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Ozempic, Wegovy, Rybelsus: Are we losing sight of overall health? Here’s what the science says

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters. The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>. Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized. As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments. <h2>The best of both worlds</h2> GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight. The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction. This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>. <h2>A new era</h2> GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger. These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope. Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions. Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support. <h2>Treating the effects but not the causes</h2> To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again. In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta). Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise. <h2>Prescribe and treat</h2> A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it. This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance. This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic. <h2>What lessons can we learn?</h2> The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment. We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<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/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ozempic-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>. </div>

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The internet is worse than it used to be. How did we get here, and can we go back?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> When it comes to our experience of the internet, “the times, <a href="https://en.wikipedia.org/wiki/The_Times_They_Are_a-Changin%27_(song)">they are a-changin’</a>”, as Bob Dylan would say. You can’t quite recall how, but the internet certainly feels different these days. To some, it is “<a href="https://www.npr.org/2024/01/16/1224878097/everyday-users-are-complaining-that-the-internet-is-more-chaotic-than-ever">less fun and less informative</a>” than it used to be. To others, online searches are made up of “<a href="https://www.theverge.com/c/23998379/google-search-seo-algorithm-webpage-optimization?src=longreads">cookie cutter</a>” pages that drown out useful information and are saturated with scams, spam and content generated by artificial intelligence (AI). Your social media feeds are full of eye-catching, provocative, hyper-targeted, or anger-inducing content, from <a href="https://theconversation.com/the-dead-internet-theory-makes-eerie-claims-about-an-ai-run-web-the-truth-is-more-sinister-229609">bizarre AI-generated imagery</a> to robot-like comments. You’re lucky if your video feeds are not solely made up of exhortations to “subscribe”. How did we get here? And can we claw our way back? <h2>Commercial interests rule</h2> One major factor contributing to the current state of the internet is its over-commercialisation: financial motives drive much of the content. This has arguably led to the prevalence of sensationalism, prioritising virality over information quality. Covert and deceptive advertising is widespread, blurring the line between commercial and non-commercial content to attract more attention and engagement. Another driving force is the dominance of tech giants like Google, Meta and Amazon. They reach billions worldwide and wield immense power over the content we consume. Their platforms use advanced tracking technologies and opaque algorithms to generate hyper-targeted media content, powered by extensive user data. This creates <a href="https://www.campaignasia.com/article/the-echo-chamber-effect-how-algorithms-shape-our-worldview/491762">filter bubbles</a>, where users are exposed to limited content that reinforces their existing beliefs and biases, and <a href="https://philarchive.org/archive/NGUECA">echo chambers</a> where other viewpoints are actively discredited. Bad actors like <a href="https://abcnews.go.com/Technology/ai-fuel-financial-scams-online-industry-experts/story?id=103732051">cyber criminals and scammers</a> have been an enduring problem online. However, evolving technology like generative AI has further empowered them, enabling them to create highly realistic fake images, deepfake videos and <a href="https://www.newyorker.com/science/annals-of-artificial-intelligence/the-terrifying-ai-scam-that-uses-your-loved-ones-voice">voice cloning</a>. AI’s ability to automate content creation has also flooded the internet with low-quality, misleading and harmful material at an unprecedented scale. In sum, the accelerated commercialisation of the internet, the dominance of media tech giants and the presence of bad actors have infiltrated content on the internet. The rise of AI further intensifies this, making the internet more chaotic than ever. <h2>Some of the ‘good’ internet remains</h2> So, what was the “good internet” some of us long for with nostalgia? At the outset, the internet was meant to be a free egalitarian space people were meant to “surf” and “browse”. Knowledge was meant to be shared: sites such as Wikipedia and The Internet Archive are continuing bastions of knowledge. Before the advent of filter bubbles, the internet was a creative playground where people explored different ideas, discussed varying perspectives, and collaborated with individuals from “outgroups” – those outside their social circles who may hold opposing views. Early social media platforms were built on the ethos of reconnecting with long-lost classmates and family members. Many of us have community groups, acquaintances and family we reach out to via the internet. The “connection” aspect of the internet remains as important as ever – as we all saw during the COVID pandemic. What else do we want to preserve? Privacy. A New Yorker cartoon joke in 1993 stated that “<a href="https://web.archive.org/web/20051029045942/http://www.unc.edu/depts/jomc/academics/dri/idog.html">on the internet, nobody knows you’re a dog</a>”. Now everyone – especially advertisers – wants to know who you are. To quote the <a href="https://www.oaic.gov.au/privacy/your-privacy-rights/your-personal-information/what-is-privacy">Office of the Australian Information Commissioner</a>, one of the tenets of privacy is “to be able to control who can see or use information about you”. At the very least, we want to control what big tech knows about us, especially if they could stand to profit from it. <h2>Can we ever go back?</h2> We can’t control “a changin’” times, but we can keep as much of the good parts as we can. For starters, we can vote with our feet. Users can enact change and bring awareness to problems on existing platforms. In recent times, we have seen this with the <a href="https://theconversation.com/thinking-of-breaking-up-with-twitter-heres-the-right-way-to-do-it-195002">exodus of users</a> from X (formerly Twitter) to other platforms, and the <a href="https://www.economist.com/the-economist-explains/2023/06/26/why-reddit-users-are-protesting-against-the-sites-leadership">platform-wide protest against Reddit</a> for changing its third-party data access policies. However, voting with our feet is only possible when there’s competition. In the case of X, various other platforms – from Mastodon to Threads to Bluesky – enable users to pick one that aligns with their preferences, values and social circles. Search engines have alternatives, too, such as DuckDuckGo or Ecosia. But competition can only be created by moving to decentralised systems and removing monopolies. This actually happened in the early days of the internet during the 1990s “<a href="https://thehistoryoftheweb.com/browser-wars/">browser wars</a>”, when Microsoft was eventually accused of illegally monopolising the web browser market in <a href="https://en.wikipedia.org/wiki/United_States_v._Microsoft_Corp.">a landmark court case</a>. As users of technology, all of us must remain vigilant about threats to our privacy and knowledge. With cheap and ubiquitous generative AI, misleading content and scams are more realistic as ever. We must exercise healthy scepticism and ensure those most at risk from online threats – such as children and older people – are educated about potential harms. Remember, the internet is not optimised for your best interests. It’s up to you to decide how much power you give to the tech giants who are fuelling theirs.<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/236513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, Senior Lecturer of Information Systems, School of Computing and Information Systems; and (Honorary) Senior Fellow, Melbourne Law School, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, Associate Professor in Media and Communications, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-internet-is-worse-than-it-used-to-be-how-did-we-get-here-and-can-we-go-back-236513">original article</a>. </div>

Technology

Your gas stove might be making your asthma worse. Here’s what you can do about it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> We may think of air pollution as an outdoor problem, made up of car exhaust and smog. But if the air inside our homes is polluted, this can also affect our health. In Australia, around 12% of childhood asthma can <a href="https://pubmed.ncbi.nlm.nih.gov/29642816/">be attributed</a> to gas stoves and the toxic chemicals they release into the air. And while there’s a growing push to phase out gas indoors, some 38% of Australian households <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">rely on natural gas</a> for cooking. Recommended interventions – such as replacing a gas stove with electric – may not be possible for those who are renting or struggling with the cost of living. This is important because, as our <a href="https://ghrp.biomedcentral.com/articles/10.1186/s41256-024-00361-2">research</a> shows, childhood asthma is more common in socioeconomically disadvantaged areas. If you’re living with gas, here’s how it can affect you or your child’s asthma, and what you can do to improve air quality. <h2>What is asthma?</h2> Asthma is the most common chronic condition in Australian children. The respiratory condition affects <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">almost</a> 400,000 of those aged aged 14 and under – close to 9% of that age group. Asthma narrows the airways and obstructs airflow, making it hard to breath. Many people manage the condition with inhalers and <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma action plans</a>. But it can be serious and even fatal. Australian emergency departments saw <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">56,600 presentations</a> for asthma in 2020-21. While there is no single cause for asthma, both indoor and outdoor air pollution play a <a href="https://pubmed.ncbi.nlm.nih.gov/38247719/">significant role</a>. Being exposed to small <a href="https://aafa.org/asthma/asthma-triggers-causes/air-pollution-smog-asthma/#:%7E:text=Air%20pollution%20can%20increase%20your,if%20you%20already%20have%20asthma.&text=Small%20airborne%20particles%2C%20found%20in,%E2%80%9Cparticulate%20matter%E2%80%9D%20or%20PM.">airborne particles</a> increases your risk of getting asthma, and can aggravate symptoms if you already have it. <h2>Gas stoves release nitrogen dioxide</h2> The gas stoves commonly found in Australian homes release toxic chemicals into the air. They include carbon monoxide (CO), PM₂.₅ (small particles, often from <a href="https://www.epa.vic.gov.au/for-community/environmental-information/air-quality/pm25-particles-in-the-air">smoke</a>), benzene, formaldehyde and nitrogen dioxide (NO₂). All are harmful, but nitrogen dioxide in particular is <a href="https://go.gale.com/ps/i.do?id=GALE%7CA656312383&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00220892&p=AONE&sw=w&userGroupName=anon%7E7027bb9f&aty=open-web-entry">associated</a> with asthma developing and getting <a href="https://www.atsjournals.org/doi/10.1164/rccm.200408-1123OC">worse</a>. Gas heaters can also <a href="https://pubmed.ncbi.nlm.nih.gov/9731022/">produce</a> nitrogen dioxide. As nitrogen dioxide is a tasteless, invisible gas, it’s difficult to know how much is in your air at home unless you have an air monitor. However one US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662932/">study</a> showed houses with gas stoves can have nitrogen dioxide levels three times higher than houses with electric stoves. This is particularly concerning for households with children, given children tend to spend <a href="https://pubmed.ncbi.nlm.nih.gov/11477521/">most</a> of their time indoors. <h2>Banning gas</h2> There is a growing push across Australia to replace gas stoves with electric stoves, which are more energy efficient and can reduce indoor air pollution. <a href="https://www.premier.vic.gov.au/new-victorian-homes-go-all-electric-2024">Victoria</a> and the <a href="https://www.climatechoices.act.gov.au/energy/canberras-electrification-pathway/preventing-new-gas-network-connections">Australian Capital Territory</a> have announced bans on gas connections in new homes from 2024. Sydney’s Waverley council recently made a similar <a href="https://www.waverley.nsw.gov.au/environment/climate_resilience_and_reducing_emissions/go_electric">move</a>. But until a ban on using household gas appliances is implemented across the country, the problem persists for children who are currently living in old homes or rented properties with gas stoves. <h2>Do exhaust fans in the kitchen help?</h2> Using a high-efficiency <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">exhaust hood</a> placed over an existing gas cooktop can be effective. They can <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">capture</a> more than 75% of air pollutants and direct them outside. Cooking on the back burner – rather than the front burner – can also <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">improve their efficiency</a>. However exhaust hoods with lower flow rates, or hoods that don’t vent the air outside, are less effective. And an exhaust hood only improves air quality if you use it. One <a href="https://pubmed.ncbi.nlm.nih.gov/10520075/">study</a> in Melbourne found more than 40% of people didn’t use an exhaust hood regularly while cooking. For many people, installing high-efficiency exhaust hoods will not be practical – especially for those renting or experiencing socio-economic disadvantage. <h2>Natural ventilation</h2> There is a free way to ventilate your home. Keeping windows open during and after cooking will increase air flow and <a href="https://pubmed.ncbi.nlm.nih.gov/32970538/">evidence shows</a> this can improve overall air quality. However this is not always possible, especially during cooler months of the year which can be especially chilly in places such as Victoria and Tasmania. Unfortunately, people are also more likely to use gas heaters during those cooler months. <h2>What about heaters?</h2> There are two kinds of gas heaters, flued and unflued. Like cooking with gas, unflued gas heaters release air pollutants including nitrogen dioxide directly into the home. Flued heaters are better for air quality because they use a chimney, or “flue”, to send emissions outside. If you can, replacing your unflued gas heater with a flued one – or even better, an electric heater – can significantly <a href="https://pubmed.ncbi.nlm.nih.gov/15075170/">alleviate</a> asthma symptoms. If you can’t replace your unflued gas heater, <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/unflued-gas-heaters.aspx">do not use it overnight</a> in the room where you or your children sleep. Asthma can’t be cured, but its symptoms can be controlled by managing triggers – and this may be easier to do indoors than out. Improving air quality, even in a rented or old property, can help people with asthma breathe more easily.<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/238787/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, Senior Lecturer, School of Clinical Medicine, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-gas-stove-might-be-making-your-asthma-worse-heres-what-you-can-do-about-it-238787">original article</a>. </div>

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Young homeowners are more likely to use their home as an ‘ATM’ than their Boomer parents. Here’s why

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> For many Australians, the family home is their largest financial asset. With an increasing variety of ways to tap into home equity, the temptation to access this wealth is ever growing. Homeowners increase the debt owed on their home when they borrow against their <a href="https://doi.org/10.1080/02673037.2013.783202">equity</a>. Standard mortgage home loans now provide facilities for relatively cheap or free withdrawals of equity from the home. This turns the <a href="https://theconversation.com/your-home-as-an-atm-home-equity-a-risky-welfare-tool-22000">home into an ATM</a>, which borrowers can access when they choose. Our new <a href="https://doi.org/10.1080/02673037.2024.2400158">study</a> asks what motivates Australians to tap into their home equity, and how does this behaviour change with age? Surprisingly, despite having much lower housing equity levels, younger homeowners borrow often, and borrow more, than their Boomer parents. <h2>How common is equity borrowing?</h2> Using 15 years of data from the government-funded <a href="https://melbourneinstitute.unimelb.edu.au/hilda">Household, Income and Labour Dynamics in Australia </a>(HILDA) survey, we tracked the mortgage debt and repayments of homeowners aged 35 and over. The chart below shows younger owners are far more likely to engage in equity borrowing. In 2006, nearly 39% of the youngest homeowners, aged 35–44, borrowed against their home equity. By 2021, this number had dropped to 29%. Despite the decline, it’s still 24 percentage points more common than those aged 65 and over. The older group has remained steady at about 5% over the years. <hr /> <iframe id="Ll9Cw" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Ll9Cw/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How much do equity borrowers withdraw from their home?</h2> Among those who use their home like an ATM, younger borrowers now withdraw larger amounts than older borrowers. In 2006–07, equity borrowers aged 35–44 and 45–54 withdrew on average $43,000 and $57,000, respectively (expressed in real values set at 2022 price levels). By 2021, the amount withdrawn by these two age groups had climbed to $70,000 and $100,000. On the other hand, the amount withdrawn by borrowers aged 55 or older fell from more than $50,000 to less than $40,000. <hr /> <iframe id="ujq3S" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/ujq3S/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>What motivates equity borrowing?</h2> Young homeowners’ equity borrowing behaviours are sensitive to changes in house prices and debt values, and their financial risk preferences. Among those aged 35–44, a $10,000 increase in the primary home value raises the likelihood of equity borrowing by ten percentage points. Every $10,000 in debt against the primary home reduces the likelihood by 2.8% percentage points. Those willing to take substantial financial risk are eight percentage points more likely to borrow against their home than those who are risk-averse. Those aged 65+ are not inclined to borrow, and exhibit little change in equity borrowing behaviour with variations in asset, debt, income or financial risk preferences. <h2>Why borrowing practices differ between age groups</h2> As well as being more likely than older homeowners to borrow against equity, the younger group also withdraws higher amounts than their Boomer parents. This is despite younger borrowers already carrying much higher debt against their primary home. Among those in our study who engaged in equity borrowing in 2021, the median debt before borrowing was $401,000 for 35-44 year-olds compared to $0 for those aged 65+. As real house prices have risen over decades, the current generation of young homeowners has had to invest more money into purchasing their first home than previous generations. It’s therefore not surprising the primary home is now widely viewed as a financial resource to be <a href="https://theconversation.com/your-home-as-an-atm-home-equity-a-risky-welfare-tool-22000">tapped into to meet spending needs</a>. On the other hand, most Baby Boomers bought their first home at more affordable prices than their children, and at lower levels of debt. Now they don’t appear to be spending their kids’ inheritance by drawing down housing wealth. In fact, older parents may shy away from equity borrowing to <a href="https://www.pc.gov.au/research/completed/wealth-transfers/wealth-transfers.pdf">bequeath wealth to children</a>. Some also <a href="https://doi.org/10.1017/S0047279417000058">dislike passing debt</a> on to their children. Older people may also avoid equity borrowing due to concerns about <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150.pdf">aged care costs</a>. Some may be hampered by <a href="https://doi.org/10.1016/j.jue.2013.08.003">poor financial literacy</a>. <h2>More debt ahead without policy changes</h2> Present trends suggest young homeowners will remain indebted for longer periods, and more and more will <a href="https://theconversation.com/more-of-us-are-retiring-with-mortgage-debts-the-implications-are-huge-115134">retire with mortgage debt</a>. For indebted retirees, there are real prospects of <a href="https://theconversation.com/fall-in-ageing-australians-home-ownership-rates-looms-as-seismic-shock-for-housing-policy-120651">drawing down of superannuation</a> to pay off mortgages in retirement. This may impose extra burdens on the age pension system. Another unwelcome consequence, which may add to health costs, is the prospect of <a href="https://www.ahuri.edu.au/sites/default/files/migration/documents/AHURI-Final-Report-319-Mortgage-stress-and-precarious-home-ownership-implications-for-older-Australians.pdf">debt-related psychological distress</a> among those who can’t pay off their mortgage in old age. If the current trends continue, the <a href="https://www.afr.com/policy/economy/what-happens-when-australia-s-boomers-hand-5-trillion-to-their-heirs-20240515-p5jdvf">great wealth transfer</a> that has already begun looks set to <a href="https://theconversation.com/not-everyone-wins-from-the-bank-of-mum-and-dad-73842">further entrench inequality</a> between those who have access to the bank of mum and dad and those who do not. Encouraging older people to use their housing equity to fund their needs in old age may lighten fiscal burdens on younger generations. But policy reforms will be needed to relieve concerns about the risks of equity borrowing in old age.<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/238924/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, ARC Future Fellow & Professor of Economics, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, Research Fellow, School of Accounting, Economics and Finance, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/young-homeowners-are-more-likely-to-use-their-home-as-an-atm-than-their-boomer-parents-heres-why-238924">original article</a>. </div>

Money & Banking

You’re probably brushing your teeth wrong – here are four tips for better dental health

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> We all know the advice for healthy teeth – brush twice daily and don’t eat too much sugar. So why do those of us following these instructions find we sometimes need a filling when we visit the dentist? The truth is, there’s a little more to preventing tooth decay than these guidelines suggest. Here’s what you need to know. <h2>Brush up on your skills</h2> How you brush makes a big difference. The mechanical act of brushing removes the very sticky dental plaque – a mixture of bacteria, their acids and sticky byproducts and food remnants. It forms naturally on teeth immediately after you’ve eaten but doesn’t get nasty and start to cause damage to the teeth until it reaches a certain stage of maturity. The exact amount of time this takes isn’t known but is at least more than 12 hours. Bacteria consume sugar and, as a byproduct, produce acids which dissolve mineral out of the teeth, leaving microscopic holes we can’t see. If the process isn’t stopped and they aren’t repaired, these can become big, visible cavities. Taking two minutes to brush your teeth is a good target for removing plaque and you should brush at night and one other time daily. Brushing frequently stops the bacteria developing to a stage where the species which produce the most acid can become established. Electric toothbrushes can be <a href="https://www.cochrane.org/CD002281/ORAL_poweredelectric-toothbrushes-compared-to-manual-toothbrushes-for-maintaining-oral-health">more effective than manual brushing</a> and a small toothbrush head helps to reach awkward areas in the mouth, while medium-textured bristles help you clean effectively without causing harm to gums and teeth. The main thing, however, is to get brushing! <h2>Use fluoride toothpaste and disclosing tablets</h2> Most of the benefit from brushing comes from toothpaste. The key ingredient is fluoride, which evidence shows <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002278/full#CD002278-abs-0003">prevents tooth decay</a>. Fluoride replaces lost minerals in teeth and also makes them stronger. For maximum benefit, <a href="https://www.cochrane.org/CD007868/ORAL_comparison-between-different-concentrations-of-fluoride-toothpaste-for-preventing-tooth-decay-in-children-and-adolescents">use toothpaste with 1350-1500 ppmF</a> – that’s concentration of fluoride in parts per million – to prevent tooth decay. Check your toothpaste’s concentration by reading the ingredients on the back of the tube. <a href="https://theconversation.com/childrens-toothpaste-the-facts-80508">Not all children’s toothpastes are strong enough</a> for them to gain maximum benefit. Your dentist may prescribe higher strength fluoride toothpaste based on their assessment of your or your child’s risk of tooth decay. Plaque is difficult to see because it is whitish, like your teeth. Disclosing tablets are available in supermarkets and chemists and they make plaque more visible, showing areas you may have missed when brushing. <h2>Spit, don’t rinse</h2> At night, you produce less saliva than during the day. Because of this, your teeth have less protection from saliva and are more vulnerable to acid attacks. That’s why it’s important to remove food from your teeth before bed so plaque bacteria can’t feast overnight. Don’t eat or drink anything except water <a href="https://www.sign.ac.uk/assets/sign138.pdf">after brushing at night</a>. This also gives fluoride the longest opportunity to work. Once you’ve brushed, don’t rinse your mouth with water or mouthwash – you’re washing away the fluoride! This can be a difficult habit to break, but can <a href="https://www.sign.ac.uk/assets/sign138.pdf">reduce tooth decay by up to 25%</a>. <h2>No more than four ‘sugar hits’</h2> Intrinsic sugars are found naturally in foods like fruit and they are far less likely to cause tooth decay than added or <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/sugar-salt-and-fat/free-sugars">free sugars</a>. Free sugars are generally those added to foods by manufacturers but also include honey, syrup and fruit juices. These are all easy for bacteria to consume, metabolise and produce acids from. However, it can be difficult to tell which are the worst sugars for teeth. For example, although normal amounts of fruit are fine, fruit juices have sugar liberated from the plant cells and heavy consumption can cause decay. <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">The World Health Organization</a> and <a href="https://www.nhs.uk/common-health-questions/food-and-diet/how-much-sugar-is-good-for-me/">NHS</a> recommend free sugars should ideally make up less than 5% of your daily calorie intake. So what does this look like? For adults and children over about 11 years old, this is around 30g – about eight teaspoons – of sugar daily. A 330ml can of Coke has <a href="https://www.coca-cola.co.uk/drinks/coca-cola/coca-cola">35g of sugar</a>. The <a href="https://play.google.com/store/apps/details?id=com.phe.c4lfoodsmart&hl=en_GB">change4life app</a> is helpful to track how much sugar you consume in your diet. Although not as important as how much, how often you eat sugar also matters. Simple carbohydrates like sugar are easier for bacteria to digest than proteins or complex carbohydrates. Bacteria produce acids after they metabolise sugar which causes demineralisation. Fortunately, through the actions of fluoride toothpaste and the remineralising effects of saliva, your teeth can recover from the early stages of these attacks. It’s like having a set of scales – trying to keep the balance between sugars on one side, fluoride toothpaste and cleaning on the other. Typically, your teeth can be exposed to four “sugar hits” – episodes of sugar intake – daily without irreversible damage to the teeth. Why not try counting how many sugary hits you have a day? This includes biscuits, cups of sugary tea or coffee and other snacks with refined carbohydrates like crisps. A simple way of cutting down would be to stop putting sugar in hot drinks and limiting snacking. Brush twice daily with fluoride toothpaste, spit don’t rinse, eat and drink nothing after brushing, and don’t have sugar more than four times daily. Easy!<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/103959/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, Clinical Lecturer in Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, Professor of Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/youre-probably-brushing-your-teeth-wrong-here-are-four-tips-for-better-dental-health-103959">original article</a>. </div>

Body

Can a 10-year-old be responsible for a crime? Here’s what brain science tells us

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> The age a child can be arrested, charged and jailed in Australia is back in the spotlight. Last year, the Northern Territory became the first jurisdiction to raise the age of criminal responsibility from ten to 12. Now its new, tough-on-crime government has pledged to <a href="https://www.sbs.com.au/nitv/article/incoming-chief-minister-says-age-of-criminal-responsibility-to-be-lowered-to-10-years-old/a1xm9jy9c">return it to ten</a>. It comes after Victoria <a href="https://www.abc.net.au/news/2024-08-13/victoria-youth-justice-reform-criminal-age/104217160">walked back</a> its earlier commitment to raise the age to 14, settling instead on 12. But the United Nations Committee on the Rights of the Child says 14 should be the absolute <a href="https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-24-2019-childrens-rights-child">minimum</a>. It raised this age from its earlier recommendation (in 2007) of 12, citing a decade of new research into child and adolescent development. So what does the science say? What happens to the brain between ten and 14? And how much can those under 14 understand the consequences of their actions? <h2>Who is an adolescent?</h2> Our research shows adolescence is a <a href="https://pubmed.ncbi.nlm.nih.gov/30169257/">critical period</a> for development. It’s the time children’s experiences and explorations shape how they develop cognitive skills (including critical thinking and decision making), as well as social and emotional skills (including moral reasoning). Adolescence also lasts longer than we tend to think. Important brain development begins during late childhood, around eight to nine years. Intense changes then follow during early adolescence (ages ten to 14). But these changes continue well into the twenties, and full cognitive and emotional maturity is not usually reached until around age 24. However, everyone’s brain matures at a different rate. That means there is no definitive age we can say humans reach “adult” levels of cognitive maturity. What we do know is the period of early adolescence is critical. <h2>What does puberty do to the brain?</h2> Puberty is a defining feature of early adolescence. Most of us are familiar with the changes that occur to the body and reproductive systems. But the increase in puberty hormones, such as testosterone and oestrogen, also trigger changes to the brain. These hormones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453017313252?via%3Dihub">increase most sharply</a> between ten and 15 years of age, although gradual changes continue into the early twenties. Puberty hormones change the structures in the brain which process emotions, including the amygdala (which encodes fear and stress) and ventral striatum (involved in reward and motivation). This makes adolescents particularly reactive to emotional rewards and threats. <a href="https://doi.org/10.1016/j.cortex.2019.04.024">Our research</a> has shown the brain’s sensitivity to emotions increases throughout early adolescence until around 14 or 15 years old. At the same time, changes in puberty have <a href="http://dx.doi.org/10.1037/pspp0000172">been linked</a> to increased sensation seeking and impulsive behaviours during early adolescence. This context is crucial when we discuss the behaviour of children in the ten to 14 age range. The way their brains change during this period makes them more sensitive and responsive to emotions, and more likely to be seeking experiences that are new and intense. <h2>How do adolescents make decisions?</h2> The emotional context of puberty influences how younger adolescents make decisions and understand their consequences. Decision making relies on several basic cognitive functions, including the brain’s flexibility, memory and ability to control impulses. These cognitive abilities – which together help us consider the consequences of our actions – undergo some of the <a href="https://doi.org/10.1523/JNEUROSCI.1741-13.2013">steepest development</a> between ages ten and 14. By age 15, the ability to make complex decisions has usually <a href="https://doi.org/10.1037/lhb0000315">reached adult maturity</a>. But adolescents at this age remain highly susceptible to emotions. So while their brain may be equipped to make a complex decision, their ability to think through the consequences, weighing up costs and benefits, can be clouded by emotional situations. For example, <a href="https://doi.org/10.1111/cdev.12085">research has shown</a> 13-14 year-olds were more distracted from completing a task and less able to control their behaviour when they viewed images that made them feel negative emotions. The social world of teenagers also has a significant impact on how they make decisions – especially in early adolescence. One study found that while older adolescents (aged 15-18) are more influenced by what adults think when weighing up risk, adolescents aged 12-14 <a href="https://journals.sagepub.com/doi/full/10.1177/0956797615569578">look to other teenagers</a>. Experiments <a href="https://doi.org/10.1177/0272431616648453">have also shown</a> adolescents aged 12-15 make riskier decisions when they are with peers than by themselves. Their brain responses also suggest they experience a greater sense of reward in taking those risks <a href="https://doi.org/10.1093/scan/nsy071">with peers</a>. <h2>How do teens understand the consequences of their actions?</h2> The concept of <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp2122/Quick_Guides/MinimumAgeCriminalResponsibility">criminal responsibility</a> is based on whether a person is able to understand their action and know whether it is wrong. Moral reasoning – how people think about right and wrong – depends on the ability to understand another person’s mental state and adopt their perspective. These skills are in development <a href="https://doi.org/10.1016/j.biopsych.2020.09.012">across adolescence</a>. Research suggests it may take more effort for adolescent brains to process <a href="https://doi.org/10.1162/jocn.2009.21121">“social” emotions</a> such as guilt and embarrassment, compared to adults. This is similar when they make <a href="https://doi.org/10.1080/17470919.2014.933714">moral judgements</a>. This evidence suggests teenage brains may have to work harder when considering other people’s intentions and desires. Young adolescents have the cognitive ability to appreciate they made a bad decision, but it is more mentally demanding. And social rewards, emotions and the chance to experience something new all have a strong bearing on their decisions and actions in the moment — possibly more than whether it is right or wrong. <h2>Early adolescence is critical for the brain</h2> There are also a number of reasons adolescent brains may develop differently. This includes various forms of neurodisability such as acquired brain injury, fetal alcohol spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and intellectual disability, as well as exposure to trauma. Teenagers with neurodevelopmental disorders will likely cope differently with decision making, social pressure, impulse control and risk assessment, and face <a href="https://www.mcri.edu.au/images/research/strategic-collaborations/Flagships/Neurodevelopment/Neurodevelopment_Flagship_Brochure.pdf">extra difficulties</a>. Across the world, they are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30217-8/fulltext">disproportionately incarcerated</a>. In Australia, Indigenous children and adolescents are incarcerated <a href="https://www.indigenoushpf.gov.au/measures/2-11-contact-with-the-criminal-justice-system#:%7E:text=On%20an%20average%20day%20in%202021%E2%80%9322%2C%20there%20were%3A,AIHW%202023d%3A%20Table%20S76a">in greater numbers</a> than their non-Indigenous peers. Each child matures differently, and some face extra challenges. But for every person, the period between ten and 14 is critical for developing the cognitive, social and emotional skills they’ll carry through the rest of their life.<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/237552/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, Professor of Adolescent Health The University of Melbourne; Director, Royal Children's Hospital Centre for Adolescent Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, Research Fellow, School of Psychology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-10-year-old-be-responsible-for-a-crime-heres-what-brain-science-tells-us-237552">original article</a>. </div>

Mind

Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<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/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

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Men have a biological clock too. Here’s what’s more likely when dads are over 50

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/karin-hammarberg-113096">Karin Hammarberg</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> We hear a lot about women’s biological clock and how age affects the chance of pregnancy. <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">New research shows</a> men’s fertility is also affected by age. When dads are over 50, the risk of pregnancy complications increases. Data from more than 46 million births in the <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">United States</a> between 2011 and 2022 compared fathers in their 30s with fathers in their 50s. While taking into account the age of the mother and other factors known to affect pregnancy outcomes, the researchers found every ten-year increase in paternal age was linked to more complications. The researchers found that compared to couples where the father was aged 30–39, for couples where the dad was in his 50s, there was a: <ul> <li>16% increased risk of preterm birth</li> <li>14% increased risk of low birth weight</li> <li>13% increase in gestational diabetes.</li> </ul> The older fathers were also twice as likely to have used assisted reproductive technology, including IVF, to conceive than their younger counterparts. <h2>Dads are getting older</h2> In this <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">US study</a>, the mean age of all fathers increased from 30.8 years in 2011 to 32.1 years in 2022. In that same period, the proportion of men aged 50 years or older fathering a child increased from 1.1% to 1.3%. We don’t know the proportion of men over 50 years who father children in Australia, but data shows the average age of fathers has increased. In 1975 the <a href="https://www.abs.gov.au/statistics/people/population/births-australia/latest-release">median age of Australian dads</a> was 28.6 years. This jumped to 33.7 years in 2022. <h2>How male age affects getting pregnant</h2> As we know from <a href="https://www.businessinsider.com/celebrities-dads-first-time-over-age-50#when-he-was-54-simon-cowell-and-girlfriend-lauren-silverman-became-parents-to-their-son-eric-7">media reports</a> of celebrity dads, men produce sperm from puberty throughout life and can father children well into old age. However, there is a noticeable decline in <a href="https://www.fertstert.org/article/S0015-0282(18)30269-3/fulltext">sperm quality</a> from about age 40. Female partners of older men take longer to achieve pregnancy than those with younger partners. A study of the effect of male age on <a href="https://www.fertstert.org/article/S0015-0282(03)00366-2/fulltext">time to pregnancy</a> showed women with male partners aged 45 or older were almost five times more likely to take more than a year to conceive compared to those with partners aged 25 or under. More than three quarters (76.8%) of men under the age of 25 years impregnated their female partners within six months, compared with just over half (52.9%) of men over the age of 45. Pooled data from ten studies showed that partners of older men are also more likely to experience miscarriage. Compared to couples where the male was aged 25 to 29 years, <a href="https://pubmed.ncbi.nlm.nih.gov/32358607/">paternal age over 45 years</a> increased the risk of miscarriage by 43%. <h2>Older men are more likely to need IVF</h2> Outcomes of assisted reproductive technology, such as IVF, are also influenced by the age of the male partner. A <a href="https://doi.org/10.1016/j.rbmo.2022.03.031">review of studies</a> in couples using assisted reproductive technologies found paternal age under 40 years reduced the risk of miscarriage by about 25% compared to couples with men aged over 40. Having a male under 40 years also almost doubled the chance of a live birth per treatment cycle. With a man over 40, 17.6% of treatment rounds resulted in a live birth, compared to 28.4% when the male was under 40. <h2>How does male age affect the health outcomes of children?</h2> As a result of age-related changes in sperm DNA, the children of older fathers have increased risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957550/">a number of conditions</a>. Autism, schizophrenia, bipolar disorders and leukaemia have been linked to the father’s advanced years. A <a href="https://www.fertstert.org/article/S0015-0282(22)01979-3/fulltext">review of studies</a> assessing the impact of advanced paternal age reported that children of older fathers have increased rates of psychiatric disease and behavioural impairments. But while the increased risk of adverse health outcomes linked to older paternal age is real, the magnitude of <a href="https://pubmed.ncbi.nlm.nih.gov/29471389/">the effect is modest</a>. It’s important to remember that an increase in a very small risk is still a small risk and most children of older fathers are born healthy and develop well. <h2>Improving your health can improve your fertility</h2> In addition to the effects of older age, some chronic conditions that affect fertility and reproductive outcomes become more common as men get older. They include <a href="https://www.fertstert.org/article/S0015-0282(23)01935-0/fulltext">obesity and diabetes</a> which affect sperm quality by lowering testosterone levels. While we can’t change our age, some lifestyle factors that increase the risk of pregnancy complications and reduce fertility, can be tackled. They include: <ul> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639396/">smoking</a></li> <li>recreational <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.414">drug taking</a></li> <li><a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.414">anabolic steroid</a> use</li> <li>heavy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/">alcohol consumption</a>.</li> </ul> <h2>Get the facts about the male biological clock</h2> Research shows <a href="https://academic.oup.com/humupd/article/23/4/458/3065332?login=false">men want children</a> as much as women do. And most men want at least two children. Yet most men <a href="https://academic.oup.com/humupd/article/23/4/458/3065332?login=false">lack knowledge</a> about the limitations of female and male fertility and overestimate the chance of getting pregnant, with and without assisted reproductive technologies. We need better public education, starting at school, to improve awareness of the impact of male and female age on reproductive outcomes and help people have healthy babies. For men wanting to improve their chance of conceiving, the government-funded sites <a href="https://healthymale.org.au/">Healthy Male</a> and <a href="https://www.yourfertility.org.au/">Your Fertility</a> are a good place to start. These offer evidence-based and accessible information about reproductive health, and <a href="https://www.yourfertility.org.au/fertility-week-2022">tips</a> to improve your reproductive health and give your children the best start in life.<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/236892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/karin-hammarberg-113096">Karin Hammarberg</a>, Senior Research Fellow, Global and Women's Health, School of Public Health & Preventive Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/men-have-a-biological-clock-too-heres-whats-more-likely-when-dads-are-over-50-236892">original article</a>. </div>

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The gift of a lifetime: How one busy mum found peace of mind and left a lasting legacy

Anita lives in Sydney with her husband and three sons. She recently chose to include a gift to Lifeline Australia when writing her Will with an online Will-writing service called <a href="https://www.gatheredhere.com.au/c/lifeline-au?gh_cuid=Oxs_YC7byb&gh_cch=%40campaign%2Fchannel%2Fnews" target="_blank" rel="noopener">Gathered Here</a>. “My Will has been in the making for the last five years and it has always been pushed down on the prioritisation list due to the high cost of seeing a solicitor and us being a very busy family with young kids,” says Anita. “When I found out about Gathered Here, I thought I may as well check it out, and after 10 minutes I had a Will! The process was simple and straightforward without any complicated legal jargon to cut through. “Within the Will-writing process, summarising my wishes was an important and practical step for me. I want to ease the situation for my loved ones I leave behind by providing emotional and financial certainty in a time of confusion and grief. “There is also an opportunity to nominate and leave gifts to my favourite charities. I have three young boys and having some insight into the mental health challenges in Australia made my decision of allocating a portion of my estate to Lifeline Australia very easy. “Seeing an organisation like Lifeline continuously dedicate their effort, time and professionalism at the highest level to ensure that no one is ever alone in crisis provides me with hope of a better world for my children.” Lifeline is a national charity providing people in Australia experiencing emotional distress with access to 24-hour crisis support and suicide prevention services. Tragically, over 3,000 people in Australia lose their lives to suicide every year. This year, Lifeline will receive well over 1 million contacts from people in crisis. Every 30 seconds, someone in Australia reaches out to Lifeline. Lifeline exists to ensure that no person in Australia has to face their toughest moments alone, and believes that through connection, hope can be found. Lifeline Australia has partnered with Gathered Here to offer you the opportunity to <a href="https://www.gatheredhere.com.au/c/lifeline-au?gh_cuid=Oxs_YC7byb&gh_cch=%40campaign%2Fchannel%2Fnews" target="_blank" rel="noopener">write your Will online for free</a> this Include a Charity Week, which runs from the 2nd – 8th September and is dedicated to raising awareness of how anyone can make a lasting impact to causes that they care about with a gift in their Will. You’ll also be able to make free and unlimited changes to your Will for life. Gathered Here provides end-of-life services through probate, funerals and online Wills. They are supported by an in-house legal team of highly experienced Wills and estate lawyers who have reviewed and vetted the Will writing process. Gathered Here's online Will-writing service allows you to appoint guardians for your children and pets, set out how you want to divide your estate and leave gifts to charities that mean the most to you - like Lifeline. After you've provided for those closest to you, <a href="https://www.gatheredhere.com.au/c/lifeline-au?gh_cuid=Oxs_YC7byb&gh_cch=%40campaign%2Fchannel%2Fnews" target="_blank" rel="noopener">leaving a gift to Lifeline Australia is a lasting and meaningful way that you can have an impact for years to come</a>. You will be helping to prevent suicide and save lives in future generations. Gifts in Wills make a phenomenal difference to charities, including Lifeline. This is why a growing number of people understand that once they have provided for their loved ones, leaving a gift in their Will is one of the most powerful ways they can support Lifeline, without incurring any financial costs during their lifetime. If you would like to learn more, please do not hesitate to get in touch with Lifeline Australia’s Gifts in Wills Specialist Abi Steiner via email at <a href="mailto:giftsinwills@lifeline.org.au" target="_blank" rel="noopener">giftsinwills@lifeline.org.au</a> or phone on 02 8099 1974. If you, or someone you know, are feeling distressed or overwhelmed, we encourage you to connect with Lifeline in the way you feel most comfortable. For 24/7 crisis support, you can phone Lifeline to speak to a Crisis Supporter on 13 11 14, text 0477 131 114, chat to Lifeline online or access the Support Toolkit to self-manage what you’re going through at <a href="http://www.lifeline.org.au/" target="_blank" rel="noopener">www.lifeline.org.au</a>. This is a sponsored article produced in partnership with Lifeline Australia. Image: Lifeline Australia

Money & Banking

Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care. So what is knee osteoarthritis and what are the best ways to manage it? <h2>More than 2 million Australians have osteoarthritis</h2> Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year. Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles. Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs. <h2>Is it caused by ‘wear and tear’?</h2> Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”. <a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions. Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain. This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis. <h2>What’s the best way to manage osteoarthritis?</h2> Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines. Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms. Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management. Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future. Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you. Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time. Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>. Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs. Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits. <h2>What about surgery?</h2> People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement. Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain. However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis. Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis. Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management. The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments. <h2>I have knee osteoarthritis. What should I do?</h2> The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include: <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<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/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>. </div>

Body

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment. This is more than just anecdotal. According to data from the <a href="https://app.powerbi.com/view?r=eyJrIjoiZGU1YWFhZDgtMmRhZi00YTgyLThhMzItYjc2ODk5NTg0MTg1IiwidCI6IjhkMmUwZjRjLTU1ZjItNGNiMS04ZWU3LWRhNWRkM2ZmMzYwMCJ9">Australian Sports Commission</a>, the number of women <a href="https://www.clearinghouseforsport.gov.au/research/ausplay/results#portal">participating in weightlifting</a> (either competitively or not) grew nearly five-fold between 2016 and 2022. Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles. <h2>Health benefits</h2> <a href="https://www.womenshealth.gov/a-z-topics/osteoporosis">Osteoporosis</a>, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">bone density</a>, a crucial factor for <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-47">preventing osteoporosis</a>, especially for women negotiating menopause. Strength training also improves <a href="http://link.springer.com/10.1007/s40279-015-0379-7">insulin sensitivity</a>, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better <a href="https://doi.org/10.1139/apnm-2020-0245">heart health</a> too. There’s a mental health boost as well. Strength training has been linked to reduced symptoms of <a href="https://doi.org/10.1001/jamapsychiatry.2018.0572">depression</a> and <a href="http://link.springer.com/10.1007/s40279-017-0769-0">anxiety</a>. <h2>Improved confidence and body image</h2> Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2019.1634127">conquer challenges</a>. This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S1755296623000194">recent study</a> found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym. Strength training also has the potential to positively impact <a href="https://journals.lww.com/nsca-jscr/abstract/2002/11000/Relations_of_Strength_Training_to_Body_Image_Among.25.aspx">body image</a>. In a world where women are often judged on appearance, lifting weights can shift the focus <a href="http://journals.sagepub.com/doi/10.1177/0193732502238256">to function</a>. Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success. Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative <a href="https://journals.humankinetics.com/view/journals/wspaj/aop/article-10.1123-wspaj.2022-0088/article-10.1123-wspaj.2022-0088.xml">research</a> I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us: <blockquote> I wanted something that would allow me to train that just didn’t have anything to do with how I looked. </blockquote> Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said: <blockquote> We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we? </blockquote> This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained: <blockquote> Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life. </blockquote> This newfound confidence often spills over into other areas of life. As one woman said: <blockquote> I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter. </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> 1. Take things slow Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">compound movements</a>, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient. 2. Prioritise proper form Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially. 3. Consistency is key Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else. 4. Find a community Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum. <h2>Are there any downsides?</h2> Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag. Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging. If you’re concerned about getting too “bulky”, it’s very difficult for <a href="https://journals.sagepub.com/doi/epub/10.1177/0031512520967610">women</a> to bulk up like male bodybuilders without pharmaceutical assistance. The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>. </div>

Body

Australia’s IV fluids shortage will likely last all year. Here’s what that means for surgeries

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The current <a href="https://www.tga.gov.au/about-IV-fluids-shortages">shortage of sterile intravenous (IV) fluids</a> is a serious ongoing concern for doctors across Australia. During surgery, these sterile fluids are essential to administer drugs and hydrate patients intravenously (via the veins). But supplies of two of the most common solutions are critically low. The Australian government has recently moved to <a href="https://www.theguardian.com/australia-news/article/2024/aug/16/australia-iv-fluid-shortage-government-distribution">coordinate supplies</a> of IV fluids to increase manufacturing and ensure distribution. Despite this, supplies are not expected to return to normal levels <a href="https://www.health.gov.au/sites/default/files/2024-08/joint-statement-on-iv-fluids-health-ministers-meeting-16-august-2024.pdf">until the end of the year</a>. So, what will this mean for surgery in Australia? And are there any alternatives? <h2>Why do we need IV fluids for surgery?</h2> IV fluids are used before, during and after surgery to maintain blood volume and the body’s normal functions. They also combat dehydration, which can happen in a number of ways. Before surgery, patients may become dehydrated from illnesses that cause vomiting or diarrhoea. They are also asked to stop eating and drinking for several hours before surgery. This is to minimise the risk of stomach contents being regurgitated and inhaled into the lungs – a <a href="https://my.clevelandclinic.org/health/diseases/21954-aspiration-pneumonia">complication that can cause injury or death</a>. But it can also make them more dehydrated. During surgery, the body continues to lose fluid through normal processes such as sweating and making urine. But some aspects of surgery also exacerbate dehydration, for example, through blood loss or when internal organs are exposed and lose more fluid through evaporation. After the operation, IV fluids may be required for some days. Many patients may still be unable to eat and drink until the function of the gut returns to normal. Multiple research studies, including <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1801601">a trial </a>of 3,000 patients who underwent major abdominal surgery, have demonstrated the importance of adequate fluid therapy throughout all stages of surgery to avoid kidney damage. Apart from hydration, these sterile fluids – prepared under strict conditions so they contain no bacteria or viruses – are used in surgery for other reasons. Anaesthetists commonly use fluid infusions to slowly deliver medications into the bloodstream. There is some evidence this method of maintaining anaesthesia, compared to inhalation, can improve patients’ experience of “waking up” after the procedure, <a href="https://medcast.com.au/blog/total-intravenous-anaesthesia-tiva">such as being clearer headed and having less nausea and vomiting</a>. Surgeons also use sterile fluids to flush out wounds and surgical sites to prevent infection. <h2>Are there workarounds?</h2> Fluid given intravenously needs to closely resemble the salts in the blood to prevent additional problems. The safest and cheapest options are: <ul> <li>isotonic saline, a solution of water with 0.9% table salt</li> <li>Hartmann’s solution (compound sodium lactate), which combines a range of salts such as potassium and calcium.</li> </ul> Both are <a href="https://www.tga.gov.au/about-IV-fluids-shortages">in short supply</a>. One way to work around the shortage is to minimise how much IV fluid is used during the procedure. This can be achieved by ensuring those admitted to surgery are as well hydrated as possible. Many people presenting for minor surgery can safely drink water up until an hour or so before their operation. A recent initiative termed “<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15855">sip ‘til send</a>” has shown it is safe for patients to drink small amounts of fluid until the operating theatre team “sends” for them from the waiting room or hospital ward. However, this may not be appropriate for those at higher risk of inhaling stomach contents, or patients who take medications including <a href="https://www.journal.acorn.org.au/cgi/viewcontent.cgi?article=1291&context=jpn">Ozempic</a>, which delay the stomach emptying. Patients should follow their anaesthetist’s advice about how to prepare for surgery and when to stop eating and drinking. Large research trials have also helped establish protocols called “<a href="https://www.bjanaesthesia.org/article/S0007-0912(17)53976-8/fulltext">enhanced recovery after surgery</a>”. They show that using special hydrating, carbohydrate-rich drinks before surgery can improve patients’ comfort and speed up healing. These protocols are common in <a href="https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/736617/ERAS-Key-principles-for-colorectal-surgery.pdf">major bowel surgery</a> in Australia but not used universally. Widespread adoption of these processes may reduce the amount of IV fluids needed during and after large operations, and help patients return to normal eating and drinking earlier. Medications reducing nausea and vomiting are now also routinely administered after surgery to help with this. <h2>What will the shortage mean for surgeries?</h2> The Australian and New Zealand College of Anaesthetists <a href="https://www.anzca.edu.au/news/guidance-on-sparing-of-intravenous-fluid-use">has advised anaesthetists</a> to reduce the consumption of fluid during operations where there might be limited or minimal benefit. This means that the fluid will only be used for people who need it, without a change to the quality and safety of anaesthetic care for any patient. Even with these actions, there is still a chance that some planned surgeries may <a href="https://www.abc.net.au/news/2024-08-15/iv-fluid-shortage-elective-urgery-delays/104225280">need to be postponed</a> in the coming months. If needed, these cancelled operations will likely be ones requiring large volumes of fluid and ones that would not cause unacceptable risks if delayed. Similar to cancellations during the height of the COVID pandemic, emergency operations and surgery for cancers are unlikely to be affected. Monitoring of the supplies and ongoing honest and open dialogue between senior health managers and clinicians will be crucial in minimising the disruption to surgical services.<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/237009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, Associate Professor, Department of Critical Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australias-iv-fluids-shortage-will-likely-last-all-year-heres-what-that-means-for-surgeries-237009">original article</a>. </div>

Body

Supermoons are boring – here are 5 things in the sky worth your time

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/michael-j-i-brown-113">Michael J. I. Brown</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> A <a href="https://science.nasa.gov/solar-system/moon/what-is-a-supermoon/">supermoon</a> may sound exciting, but it’s a modest coincidence. As the Moon orbits Earth, its distance from us varies from 357,000 to 407,000 kilometres. When the Moon and the Sun are in almost opposite directions from Earth, we get a full moon. A “supermoon” is a full moon where its position along its orbit is within 10% of its closest approach to Earth. That’s it. This means a supermoon has an apparent diameter that’s 14% larger than the smallest possible full moon. That’s not a lot. You can’t really notice the difference by eye. As an astronomer, I have a problem with supermoons. There are genuine wonders to see in the night sky, so don’t be disappointed by a dull, overhyped supermoon. <h2>When is the best time to view the Moon?</h2> Articles hyping supermoons are easy. ChatGPT can do it. Say it’s the first supermoon since whenever, add some superlatives, and throw in a telephoto lens photo of a full moon with a landmark. Perhaps the supermoon coincides with another otherwise normal full moon, so it can be a “<a href="https://moon.nasa.gov/news/197/super-blue-moons-your-questions-answered/">blue supermoon</a>” or a “<a href="https://www.accuweather.com/en/space-news/super-worm-moon-how-to-see-the-final-full-moon-of-winter/695656">worm supermoon</a>” or whatever. It’s still just a full moon. If you do want to look at the Moon and it happens to be a supermoon, go for it. But there are better times to admire our only natural satellite, particularly with binoculars or a telescope. The best time to look at the Moon is when its shadows, as seen from Earth, are longest. These long shadows help the craters and mountains stand out from the surrounding plains, so you can appreciate the dramatic landscape of our neighbouring world. The shadows are longest when the Moon appears as a half moon in the night sky. During a full moon or a supermoon the shadows are at their shortest – not nearly as impressive. <h2>Supermoons are a distraction</h2> Have you seen the craters of the Moon, <a href="https://skyandtelescope.org/observing/viewing-saturn-the-planet-rings-and-moons/#:%7E:text=Viewing%20Saturn's%20Rings,the%20ball%20of%20the%20planet.">the rings of Saturn</a>, the clouds of Jupiter or <a href="https://skyandtelescope.org/observing/celestial-objects-to-watch/observing-the-great-orion-nebula/#:%7E:text=First%20locate%20Orion's%20Belt%2C%20which,ll%20find%20the%20Orion%20Nebula.">the Orion nebula</a> with a telescope? They truly are awe-inspiring. Even the most dedicated astronomers return to view them time and time again. <figure class="align-right zoomable"></figure> In fact, astronomers prefer to avoid nights with supermoons and catch up on lost sleep. Full moons flood the night sky with light and make it harder to view more subtle and interesting sights. Want to look at the grand expanse of the Milky Way with the unaided eye? Want to see a meteor shower, comet or aurora? Best done without a damn supermoon. It can be fun to see something truly rare or unusual in the sky. But supermoons don’t qualify for that either. Using the definition I mentioned earlier, there are typically three or four supermoons each year. More restrictive definitions give us one or two supermoons per year. Not only is that not rare, it still just looks like a full moon. There are rarer celestial events that really can inspire. Millions of people across the globe saw <a href="https://science.nasa.gov/science-research/heliophysics/how-nasa-tracked-the-most-intense-solar-storm-in-decades/">bright auroras in May 2024</a>, including places where truly spectacular auroras are few and far between. Comets can also be wonderful. Every decade or so, a comet swings into the inner Solar System and produces a bright tail, millions of kilometres long and visible from Earth. Back when I was a student, I saw <a href="https://en.wikipedia.org/wiki/Comet_Hyakutake">Comet Hyakutake’s bright blue tail</a> stretch across a huge expanse of sky. Sometimes comets fizzle, but when they’re great they are amazing. <h2>Want something impressive? Try an eclipse</h2> Auroras and comets can be fickle, but eclipses are predictable and put on a reliable show. Take total solar eclipses, when the Moon covers the Sun and day turns briefly into night. Thousands travel across the globe to see them. I will be travelling to New South Wales for the <a href="https://eclipse.asa.astronomy.org.au/eclipse-australia-2028/">2028 eclipse</a>. <figure class="align-left zoomable"><a href="https://images.theconversation.com/files/613126/original/file-20240813-17-ewfavl.jpeg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"> </a></figure> <a href="https://www.space.com/15689-lunar-eclipses.html">Lunar eclipses</a>, when the Moon falls within Earth’s shadow, can be a more accessible eclipse experience, which is visible from your own home <a href="https://en.wikipedia.org/wiki/List_of_lunar_eclipses_in_the_21st_century">every few years</a>. During the best lunar eclipses, the Moon turns a dark red as the only light that reaches it comes through Earth’s atmosphere. As an astronomer, I encourage people to look at celestial sights. Go out and see the Moon when it can really impress – during an eclipse or viewed through a telescope. Or enjoy the planets, auroras, comets and meteor showers when there is no Moon at all. But please don’t waste time on supermoons.<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/236416/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-j-i-brown-113">Michael J. I. Brown</a>, Associate Professor in Astronomy, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/supermoons-are-boring-here-are-5-things-in-the-sky-worth-your-time-236416">original article</a>. </div>

Travel Tips

Thinking about trying physiotherapy for endometriosis pain? Here’s what to expect

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/peter-stubbs-1531259">Peter Stubbs</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/caroline-wanderley-souto-ferreira-1563754">Caroline Wanderley Souto Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Endometriosis is a condition that affects women and girls. It occurs when tissue similar to the lining of the uterus ends up in other areas of the body. These areas <a href="https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656">include</a> the ovaries, bladder, bowel and digestive tract. Endometriosis will <a href="https://endometriosisaustralia.org/understanding-endometriosis/">affect</a> nearly one million Australian women and girls in their lifetime. Many high-profile Australians are affected by endometriosis including <a href="https://www.endofound.org/bindi-irwin-shares-her-endometriosis-story-in-detail-as-she-prepares-to-receive-endofounds-blossom-a">Bindi Irwin</a>, <a href="https://www.endofound.org/actress-sophie-monk-reveals-endometriosis-diagnosis">Sophie Monk</a> and former Yellow Wiggle, <a href="https://endometriosisaustralia.org/emma-watkins-ambassador/">Emma Watkins</a>. <a href="https://www.sciencedirect.com/science/article/pii/S0092867421005766">Symptoms</a> of endometriosis include intense pelvic, abdominal or low back pain (that is often worse during menstruation), bladder and bowel problems, pain during sex and infertility. But women and girls wait an average of <a href="https://www.epworth.org.au/newsroom/reducing-time-to-an-endometriosis-diagnosis">seven years to receive a diagnosis</a>. Many are living with the burden of endometriosis and not receiving treatments that could improve their quality of life. This includes physiotherapy. <h2>How is endometriosis treated?</h2> No treatments cure endometriosis. Symptoms can be reduced by taking <a href="https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatment">medications</a> such as non-steriodal anti-inflammatories (ibuprofen, aspirin or naproxen) and hormonal medicines. Surgery is sometimes used to diagnose endometriosis, remove endometrial lesions, reduce pain and improve fertility. But these lesions can <a href="https://pubmed.ncbi.nlm.nih.gov/39098538/">grow back</a>. Whether they take medication or have surgery, many women and girls continue to experience pain and other symptoms. Pelvic health physiotherapy is <a href="https://australian.physio/inmotion/physiotherapists-can-help-endometriosis">often recommended</a> as a non-drug management technique to manage endometriosis pain, <a href="https://www1.racgp.org.au/ajgp/2024/january-february/endometriosis">in consultation</a> with a gynaecologist or general practitioner. The goal of physiotherapy treatment depends on the symptoms but is usually to reduce and manage pain, improve ability to do activities, and ultimately improve quality of life. <h2>What could you expect from your first appointment?</h2> Physiotherapy management can differ based on the severity and location of symptoms. Prior to physical tests and treatments, your physiotherapist will comprehensively explain what is going to happen and seek your permission. They will ask questions to better understand your case and specific needs. These will include your age, weight, height as well as the presence, location and intensity of symptoms. You will also be asked about the history of your period pain, your first period, the length of your menstrual cycle, urinary and bowel symptoms, sexual function and details of any previous treatments and tests. They may also assess your posture and movement to see how your muscles have changed because of the related symptoms. They will press on your lower back and pelvic muscles to spot painful areas (trigger points) and muscle tightness. If you consent to a vaginal examination, the physiotherapist will use one to two gloved fingers to assess the area inside and around your vagina. They will also test your ability to coordinate, contract and relax your pelvic muscles. <h2>What type of treatments could you receive?</h2> Depending on your symptoms, your physiotherapist may use the following treatments: General education Your physiotherapist will give your details about the disease, pelvic floor anatomy, the types of treatment and how these can improve pain and other symptoms. They might <a href="https://pubmed.ncbi.nlm.nih.gov/38452219/">teach you about</a> the changes to the brain and nerves as a result of being in long-term pain. They will provide guidance to improve your ability to perform daily activities, including getting quality sleep. If you experience pain during sex or difficulty using tampons, they may teach you how to use vaginal dilators to improve flexibility of those muscles. Pelvic muscle exercises Pelvic muscles often contract too hard as a result of pain. <a href="https://www.physio-pedia.com/Pelvic_Floor_Exercises">Pelvic floor exercises</a> will help you contract and relax muscles appropriately and provide an awareness of how hard muscles are contracting. This can be combined with machines that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843943/">monitor muscle activity or vaginal pressure</a> to provide detailed information on how the muscles are working. Yoga, stretching and low-impact exercises <a href="https://pubmed.ncbi.nlm.nih.gov/27869485/">Yoga</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/37467936/">stretching and low impact aerobic exercise</a> can improve fitness, flexibility, pain and blood circulation. These have <a href="https://pubmed.ncbi.nlm.nih.gov/28369946/">general pain-relieving properties</a> and can be a great way to contract and relax bigger muscles affected by long-term endometriosis. These exercises can help you regain function and control with a gradual progression to perform daily activities with reduced pain. Hydrotherapy (physiotherapy in warm water) Performing exercises in water improves blood circulation and muscle relaxation due to the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049052/">pressure and warmth of the water</a>. Hydrotherapy allows you to perform aerobic exercise with low impact, which will reduce pain while exercising. However, while hydrotherapy shows positive results clinically, scientific studies to show its effectiveness studies <a href="https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001611112">are ongoing</a>. Manual therapy Women frequently have small areas of muscle that are tight and painful (trigger points) inside and outside the vagina. Pain can be temporarily reduced by <a href="https://pubmed.ncbi.nlm.nih.gov/37176750/">pressing, massaging or putting heat on</a> the muscles. Physiotherapists can teach patients how to do these techniques by themselves at home. <h2>What does the evidence say?</h2> Overall, patients report <a href="https://www.wmhp.com.au/blog/endo-story">positive experiences</a> pelvic health physiotherapists treatments. In a <a href="https://pubmed.ncbi.nlm.nih.gov/37176750/">study of 42 women</a>, 80% of those who received manual therapy had “much improved pain”. In studies investigating yoga, one study <a href="https://pubmed.ncbi.nlm.nih.gov/27869485/">showed</a> pain was reduced in 28 patients by an average of 30 points on a 100-point pain scale. Another study showed yoga was beneficial for pain in <a href="https://pubmed.ncbi.nlm.nih.gov/27552065/">all 15 patients</a>. But while some studies show this treatment <a href="https://pubmed.ncbi.nlm.nih.gov/36571475/">is effective</a>, a review <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740037/">concluded</a> more studies were needed and the use of physiotherapy was “underestimated and underpublicised”. <h2>What else do you need to know?</h2> If you have or suspect you have endometriosis, consult your gynaecologist or GP. They may be able to suggest a pelvic health physiotherapist to help you manage your symptoms and improve quality of life. As endometriosis is a chronic condition you <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10960">may be entitled</a> to five subsidised or free sessions per calendar year in clinics that accept Medicare. If you go to a private pelvic health physiotherapist, you won’t need a referral from a gynaecologist or GP. Physiotherapy rebates can be available to those with private health insurance. The Australian Physiotherapy Association has a <a href="https://choose.physio/find-a-physio">Find a Physio</a> section where you can search for women’s and pelvic physiotherapists. <a href="https://endometriosisaustralia.org/">Endometriosis Australia</a> also provides assistance and advice to women with Endometriosis. Thanks to UTS Masters students Phoebe Walker and Kasey Collins, who are researching physiotherapy treatments for endometriosis, for their contribution to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236328/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-stubbs-1531259">Peter Stubbs</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/caroline-wanderley-souto-ferreira-1563754">Caroline Wanderley Souto Ferreira</a>, Visiting Professor of Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/thinking-about-trying-physiotherapy-for-endometriosis-pain-heres-what-to-expect-236328">original article</a>. </div>

Body

Financial hardship is the biggest driver of loneliness. Here’s why – and how to tackle it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michelle-h-lim-176472">Michelle H Lim</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> One in four Australians <a href="https://lonelinessawarenessweek.com.au/wp-content/uploads/2024/08/why-we-feel-lonely.pdf">report</a> feeling lonely, according to our new report released this week from our research collaboration. The data builds on a large <a href="https://endingloneliness.com.au/wp-content/uploads/2023/10/ELT_LNA_Report_Digital.pdf">study we conducted last year</a> on social connection. Together, the data show that once someone <a href="https://endingloneliness.com.au/wp-content/uploads/2023/10/ELT_LNA_Report_Digital.pdf">becomes lonely</a>, they’re likely to stay lonely. Feeling lonely can have a <a href="https://endingloneliness.com.au/wp-content/uploads/2023/10/ELT_LNA_Report_Digital.pdf">negative impact on your health</a>. It increases the chance of having <a href="https://pubmed.ncbi.nlm.nih.gov/27124713/">social anxiety and depression</a>, and impacts the <a href="http://dx.doi.org/10.1037/0022-3514.85.1.105">health of your heart</a>, your <a href="http://pss.sagepub.com/content/13/4/384.full.pdf">sleep</a> and levels of <a href="https://pubmed.ncbi.nlm.nih.gov/15041083/">inflammation</a>. It also increases the likelihood of an <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Loneliness+and+Social+Isolation+as+Risk+Factors+for+Mortality%3A+A+Meta-Analytic+Review">earlier death</a>. Staying lonely can accelerate these <a href="https://pubmed.ncbi.nlm.nih.gov/31237442/">negative impacts</a>. As more Australians grapple with a cost-of-living crisis, a key driver of loneliness is financial hardship. <h2>Am I lonely?</h2> Loneliness is a negative feeling that arises when your <a href="https://www.gilc.global/_files/ugd/410bdf_62e236db3a7146cd9f2654877a87dbc6.pdf">social needs are not met</a> by the relationships you hold. So you can feel alone, even if you’re surrounded by others, if you’re not getting the right kind of company and support. This might mean you feel, to a certain extent, that: <ul> <li>you are not “in tune” with others</li> <li>your relationships are not meaningful</li> <li>you do not belong</li> <li>you do not have a group of friends</li> <li>no one understands you</li> <li>you do not have shared interests with others</li> <li>there is no one you can turn to.</li> </ul> Not all of these may relate to you and you may experience these in varying degrees. <h2>What drives loneliness?</h2> We <a href="https://endingloneliness.com.au/wp-content/uploads/2023/10/ELT_LNA_Report_Digital.pdf">found</a> particular communities were more at risk of persistent loneliness: <ul> <li>those aged 18 to 24</li> <li>people from culturally and linguistically diverse backgrounds</li> <li>people who were single or divorced</li> <li>those with a chronic disease</li> <li>those with mental ill health.</li> </ul> But the largest effect we found, even after we accounted for all other possible contributing factors, is the impact of financial hardship. People who face financial hardship were almost seven times more likely to report persistent loneliness, and almost five times more likely to report persistent social isolation, compared with people who did not face financial hardship. This aligns with other studies that link economic hardships to <a href="https://pubmed.ncbi.nlm.nih.gov/33241698/">poor health</a>. In <a href="https://pubmed.ncbi.nlm.nih.gov/37761396/">children from low-income backgrounds</a>, for example, their family’s economic hardship is one of the main factors that negatively impacts their physical and psychological health. In a large <a href="https://www.sciencedirect.com/science/article/pii/S0277953622004282?via%3Dihub">study</a> using the UK Biobank, people who are from a lower economic background had a higher probability of reporting loneliness. In <a href="https://pubmed.ncbi.nlm.nih.gov/37528108/">Australia</a>, when compared with people on incomes more than A$150,000, those with incomes under $80,000 were 49% more likely to experience loneliness in one year and 66% more likely to report loneliness in at least two consecutive years. <h2>Being poor affects how we interact with others</h2> Factors such as income and your living environment are some of the <a href="https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1">social determinants of health</a>, which influence our health outcomes. However, to date, little has been done to examine exactly how the lack of financial resources negatively affects the way we interact with others. There are two plausible scenarios. First, having financial pressures may change the way we feel and relate to others due to higher stress levels. Second, financial pressures may stop us from socialising because we have to take on more work to earn more money or we try to cut costs to save money. Socialising can be free in some circumstances, but most of the time, there is a cost to getting to places, or doing an activity together. <h2>What can we do as a society?</h2> The <a href="https://news.gallup.com/opinion/gallup/512618/almost-quarter-world-feels-lonely.aspx">high prevalence of loneliness across the world</a> – and the growing scientific evidence of the negative impact on our health, wellbeing and productivity, and subsequently the economy – can no longer be ignored. The World Health Organization is repositioning loneliness as a global public health priority and has established a <a href="https://www.who.int/groups/commission-on-social-connection">Commission on Social Connection</a>. This commission aims to set the global agenda for social connection, work with high-level commissioners to make the case for global action, scale up proven solutions and measure progress. We need to start by building a <a href="https://lonelinessawarenessweek.com.au/wp-content/uploads/2024/08/How-can-we-create-a-culture-of-connection.pdf">culture of connection</a> in Australia. This means changing the way we make decisions on how we relate to each other, promoting social connection within our schools, workplaces and communities. And to modify policies to allow us to start and maintain healthy social connections. Health and social policies to address loneliness and social isolation have to consider the impact of low incomes and increased financial pressures as barriers to building and maintaining meaningful social connection. Related to this is urban planning. People require safe and no- or low-cost spaces to interact in and to start and maintain relationships. This includes parks, libraries, public squares, community gardens and neighbourhood houses. Cuts to building or maintaining these spaces will stop people from interacting, gathering, or socialising within their community. Not addressing loneliness effectively or quickly will lead us to persistent loneliness and to potentially more distress. <h2>How to connect if you’re financially pressured</h2> Don’t feel alone in this experience. Let your family or friends know that you are financially pressured. Chances are, they are experiencing the same pressures because of the rise in the cost of living. Select no- or low-cost activities such as walking in the park with a friend, or connecting on the phone. Look for free events offered in your local area and city. Consider having meals at home as opposed to going out, or low-cost food options. Find some digital spaces which can allow you to interact with others in shared interest topics. If someone shares they are feeling lonely, asking “is there anything I can do to help?” facilitates the conversation and lets others know you are there without judgement. <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, you can call Lifeline on 13 11 14.<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/236135/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-h-lim-176472">Michelle H Lim</a>, Associate Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/financial-hardship-is-the-biggest-driver-of-loneliness-heres-why-and-how-to-tackle-it-236135">original article</a>. </div>

Money & Banking

It’s tax time and scammers are targeting your myGov account. Here’s how to stay safe

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/cassandra-cross-122865">Cassandra Cross</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> For many, tax time is an exciting part of the year – there’s the potential for a refund. However, it’s also an attractive time for fraudsters looking for ways to get money and deceive unsuspecting victims. Each year Australians lose large amounts of money to scams. In 2023, Australians reported <a href="https://www.accc.gov.au/media-release/scam-losses-decline-but-more-work-to-do-as-australians-lose-27-billion">losses of more than A$2.7 billion</a>. While this is a slight reduction from the $3.1 billion in 2022, there are still millions of victims who’ve suffered at the hands of scammers. Impersonation scams are one common approach. Scamwatch reports that in 2023, <a href="https://www.scamwatch.gov.au/news-alerts/shopping-for-online-bargains-this-black-friday-weekend-make-sure-its-the-real-deal">70% of reports to them</a> involved impersonation. A large number of these were linked to the Australian Taxation Office (ATO) and myGov. <h2>What is an impersonation scam?</h2> Impersonation scams are what they sound like: when an offender pretends to be someone or something they are not. Offenders may pretend to be family members or friends in our contact lists. In many cases, they will say they’re from an organisation such as a bank or a well-known retailer, or a government department – like the ATO. Offenders take on the identity of a known and trusted organisation to increase the chances of success. While we may ignore communications from unknown entities and strangers, we’re more likely to engage with what’s familiar. Additionally, the ATO has a powerful status as a government agency, and we are unlikely to ignore its messages – especially at tax time. <h2>What are they trying to get out of my myGov account?</h2> myGov is the gateway to a range of government services, including Medicare, Centrelink, My Health Record, the National Disability Insurance Scheme, and of course, the ATO. Being able to log in to myGov gives offenders access to a wide range of your personal details. This can help them build a fuller profile of you to potentially commit identity theft (such as opening new accounts in your name). There’s also the potential for direct fraud. With access to myGov, offenders can change your bank account details and redirect any refunds into their accounts, whether from the ATO or other linked services. They can even submit false tax returns, medical claims or other forms to obtain fraudulent funds. As the legitimate owner of the account, you may not immediately notice this. <h2>What does a myGov scam look like?</h2> In most instances, a myGov scam will look like one of the many phishing attempts we all receive on a daily basis. While each approach can be worded differently, their desired outcome is the same: to acquire your personal information. Fraudsters are sending text messages and emails pretending to be from the ATO, advising you there’s a refund available if you click the provided link. Another approach is to flag a “problem” with your tax return or bank account, and direct you to take immediate action via a link. Creating a sense of urgency can trick users into acting in the moment, without thinking through the request. The text or email may also be very neutral, simply stating there’s a new message waiting – with a link to where you can read it. Regardless of what the message says, the goal is to direct you to a website that looks genuine, but is fake. If you enter your myGov details into such a fake site, the offender can capture your login details and use them to log into your actual myGov account. <h2>What to do if you’ve been a victim?</h2> If you have clicked on a scam link and provided your personal details, there are steps you can take. Change your password and review your account settings if you still have access to your myGov account. Check your bank accounts, to see what, if anything, has been lost. Contact your bank or financial institution immediately if you notice any withdrawals or suspicious transactions. Contact any other organisation linked to your myGov account to see if any unauthorised actions have been taken. For anyone who has lost personal information and experienced identity crime, <a href="https://www.idcare.org/">IDCARE is the national support centre</a> for identity crime victims. They will be able to assist with a personalised response plan to your specific situation. <h2>How do I keep my account safe?</h2> Never click on links in text messages or emails that direct you to log in to your accounts. Always access your accounts independently, through details you have found independently of any text or email. Review your security settings. There have been recent reports of people’s myGov accounts being targeted <a href="https://www.theguardian.com/australia-news/article/2024/aug/01/ato-mygov-tax-return-refund-scam">with repeated login attempts</a>. Using your unique eight-digit myGov username for logging in can be safer than <a href="https://my.gov.au/en/about/help/mygov-website/help-using-your-account/manage-sign-in-details#updatingyourusername">using your email address</a>. Enable <a href="https://theconversation.com/what-is-multi-factor-authentication-and-how-should-i-be-using-it-191591">multi-factor authentication</a> where possible. myGov uses two-factor authentication in the form of a text message in addition to an online login. While this is not foolproof, it offers an additional layer of protection and can stop offenders accessing your account with only partial pieces of your information. Be vigilant on all communications. Always keep in mind that all may not be what it seems and the person you are communicating with may not be who they say they are. It is okay to be sceptical and do your own checks to verify details of what is presented to you. Remember, fraudsters thrive on the silence and shame of those who respond or fall victim to their scams. We need to communicate openly about these schemes and talk to family and friends, to increase everyone’s knowledge and awareness.<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/235785/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cassandra-cross-122865">Cassandra Cross</a>, Associate Dean (Learning & Teaching) Faculty of Creative Industries, Education and Social Justice, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/its-tax-time-and-scammers-are-targeting-your-mygov-account-heres-how-to-stay-safe-235785">original article</a>. </div>

Money & Banking

Is Australia’s climate confusing you? Here’s why rainfall and temperatures don’t always behave as expected

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/carly-tozer-1404662">Carly Tozer</a>, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> and <a href="https://theconversation.com/profiles/james-risbey-2011">James Risbey</a>, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> In the past few years in Australia, seasonal rainfall and temperatures have left a lot of people confused. Sometimes, the hot, dry conditions usually associated with an El Niño have not eventuated. Similarly, there have been years where a La Niña did not lead to the cool, wet conditions expected. It’s important for scientists to better understand all weather processes at play, so we can manage expectations around what Australia might experience when climate drivers such as El Niño and La Niña are forecast in future. That’s where our <a href="https://journals.ametsoc.org/view/journals/mwre/aop/MWR-D-23-0112.1/MWR-D-23-0112.1.xml">new research</a> comes in. We examined the state of play in November 2020 and November 2021. La Niña conditions occurred in both years. November 2021 followed the La Niña script and was wet and cool, but November 2020 departed from expectations and was dry and warm. We set out to determine why. We found the differences could be explained by fluctuations in the path of storms over the Australian continent. These fluctuations can be hard to predict well in advance, which makes it difficult to say for certain how a particular La Niña or El Niño event will affect Australia. <h2>A tale of two Novembers</h2> For large parts of Australia, the presence of a La Niña or El Niño <a href="https://theconversation.com/what-to-expect-when-youre-expecting-an-el-nino-the-answer-might-surprise-you-198510">shifts the odds</a> of experiencing wet or dry conditions. Our analysis of Novembers 2020 and 2021 shows how actual outcomes can differ from, or align with, expectations. The first step in our analysis was to examine <a href="https://theconversation.com/what-does-el-nino-do-to-the-weather-in-your-state-218257">other climate drivers</a>, including the Indian Ocean Dipole and Southern Annular Mode. We wanted to know if these drivers were in the same phase – negative, neutral or positive – during those two Novembers a year apart. So what did we find? In addition to La Nina, both Novembers occurred during positive Southern Annular Mode phases and very weak negative Indian Ocean Dipole phases. These phases are typically associated with more rainfall in Australia. So this didn’t explain why November 2020 was hot and dry. Next, we looked to the <a href="http://www.bom.gov.au/climate/about/?bookmark=mjo">Madden Julian Oscillation</a>. When this driver is located in the Australian region, it has been linked to more rainfall in Australia. Although the oscillation was in different phases during November 2020 and 2021, we found in general, this driver does not strongly influence rainfall across all of Australia in November. It was time to look for answers elsewhere. <h2>Jet streams: a key piece in the puzzle</h2> Next, we examined weather systems – in other words, the movement of high and low pressure systems across the globe. These systems are partly controlled by jet streams, which are bands of wind in the upper atmosphere. The effect of jet streams on weather systems, including storms, means they influence rainfall in the regions they pass over. We found there was a strong jet stream over Australia in November 2021. This would have assisted the development of any rain-bearing low-pressure systems moving in from the west, allowing these systems to travel across the Australian continent. These systems brought rain and contributed to the very wet conditions. In November 2020, the jet stream was largely absent over Australia. Instead, it was pushed south of the continent, which means rainfall systems received little help and were also largely steered south. That contributed to the dry month. But why did the jet streams develop in the first place? They form in part due to temperature differences, and are found in the zones where the temperature contrast between warm and cool air is strongest. In November 2021, Australia experienced cooler temperatures over land, but above-average sea surface temperatures in the waters off northern Australia. This pattern set up the zone of strongest temperature contrasts over the continent, which led to a persistent jet stream there. In November 2020, Australia was relatively warm both over land and on the sea surface to the north. This meant that the strongest temperature contrasts (and the jet stream) now sat at the junction between the warm continent and cooler Southern Ocean. <h2>But wait, there’s more</h2> So why were temperatures over Australia so different? To help answer this question we shifted our analysis from the monthly timescale to the daily timescale. That’s because atmospheric features such as jet streams vary strongly from day to day. We found for about the first three weeks of November 2021, a large low-pressure system – also known as a trough – was sitting south of Australia. It pumped cold air onto the continent, cooling it down. This maximised the north-south temperature difference between the warm sea surface temperatures to the north of Australia and the cool of the continent. And as we know, this aided the development of the jet stream over Australia. In November 2020, the continent started off relatively warm. And for a large portion of the month, there was a large high-pressure system over Australia, pulling warmer air from the tropics over the continent. This system would have also promoted clear skies over Australia and enhanced heating coming from the sun, contributing to the warm Australian continent in November 2020. <h2>More puzzle pieces to fit</h2> November 2020’s hot, dry conditions were not the only time a climate driver has failed to bring the conditions some had anticipated. Just last year El Niño <a href="https://www.theguardian.com/australia-news/2024/jan/03/experts-warned-el-nino-was-likely-to-bring-australia-a-hot-dry-summer-what-happened">did not deliver</a> expected dry conditions, leaving many people scratching their heads. Climate drivers play an important role in shaping rainfall. But they’re not the whole story. As our research shows, sometimes they are confounded by changes in weather patterns, which might mean that our expectations of a wet month or season don’t always play out. When it comes to Australia’s climate puzzle, these findings show there’s more to understand about the role of weather.<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/233345/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/carly-tozer-1404662">Carly Tozer</a>, Senior Research Scientist, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> and <a href="https://theconversation.com/profiles/james-risbey-2011">James Risbey</a>, Researcher, Oceans and Atmosphere, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-australias-climate-confusing-you-heres-why-rainfall-and-temperatures-dont-always-behave-as-expected-233345">original article</a>. </div>

Domestic Travel

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> We all know physical activity has many <a href="https://www.nhs.uk/live-well/exercise/exercise-health-benefits/">health benefits</a>, including for mental health. It helps <a href="https://theconversation.com/exercise-can-reduce-stress-and-improve-sleep-particularly-for-women-with-breast-cancer-186144">manage stress</a>, ease joint or back pain, and boost energy levels. Exercise can also improve <a href="https://theconversation.com/exercise-and-the-brain-three-ways-physical-activity-changes-its-very-structure-150203">brain function</a> and <a href="https://theconversation.com/exercise-really-can-help-you-sleep-better-at-night-heres-why-that-may-be-192427">sleep</a>, and lift mood. In contrast, inactivity or spending too much time <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308180/">sedentary</a> is a leading factor in developing a range of diseases. The <a href="https://www.who.int/publications/i/item/9789240015128">World Health Organization</a> recommends we should do a weekly minimum of 150-300 minutes of moderate intensity physical activity, such as walking, or 75 minutes of vigorous physical activity, such as swimming, jogging or an exercise class – as well as <a href="https://theconversation.com/strength-training-could-be-the-answer-to-one-of-the-worlds-worst-killers-228665">regular strength training</a>. However, many people <a href="https://www.who.int/teams/health-promotion/physical-activity/global-status-report-on-physical-activity-2022">fail to meet these guidelines</a>. So what to do about this <a href="https://www.weforum.org/agenda/2022/12/lack-exercise-inactivity-preventable-diseases/">health crisis</a>? There is already <a href="https://www.bmj.com/content/376/bmj-2021-068465">evidence</a> that when GPs give patients guidance and continued support to increase physical activity, this encourages them to be more physically active – at least in the short term. However, we don’t yet know the best way for doctors to communicate with patients to help them sustain these increased activity levels so the current guidance and support on offer to patients isn’t as effective as it could be. <figure><iframe src="https://www.youtube.com/embed/vCCD1xHKpZc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For example, my <a href="https://www.bmj.com/content/386/bmj-2023-078713">latest research</a> examines the <a href="https://www.bmj.com/content/340/bmj.c1900">“motivational interviewing” (MI)</a> method GPs currently use to encourage patients to change their lifestyle. MI is a patient-centred, non-confrontational communication style that helps patients address any problem behaviour by exploring their ambivalence towards changing it. MI has been shown to help patients with a host of health problems, including <a href="https://pubmed.ncbi.nlm.nih.gov/25577724/">addiction issues</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/23001832/">eating disorders</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/25726920/">smokers</a> and those with <a href="https://pubmed.ncbi.nlm.nih.gov/33637368/">diabetes</a> to change their behaviour. However, I found that while MI programmes can help patients increase their total amount of physical activity – the benefits are only short term. <h2>Ten simple ways to be more physically active</h2> If you want more physical activity in your life, then, there are many self-directed things you can do to help yourself, without joining a programme or seeing your GP. Here are ten simple and effective ways to help you become – and stay – more physically active: 1) Don’t sit, stand We <a href="https://theconversation.com/sitting-is-bad-for-your-health-and-exercise-doesnt-seem-to-offset-the-harmful-effects-225056">sit a lot</a>. In fact, it’s likely you’re sitting right now – and you needn’t be. Sitting for long periods has been <a href="https://doi.org/10.1016/j.amepre.2010.05.024">linked</a> with many adverse health outcomes, so try to stand more. <figure><iframe src="https://www.youtube.com/embed/wUEl8KrMz14?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> 2) Take the stairs Being physically active needn’t mean expensive gym memberships. Try building physical activity into your daily routine. One easy way to do this is by swapping the lift or escalator for the stairs. 3) Make it fun If you like doing something, you’re <a href="https://theconversation.com/why-you-shouldnt-let-guilt-motivate-you-to-exercise-220342">more likely</a> to continue doing it. Why not try an activity you liked doing as a child, or even something new? Who knows, you might enjoy it. 4) Phone a friend Exercising <a href="https://theconversation.com/exercise-can-be-punishing-but-heres-how-to-stop-thinking-of-it-as-a-punishment-76167">with a friend</a> or loved one is a great way to stay motivated, and it can make physical activity more fun too. 5) Do less, more often <a href="https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-023-01272-8">“Snacktivity”</a> – a term for breaking up your activity into shorter <a href="https://theconversation.com/forget-the-gym-in-january-exercise-snacking-is-the-way-forward-69702">activity “snacks”</a> – can help you increase activity in convenient, manageable bursts while reaping the health benefits. 6) Track your progress Activity trackers aren’t a fad. There is <a href="https://doi.org/10.1016/S2589-7500(22)00111-X">evidence</a> that just using an activity tracker such as a pedometer to count steps or a smart watch that logs activity can help increase your activity levels, reduce body fat and increase muscle mass – and increase your overall physical fitness. 7) Get into a habit We know it takes about ten weeks to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/">form a habit</a>. Repetition is key – so stick with it and keep going. Once you’ve formed a physical activity habit, it will be <a href="https://www.psychologytoday.com/gb/basics/habit-formation#:%7E:text=Building%20healthy%20habits%20can%20involve,listening%20to%20music%20while%20exercising">hard to shake it off</a>.). 8) Hold still Try to incorporate <a href="https://en.wikipedia.org/wiki/Isometric_exercise">isometric exercises</a> like the plank or wall squats into your routine. These exercises, which need no equipment, require you to tighten muscles and hold still – and have been shown to <a href="https://bjsm.bmj.com/content/57/20/1317">lower your blood pressure</a>. 9) Set a goal Give yourself an achievable target to work towards – it will <a href="https://theconversation.com/three-tips-to-help-you-stay-motivated-to-keep-exercising-all-year-long-175868">motivate you</a> to reach your goal. 10) Reward yourself And don’t forget to reward yourself when you meet that goal. You can also build in rewards to mark your progress along the way. After all, who doesn’t like to treat themselves when they’ve done well?<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, Associate professor, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/you-dont-need-a-doctor-to-get-more-physically-active-here-are-10-simple-steps-you-can-take-by-yourself-231991">original article</a>. </div>

Body

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Many people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">drinking less</a> sugary soft drink than in the past. This is a great win for public health, given the <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2749350">recognised risks</a> of diets high in sugar-sweetened drinks. But over time, intake of diet soft drinks has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">grown</a>. In fact, it’s so high that these products are now regularly <a href="https://www.sciencedirect.com/science/article/pii/S0160412020319188">detected in wastewater</a>. So what does the research say about how your health is affected in the long term if you drink them often? <h2>What makes diet soft drinks sweet?</h2> The World Health Organization (WHO) <a href="https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children">advises</a> people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.” But most regular soft drinks contain <a href="https://www.actiononsugar.org/surveys/2014/sugar-sweetened-beverages/">a lot of sugar</a>. A regular 335 millilitre can of original Coca-Cola contains at least <a href="https://www.coca-cola.com/ng/en/about-us/faq/how-much-sugar-is-in-cocacola-original-taste">seven</a> teaspoons of added sugar. Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources. Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness. Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight. But while surveys of Australian <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551593/">adults</a> and <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/adolescents-knowledge-and-beliefs-regarding-health-risks-of-soda-and-diet-soda-consumption/32F3E0FD6727F18F04C63F0390595131">adolescents</a> show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly. <h2>What does the research say about aspartame?</h2> The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the <a href="https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food">US</a> and <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame">Australia</a>. However, some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/">researchers</a> have raised concern about the long-term risks of consumption. People who drink diet soft drinks regularly and often are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446768/">more likely</a> to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks. The link was found even after accounting for other dietary and lifestyle factors (such as physical activity). In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “<a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">possibly carcinogenic to humans</a>” (carcinogenic means cancer-causing). Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally. <h2>Will diet soft drinks help manage weight?</h2> Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management. In 2022, the WHO conducted a <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">systematic review</a> (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management. Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners. But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity. In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">advising</a> artificial sweeteners should not be used to manage weight. <a href="http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30296-0">Studies</a> in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven. <h2>What about inflammation and dental issues?</h2> There is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10817473/">some early evidence</a> artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed. High amounts of diet soft drinks have <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17223-0">also been</a> linked with liver disease, which is based on inflammation. The consumption of diet soft drinks is also <a href="https://link.springer.com/article/10.1007/s40368-019-00458-0#:%7E:text=Diet%20soft%20drinks%20often%20have,2006">associated</a> with dental erosion. Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion. <h2>Moderation is key</h2> As with many aspects of nutrition, moderation is key with diet soft drinks. Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term. Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233438/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/cheeky-diet-soft-drink-getting-you-through-the-work-day-heres-what-that-may-mean-for-your-health-233438">original article</a>. </div>

Food & Wine

Joe Biden has COVID. Here’s what someone over 80 can expect

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> If US politics leading up to the 2024 presidential election was a Hollywood thriller, it would be a movie full of plot twists and surprises. The latest twist is President Joe Biden has <a href="https://edition.cnn.com/2024/07/17/politics/joe-biden-tests-positive-covid-19/index.html">COVID</a> and is isolating at home. <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2024/07/17/statement-from-press-secretary-karine-jean-pierre-3/">Biden’s doctor says</a> his symptoms are mild and include a runny nose, cough and generally feeling unwell. His temperature, oxygen levels and respiratory rate are said to be normal. Biden, who has <a href="https://www.bbc.com/news/articles/cv2gj8314nqo">been diagnosed</a> with COVID twice before, <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2024/07/17/statement-from-press-secretary-karine-jean-pierre-3/">has received</a> his COVID vaccine and booster shots, and has taken the first dose of the antiviral drug Paxlovid. No doubt, Biden will be receiving the best of medical care. Yet, as much <a href="https://theconversation.com/is-joe-biden-experiencing-cognitive-decline-heres-why-we-shouldnt-speculate-234487">recent media coverage</a> reminds us, he is 81 years old. So let’s look at what it means for an 81-year-old man to have COVID in 2024. Of course, Biden is not just any man, but we’ll come to that later. <h2>Luckily, it’s not 2020</h2> If we were back in 2020, a COVID diagnosis at this age would have been a big deal. This was a time before COVID vaccines, before specific COVID treatments and before we knew as much about COVID as we do today. Back then, being over 80 and being infected with the SARS-CoV-2 virus (the virus that causes COVID) represented a significant threat to your health. It was very clear early in the pandemic that your chances of getting severe disease and dying <a href="https://theconversation.com/why-are-older-people-more-at-risk-of-coronavirus-133770">increased with age</a>. The early data suggested that if you were over 80 and infected, you had about a 15% likelihood of dying from the illness. Also, if you did develop severe disease, we didn’t have a lot in the toolkit to deal with your infection. Remember, former UK Prime Minister Boris Johnson <a href="https://theconversation.com/scott-morrison-has-covid-its-a-big-deal-but-not-how-you-think-178298">ended up in the ICU</a> with his COVID infection in <a href="https://www.theguardian.com/world/2020/apr/17/boris-johnson-and-coronavirus-inside-story-illness">April 2020</a>, despite being 55 at the time. That’s a much younger age than Biden is now. Former US President Donald Trump also had what was understood to be a <a href="https://www.theguardian.com/us-news/2021/feb/11/trump-coronavirus-ventilator-covid-illness">very severe case</a> of COVID in October 2020. He was 74 at the time. <h2>How things have changed</h2> So let’s wind the clock forward to 2024. A lot has happened in four years. COVID is still a disease that needs to be <a href="https://www.cdc.gov/ncird/whats-new/changing-threat-covid-19.html">taken seriously</a>. And for some people with other health conditions (for instance, people with heart disease or diabetes) it poses more of a threat. And of course we know more about the well-publicised <a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">longer term effects</a> of COVID. But the threat COVID poses to an individual is far less now than it has ever been. <h2>More of us have some immunity</h2> First, <a href="https://www.theguardian.com/world/2022/dec/03/who-estimates-90-of-world-have-some-resistance-to-covid">most people</a> have some immunity to COVID now, whether this has come from vaccination or prior infection, and for many both. The fact that your immune system has had some exposure to the virus is transformative in how you respond to infection. Yes, there’s the ongoing problem of waning immunity over time and the virus mutating meaning you need to have regular booster vaccines. But as your immune system has “seen” the virus before it allows it to respond more effectively. This means the threat posed by infection has fallen drastically. We know Biden has received his booster shots. Boosters have been shown to offer <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">substantial protection</a> against severe illness and death and are particularly important for older age groups. <h2>Now we have antivirals</h2> Second, we also have antiviral medicines, such as Paxlovid, which is effective in reducing the likelihood of severe illness from COVID if taken soon after developing symptoms. In <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2118542">one study</a>, if taken soon after infection, Paxlovid reduced the likelihood of severe illness or death by 89%. So it is <a href="https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/ritonavir-boosted-nirmatrelvir--paxlovid-/">highly recommended</a> for those at higher risk of severe illness. As we know, Biden is taking Paxlovid. Paxlovid has also been associated with rebound symptoms. This is when a person looks to have recovered from infection only to have symptoms reappear. Biden experienced this <a href="https://theconversation.com/why-do-some-people-who-take-paxlovid-for-covid-get-rebound-symptoms-or-test-positive-again-like-president-biden-188002">in 2022</a>. The good news is that even if this occurs in most instances the symptoms associated with the recurrence tend to be mild. <h2>Biden would have the best care</h2> The other factor of course is that Biden would have access to some of the world’s best medical care. If his symptoms were to become more severe or any complications were to develop, you can be assured he would get the best treatment. So is Biden’s diagnosis news? Well of course, given all the speculation about his health. But in terms of COVID being a major threat to Biden’s health, there are no indications it should be.<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/234999/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Bonnie Cash/Pool via CNP/Shutterstock Editorial 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/joe-biden-has-covid-heres-what-someone-over-80-can-expect-234999">original article</a>. </div>

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