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Readers response: What seems too expensive but is really worth the price?

We asked our readers what items or experience seem, too expensive but are really worth the price, and the response was overwhelming. Here's what our audience will always justify the price of. Robbie Kirkwood - Travel insurance. Elizabeth Foster - Business class on long haul flights. Jeanette Wallis - Coffee beans. Mandy O'Connor - A good pair of Levi jeans, and a good pair of boots. Pamela McDonald - I would say electricity! Seems lots complain about the cost until you lose power, then you realise how hard life would be without it. Tess Witchell - Real butter! Three ply toilet rolls, frappe iced coffee from McDonald’s, and proper bakery bread. Sue Yunker - Wine! Michael Schulze - A decent cup of coffee. Suzanne Jones - A holiday. Rose Niemack - Fruits and vegetables. Image credits: Shutterstock

Money & Banking

"You made me enjoy the game": Federer's emotional retirement letter to Nadal

Roger Federer has penned an emotional tribute to Rafael Nadal ahead of his retirement, reflecting on their stellar careers together. Nadal’s career officially came to an end when Spain was defeated 2-1 by the Netherlands in the Davis Cup quarter-final in Malaga on Wednesday morning, with Nadal in tears as he stepped onto the court for the final time. Thousands of tributes poured in for Nadal as his retirement officially began, but Federer's tribute quickly went viral for his emotional words. “As you get ready to graduate from tennis, I’ve got a few things to share before I maybe get emotional,” Federer said. “Let’s start with the obvious: you beat me - a lot. More than I managed to beat you. You challenged me in ways no one else could. On clay, it felt like I was stepping into your backyard, and you made me work harder than I ever thought I could just to hold my ground." “You made me reimagine my game - even going so far as to change the size of my racquet head, hoping for any edge. I’m not a very superstitious person, but you took it to the next level. Your whole process. All those rituals." “Assembling your water bottles like toy soldiers in formation, fixing your hair, adjusting your underwear … All of it with the highest intensity. Secretly, I kind of loved the whole thing. Because it was so unique - it was so you." “And you know what, Rafa, you made me enjoy the game even more. OK, maybe not at first. After the 2004 Australian Open, I achieved the No. 1 ranking for the first time. I thought I was on top of the world. And I was - until two months later, when you walked on the court in Miami in your red sleeveless shirt, showing off those biceps, and you beat me convincingly." "All that buzz I’d been hearing about you - about this amazing young player from Mallorca, a generational talent, probably going to win a major someday - it wasn’t just hype." “We were both at the start of our journey and it’s one we ended up taking together. Twenty years later, Rafa, I have to say: What an incredible run you’ve had. Including 14 French Opens - historic! You made Spain proud … you made the whole tennis world proud." “And then there was London – the Laver Cup in 2022. My final match. It meant everything to me that you were there by my side – not as my rival but as my doubles partner." “Sharing the court with you that night, and sharing those tears, will forever be one of the most special moments of my career.” Federer signed off the 585-word tribute from “your fan Roger”. Image credits: ANDY RAIN/EPA-EFE/Shutterstock Editorial

Retirement Life

5 items you’re cleaning too much

Cleaning the house is no easy feat. To make life a little easier for you, here are five items you are probably cleaning more than you need to. 1. Clothes worn once For particular items of clothing such as gym gear, shirts and tights it is fine to wash clothes after every wear. However, most other items can be worn up to three times advises Carolyn Forte, the director of the Cleaning Lab at the Good Housekeeping Institute. "Over-washing and over-drying fabrics can cause fading and wear,” she said. Studies have also shown that it is ideal to wash bath towels after three uses. 2. Dinner plates Instead of spending time rinsing your plates before putting them in the dishwasher, just make sure all the food is scrapped off. "Pre-washing dishes is a waste of time and energy,” said Carolyn. "If you aren't running it right away, let the dishwasher rinse them with a 'rinse only' cycle." 3. Light Fixtures It can be tempting to dust your light fixtures every week but Carolyn advises saving your strength from a different household task. She advises that you can get away with cleaning light fixtures once a month. 4. Jackets In the cooler months jackets are worn every day. However, this necessity only needs to be washed every three months. Jackets don’t usually come into contact with skin cells or natural oils, which allows them to go longer between washes than other clothes. 5. Curtains Curtains need to be washed if you get any marks on them but if they are in pristine condition, according to Carolyn they only need to be cleaned once a year. Image credits: Shutterstock

Home & Garden

Getting antivirals for COVID too often depends on where you live and how wealthy you are

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Medical experts <a href="https://www.health.gov.au/health-alerts/covid-19/treatments/eligibility">recommend</a> antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID. But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable. <h2>Who missed out?</h2> We <a href="https://grattan.edu.au/wp-content/uploads/2024/10/How-we-analysed-COVID-antiviral-uptake-Grattan-Institute.pdf">analysed</a> COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds. Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities. <h2>How stark are the differences?</h2> Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script. People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=329&fit=crop&dpr=1 600w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=329&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=329&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=413&fit=crop&dpr=1 754w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=413&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=413&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Dispensing rates by group. Grattan Institute</figcaption></figure> Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west. Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west. <h2>Why are people missing out?</h2> COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often <a href="https://link.springer.com/article/10.1007/s40121-024-01003-3">don’t realise</a> they would benefit from the medication. They <a href="https://www.phrp.com.au/?p=43363">wait</a> until symptoms get worse and it is too late. Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral. Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell. Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% <a href="https://hwd.health.gov.au/resources/data/gp-primarycare.html">fewer</a> GPs, see their GP about half as often, and are 30% more likely to <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release">report</a> waiting too long for an appointment. Just like for <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">vaccination</a>, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds. <h2>Care should go those who need it</h2> Since the period we looked at, evidence has emerged that raises <a href="https://url.au.m.mimecastprotect.com/s/FmjFC91ZVBSmBpXpZSEh9CqMtQx?domain=nejm.org">doubts</a> about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals. But all Australians who are eligible for antivirals should have the same chance of getting them. These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than <a href="http://medicarestatistics.humanservices.gov.au/statistics/do.jsp?_PROGRAM=%2Fstatistics%2Fpbs_item_standard_report&itemlst=%2712910L%27%2C%2712996B%27&ITEMCNT=2&LIST=12910L%2C12996B&VAR=SERVICES&RPT_FMT=6&start_dt=202201&end_dt=202408">30,000</a> packs of COVID antivirals were dispensed in August, costing about $35 million. Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most. People born overseas have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#deaths-due-to-covid-19-country-of-birth">40% more likely</a> to die from COVID than those born here. Indigenous Australians have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#covid-19-mortality-among-aboriginal-and-torres-strait-islander-people">60% more likely</a> to die from COVID than non-Indigenous people. And the most disadvantaged people have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#deaths-due-to-covid-19-socio-economic-status-seifa-">2.8 times</a> more likely to die from COVID than those in the wealthiest areas. All those at-risk groups have been more likely to miss out on antivirals. It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID <a>vaccination</a>, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as <a href="https://www.aihw.gov.au/getmedia/54a38a6a-9e3c-4f58-b2f6-cdef977a7d60/aihw-can-155_15sept.pdf?v=20230915162104&inline=true">cancer</a> <a href="https://www.aihw.gov.au/getmedia/27f32443-5206-4189-8775-0c1f55a26bc4/aihw-can-160.pdf?v=20240617095924&inline=true">screening</a>. <h2>A 3-step plan to meet patients’ needs</h2> The federal government should do three things to close these gaps in preventive care. First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out. Second, the government should extend its <a href="https://www.health.gov.au/our-work/mymedicare">MyMedicare</a> reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be <a href="https://grattan.edu.au/report/a-new-medicare-strengthening-general-practice/">expanded</a> to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick. Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also <a href="https://theconversation.com/pharmacists-should-be-able-to-work-with-gps-to-prescribe-medicines-for-long-term-conditions-212359">work</a> for medications for chronic diseases, such as cardiovascular disease. COVID antivirals, unlike vaccines, have been <a href="https://theconversation.com/covid-wave-whats-the-latest-on-antiviral-drugs-and-who-is-eligible-in-australia-218423">keeping up</a> with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast. In the meantime, fairer access to care will help close the big and persistent <a href="https://www.aihw.gov.au/getmedia/0cbc6c45-b97a-44f7-ad1f-2517a1f0378c/hiamhbrfhsu.pdf?v=20230605184558&inline=true">gaps</a> in health between different groups of Australians. <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</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/getting-antivirals-for-covid-too-often-depends-on-where-you-live-and-how-wealthy-you-are-239497">original article</a>. </div>

Caring

"Not much of me left": Elton John's grim health confession

Elton John has made a blunt admission about his health battles. The 77-year-old singer opened up about his many health issues in a speech at the screening of his new documentary Elton John: Never Too Late, at the New York Film Festival on Tuesday. “To be honest with you, there’s not much of me left,” Elton told the audience. “I don’t have tonsils, adenoids or an appendix,” he continued, according to <a href="https://people.com/elton-john-jokes-not-much-of-me-left-listing-missing-organs-documentary-premiere-8721741" target="_blank" rel="noopener">People</a> magazine. “I don’t have a prostate. I don’t have a right hip or a left knee or a right knee. In fact, the only thing left to me is my left hip. “But I’m still here,” Elton continued. “And I can’t thank you [enough], you’re the people that made me.” The documentary is directed by his husband David Furnish, and American filmmaker R.J. Cutler. Throughout the years Elton has struggled with his health, and just last month he revealed he was recovering from a "severe eye infection" that affected his vision. This occured after he underwent knee and hip replacement surgery. The I'm Still Standing singer also got a pacemaker fitted in back in the 90s, and was hospitalised for influenza and a bacterial infection in 2009. In 2013 he had an abscess on his appendix, and three years later he had suffered from "gastric flu". In addition to all of these health woes he has dealt with hearing loss caused by years of touring. The singer also talked about his retirement from touring at the premiere of his new documentary, following a successful five years of performances and more than 300 shows worldwide. “As you know, I decided to stop touring because I’m 77 years of age,” he said. “I’ve done all there is to do, to play. I’ve succeeded. I’ve been there and I’ve done it.” The documentary explores his 50-year career leading up to his final North American show at Dodger Stadium in 2022. It is set to stream on Disney+ in the US on December 13. ADAM VAUGHAN/EPA-EFE/ Shutterstock Editorial

Caring

I’m iron deficient. Which supplements will work best for me and how should I take them?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant. The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration. If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day? Here are some tips to help you work out how, when and what iron supplement to take. <h2>How do I pick the right iron supplement?</h2> The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need. The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain. In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%). These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost. Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency. <h2>Should I take tablets or liquid formulas?</h2> Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference. The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term. <h2>What should I eat with my iron supplement?</h2> Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone. If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it. Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>. On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement. <h2>Should I take my supplement in the morning or evening?</h2> The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest. Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop. <a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes). <h2>My supplements are upsetting my stomach. What should I do?</h2> If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily. Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects. Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success. It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it. If you think you may be low on iron, talk to your GP to find out your best options.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic 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/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>. </div>

Body

Is white rice bad for me? Can I make it lower GI or healthier?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Rice is a <a href="http://www.ipni.net/publication/bci.nsf/0/42A2EA40E95CBD1385257BBA006531E9/$FILE/Better%20Crops%20International%202002-3%20p03.pdf">culinary staple</a> in Australia and around the world. It might seem like a given that brown rice is healthier than white and official <a href="https://www.eatforhealth.gov.au/eating-well/healthy-recipes/recipe-modification-tips">public health resources</a> often recommend brown rice instead of white as a “healthy swap”. But <a href="https://pubmed.ncbi.nlm.nih.gov/34441728/">Australians definitely prefer white rice</a> over brown. So, what’s the difference, and what do we need to know when choosing rice? <h2>What makes rice white or brown?</h2> Rice “grains” are technically seeds. A complete, whole rice seed is called a “paddy”, which has <a href="https://www.fao.org/4/t0567e/t0567e07.htm">multiple parts</a>: <ol> <li>the “hull” is the hard outer layer which protects the seed</li> <li>the “bran”, which is a softer protective layer containing the seed coat</li> <li>the “germ” or the embryo, which is the part of the seed that would develop into a new plant if was germinated</li> <li>the “endosperm”, which makes up most of the seed and is essentially the store of nutrients that feeds the developing plant as a seed grows into a plant.</li> </ol> Rice needs to be <a href="https://www.tandfonline.com/doi/pdf/10.1080/87559128509540778">processed</a> for humans to eat it. Along with cleaning and drying, the hard hulls are removed since we can’t digest them. This is how <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12449">brown rice is made</a>, with the other three parts of the rice remaining intact. This means brown rice is regarded as a “wholegrain”. White rice, however, is a “refined” grain, as it is <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12449">further polished</a> to remove the bran and germ, leaving just the endosperm. This is a mechanical and not a chemical process. <h2>What’s the difference, nutritionally?</h2> Keeping the bran and the germ means <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/cche.10322">brown rice has more</a> magnesium, phosphorus, potassium B vitamins (niacin, folate, riboflavin and pyridoxine), iron, zinc and fibre. The germ and the bran also contain more bioactives (compounds in foods that aren’t essential nutrients but have health benefits), like <a href="https://www.mdpi.com/1420-3049/28/2/532#:%7E:text=Brown%20rice%20(BR)%20is%20obtained,and%20phenolic%20compounds%20%5B3%5D.">oryzanols and phenolic compounds</a> which have antioxidant effects. But that doesn’t mean white rice is just empty calories. It <a href="https://www.glnc.org.au/wp-content/uploads/2011/04/GLNC_Rice-factsheet_WEB.pdf">still contains</a> vitamins, minerals and some fibre, and is low in fat and salt, and is naturally gluten-free. White and brown rice actually have <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12449">similar</a> amounts of calories (or kilojoules) and total carbohydrates. There are studies that show eating more white rice is linked to <a href="https://diabetesjournals.org/care/article/43/11/2625/35820/A-Global-Perspective-on-White-Rice-Consumption-and">a higher risk</a> of type 2 diabetes. But it is difficult to know if this is down to the rice itself, or other related factors such as socioeconomic variables or other dietary patterns. <h2>What about the glycaemic index?</h2> The higher fibre means brown rice has a <a href="https://www.sciencedirect.com/science/article/pii/S0002916523314862">lower glycaemic index</a> (GI), meaning it raises blood sugar levels more slowly. But this is highly variable between different rices within the white and brown categories. The <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index#:%7E:text=The%20glycaemic%20index%20(GI)%20is,simple'%20or%20'complex'.">GI system</a> uses low (less than 55), medium (55–70) and high (above 70) categories. <a href="https://glycemicindex.com/gi-search/?food_name=rice&product_category=&country=&gi=&gi_filter=&serving_size_(g)=&serving_size_(g)_filter=&carbs_per_serve_(g)=&carbs_per_serve_(g)_filter=&gl=&gl_filter=">Brown rices</a> fall into the low and medium categories. <a href="https://glycemicindex.com/gi-search/?food_name=rice&product_category=&country=&gi=&gi_filter=&serving_size_(g)=&serving_size_(g)_filter=&carbs_per_serve_(g)=&carbs_per_serve_(g)_filter=&gl=&gl_filter=">White rices</a> fall in the medium and high. There are specific <a href="https://www.gisymbol.com/low-gi-products/sunrice-doongara-low-gi-white-clever-rice-1kg/">low-GI types available</a> for both white and brown types. You can also lower the GI of rice by <a href="https://pubs.acs.org/doi/abs/10.1021/jf503203r">heating and then cooling it</a>. This process converts some of the “available carbohydrates” into “resistant starch”, which then functions like dietary fibre. <h2>Are there any benefits to white rice?</h2> The <a href="https://www.realsimple.com/brown-rice-vs-white-rice-8417468#:%7E:text=The%20eating%20experience%20between%20these,chewier%20texture%20and%20nuttier%20flavor.">taste and textural qualities</a> of white and brown rices differ. White rice tends to have a softer texture and more mild or neutral flavour. Brown rice has a chewier texture and nuttier flavour. So, while you can technically substitute brown rice into most recipes, the experience will be different. Or other ingredients may need to be added or changed to create the desired texture. Removing more of the outer layers may also reduce the levels of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375490/">contaminants</a> such as pesticides. <h2>We don’t just eat rice</h2> Comparing white and brown rice seems like an easy way to boost nutritional value. But just because one food (brown rice) is more nutrient-dense doesn’t make the other food (white rice) “bad”. Ultimately, it’s not often that we eat just rice, so we don’t need the rice we choose to be the perfect one. Rice is typically the staple base of a more complex dish. So, it’s probably more important to think about what we eat with rice. Adding vegetables and lean proteins to rice-based dishes can easily add the micronutrients, bioactives and fibre that white rice is comparatively lacking, and this can likely do more to contribute to diet quality than eating brown rice instead.<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/236767/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation - School of Health Sciences, <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/is-white-rice-bad-for-me-can-i-make-it-lower-gi-or-healthier-236767">original article</a>. </div>

Food & Wine

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>

Body

5 foods to add to your shopping list to save money – and they’re good for you too

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Food prices are <a href="https://www.abc.net.au/news/2024-06-13/anglicare-cost-living-unemployment-groceries-fuel-rent-prices/103972166?utm_medium=social&utm_content=sf273549397&utm_campaign=abc&utm_source=linkedin.com&sf273549397=1">adding pressure on household budgets</a>, especially for Australians on the lowest incomes. To help save money on the weekly groceries, consider adding these five staples to your shopping trolley: eggs, oats, carrots, UHT milk and apples. These foods rate highly on the <a href="https://pubmed.ncbi.nlm.nih.gov/20181811/">nutrient-rich foods index</a> and on cost, meaning they represent good value for money when it comes to buying nutritious food. Loading up on these items helps push more expensive, less nutritious foods out of your trolley. Keeping a supply at your place will also save extra trips to the shops, which saves petrol and time. <h2>1. Eggs</h2> Eggs are extremely good value at around A$6 a dozen (50 cents an egg). Meat, chicken and fish prices vary from $12 a kilo for mince, $12–$20 a kilo for chicken, to $20–$50 a kilo for steak and fish depending on cut or type. Selecting the cheapest cuts still costs $2–$3 a serve, compared to two eggs at a $1 serve. When you swap a red meat meal for an eggy dish, this can add up to a big saving. Try our egg recipes on the <a href="https://nomoneynotime.com.au/healthy-easy-recipes/filter/meals--dinner,lunch/superfoods--eggs">No Money No Time website</a>, from <a href="https://nomoneynotime.com.au/healthy-easy-recipes/sweetcorn-and-zucchini-fritters">fritters</a>, to <a href="https://nomoneynotime.com.au/healthy-easy-recipes/mushroom-omelette">omelettes</a>, or <a href="https://nomoneynotime.com.au/healthy-easy-recipes/clares-rainbow-rice">fried rice</a>. These recipes also help use up other items you have in the pantry, fridge and veggie crisper. Eggs are a good <a href="https://www.australianeggs.org.au/nutrition/nutrients-and-vitamins">source</a> of protein and also contain choline, lutein and zeaxanthin, vitamins A, B2, B12, D, E and folate, and minerals iron, zinc, iodine and selenium. For people concerned about eggs raising cholesterol, a <a href="https://pubmed.ncbi.nlm.nih.gov/38370115/">recent review of research evidence</a> concluded there wasn’t likely to be any adverse effect on overall disease risk when consuming up to one egg a day. <h2>2. Rolled oats</h2> Rolled oats vary a lot in price from about $2 a kilogram for “own brand”, up to $9 for premium varieties. Oats are really <a href="https://nomoneynotime.com.au/healthy-easy-recipes/filter/keywords--Oats">versatile</a>. For breakfast you can make <a href="https://nomoneynotime.com.au/healthy-easy-recipes/microwave-porridge">porridge</a>, <a href="https://nomoneynotime.com.au/healthy-easy-recipes/easy-overnight-oats">overnight oats,</a> DIY muesli or <a href="https://nomoneynotime.com.au/healthy-easy-recipes/gingerbread-granola">granola</a>. Oats make a pastry substitute for a <a href="https://nomoneynotime.com.au/healthy-easy-recipes/clares-rolled-oats-quiche">quick and easy quiche base</a>. Or blitz them in a food processor and use as a breadcrumb substitute. For dessert, you can use them to top a comforting <a href="https://nomoneynotime.com.au/healthy-easy-recipes/wholegrain-apple-crumble">apple crumble</a>. <a href="https://www.glnc.org.au/resource/oats-2/">Oats are a wholegrain</a>, meaning they retain every part of the original grain – the germ, bran and outer layers – and hence more fibre and nutrients. Oats are a rich in beta-glucan, a soluble fibre that <a href="https://pubmed.ncbi.nlm.nih.gov/34236436/">helps lower blood cholesterol levels</a> by binding with bile acids in the gut, meaning they can’t be converted into LDL (bad) cholesterol. They <a href="https://www.glnc.org.au/resource/oats-2/">also contain</a> B vitamins of thiamin (b1), riboflavin (B2), niacin (B3), pyridoxine (B6), pantothenic acid (B5) and folate (B9), as well as vitamin E and the minerals iron, zinc, magnesium, phosphorus and potassium. <h2>3. Carrots</h2> It’s hard to get better value than a bag of carrots at about $2.50 a kilo. They last for ages in the fridge and can be eaten raw, as carrot sticks or with <a href="https://nomoneynotime.com.au/healthy-easy-recipes/moroccan-carrot-dip">carrot dip</a>, or baked to make carrot veggie “<a href="https://nomoneynotime.com.au/healthy-easy-recipes/vegetable-chips">chips</a>”. Try grating carrot as an extra on a salad roll or <a href="https://nomoneynotime.com.au/healthy-easy-recipes/basic-beef-burgers">burger</a>, or mixed into grated cheese to extend it when topping tacos, pasta or pizza, or even a dish like <a href="https://nomoneynotime.com.au/healthy-easy-recipes/carrot-and-cauliflower-macaroni-cheese">mac and cheese</a>. Other versatile uses include soup, <a href="https://nomoneynotime.com.au/healthy-easy-recipes/carrot-puree">carrot mash</a>, <a href="https://nomoneynotime.com.au/healthy-easy-recipes/baked-carrots-with-honey-thyme">roasted carrots</a> or, for something sweet, carrot muffins or <a href="https://nomoneynotime.com.au/healthy-easy-recipes/easy-carrot-cake-bliss-balls">bliss balls</a>. Carrots are rich in the carotenoids <a href="https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/">alpha-carotene and beta-carotene</a>, which get converted into vitamin A in the body and used in antibody production and to maintain <a href="https://ods.od.nih.gov/factsheets/VitaminA-Consumer/">healthy functioning</a> of your eyes, skin, lungs and gut. <h2>4. Longlife skim milk</h2> Longlife skim milk costs about $1.60 a litre. While some fresh varieties are around the same price, the value of longlife milk is that you can keep a store of it in the cupboard, meaning you never run out and it has a long shelf life. Milk makes great <a href="https://nomoneynotime.com.au/healthy-easy-recipes/banana-breakfast-smoothie">smoothies</a> and is an essential ingredient in dishes from quiche to <a href="https://nomoneynotime.com.au/healthy-easy-recipes/cauliflower-cheese-bake">cauliflower cheese</a> to <a href="https://nomoneynotime.com.au/healthy-easy-recipes/clares-lemon-orange-delicious">lemon delicious</a> pudding. <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/milk#nutrients-in-milk">Milk contains</a> protein, calcium, magnesium, zinc, potassium and vitamins A, B2 and B12. Research shows regular milk consumption is <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/milk#milk-and-health-conditions">associated with</a> a lower risk of developing osteoporosis, high blood pressure, type 2 diabetes, heart disease and colon cancer. <h2>5. Apples</h2> A bag of apples costs about $4 or 60 cents an apple and $4–$5 for a large can of stewed apple. Apples make a portable snack. Add <a href="https://nomoneynotime.com.au/healthy-easy-recipes/comforting-apple-porridge">them to porridge</a>, serve <a href="https://nomoneynotime.com.au/healthy-easy-recipes/pork-loin-rolls">with pork</a>, <a href="https://nomoneynotime.com.au/healthy-easy-recipes/carrot-and-apple-coleslaw-with-mustard-vinaigrette">in coleslaw</a> or in <a href="https://nomoneynotime.com.au/healthy-easy-recipes/wholegrain-apple-crumble">apple crumble</a>. Apples <a href="https://pubmed.ncbi.nlm.nih.gov/35502671/">contain</a> dietary fibre and pectin, vitamin B6 and C, and the minerals potassium, calcium, nitrogen, magnesium and traces of zinc, iron and copper. In <a href="https://pubmed.ncbi.nlm.nih.gov/31667463/">observational studies</a>, people who ate more apples had a lower risk of heart disease, stroke, type 2 diabetes and death from any cause. For easy, tasty, economical meals that are quick to prepare, without too much effort, along with our food budget tips, visit our team’s <a href="https://nomoneynotime.com.au/">No Money No Time</a> website.<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/229903/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</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/5-foods-to-add-to-your-shopping-list-to-save-money-and-theyre-good-for-you-too-229903">original article</a>. </div>

Food & Wine

How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> A growing number of complaints against older doctors has prompted the Medical Board of Australia to <a href="https://www.medicalboard.gov.au/News/2024-08-07-Medical-Board-consults-on-new-approach-to-keep-late-career-doctors-in-safe-practice.aspx">announce</a> today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table. The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine. The second would require only general health checks for doctors over 70. A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their <a href="https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx">professional code of conduct</a>, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo. <h2>Haven’t we moved on from set retirement ages?</h2> It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “<a href="https://law.unimelb.edu.au/__data/assets/pdf_file/0019/2061019/02-Blackham.pdf">still valid in a modern society</a>”. However, unlike judges, doctors are already <a href="https://www.medicalboard.gov.au/Registration/Registration-Renewal.aspx">required to renew their registration</a> annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct <a href="https://www.ahpra.gov.au/Notifications/Further-information/Guides-and-fact-sheets/Performance-assessments.aspx">performance assessments</a> if and when they are needed. <h2>What has prompted these proposals?</h2> This latest <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD24%2f33840&dbid=AP&chksum=vCEdxXaBs0%2bMeMZFxSb7SQ%3d%3d&_gl=1*3ol06k*_ga*MzU1NjAzMTc1LjE3MjMwMDA1Nzc.*_ga_F1G6LRCHZB*MTcyMzAwMDU3Ny4xLjEuMTcyMzAwMDU4My4wLjAuMA..">proposal</a> identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years. Studies of medical competence in ageing doctors show <a href="https://qualitysafety.bmj.com/content/29/2/113">variable results</a>. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour. The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors. In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70. In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015. While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate. It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients. <h2>So what distinguishes the two new proposed options?</h2> The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80. Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions. Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia. The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia. In practice, both of these proposals appear to allow doctors to manage their own general health confidentially. <h2>The law tends to prioritise patient safety</h2> All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/act/consol_act/hprnl428/s3a.html">That provision</a> basically says patient safety is paramount and trumps all other considerations. <figure class="align-center zoomable"><figcaption></figcaption></figure> As with legal <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2010-104a#sec.3">regimes regulating childcare</a>, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional. Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3383892">punished</a>” for errors in practice. All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care. <h2>Could these proposals amount to age discrimination?</h2> It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws. For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/ada2004174/s22.html?context=1;query=inherent;mask_path=au/legis/cth/consol_act/ada2004174">who are</a> “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”. In broader terms, a licence to practise medicine is often compared to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797044/">licence to drive</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236877/">pilot an aircraft</a>. Despite <a href="https://www.smh.com.au/national/nsw/mandatory-test-older-drivers-facing-discrimination-says-pensioner-group-20170607-gwm45u.html">claims of discrimination</a>, New South Wales law requires older drivers to undergo a medical assessment <a href="https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/older-drivers-and-riders/assessments">every year</a>; and similar requirements affect older <a href="https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.casa.gov.au/guidelines-medical-assessment-aviation&ved=2ahUKEwil-9GXlOKHAxUdslYBHdN_EboQFnoECBkQAQ&usg=AOvVaw0SgpoCCKjNriMN20fs16rq">pilots and air traffic controllers</a>. <h2>Where to from here?</h2> When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different. How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, <a href="https://www1.racgp.org.au/newsgp/professional/ahpra-eyes-mandatory-health-checks-for-older-gps">others have suggested</a> this would only exacerbate shortages in the health-care workforce. The proposals are open for <a href="https://www.medicalboard.gov.au/News/Current-Consultations.aspx">public comment</a> until October 4.<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/236305/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <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/how-olds-too-old-to-be-a-doctor-why-gps-and-surgeons-over-70-may-need-a-health-check-to-practise-236305">original article</a>. </div>

Body

"I really thought he would kill me": Erin Molan opens up about abusive relationship

Warning: This article contains discussions of domestic violence which some readers may find confronting Radio and TV presenter Erin Molan has opened up for the first time about horrific abuse she endured at the hands of an ex-partner. Speaking candidly to the <a href="https://www.dailytelegraph.com.au/news/nsw/exclusive-interview-erin-molan-opens-up-about-horrific-abuse-she-suffered-from-a-man-she-dated/news-story/d2921145ef5010a413bab6c9a830f3bc" target="_blank" rel="noopener">Sunday Telegraph</a>, the 40-year-old presenter recalled many of her "worst" moments with her former boyfriend, sharing how she feared for her life when he became physically abusive. '“He came in drunk and dragged me out of bed and started stamping his foot into my head over and over and over,” she told the publication. “I was lying on the floor screaming and normally if I screamed really loudly he would stop because neighbours would hear. But that time he just kept going and going and it felt like my skull was going to crack open.” She said the relentless physical violence became a pattern of behaviour, and she would regularly be brutally injured. “One time he smashed a bottle over my head,” she says. “Another time I was terrified he’d throw me off a balcony. Once I ran to hide in my car and he got a rubbish bin and started smashing it against the windscreen and I feared I would be killed by glass shattering over me. “Another time he covered my face with a pillow so I couldn’t breathe. I was crying for my mum. I really thought he would kill me.” Molan said she chose not publicly discuss the abuse while her beloved dad, Senator Jim Molan, was alive because she didn’t want to break his heart, but now she wants others to know what she went through. In sharing her heartbreaking story, she also hopes she can give other victims of domestic violence the courage to come forward. “I’m not sharing my story because I want to. My preference would be for this part of my life to never be shared but with every single death I see in this space, a part of me wonders whether I could have made a difference,” she says. “Could my experience have made these beautiful, innocent women feel less alone, less ashamed, less scared and could that have been the tiny thing that may have empowered them to ask for help, the thing that might have helped to save their lives?” Molan added that while it’s confronting for her to speak out, she wants things to change, not just for her generation but for her daughter’s. As she says, “I want to worry about my daughter’s first boyfriend breaking her heart, not her bones.” Image credits: for AWAPAC/Shutterstock Editorial

Caring

We have too few aged care workers to care for older Australians. Why? And what can we do about it?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> In a country like Australia, we all expect that when we get old, we’ll be able to rely on a robust aged care system. But aged care providers can’t find staff and a crisis is brewing. If the problem isn’t fixed, there are serious risks to quality and access to services for older people who need support. There are also broader social, economic and political consequences for undervaluing the rapidly expanding health and social assistance workforce. Aged care <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">employs</a> around 420,000 people. Around 80% of those are front line staff providing care and demand for them is increasing rapidly. <h2>Australians are ageing</h2> The number of people aged 80 and over is <a href="https://treasury.gov.au/sites/default/files/2019-03/IGR_2010_Overview.pdf">projected to double</a> by 2050. At the same time, informal family care is becoming less available. In the next 25 years, <a href="https://www.australianageingagenda.com.au/executive/shortfall-of-400000-aged-care-workers-predicted-by-2050/">twice as many</a> aged care staff will be needed. Currently, about 1.4 million older people <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/aged-care">receive</a> aged care services, including basic and more intensive home care and residential care. Health care and social support job vacancies and ads are the highest of any industry. Between 30,000 and 35,000 additional direct aged care workers a year are already needed. By 2030 the <a href="https://cedakenticomedia.blob.core.windows.net/cedamediacontainer/kentico/media/attachments/ceda-duty-of-care-3.pdf">shortfall</a> is likely to be 110,000 full time equivalent workers. <h2>Why don’t enough people want to work in aged care?</h2> Despite recent <a href="https://www.health.gov.au/topics/aged-care-workforce/what-were-doing/better-and-fairer-wages">pay increases</a>, it is difficult to attract and retain aged care workers because the work is under-valued. The Australian workforce is undergoing profound change. A generation ago, manufacturing made up 17% of the workforce. Today it has fallen to 6%. By contrast, the health care and social assistance workforce has doubled from 8% to 16%. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The manufacturing workforce has declined, while health, aged care and social assistance has risen. ABS 6291.0.55.001 Labour Force, Australia.</figcaption></figure> Manufacturing jobs were <a href="https://australiainstitute.org.au/wp-content/uploads/2020/12/Manufacturing-Briefing-Paper-FINAL.pdf">mainly</a> secure, full-time, reasonably paid jobs dominated by male workers. By contrast, jobs in aged care are often insecure, part-time and poorly paid, dominated by women, with many workers coming from non-English speaking backgrounds. Since moving to take over aged care in the 1980s, the federal government has over-emphasised <a href="https://arena.org.au/a-genealogy-of-aged-care/">cost constraint</a> through service privatisation, activity-based funding and competition, often under the cover of consumer choice. The result is a highly fragmented and poorly coordinated aged care sector with almost 3,200, often small and under-resourced providers centrally funded and regulated from Canberra. This has <a href="https://www.health.gov.au/sites/default/files/a-matter-of-care-australia-s-aged-care-workforce-strategy.pdf">led to</a> high levels of casualisation, low investment in training and professional development, and inadequate supervision, particularly in the home care sector. Aged care is facing a perfect storm. Demand for care and support staff is increasing dramatically. The sector is poorly coordinated and difficult to navigate. Pay and conditions remain poor and the workforce is relatively untrained. There are no minimum standards or registration requirements for many front-line aged care staff. <h2>What are the consequences?</h2> An understaffed and under-trained aged care workforce reduces access to services and the quality of care and support. Aged care providers <a href="https://www.agedhealth.com.au/content/compliance-and-governance/news/troubled-outlook-for-aged-care-reforms-1224428737#:%7E:text=Its%20report%20found%20that%2053.8,was%20%22impossible%20to%20achieve%22.">routinely report</a> it is difficult to attract staff and they can’t meet the growing demand for services from older people. Staff shortages are already having an impact on residential care occupancy rates falling, with some regional areas now down to only 50% occupancy. That means older people either don’t get care or they are at increased risk of neglect, malnutrition, avoidable hospital admissions and a poorer quality of life. Inevitably, lack of aged care workers puts pressure on hospital services when older people have nowhere else to go. <h2>What needs to be done?</h2> Addressing these challenges requires a multifaceted approach. Australia will need a massive increase in the number of aged care workers and the quality of the care they provide. Wages have to be competitive to attract and retain staff. But better pay and conditions is only part of the story. Unless aged care becomes a career the community recognises, values and supports, it will continue to be difficult to train, attract and retain staff. The recent <a href="https://www.royalcommission.gov.au/aged-care">Royal Commission on Aged Care Quality and Safety</a> highlighted the need for a more skilled workforce, emphasising the importance of ongoing professional development for all staff. To date the federal government’s aged care workforce initiatives have been underwhelming. They are a limited and piecemeal rather than a coherent workforce strategy. In the short term, skilled migration may be part of the solution. But progress to bring in skilled aged care workers has been glacial. Currently only about 1% of providers <a href="https://theconversation.com/overseas-recruitment-wont-solve-australias-aged-care-worker-crisis-189126">have agreements</a> to bring in staff from overseas. At best, overseas migration will meet only 10% of the workforce shortfall. Registration, qualifications and training for direct care work have to become mandatory to make sure care standards are met. Much more significant and systematic incentives and support for training will be needed. Supervision, career progression and staff development will also have to be dramatically improved if we are to attract and retain the workforce that is needed. “Learn and earn” incentives, including scholarships and traineeships for aged care, are needed to attract the future workforce. At the same time, a much broader investment in upskilling the entire workforce through continuing professional development and good quality supervision is necessary. Like manufacturing a generation ago, aged care needs to become valued, skilled, secure and well-paid employment if it is going to attract the staff that are needed to avoid a looming crisis.<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/232707/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, Emeritus Professor of Public Health, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe 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/we-have-too-few-aged-care-workers-to-care-for-older-australians-why-and-what-can-we-do-about-it-232707">original article</a>. </div>

Caring

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

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

3 signs your diet is causing too much muscle loss – and what to do about it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> When trying to lose weight, it’s natural to want to see quick results. So when the number on the scales drops rapidly, it seems like we’re on the right track. But as with many things related to weight loss, there’s a flip side: rapid weight loss can result in a significant loss of muscle mass, as well as fat. So how you can tell if you’re losing too much muscle and what can you do to prevent it? <h2>Why does muscle mass matter?</h2> Muscle is an important factor in determining our metabolic rate: how much energy we burn at rest. This is determined by how much muscle and fat we have. Muscle is more metabolically active than fat, meaning it burns more calories. When we diet to lose weight, we create a calorie deficit, where our bodies don’t get enough energy from the food we eat to meet our energy needs. Our bodies start breaking down our fat and muscle tissue for fuel. A decrease in calorie-burning muscle mass slows our metabolism. This quickly slows the rate at which we lose weight and impacts our ability to maintain our weight long term. <h2>How to tell you’re losing too much muscle</h2> Unfortunately, measuring changes in muscle mass is not easy. The most accurate tool is an enhanced form of X-ray called a dual-energy X-ray absorptiometry (DXA) scan. The scan is primarily used in medicine and research to capture data on weight, body fat, muscle mass and bone density. But while DEXA is becoming more readily available at weight-loss clinics and gyms, it’s not cheap. There are also many “smart” scales available for at home use that promise to provide an accurate reading of muscle mass percentage. However, the accuracy of these scales is questionable. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122302/">Researchers found</a> the scales tested massively over- or under-estimated fat and muscle mass. Fortunately, there are three free but scientifically backed signs you may be losing too much muscle mass when you’re dieting. <h2>1. You’re losing much more weight than expected each week</h2> Losing a lot of weight rapidly is one of the early signs that your diet is too extreme and you’re losing too much muscle. Rapid weight loss (of more than 1 kilogram per week) results in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702468/">greater muscle mass loss</a> than slow weight loss. Slow weight loss better preserves muscle mass and often has the added benefit of <a href="https://www.sciencedirect.com/science/article/pii/S0195666312000153">greater fat mass loss</a>. One study compared people in the obese weight category who followed either a very low-calorie diet (500 calories per day) for five weeks or a low-calorie diet (1,250 calories per day) for 12 weeks. While both groups lost similar amounts of weight, participants following the very low-calorie diet (500 calories per day) for five weeks lost <a href="https://pubmed.ncbi.nlm.nih.gov/26813524/">significantly more muscle mass</a>. <h2>2. You’re feeling tired and things feel more difficult</h2> It sounds obvious, but feeling tired, sluggish and finding it hard to complete physical activities, such as working out or doing jobs around the house, is another strong signal you’re losing muscle. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648712/">Research</a> shows a decrease in muscle mass may negatively impact your body’s physical performance. <h2>3. You’re feeling moody</h2> Mood swings and feeling anxious, stressed or depressed may also be signs you’re losing muscle mass. <a href="https://pubmed.ncbi.nlm.nih.gov/26228522/">Research</a> on muscle loss due to ageing suggests low levels of muscle mass can negatively impact mental health and mood. This seems to stem from the relationship between low muscle mass and proteins called neurotrophins, which help regulate mood and feelings of wellbeing. <h2>So how you can do to maintain muscle during weight loss?</h2> Fortunately, there are also three actions you can take to maintain muscle mass when you’re following a calorie-restricted diet to lose weight. <h2>1. Incorporate strength training into your exercise plan</h2> While a broad exercise program is important to support overall weight loss, strength-building exercises are a surefire way to help prevent the loss of muscle mass. A <a href="https://pubmed.ncbi.nlm.nih.gov/29596307/">meta-analysis of studies</a> of older people with obesity found resistance training was able to prevent almost 100% of muscle loss from calorie restriction. Relying on diet alone to lose weight will reduce muscle along with body fat, slowing your metabolism. So it’s essential to make sure you’ve incorporated sufficient and appropriate exercise into your weight-loss plan to hold onto your muscle mass stores. But you don’t need to hit the gym. Exercises using body weight – such as push-ups, pull-ups, planks and air squats – are just as effective as lifting weights and using strength-building equipment. Encouragingly, moderate-volume resistance training (three sets of ten repetitions for eight exercises) <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/sms.14237">can be as effective</a> as high-volume training (five sets of ten repetitions for eight exercises) for maintaining muscle when you’re following a calorie-restricted diet. <h2>2. Eat more protein</h2> Foods high in protein play an essential role in building and maintaining muscle mass, but <a href="https://europepmc.org/article/MED/19927027">research</a> also shows these foods help prevent muscle loss when you’re following a calorie-restricted diet. But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado. <h2>3. Slow your weight loss plan down</h2> When we change our diet to lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">several physiological responses</a> to defend our body weight and “survive” starvation. Our body’s survival mechanisms want us to regain lost weight to ensure we survive the next period of famine (dieting). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">Research</a> shows that more than half of the weight lost by participants is regained within two years, and more than 80% of lost weight is regained within five years. However, a slow and steady, stepped approach to weight loss, prevents our bodies <a href="https://pubmed.ncbi.nlm.nih.gov/38193357/">from activating defence mechanisms</a> to defend our weight when we try to lose weight. Ultimately, losing weight long-term comes down to making gradual changes to your lifestyle to ensure you form habits that last a lifetime. <hr /> At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<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/223865/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <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/3-signs-your-diet-is-causing-too-much-muscle-loss-and-what-to-do-about-it-223865">original article</a>. </div>

Body

"You guys can't touch me": Djokovic slams Wimbledon crowd

Novak Djokovic has launched into a staggering tirade after emerging from the Wimbledon courts victorious, after claiming the crowd was being "disrespectful" by booing him. The Serbian tennis champ accused the audience after his 6-3, 6-4, 6-2 victory over Danish player Holger Rune, calling out the behaviour during his winning speech. “To all the fans that have had respect and stayed here tonight, I thank you from the bottom of my heart and I appreciate it,” he said. “And to all those people that have chosen to disrespect the player, in this case me, have a goooood night." “Goooood night, goooood night, have a good night,” he continued. The on-court interviewer suggested that the crowd was chanting “Rooooon” and was not in fact booing, but Djokovic was determined. “I’m hoping they were just commenting on Rune and they weren’t disrespecting you,” the courtside interviewer said, as Djokovic responded, “They were, they were, they were, they were.” “I am not accepting it. No, no, no. I know they were cheering for Rune but that’s an excuse to also boo." “Listen, I have been on the tour for more than 20 years." “I know all the tricks. I focus on the respectful people that pay for the ticket, and love tennis and appreciate the players." “I have played in much more hostile environments, trust me ... you guys can’t touch me.” He then headed for the Centre Court exit to initial applause before further chants of "Ruuuuuuune" followed. Image credits: ADAM VAUGHAN/EPA-EFE/Shutterstock Editorial

Travel Trouble

Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact? The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines). I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65. <h2>Polypharmacy among older adults</h2> Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics. Is it a good idea to take so many drugs? According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability. In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses? </li> <li> The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences. </li> <li> The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death. </li> <li> Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks. </li> </ol> Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements. Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ? </li> <li> Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced? </li> <li> Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter. </li> </ol> <h2>Benefits should outweigh the risks</h2> Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion. Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<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/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>. </div>

Body

"Terrifies me": Tracy Grimshaw reveals her biggest fears around ageing

Tracy Grimshaw has headed back to TV alongside alongside Dr Nick Coatsworth in a new medical series Do You Want To Live Forever? In an interview with 9Entertainment, the journalist explained why she chose to return to TV, after standing down from A Current Affair in 2022 following 17 years on the show. She explained that what pulled her to the medical series was "the extreme end of longevity." "People who shake the tree always fascinate me, particularly if they're putting their bodies on the line," she said. "It's so new, some of this stuff... that's probably what brought me in, but we're not just going to be at that end of the whole longevity discussion. "We're talking to people on how they can improve their quality of life and address issues that might lead to a premature death." In the interview she also revealed her own fears on ageing, especially what she finds most terrifying about it. "I'm not too scared about the passage of time," she began. "The only thing that scares me about getting older is becoming feeble." "Alzheimer's terrifies me. My brain has always been I think the best part of me, and it would be really sad to lose that." The show itself follows four pairs of everyday Aussies, including sisters from The Block, Eliza and Liberty, husband and wife, Enver and Eliana, partners Luke and Taylor, and father and son duo Duncan and Tom, as they undergo medically supervised trials and health interventions that may provide clues to help us live longer. Image: Channel 9

"Do not cry for me": Teacher announces own death

A teacher and mum-of-two who chronicled her breast cancer journey online has announced her own death, through a social media post written before her passing. "If you're reading this, it means I have died," Kate Rackham, 45, shared on her Teacher With Cancer X account. "But do not cry for me. I have lived my life on my own terms, the way I have wanted to." The mum told her followers that she joined X, formerly Twitter, as she "needed an outlet", but "what I got was so much more". "You made me feel validated in my feelings and much less alone. Thank you." <blockquote class="twitter-tweet"> If you’re reading this, it means I have died. But do not cry for me. I have lived my life on my own terms, the way I have wanted to. I joined X because I needed an outlet, what I got was so much more. You made me feel validated in my feelings and much less alone. Thank you ❤️ — Teacher with Cancer (@kate_rackham) <a href="https://twitter.com/kate_rackham/status/1801137648146243756?ref_src=twsrc%5Etfw">June 13, 2024</a></blockquote> The British mum was only 39 when she was diagnosed with incurable oestrogen-receptive breast cancer and spent the past six years fighting the disease. She began documenting her journey online, and explained that she had no obvious risk factors leading to the disease. Just before her passing, she was admitted into hospital and was told by doctors that "there is nothing more we can do" and that she "needed a bit of time" to process the news. "I'm now home, where I want to be. With Mark and the girls. Surrounded by love, family and friends," she shared at the time. "Everyone is rallying around and I have so much support. Despite everything I feel blessed." Many have shared their condolences, including friends and those who are also battling breast cancer. "When my time comes, I can but hope I display the dignity and strength of character you did. Much love and condolences to your family and friends," one wrote. "I hope you are free from the pain. You still live in your children your husband. Your legacy," another said. "Thank you for sharing your journey with grace and dignity," a third added. "I hope wherever you are you are no longer in pain. Sending love and thoughts to your family." Rackham is survived by her husband Mark and their two daughters Ruby and Nancy. Images: X/ Nine

Caring

“He tried to kill me": Shock claims against former TV presenter

Former Channel Seven presenter Liam David Cox has appeared via audiovisual link in Sydney Downing Centre Local Court on Monday, following claims that he forcefully strangled a woman during a domestic dispute. The woman told police that Cox had wrestled her to the ground, straddled her, and proceeded to forcefully strangle her until she lost consciousness. “He tried to kill me,” she told police. The court heard that police found the woman bleeding from her nose and coughing up blood, when they attended the scene. They also found blood splattered on the bedsheets and pillows, and on tissues in the toilet. She was treated by paramedics before being hospitalised for her injuries. The alleged incident occurred at a house in Vaucluse, in Sydney’s eastern suburbs, on the night of May 4, and Cox was arrested at a hotel in Bondi Beach the following day. Cox has spent nearly a month behind bars, and was applying for bail during the court hearing on Monday. The court heard that the altercation occurred after he had attended a charity fundraiser with the woman where he had a few drinks before they became embroiled in a heated argument. Magistrate Greg Grogin said the facts stated that the woman had been “the instigator” and “quite aggressive”, adding that he wasn't "victim blaming" but adding context to the “extremely serious allegations” where Cox allegedly lashed out after an “ongoing” argument. Cox's lawyer Ben Barrack told the court the couple had clashed three times that night, and the woman had punched and kicked him in the lead up to the alleged assault. The former TV presenter also claimed that he was acting in self-defence, but admitted that he had not used reasonable force. His lawyer added that the woman’s allegations were “highly problematic” and emphasised she had not yet provided a statement to police about the alleged assault. Police prosecutor Nellia Ng argued that Cox should not be granted bail because there was a risk that he would further endangered the alleged victim commit further offences, or fail to appear in court. However, the Magistrate determined that the risks could be mitigated if Cox resided in Queensland and was barred from contacting his alleged victim. He granted bail with strict conditions including having to surrender his passport, report to police, and abstain from contacting the woman. “Domestic violence should not occur anywhere at any time with anybody for any reason,” Magistrate Grogin said. “Any temptation to contact (the woman) will be a short-course way to come back before the court via AVL wearing green. You don’t need to do that.” Image: YouTube

Legal

Spending too much time on social media and doomscrolling? The problem might be FOMO

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> For as long as we have used the internet to <a href="https://www.theguardian.com/technology/2016/mar/07/email-ray-tomlinson-history">communicate and connect with each other</a>, it has influenced how we think, feel and behave. During the COVID pandemic, many of us were <a href="https://www.sciencedirect.com/science/article/pii/S0277953622007985">“cut off” from our social worlds</a> through restrictions, lockdowns and mandates. Understandably, many of us tried to <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258344">find ways to connect online</a>. Now, as pandemic restrictions have lifted, some of the ways we use the internet have become concerning. Part of what drives problematic internet use may be something most of us are familiar with – the fear of missing out, or FOMO. In <a href="https://link.springer.com/article/10.1186/s12888-024-05834-9">our latest research</a>, my colleagues and I investigated the role FOMO plays in two kinds of internet use: problematic social media use and “doomscrolling”. <h2>What are FOMO, problematic social media use and doomscrolling?</h2> FOMO is the fear some of us experience when we get a sense of “missing out” on things happening in our social scene. Psychology researchers have been studying FOMO for <a href="https://doi.org/10.1016/j.chb.2013.02.014">more than a decade</a>, and it has consistently been linked to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283615/">mental health and wellbeing</a>, <a href="https://www.sciencedirect.com/science/article/pii/S0376871624001947">alcohol use</a> and <a href="https://doi.org/10.1016/j.chb.2021.106839">problematic social media use</a>. Social media use becomes a problem for people when they have difficulty controlling urges to use social media, have difficulty cutting back on use, and where the use has a negative impact on their everyday life. Doomscrolling is characterised by a need to constantly look at and <a href="https://www.bbc.com/worklife/article/20210226-the-darkly-soothing-compulsion-of-doomscrolling">seek out “bad” news</a>. Doomscrollers may constantly refresh their news feeds or stay up late to read bad news. While problematic social media use has been around for a while, doomscrolling seems to be a more recent phenomenon – <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735659/">attracting research attention</a> during and following the pandemic. <h2>What we tried to find out</h2> In our study, we wanted to test the idea that FOMO leads individuals to engage in problematic use behaviours due to their difficulty in managing the “fear” in FOMO. The key factor, we thought, was <a href="https://link.springer.com/article/10.1023/b:joba.0000007455.08539.94">emotion regulation</a> – our ability to deal with our emotions. We know some people tend to be good at this, while others find it difficult. In fact, greater difficulties with emotion regulation was linked to experiencing <a href="https://www.sciencedirect.com/science/article/pii/S088761852100058X">greater acute stress related to COVID</a>. However, an idea that has been gaining attention recently is <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.636919/full">interpersonal emotion regulation</a>. This means looking to others to help us regulate our emotions. Interpersonal emotion regulation can be helpful (such as “<a href="https://link.springer.com/article/10.1007/s11031-016-9569-3">affective engagement</a>”, where someone might listen and talk about your feelings) or unhelpful (such as “<a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2F0012-1649.43.4.1019">co-rumination</a>” or rehashing problems together), depending on the context. In our analyses, we sought to uncover how both intrapersonal emotion regulation (ability to self-manage our own emotional states) and interpersonal emotion regulation (relying on others to help manage our emotions) accounted for the link between FOMO and problematic social media use, and FOMO and doomscrolling, respectively. <h2>What we found – and what it might mean for the future of internet use</h2> Our findings indicated that people who report stronger FOMO engage in problematic social media use because of difficulty regulating their emotions (intrapersonally), and they look to others for help (interpersonally). Similarly, people who report stronger FOMO are drawn to doomscrolling because of difficulty regulating their emotions intrapersonally (within themselves). However, we found no link between FOMO and doomscrolling through interpersonal emotion regulation. We suspect this difference may be due to doomscrolling being more of a solitary activity, occurring outside more social contexts that facilitate interpersonal regulation. For instance, there are probably fewer people with whom to share your emotions while staying up trawling through bad news. While links between FOMO and doomscrolling have been observed before, our study is among the first to try and account for this theoretically. We suspect the link between FOMO and doomscrolling may be more about having more of an online presence while things are happening. This would account for intrapersonal emotion regulation failing to help manage our reactions to “bad news” stories as they unfold, leading to doomscrolling. Problematic social media use, on the other hand, involves a more complex interpersonal context. If someone is feeling the fear of being “left out” and has difficulty managing that feeling, they may be drawn to social media platforms in part to try and elicit help from others in their network. <h2>Getting the balance right</h2> Our findings suggest the current discussions around <a href="https://www.nbcnews.com/news/us-news/psychology-group-says-infinite-scrolling-social-media-features-are-par-rcna147876">restricting social media use for young people</a>, while controversial, are important. We need to balance our need for social connection – which is happening increasingly online – with the <a href="https://www.biomedcentral.com/collections/spia#tab-3">detrimental consequences </a> associated with problematic internet use behaviours. It is important to also consider the nature of social media platforms and how they have changed over time. For example, adolescent social media use patterns across various platforms are <a href="https://link.springer.com/article/10.1007/s10964-019-01060-9">associated with</a> different mental health and socialisation outcomes. Public health policy experts and legislators have quite the challenge ahead of them here. Recent work has shown how loneliness is <a href="https://doi.org/10.1371/journal.pone.0190033">a contributing factor</a> to all-cause mortality (death from any cause). We have long known, too, that social connectedness is <a href="https://doi.org/10.1371/journal.pone.0190033">good for our mental health</a>. In fact, last year, the World Health Organization established a <a href="https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection">Commission on Social Connection</a> to help promote the importance of socialisation to our lives. The recent controversy in the United States around the ownership of TikTok illustrates how central social media platforms are to our lives and ways of interacting with one another. We need to <a href="https://www.theguardian.com/commentisfree/article/2024/may/27/dominic-andre-tiktok-ban">consider the rights of individuals</a> to use them as they please, but understand that governments carry the responsibility of <a href="https://www.theguardian.com/technology/2023/apr/04/what-does-tiktoks-ban-on-australian-government-devices-mean-for-its-future">protecting users from harm</a> and safeguarding their privacy. <hr /> If you feel concerned about problematic social media use or doomscrolling, you can speak to a healthcare or mental health professional. You can also call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14, or <a href="https://www.13yarn.org.au/">13 YARN</a> (13 92 76) to yarn with Aboriginal or Torres Strait Islander crisis supporters.<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/230980/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, Senior Lecturer - Psychology | Chair, Researchers in Behavioural Addictions, Alcohol and Drugs (BAAD), <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin 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/spending-too-much-time-on-social-media-and-doomscrolling-the-problem-might-be-fomo-230980">original article</a>. </div>

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Spending too much time on social media and doomscrolling? The problem might be FOMO

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