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Better sleep is a protective factor against dementia

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, <a href="https://theconversation.com/institutions/monash-university-1065"><em>Monash University</em></a></em></p> <p>Dementia is a progressive loss of cognitive abilities, such as memory, that is significant enough to have an impact on a person’s daily activities.</p> <p>It can be caused by a number of different diseases, including <a href="https://alzheimer.ca/en/about-dementia/what-alzheimers-disease">Alzheimer’s</a>, which is the most common form. Dementia is caused by a loss of neurons over a long period of time. Since, by the time symptoms appear, many changes in the brain have already occurred, many scientists are focusing on studying the risk and protective factors for dementia.</p> <p>A risk factor, or conversely, a protective factor, is a condition or behaviour that increases or reduces the risk of developing a disease, but does not guarantee either outcome. Some risk factors for Alzheimer’s disease and dementia, such as age or genetics, are not modifiable, but there are several other factors we can influence, <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">specifically lifestyle habits and their impact on our overall health</a>.</p> <p>These risk factors include depression, lack of physical activity, social isolation, high blood pressure, obesity, diabetes, excessive alcohol consumption and smoking, as well as poor sleep.</p> <p>We have been focusing our research on the question of sleep for over 10 years, particularly in the context of the <a href="https://www.nhlbi.nih.gov/science/framingham-heart-study-fhs">Framingham Heart Study</a>. In this large community-based cohort study, ongoing since the 1940s, the health of surviving participants has been monitored to the present day. As researchers in sleep medicine and epidemiology, we have expertise in researching the role of sleep and sleep disorders in cognitive and psychiatric brain aging.</p> <p>As part of our research, we monitored and analyzed the sleep of people aged 60 and over to see who did — or did not — develop dementia.</p> <h2>Sleep as a risk or protective factor against dementia</h2> <p>Sleep appears to play an essential role in a number of brain functions, such as memory. Good quality sleep <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2793873">could therefore play a vital role in preventing dementia</a>.</p> <p>Sleep is important for maintaining <a href="https://www.science.org/doi/10.1126/science.1241224">good connections in the brain</a>. Recently, research has revealed that sleep seems to have a function similar to that of a garbage truck for the brain: <a href="https://doi.org/10.1016/j.mad.2023.111899">deep sleep could be crucial for eliminating metabolic waste from the brain</a>, including clearing certain proteins, such as those known to accumulate in the brains of people with Alzheimer’s disease.</p> <p>However, the links between deep sleep and dementia still have to be clarified.</p> <h2>What is deep sleep?</h2> <p>During a night’s sleep, we go through several <a href="http://ceams-carsm.ca/en/a-propos-du-sommeil/">sleep stages</a> that succeed one another and are repeated.</p> <p>NREM sleep (non-rapid eye movement sleep) is divided into light NREM sleep (NREM1 stage), NREM sleep (NREM2 stage) and deep NREM sleep, also called slow-wave sleep (NREM3 stage). The latter is associated with several restorative functions. Next, REM sleep (rapid eye movement sleep) is the stage generally associated with the most vivid dreams. An adult generally spends around 15 to 20 per cent of each night in deep sleep, if we add up all the periods of NREM3 sleep.</p> <p>Several sleep changes are common in adults, such as going to bed and waking up earlier, sleeping for shorter periods of time and less deeply, and waking up more frequently during the night.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=279&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=350&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Sleep stages, and the role of deep sleep for brain health.</span> <span class="attribution"><span class="source">(Andrée-Ann Baril)</span></span></figcaption></figure> <h2>Loss of deep sleep linked to dementia</h2> <p>Participants in the <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2810957">Framingham Heart Study</a> were assessed using a sleep recording — known as polysomnography — on two occasions, approximately five years apart, in 1995-1998 and again in 2001-2003.</p> <p>Many people showed a reduction in their deep slow-wave sleep over the years, as is to be expected with aging. Conversely, the amount of deep sleep in some people remained stable or even increased.</p> <p>Our team of researchers from the Framingham Heart Study followed 346 participants aged 60 and over for a further 17 years to observe who developed dementia and who did not.</p> <p>Progressive loss of deep sleep over time was associated with an increased risk of dementia, whatever the cause, and particularly Alzheimer’s type dementia. These results were independent of many other risk factors for dementia.</p> <p>Although our results do not prove that loss of deep sleep causes dementia, they do suggest that it could be a risk factor in the elderly. Other aspects of sleep may also be important, such as its duration and quality.</p> <h2>Strategies to improve deep sleep</h2> <p>Knowing the impact of a lack of deep sleep on cognitive health, what strategies can be used to improve it?</p> <p>First and foremost, if you’re experiencing sleep problems, it’s worth talking to your doctor. Many sleep disorders are underdiagnosed and treatable, particularly through behavioural (i.e. non-medicinal) approaches.</p> <p>Adopting good sleep habits can help, such as going to bed and getting up at consistent times or avoiding bright or blue light in bed, like that of screens.</p> <p>You can also avoid caffeine, limit your alcohol intake, maintain a healthy weight, be physically active during the day, and sleep in a comfortable, dark and quiet environment.</p> <p>The role of deep sleep in preventing dementia remains to be explored and studied. Encouraging sleep with good lifestyle habits could have the potential to help us age in a healthier way.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222854/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, Professeure-chercheure adjointe au Département de médecine, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, Associate Professor of Neurology and Epidemiology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/better-sleep-is-a-protective-factor-against-dementia-222854">original article</a>.</em></p> </div>

Mind

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Could not getting enough sleep increase your risk of type 2 diabetes?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936"><em>University of Technology Sydney</em></a></em></p> <p>Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.</p> <p>So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.</p> <h2>The study</h2> <p>Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.</p> <p>The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.</p> <p>As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.</p> <p>Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.</p> <p>The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.</p> <p>One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.</p> <p>Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.</p> <h2>Why might short sleep increase diabetes risk?</h2> <p>In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.</p> <p>We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.</p> <p>Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>.</p> <p>This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.</p> <p>These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.</p> <p>While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.</p> <p>Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.</p> <p>The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>.</p> <h2>Good sleep, healthy diet</h2> <p>Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.</p> <p>Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.</p> <p>While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health.</p> <p>The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk.</p> <p>In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.</em></p> </div>

Body

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The unique travel hack that is guaranteed to help beat jet lag

<p dir="ltr">Experts have revealed how to beat jet lag on your next overseas holiday, and it all comes down to your modes of transport. </p> <p dir="ltr">Sleep researchers said it's good news for cruise lovers, as exposure to sea air and bright natural light improves sleep to cure the annoying condition quickly.</p> <p dir="ltr">Some experts say to avoid travelling by plane all together, and always opt for cruising holidays instead. </p> <p dir="ltr">However, if you have to travel to your cruise by plane, being on board is a great way to tackle the dreadful feeling, compared with holidaying on land, Panache Cruises said.</p> <p dir="ltr">Dr Lindsay Browning, expert at Trouble Sleeping said exposing yourself to bright lights at the right time after a long-haul flight is one of the most powerful things we can do to boost and help shift circadian rhythm, and being on a ship is the perfect place for that.</p> <p dir="ltr">"As a general rule, you want to get lots of bright light exposure during the daytime and avoid light at night," Browning said.</p> <p dir="ltr">"When travelling on a cruise ship, you will naturally get a lot of bright light exposure during the day, helping your circadian rhythm.”</p> <p dir="ltr">"Further, when travelling by ship you will have a cabin with a proper bed and curtain, enabling you to sleep at night when you want to."</p> <p dir="ltr">The company claimed research showed how prolonged exposure to sea air can improve blood oxygen levels, boost vitamin D, and improve breathing leading to higher-quality sleep, helping to rid travellers of pesky jet lag so they can enjoy their holidays. </p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

Travel Tips

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

<p>It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast.</p> <p><strong>Give meditation a try </strong></p> <p>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.</p> <p>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.</p> <p><em>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. </em></p> <p><strong>Stop wanting to fall asleep</strong></p> <p>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.</p> <p>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.</p> <p><em>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>.</em></p> <p><strong>Start a journal </strong></p> <p>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.</p> <p>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.</p> <p><strong>Find yourself a "3am friend"</strong></p> <p>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.</p> <p>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.</p> <p><strong>Take a warm shower</strong></p> <p>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.</p> <p>(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.</p> <p><strong>Stretch yourself to sleep </strong></p> <p>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.</p> <p>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.</p> <p><em>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.</em></p> <p><strong>Read (or listen!) to something new</strong></p> <p>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.</p> <p>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.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article by </em><em>Deepak Kashyap </em><em style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">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>. </em></p>

Body

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Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

<p><a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>Rumours and conspiracies have been <a href="https://www.nytimes.com/2024/02/28/style/princess-kate-middleton-health.html">swirling</a> following the abdominal surgery and long recovery period of Catherine, Princess of Wales, earlier this year. They intensified on Monday when Kensington Palace released a photo of the princess with her three children.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>The photo had clear signs of tampering, and international wire services <a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">withdrew the image</a> amid concerns around manipulation. The princess later <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised for any confusion</a> and said she had “experimented with editing” as many amateur photographers do.</p> <p>Image editing is extremely common these days, and not all of it is for nefarious purposes. However, in an age of rampant misinformation, how can we stay vigilant around suspicious images?</p> <h2>What happened with the royal photo?</h2> <p>A close look reveals at least eight inconsistencies with the image.</p> <p>Two of these relate to unnatural blur. Catherine’s right hand is unnaturally blurred, even though her left hand is sharp and at the same distance from the camera. The left side of Catherine’s hair is also unnaturally blurred, while the right side of her hair is sharp.</p> <p>These types of edits are usually made with a blur tool that softens pixels. It is often used to make the background of an image less distracting or to smooth rough patches of texture.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.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/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=358&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=358&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=358&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=450&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=450&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=450&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><span class="caption">At least eight logical inconsistencies exist in the doctored image the Prince and Princess of Wales posted on social media.</span> <span class="attribution"><a class="source" href="https://www.instagram.com/p/C4U_IqTNaqU/">Photo by the Prince of Wales/Chart by T.J. Thomson</a></span></figcaption></figure> <p>Five of the edits appear to use the “clone stamp” tool. This is a Photoshop tool that takes part of the same or a different image and “stamps” it onto another part.</p> <p>You can see this with the repeated pattern on Louis’s (on the left) sweater and the tile on the ground. You can also see it with the step behind Louis’s legs and on Charlotte’s hair and sleeve. The zipper on Catherine’s jacket also doesn’t line up.</p> <p>The most charitable interpretation is that the princess was trying to remove distracting or unflattering elements. But the artefacts could also point to multiple images being blended together. This could either be to try to show the best version of each person (for example, with a smiling face and open eyes), or for another purpose.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Like many amateur photographers, I do occasionally experiment with editing. I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother’s Day. C</p> <p>— The Prince and Princess of Wales (@KensingtonRoyal) <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616?ref_src=twsrc%5Etfw">March 11, 2024</a></p></blockquote> <h2>How common are image edits?</h2> <p>Image editing is increasingly common as both photography and editing are increasingly becoming more automated.</p> <p>This sometimes happens without you even knowing.</p> <p>Take HDR (high dynamic range) images, for example. Point your iPhone or equivalent at a beautiful sunset and watch it capture the scene from the brightest highlights to the darkest shadows. What happens here is your camera makes multiple images and automatically stitches them together to make an image <a href="https://www.adobe.com/creativecloud/photography/hub/guides/what-is-hdr-photography.html">with a wider range of contrast</a>.</p> <p>While face-smoothing or teeth-whitening filters are nothing new, some smartphone camera apps apply them without being prompted. Newer technology like Google’s “Best Take” <a href="https://blog.google/products/photos/how-google-photos-best-take-works/">feature</a> can even combine the best attributes of multiple images to ensure everyone’s eyes are open and faces are smiling in group shots.</p> <p>On social media, it seems everyone tries to show themselves in their best light, which is partially why so few of the photos on our <a href="https://www.tandfonline.com/doi/abs/10.1080/15551393.2020.1862663">camera rolls</a> make it onto our social media feeds. It is also why we often edit our photos to show our best sides.</p> <p>But in other contexts, such as press photography, the <a href="https://www.ap.org/about/news-values-and-principles/telling-the-story/visuals">rules are much stricter</a>. The Associated Press, for example, bans all edits beyond simple crops, colour adjustments, and “minor adjustments” that “restore the authentic nature of the photograph”.</p> <p>Professional photojournalists haven’t always gotten it right, though. While the majority of lens-based news workers adhere to ethical guidelines like those published by the <a href="https://nppa.org/resources/code-ethics">National Press Photographers Association</a>, others have let deadline pressures, competition and the desire for exceptional imagery cloud their judgement.</p> <p>One such example was in 2017, when British photojournalist Souvid Datta admitted to <a href="https://time.com/4766312/souvid-datta/">visually plagiarising</a> another photographer’s work within his own composition.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Photographer Souvid Datta appears to have plagiarized Mary Ellen Mark: <a href="https://t.co/iO1Lm8CowU">https://t.co/iO1Lm8CowU</a> <a href="https://t.co/jswHyApGNj">pic.twitter.com/jswHyApGNj</a></p> <p>— PetaPixel (@petapixel) <a href="https://twitter.com/petapixel/status/859824132258537472?ref_src=twsrc%5Etfw">May 3, 2017</a></p></blockquote> <p>Concerns around false or misleading visual information are at an all-time high, given advances in <a href="https://theconversation.com/nine-was-slammed-for-ai-editing-a-victorian-mps-dress-how-can-news-media-use-ai-responsibly-222382">generative artificial intelligence (AI)</a>. In fact, this year the World Economic Forum named the risk of misinformation and disinformation as the world’s greatest <a href="https://www.weforum.org/agenda/2024/01/ai-disinformation-global-risks/">short-term threat</a>. It placed this above armed conflict and natural disasters.</p> <h2>What to do if you’re unsure about an image you’ve found online</h2> <p>It can be hard to keep up with the more than <a href="https://theconversation.com/3-2-billion-images-and-720-000-hours-of-video-are-shared-online-daily-can-you-sort-real-from-fake-148630">3 billion photos</a> that are shared each day.</p> <p>But, for the ones that matter, we owe it to ourselves to slow down, zoom in and ask ourselves a few simple <a href="https://www.aap.com.au/factcheck-resources/how-we-check-the-facts/">questions</a>:</p> <p>1. Who made or shared the image? This can give clues about reliability and the purpose of making or sharing the image.</p> <p>2. What’s the evidence? Can you find another version of the image, for example, using a <a href="https://tineye.com/">reverse-image search engine</a>?</p> <p>3. What do trusted sources say? Consult resources like <a href="https://www.aap.com.au/factcheck/">AAP FactCheck</a> or <a href="https://factcheck.afp.com/">AFP Fact Check</a> to see if authoritative sources have already weighed in.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225553/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, Senior Lecturer in Visual Communication & Digital Media, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>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/yes-kate-middletons-photo-was-doctored-but-so-are-a-lot-of-images-we-see-today-225553">original article</a>.</p> <p><em>Hero image: The Conversation / X / Instagram</em></p>

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Why do I need to get up during the night to wee? Is this normal?

<p><em><a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>It can be normal to wake up once or even twice during the night to wee, especially as we get older.</p> <p>One in three adults over 30 makes <a href="https://pubmed.ncbi.nlm.nih.gov/30085529">at least two</a> trips to the bathroom every night.</p> <p>Waking up from sleep to urinate on a regular basis is called <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">nocturia</a>. It’s one of the most commonly reported <a href="https://pubmed.ncbi.nlm.nih.gov/32249998/">bothersome urinary symptoms</a> (others include urgency and poor stream).</p> <p>So what causes nocturia, and how can it affect wellbeing?</p> <h2>A range of causes</h2> <p>Nocturia can be caused by a variety of <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">medical conditions</a>, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an <a href="https://www.nature.com/articles/s41598-023-44916-8">overactive bladder</a>, or gastrointestinal issues. Other causes include pregnancy, <a href="https://onlinelibrary.wiley.com/doi/10.1002/nau.24839">medications</a> and consumption of alcohol or caffeine before bed.</p> <p>While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055528/">insomnia</a>, can also cause nocturia.</p> <p>When we sleep, an antidiuretic hormone is released that slows down the rate at which our <a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">kidneys produce urine</a>. If we lie awake at night, less of this hormone <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00025.2023">is released</a>, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.</p> <p>Stress, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153377/">anxiety</a> and watching television <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987">late into the night</a> are common causes of insomnia.</p> <h2>Effects of nocturia on daily functioning</h2> <p>The recommended amount of sleep for adults is between <a href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep">seven and nine hours</a> per night. The more times you have to get up in the night to go to the bathroom, the more this impacts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602727/#:%7E:text=Nocturia%20is%2C%20however%2C%20an%20important,(QoL)%20and%20general%20health.">sleep quantity and quality</a>.</p> <p>Decreased sleep can result in increased <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1251-5">tiredness</a> during the day, poor concentration, forgetfulness, changes in mood and impaired <a href="https://pubmed.ncbi.nlm.nih.gov/28425062/">work performance</a>.</p> <p>If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.</p> <p>In more severe cases, nocturia has been compared to having a similar impact on <a href="https://www.racgp.org.au/getattachment/b43c05ba-e29e-47c3-b816-ec47ceeafe97/Nocturia-a-guide-to-assessment-and-management.aspx">quality of life</a> as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.</p> <p>Nocturia not only upsets sleep, but also increases the risk of <a href="https://www.auajournals.org/doi/10.1097/JU.0000000000000459">falls</a> from moving around in the dark to go to the bathroom.</p> <p>Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.</p> <h2>Can you have a ‘small bladder’?</h2> <p>It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is <a href="https://youtu.be/blVmyrBPves">smaller</a> relative to your other organs.</p> <p>If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.</p> <figure><iframe src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Can you have a small bladder?</span></figcaption></figure> <p>If you find you are going to the bathroom quite a lot during the day and evening (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903463/">more than eight times</a> in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.</p> <p>If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.</p> <p>There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.</p> <h2>A happy and healthy bladder</h2> <p>Here are some tips to maintain a happy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/">healthy</a> bladder, and reduce the risk you’ll be up at night:</p> <ul> <li> <p>make your <a href="https://theconversation.com/what-position-should-i-sleep-in-and-is-there-a-right-way-to-sleep-189873">sleep environment comfortable</a>, with a suitable mattress and sheets to suit the temperature</p> </li> <li> <p>get to bed early, and limit <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">screens</a>, or activites before bed</p> </li> <li> <p>limit foods and drinks that irritate the bladder, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811496/">coffee or alcohol</a>, especially before bedtime</p> </li> <li> <p>sit in a <a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">relaxed position</a> when urinating, and allow time for the bladder to completely empty</p> </li> <li> <p>practice <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor muscle exercises</a></p> </li> <li> <p>drink an adequate amount of fluids during the day, and avoid becoming <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">dehydrated</a></p> </li> <li> <p>maintain a healthy lifestyle, eat <a href="https://journals.physiology.org/doi/full/10.1152/advan.00052.2023">nutritious foods</a> and do not do anything harmful to the body such as smoking or using illicit drugs</p> </li> <li> <p>review your medications, as the time you take some <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">pharmaceuticals</a> may affect urine production or sleep</p> </li> <li> <p>if you have <a href="https://pubmed.ncbi.nlm.nih.gov/28675633/">swollen legs</a>, raise them a few hours before bedtime to let the <a href="https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management">fluid drain</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224160/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, Associate Professor of Science &amp; Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, Senior Teaching Fellow, Medical Program, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-get-up-during-the-night-to-wee-is-this-normal-224160">original article</a>.</em></p>

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Why Barnaby Joyce’s TV diagnosis of insomnia plus sleep apnoea is such a big deal

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>The <a href="https://theconversation.com/view-from-the-hill-how-does-david-littleproud-handle-the-latest-barnaby-joyce-embarrassment-223289">health</a> of Nationals MP Barnaby Joyce is in the news again, this time with a diagnosis of a sleep disorder made <a href="https://www.afr.com/companies/media-and-marketing/barnaby-joyce-to-be-diagnosed-with-a-sleep-disorder-on-live-tv-20240223-p5f79q">while filming</a> a TV documentary.</p> <p>Joyce’s diagnosis of insomnia plus sleep apnoea arose while filming <a href="https://www.sbs.com.au/whats-on/article/australias-sleep-revolution-with-dr-michael-mosley/nuyko305b">Australia’s Sleep Revolution with Dr Michael Mosley</a> in 2023. SBS has confirmed episode three, in which my Flinders University colleagues reveal his sleep disorder, is set to air on March 20.</p> <p>I was not involved in the program and have no knowledge of Joyce’s <a href="https://www.theaustralian.com.au/weekend-australian-magazine/australias-sleep-crisis-has-flinders-university-cracked-the-code-to-a-better-nights-sleep/news-story/d3b82617af33fff82487da2534722733">ongoing health care</a>. But I was part of the research team that in 2017 <a href="https://doi.org/10.1016/j.smrv.2016.04.004">coined the term COMISA</a> (co-morbid insomnia and sleep apnoea), the official name of Joyce’s on-screen diagnosis. Since then, I’ve led research into this <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> sleep disorder.</p> <p>Here’s why it’s so important to diagnose and treat it.</p> <h2>What was Joyce’s diagnosis?</h2> <p>People can be diagnosed separately with <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">insomnia</a> or <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/obstructive-sleep-apnoea">sleep apnoea</a>.</p> <p>Insomnia includes frequent difficulties falling asleep at the start of the night or difficulties staying asleep during the night. These can result in daytime fatigue, reduced energy, concentration difficulties and poor mood. Over time, insomnia can start to impact your <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and quality of life.</p> <p>Sleep apnoea (specifically, obstructive sleep apnoea) is when people experience repeated interruptions or pauses in breathing while they sleep. This reduces oxygen levels during sleep, and you can wake up multiple times at night. People with sleep apnoea may be aware of loud snoring, gasping for air when they wake up, or feeling exhausted the next morning. However, not all people have these symptoms, and sleep apnoea can go undiagnosed for years.</p> <p>But in Joyce’s case, both insomnia and sleep apnoea occur at the same time.</p> <p>We’ve known this could happen since <a href="https://doi.org/10.1126/science.181.4102.856">the 1970s</a>, with <a href="https://psycnet.apa.org/doi/10.1037/0022-006X.67.3.405">evidence growing</a> over <a href="https://doi.org/10.1378/chest.120.6.1923">subsequent decades</a>. Since then, sleep researchers and clinicians around the world have learned more about how <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> this is, its <a href="https://doi.org/10.1183/13993003.01958-2021">consequences</a> and how best to <a href="https://doi.org/10.1111/jsr.13847">treat it</a>.</p> <h2>How do you know if you have it?</h2> <p>Many people <a href="https://doi.org/10.1016/j.sleep.2005.08.008">seek help</a> for their sleep problems because of fatigue, exhaustion, physical symptoms, or poor mood during the day.</p> <p>If you think you have insomnia, a GP or sleep specialist can talk to you about your sleep pattern, and might ask you to complete <a href="https://www.sleepprimarycareresources.org.au/insomnia/assessment-questionnaires">brief questionnaires</a> about your sleep and daytime symptoms. You might also be asked to fill in a “sleep diary” for one to two weeks. These will allow a trained clinician to see if you have insomnia.</p> <p>If you or your GP think you may have (or are at risk of having) sleep apnoea, you may be referred for a sleep study. This normally involves sleeping overnight in a sleep clinic where your sleep patterns and breathing are monitored. Alternatively, you might be set up with a recording device to monitor your sleep at home. A trained medical professional, such as a sleep and respiratory physician, will often make the diagnosis.</p> <p><a href="https://doi.org/10.1016/j.smrv.2021.101519">Up to 50%</a> of people with sleep apnoea report symptoms of insomnia. About <a href="https://doi.org/10.1016/j.smrv.2021.101519">30–40%</a> of people with insomnia also have sleep apnoea.</p> <h2>What are the consequences?</h2> <p>Insomnia and sleep apnoea (individually) are associated with reduced <a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">sleep quality</a>, <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and <a href="https://theconversation.com/health-check-heres-what-you-need-to-know-about-sleep-apnoea-26402">physical health</a>.</p> <p>Importantly, people with both at the same also tend to <a href="https://doi.org/10.3390/brainsci9120371">experience</a> worse sleep, daytime function, mental health, physical health and quality of life, compared with people with no sleep disorder.</p> <p>For instance, we know having both conditions comes with an <a href="https://doi.org/10.1111/jsr.13563">increased risk</a> of diseases of the heart.</p> <p><a href="https://doi.org/10.2147/NSS.S379252">In</a> <a href="https://doi.org/10.1183/13993003.01958-2021">three</a> <a href="https://doi.org/10.1016/j.sleepe.2022.100043">studies</a>, we found people with both insomnia and sleep apnoea have about a 50–70% higher risk of dying early from any cause, compared with people with neither sleep condition. People with insomnia alone and sleep apnoea alone did not have an increased risk of dying early.</p> <p>However, there are effective treatments to reduce these health consequences.</p> <h2>How is it treated?</h2> <p>In general, it is best for people to access evidence-based treatments for both disorders. These treatments vary according to the patient and the severity of their condition.</p> <p>For instance, wearing a <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/cpap-continuous-positive-airway-pressure">CPAP mask</a> while sleeping improves breathing during sleep and reduces many of the daytime consequences of obstructive sleep apnoea. However, other effective treatments may be recommended based on each person’s symptoms, such as weight management, avoiding sleeping on your back, <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/oral-appliances-to-treat-snoring-and-obstructive-sleep-apnoea-osa">oral devices</a> (which look a bit like a mouthguard), or surgery.</p> <p>The <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">most effective</a> treatment for insomnia is cognitive behavioural therapy for insomnia, also known as <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a>. About four to eight sessions often lead to improvements in sleep, daytime function and mental health that are maintained for many <a href="https://doi.org/10.1080/16506073.2021.2009019">years</a>. This can be delivered by trained therapists such as psychologists, nurses or GPs, as well as via <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online</a> programs.</p> <p>Last year, we drew together evidence from more than 1,000 people with both conditions. We found CBTi is an <a href="https://doi.org/10.1111/jsr.13847">effective treatment</a> for insomnia in people with treated and untreated sleep apnoea.</p> <h2>New treatments and approaches</h2> <p><a href="https://www.frontiersin.org/articles/10.3389/frsle.2024.1355468/abstract">We</a> and <a href="https://doi.org/10.1186/s13063-022-06753-4">other teams</a> internationally are developing and testing new ways of delivering CBTi.</p> <p>Several groups are testing devices, which <a href="https://doi.org/10.1002%2Flio2.761">stimulate</a> the tongue muscles during sleep, to treat sleep apnoea in people with both disorders.</p> <p>And we’re still working out the best order for patients to access treatments, and the best combination of treatments.</p> <h2>The power of TV</h2> <p>Joyce’s public diagnosis of both insomnia and sleep apnoea will no doubt raise awareness of what we suspect is an underdiagnosed condition.</p> <p>Based on how common insomnia and sleep apnoea are in Australia, we estimate Joyce is one of about <a href="https://doi.org/10.1016/j.sleep.2021.03.023">5–10%</a> of Australian adults to have both at the same time.</p> <p>The Conversation contacted Joyce’s spokesperson for comment but did not hear back before deadline.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224616/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-barnaby-joyces-tv-diagnosis-of-insomnia-plus-sleep-apnoea-is-such-a-big-deal-224616">original article</a>.</em></p>

Body

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"I thought I was gone": Doctors reveal how close Jimmy Barnes came to dying

<p>Jimmy Barnes has shared how he fought to stay alive after being forced to undergo major surgery, admitting he didn't think we would survive. </p> <p>The rock legend underwent emergency heart surgery in December 2023, after being struck down with a dangerous infection that threatened his life. </p> <p>Speaking candidly to <a href="https://9now.nine.com.au/60-minutes/jimmy-barnes-cold-chisel-illness-how-rock-icon-fought-to-stay-alive/3717a0d8-25ff-4400-bab3-f556e0b417c2" target="_blank" rel="noopener"><em>60 Minutes</em></a>, the 67-year-old said he didn't have much hope in his survival. </p> <p>"I just said to Jane, 'I don't think I'm gonna make it'. I just had this horrible morbid feeling because I've never felt this sick before. I thought I was gone," he said. </p> <p>Barnes was first admitted to hospital the day after pushing through excruciating pain in November to perform at a tribute concert for his late friend Michael Gudinski. </p> <p>After being admitted to St Vincent's Hospital in Sydney with pneumonia, a team of specialists including cardiothoracic surgeon Dr Paul Jansz, soon discovered a much more sinister health issue was at play, as an infection quickly led to endocarditis: a life-threatening inflammation of the heart.</p> <p>"[The infection] was just eating at his heart. You see an abscess cavity forming around the valve, and that would've just grown and grown and grown," Jansz said.</p> <p>"It's fatal. If he didn't die of the infection, he would've died from heart failure, from the whole valve falling apart."</p> <p>By the time he was wheeled into theatre, his doctors say he had hours to live.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C3e_KPSPsC-/?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/C3e_KPSPsC-/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by 60 Minutes Australia (@60minutes9)</a></p> </div> </blockquote> <p>"When I contemplated dying before surgery, I just thought, 'you have to savour those moments; have I told my children that I love 'em enough? Have I told Jane? The people you love, make sure you tell 'em'," Barnes said.</p> <p>Surgeons managed to fix Barnes' heart in a marathon seven-hour surgery, as the musician then faced a lengthy recovery process. </p> <p>"It's like you've been ripped in half," he said.</p> <p>"Your best friend is a pillow. If you cough, it's just agony. If you breathe too deep, it's agony. And sneezing would be the end of you."</p> <p>"But I think it's made me stronger. I want to be better than I was. I've got all this new life from this and I want to make the best of it. I want every minute to count."</p> <p>Now two months into his recovery, Jimmy is getting stronger everyday, and has nothing but thanks for his loved ones that stayed by his side during the difficult journey. </p> <p>"Without a doubt, the fact that my family were there and Jane was there, I wasn't going anywhere. I wanted to spend every breath I could spend with Jane. And if that meant fighting to live longer, I was going to do it."</p> <p>When asked about his highly-anticipated <a href="https://oversixty.com.au/entertainment/music/huge-news-for-jimmy-barnes-fans" target="_blank" rel="noopener">return to the stage</a> in April, he joked it would be his version of resurrection. </p> <p>He said, "I miss being on stage, I have to do it, I don't have a choice. I need to get out there and scream, it just clears the emotions out of you."</p> <p><em>Image credits: 60 Minutes </em></p>

Caring

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Heartbroken parents of slain Melbourne doctor break silence

<p>Dr Ash Gordon's heartbroken parents have spoken out about the moment they found out their son had died. </p> <p>The Melbourne GP was allegedly killed after <a href="https://www.oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor" target="_blank" rel="noopener">confronting two teenage</a> boys who had allegedly broken into his home in Doncaster in the early hours on Saturday, January 13.</p> <p>Dr Gordon’s grieving mother Catherine, recalled the moment she was woken by the phone call no parent wants to receive. </p> <p>“He said that Ashley had gone. And I said gone where? He’s gone. He’s no longer with us,” Mrs Gordon told <em>A Current Affair </em>about the moment her son's housemate delivered the devastating news. </p> <p>“I said, ‘Don’t lie, you’re joking.‘ And I hung up on him."</p> <p>Holding back tears, Mrs Gordon also shared the denial she went through as she received the call from a detective. </p> <p>"Then the detective rang and I told him that I didn’t believe him, and he said 'how can I get you to believe?', I said 'until there is a police person in uniform in front of me, it's not happening'"</p> <p>"Well you don't want to believe do you?" <em>A Current Affair </em>host Ally Langdon replied, and both parents shook their heads. </p> <p>“We saw the police car coming up, and I just prayed to God they’d just keep going. I didn’t want them to turn into the driveway, but unfortunately, it happened.”</p> <p>Ally Langdon who was brought to tears during the interview added: “It’s a cruel contrast isn’t it? That Ash has dedicated his life to saving lives, yet his was taken in this horrible way." </p> <p>The 33-year-old doctor was found by police less than a kilometre from his home, but unfortunately he died at the scene. </p> <p>In the days following the incident, two 16-year-old boys with Dr Gordon’s murder as well as aggravated burglary and theft.</p> <p>Dr Gordon's family have since held a <a href="https://www.oversixty.com.au/health/caring/i-ll-see-you-again-one-day-sister-of-slain-doctor-s-emotional-tribute" target="_blank" rel="noopener">memorial service</a> for him to honour the slain doctor. </p> <p><em>Image: A Current Affair</em></p>

Family & Pets

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“I’ll see you again one day”: Sister of slain doctor’s emotional tribute

<p dir="ltr">Dr Ash Gordon has been farewelled in an emotional memorial service, with his family and friends joining together to honour the slain doctor. </p> <p dir="ltr">The 33-year-old died after a violent altercation following a home invasion on January 13th in the Melbourne suburb of Doncaster. </p> <p dir="ltr">Loved ones gathered at Kernot Hall, in Morwell, south-east Victoria, to honour his life and share in their grief.</p> <p dir="ltr">Funeral celebrant Elisha Dowsett opened the funeral by encouraging the mourners to “leave the anger” and focus on remembering Dr Gordon’s celebrated life. </p> <p dir="ltr">“He warmed the hearts of anyone lucky enough to cross paths with him,” she said.</p> <p dir="ltr">“He was a strong, compassionate, funny, driven, determined and cheeky man. He filled this dark and unpredictable world with genuine goodness.”</p> <p dir="ltr">Dr Gordon’s sister Natalie spoke to the congregation, sharing how she will “never get over his death”.</p> <p dir="ltr">“He was a huge part of our lives. He always encouraged me to take risks because he would say, ‘if you don’t, you’ll wonder what if’,” she said.</p> <p dir="ltr">Breaking down in tears, Ms Gordon told mourners she had promised to “take the risk and live the life I dreamt of just as he did”.</p> <p dir="ltr">“This isn’t goodbye little brother, this is see you soon. I’ll see you again one day,” Ms Gordon said.</p> <p dir="ltr">“And, when I do, I can't wait for you to tell me how bad my wrinkles are and for you to give me a big hug. Until we meet again Brother Bear.”</p> <p dir="ltr">Ash’s other sister Tammy Gordon said she “cannot express” how proud she is to call Dr Gordon her brother.</p> <p dir="ltr">“Losing a sibling is losing the person you can truly be yourself with,” she said.</p> <p dir="ltr">Following the passing of Dr Gordon, two 16-year-olds were <a href="https://oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor">charged</a> with murder, aggravated burglary and theft over his death. </p> <p dir="ltr">The teenagers allegedly broke into the home of 33-year-old Dr Ash Gordon, when the doctor then pursued the intruders after they fled the house. </p> <p dir="ltr">The teens then became violent, allegedly stabbing Dr Gordon several times and leaving him to die a kilometre from his home. </p> <p dir="ltr"><em>Image credits: YouTube</em></p> <p><span id="docs-internal-guid-aab57aa9-7fff-de2f-7f15-6813b34ca13d"></span></p>

Caring

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Major update in fatal stabbing of young Melbourne doctor

<p dir="ltr">The 16-year-old accused of stabbing a young Melbourne doctor to death had allegedly committed a similar crime just months prior. </p> <p dir="ltr">The teenager was allegedly involved in the home invasion of Dr Ash Gordon, which turned fatal after the doctor chased the intruders from his home, ending when Dr Gordon was stabbed and left for dead. </p> <p dir="ltr">As the teens now <a href="https://oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor" target="_blank" rel="noopener">face charges</a> for his death, an alleged previous victim of the same teenager has come forward, claiming the young man left him with serious head injuries after robbing his house in October. </p> <p dir="ltr">His alleged previous victims claim that the Victorian government has “blood on its hands” and that the boy should not have been released on bail.</p> <p dir="ltr">The victims told<a href="https://www.heraldsun.com.au/truecrimeaustralia/police-courts-victoria/we-feel-anxious-helpless-and-frustrated-with-the-broken-system-alleged-victims-speak-out/news-story/c05575a0908bf85f014217bb4fda7fa4"> <em>the Herald Sun</em></a> that Dr Gordon's death has left them traumatised and struggling to move on from their own terrifying encounter.</p> <p dir="ltr">In an emotional statement, the alleged previous victims pleaded with Victorian premier Jacinta Allan to reconsider the state's planned youth justice reform. </p> <p dir="ltr">“We are trying to move on with our lives, however, when a case on (alleged) teen crime is reported, we feel anxious, helpless and frustrated with the broken system," they told the publication.</p> <p dir="ltr">“The Allan government and the justice system have blood on their hands, and ultimately should be held accountable.”</p> <p dir="ltr">Under the terms of the 16-year-old’s bail, he was to adhere to a strict nightly curfew, but still managed to allegedly break into Dr Gordon's home shortly before 5:30am on January 13th. </p> <p dir="ltr">Ms Allan has faced increasing pressure to abandon Victoria's overhaul of the youth justice system which would see the age of criminal responsibility raised.</p> <p dir="ltr">The government has committed to raising the age that a child can be arrested, jailed or charged from 10 to 12 by the end of 2024, and again to 14 by 2027, with serious crimes such as homicide being exempt from these changes. </p> <p dir="ltr">Ms Allen however has insisted that the reforms are a key priority of her government and that they will help prevent future criminal ­activity.</p> <p dir="ltr">“There’s a huge amount of work that’s being undertaken by Victoria Police to work with those young people ... [and] that sort of prevention-based activity is the best way to address future youth crime,” she said.</p> <p dir="ltr">“At the same time, when offences are made, Victoria Police have the tools and resources to deal with those.”</p> <p dir="ltr" style="line-height: 1.38; margin-top: 0pt; margin-bottom: 12pt;"><em>Image credits: Facebook</em><span id="docs-internal-guid-deb8779e-7fff-f1a9-74f6-d47cadad48af"></span></p>

News

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“We will hurt forever”: Sister of slain doctor speaks out

<p>Dr Ash Gordon’s sister Natalie, has broken her silence after her brother's tragic <a href="https://www.oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor" target="_blank" rel="noopener">passing</a>.</p> <p>Ash was found allegedly stabbed to death less than a kilometre from his home, following an  aggravated burglary in Doncaster, Melbourne on Saturday night. </p> <p>Two 16-year-old boys have since been arrested and have been charged with murder, aggravated burglary and theft. </p> <p>Recalling the moment she found out the two boys were arrested, Natalie said she felt slightly relieved. </p> <p>“We thought we’d be going through this a lot longer,” she said. </p> <p>“Then I felt anger (and) a whole new wave of sadness.”</p> <p>She added that her family is grieving and having a hard time processing that their beloved son and brother is gone. </p> <p>"We will hurt forever," she said. “Ash’s patients, colleagues ... Ash’s friends, will all hurt. He was an amazing person, with the best smile, the biggest heart. Our family will never, ever repair itself.”</p> <p>She said that the hardest part for her was watching her parents breakdown. </p> <p>“We all held him on the biggest pedestal, and it’s gone. It’s just gone.”</p> <p>Ash's funeral will be held next Thursday and the family wants to send him off “with a bang”, just like what he would want, according to his sister. </p> <p>“I can’t begin to explain how hard it is now to go through photos ... to go through photos and try to pick photos to show everyone how amazing he was.”</p> <p>Natalie, who has three daughters herself, said that she hopes no other family will ever have to go through the heartache she's experiencing. </p> <p>“I would never want any other family to have to go through what we’re going through,” she said.</p> <p>The two teenagers will appear at a children’s court on February 8, and the prosecution has asked for 12 weeks to prepare a brief of evidence.</p> <p><em>Images: 7NEWS</em></p>

Family & Pets

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“They have stolen everything”: Slain doctor’s partner speaks out

<p dir="ltr">Dr Ash Gordon’s long-term girlfriend has broken her silence after her partner’s untimely death, saying she expects her boyfriend’s killers to be dealt “the maximum punishment”.</p> <p dir="ltr">The 33-year-old doctor was left for dead after a home invasion went wrong, with two teenagers now facing <a href="https://oversixty.com.au/news/news/major-update-in-tragic-death-of-young-melbourne-doctor">murder charges</a>. </p> <p dir="ltr">Two 16-year-olds have been charged with murder, aggravated burglary and theft after breaking into the young physician’s home, before allegedly stabbing him. </p> <p dir="ltr">Now, Dr Gordon’s grieving girlfriend Dakota Nagel has spoken out for the first time, telling <em><a href="https://www.news.com.au/national/victoria/ash-gordons-partner-dakota-nagel-speaks-after-teens-charged-over-alleged-murder/news-story/c5bf92f8f14ba87b0c3efd0cd8d1f1e7">news.com.au</a></em> she was grateful for the work of police in the days since the alleged murder.</p> <p dir="ltr">Ms Nagel said those allegedly responsible “deserve the maximum punishment and I will accept nothing less”.</p> <p dir="ltr">“They are heartless enough to take a life that meant so much to all of us,” she said.</p> <p dir="ltr">Ms Nagel said her partner of almost six years was the “light of my life” and “irreplaceable”.</p> <p dir="ltr">“They’ve stolen more than just belongings, they have stolen everything from myself and his family and friends, he was our world,” she said.</p> <p dir="ltr">“He was the most beautiful, kind, patient and understanding person I’ve ever met and I’m just lucky to have spent my life with him.”</p> <p dir="ltr">Miss Nagel told the <em>Herald Sun</em> that her boyfriend should be remembered for the positive impact he had on everyone he knew, including his patients.</p> <p dir="ltr">“We wish for Ash to be remembered for the loving kind person he was and the impact of good he made on the world,” she said.</p> <p dir="ltr">“He died a hero and the people responsible will be held accountable, and justice will be served for Ash and his loved ones.”</p> <p dir="ltr">Superintendent Janet Stevenson said police worked “tirelessly” to “apprehend those responsible for his tragedy”. </p> <p dir="ltr">“We know that Ash’s family and loved ones are grieving. This arrest will not take away the tragedy of this dreadful situation, but we hope that it will alleviate some of their distress,” she said.</p> <p dir="ltr">“We will continue to provide all the support they require during this difficult time.”</p> <p dir="ltr">The alleged attackers will face children’s court at a later date. </p> <p dir="ltr"><em>Image credits: Instagram / Nine</em></p> <p> </p>

Relationships

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Major update in tragic death of young Melbourne doctor

<p dir="ltr">Two teenage boys have been charged with murder just days after the <a href="https://oversixty.com.au/health/caring/sister-of-slain-doctor-calls-for-killers-to-turn-themselves-in">death</a> of a Melbourne doctor. </p> <p dir="ltr">The 16-year-old boys allegedly broke into the home of 33-year-old Dr Ash Gordon on Saturday, when the doctor then pursued the intruders after they fled the house. </p> <p dir="ltr">The teens then became violent, allegedly stabbing Dr Gordon several times and leaving him to die a kilometre from his home. </p> <p dir="ltr">As his heartbroken family continue to grieve their loss, homicide detectives confirmed that the two 16-year-olds have been charged with murder, aggravated burglary and theft and will face a children’s court at a later date. </p> <p dir="ltr">Superintendent Janet Stevenson said police worked “tirelessly” to “apprehend those responsible for his tragedy”. </p> <p dir="ltr">“We know that Ash’s family and loved ones are grieving. This arrest will not take away the tragedy of this dreadful situation, but we hope that it will alleviate some of their distress,” she said.</p> <p dir="ltr">“We will continue to provide all the support they require during this difficult time.”</p> <p dir="ltr">Tributes have poured in for the young doctor, with his sister Natalie describing the 33-year-old as her “world”.</p> <p dir="ltr">“I’m his older sister, but I looked up to him for so much, as did our other siblings. He’s the youngest, but we all looked up to him. Mum and dad would ring him for advice,” she said.</p> <p dir="ltr">“He was just so sure of himself. Such a confident person and so willing to help anyone and everyone.”</p> <p dir="ltr">Friends have also flooded social media with their grief, sharing words of condolences for his loved ones while posting kind words about their fallen friend. </p> <p dir="ltr">“Thank you for the many unforgettable memories, you were one of a kind,” one friend wrote on Facebook.</p> <p dir="ltr">“You were definitely such an inspiration to others, you worked so hard to get where you are! Life’s just not fair.”</p> <p dir="ltr"><em>Image credits: Nine / Instagram </em></p>

News

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Sister of slain doctor calls for killers to turn themselves in

<p dir="ltr">The distraught sister of Dr Ash Gordon has made an emotional appeal for those responsible for the death of her brother to turn themselves in. </p> <p dir="ltr">In the early hours of Saturday morning, the 33-year-old doctor was killed after a group of criminals broke into his home in Doncaster in Melbourne’s east. </p> <p dir="ltr">After they stole several items from his home, he managed to chase them out of the house and pursued them in his car, until both he and the intruders exited their vehicles and a fight erupted just 500 metres away. </p> <p dir="ltr">Dr Gordon was stabbed fatally several times in the altercation and was left for dead. </p> <p dir="ltr">As his family grieve his premature death, his devastated sister Natalie has called for justice. </p> <p dir="ltr">Appearing on <em>Sunrise</em>, she shared how angry the situation has made her. </p> <p dir="ltr">“I think for me it's been anger the entire time. I'm just obviously devastated, but so angry that anyone could do this to not only my brother but any person, any human being,” she said.</p> <p dir="ltr">"His girlfriend is heartbroken, mum is completely broken and I've never seen my dad like this. You never want to have to bury your own children."</p> <p dir="ltr">Ms Gordon said her little brother had “a big personality with a large heart”, sharing how “his presence was known everywhere.”</p> <p dir="ltr">“He had a cheeky grin, a charm and charisma about him that had everyone wrapped around his little finger.”</p> <p dir="ltr">“He was the absolute apple of all of our eyes. He was the centre of our family and he was the youngest of five but we all looked up to him.”</p> <p dir="ltr">While Dr Gordon's attackers remain on the run and no arrests have been made, Natalie has pleaded for the killers to turn themselves in to police. </p> <p dir="ltr">“Wear the consequences, because you'll never imagine what we're feeling, what we're going through,” she said.  </p> <p dir="ltr">“You have taken away a wonderful doctor, a caring man and the best little brother. Don't be a coward now.”</p> <p dir="ltr"><em>Image credits: Nine / Sunrise</em></p>

Caring

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Christmas drinks anyone? Why alcohol before bedtime leaves you awake at 3am, desperate for sleep

<p><em><a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/chris-irwin-249481">Chris Irwin</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/grace-vincent-1484516">Grace Vincent</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>, and <a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p>You’ve come home after a long day at work, you have dinner, put the kids to bed, and then you have your usual nightcap before drifting off to sleep. Or, perhaps you’re at the pub for the work Christmas party, and you think you’ll just have one more drink before heading home.</p> <p>That last drink might help you fall asleep easily. But your nightcap can also wreck a good night’s sleep. How could it do both?</p> <p>Here’s what’s going on in your body when you drink alcohol just before bedtime. And if you want to drink at the Christmas party, we have some tips on how to protect your sleep.</p> <h2>What happens to my body when I drink?</h2> <p>Soon after you drink, alcohol enters your bloodstream and travels to your brain.</p> <p><a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1530-0277.1998.tb03695.x">There</a>, it affects chemical messengers known as neurotransmitters and <a href="https://pubmed.ncbi.nlm.nih.gov/2700603/">slows down communication</a> between nerve cells.</p> <p>Certain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040959/">regions of the brain</a> are particularly vulnerable to the effects of alcohol. When alcohol interacts with cells in these regions, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826822/">overall effect</a> leads to those characteristic feelings of relaxation, lowered inhibitions, slurred speech, and may induce feelings of drowsiness and lethargy.</p> <p>Alcohol can also have immediate effects on the heart and circulatory system. Blood vessels widen, resulting in a <a href="https://link.springer.com/article/10.1007/s11906-021-01160-7">drop in blood pressure</a>, which can make you feel dizzy or lightheaded.</p> <h2>What happens soon after a nightcap?</h2> <p>Drinking alcohol before sleeping is like flipping a switch. At first, alcohol has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826822/">sedative effect</a> and you will probably feel <a href="https://pubmed.ncbi.nlm.nih.gov/23347102/">more relaxed</a> and <a href="https://www.nature.com/articles/s41598-020-62227-0#:%7E:text=In%20this%20large%2C%20population%20based,sleep%20(cross%20sectional%20analyses).">drift off easily</a>.</p> <p>At this point, you still have a high level of alcohol in your blood. But don’t be fooled. As your body <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">processes the alcohol</a>, and the night goes on, alcohol actually <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12621">disrupts your sleep</a>.</p> <h2>And later that night?</h2> <p>As your body processes the alcohol and your blood alcohol level drops, your brain rebounds from the drowsiness you would have felt earlier in the night.</p> <p>This disturbs your sleep, and can wake you up <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">multiple times</a>, particularly in the second half of the night. You may also have vivid and stressful <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">dreams</a>.</p> <p>This sleep disruption is mainly to the deep, “rapid eye movement” or REM sleep.</p> <p>This type of sleep plays an important role in regulating your emotions and for your cognitive function. So not getting enough explains why you wake up feeling pretty lousy and groggy.</p> <p>Drinking alcohol before bedtime also tends to mean you <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775419/?source=post_page---------------------------">sleep less overall</a>, meaning important rest and recharge time is cut short.</p> <p>There are also <a href="https://pubmed.ncbi.nlm.nih.gov/31234199/">long-term impacts</a> of alcohol on sleep. Moderate and heavy drinkers consistently have <a href="https://academic.oup.com/sleepadvances/article/3/1/zpac023/6632721">poor sleep quality</a> and more <a href="https://www.nature.com/articles/s41598-020-62227-0#:%7E:text=In%20this%20large%2C%20population%20based,sleep%20(cross%20sectional%20analyses).">sleep disturbances</a> over time.</p> <h2>How about the Christmas party then?</h2> <p>If you plan to drink this holiday season, here are some tips to minimise the effect of alcohol on your sleep:</p> <ul> <li> <p><strong>swap every other drink</strong>. Try swapping every second drink for a non-alcoholic drink. The more alcohol you drink, <a href="https://academic.oup.com/sleep/article/44/1/zsaa135/5871424?casa_token=okbJAuf8TXUAAAAA:ye_q-DACToxvj8H3IVaiKrjNkDhHZnl-LKJdds3iteaKyzJFuHUzitlRv45DqxNO-FraDRAlQMV53z8">the more</a> sleep disruption you can expect. Reducing how much you drink in any one sitting can minimise the effect on your sleep</p> </li> <li> <p><strong>avoid drinking alcohol close to bedtime</strong>. If you give your body a chance to process the alcohol before you go to sleep, your sleep will be less disrupted</p> </li> <li> <p><strong>eat while you drink</strong>. Drinking on an empty stomach is going to worsen the effects of alcohol as the alcohol will be absorbed <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-3010.2006.00588.x?casa_token=TQiCqcbasYAAAAAA:GbEvnTT82aB3_sPfmJLOQXIV3ivjnbZdIoP2_XZBa8IDZ0YLaPxNfE6DMHLgH7obnpA22VDsM4vyGZV4dQ">faster</a>. So try to eat something while you’re drinking</p> </li> <li> <p><strong>ditch the espresso martinis and other caffeinated drinks</strong>. <a href="https://www.sciencedirect.com/science/article/pii/S1087079207000937?casa_token=NJsobF-C-vwAAAAA:opzPjrglPdZTwXEo7rHil5vm0a1K3KmXw9vp0Het-eRHZEWbfRAA40vgicU3Z5kC8x7uEJF39C8">Caffeine</a> can make it hard to get to sleep, and hard to stay asleep</p> </li> <li> <p><strong>be careful if you have sleep apnoea</strong>. People who have sleep apnoea (when their upper airway is repeatedly blocked during sleep) can be even more impacted by drinking alcohol. That’s because alcohol can act as a muscle relaxant, <a href="https://academic.oup.com/sleep/article/5/4/318/2753287">leading to</a> more snoring, and lower oxygen levels in the blood. If you have sleep apnoea, limiting how much alcohol you drink is the best way to avoid these effects</p> </li> <li> <p><strong>drink plenty of water</strong>. Staying hydrated will help you <a href="https://academic.oup.com/sleep/article/42/2/zsy210/5155420">sleep better</a> and will hopefully stave off the worst of tomorrow’s hangover.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216834/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, Postdoctoral research fellow, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/chris-irwin-249481">Chris Irwin</a>, Senior Lecturer in Nutrition and Dietetics, School of Health Sciences &amp; Social Work, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/grace-vincent-1484516">Grace Vincent</a>, Senior Lecturer, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>, and <a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/christmas-drinks-anyone-why-alcohol-before-bedtime-leaves-you-awake-at-3am-desperate-for-sleep-216834">original article</a>.</em></p>

Body

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Devastating update after doctor attacked at home

<p>Prominent Adelaide doctor and former head of the intensive care unit at Adelaide Women’s and Children’s Hospital <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Dr Michael Yung, who fell victim to a brutal assault during a home invasion, has tragically succumbing to life-threatening injuries at the age of 61.</span></p> <p>The news of Dr Yung's death sent shockwaves through the medical community, with the state's Health Minister, Chris Picton, expressing profound sorrow. In a statement, he spoke of Dr Yung's unwavering dedication to healing others, particularly the most vulnerable children in South Australia. The abrupt loss has left the entire SA Health family grappling with grief, as they remember a man who dedicated his life to serving those in their darkest times.</p> <p>As the investigation into the incident unfolds, Detective Superintendent Des Bray revealed a <a href="https://www.oversixty.com.au/finance/legal/prominent-aussie-doctor-fighting-for-life-after-violent-home-invasion" target="_blank" rel="noopener">chilling sequence of events</a> leading up to the fatal assault. In the days preceding Dr Yung's attack, a wave of home break-ins and car thefts plagued the affluent suburbs. The community of Medindie, adjacent to Dr Yung's residence, witnessed a series of intrusions, with surveillance capturing the haunting image of five youths attempting to break into a home.</p> <p><strong>IMPORTANT EDITOR'S UPDATE:</strong></p> <p>South Australian Police have swiftly taken action, announcing the arrest of a 22-year-old man and a 27-year-old woman from Thebarton in connection with the crime. The arrests took place in Torrensville, where the suspects were apprehended on Tuesday evenin. The charges laid against the pair include not only murder but also aggravated serious criminal trespass and committing theft using force.</p> <p>Police have indicated that the investigation is progressing, with detectives diligently working on the case. Authorities have reassured the public that no additional suspects are being sought in connection with Dr Yung's alleged murder. Furthermore, there appears to be no discernible link between the arrested individuals and those sought in connection with a recent crime spree across Adelaide, providing a measure of relief to residents.</p> <p>While the Adelaide Major Crime Unit continues to work on the case, authorities are urging anyone with further information or dashcam footage from the vicinity to come forward.</p> <p><em>Images: SA Police / Adelaide Women’s and Children’s Hospital</em></p>

Caring

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Prominent Aussie doctor fighting for life after violent home invasion

<p>Dr. Michael Yung, a distinguished 61-year-old Adelaide doctor and former head of the intensive care unit at Adelaide Women’s and Children’s Hospital, is fighting for his life following a brutal home invasion early on Monday morning.</p> <p>The assault, deemed "life-threatening" by South Australia Police, unfolded within the confines of Dr Yung's opulent $2 million residence on James Street, Gilberton, at approximately 4:20am. Transpiring in one of the city's most affluent suburbs, the incident has been elevated to the status of a "major crime", prompting an expansive manhunt.</p> <p>Upon the arrival of emergency services, Dr Yung, suffering from severe injuries, was promptly transported to the Royal Adelaide Hospital, where he currently remains in critical condition.</p> <p>A comprehensive investigative effort is underway, involving Major Crime Detectives, Eastern District Detectives and patrol officers. Specialised forensic officers have diligently combed through the crime scene, with their efforts extending well into the night.</p> <p>Despite the intensive search, no suspects have been apprehended. Authorities suspect the involvement of multiple offenders, though the investigation is still in its early stages. Officers are actively pursuing leads and appealing to the public for assistance, requesting dashcam footage recorded between 3:30am and 5am on Monday in the vicinity of James Street and Nottage Terrace at Gilberton.</p> <p>CCTV footage has been secured, revealing a group of youths attempting a break-in at a nearby residence in Medindie hours before the assault on Dr Yung. Residents in the area have recently experienced a series of break-ins, although it remains uncertain if this incident is linked to other offences.</p> <p>Dr Yung's 30-year-old son emerged unscathed from the ordeal and is being treated as a witness, not a suspect, by detectives. Additional family members, including his second son, are reportedly en route from interstate to stand vigil by Dr Yung's bedside.</p> <p>This tragedy compounds the family's grief, as it follows the sudden death of Dr Yung's wife, Kathryn Browne-Yung, in March 2020. The wider medical community, as well as the Women’s and Children’s Hospital and SA Health family, are extremely distressed by the attack.</p> <p>SA Health Minister Chris Picton expressed the gravity of the situation, stating, "Dr Michael Yung has been there for so many South Australian children and families at their darkest times – now it is time for all of us to be there for him and his family."</p> <p><em>Images: SA Police / Adelaide Women’s and Children’s Hospital</em></p>

Legal

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No, antibiotics aren’t always needed. Here’s how GPs can avoid overprescribing

<p><em><a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>The growth in antibiotic resistance threatens to return the world to the pre-antibiotic era – with deaths from now-treatable infections, and some elective surgery being restricted because of the risks of infection.</p> <p>Antibiotic resistance is a major problem worldwide and should be the concern of everyone, including you.</p> <p>We need to develop new antibiotics that can fight the resistant bacteria or antibiotics that bacteria would not be quickly resistant to. This is like finding new weapons to help the immune system fight the bacteria.</p> <p>More importantly, we need to use our current antibiotics – our existing weapons against the bacteria – more wisely.</p> <h2>Giving GPs the tools to say no</h2> <p>In 2022, more than <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one-third of Australians</a> had least one antibiotic prescription, with <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/analysis-2015-2022-pbs-and-rpbs-antimicrobial-dispensing-data">88%</a> of antibiotics prescribed by GPs.</p> <p>Many people <a href="https://pubmed.ncbi.nlm.nih.gov/28289114/">mistakenly think</a> antibiotics are necessary for treating any infection and that infections won’t improve unless treated with antibiotics. This misconception is found in studies involving patients with various conditions, including respiratory infections and conjunctivitis.</p> <p>In reality, not all infections require antibiotics, and this belief drives patients requesting antibiotics from GPs.</p> <p>Other times, GPs give antibiotics because they think patients want them, even when they might not be necessary. Although, in reality they are <a href="https://pubmed.ncbi.nlm.nih.gov/17148626/">after symptom relief</a>.</p> <p>For GPs, there are ways to target antibiotics for only when they are clearly needed, even with short appointments with patients perceived to want antibiotics. This includes:</p> <ul> <li> <p>using <a href="https://pubmed.ncbi.nlm.nih.gov/32357226/">decision guides</a> or tests to decide if antibiotics are really necessary</p> </li> <li> <p>giving <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">patients information sheets</a> when antibiotics aren’t needed</p> </li> <li> <p>giving a “<a href="https://pubmed.ncbi.nlm.nih.gov/33910882/">delayed prescription</a>” – only to be used after the patient waits to see if they get better on their own.</p> </li> </ul> <p>All these strategies need some <a href="https://www.nps.org.au/assets/NPS/pdf/NPS-MedicineWise-Economic-evaluation-report-Reducing-Antibiotic-Resistance-2012-17.pdf">training</a> and practice, but they can help GPs prescribe antibiotics more responsibly. GPs can also learn from each other and use tools like <a href="https://pubmed.ncbi.nlm.nih.gov/24474434/">posters</a> as reminders.</p> <p>To help with patients’ expectations, public campaigns have been run periodically to educate people about antibiotics. These campaigns <a href="https://pubmed.ncbi.nlm.nih.gov/35098267/">explain why</a> using antibiotics too much can be harmful and when it’s essential to take them.</p> <h2>Giving doctors feedback on their prescribing</h2> <p>National programs and interventions can help GPs use antibiotics more wisely</p> <p>One successful way they do this is by <a href="https://pubmed.ncbi.nlm.nih.gov/34356788/">giving GPs feedback</a> about how they prescribe antibiotics. This works better when it’s provided by organisations that GPs trust, it happens more than once and clear goals are set for improvement.</p> <p>The NPS (formerly National Prescribing Service) MedicineWise program, for example, had been giving feedback to GPs on how their antibiotic prescriptions compared to others. This reduced the number of antibiotics prescribed.</p> <p>However, <a href="https://australianprescriber.tg.org.au/articles/the-end-of-nps-medicinewise.html">NPS no longer exists</a>.</p> <p>In 2017, the Australian health department did something similar by sending <a href="https://behaviouraleconomics.pmc.gov.au/projects/nudge-vs-superbugs-behavioural-economics-trial-reduce-overprescribing-antibiotics">feedback letters</a>, randomly using different formats, to the GPs who prescribed the most antibiotics, showing them how they were prescribing compared to others.</p> <p>The most effective letter, which used pictures to show this comparison, reduced the number of antibiotics GPs prescribed by <a href="https://behaviouraleconomics.pmc.gov.au/sites/default/files/projects/nudge-vs-superbugs-12-months-on-report.pdf">9% in a year</a>.</p> <h2>Clearer rules and regulations</h2> <p>Rules and regulations are crucial in the fight against antibiotic resistance.</p> <p>Before April 2020, many GPs’ computer systems made it easy to get multiple repeat prescriptions for the same condition, which could encourage their overuse.</p> <p>However, in April 2020, the Pharmaceutical Benefits Scheme (PBS) <a href="https://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/psd/2019-08/antibiotic-repeats-on-the-pharmaceutical-benefits-scheme">changed the rules</a> to ensure GPs had to think more carefully about whether patients actually needed repeat antibiotics. This meant the amount of medicine prescribed better matched the days it was needed for.</p> <p>Other regulations or policy targets could include:</p> <ul> <li> <p>ensuring all GPs have access to antibiotic prescribing guidelines, such as <a href="https://www.tg.org.au/">Therapeutic Guidelines</a>, which is well accepted and widely available in Australia</p> </li> <li> <p>ensuring GPs are only prescribing antibiotics when needed. Many of the conditions antibiotics are currently prescribed for (such as sore throat, cough and middle ear infections) are self-limiting, meaning they will get better without antibiotics</p> </li> <li> <p>encouraging GP working with antibiotics manufacturers to align pack sizes to the recommended treatment duration. The recommended first-line treatments for uncomplicated urinary tract infections in non-pregnant women, for example, are either three days of trimethoprim 300 mg per night or five days of nitrofurantoin 100 mg every six hours. However, the packs contain enough for seven days. This can mean patients take it for longer or use leftovers later.</p> </li> </ul> <h2>Australia lags behind Sweden</h2> <p>Australia has some good strategies for antibiotic prescribing, but we have not had a sustained long-term plan to ensure wise use.</p> <p>Although Australian GPs have been doing well in <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/aura-2021">reducing antibiotic prescribing</a> since 2015, <a href="https://pubmed.ncbi.nlm.nih.gov/35098269/">more</a> could be done.</p> <p>In the 1990s, Sweden’s antibiotic use was similar to Australia’s, but is now less than half. For more than two decades, Sweden has had a national strategy that reduces antibiotic use by about <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677604/">7% annually</a>.</p> <p>It is vital Australia invests in a similar long-term national strategy – to have a centrally funded program, but with regional groups working on the implementation. This could be funded directly by the Commonwealth Department of Health and Ageing, or with earmarked funds via another body such as the Australian Centre for Disease Control.</p> <p>In the meantime, individual GPs can do their part to prescribe antibiotics better, and patients can join the national effort to combat antibiotic resistance by asking their GP: “what would happen if I don’t take an antibiotic?”.<!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, Assistant Professor of Public Health, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-antibiotics-arent-always-needed-heres-how-gps-can-avoid-overprescribing-213981">original article</a>.</em></p>

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Why a familiar face made Adele break down on stage

<p dir="ltr">Adele has broken down during an emotional show in Las Vegas, after she locked eyes with a special audience member. </p> <p dir="ltr">The British songstress was performing at her residency show with a special Halloween show when she spotted a familiar face in the crowd.</p> <p dir="ltr">While dressed as Morticia from the Addams Family for the spooky-themed concert, Adele began to perform her hit song <em>When We Were Young</em> from her award-winning album <em>25</em>. </p> <p dir="ltr">She suddenly burst into tears and ran into the audience, as she spotted the doctor who delivered her son Angelo ten years ago. </p> <p dir="ltr">Adele could be seen mouthing “Shut up!” in between lines of the heartbreaking ballad, as she couldn't believe what she was seeing.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/Cy_HGsFrr7Q/?utm_source=ig_embed&amp;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/Cy_HGsFrr7Q/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by 𝒜𝒹𝑒𝓁𝑒 𝐿𝒶𝓊𝓇𝒾𝑒 𝐵𝓁𝓊𝑒 𝒜𝒹𝓀𝒾𝓃𝓈 (@thirtyfreeadele)</a></p> </div> </blockquote> <p dir="ltr">“Oh my god, Colin! Oh my god! This is my doctor that gave birth to my baby!”</p> <p dir="ltr">“I haven't seen you for years!” she exclaimed, as she paused the song and ran up into the audience.</p> <p dir="ltr">As Adele caught up with her long-lost friend, the tune continued playing in the background. </p> <p dir="ltr">The singer apologised to her fans as she was caught up in the emotional moment.</p> <p dir="ltr">“Sorry!” she said to the crowd. “Will you sing it for me? That man delivered my baby!”</p> <p dir="ltr">Fans on Twitter rushed to praise the touching moment and Adele's sweet gesture to the doctor. </p> <p dir="ltr">One said, “This is so heartwarming,” while another added, “That's just the coolest thing ever!”</p> <p dir="ltr"><em>Image credits: Instagram</em></p>

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