Placeholder Content Image

Walking can prevent low back pain, a new study shows

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year.</p> <p>The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system.</p> <p>In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.</p> <h2>The WalkBack trial</h2> <p>We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).</p> <p>Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.</p> <p>The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.</p> <p>The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.</p> <p>Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.</p> <p>People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care.</p> <h2>What the results showed</h2> <p>We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.</p> <p>The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.</p> <p>Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.</p> <p>Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.</p> <p>This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.</p> <p>Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.</p> <h2>Walking has multiple benefits</h2> <p>We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain.</p> <p>A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.</p> <p>On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.</p> <p>Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.</p> <p>While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.</p> <h2>Why is walking helpful for low back pain?</h2> <p>We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain.</p> <p>It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this.</p> <p>Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

<p><em><a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.</p> <p>The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.</p> <p>Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.</p> <p>The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.</p> <h2>What’s CJD got to do with Alzehimer’s?</h2> <p>CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.</p> <p>Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s.</p> <h2>Human growth hormone used to come from donated organs</h2> <p>Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.</p> <p>But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>.</p> <p>An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.</p> <p>hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.</p> <h2>What are the latest findings about Alzheimer’s disease?</h2> <p>The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.</p> <p>The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.</p> <p>They considered other explanations for the findings but concluded donated hGH was the likely cause.</p> <p>Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.</p> <p>Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible.</p> <p>However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.</p> <h2>When was this process used in Australia?</h2> <p>In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility.</p> <p><a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.</p> <p>The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small.</p> <p>Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.</p> <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> <p>The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.</p> <p>Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.</p> <p>The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/steve-macfarlane-4722"><em>Steve Macfarlane</em></a><em>, Head of Clinical Services, Dementia Support Australia, &amp; Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.</em></p>

Mind

Placeholder Content Image

Women and low-income earners miss out in a superannuation system most Australians think is unfair

<p><em><a href="https://theconversation.com/profiles/antonia-settle-1019551">Antonia Settle</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Most Australians think the superannuation system is unfair, with only one in three agreeing the retirement savings scheme is fair for most Australians, according to a survey conducted for the University of Melbourne.</p> <p>In fact, only about half of those <a href="https://melbourneinstitute.unimelb.edu.au/publications/research-insights/search/result?paper=4630688">surveyed</a> agreed superannuation works well for them.</p> <p>These results contradict a conventional view based on earlier studies and held by academics and many in the personal finance sector, that Australians give little thought to superannuation.</p> <p>A 2013 survey found Australians have <a href="https://search.informit.org/doi/abs/10.3316/INFORMIT.285049750322819">poor knowledge</a> of how the superannuation system works, while another study in 2022 highlighted <a href="https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0011/4382057/HILDA_Statistical_Report_2022.pdf">low financial literacy</a> in general.</p> <p>Australians also showed <a href="https://behaviouraleconomics.pmc.gov.au/sites/default/files/projects/retirement-planning-saving-attitudes_0_0.pdf">little interest in superannuation</a>, according to a 2020 Department of Prime Minister and Cabinet survey, with few Australians showing interest in reading their superannuation statements, choosing their fund or making voluntary contributions.</p> <p>With Australian households seen as uninformed and uninterested, their opinions tend to be left out of the public debate. We hear much about the gender pension gap, for example, but little about what women actually think about superannuation.</p> <p>Similarly, the distribution of tax advantage in superannuation is hotly debated by economists but survey data tends to refrain from asking households what they think about equity in the superannuation system.</p> <p>The University of Melbourne survey of 1,003 Australians was undertaken by Roy Morgan Research in April.</p> <p>Its results show women and low-income households are widely seen as disadvantaged in the superannuation system.</p> <p>In fact, only one in five Australians see the superannuation system as well suited to the needs of women and of low-income households, while 70% believe super favours wealthy households.</p> <p><iframe id="5VX3K" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/5VX3K/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>This suggests although Australians may show little interest in the management of their super accounts and may report they find the system confusing or even <a href="https://www.professionalplanner.com.au/wp-content/uploads/2016/05/Attitudes-to-Super-Report-May-2016.pdf">boring</a>, they are surprisingly aware of how superannuation is distributed.</p> <h2>Women, singles and low-income earners miss out</h2> <p>The federal government’s 2020 <a href="https://treasury.gov.au/publication/p2020-100554">Retirement Income Review</a> documents these gaps. Renters, women, uncoupled households and those on low-incomes fare poorly in the retirement income system.</p> <p>With little super to supplement the public pension, these groups are vastly over-represented in elderly poverty statistics, which are among the <a href="https://www.oecd-ilibrary.org/sites/d76e4fad-en/index.html?itemId=/content/component/d76e4fad-en">highest in the OECD</a>.</p> <p>Mirroring the gaps in the superannuation system reported by the review, the University of Melbourne survey shows that it is outright homeowners and those who are married who believe the superannuation system works well.</p> <p>Concerns the system works poorly for women and low-income households are strongest among women and low-income households. Only one in three renters believe the superannuation system meets their needs.</p> <p><iframe id="N9GO6" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/N9GO6/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>This suggests individuals’ concerns about fairness in the superannuation system are driven by their own experiences of disadvantage, regardless of financial literacy.</p> <p>This is consistent with my own <a href="https://www.tandfonline.com/doi/full/10.1080/13563467.2023.2195159">research</a> into household attitudes to superannuation, which showed some resentment among women who were well aware their male partners had substantially higher superannuation balances than them.</p> <p>This all matters for policymakers.</p> <h2>Why public perceptions are important</h2> <p>In the short term, these results suggest public support for making super fairer is likely to be stronger than previously thought. Recent government changes to tax concessions on large balances, for example, could have gone much further without losing support from the 70% of households that think the system favours the wealthy.</p> <p>But it matters for the longer term too.</p> <p>Public perceptions of fairness, effectiveness and efficiency are crucial to policy sustainability. This is well established in the academic literature from <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/spol.12683">B Ebbinghaus</a>, 2021 and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1911-3838.12171">H Chung et al.</a>, and accepted by the Retirement Income Review.</p> <p>The review assessed the public’s confidence in the system to both “deliver an adequate retirement income for them(selves) and (to) generate adequate outcomes across society”.</p> <p>As the review makes clear, the system must avoid a loss of public confidence from perceptions of unfairness.</p> <p>Yet perceptions of unfairness are exactly what the University of Melbourne results suggest. This would have been clearer to policymakers if they asked earlier.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207633/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/antonia-settle-1019551">Antonia Settle</a>, Academic (McKenzie Postdoctoral Research Fellow), <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/women-and-low-income-earners-miss-out-in-a-superannuation-system-most-australians-think-is-unfair-207633">original article</a>.</em></p>

Retirement Income

Placeholder Content Image

6 signs you’re low in iron

<p>Feeling constantly tired, looking pale and having heart palpitations? Well you could be one of the two billion people thought to suffer from some degree of iron deficiency.</p> <p>Low iron is the most common and widespread nutritional disorder in the world, and is the only nutrient deficiency that is significantly prevalent in the western world, according to the World Health Organization.  </p> <p>Here's how to know, and what to do if you tick all the low iron boxes</p> <p><strong>1. You suffer from fatigue (aka feel tired ALL of the time)</strong></p> <p>The body uses iron to make haemoglobin, the substance in red blood cells that transports oxygen around the body. When you don't have enough healthy red blood cells, you start to feel pretty exhausted. </p> <p><strong>2. You seem to get out of breath easily – even if you’re fit</strong></p> <p>When the body is not efficiently transporting oxygen to the lungs, you can feel breathlessness after minimal exertion. Low iron levels can also cause your endurance to suffer too.</p> <p><strong>3. You look pale and washed out</strong></p> <p>In addition to looking pale, if the inside of your lips, your gums, and the inside of your bottom eyelids are less red than usual, low iron may be the reason behind this. </p> <p><strong>4. You get sick often</strong></p> <p>Ever felt like you’re fighting an endless cold? Research has shown iron deficiency can affect the immune system, making you more likely to pick up infections and viruses.</p> <p><strong>5. You experience heart palpitations</strong></p> <p>Your heart may feel like it's pounding, fluttering or beating irregularly, often for just a few seconds or minutes. </p> <p><strong>6. You get unusual cravings for non-food substances such as dirt, ice, paint, or clay</strong></p> <p>Yes, this does sound very strange, but it's a real symptom that can occur when your body is low in iron – it's called pica. </p> <p><em>Image credits: Getty Images</em></p>

Body

Placeholder Content Image

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p>If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months).</p> <p>There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles.</p> <p>We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>.</p> <p>But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again.</p> <h2>People are often given the wrong advice</h2> <p>People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis.</p> <p>But these findings are very common in people <em>without</em> low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain.</p> <p>Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain.</p> <p>In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress.</p> <p>It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves.</p> <h2>So how should low back pain be treated?</h2> <p>A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety.</p> <p>Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language.</p> <p>They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities.</p> <p>An example of this type of care is cognitive functional therapy.</p> <h2>What is cognitive functional therapy?</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out.</p> <p>The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it.</p> <p>It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>.</p> <p>Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required.</p> <h2>What’s the evidence for this type of therapy?</h2> <p>Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments.</p> <p>We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”.</p> <p>We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care.</p> <p>The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>.</p> <p>People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group.</p> <p>The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work.</p> <h2>What does this mean for you?</h2> <p>This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success.</p> <p><a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up.</p> <p>The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.</em></p>

Body

Placeholder Content Image

Rob Lowe's West Wing confession

<p>Rob Lowe has spoken candidly about leaving one of his most acclaimed TV shows. </p> <p>The 59-year-old actor has opened up about leaving <em>The West Wing</em>, which first aired in 1999 with Lowe playing  the character of Sam Seaborn, the Bartlet administration's deputy communications director, on the very first episode of the show. </p> <p>The show ran for seven seasons and went off the air in 2006, although Lowe left the show during season four. </p> <p>Despite the show's popularity, Lowe said that leaving the show when he did was the best decision to make for him and his future career. </p> <p>Speaking candidly on the Stitcher Studios' podcast <em>Podcrushed</em>, Lowe was asked about why he left the show, and he summed up his departure with an analogy.</p> <p>He said, "I walked away from the most popular girl at school, but I also knew that it was a super unhealthy relationship, and it was the best thing I ever did."</p> <p>The unofficial story when Lowe left the show, as reported by <em><a href="https://www.cnn.com/2002/SHOWBIZ/TV/07/24/west.wing.lowe/index.html" target="_blank" rel="nofollow noopener" data-i13n="cpos:3;pos:1" data-ylk="slk:Daily Variety;cpos:3;pos:1;elm:context_link;itc:0" data-rapid_p="33" data-v9y="1">Daily Variety</a></em>, was that he was doing so because he couldn't get the salary that he wanted.</p> <p>As Lowe explained to <em>Podcrushed</em> hosts Penn Badgley, Nava Kavelin and Sophie Ansari, his decision had boiled down to one thing.</p> <p>"I felt very undervalued," said Lowe, the author of 2012's <em>Stories I Only Tell My Friends</em>. "Whenever I talk to actors who complain about, you know, their relationships on their shows, it happens. It happens in any workplace. You could be in an environment where people sandbag you, want to see you fail, don't appreciate you, whatever it is and whenever I share my stories, people are like, 'I will never share my own stories again.'"</p> <p>"They would make your hair stand up and there's some of them I wrote. I shared some of them in my book, but I purposely didn't share half of the other ones because it would make the people involved look so bad that I didn't want to do it to them."</p> <p>"So, I did not have a good experience. Tried to make it work and tried to make it work and tried to make it work and then what happened was my kids were getting to a certain age where I could see them having first girlfriends or friends and being in a relationship that was abusive and taking it," said Lowe, the father of sons John Owen, a 27-year-old actor, and venture capitalist Matthew, 29.</p> <p>"She's the popular girl, everybody likes her, she's beautiful, it must be great. All the things that people would say about making <em>The West Wing</em> to me. It's so popular, it's so amazing, it must be amazing, but I know what it's like and if I couldn't walk away from it, then how could I empower my kids to walk away from it?"</p> <p>When Lowe did leave the show, he issued a statement on why his character would be written out.</p> <p>"As much as it hurts to admit it, it has been increasingly clear, for quite a while, that there was no longer a place for Sam Seaborn on<em> The West Wing</em>," he said, <a href="https://www.cnn.com/2002/SHOWBIZ/TV/07/24/west.wing.lowe/index.html" target="_blank" rel="nofollow noopener" data-i13n="cpos:5;pos:1" data-ylk="slk:per CNN;cpos:5;pos:1;elm:context_link;itc:0" data-rapid_p="36" data-v9y="1">per CNN</a>. "However, Warner Bros. has allowed me an opportunity to leave the show as I arrived ... grateful for it, happy to have been on it and proud of it. We were a part of television history and I will never forget it."</p> <p><em>Image credits: Getty Images</em></p>

TV

Placeholder Content Image

Harrison Ford is back as an 80-year-old Indiana Jones – and a 40-something Indy. The highs (and lows) of returning to iconic roles

<p><a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Saddle up, don the fedora and crack that whip: Harrison Ford is back as the intrepid archaeologist in <em>Indiana Jones and the Dial of Destiny</em>. The film premiered at Cannes, where Ford was <a href="https://www.hollywoodreporter.com/movies/movie-news/harrison-ford-honorary-palme-dor-cannes-1235495463/">awarded</a> an Honorary Palme d’Or in recognition of his life’s work.</p> <p>Reviews for the fifth film in the franchise <a href="https://www.hollywoodreporter.com/movies/movie-news/indiana-jones-5-review-roundup-1235495961/">have been mixed</a>, and it is the first Indy film not to be directed by Steven Spielberg (this time, it’s James Mangold, best known for his motor-racing drama Ford v Ferrari).</p> <p>But this is “event” cinema that combines nostalgia, old-school special effects and John Williams’ <a href="https://theconversation.com/from-jaws-to-star-wars-to-harry-potter-john-williams-90-today-is-our-greatest-living-composer-176245">iconic score</a>.</p> <p>So, Ford is back, aged 80. What draws actors back after all this time?</p> <figure><iframe src="https://www.youtube.com/embed/eQfMbSe7F2g?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Role returns</h2> <p>Ford first played Indy in 1981 and last played him in 2008. That is a full 15 years since the most recent film in the series, and 42 years since his first outing in <em>Raiders of the Lost Ark</em>.</p> <p>Ford has form in returning to celebrated characters. One of the great pleasures of watching <em>The Force Awakens</em> back in 2015 was seeing Ford play Han Solo again for the <a href="https://www.dailymotion.com/video/x3j2j09">first time in over 30 years</a>.</p> <figure><iframe src="https://www.youtube.com/embed/0xQSIdSRlAk?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Actors return to roles for numerous reasons:</p> <ul> <li>financial (Ford was reportedly paid <a href="https://okmagazine.com/exclusives/harrison-ford-paid-indiana-jones-5-plagued-with-problems/">US$25 million</a> for <em>Dial of Destiny</em>)</li> <li>protection of their brand, image and star persona (Michael Keaton <a href="https://www.fortressofsolitude.co.za/the-flash-movies-biggest-hero-how-michael-keaton-saved-the-film/">returning to play Batman</a> after three decades and three other actors who have embodied the role)</li> <li>professional (Tom Cruise admitted over the 36 years between <em>Top Gun</em> films he wanted to make sure the sequel <a href="https://screenrant.com/top-gun-maverick-tom-cruise-return-how-explained/">could live up to the original</a>)</li> <li>personal (once-huge stars are working less and less, and only feel the need to return to a built-in fan base every few years – Bill Murray in the 2021 <em>Ghostbusters</em> sequel springs to mind).</li> </ul> <p>It’s not always a successful endeavour.</p> <p>Arnold Schwarzenegger and Sylvester Stallone – two of the biggest action stars of the 1980s off the back of iconic roles as <em>The Terminator</em>, Rocky Balboa and John Rambo – have repeatedly returned to those roles, and critics have been <a href="https://screenrant.com/terminator-dark-fate-undermined-john-connor-storyline-franchise-bad/">particularly harsh</a>.</p> <p>It did not work for Sigourney Weaver in <em><a href="https://www.rogerebert.com/reviews/alien-resurrection-1997">Alien: Resurrection</a></em> in 1997, 18 years after her first time as Ripley; nor for Keanu Reeves in <em><a href="https://www.theguardian.com/film/2021/dec/21/the-matrix-resurrections-review-keanu-reeves">The Matrix Resurrections</a></em> in 2021, 23 years after the original.</p> <p>And still, I’m intrigued to see what Michael Mann could do with his long-rumoured sequel to <em>Heat</em>, his definitive 1995 crime film. Ever since Mann published his novel Heat 2 last year – a kind of origin story for <em>Heat’s</em> key protagonists – fans have been hoping a de-aged Al Pacino (now aged 83) <a href="https://deadline.com/2023/04/michael-mann-heat-2-warner-bros-adam-driver-young-neil-mccauley-1235316777/">might return</a> as LA cop Vincent Hanna.</p> <h2>Undoing time</h2> <p>“Digital de-ageing” first entered the Hollywood mainstream in 2019 with <em>The Irishman</em> and <em>Captain Marvel</em>.</p> <p><a href="https://www.indiewire.com/features/craft/de-aging-actors-history-benjamin-button-dial-of-destiny-harrison-ford-1234863938/">Via this process</a>, older actors (Robert De Niro, Al Pacino and Samuel L. Jackson have all been subject to the technology) move back and forwards in time without younger actors having to play them.</p> <figure><iframe src="https://www.youtube.com/embed/OF-lElIlZM0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Films still tend to cast two actors to play older and younger versions of the same character, a choice that dates back at least to 1974’s <em>The Godfather Part II</em>, in which a young Robert de Niro plays Vito Corleone, portrayed by the much older Marlon Brando in the first film.</p> <p>In 1989, <em>Indiana Jones and the Last Crusade</em> features a delightful opening scene where River Phoenix plays the young version of Indiana Jones, before Ford takes over for the rest of the film.</p> <figure><iframe src="https://www.youtube.com/embed/AwH6-Yh7_SM?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Actors used to just play characters of their own age when reprising earlier roles. Paul Newman finally won a Best Actor Oscar for his role as “Fast Eddie” Felson in <em>The Color of Money</em> (1986), a quarter of a century after first playing him in The Hustler.</p> <p>The sequel plays on Newman’s age, and his role as a mentor to an upcoming Tom Cruise, and bathes viewers in nostalgia and memories of <a href="https://faroutmagazine.co.uk/paul-newman-schooled-tom-cruise-the-color-of-money/">a younger Newman</a>.</p> <figure><iframe src="https://www.youtube.com/embed/k7gmrKAFshE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But actors no longer have to exclusively play their age.</p> <p>The first part of <em>Dial of Destiny</em> is an extended flashback, set in 1944, in which Ford has been digitally de-aged to appear in his 40s. This process used an AI system that scanned used and unused reels of footage of Ford from <a href="https://www.cbr.com/harrison-ford-de-aging-indiana-jones-dial-of-destiny/">the first three Indy films</a> to match his present-day performance.</p> <p>Here, it is as if we are getting two Fords for the price of one: the “younger”, fitter Indy and the older, more world-weary version. It makes for a powerfully emotional connection on screen.</p> <p>Yet there are some <a href="https://variety.com/2023/film/awards/indiana-jones-5-harrison-ford-de-aging-not-working-1235618698/">pitfalls to de-ageing</a>. Some viewers complain that the whole process is distracting and that the hyper-real visual look of de-aged scenes resembles a video game.</p> <p>Even so, de-ageing in Hollywood cinema is here to stay. Tom Hanks’s <a href="https://variety.com/2023/film/news/tom-hanks-robin-wright-digitally-deaged-robert-zemeckis-movie-1235507766/">next film</a> is using AI-based generative technology to digitally de-age him.</p> <p>Given its reduced cost, speed and reduced human input, AI-driven innovation might have <a href="https://filmstories.co.uk/news/new-ai-driven-de-ageing-tools-to-be-used-in-tom-hanks-project/">industry-changing ramifications</a>.</p> <h2>The star of Ford</h2> <p>Harrison Ford remains a bona fide “movie star” in an industry profoundly buffeted by COVID, the rise of streaming platforms, the demise of the monoculture, and the changing nature of who constitutes a star.</p> <p>In the midst of all this industry uncertainty, it seems there is no longer a statute of limitations on actors returning to much-loved characters.</p> <p>The next big ethical issue for the film industry as it further embraces AI is whether to <a href="https://collider.com/james-dean-digital-cgi-performance-in-new-movie/">resurrect deceased actors</a> and cast them in new movies.</p> <p>Still, I’m looking forward to seeing more actors de-aged as the technology improves and audiences acclimatise to watching older actors “playing” younger versions of themselves. We are only at the start of Hollywood’s next big adventure.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/202357/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, Associate Professor of French Studies, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/harrison-ford-is-back-as-an-80-year-old-indiana-jones-and-a-40-something-indy-the-highs-and-lows-of-returning-to-iconic-roles-202357">original article</a>.</em></p>

Movies

Placeholder Content Image

Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Opioids are the one of the most prescribed pain-relief for people with low back and neck pain. In Australia, around <a href="https://link.springer.com/article/10.1007/s00586-017-5178-4">40% of people</a> with low back and neck pain who present to their GP and <a href="https://qualitysafety.bmj.com/content/28/10/826">70% of people</a> with low back pain who visit a hospital emergency department are prescribed opioids such as oxycodone.</p> <p>But our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext">new study</a>, published today in the Lancet medical journal, found opioids do not relieve “acute” low back or neck pain (lasting up to 12 weeks) and can result in worse pain.</p> <p>Prescribing opioids for low back and neck pain can also cause <a href="https://www.healthdirect.gov.au/taking-opioid-medicines-safely">harms</a> ranging from common side effects – such as nausea, constipation and dizziness – to <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/opioid-harm-in-australia/summary">misuse, dependency, poisoning and death</a>.</p> <p>Our findings show opioids should <em>not</em> be recommended for acute low back pain or neck pain. A change in prescribing for low back pain and neck pain is urgently needed in <a href="https://www.tga.gov.au/resources/publication/publications/addressing-prescription-opioid-use-and-misuse-australia">Australia</a> and <a href="https://www.thelancet.com/commissions/opioid-crisis">globally</a> to reduce opioid-related harms.</p> <h2>Comparing opioids to a placebo</h2> <p>In our trial, we randomly allocated 347 people with acute low back pain and neck pain to take either an opioid (oxycodone plus naloxone) or <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo</a> (a tablet that looked the same but had no active ingredients).</p> <p>Oxycodone is an opioid pain medicine which can be given orally. <a href="https://www.nps.org.au/radar/articles/oxycodone-with-naloxone-controlled-release-tablets-targin-for-chronic-severe-pain">Naloxone</a>, an opioid-reversal drug, reduces the severity of constipation while not disrupting the pain relieving effects of oxycodone.</p> <p>Participants took the opioid or placebo for a maximum of six weeks.</p> <p>People in the both groups also received <a href="https://www.sciencedirect.com/science/article/pii/S1836955321000941">education and advice</a> from their treating doctor. This could be, for example, advice on returning to their normal activities and avoiding bed rest.</p> <p>We assessed their outcomes over a one-year period.</p> <h2>What did we find?</h2> <p>After six weeks of treatment, taking opioids did not result in better pain relief compared to the placebo.</p> <p>Nor were there benefits to other outcomes such as physical function, quality of life, recovery time or work absenteeism.</p> <p>More people in the group treated with opioids experienced nausea, constipation and dizziness than in the placebo group.</p> <p>Results at one year highlight the potential long-term harm of opioids even with short-term use. Compared to the placebo group, people in the opioid group experienced slightly worse pain, and reported a higher risk of <a href="https://academic.oup.com/painmedicine/article/20/1/113/4728236#129780622">opioid misuse</a> (problems with their thinking, mood or behaviour, or using opioids differently from how the medicines were prescribed).</p> <p>More people in the opioid group reported pain at one year: 66 people compared to 50 in the placebo group.</p> <h2>What will this mean for opioid prescribing?</h2> <p>In recent years, international low back pain guidelines have shifted the focus of treatment from drug to non-drug treatment due to <a href="https://www.thelancet.com/article/S0140-6736(18)30489-6/fulltext">evidence</a> of limited treatment benefits and concern of medication-related harm.</p> <p>For acute low back pain, <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">guidelines</a> recommend patient education and advice, and if required, anti-inflammatory pain medicines such as ibuprofen. Opioids are <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">recommended only</a> when other treatments haven’t worked or aren’t appropriate.</p> <p>Guidelines for <a href="https://pubmed.ncbi.nlm.nih.gov/33064878/">neck</a> pain similarly discourage the use of opioids.</p> <p>Our latest research clearly demonstrates the benefits of opioids do not outweigh possible harms in people with acute low back pain and neck pain.</p> <p>Instead of advising opioid use for these conditions in selected circumstances, opioids should be discouraged without qualification.</p> <h2>Change is possible</h2> <p>Complex problems such as opioid use need smart solutions, and another study we recently conducted provides convincing data opioid prescribing can be successfully reduced.</p> <p>The <a href="https://qualitysafety.bmj.com/content/30/10/825">study</a> involved four hospital emergency departments, 269 clinicians and 4,625 patients with low back pain. The intervention comprised of:</p> <ul> <li>clinician education about <a href="https://aci.health.nsw.gov.au/networks/musculoskeletal/resources/low-back-pain">evidence-based management</a> of low back pain</li> <li>patient education using posters and handouts to highlight the benefits and harms of opioids</li> <li>providing heat packs and anti-inflammatory pain medicines as alternative pain-management treatments</li> <li>fast-tracking referrals to outpatient clinics to avoid long waiting lists</li> <li>audits and feedback to clinicians on information about opioid prescribing rates.</li> </ul> <p>This intervention reduced opioid prescribing from <a href="https://qualitysafety.bmj.com/content/30/10/825">63% to 51% of low back pain presentations</a>. The <a href="https://emj.bmj.com/content/early/2023/04/02/emermed-2022-212874">reduction was sustained for 30 months</a>.</p> <p>Key to this successful approach is that we worked with clinicians to develop suitable pain-management treatments without opioids that were feasible in their setting.</p> <p>More work is needed to evaluate this and other interventions aimed at reducing opioid prescribing in other settings including GP clinics.</p> <p>A nuanced approach is often necessary to avoid causing <a href="https://theconversation.com/opioid-script-changes-mean-well-but-have-left-some-people-in-chronic-pain-156753">unintended consequences</a> in reducing opioid use.</p> <p>If people with low back pain or neck pain are using opioids, especially at higher doses over an extended period of time, it’s important they seek advice from their doctor or pharmacist before stopping these medicines to avoid <a href="https://www.healthdirect.gov.au/opioid-withdrawal-symptoms">unwanted effects when the medicines are abruptly stopped</a>.</p> <p>Our research provides compelling evidence opioids have a limited role in the management of acute low back and neck pain. The challenge is getting this new information to clinicians and the general public, and to implement this evidence into practice.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203244/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, Postdoctoral Research Associate in Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/opioids-dont-relieve-acute-low-back-or-neck-pain-and-can-result-in-worse-pain-new-study-finds-203244">original article</a>.</em></p>

Body

Placeholder Content Image

“It’s the court of public opinion”: Sarah Ferguson condemns Phillip Schofield backlash

<p dir="ltr">Sarah Ferguson has spoken out against the wave of judgement directed at former This Morning presenter Phillip Schofield and the relationship scandal that swept the world. </p> <p dir="ltr">The 63-year-old Duchess of York was chatting to businesswoman Sarah Jane Thomson on her podcast, <em>Tea Talks</em>, when conversation turned to Schofield, and his controversial affair with a man - and co-worker - 30 years younger than him. </p> <p dir="ltr">When news of the affair broke, Schofield stepped down from his 20 year position as the face of This Morning. He later confessed to the Daily Mail that he had lied about the relationship, and <a href="https://www.oversixty.com.au/news/news/i-will-die-sorry-phillip-schofield-breaks-his-silence-on-his-career-ending-affair">informed <em>The Sun </em>that he was “not a groomer”</a>, despite public opinion.</p> <p dir="ltr">Criticism for the disgraced host flooded social media in the wake of the whole ordeal, with the story and its related rumours splashed across publications worldwide, and it was the backlash that Ferguson wanted to address, namely the idea of ‘cancel culture’ at the centre of it all. </p> <p dir="ltr">Thomson prompted the discussion by comparing social media’s take to a “huge game of Chinese whispers”, to which Ferguson responded that “it’s like the court of public opinion.”</p> <p dir="ltr">“And then [that can lead to] massive bullying to the point of extermination of a soul,” she added. “I don’t believe that anybody has that right to judge and exterminate a person’s own beliefs.”</p> <p dir="ltr">From there, Ferguson encouraged listeners not to leap to assumptions, as “we all have failings”. She asked that everyone instead take a moment “or make a cup of tea before you judge another human being without knowing all the facts”. </p> <p dir="ltr">“We don’t know the facts,” she pointed out. “We certainly don’t know what people get up to.”</p> <p dir="ltr">Thomson had her own thoughts to share on the matter, noting that “the problem is, when you’re in the public eye, any failing you make is there to be talked about, and the rest of us don’t have that. </p> <p dir="ltr">“We don't have that deep examining of where we've gone wrong, and then it's reflected over and over and over.”</p> <p dir="ltr">And while the two had made their point, Ferguson took a moment to discuss a - in her opinion “spot on” - article by Jeremy Clarkson for the<em> Sunday Times</em>, in which he wrote about the public’s race to condemn Schofield.</p> <p dir="ltr">“I’ve never seen a witch-hunt like it,” he said, “and what baffles me most of all is that, as things stand, no crime has been committed. I don’t know him at all well and have no skin in the game, but it seems to me he is only guilty of being what he said he was: gay.”</p> <p dir="ltr">In the article, Clarkson went on to note that the age gap between Schofield and his partner in the affair was receiving a different degree of attention to heterosexual stars in similar relationship situations - from the likes of Leonardo DiCaprio, who frequently dates women significantly younger than himself, and Al Pacino’s 54-year age gap with his pregnant partner.</p> <p dir="ltr">“Phil is no longer the genial host of some morning-time televisual cappuccino froth,” Clarkson surmised. “According to the people's court of social media, he's like his brother, a nonce.”</p> <p dir="ltr"><em>Images: Getty</em></p> <p> </p>

Relationships

Placeholder Content Image

RBA announces major interest rate rise

<p>The Reserve Bank of Australia has lifted its official interest rate to 4.1 per cent, an increase not seen since early 2012.</p> <p>The bank’s board chose to lift the cash rate target by 0.25 of a percentage point for the second month in a row amid concerns that inflation is taking too long to decrease.</p> <p>The latest monthly consumer price index from the Australian Bureau of Statistics saw prices rise 6.8 per cent from 2022 to April 2023, up from the March reading due to statistical uncertainties caused by last year’s temporary fuel excise cut.</p> <p>Reserve Bank governor Phillip Lowe warned the public about rising costs of services including hospitality which are labour intensive and vulnerable to increased wages.</p> <p>"Recent data indicate that the upside risks to the inflation outlook have increased and the board has responded to this," he highlighted in his post-meeting statement.</p> <p>"While goods price inflation is slowing, services price inflation is still very high and is proving to be very persistent overseas. Unit labour costs are also rising briskly, with productivity growth remaining subdued.”</p> <p>Lowe noted the most recent and bigger than expected rise in minimum and award wages, which was the highest increase in decades.</p> <p>"Wages growth has picked up in response to the tight labour market and high inflation," he explained.</p> <p>"At the aggregate level, wages growth is still consistent with the inflation target, provided that productivity growth picks up.”</p> <p>The interest rate spike will add around $76 a month to the repayments on a $500,000 loan, and double that on a million-dollar 25-year mortgage.</p> <p>Someone with $500,000 owing on their home loan will see their monthly repayment increase by around $1,134 a month since the RBA started lifting rates from a record low of 0.1 per cent in May 2022.</p> <p>However, there is still the risk of another rate rise.</p> <p>"Some further tightening of monetary policy may be required to ensure that inflation returns to target in a reasonable time frame, but that will depend upon how the economy and inflation evolve," Lowe warned.</p> <p><em>Image credit: Twitter</em></p>

Money & Banking

Placeholder Content Image

"I will die sorry": Phillip Schofield breaks his silence on his career-ending affair

<p>Former <em>This Morning </em>host Phillip Schofield has broken his silence over his affair with a colleague 30 years his junior in an interview with <em>The Sun</em>. </p> <p>And while the disgraced British television star shared that he had been left feeling “utterly broken and ashamed” over the whole ordeal, he stressed that any rumours of grooming were not true. </p> <p>“I did not,” he told the publication, after a week of the social media rumour mill running riot. “I did not [groom him].”</p> <p>“I know the photos of us circulating on Twitter look shocking, but I’m not a groomer,” Phillip insisted.</p> <p>He noted that “there are accusations of all sorts of things”, but claimed that had never been an abuse of power, as “we’d become mates … but of course I understand that there will be a massive judgement, but bearing in mind, I have never exercised that anywhere else.”</p> <p>According to Phillip, the two remain friends. And although the ex-show runner had been 30 years younger than him at the time of their affair, he added that the relationship had only begun after the man was 20 years old, when “something just happened between us that changed everything.” </p> <p>“I assume somebody, somewhere, assumed something was going on, correctly” he shared, “and didn't say anything. </p> <p>“At the time I did not think about it possibly ruining my career. I really probably only thought about it when I saw the rumour mill, and saw it growing.</p> <p>“Then I saw the link with the drama school photo [from] all those years before, and thought, ‘this looks shocking’.”</p> <p>However, as Phillip said, he hadn’t lied in order to protect his own career, but instead because the other man in the affair hadn’t wanted “his name in public. He wanted his own life.” </p> <p>Phillip explained that “the lies grew bigger and bigger and bigger”, and that it was starting to have a deep effect on both of them. </p> <p>“It got to the stage where it was out of control,” he said, “and for whatever cost, it had to stop.</p> <p>“I have massive guilt, and regret. I’ve made a mistake, I’ve had an affair at work.”</p> <p> “I think my greatest apology must go to him,” Phillip revealed. “It has brought the greatest misery into his totally innocent life, his totally innocent family, his totally innocent friends.</p> <p>“It has brought the greatest grief to them.”</p> <p>He added that the pair hadn’t spoken since the story broke - and that he also no longer speaks to his former friend and co-host Holly Willoughby - but that when things began to spiral out of control, he’d “paid for his lawyers to independently work on his behalf. </p> <p>“I am deeply sorry and I apologise to him because I should have known better. I should have acted the way I have always acted. I should not have done it.</p> <p>“I’m sorry. And I will forever be sorry. I will die sorry. I am so deeply mortified.”</p> <p><em>Images: Getty</em></p>

News

Placeholder Content Image

Back on course: overcoming low back pain for senior golfers

<p>As a retiree and avid golfer, I experienced the debilitating pain of a herniated disc in my lower back. I never thought golf could cause such agony, but I was determined to overcome it and return to the game I love.</p> <p>Low back pain is a common condition among senior-aged golfers, with reported prevalence rates of up to 50%. Which means if you're playing in a foursome with fellow seniors it's likely two of you have low back pain. </p> <p>Why? Because we are more prone to back pain due to age-related changes in the spine, such as disc degeneration, and arthritis. Additionally, poor swing mechanics, lack of flexibility, or poor physical conditioning increase the risk.</p> <p>The golf swing involves a complex sequence of movements that can sometimes place significant stress on the lower back, particularly the lumbar spine. The repetitive twisting, bending, and rotational forces can lead to various types of back injuries, including herniated discs, muscle strains, and degenerative disc disease.</p> <p>After being diagnosed with a herniated disc six weeks ago, my doctor recommended physical therapy treatments with a chiropractor and physiotherapist. I also found relief through regular massage and daily use of a TENS machine. Stretching and strengthening exercises can improve flexibility and core stability. I found simple Qi Gong exercises easy. Qi Gong has been described as like high-powered Tai Chi. The standing exercises appealed to me as I'm stubbornly averse to any exercise requiring laying on the floor.  </p> <p>Within weeks of therapy and home exercises, the pain had subsided enough for me to consider a gentle swing in the backyard. A few easy swings with the 7-iron and all felt good. No added discomfort.</p> <p>To prepare for a game, I enrolled in an online course called 'Pain Free Golf' by Croker Golf System. The course helped me adjust my swing to avoid re-injury.</p> <p>To further protect my lower back, I purchased two helpful devices. A ball pick-up device which attaches to the handle end of the putter ($10 approx. from the local pro shop) to enable retrieving my ball from the cup without bending forward. A second device I found was the 'easy tee-up' ($130 approx. - search “Easy Tee Up” online) which helps me tee up the ball without bending down to the ground.</p> <p>Now, six weeks after my herniated disc incident, I'm playing almost painless golf again, and my game has even improved. I never would have thought that a herniated disc would ultimately improve my golf game, but the experience taught me the importance of taking better care of my body and using the right resources to get back in the swing.</p> <p>To all fellow golfers, take care of yourselves and don't give up hope if you ever find yourself in the same situation. There are plenty of people and resources available to help you get back to playing the game you love - with no or low back pain.</p> <p><em>About the writer: Mike Searles is a Melbourne retiree who loves playing golf.</em></p> <p><em>Image: Shutterstock</em></p>

Body

Placeholder Content Image

King Charles cuts ties with TV host over affair revelations

<p>King Charles has cut all ties with UK television host Phillip Schofield, after he lied about having an affair. </p> <p>Schofield has been dumped from his hosting gig at <em>This Morning</em>, which he has been the face of for 21 years, after he admitted he had an affair with a much younger man who worked at the ITV network.</p> <p>The 61-year-old resigned from the network after lying about the “consensual on-off relationship", admitting in a statement that the affair was "unwise" but stressed it was "not illegal".</p> <p>He added that he was "deeply sorry" for having lied to his wife and to ITV about his relationship with the man reportedly 30 years his junior and who he first met as a teenager.</p> <p>“Contrary to speculation, whilst I met the man when he was a teenager and was asked to help him to get into television, it was only after he started to work on the show that it became more than just a friendship,” he said in his recent statement.</p> <p>In light of the affair, Schofield has been dropped by The Prince's Trust, after being an ambassador for several years. </p> <p>A spokesperson from the King's charity told <em><a title="The Telegraph" href="https://www.telegraph.co.uk/news/2023/05/30/phillip-schofield-dropped-princes-trust-this-morning-affair/" target="_blank" rel="noopener">The Telegraph</a> UK</em> that it was mutually agreed it was "no longer appropriate to work together".</p> <p>"In light of Phillip's recent admissions, we have agreed with him that it is no longer appropriate to work together," a Prince's Trust spokesperson said.</p> <p>All references to Schofield have been removed from the charity's website and also his own page.</p> <p>It previously read, "Outside of work, Phillip is an ambassador for the charity The Prince's Trust, dedicating time to further the work of supporting vulnerable young people in the UK".</p> <p>The Prince's Trust was created in 1976 by then-Prince Charles to help young disadvantaged people in the UK, with the hugely successful charity helping more than one million young people by providing them with business grants, education and training.</p> <p>Following the bombshell revelation of Schofield's affair, ITV said it had investigated the allegations of his affair "several times" from early 2020, but said it didn't find any evidence.</p> <p>It's been a trying time for the ex-presenter with his brother Timothy recently being jailed for 12 years over child sex offences.</p> <p><em>Image credits: Getty Images</em></p>

News

Placeholder Content Image

Don’t blame women for low libido. Sexual sparks fly when partners do their share of chores – including calling the plumber

<p>When a comic about “mental load” <a href="https://english.emmaclit.com/2017/05/20/you-shouldve-asked/">went viral in 2017</a>, it sparked conversations about the invisible workload women carry. Even when women are in paid employment, they remember their mother-in-law’s birthday, know what’s in the pantry and organise the plumber. This mental load often goes unnoticed.</p> <p>Women also <a href="https://theconversation.com/yet-again-the-census-shows-women-are-doing-more-housework-now-is-the-time-to-invest-in-interventions-185488">continue to do more housework</a> and childcare than their male partners.</p> <p>This burden has been exacerbated over the recent pandemic (homeschooling anyone?), <a href="https://theconversation.com/planning-stress-and-worry-put-the-mental-load-on-mothers-will-2022-be-the-year-they-share-the-burden-172599">leaving women</a> feeling exhausted, anxious and resentful.</p> <p>As sexuality researchers, we wondered, with all this extra work, do women have any energy left for sex?</p> <p>We decided to explore how mental load affects intimate relationships. We focused on female sexual desire, as “low desire” affects <a href="https://www.sciencedirect.com/science/article/abs/pii/S1743609520307566">more than 50% of women</a> and is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0091302217300079">difficult to treat</a>.</p> <p>Our study, published in the <a href="https://www.tandfonline.com/doi/full/10.1080/00224499.2022.2079111">Journal of Sex Research</a>, shows women in equal relationships (in terms of housework and the mental load) are more satisfied with their relationships and, in turn, feel more sexual desire than those in unequal relationships.</p> <p> </p> <h2>How do we define low desire?</h2> <p>Low desire is tricky to explore. More than simply the motivation to have sex, women describe sexual desire as a state-of-being and a need for closeness.</p> <p>Adding to this complexity is the fluctuating nature of female desire that changes in response to life experiences and the <a href="https://www.bbc.com/future/article/20160630-the-enduring-enigma-of-female-desire">quality of relationships</a>.</p> <p>Relationships are especially important to female desire: relationship dissatisfaction is a <a href="https://pubmed.ncbi.nlm.nih.gov/18410300/">top risk factor</a> for low desire in women, even more than the physiological impacts of age and menopause. Clearly, relationship factors are critical to understanding female sexual desire.</p> <p>As a way of addressing the complexity of female desire, a <a href="https://link.springer.com/article/10.1007/s10508-018-1212-9">recent theory</a> proposed two different types of desire: dyadic desire is the sexual desire one feels for another, whereas solo desire is about individual feelings.</p> <p>Not surprisingly, dyadic desire is intertwined with the dynamics of the relationship, while solo desire is more amorphous and involves feeling good about yourself as a sexual being (feeling sexy), without needing validation from another.</p> <h2>Assessing the link</h2> <p>Our research acknowledged the nuances of women’s desire and its strong connection to relationship quality by exploring how fairness in relationships might affect desire.</p> <p>The research involved asking 299 Australian women aged 18 to 39 questions about desire and relationships.</p> <p>These questions included assessments of housework, mental load – such as who organised social activities and made financial arrangements – and who had more leisure time.</p> <p>We compared three groups:</p> <ul> <li>relationships where women perceived the work as equally shared equal (the “equal work” group)</li> <li>when the woman felt she did more work (the “women’s work” group)</li> <li>when women thought that their partner contributed more (the “partner’s work” group).</li> </ul> <p>We then explored how these differences in relationship equity impacted female sexual desire.</p> <h2>What we found</h2> <p>The findings were stark. Women who rated their relationships as equal also reported greater relationship satisfaction and higher dyadic desire (intertwined with the dynamics of the relationship) than other women in the study.</p> <p>Unfortunately (and perhaps, tellingly), the partner’s work group was too small to draw any substantial conclusions.</p> <p>However, for the women’s work group it was clear their dyadic desire was diminished. This group was also less satisfied in their relationships overall.</p> <p>We found something interesting when turning our attention to women’s solo desire. While it seems logical that relationship inequities might affect all aspects of women’s sexuality, our results showed that fairness did not significantly impact solo desire.</p> <p>This suggests women’s low desire isn’t an internal sexual problem to be treated with <a href="https://www.insider.com/guides/health/yoni-eggs#:%7E:text=Yoni%20eggs%20are%20egg%2Dshaped,bacterial%20infections%20and%20intense%20pain.">mindfulness apps and jade eggs</a>, but rather one that needs effort from both partners.</p> <p>Other relationship factors are involved. We found children increased the workload for women, leading to lower relationship equity and consequently, lower sexual desire.</p> <p> </p> <p>Relationship length also played a role. Research shows long-term relationships are <a href="https://link.springer.com/article/10.1007/s10508-018-1175-x">associated with</a> decreasing desire for women, and this is often attributed to the tedium of over-familiarity (think of the bored, sexless <a href="https://www.youtube.com/watch?v=kBq-Nyo0lQg">wives in 90s sitcoms</a>).</p> <p>However our research indicates relationship boredom is not the reason, with the increasing inequity over the course of a relationship often the cause of women’s disinterest in sex.</p> <p>The longer some relationships continue, the more unfair they become, lowering women’s desire. This may be because women take on managing their partner’s relationships, as well as their own (“It’s time we had your best friend over for dinner”).</p> <p>And while domestic housework may start as equally shared, over time, women <a href="https://www.abs.gov.au/media-centre/media-releases/women-spent-more-time-men-unpaid-work-may">tend to do more</a> household tasks.</p> <h2>What about same-sex couples?</h2> <p>Same-sex couples have <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/fare.12293">more equitable relationships</a>.</p> <p>However, we found the same link between equity and desire for women in same-sex relationships, although it was much stronger for heteronormative couples.</p> <p>A sense of fairness within a relationship is fundamental to all women’s satisfaction and sexual desire.</p> <h2>What happens next?</h2> <p>Our findings suggest one response to low desire in women could be to address the amount of work women have to take on in relationships.</p> <p>The link between relationship satisfaction and female sexual desire has been firmly established in <a href="https://link.springer.com/article/10.1007/s10508-018-1175-x">previous research</a> but our findings explain how this dynamic works: women’s sense of fairness within a relationship forecasts their contentment, which has repercussions on their desire for their partner.</p> <p>To translate our results into clinical practice, we could run trials to confirm if lowering women’s mental load results in greater sexual desire.</p> <p>We could have a “housework and mental load ban” for a sample of women reporting low sexual desire and record if there are changes in their reported levels of desire.</p> <p>Or perhaps women’s sexual partners could do the dishes tonight and see what happens.</p> <p><em>Image credit: Shutterstock</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/dont-blame-women-for-low-libido-sexual-sparks-fly-when-partners-do-their-share-of-chores-including-calling-the-plumber-185401" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Relationships

Placeholder Content Image

Unique transportable home to be sold at low-cost

<p>A tiny foldable house is set to sell for less than a quarter of the average Queensland home loan deposit, already attracting 48 bids in an ongoing auction.</p> <p>The 35sqm portable house, popularly known as a donga, was listed for auction “brand new” by a company in Toowoomba.</p> <p>The 19ft by 20ft modified transportable house has seen 48 bids cast, lifting the price to $13,000, with bids rising in $250 increments. Market prices for fully fitted out dongas generally sell for around $20,000, depending on the quality of the fittings required.</p> <p>The owner of the literal ‘pick-up-and-go’ home has no reserve price set for the little container, meaning whenever the highest bid is made, the auction will close. </p> <p>The unique foldable home has an ensuite with a basic shower, toilet, sink and mirror. It also has eight lockable windows, one door and is decked out with timber flooring.</p> <p>There are hot and cold water inlets, two waste outlets, lighting, an exhaust fan vent, gas struts and winches for easy assembly. The container home has an efficiency star rating of 4, with water consumption at 4.5l full flush and 3.1l half flush.</p> <p>“Units are plumbed for the shower but showerhead/mixer needs to be supplied and installed by buyer.”</p> <p>The only issue with this unique little unit is it does not come wired, so the buyer has to arrange for an electrician to supply and install the wiring.</p> <p>The home also has “adjustable feet for easy levelling” and can be folded up and ready to transport.</p> <p><em>Image credit: realestate.com.au</em></p>

Real Estate

Placeholder Content Image

"Bullet in your head": Guy Sebastian’s neighbour faces court over death threats

<p>Phillip Hanslow, neighbour to Australian singer Guy Sebastian, faced court for the first time this morning over his alleged death threats. </p> <p>Phillip arrived to a media frenzy with his wife, Carol, and her oxygen tank. He became emotional as he opened up about the state of his health in the wake of the six-year feud’s climax, and drew comparisons between his fight with the singer to the 1977 film <em>Castle</em>. </p> <p>The feud between the neighbours reached breaking point on January 23 when Phillip allegedly confronted Guy outside their properties in Sydney’s eastern beaches. Guy was returning from a family holiday in Japan when Phillip is said to have kicked down his fence. </p> <p>Phillip is said to have told the singer that “I’ll put a bullet in your head”, supposedly with a hammer in hand. However, the 66-year-old argues that his actual words were “one day someone will put a bullet in your head.” </p> <p>In the days to follow the incident, Phillip was arrested and issued with an apprehended violence order. Guy was granted the order that prevented Philip from contacting him or from entering his property by Magistrate Ross Hudson.</p> <p>Outside of the court, Phillip spoke of his arrest, and the manner in which law enforcement officers entered his home, claiming they “broke into the back of the house, smashed down the door, and came into the house while I was on the toilet and arrested me.</p> <p>“And then took me off to Maroubra Police Station and I spent six-and-a-half hours in the lockup. All over just a heated argument with a neighbour which I think is clearly overboard.”</p> <p>Phillip’s admissions to reporters didn’t stop there, with the former builder opening up about his health, and the full-time care he provides his wife. </p> <p>“I’m 66 – on my way out, I suppose – my body’s worn out from years and years of working as a tradie, so it’s not easy trying to deal with what’s in front of me, but you’ve got to just move forward and do your best,” he said of his health conditions - including a herniated disk in his back, brain fog, and sciatica. “But I can’t cry about it, I’ve gotta keep moving forward.” </p> <p>Phillip informed the court that he had to have his infected bowel removed, and that it would mean a three-week recovery for him. He did not enter pleas during his appearance, stating that he required legal aid but had been unable to find anyone who was available. </p> <p>Under the circumstances, Magistrate Ross Hudson adjourned the matter, allowing Phillip until March 9 to find legal representation and to recover from his procedure.</p> <p><em>Images: Getty</em></p>

Legal

Placeholder Content Image

The verdict: Full fat versus low fat milk

<p>The idea of full low milk being healthier for us began circulating in the 1950s. It was shown that saturated fat increased blood cholesterol levels, with certain statistical evidence leading to the assumption it resulted in higher rates of heart disease and obesity.  </p> <p>This idea is not totally wrong. Full fat milk does indeed have a high saturated fat content, about 65 percent in fact.</p> <p><span style="text-decoration: underline;"><strong><a href="http://www.simoneaustin.com/" target="_blank" rel="noopener">Simone Austin</a></strong></span>, accredited practising dietitian and spokesperson for the <span style="text-decoration: underline;"><strong><a href="http://daa.asn.au/" target="_blank" rel="noopener">Dietitians Association of Australia</a></strong></span> addresses the claims that saturated fat should be avoided when it comes to weight management.</p> <p> “We are still recommending saturated fat should be kept to a minimum as there is still a link between saturated and plasma cholesterol levels, however full cream milk is only 4% total fat and is therefore not a high fat product, depending on quantity of course.”</p> <p>Health and nutrition coach and whole foods chef, Lee Holmes, believes that low-fat milk is a great option for those trying to lose weight.  Even though the fat is skimmed, the milk itself still contains an abundance of calcium and protein, and these are essential to weight loss.</p> <p>“Low-fat milk is better for overall weight control and maintenance as it only contains 0.15% fat as opposed to full-cream milk which contains 3.8% fat” she explains.</p> <p>The New Zealand Ministry of Health recommends enjoying mostly low and reduced fat milk and milk products, as it can reduce the total daily kilojoule intake to aid with weight management. This is generally believed to lead to weight loss and reduced risk of heart disease.</p> <p>However, Simone explains why it is not quite that straight forward. “Fat can give some feeling of satiety. If you are having less milk overall, and it is more filling to have full cream milk, then this might decrease overall volume of food consumed and therefore not be detrimental”.</p> <p>This approach is supported by recent research conducted by <a href="../%20http:/www.ncbi.nlm.nih.gov/pubmed/26746178"><strong>Swedish researchers</strong></a>, looking at the dairy consumption of a group of middle aged men. If found that those who ate full fat dairy products were less likely to become obese over a period of 12 years, compare with men who rarely ate high- fat diary.  This is because the weight-loss effect of reducing saturated fat depends on what replaces it in the diet, which is usually sugar and carbohydrates. Unfortunately, most of us are susceptible to consciously or unconsciously replacing a larger reduction in calories with something else.</p> <p>So, if you drink low-fat varieties of milk in order to reduce calorie intake, you must ensure you are not making up these calories elsewhere for this approach to be effective.</p> <p>However, in your quest for a slimmer waist line, it is important not to overlook other important health factors.</p> <p>Milk is a primary source of nutrients, and according to both Simone and the <strong><a href="http://ro.uow.edu.au/cgi/viewcontent.cgi?article=2032&amp;context=sspapers" target="_blank" rel="noopener"><span>ABS</span></a></strong>, most over-60s simply aren’t getting what they need.</p> <p>“In New Zealand the annual per capita consumption of milk has declined by 30% in the last 20 years, and 20% of the New Zealand population has an inadequate intake of calcium”.</p> <p>Simone stresses that simply aiming to meet serves is the priority. “Milk also provides a valuable source of protein and as we age our efficiency at using protein reduces, so we need to have a little more”.</p> <p>Lee Holmes echoes this, stating that ideally, people over 60 years of age should be having two to three glasses of cow’s milk daily to absorb the necessary amounts of calcium. If you don’t want to consume that much milk, are lactose intolerant or prefer to opt for non-cow’s milk (such as almond) you need to make these nutrients up elsewhere.</p> <p>“You may want to consider a quality, natural supplement to ensure you are giving your body all the nutrients it needs."</p> <p>So whether it be low-fat or full-fat, say cheers to milk and manage your weight loss in accordance with other health factors.</p> <p><em>Image: Getty Images</em></p>

Food & Wine

Placeholder Content Image

Sam Newman lashes out at “woke” athletes “with low IQs”

<p dir="ltr">Former AFL player Sam Newman has weighed in on a string of recent conflicts in the sporting world over million-dollar sponsorship deals, calling out “woke” athletes “with low IQs”.</p> <p dir="ltr">He claimed the world was “being run by patronising and pompous, arrogant people”, creating a “ridiculous, woke society of nonsense”.</p> <p dir="ltr">His comments come after the news emerged of controversies involving Netball Australia and the Fremantle Dockers.</p> <p dir="ltr">Netball Australia, which is in desperate need of funding, is in dispute with some of its star players around a $15 million sponsorship deal with Hancock Prospecting, which is owned by mining magnate Gina Rinehart.</p> <p dir="ltr">The deal would also see the company’s logo featured on the uniforms of Diamonds players, but opposition came from Indigenous player Donell Wallam and her teammates in relation to the company’s historical stance against Indigenous communities.</p> <p dir="ltr">Rinehart’s father, Lang Hancock, made a series of racist comments about Indigenous people in a 1984 documentary, Couldn’t Be Fairer, including his solution to the “Aboriginal problem”.</p> <p dir="ltr">“I would dope the water up so that they were sterile and would breed themselves out in future and that would solve the problem,” Hancock said in the film.</p> <p dir="ltr">In the AFL world, major Fremantle Dockers supporter Woodside Energy, a natural gas exporter, has left some high-profile fans concerned.</p> <p dir="ltr">Author Tim Winton and former WA premier Carmen Lawrence are among a group of fans urging the football club to end the agreement with the gas company.</p> <p dir="ltr">These controversies have become fodder for Newman, who shared his opinions on both with <em>Sky News</em>.</p> <p dir="ltr">The 76-year-old said he wouldn’t wear a certain sports jersey if he didn’t agree with what was on the front of it, but that “the price of being virtuous is hypocrisy” and that it’s unrealistic to expect sports could continue without money from the mining or energy sector.</p> <p dir="ltr">“If you think fossil fuels are going to disappear in the very near future then you’re mistaken because that’s the end of the civilised world as we know it no matter what you think of climate and no matter what you think of global warming,” he said.</p> <p dir="ltr">“I notice one of the netballers said they weren’t happy with Hancock because of their climate record, I mean seriously the world we live in is being run by patronising and pompous, arrogant people who have no idea really what they’re on about.”</p> <p dir="ltr">He then dubbed the netballers as hypocrites.</p> <p dir="ltr">“We have people with low IQs telling a sporting body which is on its knees financially that they won’t accept money from sponsorship deals from a company which I’m sure that those people who are complaining use one of those products indirectly or directly that Hancock Mining or Hancock industries have fabricated on a daily basis,” he said.</p> <p dir="ltr">When <em>Sky News</em> host Chris Kenny suggested that sports stars should just not play if they don’t agree with who sponsors their game, Newman disagreed, saying that those running teams or codes have a “duty of care” to inform players before they sign up.</p> <p dir="ltr">“[They have] a duty of care [to] say to the rank and file before they sign them up, "We're going to have Alinta Energy or Hancock mining sponsor us, have you got any problems with it?’” Newman said.</p> <p dir="ltr">“And if they have you could actually sort it out before they did the deal.”</p> <p dir="ltr">As for the Fremantle Dockers, Newman took the opportunity to slam the sport in general.</p> <p dir="ltr">“If I could just go a step further (about) the feigned indignation of the AFL who insist on telling us to be the moral arbiters of what we believe in,” he said.</p> <p dir="ltr">“I've said this before. At the AFL grand final we had three references to Indigenous Australians. </p> <p dir="ltr">“One of them is absolutely appropriate and no one could agree with it more.</p> <p dir="ltr">“But they had three separate references... lest we have to be told that we (have to) respect everything that's going on in the country.</p> <p dir="ltr">“They made a Muslim woman (Haneen Zreika of the Giants) the face of the AFLW, and then... she declined (to) wear the gay pride jumper.</p> <p dir="ltr">“If you get into the political realm in a sporting organisation, you end up creating a hornet's nest for the people who want nothing more than to go to the football or the sporting event just to watch it for what it is.</p> <p dir="ltr">“But they keep forcing this moral code onto us, to perhaps appease their own social prejudices and it turns into a ridiculous, woke society of nonsense.”</p> <p><span id="docs-internal-guid-034e29be-7fff-5589-bfc8-96e96f37cce9"></span></p> <p dir="ltr"><em>Image: Sky News (Facebook)</em></p>

News

Placeholder Content Image

Ultra-processed foods: it’s not just their low nutritional value that’s a concern

<p>In countries such as the UK, US and Canada, ultra-processed foods now account for <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">50% or more</a> of calories consumed. This is concerning, given that these foods have been linked to a number of different health conditions, including a greater risk of <a href="https://pubmed.ncbi.nlm.nih.gov/33167080/">obesity</a> and various chronic diseases such as <a href="https://nutritionj.biomedcentral.com/articles/10.1186/s12937-020-00604-1">cardiovascular disease</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35896436/">dementia</a>.</p> <p>Ultra-processed foods are <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">concoctions of various industrial ingredients</a> (such as emulsifiers, thickeners and artificial flavours), amalgamated into food products by a series of manufacturing processes.</p> <p>Sugary drinks and many breakfast cereals are ultra-processed foods, as are more recent innovations, such as so-called <a href="https://www.sciencedirect.com/science/article/pii/S2213453019301144,">“plant-based” burgers</a>, which are typically made of protein isolates and other chemicals to make the products palatable.</p> <p>The intense industrial processes used to produced ultra-processed foods destroy the <a href="https://pubmed.ncbi.nlm.nih.gov/35067754/">natural structure</a> of the food ingredients and strip away many beneficial nutrients such as fibre, vitamins, minerals and phytochemicals.</p> <p>Many of us are well aware that ultra-processed foods are harmful for our health. But it’s been unclear if this is simply because these foods are of poor nutritional value. Now, two new studies have shown that poor nutrition may not be enough to explain their health risks. This suggests that other factors may be needed to fully explain their health risks.</p> <h2>The role of inflammation</h2> <p>The <a href="https://www.bmj.com/content/378/bmj-2022-070688">first study</a>, which looked at over 20,000 health Italian adults, found that participants who consumed the highest number of ultra-processed foods had an increased risk of dying prematurely from any cause. The <a href="https://www.bmj.com/content/378/bmj-2021-068921">second study</a>, which looked at over 50,000 US male health professionals, found high consumption of ultra-processed foods was associated with a greater risk of colon cancer.</p> <p>What’s most interesting about these studies is that the health risks from eating a diet high in ultra-processed foods remained even after they had accounted for the poor nutritional quality of their diets. This suggests that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8747015/">other factors</a> contribute to the harms caused by ultra-processed foods.</p> <p>It also implies that getting the right nutrients elsewhere in the diet may not be enough to cancel out the risk of disease from consuming ultra-processed foods. Similarly, attempts by the food industry to improve the nutritional value of ultra-processed foods by adding a few more vitamins may be side-stepping a more fundamental problem with these foods.</p> <p>So what factors may explain why ultra-processed foods are so harmful to our health?</p> <p>The Italian study found that inflammatory markers – such as a higher white blood cell count – were higher in groups that ate the most ultra-processed foods. Our bodies may trigger an inflammatory response for any number of reasons – for example, if we catch a cold or get cut. The body responds by sending signals to our immune cells (such as white blood cells) to attack any invading pathogens (such as bacteria or viruses).</p> <p>Usually, our inflammatory response resolves quite quickly, but some people may develop chronic inflammation throughout their body. This can cause tissue damage, and is involved in many chronic diseases – such as <a href="https://pubmed.ncbi.nlm.nih.gov/25859884/">cancer</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/28744020/">cardiovascular disease</a>.</p> <p>Many studies have found that poor diets can increase inflammation in the body, and that this is linked to <a href="https://pubmed.ncbi.nlm.nih.gov/28744020/">higher risk</a> of chronic diseases. Given that signs of inflammation were seen in participants of the Italian study who ate the most ultra-processed foods, this could suggest that inflammation may contribute to why ultra-processed foods increase disease risk. Some food additives common in ultra-processed foods (such as emulsifiers and artificial sweeteners) also increase inflammation in the gut by causing <a href="https://pubmed.ncbi.nlm.nih.gov/29899036/">changes to the gut microbiome</a>.</p> <figure class="align-center ">Some researchers have theorised that ultra-processed foods increase inflammation because they are recognised by the body as foreign – much like an invading bacteria. So the body mounts an inflammatory response, which has been dubbed “<a href="https://pubmed.ncbi.nlm.nih.gov/24939238/">fast food fever</a>”. This increases inflammation throughout the body as a result.</figure> <p>Although the US colon cancer study did not establish if inflammation increased in the men consuming the most ultra-processed foods, inflammation is strongly linked with an <a href="https://pubmed.ncbi.nlm.nih.gov/27821485/">increased risk of colon cancer</a>.</p> <p>Research shows that other mechanisms – such as <a href="https://www.bmj.com/content/378/bmj-2022-070688">impaired kidney function</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/19502515/">toxins in packaging</a> – may also explain why ultra-processed foods cause so many dangerous health problems.</p> <p>Since inflammatory responses are hard-wired in our bodies, the best way to prevent this from happening is by not eating ultra-processed foods at all. Some plant-based diets high in natural, unprocessed foods (such as the <a href="https://pubmed.ncbi.nlm.nih.gov/36039924/">Mediterranean diet</a>) have also been shown to be anti-inflammatory. This may also explain why plant-based diets free from ultra-processed foods can help ward off <a href="https://pubmed.ncbi.nlm.nih.gov/26148921/">chronic diseases</a>. It’s currently not known to what extent an anti-inflammatory diet can help counteract the effects of ultra-processed foods.</p> <p>Simply reducing your intake of ultra-processed foods may be a challenge. Ultra-processed foods are designed to be hyper-palatable – and together with persuasive marketing, this can make resisting them an enormous challenge for <a href="https://pubmed.ncbi.nlm.nih.gov/33153827/">some people</a>.</p> <p>These foods are also not labelled as such on food packaging. The best way to identify them is by looking at their ingredients. Typically, things such as emulsifiers, thickeners, protein isolates and other industrial-sounding products are a sign it’s an ultra-processed food. But making meals from scratch using natural foods is the best way to avoid the harms of ultra-processed foods.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/189918/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/richard-hoffman-221275">Richard Hoffman</a>, Associate lecturer, Nutritional Biochemistry, <em><a href="https://theconversation.com/institutions/university-of-hertfordshire-799">University of Hertfordshire</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a>. Read the <a href="https://theconversation.com/ultra-processed-foods-its-not-just-their-low-nutritional-value-thats-a-concern-189918">original article</a>.</p>

Food & Wine

Our Partners