. Let’s not wait for another pandemic.<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/214995/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, , <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</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/youve-heard-of-long-covid-but-did-you-know-there-might-also-be-a-long-cold-214995">original article</a>.

Body

Why do I crave sugar and carbs when I’m sick?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Your nose is running, your head hurts and you feel like you’re coming down with a cold. You’re settling in on the couch for a sick day. Then you reach for the snacks. When you’re sick, your appetite often decreases. So why, at other times, do you crave sugary treats and carbohydrate-loaded comfort foods? A food <a href="https://pubmed.ncbi.nlm.nih.gov/28375878/">craving</a> goes beyond a mere desire to eat, it encompasses a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399671/#CR1">complex mix</a> of emotional, behavioural, cognitive and physiological processes. Whether it’s the need for a quick energy source or a temporary relief from discomfort, our bodies and minds work in tandem to drive our food preferences. Here we’ll explore the science behind why our bodies crave sugar and carbs – especially when we’re sick. <h2>Fuelling the immune system</h2> When sickness strikes, our immune system springs into action, requiring additional energy to combat invaders. This heightened activity often leads to an increase in our <a href="https://pubmed.ncbi.nlm.nih.gov/36505552/">metabolic rate</a>, energy demands and nutritional requirements. Sugary treats and carbs are quick sources of energy, satisfying this increased demand. But while a high sugar diet during times of illness may help meet increased metabolic demands, it could also exacerbate the immune and inflammatory response, potentially impeding recovery. In the longer term, high-sugar diets promote chronic <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a>, <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">alter gut microbiota</a> composition, and are associated with chronic disease. For a <a href="https://www.mdpi.com/2072-6643/12/4/1181">well-functioning immune system</a>, aim for a <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">balanced intake</a> of <a href="https://pubmed.ncbi.nlm.nih.gov/31267783/">fruits, vegetables</a>, fibre, protein, and low-glycaemic carbohydrates. <h2>The stress response</h2> Being sick is stressful for the body. Acute mild or intense stress, like we’d see if we’re sick, boosts the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5921333/">flight or fight</a>” hormones adrenaline and cortisol. This mobilises stored energy to meet increased demands, but it can also curb appetite. <a href="https://pubmed.ncbi.nlm.nih.gov/31125634/">Prolonged stress</a> can disrupt energy balance, and cause nutritional deficiencies and alterations in gut and brain functions. This can reduce a person’s threshold for craving sugar and salt, increasing their preferences towards energy-dense foods. The stress hormone cortisol can also increase your <a href="https://pubmed.ncbi.nlm.nih.gov/24123563/">preference</a> for high-calorie, comfort foods, which can <a href="https://pubmed.ncbi.nlm.nih.gov/36615866/">temporarily alleviate stress</a>. <h2>The brain’s reward system</h2> Comfort foods trigger your brain’s reward system, releasing feel-good neurotransmitters like <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a> and serotonin. But “<a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">sugar rushes</a>” are often short-lived and can lead to decreased alertness and heightened fatigue within an hour of consumption. The link between carbohydrates (which the body converts to sugar) and serotonin can be traced back to 1971 when <a href="https://www.science.org/doi/10.1126/science.174.4013.1023?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">researchers</a> found elevated tryptophan levels (serotonin’s precursor) in rats’ plasma and brains after a carbohydrate-rich diet. Subsequent studies in humans established connections between carbohydrates and mood, especially in relation to <a href="https://pubmed.ncbi.nlm.nih.gov/2903717/">obesity, depression and seasonal affective disorder</a>. Therapies enhancing serotonin have since been shown to <a href="https://pubmed.ncbi.nlm.nih.gov/2903717/">reduce carbohydrate intake</a>. Remarkably, around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911970/pdf/molecules-27-01680.pdf">90% of serotonin</a> production occurs in the gut. The vast microbial population in our gut exerts a potent influence on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106557/">immunity, metabolism</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293578/pdf/40168_2021_Article_1093.pdf">appetite</a>. Recent mouse studies have even identified specific microbes linked to <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01750-X">sugar binges after antibiotic treatment</a>. <h2>Some people eat less when they’re sick</h2> Not everyone craves sugar and carbs when they are sick. Some people eat less for a few reasons: <ul> <li> they have less of an appetite. While <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610818/pdf/JDR2017-4527980.pdf">ghrelin</a> (the “hunger” hormone) levels might initially rise, prolonged illness can suppress appetite due to nausea, fatigue and discomfort. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5921333/">Critically ill</a> patients have reduced food intake and are at risk of malnutrition </li> <li> <a href="https://pubmed.ncbi.nlm.nih.gov/30777142/">metabolic adaptation</a>. The body might slow specific metabolic processes to conserve energy, reducing overall calorie requirements </li> <li> altered taste perception. <a href="https://pubmed.ncbi.nlm.nih.gov/32195512/#:%7E:text=The%20ability%20of%20an%20individual%20to%20perceive%20tastes,intake%2C%20playing%20an%20important%20role%20in%20promoting%20satiation%2Fsatiety.">Taste</a> is an important component that affects both appetite and energy intake. Alterations in taste and smell is a common symptom when we are sick and was common with <a href="https://doi.org/10.1101/2020.04.05.20048421">COVID</a> </li> <li> consuming fluids like water, tea or broths might be more appealing and manageable than solid foods. These fluids provide hydration but contribute minimally to calorie intake.<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/210565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-crave-sugar-and-carbs-when-im-sick-210565">original article</a>.

Body

Why we’re more prone to car-sickness when we set off on holiday

<a href="https://theconversation.com/profiles/william-emond-1431510">William Emond</a>, <a href="https://theconversation.com/institutions/universite-de-technologie-de-belfort-montbeliard-2637">Université de Technologie de Belfort-Montbéliard</a> Travel sickness isn’t just hearsay. Nearly <a href="https://www.autonomicneuroscience.com/article/S1566-0702(06)00212-8/fulltext">a third of people</a> experience motion sickness – and to this day we don’t exactly know what causes it. The prevailing theory suggests it is triggered by a <a href="https://onlinelibrary.wiley.com/doi/10.1111/cns.12468">poor perception of movement</a>. Departure to and return from summer holidays seem moments especially prone to this sickness’ stealthy advances. We (or at least those of us inclined to travel sickness) are more often ill during these particular journeys than during our normal comings and goings. Let’s note too that lots of travellers feel a sense of fatigue, drowsiness, apathy or lack of energy without having done any particularly exhausting activity. These are in fact symptoms of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0094576598001532">mild motion sickness</a>, which show that many more people are affected by the condition than you’d think. Why this apparent heightened susceptibility during holiday trips? There are many reasons. Compared to normal travel, these journeys feature certain conditions, all with the potential to increase the incidence and severity of symptoms. Here are some pieces of explanation, and advice to minimise the risk. <h2>Long journeys – repetition of movements that make you queasy</h2> In a car, the further one travels, the more likely one is to feel ill, as shown by a number of <a href="https://journals.sagepub.com/doi/10.1243/0954407042580093">mathematical models which predict motion sickness</a>. It’s the adding up of unpleasant movements which takes us over the threshold where we feel symptoms. For certain people, this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1566070206002128">can happen after just a few minutes</a>); for others it develops more slowly. Only on long journeys, after several hours on the road, in the air or on a boat, will this latter group be pushed over their limit and start feeling unwell. Activities undertaken to pass the time during a long journey could add to feelings of queasiness. Often people do something to occupy and entertain themselves: read a book, watch a film, play a video game or scroll through social media. Except, these visually stimulating activities absorb our attention to the point that we’re not tuned in to the visual cues that allows our brain to assess the movement of the vehicle. This creates a confusion in the perception of movement. As a result, it becomes <a href="https://www.sciencedirect.com/science/article/abs/pii/S0141938214000043?via%3Dihub">much easier to feel sick</a>. <h2>Journey conditions: risks adding up</h2> In summer, the temperature inside a vehicle is difficult to control, with the sun often imposing a stifling heat; conditions which <a href="https://www.ingentaconnect.com/content/asma/asem/2013/00000084/00000005/art00004">tend to accentuate the symptoms of motion sickness</a>. When it’s hot, <a href="https://theconversation.com/lesquels-de-nos-organes-sont-les-plus-menaces-par-la-canicule-119563">our body has to make an effort to regulate its temperature</a>, through sweat or breathing for example. These various signals amount to ‘primary symptoms’ as they can contribute to the appearance of other more substantive symptoms: dilation of the blood vessels, sickness, nausea or vomiting, as applicable. To counter these effects, one is tempted to switch the air conditioning on, which could itself, perversely, <a href="https://www.francetvinfo.fr/sante/environnement-et-sante/la-climatisation-rend-elle-malade_2885673.html">worsen the situation for passengers highly susceptible to motion sickness</a>. Ventilation and cabin air systems also push people toward their nausea thresholds. Unpleasant smells are another factor that can <a href="https://www.ingentaconnect.com/content/asma/asem/2013/00000084/00000005/art00004">accentuate car sickness symptoms</a>: traffic fumes, cigarette smoke, fetid air or even <a href="https://link.springer.com/article/10.1007/s00221-015-4209-9">the smell of leather</a> were identified as <a href="https://www.sciencedirect.com/science/article/pii/S1369847819306539">second most common cause of car sickness</a>! These are bigger risk factors at the start of holiday season, when <a href="https://www.francetvinfo.fr/economie/transports/trafic/vacances-les-vagues-de-departs-massifs-sont-associees-a-de-fortes-emissions-de-polluants_2839361.html">air pollution peaks regularly</a> and the sun’s rays heat up materials. It’s also known that there is a region of the brain – the area postrema or chemoreceptor trigger zone – which can trigger over-production of saliva and nausea specifically when certain smells are detected – a protective reflex against toxins and other poisonous substances. <h2>Traffic: a physical and mental imposition</h2> In a car, it isn’t speed that makes one ill but <a href="https://www.tandfonline.com/doi/abs/10.1080/001401399184730">changes in speed</a>, especially abrupt ones. Acceleration and breaking movements aggravate the human body, even more than turning corners. In practice, variations in speed are often forced on the driver by road design (speed limits, crossings, traffic lights), but also by the state of the traffic. A car stuck in jams will be forced to speed up and slow down at random intervals, <a href="https://www.researchgate.net/publication/366836220_Effect_of_Horizontal_Acceleration_and_Seat_Orientation_on_Motion_Sickness_in_Passenger_Cars">which grates, even at low speeds</a>. Traffic jams also have a psychological element. Delays to a journey (which might already have been very long), anxiousness about arriving at the arranged time, which is looking less and less likely, tiredness, stress and irritation can all cause the passengers’ mood to crash. It’s been observed that these factors <a href="https://journals.sagepub.com/doi/10.1177/0018720819876139">significantly impact the degree of motion sickness symptoms</a>. It would be better to take these setbacks calmly and stay in a relaxed frame of mind but that’s of course easier said than done. <h2>Some tips to limit the damage</h2> If you’re driving with passengers with a tendency to be car sick, or you’re susceptible yourself, some adjustments to your travel habits might help you. For the driver: <ul> <li> Take regular breaks. This allows passengers to take a breather, and to reduce to a significant extent or even get over their symptoms. Sometimes symptoms can take a while to disappear but <a href="https://content.iospress.com/articles/journal-of-vestibular-research/ves7-6-01">generally 15-30 minutes is enough</a>. </li> <li> Try to cut down the amount of hard acceleration and braking you do. Keep as far as possible to the same speed and adopt a smooth driving style, including when you overtake or brake. </li> <li> Avoid taking corners too sharply on winding roads. Passengers should be <a href="https://www.tandfonline.com/doi/abs/10.1080/00140139.2015.1109713">jolted in their seats as little as possible</a>. </li> </ul> For passengers <ul> <li> <a href="https://www.tandfonline.com/doi/abs/10.1080/001401399184730">Sit as far forward in the vehicle as possible</a>. Any movement while travelling is better absorbed by the body from this position. <a href="https://www.tandfonline.com/doi/abs/10.1080/00140139108964831">It’s in the driver’s seat that people are least affected by car sickness</a>, since one has control over the vehicle’s movement. </li> <li> Avoid looking at screens and other visual content (books, etc.), particularly when the vehicle isn’t moving at a constant speed. Instead, <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/000712699161594">try and look forward out of the window</a>, towards the horizon. </li> <li> <a href="https://www.tandfonline.com/doi/abs/10.1080/00140139.2015.1109713">Shut your eyes</a> or <a href="https://psycnet.apa.org/record/1976-12574-000">try to sleep</a>. Slowing down activity soothes the body. </li> <li> <a href="https://link.springer.com/chapter/10.1007/978-3-030-27928-8_26">Tilt your seat back</a>. This allows you to be less destabilised by the vehicle’s movements </li> <li> Go for car games with the other passengers if you get bored: play “I Spy”, <a href="https://theses.gla.ac.uk/80069/1/13905209.pdf">sing songs</a>, count cars of a particular colour or make, and other old favourites of proven effectiveness to help pass the time and, above all, <a href="http://iospress.com/articles/journal-of-vestibular-research/ves00541">take your attention away from the queasiness</a>. The emergence and disappearance of symptoms is mainly a psychological phenomenon. </li> </ul> Finally, given the role of the mind in car sickness symptoms, note that passengers experiencing queasiness can feel better with a placebo (something with no proven medicinal value but presented to them as a magic cure). Simple tips <a href="https://academic.oup.com/jtm/article/5/2/89/1801039">have been shown to be particularly effective</a>. For example, <a href="https://link.springer.com/article/10.1007/s00221-021-06303-5">offering a sweet, a piece of chewing gum</a>, <a href="https://link.springer.com/article/10.1007/s00221-017-5009-1">a sip of water or a breath of fresh air</a> while talking up their effectiveness will give your fellow travellers a little boost. We wish you happy travels, hoping your journey conditions are as good as they can be. <hr /> Translation from French to English by <a href="https://twitter.com/JoshNeicho">Joshua Neicho</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/210338/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/william-emond-1431510">William Emond</a>, Doctorant en mal des transports (PhD Student on carsickness mitigation), <a href="https://theconversation.com/institutions/universite-de-technologie-de-belfort-montbeliard-2637">Université de Technologie de Belfort-Montbéliard</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/why-were-more-prone-to-car-sickness-when-we-set-off-on-holiday-210338">original article</a>.

Travel Tips

"Disgustingly sick": Family's horrifying find in rental home

A family of six have been forced to move out of their rental home after discovering it had disturbing levels of meth residue. The family became “disgustingly sick” after moving into the home located in Sandstone Point Queensland and were told to pay for toxicity testing and decontamination by their real estate agency. What the tests revealed shocked them, with dangerous levels of methamphetamine residue found in the lounge room, bedrooms, bathrooms and, worst of all, the space used as a toy room for their children. “(It was) basically everywhere,” Queensland mum Emily Thornton told 7News. She added that it was "disgusting" to know that her four kids played in that toxic environment. According to the Clandestine Drug Laboratory Remediation Guidelines, a safe level of meth residue is below 0.5 micrograms per 100 sq cm. Their house had 1.3 micrograms per 100 sq cm - which is reportedly enough to put people's lives at risk. The house was allegedly once used as a meth lab, and the family only got it tested for toxicity when a neighbour, who was suspicious of the previous tenants, flagged the possibility. Now, the family has been left homeless. “We’re not allowed in there,” Thornton said. “Basically, we’re starting from scratch — we’ve got nothing, absolutely nothing at all.” Thornton also added that her family first started feeling sick shortly after they moved in. “We moved in, (and) we lived here for a little while, (and then) everyone started getting sick,” she said. “We were told by the neighbours that they suspected something going on here, so we decided to contact a company to get them to come out and do some testing, and the testing came back positive for meth.” “They’ve told us just to get out, we’ve just taken what we’ve got and walked out the door.” On top of being homeless, the family had to pay $500 for the toxicity and decontamination testing as both the agent and landlord refused to help them pay to get the home tested. “They weren’t interested, and it was up to us to do it if we wanted to do it," Thorton said. 7News reported that the real estate agency will ensure that the property is decontaminated, but the family will still have to pay the cost of an emergency accommodation. “We just don’t know what we’re going to do. We don’t have the money to pay for it,” Thornton said. Australian Meth Alerts spokesperson David Pie said that Meth residue is a common problem that often gets ignored as the contamination is odourless and invisible to the human eye. “It is a well-known fact within the real estate industry with property managers that this is a real issue," he said. “It’s out of control … and it’s just getting ignored,” he added, “In the worst instances, it can cause death, in particular among young kids. But it creates anger and sleeping problems — it just goes on and on and on.” He also said that it was "wrong" for Thornton's family to pay out-of-pocket for the tests. Image: 7News

Caring

Sickness or health: Healthy life split along gender, education lines

Australians are living and working longer than ever, but the number of healthy years they’re enjoying with this added longevity isn’t shared equally between the sexes, or by those who finished school before Year 12. <div class="copy"> A paper recently <a href="https://doi.org/10.1016/S2468-2667(23)00129-9" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://doi.org/10.1016/S2468-2667(23)00129-9">published</a> in The Lancet Public Health from the Ageing Futures Institute at the University of New South Wales shows an increase in longevity in Australia. Other data in the publication reveal detail about “healthy years”. Men, and those with higher levels of education, worked about 2 years longer in good health. For women and those with lower education, the years of healthy life expectancy have gone backwards. The report, led by statistician Dr Kim Kiely who is now based at The University of Wollongong, compared representative cohorts of people aged 50-100 who participated in the Household Income and Labour Dynamics in Australia survey (HILDA). Those cohorts were measured over decade long periods – the first from 2001-2010 and the second from 2011-2020. Men added an extra 11 months of healthy life between the cohorts, while women lost a month. Similarly those of any gender who had completed year 12 added about 10 months to their healthy life expectancy, while the same amount of time was lost by those who hadn’t. “Everyone’s increasing their working life expectancy, so the years they’re expected to be working,” Kiely says. “What is different is how long they’re expected to be living in good health: women and people with low education didn’t have an improvement in healthy life expectancy. “Everyone’s also living longer than ever before, but for women, those extra years seem to be years of poor health. People with lower education – they end up going backwards, they’re losing years of healthy life.” Australia’s working life trends are similar to those in Europe and the UK, though this research suggests the Australian labour force works longer in poor health than their antipodean counterparts. Kiely says the findings are important considerations for policymakers pondering questions of retirement and pension ages: the demands of some labour may not be evenly spread when it comes to considering health implications. “We have a pension age that has been rising steadily over the past couple of decades – it’s not rising anymore – but there is a strong expectation for people to be working longer,” Kiely says. “And if that is the case, then we need opportunities for work for mature age, older adults, and those work opportunities have to be suitable for their capacity to work. “We do need to address things like age and gender discrimination in the workforce. And we need to think about how we support people who are unable to work before they reach the pension age.” Kiely is extending his research into how the nature of work in Australia influences these high-level findings. He hopes this can explain why gender and education influence healthy working years. Further drilling down into other subgroups is important, say Dr Marty Lynch and Dr Ross Wilkie from Keele University, UK. They investigated healthy working life expectancy as part of Britain’s Independent State Pension Age Review last year. They too found Briton were working longer, but not at a rate that keeps pace with the national pension age. In a Lancet editorial accompanying the Australian research, they point out that the HILDA data evaluation only shows changes in average ages on gender and education lines. “The extent of HWLE [Healthy Working Life Expectancy] inequalities between subpopulations with multiple specific characteristics are likely to be even wider and will also indicate targets and interventions to increase the number of years that people can be healthy and in work,” they say. The impact of socioeconomic status on life expectancy and disease burden was recently highlighted in a large-scale review of Australia’s 30-year health data. <a href="https://cosmosmagazine.com/people/society/australias-life-expectancy-is-up-but-healthy-years-are-a-different-story/">It found</a> while Australians have added 6 years to their life expectancy since 1990, those with lower socioeconomic backgrounds had a higher risk of death-causing disease. Image credits: Getty Images <a href="https://cosmosmagazine.com/people/society/sickness-or-health-healthy-life-split-along-gender-education-lines/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="null">Cosmos</a>. </div>

Retirement Life

What happens in our body when we encounter and fight off a virus like the flu, SARS-CoV-2 or RSV?

<a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> <a href="https://www.labcorp.com/coronavirus-disease-covid-19/covid-news-education/covid-19-vs-flu-vs-rsv-how-tell-difference">Respiratory viruses</a> like influenza virus (flu), SARS-CoV-2 (which causes COVID) and respiratory syncytial virus (RSV) can make us sick by infecting our respiratory system, including the nose, upper airways and lungs. They spread from person to person through respiratory droplets when someone coughs, sneezes, or talks and can cause death in serious cases. But what happens in our body when we first encounter these viruses? Our immune system uses a number of strategies to fight off viral infections. Let’s look at how it does this. <h2>First line of defence</h2> When we encounter respiratory viruses, the <a href="https://www.sciencedirect.com/science/article/pii/S193131281600038X?via%3Dihub/">first line of defence</a> is the physical and chemical barriers in our nose, upper airways, and lungs. Barriers like the mucus lining and hair-like structures on the surface of cells, work together to trap and remove viruses before they can reach deeper into our respiratory system. Our defence also includes our behaviours such as coughing or sneezing. When we blow our nose, the mucus, viruses, and any other pathogens that are caught within it are expelled. But sometimes, viruses manage to evade these initial barriers and sneak into our respiratory system. This activates the cells of our innate immune system. <h2>Patrolling for potential invaders</h2> While our acquired immune system develops over time, our innate immune system is present at birth. It generates “non-specific” immunity by identifying what’s foreign. The cells of innate immunity act like a patrol system, searching for any invaders. These innate cells patrol almost every part of our body, from our skin to our nose, lungs and even internal organs. Our respiratory system has different type of innate cells such – as macrophages, neutrophils and natural killer cells – which patrol in our body looking for intruders. If they recognise anything foreign, in this case a virus, they will initiate an attack response. Each cell type plays a slightly different role. Macrophages, for example, will not only engulf and digest viruses (phagocytosis) but also release a cocktail of different molecules (cytokines) that will warn and recruit other cells to <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/cmi.12580">fight against the danger</a>. In the meantime, natural killer cells, aptly named, attack infected cells, and stop viruses from multiplying and <a href="https://www.nature.com/articles/s41577-021-00558-3">invading our body further</a>. Natural killer cells also promote inflammation, a <a href="https://www.hindawi.com/journals/jir/2018/1467538/">crucial part of the immune response</a>. It helps to recruit more immune cells to the site of infection, enhances blood flow, and increases the permeability of blood vessels, allowing immune cells to reach the infected tissues. At this stage, our immune system is fighting a war against viruses and the result can cause inflammation, fevers, coughs and congestion. <h2>Launching a specific attack</h2> As the innate immune response begins, another branch of the immune system called the adaptive immune system is <a href="https://www.ncbi.nlm.nih.gov/books/NBK21070/">activated</a>. The adaptive immune system is more specific than the innate immune system, and it decides on the correct tools and strategy to fight off the viral invaders. This system plays a vital role in eliminating the virus and providing long-term protection against future infections. Specialised cells called T cells and B cells are key players in acquired immunity. T cells (specifically, helper T cells and cytotoxic T cells) recognise viral proteins on the surface of infected cells: <ul> <li> helper T cells release molecules that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764486/">further activate immune cells</a> </li> <li> cytotoxic T cells directly kill infected cells with a very great precision, <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2018.00678/full">avoiding any healthy cells around</a>. </li> </ul> B cells produce antibodies, which are proteins that can bind to viruses, neutralise them, and mark them for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247032/">destruction by other immune cells</a>. B cells are a critical part of memory in our immune system. They will remember what happened and won’t forget for years. When the same virus attacks again, B cells will be ready to fight it off and will neutralise it faster and better. Thanks to the adaptive immune system, vaccines for respiratory viruses such as the COVID mRNA vaccine keep us protected from <a href="https://www.health.gov.au/our-work/covid-19-vaccines/our-vaccines/how-they-work">being sick or severely ill</a>. However, if the same virus became mutated, our immune system will act as if it was a new virus and will have to fight in a war again. <h2>Neutralising the threat</h2> As the immune response progresses, the combined efforts of the innate and adaptive immune systems helps control the virus. Infected cells are cleared, and the virus is neutralised and eliminated from the body. As the infection subsides, symptoms gradually improve, and we begin to feel better and to recover. But recovery varies depending on the specific virus and us as individuals. Some respiratory viruses, like rhinoviruses which cause the common cold, may cause relatively mild symptoms and a quick recovery. Others, like the flu, SARS-CoV-2 or severe cases of RSV, may lead to more severe symptoms and a longer recovery time. Some viruses are very strong and too fast sometimes so that our immune system does not have the time to develop a proper immune response to fight them off. <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/207023/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith 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/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">original article</a>.

Body

“My heart is breaking”: The Wiggles perform for dying young fan

The Wiggles have made a young girl’s dreams come true, as they stood by her and performed just hours before she died. Purple Wiggle Lachlan Gillespie, new Blue Wiggle Lucia Field, and Dorothy the Dinosaur visited young Zahra’s bedside in Westmead Children’s Hospital, just before she passed away last month to perform a sweet rendition of Twinkle Twinkle. Earlier this week, Zahra’s mum posted the sweet video on TikTok, while sharing the story of how Zahra was diagnosed with Leigh syndrome, a rare neurometabolic disorder that affects the central nervous system. “On Zahra’s last day, she got a special visit from her fav Wiggles,” Zahra’s mum wrote in the video shared on her TikTok account. <div class="embed" style="font-size: 16px; box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; vertical-align: baseline; outline: none !important;"><iframe class="embedly-embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border-width: 0px; vertical-align: baseline; width: 611px; max-width: 100%; outline: none !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7254527205701733633&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40keish_el%2Fvideo%2F7254527205701733633&image=https%3A%2F%2Fp16-sign-sg.tiktokcdn.com%2Fobj%2Ftos-alisg-p-0037%2FoACeAheW25teaIoFQJHPEC2YgpcNAKrzDgaksj%3Fx-expires%3D1689325200%26x-signature%3D8aPR7s6As4g3eiheXA%252B7PmnZSBk%253D&key=59e3ae3acaa649a5a98672932445e203&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> In the caption, she added, “This day was so special to us, Zahra was obsessed with the Wiggles and for them to come and see her is a memory we will never forget.” She went on to say that on her last day on earth, her doctors and parents gave her “one full day” off the tube where she got to do “all her favourite things with family and friends”, including the Wiggles. Lucia, who is the daughter of original Blue Wiggle Anthony Field, commented, “Lachy and I were so grateful to have met your beautiful family. May your beautiful little girl be happily resting”. The video has racked up over two million views, with many sharing their condolences for the grieving family. One user said, “I can't handle it. I'm so sorry… my heart breaks for you.” Another emotional viewer wrote, “RIP you little angel, you have earned your wings.” One person wrote that they were praying for Zahra and her family, and her grieving mother responded, “Thank you so much for those prayers. I know they would have kept her with us for as long as she could.” Image credits: TikTok

Caring

6 habits of people who don’t get sick

Winter is a dangerous time. Although cold temperatures themselves don’t cause us to get sick, our winter habits invite the spread of germs and risk of contagion is high. If you find yourself sick every winter, here are some useful habits of those healthy people to take up. 1. They get enough sleep It’s easy to experience disrupted sleep during winter. When air is too cold, it will negatively affect melatonin production and cause the body's sleep cycle to be disrupted. However, research shows that people who sleep only five to six hours a night have a 30 per cent chance of catching a cold when exposed to the virus; those who get more than seven hours reduce their risk to 17 per cent. 2. They pay extra attention to hygiene With more germs in the air, now is the time to stay conscious about where they may be festering. Key areas include bathroom door handles, taps, fridges, elevator buttons and public transport. Keep antibacterial wipes on you so whenever you touch a high risk surface, you can cleanse you hand before eating, or touching your face and eyes. 3. They exercise regularly Winter is notorious for zapping our work-out motivation. However, exercise strengthens the immune system and makes you less likely to catch upper respiratory infections. 4. The get their flu shot Flu shots, approved for all adults, are effective 50 to 60 per cent of the time in preventing the flu and may also reduce the severity of symptoms. 5. They don’t smoke Cigarette smoke appears to damage the mucus membranes, which act as the frontline barrier to infectious agents, making smokers twice as likely to catch a cold and several times more likely to develop the flu. 6. They enjoy a drink Harvard University School of Public Health researchers found that red wine was particularly protective against colds, probably due to the anti-inflammatory action of the phenol, resveratrol. Just keep in mind that drinking more than two glasses a day raises the risk for infections. Image credit: Shutterstock

Body

Why does my back get so sore when I’m sick? The connection between immunity and pain

<a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID? This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”. A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats. <h2>Immunology basics</h2> Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing. When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology. This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual. <h2>Invisibly small changes</h2> Part of this self-protective response is a change in how we perceive threats, including sensory stimuli. When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain. Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>. <h2>Immune memories</h2> This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>. Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are. After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>. Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>. <h2>When to worry and what to do</h2> If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves. While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain. Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>. Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse. Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness. Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications. <h2>All in the mind?</h2> Is this all mind over matter? A little of yes and a lot of no. The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level. But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<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/207222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.

Caring

Breaking the mould: why rental properties are more likely to be mouldy and what’s needed to stop people getting sick

<a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicola-willand-441807">Nicola Willand</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/tim-law-1438482">Tim Law</a> Rental properties are more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8835129/">likely be mouldy</a> than other homes. This is a concern as excessive mould growth is known to <a href="https://www.who.int/publications/i/item/9789289041683">harm human health</a>. Once buildings are infested with mould, the difficult and costly issue of remediation arises. Landlords and tenants are caught in the middle of a tussle over who is responsible for fixing the problem. As one Melbourne renter and research participant told our colleague Maria Gatto, during a study validating mould reporting: <blockquote> The landlord came around [and] walked [into] every room where there’s black mould on the ceiling – like it’s freaking [something out of the TV series] Stranger Things – and she’s like, ‘Oh, a little bit of mould in winter, it’s very normal, it’s fine […] this happens every winter, it’s not a big deal’. </blockquote> Heading into winter, after <a href="https://theconversation.com/la-nina-3-years-in-a-row-a-climate-scientist-on-what-flood-weary-australians-can-expect-this-summer-190542">three consecutive La Niñas</a>, <a href="https://theconversation.com/sudden-mould-outbreak-after-all-this-rain-youre-not-alone-but-you-are-at-risk-177820">conditions are ripe</a> for a mega-mould season. Combining our expertise in health, law, building and construction, we examine the problem of mould in homes and offer guidance for both renters and landlords. <h2>Ideal conditions for growth</h2> Mould is a <a href="https://www.cdc.gov/niosh/topics/indoorenv/whatismold.html">fungal growth</a> that reproduces via tiny airborne particles called spores. When these spores settle on moist, plant-based construction materials such as wood, wallpaper or plasterboard, they can form a new colony. Growth is more likely when homes are cold, humid, lack air flow, or suffer from water damage. Outbreaks have been reported in flooded parts of southeastern Australia. <figure><iframe src="https://www.youtube.com/embed/sD2Ij_QlzwA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Black mould an invisible threat growing behind walls of flood-affected homes (ABC News)</figcaption></figure> So why is the problem of household mould worse in rentals? <a href="https://www.ahuri.edu.au/research/final-reports/338">Weak regulation of tenancy legislation</a> is just one of many factors. Rental properties tend to be poorly maintained, with <a href="https://www.ahuri.edu.au/research/final-reports/338">structural problems</a> such as leaks. Given this, they can be expensive to heat. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=422&fit=crop&dpr=1 600w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=422&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=422&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=531&fit=crop&dpr=1 754w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=531&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/526246/original/file-20230515-19465-odirz2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=531&fit=crop&dpr=3 2262w" alt="A chart showing the percentage of homes with structural defects in each category" /></a><figcaption>Rental homes have more structural defects than owner-occupied homes. <a class="source" href="https://www.ahuri.edu.au/research/final-reports/338">Nicola Willand, using data from Moore et. al., (2020), Warm, cool and energy-affordable housing policy solutions for low-income renters, AHURI Final Report, vol. no. 338. Appendix 2</a>, Author provided</figcaption></figure> <h2>How mould makes people sick</h2> The <a href="https://www.who.int/publications/i/item/9789289041683">World Health Organization</a> recognises mould can be harmful. A 2022 Asthma Australia <a href="https://asthma.org.au/what-we-do/advocacy/housing/">report</a> revealed people living in mouldy homes were more likely to have asthma and allergies. A systematic review of peer-reviewed research found <a href="https://erj.ersjournals.com/content/38/4/812">children living in mouldy homes</a> were more likely to experience asthma, wheeze and allergic irritation of the eyes, nose, throat and mouth (allergic rhinitis). Living with mould is a source of stress. People worry about the consequences for their health and there is a growing body of evidence describing the <a href="https://jech.bmj.com/content/50/1/56">negative mental health effects</a> of mouldy, damp homes. <h2>Problems with managing mould in the rental sector</h2> There is a gap between building and residential tenancies legislation. A building deemed to meet the minimum standards of the construction code with respect to mould may not meet the minimum standards for rental. That’s because there’s ambiguity in the <a href="https://ncc.abcb.gov.au/">National Construction Code</a> around “minimum standards of health”. For example the Victorian <a href="https://www.legislation.vic.gov.au/in-force/acts/building-act-1993/136">Building Act 1993</a> contains some provisions for the relevant surveyor to serve a notice on the basis of a health circumstance affecting a user. However, there is no guidance on how to assess the health of the indoor environment, or to deliver a building direction that will address the root cause for mould. This varies by state and territory. Mould remediation can be costly. A <a href="https://www.vba.vic.gov.au/about/research/examining-indoor-mould-and-moisture-damage-in-victorian-residential-buildings">study</a> by Victoria University found half the defects causing mould were water-related. These were more expensive to fix than other problems, by an average of A$7,000. Each winter, <a href="https://tenantsvic.org.au/advice/common-problems/mould-and-damp/">Tenants Victoria</a> deals with a spike in renters seeking legal help to resolve their mould problems. This led to the service launching an annual winter Mould Clinic in 2021. Despite increased legal protections, renters are still struggling to get mould fixed. For these reasons, many renters find the legal process doesn’t offer a solution to their problem, and instead move to a new property, with all its attendant costs and stresses. Others can’t afford to leave, or live in social housing with limited transfer options. <h2>Charting mould in homes across Australia</h2> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/525848/original/file-20230512-21-xb83ft.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="A bar chart comparing the prevalence of mould in homes across Australian states and territories" /></a><figcaption>Mould is more prevalent in rentals compared to owner-occupied dwellings. Mould is most commonly reported in New South Wales. The difference between owners and renters is greatest in the ACT. Australian Housing Conditions Dataset 2022 doi:10.26193/SLCU9J, Author provided</figcaption></figure> <h2>Where does the responsibility lie?</h2> Tenancy legislation varies by state and territory. Renters should familiarise themselves with the regulations in their jurisdiction. In Victoria, <a href="https://www.legislation.vic.gov.au/in-force/acts/residential-tenancies-act-1997/101">residential tenancies legislation</a> has set the criteria that “each room in the rented premises must be free from mould and damp caused by or related to the building structure”. Landlords now must disclose if they have treated mould in the past three years. Similarly, <a href="https://www.rta.qld.gov.au/rental-law-changes">new legislation in Queensland</a> (coming into effect in September) states rental properties should be free from vermin, damp and mould where this is caused by issues with the structural soundness of the property. In New South Wales, the landlord needs to <a href="https://www.fairtrading.nsw.gov.au/housing-and-property/renting/during-a-tenancy/health,-safety-and-security">disclose signs of mould</a> and dampness in the condition report (but not necessarily have fixed it). Mould is not mentioned in the <a href="https://www.legislation.act.gov.au/a/1997-84/">ACT residential tenancies legislation</a>. For the most part, the responsibility for mould in rental properties lies with landlords if the cause is structural –- for example, if a broken or faulty window frame has let rainwater inside. Requests for urgent repairs can be accompanied by an assessment report by an occupational hygienist, environmental health professional or expert from the local council. People with an existing health condition such as asthma can include a doctor’s report. <h2>What next?</h2> To achieve change across all relevant domains of regulation, construction, natural disaster response and government policy, we need a sustainable, broad healthy <a href="https://www.healthyhousing-cre.org">housing agenda in Australia</a>. We also need to consider options for immediate action. As one Victorian renter noted: <blockquote> When we buy a car for the purpose of driving on the roads, we’re required to get a roadworthy certificate to make sure it’s safe, because of the risk to other people […] Ideally it would be great if there was [some] kind of ‘rentworthy’ certificate […] to demonstrate that the property has been inspected, to identify any structural issues that might affect the tenant’s health and wellbeing. And that that be available to tenants […] before they enter into a lease or before (the property is) even able to be advertised. </blockquote> Quotes in this article were collected by Maria Gatto as part of her Masters of Public Health, conducted at the Melbourne School of Population and Global Health in 2022.<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/205472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rebecca-bentley-173502">Rebecca Bentley</a>, Professor of Social Epidemiology and Director of the Centre of Research Excellence in Healthy Housing at the Melbourne School of Population and Global Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicola-willand-441807">Nicola Willand</a>, Senior Lecturer, School of Property, Construction and Project Management, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/tim-law-1438482">Tim Law</a>, Guest lecturer and Practice Lead — Building Sciences, at Restoration Industry Consultants 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/breaking-the-mould-why-rental-properties-are-more-likely-to-be-mouldy-and-whats-needed-to-stop-people-getting-sick-205472">original article</a>.

Real Estate

Should I get a flu vaccine this year? Here’s what you need to know

<a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> After having low rates of influenza (flu) transmission in recent years thanks to our COVID control strategies, case numbers are now rising. So far this year, Australia has had <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">more than 32,000</a> lab-confirmed cases of the flu and 32 deaths. Getting a flu vaccine is the best way to protect against getting the flu. These are reformulated each year to protect against the most widely circulating strains – if our predictions are right. Below you’ll find everything you need to know about the 2023 flu vaccine. But first, some flu basics. <h2>What are the different types of flu?</h2> There are two main types of influenza: influenza A and influenza B. On the surface of the influenza virus there are two main proteins, the hemagglutinin (HA or H) and neuraminidase (NA or N). Different strains are named after their versions of the H and N proteins, as in H1N1 or “swine flu”. <figure class="align-center "><img src="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=396&fit=crop&dpr=1 600w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=396&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=396&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=498&fit=crop&dpr=1 754w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=498&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=498&fit=crop&dpr=3 2262w" alt="" /><figcaption>HA is the yellow spike, while the NA is the green oval. <a class="source" href="https://www.shutterstock.com/image-vector/structure-influenza-virus-infographics-vector-illustration-542924464?src=ixiW0w-59I3I17RpN4L3wQ-1-12">Shutterstock</a></figcaption></figure> Minor changes in the proteins (HA and NA) on the surface are common because the enzyme the virus uses to make copies of itself is prone to errors. Sometimes the influenza virus can change more abruptly when it mixes up components from different influenza viruses – including influenza viruses that typically infect birds, pigs or bats – to create a virus that’s basically new. The regular change in the virus is the reason the vaccine is updated every year. The <a href="https://www.tga.gov.au/about-tga/advisory-bodies-and-committees/australian-influenza-vaccine-committee-aivc">Australian Influenza Vaccine Committee</a> meets late in the year to plan what should be included in the vaccine for the following season, after considering what happened in our last flu season and in the Northern hemisphere winter. <h2>What strains does this year’s flu shot protect against?</h2> Modern flu vaccines typically protect against four strains. For this year’s vaccine, the committee <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2023">has recommended</a> it includes: <ul> <li> an A/Sydney/5/2021 (H1N1)pdm09-like virus </li> <li> an A/Darwin/9/2021 (H3N2)-like virus </li> <li> a B/Austria/1359417/2021 (B/Victoria lineage)-like virus </li> <li> a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus. </li> </ul> The naming of the viral components can sometimes be confusing. The name is <a href="https://www.cdc.gov/flu/about/viruses/types.htm">derived from</a> the virus type (A or B)/the place it was first isolated/strain number/year isolated (virus subtype). This year’s vaccine therefore includes an influenza A virus similar to the 2009 pandemic-causing H1N1 isolated from Sydney in 2021 and a second influenza A virus (H3N2) isolated in Darwin in 2021. Influenza B viruses are classified into 2 lineages: Victoria and Yamagata. This year’s vaccine includes an influenza B isolated from Austria in 2021 (Victoria lineage) and an influenza B isolated in Phuket in 2013 (Yamagata lineage). <h2>Who should get a flu shot?</h2> Health authorities <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">recommend</a> everyone aged six months of age or over should get the flu vaccine every year. <a href="https://www.health.gov.au/news/2023-national-immunisation-program-influenza-vaccination-early-advice-for-vaccination-providers">Some groups</a> are at greater risk of significant disease from the flu and can access the flu vaccine for free. This includes: <ul> <li> Aboriginal and Torres Strait Islander people aged six months and over </li> <li> children aged six months to five years </li> <li> pregnant women at any stage of pregnancy </li> <li> people aged 65 years or over </li> <li> people aged five years to 65 years who have certain underlying health conditions affecting the heart, lungs, kidneys or immune system, and those with diabetes. </li> </ul> <h2>How can I get it?</h2> You can get a flu shot from your local general practice or pharmacy. Or you may have an opportunity to get vaccinated at your workplace if your employer supplies it. While the vaccine is free for those in the <a href="https://www.health.gov.au/sites/default/files/2023-02/fighting-flu-starts-with-you-consumer-fact-sheet.pdf">above groups</a>, there can be a consultation or administration fee, depending on where you get your vaccine. If you aren’t eligible for a free vaccine, it usually costs around A$20-$30. <h2>Are there different options?</h2> For over 65s, whose immune systems may not work as well as when they were younger, a <a href="https://www.health.gov.au/sites/default/files/2023-03/atagi-advice-on-seasonal-influenza-vaccines-in-2023.pdf">specific vaccine</a> is available that includes an adjuvant which boosts the immune response. This is free for over-65s under the national immunisation program. A high-dose vaccine is also available for people aged 60 and over. However this isn’t currently funded and costs around $70 on a private prescription. People with egg allergies can safely get the egg-based flu vaccine. However there is also a cell-based immunisation for people who don’t want a vaccine made in eggs. When vaccines are grown in eggs, sometimes the virus can change and this might affect the level of protection. Cell-based vaccines aim to address this issue. The cell-based vaccine isn’t funded so patients will pay around $40 for a private prescription. <h2>How well do they work?</h2> The vaccine’s effectiveness depends on how well the strains in the vaccine match those circulating. It generally <a href="https://www.health.gov.au/resources/publications/aisr-2022-national-influenza-season-summary">reduces</a> the chance of being admitted to hospital with influenza by <a href="https://www.health.gov.au/sites/default/files/documents/2022/08/influenza-vaccine-efficacy-effectiveness-and-impact-explained.docx">30-60%</a>. <h2>What are the side effects?</h2> You can’t get the flu from the vaccine as there’s no live virus in it. When people get a flu-like illness after the vaccine, it can be due to mild effects we sometimes see after vaccination, such as headaches, tiredness or some aches and pains. These usually go away <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#possible-side-effects-of-influenza-vaccination">within a day or two</a>. Alternatively, symptoms after getting a flu shot may be due to another respiratory virus such as respiratory syncytial virus (RSV) that circulates in winter. <h2>When’s the best time to get your flu shot?</h2> The vaccine provides <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#vaccine-information">peak protection</a> around three to four months <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#when-to-get-the-influenza-vaccine">after</a> you get it. The <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">peak of the flu season</a> is usually between June and September, however this changes every year and can vary in different parts of the country. Given this, the best time to get the vaccine is usually around late April or early May. So if you haven’t already, now would be a good time to get it.<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/203406/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Associate Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/should-i-get-a-flu-vaccine-this-year-heres-what-you-need-to-know-203406">original article</a>.

Body

Scented products may be making us sick

From body wash, air fresheners and hand soap to our household cleaners, scented products may be making us sick, according to new research. The University of Melbourne study found that one in three Australians reported adverse health effects – including breathing problems, migraine headaches, skin irritation and asthma attacks – from fragranced products. "There's a belief that fragrance products in some way improve air quality but the opposite is actually true: fragrance products impair rather than improve indoor air quality and they pose a range of health and economic risks," says lead author Professor Anne Steinemann, a world expert on environmental pollutants, air quality, and health effects. "Some people have immediate, severe and disabling health effects. But the effects can be very subtle and insidious and people may not realise they're being affected until it's too late." Steinemann says the findings confirm her previous research on the subjects, including an <a href="http://www.smh.com.au/lifestyle/health-and-wellbeing/wellbeing/a-problem-of-hidden-hazards-common-fragrances-a-public-health-problem-20161026-gsax8k.html">American study she published in 2016</a> and a yet-to-be published British study. "There's something about these fragrance chemicals. It doesn't matter whether the product is called 'green', 'organic', 'natural' or with 'essential oils', basically if it has a fragrance it can cause health problems," she said. "When I've analysed these fragranced products called 'green', 'organic', 'all-natural', there's little difference in the hazardous chemicals they emit compared to regular versions." There is currently no law in Australia that requires the disclosure of all the chemicals in a fragrance or a consumer product. "We have very little information on the toxicity of these mixtures – there's a focus on individual chemicals. Also very little information on the toxicity of a natural versus synthetic version of a chemical,” says Steinemann. Images: Getty

Body

"Makes us feel sick": Angry vegan slams meat-eating neighbours

A letter from a vegan neighbour has gone viral, as they asked a close-by resident to close their windows while they cook meat. The hand-written note was published on a community Facebook page for the Perth northern coastal suburb of Burns Beach, and was labelled as an "Important message" for the recipient to "Please take seriously". The note began, "Hello, neighbour." "Could you please shut your side window when cooking, please?" "My family are vegan (we eat only plant-based food), and the smell of the meat you cook makes us feel sick and upset." "We would appreciate your understanding." The letter went viral not long after it was posted, and drew in a range of divided comments. Some people believed the request was a ridiculous ask, with many people wondering where they draw the line when it comes to catering for others. "I'd understand if they were smoking cigarettes and the smoke and smell was spreading and affecting the family's health," one person wrote. "But not liking the smell of meat, this isn't really a good reason to ask someone to close their windows." "What does she do when she takes the kids to the park, and people are cooking BBQs? Ask them to stop cooking. Audacity." Others thought the request was reasonable, and praised the writer's politeness. "I feel like this was a genuinely polite letter, and it’s true the smell of meat is overpowering," one person wrote. "It would be nice to see some respect for your neighbours, and not publicly trying to shame them for holding strong ethical morals." Another put it simply, "Be vegan. Eat meat. Each to their own!" One commenter suggested the recipient resort to good old neighbourly pettiness, encouraging them to "Write back and say you're offended and sad by what they said about your cooking and could they please move to a different room as you would appreciate their understanding." Image credits: Facebook

Food & Wine

The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick

Are we in the midst of a wellbeing pandemic? The question may seem curious, even contradictory. But look around, the concept is everywhere and spreading: in the media, in government institutions and transnational organisations, in schools, in workplaces and in the marketplace. To be clear, it’s not just wellbeing’s infectiousness in public discourse that makes it pandemic-like. It’s also the genuine malaise that can be caused by the term’s misuse and exploitation. Do you sense, for example, that your wellbeing is increasingly being scrutinised by peers, managers and insurance companies? Are you noticing an increasing number of advertisements offering products and services that promise enhanced wellbeing through consumption? If so, you’re not alone. But we also need to ask whether this obsession with wellbeing is having the opposite to the desired effect. To understand why, it’s important to look at the origins, politics and complexities of wellbeing, including its strategic deployment in the process of what we call “<a href="https://otagouni-my.sharepoint.com/personal/jacst99p_registry_otago_ac_nz/Documents/Documents/SJ-Wellness/SJ-Conversation-Wellbeing/Jackson-Sam-Dawson-Porter-Frontiers-Sociology-Wellbeing-2022.pdf">wellbeing washing</a>”. <h2>The halo effect</h2> While concerns about wellbeing can be traced to antiquity, the term has emerged as a central feature of contemporary social life. One explanation is that it is often conflated with concepts as diverse as happiness, quality of life, life satisfaction, human flourishing, mindfulness and “wellness”. Wellbeing is flexible, in the sense that it can be easily inserted into a diverse range of contexts. But it’s also surrounded by a kind of halo, automatically bestowed with a positive meaning, similar to concepts such as motherhood, democracy, freedom and liberty. To contest the value and importance of such things is to risk being labelled a troublemaker, a non-believer, unpatriotic or worse. These days, there are two main concepts of wellbeing. The first – subjective wellbeing – emphasises a <a href="https://www.frontiersin.org/articles/10.3389/fsoc.2022.950557/full#B21">holistic measure</a> of an individual’s mental, physical and spiritual health. This perspective is perhaps best reflected in the World Health Organization’s <a href="https://www.corc.uk.net/outcome-experience-measures/the-world-health-organisation-five-well-being-index-who-5/">WHO-5 Index</a>, designed in 1998 to measure people’s subjective wellbeing according to five states: cheerfulness, calmness, vigour, restfulness and fulfilment. Translated into more than 30 languages, the overall influence of the WHO-5 Index should not be underestimated; both governments and corporations have embraced it and implemented policy based on it. But the validity of the index, and others like it, has been questioned. They’re prone to oversimplification and a tendency to marginalise alternative perspectives, including Indigenous approaches to physical and mental health. <h2>Individual responsibility</h2> The second perspective – objective wellbeing – was a response to rising social inequality. It focuses on offering an <a href="https://www.frontiersin.org/articles/10.3389/fsoc.2022.950557/full#B60">alternative to GDP</a> as a measure of overall national prosperity. One example of this is New Zealand’s <a href="https://www.treasury.govt.nz/information-and-services/nz-economy/higher-living-standards/our-living-standards-framework">Living Standards Framework</a>, which is guided by four operating principles: distribution, resilience, productivity and sustainability. These new and purportedly more progressive measures of national economic and social outcomes signal societal change, optimism and hope. The trouble with such initiatives, however, is that they remain rooted within a particular neoliberal paradigm in which individual behaviour is the linchpin for change, rather than the wider political and economic structures around us. Arguably, this translates into more monitoring and “disciplining” of personal actions and activities. Intentionally or not, many organisations interpret and use wellbeing principles and policies to reinforce existing structures and hierarchies. Consider how the wellbeing agenda is playing out in your organisation or workplace, for example. Chances are you have seen the growth of new departments, work units or committees, policies and programs, wellness workshops – all supposedly linked to health and wellbeing. You may even have noticed the creation of new roles: wellbeing coaches, teams or “champions”. If not, then “lurk with intent” and be on the lookout for the emergence of yoga and meditation offerings, nature walks and a range of other “funtivities” to support your wellbeing. <h2>Wellbeing washing</h2> The danger is that such initiatives now constitute another semi-obligatory work task, to the extent that non-participation could lead to stigmatisation. This only adds to stress and, indeed, unwellness. Deployed poorly or cynically, such schemes represent aspects of “wellbeing washing”. It’s a strategic attempt to use language, imagery, policies and practices as part of an organisation’s “culture” to connote something positive and virtuous. In reality, it could also be designed to enhance productivity and reduce costs, minimise and manage reputational risk, and promote <a href="https://otagouni-my.sharepoint.com/personal/jacst99p_registry_otago_ac_nz/Documents/Documents/SJ-Wellness/SJ-Conversation-Wellbeing/Jackson-Sam-Dawson-Porter-Frontiers-Sociology-Wellbeing-2022.pdf">conformity, control and surveillance</a>. Ultimately, we argue that wellbeing now constitutes a “field of power”; not a neutral territory, but a place where parties advance their own interests, often at the expense of others. As such, it’s essential that scholars, policymakers and citizens explore, as one author <a href="https://www.google.com.au/books/edition/Measuring_Wellbeing/lWBXjk1nocIC?hl=en&gbpv=1&dq=%E2%80%9Cwhat+and+whose+values+are+represented,+which+accounts+dominate,+what+is+their+impact+and+on+whom%E2%80%9D&pg=PA4&printsec=frontcover">put it</a>, “what and whose values are represented, which accounts dominate, what is their impact and on whom”. Because if wellbeing is becoming a pandemic, we may well need the “vaccine” of critical reflection. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/the-wellbeing-pandemic-how-the-global-drive-for-wellness-might-be-making-us-sick-198662" target="_blank" rel="noopener">The Conversation</a>.

Caring

8 simple measures to avoid sickness overseas

At best, getting sick overseas is an annoying inconvenience that takes time away from your trip. At worst, the outcomes of falling ill in another country can be potentially disastrous. As with most things in life, when it comes to overseas illnesses prevention is better than the cure, so we’ve put together a list of eight simple measures that will ensure you stay healthy overseas. Before you book anything, it’s a good idea to check this website and see if there are any medical warnings/requirements for your planned destinations. Once you’ve booked accommodation and tickets, you can register your plans to ensure you’re easily accessible in an emergency. To stay healthy when travelling overseas, we recommend you take the following measures: <ol> <li>Visit a travel health specialist, particularly if you’re visiting parts of the world that require vaccinations. These medical professionals can administer the vaccination.</li> <li>Take out travel insurance, which will ensure that you are covered for activities you’re undertaking, as well as any the event of hospital treatment or medical evacuation. </li> <li>Keep your insurance company’s contact details handy, and with you at all times. If they’ve got an emergency assistance card even better. It’s also important to contact the company the second you feel as though you need help. Most travel insurance companies provide 24-hour emergency contact and advice services for travellers signed onto their policies.</li> <li>Consider taking a traveller’s medical kit, which can be filled with useful items such as aspirin, antiseptic, cotton wool, band aids, insect replant and hand sanitiser.</li> <li>Exercising good personal hygiene, as well as a degree of care in regards to what you’re eating and drinking can go a long way to help avoid the dreaded symptoms of gastro.</li> <li>Pack mosquito repellent, and wear clothing items like long-sleeved shirts and long pants to avoid being bitten by mosquitos as they could be carrying some nasty diseases.</li> <li>Avoid contact with dogs, and other animals like monkeys that may be carrying rabies.</li> <li>Get a quick check up, when you return home, particularly if you’ve felt ill when away.</li> </ol> Image credits: Getty Images

Travel Tips

Johnny Ruffo’s Christmas present to sick children

Johnny Ruffo has praised his girlfriend Tahnee Sims for being by his side as he continues through treatment for brain cancer. The former Home and Away actor said that he owed everything to his incredible girlfriend who he joked had it harder than him because “she has to deal with me”. "Having Tahnee by my side every step of the way, literally and metaphorically, she's incredible. I couldn't do it without her,” he told 9Honey. "She does it just as hard as I do. She's having to deal with all the doctors and what they're saying, and then she has to deal with me once we get home as well.” The singer is going through chemotherapy once every three weeks and said he wanted to give gave as the holiday season creeps up. Ruffo partnered with Amazon Australia to help twelve superhero children from the Starlight Children’s Foundation to become official toy testers for the festive season. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Cj45neCLNj2/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Cj45neCLNj2/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Johnny Ruffo (@johnny_ruffo)</a> </div> </blockquote> "It brings such joy to me. It's a privilege to be able to know that you are helping them forget about everything that they're going through," he said in the Starlight Children's Foundation campaign. "I feel like I get as much out of it as the kids. It's quite cathartic for me to be able to bring joy to these children who are somewhat in a similar position." The 34-year-old was first diagnosed with brain cancer in 2017 after struggling with multiple headaches. Ruffo then announced in 2019 that he was in remission, but by November 2020 the cancer had returned, before confirming in 2022 that his illness is terminal. He has also recently released a memoir called No Finish Line, dedicated to his girlfriend, in which he details his experiences recording music, acting, his family and loved ones. The title, he explains, is that “it wasn’t the end”. Images: Instagram

Caring

Six tricks to combat air travel sickness

If there’s one thing that's guaranteed to ruin a travel experience, it’s unexpected motion sickness, as there's nothing worse than feeling ill and not being able to escape until you land. Experts at Travel Lens have shared their holy grail tips for people to do before and during their flights to help reduce air sickness travel symptoms. Airsickness, otherwise known as motion sickness, is caused when the body receives conflicting information from the eyes, ears and muscles in regards to movement. This confuses the brain, which can cause nausea, fatigue and dizziness. "Air sickness is very common and with plenty of holidays still to come this year, it's important that people can enjoy them fully without the added stress of feeling ill on the plane," a spokesperson told <a href="https://travel.nine.com.au/latest/travel-advice-tricks-to-combat-airsickness-on-flights-expert/91e42ab8-ae9b-4b5a-a0f2-88525ee38886#1">9Honey</a>. "For some people, sickness may be a persistent problem when travelling, but there are certain things that can be implemented to help ease any symptoms.” "Whilst on the plane it's important to stay as calm as possible and by making small adjustments you can reduce the effects of airsickness." Select your seat mindfully Your position on a plane has a drastic effect on how much movement you can expect throughout your journey. Typically the middle, the wing and closer to the front of the plane are the best places to sit as this is where the journey feels most stable. Try to avoid the back of the plane as seats further back can be subject to more turbulence. Put the book and screens down While reading or watching is a great way to pass the time on a flight, focusing on these forms of entertainment can only exacerbate the feeling of motion sickness. The best thing to do instead of reading or watching something is to try to relax and focus on breathing. Avoid alcohol Many people are inclined to indulge in an alcoholic drink on a plane, however the effects of drinking while travelling are often less than desirable. Alcohol can dehydrate the body quickly and this can exacerbate symptoms, so it may be best to opt for a soda. Wait until symptoms have completely subsided before you consider having a drink or until you land. Use mint and ginger Some studies have suggested consuming ginger before heading off on a flight can help to stop feelings of nausea. Whether it's taken as a supplement, in raw form or even as a can of ginger beer, it's definitely worth a try. The same can be said for peppermint, so taking a packet of breath mints in your carry-on is a must. Choose your food wisely While plane food is always a bit of a gamble, it's a good idea to eat before boarding. Steer clear of greasy and spicy foods as these can unsettle an already nervous stomach. And make sure you stay hydrated! Get comfortable Instead of staying upright for your whole flight, take advantage of a slight recline in your seats (just don’t forget to talk to the person sitting behind you first!) Consider taking a travel pillow to ease the strain on the neck throughout the flight and put any unnecessary items in the overhead storage to ensure the most comfortable environment for dealing with any sickness symptoms. Use the blankets provided and tune out any noise, and focus on deep breathing until you arrive safely at your destination. Image credits: Getty Images

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