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How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast. Give meditation a try As a mindfulness coach, I’m very aware of the day-to-day anxieties and worries that can interfere with a good night’s sleep. One of the most effective natural sleep aids is a quick meditation session to ease yourself out of those stresses. If you’ve never meditated before, you’ll likely find the meditation interrupted by thoughts flashing through your mind. It’s important for you to know that this isn’t a failure on your part, and that you aren’t doing anything wrong. Thinking is just what the brain does, as naturally as lungs take in air. The point is to be non-judgmental yet aware of your thoughts, bodily experiences and breath, moment by moment. Sleep better, feel better! <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/rollers-resistance/27-72435-gaiam-strengthen-stretch-kit?affiliate=GAIAM6O" target="_blank" rel="noopener">This Blackout Sleep Mask from Gaiam</a> will help you feel well rested and renewed. Stop wanting to fall asleep It’s counterintuitive, isn’t it? Sometimes trying too hard to do something is the very thing that prevents us from achieving it – and that’s never more true than when it comes to falling asleep. Desperately wanting to sleep will only stoke anxieties that will further stress your brain, essentially feeding it the message that it’s not safe to sleep. Throw in those worries about your to-do list at work the following day, and the whole thing can snowball into a panic attack. Try letting go of that feeling that you absolutely must sleep now, and observe your own anxieties for what they are without judgment. When you stop looking at sleep as a goal, you’ll find it easier to fall asleep. Before you climb into bed, set aside 10-15 minutes to help relax your body and mind, with <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/restore-massage/27-73353-gaiam-wellness-acupressure-neck-back-pillow?affiliate=GAIAM60" target="_blank" rel="noopener">this wellness acupressure neck and back pillow from Gaiam</a>. Start a journal If you find yourself struggling to fall asleep, pick up a pen and paper (not your phone!), and start writing: simply scribble down an account of what’s going on inside your head. Although there’s no “right” way to journal, you might start by listing the events of your day, and from there, how those events and encounters made you feel. Building this structured picture of your thoughts may help you see that the problem that’s keeping you up at night, and is likely less overwhelming than you thought. Why my insistence on a pen and paper? First off, studies show the simple motor action that’s involved in the act of handwriting has a calming effect. Secondly, the light emitted by laptops and phones isn’t conducive to falling asleep. Find yourself a "3am friend" Some of us are lucky to have a ‘3am friend’, that close confidant you can call up in the wee hours knowing that they won’t hold it against you in the morning. Although it’s great to have someone to talk to when you want to fall asleep, it’s important that the conversation doesn’t just rehash the anxieties that are preventing you from catching shut-eye in the first place. Rather than using the call to seek solutions for those issues, talk about things that calm your nerves, or even have them assist you in deep breathing. It may sound silly, but doing a series of deep, relaxing breaths can help you let go of the troubles that are keeping you wide awake. Take a warm shower Taking a warm shower not only relaxes your muscles and soothes minor aches and pains, but it also raises your core body temperature. As soon as you step out of the shower, your body starts working at lowering that temperature, which is something that normally happens when you’re falling asleep naturally. (That’s why we always feel the need for a blanket when we sleep, no matter how warm it is!) By kick-starting that temperature-lowering process, you’re tricking your body into falling asleep fast. Stretch yourself to sleep Anxiety keeping you up? Research suggests mild stretching can help take the edge off and relax muscles that have become stiff and sore after a long day. We’re not talking intricate yoga poses or acrobatics here, either: Simple stretches like an overhead arm stretch and bending over to touch your toes should do the trick. Ramp up the relaxation potential with a soundtrack of ambient noise at a volume that’s just barely audible. There are plenty of white noise apps that are free to download, but soft music can work as well (so long as there are no lyrics). Just remember, if you’re using an electronic device to play these sleep-promoting sounds, make sure it’s placed screen-down so you’re not distracted by the light it emits. Stretching is healing, and this <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/rollers-resistance/27-72435-gaiam-strengthen-stretch-kit?affiliate=GAIAM60" target="_blank" rel="noopener">Strengthen and Stretch Kit from Gaiam</a> is a great way to start. An on-line workout is also included to get you started. Read (or listen!) to something new When you’re struggling with insomnia, it might be tempting to pull an old favourite off the bookshelf. In reality, it’s better to read or listen to an audio book that covers a topic on which you know absolutely nothing. New information, while taking attention away from the stressors that are keeping you up at night, gives your brain enough of a workout to make it tire more quickly than when it’s engaged with familiar subjects and concepts. Again, if it’s an audio book or podcast you’re listening to, make sure the light-emitting side of the device is face down to keep the room as dark as possible. Darkness and warmth play an essential part in the production and maintenance of melatonin, the hormone that plays the central role falling asleep. Image credits: Getty Images This article by Deepak Kashyap originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/sleep/how-to-fall-asleep-without-sleeping-pills-7-natural-sleep-aids-that-actually-work" target="_blank" rel="noopener">Reader's Digest</a>.

Body

10 million animals die on our roads each year. Here’s what works (and what doesn’t) to cut the toll

<a href="https://theconversation.com/profiles/graeme-coulson-1378778">Graeme Coulson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/helena-bender-98800">Helena Bender</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> There’s almost no warning. A dark shape appears on the side of the road, then you feel a jolt as something goes under the car. Or worse, the shape rears up, hits the front of your vehicle, then slams into the windscreen. You have just experienced a wildlife-vehicle collision. This gruesome scene plays out <a href="https://www.bbcearth.com/news/australias-road-kill-map">every night across Australia</a>. When these collisions happen, many animals become instant roadkill. An <a href="https://ses.library.usyd.edu.au/bitstream/handle/2123/23121/Thesis%20updated%20for%20library%20submission.pdf?sequence=1">estimated 10 million</a> native mammals, reptiles, birds and other species are killed each year. Others are injured and die away from the road. Some survive with <a href="https://theconversation.com/10-million-animals-are-hit-on-our-roads-each-year-heres-how-you-can-help-them-and-steer-clear-of-them-these-holidays-149733">terrible injuries and have to be euthanised</a>. The lucky ones might <a href="https://kb.rspca.org.au/knowledge-base/who-should-i-contact-about-injured-wildlife/">be rescued</a> by groups such as <a href="https://wildliferescue.net.au/">Wildlife Rescue</a>, <a href="https://www.wildlifevictoria.org.au/">Wildlife Victoria</a> and <a href="https://www.wires.org.au/">WIRES</a>. Wildlife-vehicle collisions also increase the risk to whole populations of some threatened species, such as <a href="https://doi.org/10.1071/WR17143">Lumholtz’s tree-kangaroo</a> on the Atherton Tablelands in Queensland. People are affected, too. Human <a href="https://doi.org/10.1111/1742-6723.13361">deaths and injuries</a> from these collisions are rising, with motorcyclists at greatest risk. Vehicle repairs are <a href="https://www.mynrma.com.au/-/media/wildlife-road-safety-report--final.pdf">inconvenient and costly</a>. Added to this is the distress for people when dealing with a dead or dying animal on the roadside. How can we reduce the wildlife toll on our roads? Many measures have been tried and proven largely ineffective. However, other evidence-based approaches can help avoid collisions. <h2>Evidence for what works is limited</h2> Many communities are worried about the growing impacts of wildlife-vehicle collisions and are desperate for solutions. Recent reports from <a href="https://www.diva-portal.org/smash/get/diva2:1822182/FULLTEXT01.pdf">Europe</a> and <a href="https://westerntransportationinstitute.org/wp-content/uploads/2021/12/4w7576_Huijser_etal_WVC_ConnectivityLiteratureReview_PooledFundStudyFinalReport_2021.pdf">North America</a> review the many methods to reduce such collisions. Do these findings apply to Australia’s unique fauna? Unfortunately, we don’t have a detailed analysis of options for our wildlife, but here’s what we know now. Well-designed fences keep wildlife off our highways but also fragment the landscape. Happily, animals will use crossing structures – overpasses and <a href="https://theconversation.com/good-news-highway-underpasses-for-wildlife-actually-work-187434">underpasses</a> – to get to food and mates on the other side of the road. Fences and crossings do work, but are regarded as too costly over Australia’s vast road network. As for standard wildlife warning signs, drivers <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494358/">ignore most of them</a> after a while, making them ineffective. Signs with graphic images and variable messages get <a href="https://doi.org/10.3390/ani3041142">more attention</a>, but we need road trials to assess their effect on drivers and collision rates. <h2>Whistling in the dark</h2> Some drivers install cheap, wind-driven, high-pitched wildlife whistles on their vehicles. Tests in the United States 20 years ago found humans and deer <a href="https://doi.org/10.1121/1.1582071">could not hear any whistling sound</a> above the road noise of the test vehicle. Yet these devices are still sold in Australia as kangaroo deterrents. The Shu-Roo, an Australian invention, is an active wildlife whistle. It is fitted to the bumper bar, producing a high-pitched electronic sound, which is claimed to scare wildlife away from the road. Sadly, <a href="https://rest.neptune-prod.its.unimelb.edu.au/server/api/core/bitstreams/3c3154e0-2f48-5b73-a6cd-a7423c2a75ee/content">our tests</a> show the Shu-Roo signal can’t be heard above road noise 50 metres away and has no effect on captive kangaroo behaviour. We also recruited fleets of trucks, buses, vans, utes and cars to field test the Shu-Roo. Nearly 100 vehicles covered more than 4 million kilometres across Australia over 15,500 days. The drivers reported just over one wildlife-vehicle collision per 100,000km travelled, but <a href="https://doi.org/10.7882/AZ.2021.042">there was no difference in the rate</a> for vehicles fitted with a Shu-Roo versus those without one. The virtual fence is the latest attempt to reduce wildlife-vehicle collisions. It uses a line of posts spaced along the roadside, each with a unit producing loud sounds and flashing lights aimed away from the road. Vehicle headlights activate the units, which are claimed to alert animals and reduce the risk of collision. Early results from Tasmania were encouraging. A 50% drop in possum and wallaby deaths was reported, but <a href="https://doi.org/10.1071/AM19009">this trial had many design flaws</a>. Recent trials in <a href="https://www.mdpi.com/2076-2615/9/10/752">Tasmania</a>, <a href="https://www.mdpi.com/2076-2615/12/10/1323">New South Wales</a> and <a href="https://www.redland.qld.gov.au/downloads/download/292/virtual_fence_to_reduce_vehicle_collisions_with_wallabies_on_heinemann_rd_-_final_report_2020">Queensland</a> show no effect of virtual fencing on collisions with possums, wallabies or wombats. Our concern is that this system is being <a href="https://www.abc.net.au/news/2020-06-02/wildlife-fence-trial-underway-in-queensland-and-phillip-island/12268110">rolled out</a> in <a href="https://www.townsville.qld.gov.au/about-council/news-and-publications/media-releases/2023/june/councils-innovative-trial-helping-keep-local-wildlife-safe">many</a> <a href="https://www.abc.net.au/news/2022-10-26/nsw-south-coast-council-first-virtual-fence-to-protect-wildlife/101571600">parts</a> of <a href="https://www.theage.com.au/politics/victoria/the-stealth-tech-aiming-to-stop-roos-from-becoming-roadkill-20231222-p5etda.html">Australia</a>. It gives the impression of action to reduce collisions with wildlife, but without an evidence base, solid study design or adequate monitoring. <h2>A very messy problem</h2> The problem has many dimensions. We need to consider all of them to achieve safe travel for people and animals on our roads. At a landscape level, collision hotspots occur where wildlife frequently cross roads, which can help us predict the collision risk for species such as <a href="https://doi.org/10.1111/aec.13465">koalas</a>. But the risk differs between species. For example, <a href="https://doi.org/10.1016/j.gecco.2021.e01530">on Phillip Island</a> most wallaby collisions happen on rural roads, while most involving possums and birds are in urban streets. Traffic volume and speed are key factors for many species, including <a href="https://doi.org/10.1002/ece3.2306">kangaroos</a>. Driver training and experience are also important. In the Royal National Park in New South Wales, <a href="https://www.mdpi.com/2076-2615/6/6/40">half the drivers surveyed</a> had struck animals, including wallabies and deer. Yet most still <a href="https://theconversation.com/10-million-animals-are-hit-on-our-roads-each-year-heres-how-you-can-help-them-and-steer-clear-of-them-these-holidays-149733">weren’t keen</a> to slow down or avoid driving at dawn and dusk. Road design has a major influence on wildlife-vehicle collions too, but the planning process too often <a href="https://www.frontiersin.org/articles/10.3389/fenvs.2022.959918">neglects wildlife studies</a>. Smarter cars are <a href="https://www.diva-portal.org/smash/get/diva2:1822182/FULLTEXT01.pdf">being developed</a>. One day these will use AI to spot animal hazards, apply automatic emergency braking and alert other drivers of real-time risk. To explore potential technological solutions, Transport for NSW is running a <a href="https://www.eianz.org/events/event/symposium-using-technology-to-reduce-wildlife-vehicle-collisions">symposium</a> at the University of Technology Sydney on May 21. The symposium will cover wildlife ecology and the evidence base for options to reduce wildlife-vehicle collisions in Australia. <hr /> If you see an injured animal on the road, call <a href="https://www.wildliferescue.net.au/">Wildlife Rescue Australia</a> on 1300 596 457. for specific state and territory numbers, go to the <a href="https://kb.rspca.org.au/knowledge-base/who-should-i-contact-about-injured-wildlife/">RSPCA injured wildlife site</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/222367/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/graeme-coulson-1378778">Graeme Coulson</a>, Honorary Principal Fellow, School of BioSciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/helena-bender-98800">Helena Bender</a>, Senior Lecturer, Environmental Social Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/10-million-animals-die-on-our-roads-each-year-heres-what-works-and-what-doesnt-to-cut-the-toll-222367">original article</a>.

Domestic Travel

Who will look after us in our final years? A pay rise alone won’t solve aged-care workforce shortages

<a href="https://theconversation.com/profiles/stephen-duckett-10730">Stephen Duckett</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Aged-care workers will receive a significant pay increase after the Fair Work Commission <a href="https://www.fwc.gov.au/documents/decisionssigned/pdf/2024fwcfb150.pdf">ruled</a> they deserved substantial wage rises of up to 28%. The federal government <a href="https://ministers.dewr.gov.au/burke/fair-work-decision-aged-care">has committed to</a> the increases, but is yet to announce when they will start. <blockquote class="twitter-tweet"> Tens of thousands of aged care workers will receive a major pay rise after the Fair Work Commission recommended the increase. <a href="https://t.co/NeNt1Gvxd9">https://t.co/NeNt1Gvxd9</a> — SBS News (@SBSNews) <a href="https://twitter.com/SBSNews/status/1768557710537068889?ref_src=twsrc%5Etfw">March 15, 2024</a></blockquote> But while wage rises for aged-care workers are welcome, this measure alone will not fix all workforce problems in the sector. The number of people over 80 is expected to <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150.pdf">triple over the next 40 years</a>, driving an increase in the number of aged care workers needed. <h2>How did we get here?</h2> The Royal Commission into Aged Care Quality and Safety, which delivered its <a href="https://www.royalcommission.gov.au/aged-care/final-report">final report</a> in March 2021, identified a litany of tragic failures in the regulation and delivery of aged care. The former Liberal government was dragged reluctantly to accept that a total revamp of the aged-care system was needed. But its <a href="https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/respect-care-and-dignity-aged-care-royal-commission-452-million-immediate-response-as-government-commits-to-historic-reform-to-deliver-respect-and-care-for-senior-australians#:%7E:text=Minister%20for%20Senior%20Australians%20and,%2C%20dementia%2C%20food%20and%20nutrition.">weak response</a> left the heavy lifting to the incoming Labor government. The current government’s response started well, with a <a href="https://theconversation.com/anthony-albanese-offers-2-5-billion-plan-to-fix-crisis-in-aged-care-180419">significant injection of funding</a> and a promising regulatory response. But it too has failed to pursue a visionary response to the problems identified by the Royal Commission. Action was needed on four fronts: <ul> <li>ensuring enough staff to provide care</li> <li>building a functioning regulatory system to encourage good care and weed out bad providers</li> <li>designing and introducing a fair payment system to distribute funds to providers and</li> <li>implementing a financing system to pay for it all and achieve intergenerational equity.</li> </ul> A government taskforce which proposed a <a href="https://theconversation.com/what-will-aged-care-look-like-for-the-next-generation-more-of-the-same-but-higher-out-of-pocket-costs-225551">timid response to the fourth challenge</a> – an equitable financing system – was released at the start of last week. Consultation closed on a <a href="https://media.opan.org.au/uploads/2024/03/240308_Aged-Care-Act-Exposure-Draft-Joint-Submission_FINAL.pdf">very poorly designed new regulatory regime</a> the week before. But the big news came at end of the week when the Fair Work Commission handed down a further <a href="https://www.fwc.gov.au/documents/decisionssigned/pdf/2024fwcfb150.pdf">determination</a> on what aged-care workers should be paid, confirming and going beyond a previous <a href="https://www.fwc.gov.au/documents/sites/work-value-aged-care/decisions-statements/2022fwcfb200.pdf">interim determination</a>. <h2>What did the Fair Work Commission find?</h2> Essentially, the commission determined that work in industries with a high proportion of women workers has been traditionally undervalued in wage-setting. This had consequences for both care workers in the aged-care industry (nurses and <a href="https://training.gov.au/Training/Details/CHC33021">Certificate III-qualified</a> personal-care workers) and indirect care workers (cleaners, food services assistants). Aged-care staff will now get significant pay increases – 18–28% increase for personal care workers employed under the Aged Care Award, inclusive of the increase awarded in the interim decision. <figure class="align-center "><figcaption></figcaption>Indirect care workers were awarded a general increase of 3%. Laundry hands, cleaners and food services assistants will receive a further 3.96% <a href="https://www.fwc.gov.au/documents/decision-summaries/2024fwcfb150-summary.pdf">on the grounds</a> they “interact with residents significantly more regularly than other indirect care employees”.</figure> The final increases for registered and enrolled nurses will be determined in the next few months. <h2>How has the sector responded?</h2> There has been no push-back from employer groups or conservative politicians. This suggests the uplift is accepted as fair by all concerned. The interim increases of up to 15% probably facilitated this acceptance, with the <a href="https://theconversation.com/what-does-the-budget-mean-for-medicare-medicines-aged-care-and-first-nations-health-192842">recognition of the community</a> that care workers should be paid more than fast food workers. There was <a href="https://www.accpa.asn.au/media-releases/accpa-welcomes-further-aged-care-wage-rises">no criticism from aged-care providers</a> either. This is probably because they are facing difficulty in recruiting staff at current wage rates. And because government payments to providers reflect the <a href="https://www.ihacpa.gov.au/">actual cost of aged care</a>, increased payments will automatically flow to providers. When the increases will flow has yet to be determined. The government is due to give its recommendations for staging implementation by mid-April. <h2>Is the workforce problem fixed?</h2> An increase in wages is necessary, but alone is not sufficient to solve workforce shortages. The health- and social-care workforce is <a href="https://www.jobsandskills.gov.au/data/employment-projections">predicted</a> to grow faster than any other sector over the next decade. The “care economy” will <a href="https://theconversation.com/care-economy-to-balloon-in-an-australia-of-40-5-million-intergenerational-report-211876">grow</a> from around 8% to around 15% of GDP over the next 40 years. This means a greater proportion of school-leavers will need to be attracted to the aged-care sector. Aged care will also need to attract and retrain workers displaced from industries in decline and attract suitably skilled migrants and refugees with appropriate language skills. The <a href="https://theconversation.com/demand-driven-funding-for-universities-is-frozen-what-does-this-mean-and-should-the-policy-be-restored-116060">caps on university and college enrolments</a> imposed by the previous government, coupled with weak student demand for places in key professions (such as nursing), has meant workforce shortages will continue for a few more years, despite the allure of increased wages. A significant increase in intakes into university and vocational education college courses preparing students for health and social care is still required. Better pay will help to increase student demand, but funding to expand place numbers will ensure there are enough qualified staff for the aged-care system of the future. <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/225898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephen-duckett-10730">Stephen Duckett</a>, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/who-will-look-after-us-in-our-final-years-a-pay-rise-alone-wont-solve-aged-care-workforce-shortages-225898">original article</a>. Image: Getty

Retirement Income

Boss slammed for demanding an employee complete work during annual leave

A boss has been dubbed an “abysmal manager” for demanding his employee join a video call for work, despite being on annual leave. Businessman Ben Askins, who has dedicated his TikTok account to calling out unacceptable workplace behaviour, read out the text exchange between the man and his boss, who quickly became unreasonable in his demands. The first message came from the man’s boss, who asked “Where are you? Haven’t seen you at your desk today? I need to run something by you.” The employee responded, reminding his boss that he was off on pre-approved annual leave, and was enjoying a holiday abroad in Spain. Despite his holiday, the employee still offered to help, saying he could “probably jump on a quick call when I am on the bus from the airport if it is really urgent.” <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C2QFCsgtSoS/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C2QFCsgtSoS/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ben Askins (@benaskins.official)</a> </div> </blockquote> Unhappy with the compromise, the demanding boss then asked if the employee would “jump on a Zoom call when you get to the hotel” as he would “prefer to do this in person”. “Sorry, not really possible, we have a really packed schedule,” the worker replied to his boss, to which the manager hit back with, “Damn, wish you had told me that you were on annual leave.” The man reminded his boss he had signed off his leave two months prior and it was “in the system” but he came back saying, “Lol as if I would remember that. It is poor form for you to not remind me.” As Ben continued to read the text exchange, he added his own commentary on the situation, saying, “It's your job to remember that, it's not his fault you're just being unbelievably shocking at yours.” “This is so bad, this poor employee has done everything right; he's got it signed off two months in advance, he's done all the handover, he's done everything he could have done,' Ben ranted. “Because the manager is shocking, it's now impacting the employee's holiday. I just hate it when that happens.” Ben, a self-described “champion of younger gens in the workplace” said the heated chat showed the boss's “really poor” form and “abysmal management”. “What are you doing being so unorganised? Because the problem when an unorganised manager happens it hits down to the team below him - what the hell he's playing at? I have no idea,” he said. Ben's clip was viewed more than 2.3million and had users fired up, with thousands of comments flooding in in support of the burnt out employee trying to enjoy his holiday. Image credits: Instagram

Legal

What is micellar water and how does it work?

<a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Micellar water, a product found in supermarkets, chemists and bathroom cabinets around the world, is commonly used to remove make-up. It’s a very effective cleanser and many people swear by it as part of their skincare routine. So, what is micellar water and why is it so good at getting makeup and sunscreen off? Here’s the science. <h2>What are micelles?</h2> Oil and water generally don’t mix, which is why you’ll struggle to remove makeup and sunscreen (which both contain oils) with just plain water. But micellar water products contain something called micelles – clusters of molecules that are very effective at removing oily substances. To understand why, you need to first know two chemistry terms: hydrophilic and hydrophobic. A hydrophilic substance “loves” water and mixes easily with it. Salt and sugar are examples. A hydrophobic substance “hates” water and generally refuses to mix with it. Examples include oil and wax. Hydrophilic materials will happily mix with other hydrophilic materials. The same goes for hydrophobic substances. But if you try to combine hydrophilic and hydrophobic materials, they won’t mix. <h2>How are micelles formed? It’s all about surfactants</h2> The micelles in micellar water are formed by special molecules known as surfactants. Surfactant stands for surface active agent. These molecules looked at their hydrophilic and hydrophobic brethren and said, why not both? They are typically comprised of two ends: a head group that is hydrophilic and a tail that is hydrophobic. When a small amount of surfactant is added to water, the two ends of the molecule have competing interests. The hydrophilic head wants to be in the water, but the hydrophobic tail can’t stand water. Add enough surfactant and, eventually, we will pass a critical micelle concentration and the surfactants will self-assemble into clusters of approximately 20 to 100 surfactant molecules. All the hydrophilic heads will be pointing outwards, while the hydrophobic tails remain “hidden” at the centre. These clusters are micelles. These micelles have a hydrophilic exterior, meaning that they are very happy to remain mixed throughout water. However, in the centre remains a hydrophobic pocket that’s very good at attracting oils. This is very handy, and helps explain why adding some detergent (a surfactant) to water will allow you to wash an oily saucepan. The surfactant first helps lift of the oil, and then the oil can remained mixed into the water, finding a new home in the hydrophobic centre of the micelle. <figure><iframe src="https://www.youtube.com/embed/fnRBCn8fm2o?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Micellar water in action</h2> Surfactants are in your dishwashing detergent, your body wash, your shampoo, your toothpaste and even many foods. In all of these cases, they are there to help the water interact with the dirt and oils, and micellar water is no different. When you apply some micellar water to a cotton pad, another convenient interaction occurs. The wet cotton is hydrophilic (loves water). Consequently, some of the micelles will unravel, with the hydrophilic heads being attracted to the wet cotton pad. Now, sticking out from the surface will be a layer of hydrophobic tail groups. These hydrophobic tails cannot wait to attract themselves to makeup, sunscreen, oils, dirt, grease and other contaminants on your face. As you sweep the cotton pad across your skin, these contaminants bind to the hydrophobic tails and are removed from the skin. Some contaminants will also find themselves encapsulated in the hydrophobic centres of the micelle. Either way, a cleaner surface is left behind. Look at how a cotton wipe soaked in micellar water cleans up a small oil spill, in comparison to water alone. <figure><iframe src="https://www.youtube.com/embed/5Nge5FEiuYE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>So why shouldn’t I just use dishwashing detergent to wash my face?</h2> Technically, that would work as detergent does indeed contain lots of micelle-forming surfactants. But these particular surfactants would probably cause a lot of skin and eye irritation, while also damaging and drying out your skin. Not nice. The surfactants in micellar water are chosen to be mild and well tolerated by most people’s skin. But micellar water isn’t the only skincare product to contain micelles. There are many other face-cleaning products that also make great use of surfactant molecules and work very well too. Now, it’s not perfect. While it is effective at removing a wide range of contaminants, thick or heavy makeup might not come off easily with micellar water (you might need to do a more vigorous clean). Some products say there is “zero residue”, although the fine print clearly states this refers to visible residue. Many products also state there is no rinse off required. Surfactants will remain on your skin after product use, but for many people they don’t cause irritation. If your skin is feeling irritated after using a micellar water product, you can try rinsing afterwards or discontinuing use. And as is the case with many cosmetic products, you should test it first on a small patch of skin before using it all over your face.<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/219492/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</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-is-micellar-water-and-how-does-it-work-219492">original article</a>.

Beauty & Style

What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<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> As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection. These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID. Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older. Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe? <h2>Who’s eligible for the new boosters?</h2> The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September. ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose. People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.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/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>For people without risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> Adults aged 18 to 64 with underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.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/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=311&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=311&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=311&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=391&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=391&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=391&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Advice for people with risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> For adults aged 18 to 64 without underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose. Additional doses aren’t recommended for children without underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years without additional risk factors. <h2>Monovalent, bivalent? What’s the difference?</h2> From monovalent The initial COVID vaccines were “monovalent”. They had one target – the original viral strain. But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity. To bivalent So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>. Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission. The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5. Back to monovalent Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement. This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>). This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed. According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is. The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore. In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>. <h2>Do these newer vaccines work?</h2> Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA. Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control. Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster. The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>. It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored. <h2>Are they safe?</h2> The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported. Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines. <h2>What happens next?</h2> The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated. We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<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/217804/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>, 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/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.

Body

How do stimulants actually work to reduce ADHD symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Stimulants are <a href="https://adhdguideline.aadpa.com.au/">first-line drugs</a> for children and adults diagnosed with attention-deficit hyperactivity disorder (ADHD). But how do they actually work? <h2>First, let’s look at the brain</h2> ADHD is a neurodevelopmental condition, which means it affects how the brain functions. Medical imaging indicates people with ADHD may have slight differences in their brain’s <a href="https://jamanetwork.com/journals/jama/article-abstract/195386">structure</a>, the way their brain regions work together to perform tasks, and how their brain’s chemical messengers, called neurotransmitters, pass on information. These brain differences are associated with the symptoms of ADHD, including inattention, impulse control and problems with memory. <h2>What stimulants are prescribed in Australia?</h2> The three main stimulants prescribed for ADHD in Australia are dexamfetamine, methylphenidate (sold under the brand names Ritalin and Concerta) and lisdexamfetamine (sold as Vyvanse). Dexamfetamine and methylphenidate have been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/">since</a> the 1930s and 1940s respectively. Lisdexamfetamine is a newer stimulant that has been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">since</a> the late 2000s. Dexamfetamine and lisdexamfetamine are amphetamines. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">Lisdexamfetamine</a> is inactive when it’s taken and actually changes into active dexamfetamine in the red blood cells. This is what’s known as a “prodrug”. <h2>So how do they work for ADHD?</h2> Stimulant drugs are thought to alter the activity of key neuotransmitters, dopamine and noradrenaline, in the brain. These neurotransmitters help with attention and focus, among other things. Stimulants increase the amount of dopamine and noradrenaline in the tiny gaps between neurons, known as synapses. They do this by predominantly blocking a transporter that then prevents their re-uptake back into the neuron that released them. This means more dopamine and noradrenaline can bind to their respective receptors. This <a href="https://www.tga.gov.au/sites/default/files/auspar-lisdexamfetamine-dimesilate-180515-pi.pdf">helps</a> connected neurons in the brain talk to one another. Amphetamines also increase the amount of dopamine the neuron releases into the synapse (the tiny gaps between neurons). And it stops the enzymes that break down dopamine. This results in an increase of dopamine in the synapse. <h2>What effect do they have on ADHD symptoms?</h2> We still don’t fully understand the underlying brain mechanisms that change behaviour in people with ADHD. But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109107/">research shows</a> stimulants that modulate noradrenaline and dopamine can improve brain processes such as: <ul> <li>attention</li> <li>memory</li> <li>decision-making</li> <li>task completion</li> <li>hyperactivity.</li> </ul> They can also improve general behaviour, such as self-control, not talking over the top of others, and concentration. These behaviours are important for social interactions. Stimulants <a href="https://pubmed.ncbi.nlm.nih.gov/15737659/">reduce ADHD symptoms</a> in about 70% to 80% of children and adults who take them. Some people will notice their symptoms improve right away. Other times, these improvements will be more noticeable to parents, carers, teachers, colleagues and partners. <h2>Not everyone gets the same dose</h2> The optimal stimulant dose varies between individuals, with multiple dosage options available. This enables a “start low, go slow” approach, where the stimulant can be gradually increased to the most effective dose for the individual. There are also different delivery options. Dexamfetamine and methylphenidate are available in immediate-release preparations. As these have short half-lives (meaning they act quickly and wear off rapidly), they are often taken multiple times a day – usually in the morning, lunch and afternoon. Methylphenidate is also <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03175-3&d=20231023172310101">available</a> in long-acting tablets (Concerta) and capsules (Ritalin LA). They are released into the body over the day. Lisdexamfetamine is a long-acting drug and is not available in a short-acting formulation. The long-acting stimulants are generally taken once in the morning. This avoids the need to take tablets during school or work hours (and the need to store a “controlled drug”, which has the potential for abuse, outside the home). <h2>What are the side effects?</h2> The most common side effects are sleep problems and decreased appetite. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012069.pub2/full">recent study</a> showed children and young people taking methylphenidate for ADHD were around 2.6 times more likely to have sleep problems and 15 times more likely to have a decreased appetite than those not taking methylphenidate. Headache and abdominal pain are also relatively common. <h2>Can someone without ADHD take a stimulant to improve productivity?</h2> Stimulants are tightly controlled because of their potential for abuse. In Australia, only paediatricians, psychiatrists or neurologists (and GPs in special circumstances) can prescribe them. This follows a long assessment process. As stimulants increase dopamine, they can cause euphoria and a heightened sense of wellbeing. They can also cause <a href="https://www.ncbi.nlm.nih.gov/books/NBK576548/#:%7E:text=The%20immediate%20psychological%20effects%20of,and%20may%20result%20in%20insomnia.">weight loss</a>. A common myth about stimulant medicines is they can improve the concentration and productivity of people without ADHD. A <a href="https://www.science.org/doi/full/10.1126/sciadv.add4165">recent study shows</a> the opposite is true. This study gave a group of 40 people online arithmetic tasks to complete across four sessions. At each of the sessions, participants were given either a placebo or a stimulant before completing the task. The results showed that while stimulants did not impact getting the correct answer, it increased the number of moves and time to solve the problems compared to a placebo. This indicates a reduction in productivity. However, the myth that stimulants improve study prevails. It’s likely that users feel different – after all, they are taking a medicine that speeds up messages between the brain and body. It may make them “feel” more alert and productive, even if they’re not.<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/215801/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/how-do-stimulants-actually-work-to-reduce-adhd-symptoms-215801">original article</a>.

Mind

How can I get some sleep? Which treatments actually work?

<a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months? If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia. You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next? <h2>What not to do</h2> These probably won’t help: <ul> <li> spending more time in bed often results in more time spent awake in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a> </li> <li> drinking coffee and taking naps might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening </li> <li> drinking alcohol might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid. </li> </ul> <h2>What to do next?</h2> If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours. So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills. It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia. You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>. Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some. <a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>. <h2>What if that doesn’t work?</h2> If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia. It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep. Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor. <h2>What about sleeping pills?</h2> Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful. Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep. However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence. Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits. <h2>Are there new treatments? How about medicinal cannabis?</h2> Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant). These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines. However, we don’t know if they work or are safe over the long term. <a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>. In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>. But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment. So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term. <h2>What now?</h2> If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these. Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors. <hr /> For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</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/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.

Body

If you’re 65 or over and want to work, you’re far better off in New Zealand than Australia

<a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Want to keep working after you’ve reached pension age? The Australian government has just made it a <a href="https://ministers.treasury.gov.au/ministers/jim-chalmers-2022/media-releases/getting-more-australians-back-work">little bit</a> easier, increasing the amount you can earn per year from work before losing some of your pension by A$4,000 on an ongoing basis. Late last year, it temporarily upped the so-called <a href="https://www.dss.gov.au/seniors/programmes-services/work-bonus">work bonus</a> from $7,800 per year to $11,800 to “<a href="https://images.theconversation.com/files/555212/original/file-20231023-17-xduxan.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip">incentivise pensioners into the workforce</a>”. It was part of the government’s response to its September jobs and skills summit. It meant pensioners could earn an underwhelming $227 per week from work without harming their pension, up from the previous $150. The rules for older workers are very different in New Zealand. In fact, if Australia adopted New Zealand’s approach, we could have an extra 500,000 willing workers – a fair chunk of them paying tax. <h2>What’s NZ doing differently for older workers?</h2> Last month, as part of his <a href="https://treasury.gov.au/employment-whitepaper/final-report">employment white paper</a>, Australian Treasurer Jim Chalmers made the increase to $227 per week permanent. Chalmers headlined the announcement: <a href="https://ministers.treasury.gov.au/ministers/jim-chalmers-2022/media-releases/getting-more-australians-back-work">Getting more Australians back into work</a>. But it’s doing an underwhelming job. In Australia, <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed/aug-2023">15.1%</a> of the population aged 65 and older are in some kind of paid work, up from 14.7% a year earlier. In contrast, in New Zealand the proportion has just hit <a href="https://www.stats.govt.nz/information-releases/labour-market-statistics-june-2023-quarter/">26%</a>. That’s right: more than one-quarter of New Zealanders aged 65 and older are employed. It’s a similar story if we look at how Australia and New Zealand compared to others internationally on labour force participation (which covers those in paid work plus people actively looking for it). <hr /> <iframe id="qjojO" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/qjojO/5/" width="100%" height="400px" frameborder="0"></iframe> <hr /> New Zealand wants to see that number rise further. It has been talking about <a href="https://www.msd.govt.nz/documents/what-we-can-do/seniorcitizens/older-workers-employment-action-plan/the-ageing-workforce-briefing-paper-future-of-work-governance-group-meeting-4-may-.pdf">33.1%</a> of its population aged 65 or more in paid work, which is what Iceland has. What is New Zealand doing for over-65s that Australia is not? You won’t find it mentioned in either treasury’s employment <a href="https://treasury.gov.au/employment-whitepaper/final-report">white paper</a> (released in September) or <a href="https://treasury.gov.au/publication/2023-intergenerational-report">intergenerational report</a> (released in August) – even though National Seniors Australia <a href="https://nationalseniors.com.au/uploads/NSA-Employment-White-Paper-Submission-Final-Web.pdf">pointed it out</a> in submissions. One crucial thing New Zealand is not doing is annoying pensioners who work. Australian pensioners in paid work get called in for discussions with Centrelink, if it looks as if they are at risk of doing too many hours and going over the $227 per week limit. <h2>The more you work, the more your pension is cut</h2> Pensioners who do go over the $227 per week limit lose half of every extra dollar they earn in a cut to their pension. Plus tax, this means they lose a total of <a href="https://ipa.org.au/publications-ipa/media-releases/employment-white-paper-cop-out">69%</a> of what they earn over the limit where their tax rate is 19%, and 82.5% on the portion of earnings taxed at 32.5%. And this is after the boost designed to “<a href="https://images.theconversation.com/files/555212/original/file-20231023-17-xduxan.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip">incentivise pensioners into the workforce</a>”. Last year’s jobs summit also set up a <a href="https://www.pmc.gov.au/sites/default/files/resource/download/womens-economic-equality-taskforce-final-report.pdf">Women’s Economic Equality Taskforce</a>. It reported this week, drawing attention to the “disincentive rates” facing second earners (usually women) who return to work after caring for children. It said that taking the loss of benefits, tax and childcare costs together, the penalty for returning to work was more than half of what was earned on the first three days of the week, and up to 110% of what was earned on the fourth and fifth days. My point here is that the losses facing age pensioners who attempt to work are of a similar order – in Australia but not in New Zealand. Australia’s rules aren’t just stopping pensioners from taking on extra hours. They seem to stop them taking up paid work at all. There were 2.6 million Australians on the age pension in June this year. Only <a href="https://data.gov.au/data/dataset/dss-payment-demographic-data/resource/7a6457a8-44a3-406c-b552-62eb0fef9d66">83,925</a> reported income from working. That’s just 3.2%. <h2>NZ pensioners keep their pensions</h2> What’s different about New Zealand is that New Zealand’s pensioners don’t face a penalty if they work. They simply face income tax. In New Zealand, the age pension (which is called <a href="https://www.workandincome.govt.nz/eligibility/seniors/superannuation/who-can-get-it.html">superannuation</a>, making it confusing for Australians) is paid to everyone of pension age. There’s no income test or assets test. You get it because you are a citizen or permanent resident. Australia wouldn’t need to go as far as New Zealand to get the same benefit. We would simply need to ditch the pension income test in cases where that income came from paid work, leaving the assets test in place. Then there would be no concern about working. <h2>Half a million reasons for change</h2> If we made that change – and if the same proportion of older Australians chose to work as New Zealanders – we would soon have an extra half a million older Australians able to step into fields such as teaching, where there are <a href="https://www.abs.gov.au/statistics/labour/jobs/job-vacancies-australia/latest-release">15,500 vacancies</a>, and health care and social assistance, where there are 68,100 vacancies. It would cost the federal government money because it’d put more Australians of pension age on the pension. But it’d cost less if we abolished the special tax concession for seniors and pensioners, known as the <a href="https://www.ato.gov.au/individuals/income-deductions-offsets-and-records/tax-offsets/seniors-and-pensioners-tax-offset/">seniors and pensioners tax offset</a>. In New Zealand, senior citizens face the same tax rates as everyone else. And it would cost less as more pensioners earned wages and paid income tax. Calculations prepared for <a href="https://nationalseniors.com.au/uploads/NSA-Employment-White-Paper-Submission-Final-Web.pdf">National Seniors Australia</a> by Deloitte suggest that beyond a certain point, the change would become revenue-positive – actually boosting federal coffers – as the extra income tax revenue outweighed the cost of the extra pensions. National Seniors is calling its campaign <a href="https://nationalseniors.com.au/advocacy/fairer-retirement-income-system/let-pensioners-work">“let pensioners work”</a>. <h2>Tapping into the cash economy</h2> Importantly – and here’s where we get to a fact National Seniors might not like me mentioning – that would happen not only because more senior Australians were employed, but also because more senior Australians were employed legitimately. It’s hard to get a handle on how many senior Australians are working and being paid in cash, which they store rather than bank to avoid tripping the income test. But we do know this. At the end of March, there were <a href="https://www.rba.gov.au/statistics/tables/xls/a06hist.xls?v=2021-04-05-19-23-58">18</a> Australian $100 notes in circulation for each Australian resident, an astonishingly high proportion given the use of cash for transactions is <a href="https://theconversation.com/cash-could-be-almost-gone-in-australia-in-a-decade-but-like-cheques-wholl-miss-it-208020">collapsing</a>. In New Zealand at the end of March, there were just <a href="https://www.rbnz.govt.nz/statistics/series/reserve-bank/bank-notes-in-the-hands-of-the-public">five</a> New Zealand $100 notes in circulation for each New Zealand resident. That may be just a coincidence. But New Zealand is certainly making it easier for retirees to work legitimately, rather than stay at home or accept cash in hand.<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/216260/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-youre-65-or-over-and-want-to-work-youre-far-better-off-in-new-zealand-than-australia-216260">original article</a>.

International Travel

Princess Beatrice reveals the “most terrifying moment” in her life

Princess Beatrice has shared the “most terrifying moment” that she encountered at work. The 35-year-old royal has been open about her struggles with dyslexia, and has opened up on a podcast about a major challenge she faced at work. "I was anecdotally talking about how difficult it was at work," Beatrice, who works for US-based technology firm Afiniti, told podcast host Kate Griggs. "Sometimes you get handed a whiteboard pen and you've got to do the group think again and collaborate and off you go to the whiteboard." "And I was thinking that's the most terrifying moment for me in my life, and please don't ever make me do it. I'll do a speech tomorrow but don't give me a pen and a whiteboard." Beatrice also shared the difficulties she faced as a child, and having to go through school before being formally diagnosed with dyslexia. "The early days of school really, really stand out as to those moments where you just don't fit in and you can't figure out what it is about you," the royal said candidly. "I remember trying to do extra lessons with teachers and just sort of blankly staring up at her face, and she was like, 'why are you looking at me? The words are not on my face' [and] I said 'well, they're not on the page either'." "So the early days, in and around that understanding that my brain worked slightly differently, I remember them being a real challenge." Princess Beatrice became emotional when talking about the teachers who helped her during her schooling career, saying she "probably wouldn't be the person I am today if they hadn't been there in my life". The princess also paid tribute to her mum, Sarah Ferguson, for championing her to find a new way to do things. "My family and I are incredibly close, so I would say that all throughout our lives, we've been able to go through everything with humour and with joy and my mum really instilled that," Beatrice said. Image credits: Getty Images

Mind

Lots of women try herbs like black cohosh for menopausal symptoms like hot flushes – but does it work?

<a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Menopause is the stage of life where the ovaries stop releasing eggs and menstrual periods cease. Most Australian women go through menopause between <a href="https://www.nature.com/articles/nrdp20154">45 and 55</a> years of age, with the average age being 51 years, although some women may be younger. Hot flushes and night sweats are <a href="https://www.nature.com/articles/nrendo.2017.180">typical symptoms</a> of menopause, with vaginal dryness, muscle and joint pains, mood changes and sleep disturbance also commonly reported. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">75% of women</a> experience menopausal symptoms, with nearly 30% severely affected. These symptoms can negatively impact day-to-day life and wellbeing. The main therapies available include menopausal hormone therapy (MHT) and non-hormonal prescription therapy. Some women will elect to try complementary and alternative medicines, such as herbal medicines and nutritional supplements. Black cohosh is one of them. <h2>What causes hot flushes</h2> The cause of hormonal hot flushes (also called hot flashes) still isn’t completely understood, but the decline in oestrogen at menopause appears to play a role in a process that involves the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833827/">area of the brain that regulates temperature</a> (the hypothalamus). Factors linked to a greater likelihood of hot flushes include <a href="https://pubmed.ncbi.nlm.nih.gov/19675142/">being overweight or having obesity</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">smoking</a>. MHT, previously known as hormone replacement therapy (HRT), usually includes oestrogen and is the <a href="https://pubmed.ncbi.nlm.nih.gov/26444994/">most effective treatment</a> for menopausal symptoms, such as hot flushes. But women may choose complementary and alternative medicines instead – either because they shouldn’t take hormone therapy, for example because they have breast cancer, or because of personal preference. Close <a href="https://pubmed.ncbi.nlm.nih.gov/26224187/">to 40%</a> of Australian women report using complementary and alternative medicines for menopausal symptoms, and up to 20% using them specifically to treat hot flushes and sweats. <h2>A long history</h2> Complementary and alternative medicines have a long history of use in many cultures. Today, their potential benefits for menopausal symptoms are promoted by the companies that make and sell them. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/">complementary and alternative medicines</a> women often try for menopausal symptoms include phytoestrogens, wild yam, dong quai, ginseng and black cohosh. Black cohosh (plant name Cimicifuga racemosa) was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">traditionally</a> used by Native Americans to treat a variety of health concerns such as sore throat, kidney trouble, musculoskeletal pain and menstrual problems. It is now a popular herbal choice for hot flushes and night sweats, as well as vaginal dryness and mood changes. There are <a href="https://pubmed.ncbi.nlm.nih.gov/37252752/">many theories</a> for how the active ingredients in black cohosh might work in the body, such as acting like oestrogen, or affecting chemical pathways in the brain. But despite extensive research, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">evidence to support these theories remains inconclusive</a>. It is also not clear whether black cohosh is effective for hot flushes. Results from individual studies are mixed, with <a href="https://pubmed.ncbi.nlm.nih.gov/17565936/">some</a> finding black cohosh improves hot flushes, while <a href="https://pubmed.ncbi.nlm.nih.gov/18257142/">others</a> have found it doesn’t. A 2012 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">review</a> combined all the results from studies of menopausal women using black cohosh to that date and found overall there was no proof black cohosh reduces hot flushes more effectively than an inactive treatment (placebo). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">This review</a> also revealed that many studies did not use rigorous research methods, so the findings are hard to interpret. A more recent <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review</a> of clinical trials claimed black cohosh may ease menopausal symptoms, but the included studies were mostly small, less than six months long, and included women with mild symptoms. There is also no meaningful evidence black cohosh helps other symptoms of menopause, such as vaginal symptoms, sexual problems, or poor general wellbeing, or that it protects against bone loss. Evidence for how black cohosh is absorbed and metabolised by the body is also lacking, and it is not known what dose or formulation is best to use. More good quality studies are needed to decide whether black cohosh works for hot flushes and other menopausal symptoms. <h2>Is it safe to try?</h2> A <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review of studies</a> suggests black cohosh is safe to use, although many of the studies have not reported possible adverse reactions in detail. Side effects such as gastrointestinal upset and rashes may occur. While there have been <a href="https://www.mja.com.au/journal/2008/188/7/liver-failure-associated-use-black-cohosh-menopausal-symptoms#0_i1091948">rare reports of liver damage</a>, there is <a href="https://pubmed.ncbi.nlm.nih.gov/21228727/">no clear evidence</a> black cohosh was the cause. Even so, in Australia, black cohosh manufacturers and suppliers are required to put a warning label for the potential of harm to the liver on their products. It is recommended black cohosh is not used by women with menopausal symptoms <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/impacted-by-breast-cancer/physical-changes/menopause/treatments-menopausal-symptoms">after breast cancer</a>, as its safety after breast cancer is uncertain. All women should consult with their doctor before using black cohosh if they are taking other medications in case of possible drug interactions. Many women like to try herbal therapies for hot flushes and other menopausal symptoms. While black cohosh is generally considered safe and some women may find it helps them, at the moment there is not enough scientific evidence to show its effects are any better than placebo. Women experiencing troublesome menopausal symptoms, such as hot flushes, should talk to their doctor about the best treatment options for them.<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/211272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, Research fellow, Chronic Disease & Ageing, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash 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/lots-of-women-try-herbs-like-black-cohosh-for-menopausal-symptoms-like-hot-flushes-but-does-it-work-211272">original article</a>.

Body

Do blue-light glasses really work? Can they reduce eye strain or help me sleep?

<a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Blue-light glasses are said to <a href="https://www.baxterblue.com.au/collections/blue-light-glasses">reduce eye strain</a> when using <a href="https://www.blockbluelight.com.au/collections/computer-glasses">computers</a>, improve your <a href="https://www.ocushield.com/products/anti-blue-light-glasses">sleep</a> and protect your eye health. You can buy them yourself or your optometrist can prescribe them. But <a href="https://mivision.com.au/2019/03/debate-continues-over-blue-blocking-lenses/">do they work</a>? Or could they do you harm? We <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">reviewed</a> the evidence. Here’s what we found. <h2>What are they?</h2> Blue-light glasses, blue light-filtering lenses or blue-blocking lenses are different terms used to describe lenses that reduce the amount of short-wavelength visible (blue) light reaching the eyes. Most of these lenses prescribed by an optometrist decrease blue light transmission by <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">10-25%</a>. Standard (clear) lenses do not filter blue light. A wide variety of lens products are available. A filter can be added to prescription or non-prescription lenses. They are widely marketed and are becoming <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">increasingly popular</a>. There’s often an added cost, which depends on the specific product. So, is the extra expense worth it? <h2>Blue light is all around us</h2> Outdoors, sunlight is the main source of blue light. Indoors, light sources – such as light-emitting diodes (LEDs) and the screens of digital devices – emit varying degrees of blue light. The amount of blue light emitted from artificial light sources is much lower than from the Sun. Nevertheless, artificial light sources are all around us, at home and at work, and we can spend a lot of our time inside. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.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/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" alt="Blue light-filtering lenses block some blue light from screens from reaching the eye" /></a><figcaption>Screens emit blue light. The lenses are designed to reduce the amount of blue light that reaches the eye. <a class="source" href="https://www.shutterstock.com/image-vector/blue-light-blocking-ray-filter-lens-2286229107">Shutterstock</a></figcaption></figure> Our research team at the University of Melbourne, along with collaborators from Monash University and City, University London, sought to see if the best available evidence supports using blue light-filtering glasses, or if they could do you any harm. So we conducted a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">systematic review</a> to bring together and evaluate all the relevant studies. We included all randomised controlled trials (clinical studies designed to test the effects of interventions) that evaluated blue light-filtering lenses in adults. We identified 17 eligible trials from six countries, involving a total of 619 adults. <h2>Do they reduce eye strain?</h2> We found no benefit of using blue light-filtering lenses, over standard (clear) lenses, to reduce eye strain with computer use. This conclusion was based on consistent findings from three studies that evaluated effects on eye strain over time periods ranging from two hours to five days. <h2>Do they help you sleep?</h2> Possible effects on sleep were uncertain. Six studies evaluated whether wearing blue-light filtering lenses before bedtime could improve sleep quality, and the findings were mixed. These studies involved people with a diverse range of medical conditions, including insomnia and bipolar disorder. Healthy adults were not included in the studies. So we do not yet know whether these lenses affect sleep quality in the general population. <h2>Do they boost your eye health?</h2> We did not find any clinical evidence to support using blue-light filtering lenses to protect the macula (the region of the retina that controls high-detailed, central vision). None of the studies evaluated this. <h2>Could they do harm? How about causing headaches?</h2> We could not draw clear conclusions on whether there might be harms from wearing blue light-filtering lenses, compared with standard (non blue-light filtering) lenses. Some studies described how study participants had headaches, lowered mood and discomfort from wearing the glasses. However, people using glasses with standard lenses reported similar effects. <h2>What about other benefits or harms?</h2> There are some important general considerations when interpreting our findings. First, most of the studies were for a relatively short period of time, which limited our ability to consider longer-term effects on vision, sleep quality and eye health. Second, the review evaluated effects in adults. We don’t yet know if the effects are different for children. Finally, we could not draw conclusions about the possible effects of blue light-filtering lenses on many vision and eye health measures, including colour vision, as the studies did not evaluate these. <h2>In a nutshell</h2> Overall, based on relatively limited published clinical data, our review does not support using blue-light filtering lenses to reduce eye strain with digital device use. It is unclear whether these lenses affect vision quality or sleep, and no conclusions can be drawn about any potential effects on the health of the retina. High-quality research is needed to answer these questions, as well as whether the effectiveness and safety of these lenses varies in people of different ages and health status. If you have eye strain, or other eye or vision concerns, discuss this with your optometrist. They can perform a thorough examination of your eye health and vision, and discuss any relevant treatment options.<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/213145/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, Associate Professor in Optometry and Vision Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/do-blue-light-glasses-really-work-can-they-reduce-eye-strain-or-help-me-sleep-213145">original article</a>.

Body

No, the Voice proposal will not be ‘legally risky’. This misunderstands how constitutions work

<a href="https://theconversation.com/profiles/william-partlett-708330">William Partlett</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The “no” campaign’s primary argument in the current referendum debate focuses on the dangerous consequences of a constitutionally enshrined Voice to Parliament. This argument is relevant to the parliamentary debate about how a constitutional Voice to Parliament will be set up through legislation. But it has no bearing on the referendum debate. This debate involves a different, moral question: do you support the idea of recognising First Australians in the Constitution by giving them a voice on matters that affect them? <h2>What exactly is the ‘no’ campaign arguing?</h2> Although the “no” campaign opposes a constitutionally enshrined Voice, some of its key leaders are not against the general idea of a Voice institution itself. Instead, many “no” campaigners, including Opposition Leader Peter Dutton, <a href="https://www.skynews.com.au/australia-news/voice-to-parliament/dutton-says-his-priority-remains-establishing-a-local-and-regional-voice/video/45255e2fa30463000b1111d7188db1aa">support</a> legislated Voice institutions at the regional level. The “no” side also does not oppose constitutional recognition for First Australians. Dutton has recently promised that if the Voice referendum fails, the Coalition would <a href="https://www.theguardian.com/australia-news/2023/sep/03/peter-dutton-says-coalition-will-hold-indigenous-recognition-referendum-if-voice-to-parliament-vote-fails">hold another referendum</a> on First Nations constitutional recognition if it is returned to power. The “no” side’s main argument, therefore, is a very specific one. It focuses on what it claims are the dangerous consequences of recognising First Australians by placing a Voice institution in the Australian Constitution. In its official campaign <a href="https://aec.gov.au/referendums/files/pamphlet/referendum-booklet.pdf">pamphlet</a>, the “no” side claims that doing this will: <ul> <li> be “legally risky” and lead to litigation </li> <li> “risk delay and dysfunction” in government </li> <li> be a “costly and bureaucratic” institution with “no issue beyond its scope”. </li> </ul> Finally, the “no” side claims the Albanese government has not put forth any details on how this Voice body would function, and it would be a “permanent” change that will open the door for “activists”. <h2>The nature of constitutions</h2> These concerns, however, fundamentally misunderstand how constitutions work. Constitutions are not detailed documents that anticipate every possible circumstance. On the contrary, they are by nature short and incomplete documents. They inherently contain large gaps. In Australia, the evolution of constitutional institutions has been primarily shaped by parliament through legislation. Take the constitutional provision creating the High Court as an example. The Constitution contains very little detail on how the High Court operates. It does not even specify how many justices will be on the court. It merely says: <blockquote> The High Court shall consist of a Chief Justice, and so many other Justices, not less than two, as the Parliament prescribes. </blockquote> Indeed, it was left to parliament to establish the jurisdiction and powers of the High Court in the <a href="https://www.legislation.gov.au/Details/C2016C00836">Judiciary Act</a> in 1903. And since then, parliament has passed numerous amendments that continue to shape the operation of the court, ensuring it continues to develop in line with the needs of contemporary Australian society. For instance, the court has <a href="https://www.hcourt.gov.au/about/history-of-the-high-court">increased</a> in size from three to seven justices in order to handle its increasing case load, which many in the early 20th century thought would be very light. <h2>The Voice to Parliament proposal</h2> The proposed Voice body will operate in the same way. The <a href="https://voice.gov.au/referendum-2023/referendum-question-and-constitutional-amendment">proposal</a> is typical of other clauses already in the Constitution – it contains little detail other than there “shall be a body” called the “Aboriginal and Torres Straits Islanders Voice” that will make “representations” to parliament. Details on how the body is selected and how it will operate are explicitly left to parliament. The final section of the proposed Voice provision <a href="https://voice.gov.au/referendum-2023/referendum-question-and-constitutional-amendment">states</a>: <blockquote> the parliament shall, subject to this Constitution, have power to make laws with respect to matters relating to the Aboriginal and Torres Strait Islander Voice, including its composition, functions, powers and procedures. </blockquote> If the October referendum vote is successful, it will be up to the current parliament to pass the foundational legislation setting up the Voice body. But this law will always be subject to change by subsequent parliaments. If there are problems with the way it functions, future parliaments can fix those issues through amending legislation (just as the functioning of the High Court has changed over time). The proposed constitutional Voice will, therefore, operate in much the same way as a legislated Voice would. In the end, both would be controlled by parliament. The various concerns of the “no” side are best suited to this legislative debate. For instance, it will be important to ensure the legislation creating the Voice does not lead to dysfunctional government or become a costly or ineffective bureaucracy. But the “no” side’s concerns have no bearing on the constitutional question we all must answer in the referendum. <h2>A moral question</h2> Instead, we face a clearer, moral question on October 14: do we support the idea of recognising First Australians in the Constitution by giving them a voice in matters that affect them? In answering this question, it is worth considering the <a href="http://www.austlii.edu.au/au/other/IndigLRes/rciadic/national/vol1/">findings</a> of the Royal Commission into Aboriginal Deaths in Custody from more than 30 years ago. The commission linked the shocking number of First Australians dying in state custody to the historical fact that Aboriginal people have faced “deliberate and systematic disempowerment” for more than a century. It said: <blockquote> Decisions were made about them and for them and imposed upon them. </blockquote> Only First Nations empowerment, the report concluded, would overcome this disadvantage. This empowerment process began with a series of First Nations regional dialogues that ultimately called for a constitutionally enshrined Voice to Parliament in 2017. This empowerment is not real, however, until we heed this call.<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/212696/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/william-partlett-708330">William Partlett</a>, Associate Professor, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/no-the-voice-proposal-will-not-be-legally-risky-this-misunderstands-how-constitutions-work-212696">original article</a>.

Legal

How do hay fever treatments actually work? And what’s best for my symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing. Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine. Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging. So what medicines can prevent or reduce hay fever symptoms, and how do they work? <h2>Antihistamines</h2> Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that anti-histamines are one of the most frequently recommended medicines to treat hay fever. Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms. In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines. Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation. The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever. The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones. Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines. The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you. Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients). <h2>Steroid nasal sprays</h2> If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended. Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation. Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever. There are also nasal sprays that contain both an antihistamine and corticosteroid. While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days. <h2>Sodium cromoglycate</h2> Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies. This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation. This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies). <h2>Decongestants</h2> Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running. However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose. <h2>Saline</h2> Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects. If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines. Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.

Body

How can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options. Could taking supplements over this time help? You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference. <h2>Why are we so worried about cholesterol?</h2> There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins. Low-density lipoprotein or LDL cholesterol This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011433">build-up of plaque</a> in arteries, which leads to an increased risk of heart disease and stroke. High-density lipoprotein or HDL cholesterol This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.312617">linked to</a> a reduced risk of heart disease and stroke. Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are <a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">well recognised</a>. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado), and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases). <h2>Fibre is your friend</h2> An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">soluble fibre</a>. This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces. You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils. <h2>Fibre supplements, such as psyllium</h2> There are also many fibre supplements and food-based products on the market that may help lower cholesterol. These include: <ul> <li> natural soluble fibres, such as inulin (for example, Benefiber) or psyllium (for example, Metamucil) or beta-glucan (for example, in ground oats) </li> <li> synthetic soluble fibres, such as polydextrose (for example, STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel) </li> <li> natural insoluble fibres, which bulk out your faeces, such as flax seeds. </li> </ul> Most of these supplements come as fibres you add to food or dissolve in water or drinks. Psyllium is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/">studied</a> in at least 24 high-quality randomised controlled trials. These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, <a href="https://www.sciencedirect.com/science/article/pii/S0002916523070107#:%7E:text=Conclusions%3A,mild%2Dto%2Dmoderate%20hypercholesterolemia.">can significantly lower</a> total cholesterol levels by 4% and LDL cholesterol levels by 7%. <h2>Probiotics</h2> Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352670/">number of mechanisms</a>. These include helping to incorporate cholesterol into cells, and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces. Using probiotics to reduce cholesterol is an upcoming area of interest and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S089990071500461X">research</a> is promising. In a <a href="https://pubmed.ncbi.nlm.nih.gov/29384846/">2018 study</a>, researchers pooled results from 32 studies and analysed them altogether in a type of study known as a meta-analysis. The people who took probiotics reduced their total cholesterol level by 13%. <a href="https://www.tandfonline.com/doi/full/10.3109/07853890.2015.1071872">Other</a> <a href="https://link.springer.com/article/10.1007/s11906-020-01080-y">systematic reviews</a> support these findings. Most of these studies use probiotics containing Lactobacillus acidophilus and Bifidobacterium lactis, which come in capsules or powders and are consumed daily. Ultimately, probiotics could be worth a try. However, the effects will likely vary according to the probiotic strains used, whether you take the probiotic each day as indicated, as well as your health status and your diet. <h2>Red yeast rice</h2> <a href="https://www.nccih.nih.gov/health/red-yeast-rice">Red yeast rice</a> is another non-fibre supplement that has gained attention for lowering cholesterol. It is often used in Asia and some European countries as a complementary therapy. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins. A <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.819482/full">2022 systematic review</a> analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4,800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins. However, these trials don’t tell us if red yeast rice works and is safe in the long term. The authors also said only one study in the review was registered in a major <a href="https://www.clinicaltrials.gov">database</a> of clinical trials. So we don’t know if the evidence base was complete or biased to only publish studies with positive results. <h2>Diet and supplements may not be enough</h2> Always speak to your GP and dietitian about your plan to take supplements to lower your cholesterol. But remember, dietary changes alone – with or without supplements – might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role. Even then, depending on your cholesterol levels and other risk factors, you may still be recommended cholesterol-lowering medications, such as <a href="https://jamanetwork.com/journals/jama/fullarticle/2795522">statins</a>. Your GP will discuss your options at your six-month review.<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/211748/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher & Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross 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/how-can-i-lower-my-cholesterol-do-supplements-work-how-about-psyllium-or-probiotics-211748">original article</a>.

Body

Australians are living and working longer – but not necessarily healthier, new study show

<a href="https://theconversation.com/profiles/kim-kiely-1457635">Kim Kiely</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/mitiku-hambisa-1457669">Mitiku Hambisa</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Australians are living and working longer, but a longer working life doesn’t always come with equivalent gains in healthy life. <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00129-9/fulltext">Our analysis</a> of change in life expectancy, health transitions and working patterns of more than 10,000 middle-aged Australians over the past two decades shows divergences in the number of years they can expect be in good health at work and in retirement. In particular, education matters. Those who left school before year 12 are losing years of healthy life, with their extra years in the workforce mainly comprising years of poor health. This is opposite to the trend among people who completed high school. And while men and women experienced improvements in life expectancy, on average women are not gaining extra healthy life years. Australians are being encouraged to extend their working life. For this to be sustainable and equitable, government and workplaces policies will need to make allowances for the health capacity of mature-age workers. <h2>How we found our results</h2> We’ve calculated <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00129-9/fulltext">healthy working life expectancies</a> – the average number of years a person can expect to work in good health – for 50-year-olds using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey. This is a longitudinal survey, meaning it seeks to interview the same households every year (about 17,000 people), enabling researchers to track life trajectories. We identified two age groups within HILDA’s survey sample and followed each cohort for 10 years. The first group was 4,951 people aged 50 years and older in 2001. The second group was 6,589 people aged 50 years and older in 2011. To estimate a healthy working life expectancy, we looked at how people transitioned in and out of good health and employment each year (based on survey data about their paid employment and long-term health conditions that limited participation in everyday activities). By combining this with deaths data, we have calculated the average duration spent (i) working in good health, (ii) working in poor health, (iii) retired in good health, and (iv) retired in poor health. <h2>Differences by education</h2> The following graphs show our results, based on expectancies at age 50. We show our data in this way, rather than total healthy life and working life expectancies from birth, because we followed people from age 50 and is this is the time from which workers start to plan for and transition into retirement. Typically we understand life expectancies to be calculated from birth, but they can be estimated for any age. If you live to 50, your life expectancy is greater than when you were born. Our first graph shows healthy life expectancies according to school completion. These estimates reflect the cumulative number of years a person will, on average, be healthy or unhealthy from age 50. Across the two cohorts, those with low education lose 0.8 years of healthy life, while those with high education gain 0.8 years of healthy life. As with all statistics, there is uncertainty in these estimates. (Our original analysis includes 95% confidence intervals but we do not show them here.) <hr /> <iframe id="47SIf" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/47SIf/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> These inequities are amplified in working-life expectancies, as the next graph shows. Among early school leavers, at age 50 healthy work years rose from 7.9 to 8.4 years, an increase of six months. But their years working in poor health rose from 2.7 to 3.6 years, a difference of 11 months. In contrast, for those who completed year 12, at age 50 healthy work years rose from 9.6 to 10.5 years, an increase of 11 months. Their years working in poor health rose from 3.1 to 3.5 years, a difference of five months. <hr /> <iframe id="kUCuy" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/kUCuy/4/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The next graph illustrates what this means in proportional terms. <hr /> <iframe id="4rBXz" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/4rBXz/1/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The next graph shows working life expectancies by sex. Men, on average, will spend 25% of their remaining working years in poor health, and women 24%. These percentages have not changed over time. <hr /> <iframe id="vQ4rK" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/vQ4rK/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> These findings are consistent with <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00026-3/fulltext">previous analyses</a> demonstrating social inequalities in health expectancies to have been maintained over time, and possibly widened in some circumstances. In that study, women with low educational attainment appeared to have had negligible improvements in life expectancy and lost healthy life years. <h2>Implications for governments and employers</h2> Australia has this month raised the age at which people qualify for the <a href="https://theconversation.com/australias-retirement-age-just-became-67-so-why-are-the-french-so-upset-about-working-until-64-208648">age pension to 67</a>. When the pension was introduced in 1908, the qualifying age was 65 for men and 60 for women. At the time, average life expectancy for Australians at birth was about <a href="https://www.aihw.gov.au/reports/life-expectancy-deaths/how-long-can-australians-live/data">55 for men and 59 for women</a>. Now it exceeds 81 for men and 85 for women (though is considerably lower for some groups, notably Indigenous Australians). There’s an obvious rationale to prolong people’s working lives – to meet the challenges posed by population ageing and sustain the social security system. Nevertheless, consideration should be made for inequalities in life expectancy and health expectancy. For many ageing workers, health limitations constrain their capacity and opportunity to work. To achieve longer working lives, workplaces will be need become more supportive of mature-age workers, including accommodating long-term health conditions. This will likely involve addressing ageism in the workplace, increasing employer demand for older workers, creating appropriate work roles to fit the capacities and preferences of older workers, and providing pathways to lifelong education and training. We may also need to rethink our idea of flexible work, which has largely centred around the needs of parents and younger workers. Many older workers will have expectations for an independent and active retirement period, and it should be possible for flexible work arrangements to accommodate this. Finally, we should not discount the unpaid contributions made by many older adults through community service and providing care to loved ones.<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/210542/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-kiely-1457635">Kim Kiely</a>, Lecturer, Statistics and Data Science, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/mitiku-hambisa-1457669">Mitiku Hambisa</a>, Senior Research Associate, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australians-are-living-and-working-longer-but-not-necessarily-healthier-new-study-shows-210542">original article</a>.

Retirement Income

Sarah Abo reveals what it’s actually like to work with Karl Stefanovic

Sarah Abo has opened up on what it's really like to work alongside Karl Stefanovic. The veteran breakfast show presenter has a personality and voice that's larger than life, so being able to match his energy has become one of Abo's talents after six months of being a co-host for the Today Show. The 37-year-old presenter only had good things to say about Stefanovic. "One thing I will tell you is Karl is an incredible person, an incredible broadcaster," she said. "That mind of his, it does not stop - I don't know when he finds time to sleep, he's always thinking about the next thing," she added. She praised her co-hosts ability to understand the core of a story, no matter how complex it is, share it with the viewers in a way that is easy to digest. "That's something that comes through in all the stories we cover," she said. "It is incredible to sit alongside somebody who is so experienced and so supportive of me as well, as I'm learning and finding my feet and work my way through this crazy world that is breakfast television. "I couldn't ask for a better partner working alongside me," she praised her senior. Her one minor complaint is that Stefanovic's quirky sense of humour can be hard to understand Although she remains a good sport and pretends to laugh at them. "I mean sometimes I've gotta pretend to like his jokes which can be a bit awkward, but hey - I know how to laugh," she chuckled. Image: Today Show

“A little bit unfair”: Hard-working tradies blast age pension increase

A group of tired tradies have rallied against the “unfair” decision to increase the age of eligibility for the age pension. The tradesmen, all in their 60s, simply said their bodies “can’t handle” working in manual labour until they’re 70, which may be in their future if the eligibility age continues to rise. The age to qualify for the pension was raised from 66 years and six months to 67 on July 1st with the move impacting any Australian born after December 31st, 1956. Experts predict the age could rise even further to 70 by the year 2050 with the news sparking backlash among hardworking Aussies. One man, a concreter in his mid-60s named Steve, said working the manual labour job was already taking a toll on his body and that the new retirement age was “unfair” on those working physically demanding jobs. “Now I'm starting to feel it more in my knees, I've got arthritis in my hands, I've had two back surgeries,” he told <a href="https://9now.nine.com.au/a-current-affair/australian-tradies-outraged-over-decision-to-raise-pension-age-to-67/5b5c6dda-c995-44ad-bb29-98c625e9d276" target="_blank" rel="noopener">A Current Affair</a>. “It does seem a little bit unfair that you have to work all your life.” Peter, who cuts down trees in the Gold Coast for a living, compared the raising of the pension age to the harsh realities of his job. “It's just like climbing a tree,” he said. “The injuries are just climbing all the time, it's getting harder, worse, sorer all the time.” He described what was happening as “very scary”. “Unfortunately I thought 65 would be a nice time to retire and get on a pension but now we are talking 67,” he said. “Is it going to go up to 68, 69, 70?” Macquarie University Professor Hanlin Shang believes the pension age will need to rise to 70 or government spending will spiral out of control. He and other researchers estimate that the retirement age will rise to 68 by 2030, 69 in 2036 and 70 by 2050. “As Australians live longer than before, it presents a challenge to the government to fund retirees through a pension scheme,” Professor Shang said. Despite these challenges, Peter said politicians don't understand the burden that working physical jobs has on older bodies. “It would be nice to be a politician sitting on a nice comfortable chair all day in an air conditioned room or office,” he said. “They need to come out and see what it's like to do some physical work. That would make them change their mind in trying to stretch this pension out to 67, 68, 69, 70.” Image credits: A Current Affair

Retirement Income

Australia’s ‘retirement age’ just became 67. So why are the French so upset about working until 64?

<a href="https://theconversation.com/profiles/peter-whiteford-2016">Peter Whiteford</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Since Saturday, Australians have been required to wait until the age of 67 until they can get the age pension. The original so-called “retirement age” of 65 for men dated back to <a href="https://treasury.gov.au/sites/default/files/2021-02/p2020-100554-ud01_outline.pdf">1909</a>. Women had their pension age lifted from 60 to 65 between 1995 and <a href="https://insidestory.org.au/work-till-you-drop/">2013</a>. And all Australians have had it lifted in stages from July 2017, in a process that ended on <a href="https://www.dss.gov.au/seniors/benefits-payments/age-pension">July 1 2023</a>. It has happened with little protest – a stark contrast to the demonstrations and riots that rocked France earlier this year, when President Macron proposed and passed laws to lift the French pension age from 62 to 64. <h2>What’s so special about French pensions?</h2> French strikes and demonstrations over the retirement age aren’t new. There were nationwide protests when France increased its retirement age from 60 to 62 in <a href="https://www.theguardian.com/world/2010/nov/10/french-retirement-age-reform-62">2010</a>, before that in <a href="https://www.etui.org/covid-social-impact/france/pension-reform-in-france-background-summary-an-overview-of-pension-reforms-since-the-1990s-updated-july-2019">2003</a>, and in <a href="https://theconversation.com/pension-reform-in-france-macron-and-demonstrators-resume-epic-tussle-begun-over-30-years-ago-198354">1995</a>, when France tried to increase the pension age for public sector workers. Just about anything you could want to know about public pension schemes in high-income countries can be found in the <a href="https://www.oecd.org/about/">OECD</a> report <a href="https://www.oecd.org/publications/oecd-pensions-at-a-glance-19991363.htm">Pensions at a Glance</a>, published every two years, most recently in 2021. Public pension spending in <a href="https://www.oecd.org/els/public-pensions/PAG2021-country-profile-France.pdf">France</a> is 13.6% of GDP, compared to 4% in <a href="https://www.oecd.org/els/public-pensions/PAG2021-country-profile-Australia.pdf">Australia</a>. In part, this is because France has an older population than Australia, but it is also because French pension payments are more generous than both Australia’s age pension and superannuation supports taken together. <hr /> <iframe id="E0wpD" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/E0wpD/7/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The OECD finding that Australia provides a replacement rate of about 40% and France of about 74% is “forward looking”, in that it is based on what a worker on average earnings is estimated to be entitled to under the system applying in 2020, if she or he works from age 22 until that country’s normal retirement age. For low-paid workers, Australia’s means-tested age pension makes the payments about as generous as those in France. <hr /> <iframe id="rJpy5" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/rJpy5/4/" width="100%" height="400px" frameborder="0"></iframe> <hr /> A separate 2018 OECD calculation showed that the average after-tax income of a French household headed by someone 65 years or older was <a href="https://www.oecd.org/publications/oecd-pensions-at-a-glance-19991363.htm">99.8%</a> of the average income of all French households. In contrast, the average after-tax income of an Australian household headed by someone of that age was 75% of that of all households. Given that French households receive about the same disposable income while retired as working, it is easy to see why they are keen to retire. And the heavy tax contributions required to fund their retirement incomes give them little opportunity to save privately while working. The level of median private wealth in Australia (converted at prevailing exchange rates) is nearly <a href="https://www.credit-suisse.com/media/assets/corporate/docs/about-us/research/publications/global-wealth-databook-2022.pdf">twice</a> that in France. Yet French public pension wealth is substantial. Calculating the value of the future pension income streams using life expectancies, the net pension wealth of French retirees amounts to 14 years of average earnings, compared to just over seven in Australia. Because the value of these income streams is strongly influenced by how long the pensions are received, raising the French pension age by two years would cut the value of French pension wealth by around 8%. <h2>Why was postponing pensions easier in Australia?</h2> The phase-in of the Australian change after 2017 meant it didn’t affect the retirement incomes of Australian workers until many years after the change was first announced, and didn’t affect the incomes of those already retired at all. And the Australian change legislated in 2009 was part of a <a href="https://cdn.theconversation.com/static_files/files/2738/2009_budget_pension_changes.pdf">broader program</a> of reforms that included the biggest single <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Newstartrelatedpayments/Report/section?id=committees%2Freportsen%2F024323%2F72678">increase in age and disability pensions and carer payments</a> in Australian history. Yet it will have losers. Those losing the most will be those with the shortest life expectancies. Indigenous men have life expectancies nearly <a href="https://www.niaa.gov.au/resource-centre/indigenous-affairs/commonwealth-closing-gap-annual-report-2022">nine</a> years lower than non-Indigenous men and Indigenous women nearly eight years lower. <h2>Which Australians will pay the highest price?</h2> And the change has pushed a substantial number of Australians aged 65 and over who would have once received the pension on to the <a href="https://theconversation.com/top-economists-want-jobseeker-boosted-100-per-week-tied-to-wages-150364">much-lower</a> Jobseeker unemployment payment. The number of people aged 65 years and over receiving JobSeeker climbed from zero in 2017 to <a href="https://www.data.gov.au/data/dataset/dss-income-support-recipients-monthly-time-series/resource/05f06c42-e027-43aa-b83e-28292f683ede">40,300</a> by May this year – and will climb further because of this month’s change. <figure class="align-right zoomable"><figcaption></figcaption></figure> These people are severely disadvantaged by this change, as the level of payment for an older unemployed person is more than $300 a fortnight less than the age pension, a gap that will only be slightly reduced by the increases announced in the most recent Commonwealth budget. Relatively little attention has been paid to these people, who because of the low level of payment are among the poorest in the Australian population – with very limited prospects of being able to improve their circumstances. In contrast, the idea of boosting tax on the earnings of superannuation balances over <a href="https://www.theguardian.com/australia-news/2023/feb/28/albanese-government-lifts-tax-rate-on-superannuation-balances-over-3m">A$3 million</a> attracted <a href="https://www.firstlinks.com.au/mechanics-3m-dollar-super-tax-must-fixed">widespread criticism</a>. The very different institutional environments of Australia and France have created different lobby groups, with different interests to protect.<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/208648/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-whiteford-2016">Peter Whiteford</a>, Professor, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australias-retirement-age-just-became-67-so-why-are-the-french-so-upset-about-working-until-64-208648">original article</a>.

Retirement Life

Do psychedelics really work to treat depression and PTSD? Here’s what the evidence says

<a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> As of July 1, authorised psychiatrists have been allowed to prescribe MDMA (the chemical found in “ecstasy”) to treat post-traumatic stress disorder (PTSD), and psilocybin (found in “magic mushrooms”) to treat depression that hasn’t responded to other treatment. Psychedelic therapies have researchers excited because evidence suggests they might have lasting beneficial effects on factors that cause psychological distress beyond the treatment period. These include <a href="https://link.springer.com/article/10.1007/s00213-017-4701-y">feeling disconnected from other people</a>, <a href="https://link.springer.com/article/10.1007/s00213-019-05391-0">fear of death</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S2212144719301140?casa_token=OP6tKGxjPHAAAAAA:NTQ4khgsOY5wmsQ5HzCMcZ4eZ43wQV-sdhUbf5LXFiIeKWNwdonhfCxo77k7QbNk4G69EfX-">rigid ways of thinking</a>. This stands in contrast to most medications for psychological issues, which only directly help while people keep taking them regularly. But how strong is the evidence for psychedelic therapy? <h2>Early promise</h2> Early results from studies around the world have found psychedelic therapy <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">might be effective</a> for treating a range of psychological issues. For instance, most studies (<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">but not all</a>) have found patients tend to report <a href="https://pubmed.ncbi.nlm.nih.gov/37357767/">fewer depression symptoms</a> for periods ranging from several weeks to several months after psilocybin therapy. Similarly, studies have found <a href="https://journals.sagepub.com/doi/10.1177/0269881120965915">reductions in PTSD symptoms</a> three weeks after MDMA therapy. <h2>Not so fast</h2> However, as psychedelic research has grown, <a href="https://pubmed.ncbi.nlm.nih.gov/35243919/">limitations</a> of the research have been identified by researchers both <a href="https://psyarxiv.com/ak6gx/">within</a> and <a href="https://www.sciencefictions.org/p/psychedelics">outside</a> the psychedelic field. One issue is that we aren’t sure whether findings might be due to a <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo effect</a>, which occurs when a treatment works because people expect it to work. In clinical trials, participants are often given either a medication or a placebo (inactive) drug – and it’s important they don’t know which they have been given. However, due to the strong effects, it is difficult to prevent participants from knowing whether they have been given a psychedelic drug. Researchers have tried to use a range of different drugs (such as Ritalin) as a placebo in order to “trick” those participants not given a psychedelic into thinking they have received one. But this can be difficult to achieve. In 2021, researchers <a href="https://www.tandfonline.com/doi/full/10.1080/17512433.2021.1933434?casa_token=Dovn7x_rkdUAAAAA%3AsPzBTYNTPnNwqj9NvwN0m9ptrP4x4-c83gp3tGcshs30dWHNnmB_Vx-X5H5Y3pZJdG02IWW6X2E">reviewed</a> clinical trials involving psychedelics such as LSD, psilocybin, and dimethyltryptamine (found in animals and plants) for mood and anxiety disorders. They found trials either had not assessed whether participants guessed correctly which drug they had been given, or that this had been tested and participants tended to guess correctly. More recent trials <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">either don’t measure this</a> or find participants have a <a href="https://journals.sagepub.com/doi/full/10.1177/02698811231154852?casa_token=VsPt344fVGwAAAAA%3AA-i1VPBE1EWyFITWNncZEt876lWMiC7rtTOLJBQnb2pHI2775imUJhrzeSZW6r9doaBeDaj61D0">pretty good idea</a> of whether they’ve had a placebo or a psychedelic drug. Given the publicity and excitement around psychedelic research in recent years, it is likely most participants have <a href="https://culanth.org/fieldsights/the-pollan-effect-psychedelic-research-between-world-and-word">strong beliefs</a> such therapies work. This could lead to a significant placebo effect for participants given a psychedelic dose. Additionally, participants who realise they have received a placebo could experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184717/">disappointment and frustration</a>, resulting in worse symptoms. The benefits of a psychedelic may seem even greater when they are compared to the experiences of disappointed participants. <h2>Translating trials to practice</h2> Anecdotally, patients might be motivated to report they have gotten better, even when they haven’t. On a 2021 podcast, one clinical trial participant <a href="https://www.psymposia.com/powertrip/">described</a> how, in hindsight, the information they provided to the trial did not accurately capture the worsening of their symptoms. Trial participants are likely aware their results might affect whether treatments are legalised. They may not want to “ruin” the research by admitting the treatment didn’t work for them. There is also uncertainty about whether the findings from clinical trials mean treatments will work in private practice. There may be a lack of clarity around <a href="https://psyarxiv.com/ak6gx/">how trial participants</a> are recruited and selected. Therefore participants may not represent the typical person with PTSD or treatment-resistant depression. And while <a href="https://journals.sagepub.com/doi/full/10.1177/02698811211069100">the safety of psychedelics</a> within controlled contexts is often emphasised by advocates, less is known about safety of psychedelic therapy <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2021.737738/full">outside</a> clinical trials. <h2>Resolving issues</h2> These issues do not mean the promising psychedelic research conducted over the past several decades is worthless. Nevertheless, a <a href="https://pubmed.ncbi.nlm.nih.gov/35285280/#full-view-affiliation-1">recent review</a> of the effects of MDMA and psilocybin on mental, behavioural or developmental disorders by Australian researchers concluded the “overall certainty of evidence was low or very low”. Dutch researchers recently drafted a <a href="https://psyarxiv.com/ak6gx/">roadmap for psychedelic science</a> with a checklist for future research to help avoid these pitfalls. When more research is done, it might turn out psychedelic treatments help patients and don’t come with unacceptable harms – we simply don’t know that yet.<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/208857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, Associate Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/do-psychedelics-really-work-to-treat-depression-and-ptsd-heres-what-the-evidence-says-208857">original article</a>.

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Australia’s ‘retirement age’ just became 67. So why are the French so upset about working until 64?

Do psychedelics really work to treat depression and PTSD? Here’s what the evidence says

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