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Millions warned as dangerous disease spreads in Melbourne

Health authorities have issued an urgent warning to Victorians after multiple people have been admitted to hospital with severe symptoms. Victoria's Department of Health has revealed it is investigating an outbreak of Legionnaires disease after a "significant increase" in cases across Melbourne since Friday. Over just three days, 22 cases of the disease have been confirmed with another six cases suspected. Most of the cases are in adults aged over 40, with many of them requiring hospitalisation and intensive care for severe pneumonia. Health authorities are now searching for the source of the outbreak, as the health department said in a statement, "Legionnaires' disease can cause a chest infection with symptoms of fever, chills, cough, headache and muscle aches and pains. Other atypical symptoms may include nausea, vomiting, diarrhoea and confusion." "All cases have visited or reside in metropolitan Melbourne. Those most at risk are adults aged over 40 years, especially people with other medical conditions or immune compromise, or who smoke." The source of the outbreak is not yet known but investigations are underway to determine where it has come from. Legionnaires' disease is spread by breathing in fine droplets of water that contain legionella bacteria, and is not commonly spread from person-to-person or by drinking contaminated water. The <a href="https://www.health.vic.gov.au/health-alerts/outbreak-of-legionnaires-disease-in-metropolitan-melbourne" target="_blank" rel="noopener">Department of Health</a> is urging anyone who lives in, works in or has visited metropolitan Melbourne and surrounding areas to seek urgent medical care if they develop symptoms. Image credits: Shutterstock

Caring

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

<a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> 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. 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. Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s. 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. <h2>What’s CJD got to do with Alzehimer’s?</h2> 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. 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. <h2>Human growth hormone used to come from donated organs</h2> Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue. 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>. 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. 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. <h2>What are the latest findings about Alzheimer’s disease?</h2> The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission. 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. They considered other explanations for the findings but concluded donated hGH was the likely cause. 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. 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. 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. <h2>When was this process used in Australia?</h2> 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. <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. 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. 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. <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> 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. 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. 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.<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" /> <a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.

Mind

How does cancer spread to other parts of the body?

<a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> All cancers begin in a single organ or tissue, such as the lungs or skin. When these cancers are confined in their original organ or tissue, they are generally more treatable. But a cancer that spreads is much more dangerous, as the organs it spreads to may be vital organs. A skin cancer, for example, might spread to the brain. This new growth makes the cancer much more challenging to treat, as it can be difficult to find all the new tumours. If a cancer can invade different organs or tissues, it can quickly become lethal. When cancer spreads in this way, it’s called metastasis. Metastasis is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745820/">responsible for</a> the majority (67%) of cancer deaths. <h2>Cells are supposed to stick to surrounding tissue</h2> Our bodies are made up of trillions of tiny cells. To keep us healthy, our bodies are constantly replacing old or damaged cells. Each cell has a specific job and a set of instructions (DNA) that tells it what to do. However, sometimes DNA can get damaged. This damage might change the instructions. A cell might now multiply uncontrollably, or lose a property known as adherence. This refers to how sticky a cell is, and how well it can cling to other surrounding cells and stay where it’s supposed to be. If a cancer cell loses its adherence, it can break off from the original tumour and travel through the bloodstream or lymphatic system to almost anywhere. This is how metastasis happens. Many of these travelling cancer cells will die, but some will settle in a new location and begin to form new cancers. Particular cancers are more likely to metastasise to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381616/">particular organs</a> that help support their growth. Breast cancers commonly metastasise to the bones, liver, and lungs, while skin cancers like melanomas are more likely to end up in the brain and heart. Unlike cancers which form in solid organs or tissues, blood cancers like leukaemia already move freely through the bloodstream, but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722462/">can escape</a> to settle in other organs like the liver or brain. <h2>When do cancers metastasise?</h2> The longer a cancer grows, the more likely it is to metastasise. If not caught early, a patient’s cancer may have metastasised even before it’s initially diagnosed. Metastasis can also occur after cancer treatment. This happens when cancer cells are dormant during treatment – drugs may not “see” those cells. These invisible cells can remain hidden in the body, only to wake up and begin growing into a new cancer months or even years later. For patients who already have cancer metastases at diagnosis, identifying the location of the original tumour – called the “primary site” – is important. A cancer that began in the breast but has spread to the liver will probably still behave like a breast cancer, and so will respond best to an anti-breast cancer therapy, and not anti-liver cancer therapy. As metastases can sometimes grow faster than the original tumour, it’s not always easy to tell which tumour came first. These cancers are called “cancers of unknown primary” and are the <a href="https://www.canceraustralia.gov.au/cancer-types/unknown-primary-cancer/statistics">11th most commonly diagnosed cancers in Australia</a>. One way to improve the treatment of metastatic cancer is to improve our ways of detecting and identifying cancers, to ensure patients receive the most effective drugs for their cancer type. <h2>What increases the chances of metastasis and how can it be prevented?</h2> If left untreated, most cancers will eventually acquire the ability to metastasise. While there are currently no interventions that specifically prevent metastasis, cancer patients who have their tumours surgically removed may also be given chemotherapy (or other drugs) to try and weed out any hidden cancer cells still floating around. The best way to prevent metastasis is to diagnose and treat cancers early. Cancer screening initiatives such as Australia’s <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">cervical</a>, <a href="https://www.health.gov.au/our-work/national-bowel-cancer-screening-program">bowel</a>, and <a href="https://www.health.gov.au/our-work/breastscreen-australia-program">breast</a> cancer screening programs are excellent ways to detect cancers early and reduce the chances of metastasis. New screening programs to detect cancers early are being researched for many types of cancer. Some of these are simple: CT scans of the body to look for any potential tumours, such as in England’s new <a href="https://theconversation.com/how-englands-new-lung-cancer-screening-could-save-thousands-of-lives-expert-qanda-208867">lung cancer screening program</a>. Using artificial intelligence (AI) to help examine patient scans is also <a href="https://theconversation.com/ai-can-help-detect-breast-cancer-but-we-dont-yet-know-if-it-can-improve-survival-rates-210800">possible</a>, which might identify new patterns that suggest a cancer is present, and improve cancer detection from these programs. More advanced screening methods are also in development. The United States government’s Cancer Moonshot program is currently funding research into blood tests that could detect <a href="https://theconversation.com/a-blood-test-that-screens-for-multiple-cancers-at-once-promises-to-boost-early-detection-191728">many types of cancer at early stages</a>. One day there might even be a RAT-type test for cancer, like there is for COVID. <h2>Will we be able to prevent metastasis in the future?</h2> Understanding how metastasis occurs allows us to figure out new ways to prevent it. One idea is to <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2019/breast-cancer-chemotherapy-sensitizing-dormant-cells">target dormant cancer cells</a> and prevent them from waking up. Directly preventing metastasis with drugs is not yet possible. But there is hope that as research efforts continue to improve cancer therapies, they will also be more effective at treating metastatic cancers. For now, early detection is the best way to ensure a patient can beat their cancer.<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/219616/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, Senior Resarch Officer, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">original article</a>.

Body

Bring a plate! What to take to Christmas lunch that looks impressive (but won’t break the bank)

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/amy-kirkegaard-1401256">Amy Kirkegaard</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/breanna-lepre-1401257">Breanna Lepre</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Christmas lunch is at your friend’s house this year, and they’ve asked you to bring a plate. Money is tight. So, you find yourself wondering, “What’s cheap, healthy but also looks impressive?” While a tray of mangoes would certainly be a cheap, healthy and colourful contribution, you want to look as if you’ve put in a bit of effort. If you’re struggling for inspiration, here are some tried and tested ideas. <h2>First, choose your ingredients</h2> Check your pantry for inspiration or ingredients. Crackers, dried fruit or nuts are great ideas for a charcuterie board. You can use herbs and spices to add flavour to dishes, or you could use up packets of dried pasta to make a <a href="https://nomoneynotime.com.au/healthy-easy-recipes/salmon-and-pasta-salad">pasta salad</a>. This is also a great way to clean out your pantry. Focus on fruit and vegetables that are in season, so are cheaper and more readily available. Keep an eye out at your local fruit and veggie shop or market as it will usually have in-season fruit and vegetables in bulk quantities at reduced prices. Check out <a href="http://seasonalfoodguide.com/australia-general-seasonal-fresh-produce-guide-fruits-vegetables-in-season-availability.html">this seasonal food guide</a> to help you plan your Christmas menu. Ask around for deals by chatting to your local butcher, fishmonger or grocer and let them know your budget. They may suggest cheaper cuts of meat (such as, <a href="https://www.australianbutchersguild.com.au/the-blog/the-abg-blog/underrated-cuts-of-beef/">oyster</a>, <a href="https://www.australianbeef.com.au/know-your-meat/beef-cuts/">blades, rump caps</a>). Try cooking <a href="https://www.bestrecipes.com.au/recipes/slow-cooker-corned-beef-mustard-sauce-recipe/z47lwrbv?r=entertaining/9clz7475&h=entertaining">corned beef</a> or <a href="https://www.bbcgoodfood.com/recipes/slow-cooker-roast-chicken">roast chicken</a> in a slow cooker with lots of vegetables. Slow-cooked meals can be frozen and can come in handy for left-overs. Lean into <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608274/">legumes</a>. These are packed with fibre, protein, vitamins and minerals. They are also budget-friendly and a great way to add texture to salads. Tinned chickpeas, or cannellini, kidney, or butter beans are quick and easy additions that can make filling dishes go further. You could even turn tinned chickpeas into homemade hommus for a healthy and delicious side dish. Check out these healthy legume <a href="https://nomoneynotime.com.au/healthy-easy-recipes/filter/keywords--legumes">recipes</a>. <h2>7 ways to keep food costs down this Christmas</h2> 1. Plan ahead Plan your menu by asking how many people are coming and checking for any food preferences or dietary requirements. Check for items you already have at home, and make a shopping list for only what you <a href="https://www.emerald.com/insight/content/doi/10.1108/BFJ-12-2017-0726/full/html">need</a>. 2. Use free recipes Use free online recipe collections and e-books tailored for budget cooking that can help you design your Christmas menu to meet your budget. This <a href="https://nomoneynotime.com.au/uploads/Our-Guide-to-the-Perfect-Christmas-Feast.pdf">one</a> was created by a group of <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitians</a> and has healthy, budget friendly recipes and ideas. You could also try this budget friendly collection of Christmas recipes from <a href="https://www.taste.com.au/recipes/collections/budget-christmas-recipes">taste</a>. 3. Involve the family Get together with other family members and make it a challenge to see who can make the cheapest, most delicious dish. Get the kids involved in fun activities, such as making a DIY gingerbread house or putting together mixed skewers for the barbecue. 4. Pool your resources Larger quantities of a single dish will be cheaper than multiple different dishes (and easier to prepare). 5. Frozen is fine Use frozen fruits and vegetables if you need to. These can have just as <a href="https://pubmed.ncbi.nlm.nih.gov/25526594/">many vitamins and minerals</a> as fresh, are often cheaper than fresh produce and last longer. Try using frozen berries to decorate the pavlova or add them to your favourite cake, muffin or pie. 6. Make your own drinks You could make your own drinks, such as home-brewed iced tea. See if anyone in your family has a soda stream you can borrow to make sparkling mineral water. Add some freshly squeezed lemon or lime for extra flavour. 7. Reduce waste Use your own crockery and re-use leftovers to reduce waste. After all, washing up is cheaper than buying plastic or paper plates and better for the environment. Remember to save any leftovers and re-use them. Leftover fresh vegetables could be used to make a hearty soup or chutney. <h2>It doesn’t have to be perfect</h2> Christmas comes and goes quickly. If your cooking ideas don’t work out, it’s not the end of the world. Choosing healthy foods on a budget is important all year around, so you may like to think about trying these tips throughout the years to come. <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/196565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/amy-kirkegaard-1401256">Amy Kirkegaard</a>, Postdoctoral Research Fellow, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/breanna-lepre-1401257">Breanna Lepre</a>, Research Fellow, Mater Research Institute, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian and Researcher, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/bring-a-plate-what-to-take-to-christmas-lunch-that-looks-impressive-but-wont-break-the-bank-196565">original article</a>.

Food & Wine

Sir Paul McCartney spreads joy by signing fan's piano

A lucky Adelaide fan's dream came true after getting his piano signed by the one and only Sir Paul McCartney. The former Beatle took to Instagram to share the moment he signed a piano for music enthusiast, Pete. "Alright, here we are signing Pete's piano," the icon said while dressed casually in an all-black outfit with a grey sharpie in one hand. "Pete's from Adelaide, so am I, here we go," the 81-year-old joked as he signed the piano. "To Pete, cheers, Paul McCartney 2023." The former Beatle then said: "you’ll have to look at that every time you play," before playing the intro of one his former band's smash hits Lady Madonna. The video was captioned: "Who knew Pete would hit the right keys with Paul? Taking a moment out of his #PaulMcCartneyGotBack tour Paul signs a dedicated fan's piano in Adelaide 🇦🇺". <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/Cy_6zyUv_wX/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/Cy_6zyUv_wX/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Paul McCartney (@paulmccartney)</a> </div> </blockquote> The cover photo of the reel showed Pete holding a sign which said: "Paul please sign my piano" and his dreams finally came true. Fans have expressed their joy for Pete and praised Sir Paul for his kindness. "Pete just had the best day of his life and he knows it ❤️" one wrote. "He's surely gonna treasure that piano for the rest of his life!" another commented. "Sir Paul…. Thank you for being so gracious, and so generous. You were an absolute pleasure to meet!" Pete, the fan whose dreams came true, added. Images: Instagram

Music

A rose in every cheek: 100 years of Vegemite, the wartime spread that became an Aussie icon

<a href="https://theconversation.com/profiles/hannah-viney-1153558">Hannah Viney</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> There are roughly <a href="https://www.onlymelbourne.com.au/vegemite">22 million jars of Vegemite</a> manufactured in the original Melbourne factory every year. According to the Vegemite website, around 80% of Australian households have a jar in the cupboard. The cultural status of Vegemite is so enduring that, in 2022, the City of Melbourne Council <a href="https://www.theguardian.com/australia-news/2022/jun/01/smell-of-vegemite-factory-given-special-heritage-recognition-by-melbourne-council">included the smell of the factory</a> at 1 Vegemite Way, Fishermans Bend, in a statement of heritage significance. Vegemite first hit Australian supermarket shelves in 1923, but it took a while to find its feet. Indeed, the now classic spread may have failed into obscurity as “Parwill” if not for a very clever advertising campaign in the second world war. <figure><iframe src="https://www.youtube.com/embed/YNiOZInvLog?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>A product of war</h2> Vegemite has German U-boats to thank for its invention. When the first world war began in 1914, Australians were big fans of <a href="https://www.marmite.co.uk/">Marmite</a>, the British yeast extract spread. As the Germans began sinking ships full of British supplies to Australia, Marmite disappeared from the shelves. <a href="https://doi.org/10.1108/JHRM-06-2015-0019">Due to the conditions of its patent</a>, Marmite could only be manufactured in Britain. As a result, there was a gap in the market for a yeast spread. <a href="https://adb.anu.edu.au/biography/walker-fred-8953">Fred Walker</a>, who produced canned foods, hired food technologist <a href="https://adb.anu.edu.au/biography/callister-cyril-percy-5468">Cyril P. Callister</a> to create a homegrown yeast spread using brewer’s yeast from the Carlton Brewery. Callister’s experiments produced a thicker, stronger spread than the original Marmite. Callister’s inclusion of vegetable extracts to improve the flavour would <a href="https://doi.org/10.1080/08949468.1993.9966612">give the spread its name, Vegemite</a>, chosen by Walker’s daughter from competition entries. Australians were wary of Vegemite when it first appeared on grocery shelves, perhaps due to brand loyalty to Marmite. To try and combat this, <a href="https://vegemite.com.au/heritage/">Walker renamed Vegemite “Parwill”</a> in 1928 as a play on Marmite: “if Ma might, Pa will”. This rebrand was short-lived. Australians were not any more interested in Parwill than they were in Vegemite. <h2>A nutritious food replacement</h2> In the 1930s, <a href="https://doi.org/10.1108/JHRM-06-2015-0019">Walker hired American advertiser J. Walter Thompson</a>. Thompson began offering free samples of Vegemite with purchases of other Kraft-Walker products, including the popular Kraft cheese. Kraft-Walker also ran limerick competitions to advertise Vegemite. Entrants would write the final line of a limerick to enter into the draw to win a brand new car. It would take another world war, however, before Vegemite became part of Australian national identity. The second world war also disrupted shipping supply routes. <a href="https://www.oldtreasurybuilding.org.au/work-for-victory/housewives-to-action/food-rationing/">With other foodstuffs hard to come by</a>, Vegemite was marketed as a nutritious replacement for many foods. One 1945 advertisement <a href="http://nla.gov.au/nla.news-article1106308">read</a>: "If you are one of those who don’t need Vegemite medicinally, the thousands of invalids and babies are asking you to deny yourself of it for the time being." With its long shelf life and high levels of B-vitamins, the Department of Supply also saw the advantages of Vegemite. The department began buying Vegemite in bulk and <a href="https://www.awm.gov.au/collection/C1070486">including it in ration kits</a> sent to soldiers on the front lines. Due to this demand, Kraft-Walker foods rationed the Vegemite available to civilians. Yet the <a href="https://doi.org/10.1108/JHRM-06-2015-0019">brand increased advertisements</a>. Consumers were told Vegemite was limited because it was in demand for Australian troops due to its incredible health benefits. <a href="http://nla.gov.au/nla.news-article1106308">One ad told Australians</a>: "In all operational areas where our men and those of our Allies are engaged, and in military hospitals, Vegemite is in great demand, because of its value in fighting Vitamin B deficiency diseases. That’s why the fighting forces have first call on all Vegemite produced. And that is why Vegemite is in short supply for civilian consumption. But it won’t always be that way. When the peace is won and our men come home, ample stocks of this extra tasty yeast extract will be available for everyone." This clever advertising linked Vegemite with Australian nationalism. Though most could not buy the spread during the rationing years, the idea that Vegemite was vital for the armed forces cemented the idea that Vegemite was fundamentally Australian. Buying Vegemite was an act of patriotism and a way to support Australian troops overseas. <h2>Happy little Vegemites</h2> In the postwar baby boom, Vegemite advertisements responded to concerns about the nation’s health and the need to rebuild a healthy population. <figure><iframe src="https://www.youtube.com/embed/vLhk_wE4l2Q?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> This emphasis on <a href="http://nla.gov.au/nla.news-article46442748">Vegemite as part of a healthy diet</a> for growing children would remain the key advertising focus of the next 60 years. <a href="https://www.nfsa.gov.au/collection/curated/happy-little-vegemites-jingle-1953">The ear-catching jingle was composed</a> in the early 1950s, first for radio and then later used in the 1959 television ad. The link between Australian identity and Vegemite was popularised internationally by Men At Work’s 1981 song Down Under, with the lyrics “He just smiled and gave me a Vegemite sandwich”. The 1980s also saw <a href="https://youtu.be/h5r3HAJh8es">the first remake of the 1950s television campaign</a>, re-colourising it for nostalgic young parents who had grown up with the original. <figure><iframe src="https://www.youtube.com/embed/h5r3HAJh8es?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> In February 2022, the first international arrivals welcomed back into Australia post-COVID were greeted with a DJ playing Down Under, koala plushies and <a href="https://www.theguardian.com/australia-news/2022/feb/21/today-we-rejoined-the-world-hugs-tears-and-vegemite-as-australia-reopens-international-borders">jars of Vegemite</a>. On Vegemite’s centenary in 2023, the unassuming spread is now firmly cemented as an Australian cultural icon. Love it or hate it, Vegemite is here to stay. <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/204917/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hannah-viney-1153558">Hannah Viney</a>, Researcher, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/a-rose-in-every-cheek-100-years-of-vegemite-the-wartime-spread-that-became-an-aussie-icon-204917">original article</a>.

Food & Wine

“Putrid cookers”: Anti-vaxxers slammed for spreading lies about Jock Zonfrillo’s death

Just hours after MasterChef judge Jock Zonfrillo’s sudden death, heartless anti-vaxxers took to social media to spread disinformation. Zonfrillo died in Melbourne on May 1. While the cause of death has not been publicly announced, police said that his death was not being treated as suspicious, and a report was made for the coroner. The anti-vaxxers took this as a chance to spread disinformation online, implying that his death was linked to the Covid vaccine. “Did Jock Zonfrillo get the Pfizer or Moderna RNA vaccine?” one person tweeted the day after his death. Another commented on the way that his death was described as “sudden” with no confirmed cause- completely ignoring the fact that Zonfrillo’s family have not released that information. “The mainstream media has been reporting countless such ‘sudden deaths’ with ‘no cause of death given’,” wrote the anti-vaxxer on Facebook on May 2. “Since when are death reports being provided with no cause given? “I know since when: since they rolled out those experimental Covid vaccines, which are dropping people faster than they can clue in that it is murdering them. The mainstream media and medical establishment will never admit it – they omit the REAL reason someone died by saying ‘no immediate cause of death was given’,” wrote another. The ill-informed comments have attracted significant backlash from Aussies who slammed the “cookers” for taking advantage of the tragedy to spread disinformation. “Of course the putrid cookers have already come out, saying it was the Covid vaccine that killed Jock Zonfrillo. They really are opportunistic scum. RIP Jock,” one person tweeted in response to the lies. <blockquote class="twitter-tweet"> Of course the putrid cookers have already come out, saying it was the covid vaccine that killed Jock Zonfrillo. They really are opportunistic scum. RIP Jock. <a href="https://t.co/t7jxe9QX1P">pic.twitter.com/t7jxe9QX1P</a> — JayJay (@JayJay91341991) <a href="https://twitter.com/JayJay91341991/status/1653215630768865281?ref_src=twsrc%5Etfw">May 2, 2023</a></blockquote> “I’m always unsurprised at the amount of cookers that come out of the woodwork when a celebrity dies. Shame on anyone who is using Jock Zonfrillo’s death to push their anti-vax vile rhetoric,” tweeted another. <blockquote class="twitter-tweet"> I’m always unsurprised at the amount of cookers that come out of the woodwork when a celebrity dies. Shame on anyone who is using Jock Zonfrillo’s death to push their anti-vax vile rhetoric. — MrDreeps (@MrDreepy) <a href="https://twitter.com/MrDreepy/status/1652947746419281921?ref_src=twsrc%5Etfw">May 1, 2023</a></blockquote> “Distance yourself from people who impulsively attribute the death of a celebrity to the Covid-19 Vaccine. “It demonstrates extreme congruence bias, and a profound lack of empathy. #jockzonfrillo,” wrote a third. <blockquote class="twitter-tweet"> Distance yourself from people who impulsively attribute the death of a celebrity to the Covid-19 Vaccine. It demonstrates extreme congruence bias, and a profound lack of empathy. <a href="https://twitter.com/hashtag/jockzonfrillo?src=hash&ref_src=twsrc%5Etfw">#jockzonfrillo</a> — Nick Holt (@realnickholt) <a href="https://twitter.com/realnickholt/status/1652919969926254592?ref_src=twsrc%5Etfw">May 1, 2023</a></blockquote> Images: Instagram

News

Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t

The question of whether and to what extent face masks work to prevent respiratory infections such as COVID and influenza has split the scientific community for <a href="https://www.baltimoresun.com/news/bs-xpm-2007-03-06-0703060040-story.html">decades</a>. Although there is strong evidence face masks <a href="https://www.sciencedirect.com/science/article/pii/S0020748920301139?via%3Dihub">significantly reduce transmission of such infections</a> both in health-care settings and in the community, some experts do not agree. An updated <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full">Cochrane Review</a> published last week is the latest to suggest face masks don’t work in the community. <blockquote class="twitter-tweet"> "Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks"<a href="https://twitter.com/CochraneLibrary?ref_src=twsrc%5Etfw">@CochraneLibrary</a> Review. Published: 30 January 2023 <a href="https://t.co/zODu6QEF1M">https://t.co/zODu6QEF1M</a> <a href="https://t.co/c26yHPaSCD">pic.twitter.com/c26yHPaSCD</a> — Robin Monotti (@robinmonotti) <a href="https://twitter.com/robinmonotti/status/1620311528523304960?ref_src=twsrc%5Etfw">January 31, 2023</a></blockquote> However there are problems with the review’s methodology and its underpinning assumptions about transmission. The Cochrane Review combined randomised controlled trials (RCTs) using <a href="https://ebn.bmj.com/content/16/1/3">meta-analysis</a>. RTCs test an intervention in one group and compare it with a “control” group that doesn’t receive the intervention or receives a different intervention. A meta-analysis pools the results of multiple studies. This approach assumes (a) RCTs are the “best” evidence and (b) combining results from multiple RCTs will give you an average “effect size”. But RCTs are only the undisputed gold standard for certain kinds of questions. For other questions, a mix of study designs is better. And RCTs should be combined in a meta-analysis only if they are all addressing the same research question in the same way. Here are some reasons why the conclusions of this Cochrane Review are misleading. <h2>It didn’t consider how COVID spreads and how masks work</h2> COVID, along with influenza and many other respiratory diseases, is transmitted primarily <a href="https://theconversation.com/covid-how-the-disease-moves-through-the-air-173490">through the air</a>. Respirators (such as N95s) are designed and regulated to prevent airborne infections by fitting <a href="https://theconversation.com/high-filtration-masks-only-work-when-they-fit-so-we-created-a-new-way-to-test-if-they-do-155987">closely to the face</a> to prevent air leakage and by filtering out 95% or more of potential infectious particles. In contrast, surgical masks are designed to prevent splatter of fluid on the face and are loose-fitting, causing unfiltered air to leak in through the gaps around the mask. The filtration of a surgical mask is not regulated. In other words, respirators are designed for respiratory protection and cloth and surgical masks are not. The review starts with an assumption that masks provide respiratory protection, which is flawed. An understanding of these differences should inform both studies and reviews of those studies. <h2>The studies addressed quite different questions</h2> A common mistake in meta-analysis is to combine apples and oranges. If apples work but oranges don’t, combining all studies in a single average figure may lead to the conclusion that apples do not work. This Cochrane Review combined RCTs where face masks or respirators were worn part of the time (for example, when caring for patients with known COVID or influenza: “occasional” or “targeted” use) with RCTs where they were worn at all times (“continuous use”). Because both SARS-CoV-2 and influenza viruses are airborne, an unmasked person could be infected anywhere in the building and even after an infectious patient has left the room, especially since some people have <a href="https://www.pnas.org/doi/10.1073/pnas.2109229118">no symptoms</a> while contagious. Most RCTs of masks and N95s included in the review have not had a <a href="https://jamanetwork.com/journals/jama/fullarticle/184819">control arm</a> – therefore finding no difference could indicate equal efficacy or equal inefficacy. <a href="https://jamanetwork.com/journals/jama/fullarticle/2749214">Studies</a> examining wearing a surgical mask or respirator (such as an N95) only when in contact with sick people or when doing a high-risk procedure (occasional use) have generally shown that, when worn in this way, there is no difference. An RCT comparing occasional versus continuous use of respirators in health care workers <a href="https://www.atsjournals.org/doi/10.1164/rccm.201207-1164OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubme">showed</a> N95 respirators and surgical masks were equally ineffective when only worn occasionally by hospital workers. They had to wear them all the time at work to be protected. We also combined only apples and apples in a <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">meta-analysis</a> of two RCTs conducted in exactly the same way and measuring the same interventions and outcomes. We found N95 respirators provide significant protection against respiratory infections when surgical masks did not, even against infections assumed to be “droplet spread”. <h2>Most trials addressed only half the question</h2> Face masks and respirators work in two ways: they protect the wearer from becoming infected and they prevent an infected wearer from spreading their germs to other people. Most RCTs in this Cochrane Review looked only at the former scenario, not the latter. In other words, the researchers had asked people to wear masks and then tested to see if those people became infected. A previous <a href="https://pubmed.ncbi.nlm.nih.gov/20092668/">systematic review</a> found face masks worn by sick people during an influenza epidemic reduced the risk of them transmitting the infection to family members or other carers. Preventing an infection in one person also prevents onward transmission to others within a closed setting, which means such RCTs should use a special method called “cluster randomisation” to account for this. Data from a RCT of N95 respirator use by <a href="https://journals.sagepub.com/doi/full/10.1177/0300060516665491?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">health workers</a> showed even their unmasked colleagues were protected. Yet some of the trials included in the review did not use cluster randomisation. <h2>The new paper combined health and community settings</h2> This is another apples-plus-oranges issue. Different settings have widely differing risks of transmission, since airborne particles build up when sick patients are exhaling the virus in <a href="https://theconversation.com/heres-where-and-how-you-are-most-likely-to-catch-covid-new-study-174473">underventilated, crowded settings</a> especially if many infected people are present (such as in a hospital). <blockquote class="twitter-tweet"> Here’s where (and how) you are most likely to catch COVID – new study <a href="https://t.co/Ro88Shc897">https://t.co/Ro88Shc897</a> <a href="https://t.co/TlFA9EQskF">pic.twitter.com/TlFA9EQskF</a> — Jeffrey J Davis (@JeffreyJDavis) <a href="https://twitter.com/JeffreyJDavis/status/1484210379093954564?ref_src=twsrc%5Etfw">January 20, 2022</a></blockquote> A genuine protective effect of masks or respirators shown in a RCT in a high-risk setting will be obscured if that trial is combined in a meta-analysis with several other RCTs that were conducted in low-risk settings. A large <a href="https://www.science.org/doi/10.1126/science.abi9069">RCT in the community in Bangladesh</a> found face masks reduced the risk of infection by 11% overall and 35% in people over 60 years. In contrast, in <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">hospitals</a>, N95 reduce risk by 67% against bacterial infections and 54% against viral infections. Viruses like influenza also vary substantially from year to year – some years there is very little influenza, and if a RCT is conducted during such a year, it will not find enough infections to show a difference. The review failed to account for such seasonal effects. <h2>But did they actually wear the mask?</h2> The authors of the Cochrane Review acknowledged compliance with masking advice was poor in most studies. In the real world, we can’t force people to follow medical advice, so RCTs should be analysed on an “intention to treat” basis. For example, people who are prescribed the active drug but who choose not to take it should not be shifted to the placebo group for the analysis. But if in a study of masking, most people don’t actually wear them, you can’t conclude that masks don’t work when the study shows no difference between the groups. You can only conclude that the mask advice didn’t work in this study. There is a great deal of <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246317">psychological evidence</a> on why people do or don’t choose to comply with advice to mask and how to improve uptake. The science of masking needs to separate the impact of the mask itself from the impact of the advice to mask. Mask-wearing <a href="https://www.ijidonline.com/article/S1201-9712(21)00274-5/fulltext">goes up</a> substantially to over 70% if there is an actual mandate in place. <h2>It didn’t include other types of research</h2> A comprehensive review of the evidence would also include other types of study besides RCTs. For example, a <a href="https://www.sciencedirect.com/science/article/pii/S0140673620311429">large systematic review</a> of 172 various study designs, which included 25,697 patients with SARS-CoV-2, SARS, or MERS, concluded masks were effective in preventing transmission of respiratory viruses. Well-designed <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm?s_cid=mm7106e1_w">real-world studies</a> during the pandemic showed any mask reduces the risk of COVID transmission by 50–80%, with the highest protection offered by N95 respirators. <a href="https://pubmed.ncbi.nlm.nih.gov/20095070/">Many lab-based studies</a> have shown respirators are superior to masks at preventing airborne respiratory infections and the <a href="https://thorax.bmj.com/content/75/11/1024.long">incremental superiority</a> from a single to two layered cloth mask to a three-layered surgical mask in blocking respiratory aerosols. <h2>Yes, masks reduce the spread of COVID</h2> There is strong and consistent evidence for the effectiveness of masks and (even more so) respirators in protecting against respiratory infections. Masks are an important protection against serious infections. Current COVID vaccines protect against death and hospitalisation, but do <a href="https://fortune.com/well/2023/01/06/kraken-xbb15-omicron-covid-variant-most-transmissible-yet-could-spawn-more-immune-evasive-variants-study-china-vaccine-monoclonal-antibodies-breakthrough-infection/">not prevent infection</a> well due to waning vaccine immunity and substantial immune escape from new variants. A systematic review is only as good as the rigour it employs in combining similar studies of similar interventions, with similar measurement of outcomes. When very different studies of different interventions are combined, the results are not informative. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992" target="_blank" rel="noopener">The Conversation</a>.

Body

Air travel spreads infections globally, but health advice from inflight magazines can limit that

“Travel safe, travel far, travel wide, and travel often,” <a href="https://thoughtcatalog.com/matthew-kepnes/2014/01/53-travel-quotes-to-inspire-you-to-see-the-world/">says</a> <a href="https://www.nomadicmatt.com/">Nomadic Matt</a>, the American who quit his job to travel the world, write about it and coach others to do the same. But there’s a downside to all this travel, with its unprecedented volume of passengers moving from one side of the world to the other, largely by plane. There’s the risk of those passengers spreading infectious diseases and microorganisms resistant to multiple drugs (superbugs) around the world. Yet, our recently published <a href="https://www.sciencedirect.com/science/article/pii/S1477893919301218">research</a> into health advice provided by inflight magazines shows plane passengers are given practically no advice on how to limit the spread of infectious diseases. Should we be worried about the part air travel plays in spreading infectious diseases? And what can we do about it? How big is the risk? Low airfares and a series of social and economic factors have made global air travel more common than ever. According to the Australian government department of infrastructure, transport, cities and regional development the <a href="https://www.bitre.gov.au/publications/ongoing/files/International_airline_activity_CY2018.pdf">number of passengers taking international scheduled flights in 2018 was 41.575 million</a>. But the International Air Transport Association projects passenger demand will <a href="https://www.iata.org/pressroom/pr/Pages/2019-02-27-02.aspx">reach 8.2 billion by 2037</a>. There are many examples of infectious diseases spread via international flying. The World Health Organization documented <a href="https://www.who.int/ith/mode_of_travel/tcd_aircraft/en/">transmission of tuberculosis</a> (TB) on board commercial aircraft during long-haul flights during the 1980s. Research published in 2011 documents the <a href="https://wwwnc.cdc.gov/eid/article/17/7/10-1135_article">transmission of influenza</a> on two transcontinental international flights in May 2009. More recently, the current <a href="https://theconversation.com/why-people-born-between-1966-and-1994-are-at-greater-risk-of-measles-and-what-to-do-about-it-110167">global outbreak of measles</a> in many countries, including the Philippines and the United States, gave rise to the risk of transmission during international travel. In a recent case a <a href="https://www.health.nsw.gov.au/Infectious/alerts/Pages/measles-alert-january.aspx">baby</a> too young to be vaccinated who had <a href="https://www.smh.com.au/national/nsw/measles-alert-after-infectious-baby-flew-from-manila-went-to-central-coast-20190603-p51tzs.html">measles</a> returned from Manilla in the Philippines to Sydney, exposing travellers on that flight to infection. Then there is the risk of transmitting antimicrobial-resistant organisms that cause disease, such as <a href="https://theconversation.com/explainer-what-is-tb-and-am-i-at-risk-of-getting-it-in-australia-75290">multi-drug resistant TB</a>. Recently, patients in Victoria and New South Wales were identified as carrying the drug-resistant fungus <a href="https://www2.health.vic.gov.au/about/news-and-events/healthalerts/candida-auris-case-detected-in-victoria">Candida auris</a>, which they acquired overseas. <a href="https://www.ncbi.nlm.nih.gov/pubmed/27890665">One study</a> estimates that over 300 million travellers visit high-risk areas, such as the western Pacific, Southeast Asia and Eastern Mediterranean, each year worldwide, and more than 20% return as new carriers of resistant organisms. These popular destinations, as well as the Middle East, have high rates of drug resistant organisms. How is this happening? Aircraft move large volumes of people around the world swiftly. But what sets them apart from buses and trains is that passengers are close together, in confined spaces, for a long time. This increases the risk of transmitting infections. Passengers interact with high-touch surfaces, such as tray tables, headsets, seats and handles. We cough, sneeze and touch multiple surfaces multiple times during a flight, with limited opportunities to clean our hands with soap and water. Many infections, such as gastroenteritis and diarrhoea, are spread and contracted by touch and contact. What can we do about it? Providing plane travellers with relevant health advice is one way to limit the spread of infectious diseases via air travel. This would include information and advice on routine hand washing with soap and water, or using alcohol-based hand rubs, and other basic measures including cough etiquette, such as coughing into your elbow and covering your nose and face. <a href="https://academic.oup.com/jtm/article/4/2/102/1847252">Researchers</a> have looked at the role commercial websites and travel agencies might play in providing that advice. And since the 1990s, airline magazines have been <a href="https://academic.oup.com/jtm/article/4/2/102/1847252">highlighted</a> as an underused source of traveller health advice. More than 20 years on, we discovered little has changed. In our recent study, published in the journal <a href="https://www.sciencedirect.com/science/article/pii/S1477893919301218">Travel Medicine and Infectious Disease</a>, we looked at the content of inflight magazines from 103 airlines issued during January 2019. Of the 47 available online, only a quarter (11) included an official section on passengers’ general health and well-being, of which only two contained information related to infection control and the preventing infectious diseases. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284424/original/file-20190717-173366-w48bmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Inflight magazines have a potential audience of billions. So why not include advice on hand hygiene and coughing etiquette? <a class="source" href="https://www.shutterstock.com/download/confirm/1424594042?src=vUDfEziJwFDV7GZr5OYMRA-1-2&studio=1&size=medium_jpg">from www.shutterstock.com</a></figcaption></figure> The first magazine, from a UAE-based airline, had an official section on passenger health and well-being that included very limited relevant content. It advised passengers “with blood diseases or ear, nose and sinus infections should seek medical advice before flying”. There was no further explanation or information, nor were there any strategies to prevent these or other infections. The second magazine, from a USA-based airline, contained general travel health advice, but none specifically about infectious diseases. However there was a full-page, colour advertisement next to the health section. This contained images of many disease causing microorganisms on passengers’ tray tables and advocated the use of a disinfectant wipe for hands and other inflight surfaces. The slogan “because germs are frequent fliers” was displayed across the tray table. This was accompanied by information about the use and effectiveness of disinfectant wipes for hand hygiene and disinfecting surfaces during air travel, public transport use, and in hotels and restaurants. Inflight magazines are valuable assets for airlines and are the source of considerable advertising revenue. They are read by potentially billions of passengers every year. The results of this study show that they are a greatly underused source of information about infection control and measures to prevent the spread of infectious diseases. Airlines should also provide health advice to passengers in other media, in particular video screens, about infection prevention and basic control measures such as hand hygiene, cough etiquette and personal hygiene. Such advice should be provided before, during and after the flight. It could also include destination-related advice for particularly risky travel routes and destinations. More information for passengers Airlines providing health advice to passengers is just one way to limit the spread of infectious diseases and antimicrobial-resistant organisms around the world via air travel. This would need to sit alongside other measures, such as <a href="https://wwwnc.cdc.gov/travel/page/travel-industry-information-center">information and guidelines</a> provided to those who travel via the sea. The simple, low-cost measures highlighted in our research could go a long way to help passengers stay healthy and avoid illness from infectious diseases. At the same time, these measures could reduce the impact of outbreaks of infectious diseases for airlines and society as a whole.<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/120283/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Ramon Zenel Shaban and Cristina Sotomayor-Castillo. Republished with permission from <a href="https://theconversation.com/air-travel-spreads-infections-globally-but-health-advice-from-inflight-magazines-can-limit-that-120283" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

International Travel

Democracy spreads in waves – but shared cultural history might matter more than geography

Recent events like the war in Ukraine, conflicts over Taiwan and the rise of authoritarian ideology have renewed interest in the foundations of modern democracy. They have raised questions about why some nations are more democratic than others, and how democratic institutions, freedoms and values are spread or lost. We tend to think of this variation in terms of geography – democratic Western Europe or autocratic Middle East. But in a <a href="https://www.cambridge.org/core/journals/evolutionary-human-sciences/article/shared-cultural-ancestry-predicts-the-global-diffusion-of-democracy/90C7A170B924FC305DD66FF8853799FC" target="_blank" rel="noopener">new analysis of 220 years of political data</a>, we show that deep cultural connections between countries such as shared linguistic or religious ancestry matter more than geography. <h2>Waves of democratisation</h2> The emergence of modern democracy coincides with the rise of nation states in Europe at the beginning of the 19th century. Democracy spread across European nations and their colonies, over <a href="https://en.wikipedia.org/wiki/The_Third_Wave:_Democratization_in_the_Late_Twentieth_Century" target="_blank" rel="noopener">three waves</a>. The first wave lasted about a century, from 1828 to 1926, halting after the first world war. A second, rapid wave (1945-1962) followed the second world war and decolonisation. The third wave began in 1974 and continues today. It encompassed political transitions and new countries in Europe, Latin America and the Pacific. Each wave was followed by a period of reversals when nations turned to autocratic regimes, junta or fascism. Indeed, some researchers speculate we are heading into <a href="https://www.tandfonline.com/doi/full/10.1080/13510347.2019.1582029" target="_blank" rel="noopener">another period of reversal</a>. <h2>What drives modern democracy?</h2> Scholars traditionally considered factors internal to a country – economic growth, rates of education or the natural environment – as the drivers of these waves. However, the geographic clustering of democracy and the wave-like pattern of expansion suggest the process may also involve a kind of contagion where democracy passes from one nation to another. One explanation for this is that democratic change spreads across borders, so that neighbouring countries end up with similar levels of democracy. Culture provides another explanation. Neighbouring countries tend to share a common cultural heritage, such as related languages or religions. This shapes national institutions, norms and values. In our research, we tested the idea that common cultural ancestry explains variation and change in democracy around the globe. We brought together 220 years of democracy data with information on the cultural relationships between nations. The cultural relationships we examined were based on languages and religious beliefs. For example, Portugal is linguistically closer to Spanish-speaking Argentina and Spain than to England and Germany (which speak Germanic languages). Likewise, Myanmar, a Theravada Buddhist country, is religiously closer to Mongolia (where Vajrayana Buddhism is predominant) than to Muslim Malaysia. <h2>Culture is more important than geography</h2> The democracy data we studied cover 269 modern and historical nations and three widely-used democracy indicators, measuring democratic and autocratic authority in governing institutions (<a href="https://www.systemicpeace.org/polityproject.html" target="_blank" rel="noopener">Polity 5</a>), electoral participation and competition (<a href="https://www.prio.org/data/20" target="_blank" rel="noopener">Vanhanen Index</a>) and individual rights and freedoms (<a href="https://freedomhouse.org/" target="_blank" rel="noopener">Freedom House</a>). Across all three indicators of democracy, we found countries that share linguistic or religious ancestry tend to have more similar democracy scores. These shared cultural ties were better predictors of democracy than geography, especially during the third wave of democratisation. Knowing the democratic status of a country’s linguistic or religious relatives helps predict that country’s future level of democracy five, ten or even 20 years later. These effects were not just due to countries sharing a language (for example, the English-speaking world) or religion (such as the Sunni Islam majority countries). This suggests deeper cultural connections between countries are important. <h2>What this means for the spread of democracy</h2> These effects could be the result of a number of processes. One possibility is that countries directly inherited institutions along the same pathways they inherited cultural features like language. For instance, Aotearoa New Zealand and other Commonwealth countries inherited the British legal system along with the English language. Another possibility is that cultural similarities might make countries more likely to maintain ongoing social connections, including foreign relations, which then aid the spread of institutions. For example, the <a href="https://theconversation.com/how-the-arab-spring-changed-the-middle-east-and-north-africa-forever-161394" target="_blank" rel="noopener">Arab Spring</a> spread among a set of countries with common linguistic and religious heritage. A third possibility is that inherited cultural values could steer countries towards similar institutions. For example, <a href="https://www.nature.com/articles/s41562-019-0769-1" target="_blank" rel="noopener">in previous research</a> we found that tolerance of diversity (cosmopolitan values) promotes a shift to more democratic institutions, but the reverse is not true. Democratic institutions do not shift tolerance. Countries that have inherited cosmopolitan values as part of their shared cultural ancestry may be more likely to shift towards democracy. If this theory is correct, it calls into question the assumption that democratic institutions can endure without sustained efforts to promote the cultural values that support them. The US interventions in Afghanistan and Iraq may be tragic examples of this. Our findings indicate cultural history matters for understanding the spread of democracy around the globe. This does not mean culture is the only factor at play (our analyses still leave a lot of variation unexplained). Neither do our findings speak to a population’s ultimate potential to achieve democratic outcomes, but we see this as within the reach of all populations. This means those wishing to support democracy at home or abroad should take cultural barriers seriously. We cannot assume that institutions that work well in one cultural setting can be easily transplanted to another, very different setting, with different values, norms and traditions. We should pay more attention to culturally closely related countries that have succeeded at merging local norms and values with democratic institutions. This article originally appeared on <a href="https://theconversation.com/democracy-spreads-in-waves-but-shared-cultural-history-might-matter-more-than-geography-189959" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Legal

What is listeria and how does it spread in rockmelons?

Listeriosis is caused by eating food contaminated with a bacterium called Listeria monocytogenes. It’s an <a href="http://www.health.nsw.gov.au/Infectious/factsheets/Pages/listeriosis.aspx">uncommon illness</a> but can be deadly if it causes septicaemia (blood poisoning) or meningitis (inflammation of the membranes around the brain). The ten reported cases are among people aged over 70. The elderly are <a href="http://www.foodstandards.gov.au/consumer/safety/listeria/Pages/default.aspx">particularly susceptible</a> to listeriosis, as are pregnant women and their fetuses, and those with weakened immune systems. Past outbreaks <a href="http://www.health.nsw.gov.au/Infectious/factsheets/Pages/listeriosis.aspx">have been linked with</a> raw milk, soft cheeses, salads, unwashed raw vegetables, cold diced chicken, pre-cut fruit and fruit salad. <h2>How does it spread?</h2> Listeria is found widely in soil, water and vegetation, and can be carried by pets and wild animals. A vegetable or fruit food product can become contaminated anywhere along the chain of food production: planting, harvesting, packing, distribution, preparation and serving. Even on a farm, sources of contamination can include irrigated waters, wash waters and soil. Listeria <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0075969">can survive</a> for up to 84 days in some soils. Heavy rains on a crop can splash listeria from soils onto the surface or skin of the vegetable, especially those that grow low to the ground, such as rockmelons. Listeria contamination can also occur in restaurants and home kitchens, where the bacterium can be found – and spread – in areas where foods are being handled. Listeria monocytogenes is quite a hardy bacterium. It <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913888/">can survive</a> at refrigerated temperatures and has adapted mechanisms to survive acidic environments such as the stomach. <h2>What are the symptoms?</h2> First, it’s important to note that eating foods that contain listeria bacteria <a href="http://www.foodstandards.gov.au/publications/pages/listeriabrochuretext.aspx">won’t necessarily make you sick</a>. Listeria monocytogenes can survive in the body, moving between cells (human phagocytes) for a long time. This is, in part, why there can be a long “incubation period” between ingestion and onset of illness. This <a href="https://www.ncbi.nlm.nih.gov/pubmed/3137471">can be as long as 70 days</a> but is usually around three weeks. Symptoms include fever, muscle aches and gastrointestinal problems such as nausea, vomiting and diarrhoea. In severe cases, symptoms can include collapse and shock, particularly if there is septicaemia. If the infection has spread to the central nervous system, more worrying symptoms will occur, such as headache, stiff neck, confusion, seizures and the person may go into a coma. In such cases, the fatality rate is <a href="https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/listeriosis">as high as 30%</a>. In pregnant women, the bacteria are <a href="https://www.ncbi.nlm.nih.gov/pubmed/22417207">thought to</a> cross the lining of maternal blood vessels and then enter the fetal circulation of the placenta. Infection during pregnancy <a href="http://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Health+topics/Health+conditions+prevention+and+treatment/Infectious+diseases/Listeria+infection/">can lead to</a> miscarriage, stillbirth and newborn infections. Treatment for confirmed infections involves <a href="https://www.ncbi.nlm.nih.gov/pubmed/10852095">antibiotics</a> and supportive measures such as intravenous fluids for dehydration. When infection does occur in pregnancy, the early use of antibiotics can often prevent infection of the fetus or newborn. But even with very prompt treatment, infections can be deadly in high-risk groups. <h2>Why are some groups at higher risk?</h2> Pregnant women are a special group known to be at higher risk for listeriosis. The underlying mechanisms for why pregnant women are susceptible to listeriosis <a href="https://www.ncbi.nlm.nih.gov/pubmed/28398675">are not well understood</a> but it’s thought an altered immune system is involved. People with weakened immune systems, such as those on cancer treatment or medications that suppress the immune system, are more susceptible to developing listeriosis because their bodies are less able to fight off the bug. Newborn babies are also extremely vulnerable as their immune systems have not yet matured, as are the elderly, whose immune systems are declining. <h2>Tracking and finding the source</h2> The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562139/">life cycle of the bacteria</a> can make it difficult to track the source of the outbreak. Listeria is able to contaminate a variety of foods, which may have a long shelf life, and listeriosis has a long incubation period. All ten people in the current outbreak <a href="http://www.abc.net.au/news/rural/2018-02-28/two-dead-national-rockmelon-listeria-outbreak/9494576">consumed rockmelon</a> before they fell sick and state and territory health departments were able to pinpoint the source to a farm in the NSW Riverina district. But it’s not always that easy. The current <a href="http://www.foodsafetynews.com/2018/01/south-africa-hit-by-deadliest-listeriosis-outbreak-in-history/">South African listeriosis outbreak</a> is the worst outbreak in recorded history with <a href="http://ewn.co.za/2018/02/28/listeriosis-outbreaks-difficult-to-investigate-says-nicd">172 deaths recorded to date</a>. The source has not yet been identified. <h2>How can you prevent listeriosis?</h2> Here are some <a href="http://www.health.nsw.gov.au/Infectious/factsheets/Pages/listeriosis.aspx">practical things</a> you can do to prevent the spread of listeria: <ul> <li>thoroughly cook raw food from animal sources, such as beef, lamb, pork and poultry</li> <li>wash raw vegetables and fruit thoroughly before eating</li> <li>use separate cutting boards for raw meat and foods that are ready to eat</li> <li>wash your hands with soapy water before and after preparing food</li> <li>wash knives and cutting boards after handling uncooked foods</li> <li>wash your hands after handling animals.</li> </ul> If you are at greater risk for listeriosis, consider <a href="http://www.health.nsw.gov.au/news/Pages/20180223_01.aspx">avoiding</a>: <ul> <li>pre-cut melons such as rockmelon or watermelon</li> <li>pre-packed cold salads including coleslaw and fresh fruit salad</li> <li>pre-cooked cold chicken, cold delicatessen meats, pâté</li> <li>raw and uncooked smoked seafood (such as smoked salmon)</li> <li>unpasteurised milk or milk products, soft cheeses (such as brie, camembert, ricotta or blue-vein)</li> <li>sprouted seeds</li> <li>raw mushrooms.</li> </ul> The NSW Food Authority is also <a href="http://www.foodauthority.nsw.gov.au/news/newsandmedia/departmental/2018-02-28-listeriosis-outbreak-link-to-rockmelon">advising consumers who are most at risk</a> of listeriosis to avoid eating rockmelon and discard any rockmelon they already have at home. This article originally appeared on <a href="https://theconversation.com/what-is-listeria-and-how-does-it-spread-in-rockmelons-92651" target="_blank" rel="noopener">The Conversation</a>. Image: Getty

Food & Wine

Fresh warnings after spread of mosquito-born disease

Two NSW residents have fallen seriously ill and are currently being hospitalised with a mosquito-borne disease that can result in potentially severe neurological impacts, sparking warnings about avoiding bites. NSW Health on Monday evening said the patients were a man from Corowa and a child from Wentworth, both in the NSW-Victoria border region. The department said the man was in intensive care and the child had been discharged from the ICU but was staying in hospital because of the seriousness of their illness. Authorities are expecting more cases to be confirmed in the future and several people are undergoing further testing. Acting Chief Health Officer Marianne Gale urged NSW residents to take steps to avoid being bitten by mosquitos. "We are working closely with the NSW Department of Primary Industries and other states and territories to determine the extent to which the virus is circulating," Dr Gale said. "Unfortunately, our recent wet weather has led to very high mosquito numbers, so we need the community to be particularly vigilant and take steps to avoid mosquito bites. "We know mosquitoes are most active between dusk and dawn, and we need people planning activities near waterways or where mosquitoes are present to be especially cautious, particularly those in the vicinity of the Murray River and its branches." Australia's acting Chief Medical Officer Dr Sonya Bennett last week declared a national alert over the virus, which is spread through the bite of an infected mosquito. Fortunately, this disease cannot move directly from person to person. The virus is common in a wide swathe of Asia and the Western Pacific, including India, most of China, Indonesia, Papua New Guinea and Japan. Recent cases are the first time it's been identified in NSW in humans or animals, according to NSW Health. Most humans who contract the virus do not experience any symptoms or only experience mild symptoms like headaches or fever. But the worst affected may suffer inflammation of the brain, a sudden onset of vomiting, high fever and chills, severe headaches, sensitivity to light, neck stiffness and nausea. Image: Getty

Body

Fake viral footage is spreading alongside the real horror in Ukraine. Here are 5 ways to spot it

Amid the alarming images of <a href="https://theconversation.com/russia-invades-ukraine-5-essential-reads-from-experts-177815" target="_blank" rel="noopener">Russia’s invasion of Ukraine</a> over the past few days, millions of people have also seen <a href="https://www.politico.com/news/2022/02/24/social-media-platforms-russia-ukraine-disinformation-00011559" target="_blank" rel="noopener">misleading, manipulated or false information</a> about the conflict on social media platforms such as Facebook, Twitter, TikTok and Telegram. <figure class="align-right zoomable"><a href="https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=891&fit=crop&dpr=1 600w, https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=891&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=891&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1119&fit=crop&dpr=1 754w, https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1119&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/448664/original/file-20220226-31488-1blhz2o.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1119&fit=crop&dpr=3 2262w" alt="Screenshot of fake news TikTok video" /></a><figcaption>Old footage, rebadged on TikTok as the latest from Ukraine. TikTok</figcaption></figure> One example is this <a href="https://www.tiktok.com/@notimundo/video/7068170668507974918?_t=8Q8LwdZRa8s&_r=1" target="_blank" rel="noopener">video of military jets posted to TikTok</a>, which is historical footage but captioned as live video of the situation in Ukraine. Visuals, because of their persuasive <a href="https://link.springer.com/article/10.1007/s12525-019-00345-y" target="_blank" rel="noopener">potential</a> and attention-grabbing nature, are an especially potent choice for those seeking to mislead. Where creating, editing or sharing inauthentic visual content isn’t satire or art, it is usually <a href="https://www.tandfonline.com/doi/pdf/10.1080/21670811.2017.1345645?casa_token=t8LANzDiQGUAAAAA:3vZ76fwtwpHt82jeB3mFJXPOpfsks4aRZHhDiCpcNVgJtDFIFcqskhUL796_P609UZm2KVwxeHy8xM4" target="_blank" rel="noopener">politically or economically motivated</a>. Disinformation campaigns aim to distract, confuse, manipulate and sow division, discord, and uncertainty in the community. This is a common strategy for <a href="http://repository.ou.ac.lk/bitstream/handle/94ousl/928/journalism_fake_news_disinformation_print_friendly_0%20(1).pdf?sequence=1" target="_blank" rel="noopener">highly polarised nations</a> where socioeconomic inequalities, disenfranchisement and propaganda are prevalent. How is this fake content created and spread, what’s being done to debunk it, and how can you ensure you don’t fall for it yourself? What are the most common fakery techniques? Using an existing photo or video and claiming it came from a different time or place is one of the most common forms of misinformation in this context. This requires no special software or technical skills – just a willingness to upload an old video of a missile attack or other arresting image, and describe it as new footage. Another low-tech option is to <a href="https://www.grid.news/story/misinformation/2022/02/23/autopsied-bodies-and-false-flags-how-pro-russian-disinformation-spreads-chaos-in-ukraine/" target="_blank" rel="noopener">stage or pose</a> actions or events and present them as reality. This was the case with destroyed vehicles that Russia claimed were bombed by Ukraine. Using a particular lens or vantage point can also change how the scene looks and can be used to deceive. A tight shot of people, for example, can make it hard to gauge how many were in a crowd, compared with an aerial shot. Taking things further still, Photoshop or equivalent software can be used to add or remove people or objects from a scene, or to crop elements out from a photograph. An example of object addition is the below photograph, which purports to show construction machinery outside a kindergarten in eastern Ukraine. The satirical text accompanying the image jokes about the “calibre of the construction machinery” - the author suggesting that reports of damage to buildings from military ordinance are exaggerated or untrue. Close inspection reveals this image was <a href="https://www.reuters.com/article/factcheck-ukraine-alteredmachinery-idUSL1N2UT2W0" target="_blank" rel="noopener">digitally altered</a> to include the machinery. This tweet could be seen as an attempt to downplay the extent of damage resulting from a Russian-backed missile attack, and in a wider context to create confusion and doubt as to veracity of other images emerging from the conflict zone. What’s being done about it? European organisations such as <a href="https://www.bellingcat.com/news/2022/02/23/documenting-and-debunking-dubious-footage-from-ukraines-frontlines/" target="_blank" rel="noopener">Bellingcat</a> have begun compiling lists of dubious social media claims about the Russia-Ukraine conflict and debunking them where necessary. Journalists and fact-checkers are also working to verify content and <a href="https://twitter.com/AricToler/status/1494738571483353092?s=20&t=bndDHkpko9nibN9LjRmaWw" target="_blank" rel="noopener">raise awareness</a> of known fakes. Large, well-resourced news outlets such as the BBC are also <a href="https://www.bbc.com/news/60513452" target="_blank" rel="noopener">calling out misinformation</a>. Social media platforms have added new <a href="https://help.twitter.com/en/rules-and-policies/state-affiliated" target="_blank" rel="noopener">labels</a> to identify state-run media organisations or provide more <a href="https://9to5mac.com/2018/04/03/facebook-newsfeed-update/" target="_blank" rel="noopener">background information</a> about sources or people in your networks who have also shared a particular story. They have also <a href="https://www.politico.com/news/2022/02/24/social-media-platforms-russia-ukraine-disinformation-00011559" target="_blank" rel="noopener">tweaked their algorithms</a> to change what content is amplified and have hired staff to spot and flag misleading content. Platforms are also doing some work behind the scenes to detect and <a href="https://transparency.twitter.com/en/reports/information-operations.html" target="_blank" rel="noopener">publicly share</a> information on state-linked information operations. What can I do about it? You can attempt to <a href="https://www.tandfonline.com/doi/full/10.1080/17512786.2020.1832139" target="_blank" rel="noopener">fact-check images</a> for yourself rather than taking them at face value. An <a href="https://www.aap.com.au/factcheck-resources/how-do-you-fact-check-an-image/" target="_blank" rel="noopener">article</a> we wrote late last year for the Australian Associated Press explains the fact-checking process at each stage: image creation, editing and distribution. Here are five simple steps you can take: 1. Examine the metadata This <a href="https://t.me/nm_dnr/6192" target="_blank" rel="noopener">Telegram post</a> claims Polish-speaking saboteurs attacked a sewage facility in an attempt to place a tank of chlorine for a “<a href="https://theconversation.com/what-are-false-flag-attacks-and-did-russia-stage-any-to-claim-justification-for-invading-ukraine-177879">false flag</a>” attack. But the video’s metadata – the details about how and when the video was created – <a href="https://twitter.com/EliotHiggins/status/1495356701717020681?s=20&t=DSIyWgyKfPu2vKvVQLjnOw">show</a> it was filmed days before the alleged date of the incident. To check metadata for yourself, you can download the file and use software such as Adobe Photoshop or Bridge to examine it. Online <a href="http://metapicz.com/#landing" target="_blank" rel="noopener">metadata viewers</a> also exist that allow you to check by using the image’s web link. One hurdle to this approach is that social media platforms such as Facebook and Twitter often strip the metadata from photos and videos when they are uploaded to their sites. In these cases, you can try requesting the original file or consulting fact-checking websites to see whether they have already verified or debunked the footage in question. 2. Consult a fact-checking resource Organisations such as the <a href="https://www.aap.com.au/factcheck/" target="_blank" rel="noopener">Australian Associated Press</a>, <a href="https://www.rmit.edu.au/about/schools-colleges/media-and-communication/industry/factlab/debunking-misinformation" target="_blank" rel="noopener">RMIT/ABC</a>, <a href="https://factcheck.afp.com/" target="_blank" rel="noopener">Agence France-Presse (AFP)</a> and <a href="https://www.bellingcat.com/news/2022/02/23/documenting-and-debunking-dubious-footage-from-ukraines-frontlines/" target="_blank" rel="noopener">Bellingcat</a> maintain lists of fact-checks their teams have performed. The AFP has already <a href="https://factcheck.afp.com/doc.afp.com.323W3V8" target="_blank" rel="noopener">debunked</a> a video claiming to show an explosion from the current conflict in Ukraine as being from the <a href="https://theconversation.com/what-is-ammonium-nitrate-the-chemical-that-exploded-in-beirut-143979" target="_blank" rel="noopener">2020 port disaster</a> in Beirut. 3. Search more broadly If old content has been recycled and repurposed, you may be able to find the same footage used elsewhere. You can use <a href="https://www.google.com/imghp?hl=EN" target="_blank" rel="noopener">Google Images</a> or <a href="https://tineye.com/" target="_blank" rel="noopener">TinEye</a> to “reverse image search” a picture and see where else it appears online. But be aware that simple edits such as reversing the left-right orientation of an image can fool search engines and make them think the flipped image is new. 4. Look for inconsistencies Does the purported time of day match the direction of light you would expect at that time, for example? Do <a href="https://twitter.com/Forrest_Rogers/status/1496254107660738568?s=20&t=KSr6GYxwMhqW719GhZPvlA" target="_blank" rel="noopener">watches</a> or clocks visible in the image correspond to the alleged timeline claimed? You can also compare other data points, such as politicians’ schedules or verified sightings, <a href="https://earth.google.com/static/9.157.0.0/app_min.html" target="_blank" rel="noopener">Google Earth</a> vision or <a href="https://www.google.com/maps" target="_blank" rel="noopener">Google Maps</a> imagery, to try and triangulate claims and see whether the details are consistent. 5. Ask yourself some simple questions Do you know where, when and why the photo or video was made? Do you know who made it, and whether what you’re looking at is the original version? Using online tools such as <a href="https://www.invid-project.eu/" target="_blank" rel="noopener">InVID</a> or <a href="https://29a.ch/photo-forensics/#forensic-magnifier" target="_blank" rel="noopener">Forensically</a> can potentially help answer some of these questions. Or you might like to refer to this list of <a href="https://drive.google.com/file/d/1kRfo1ToexG8dEiMqurXKqzEeXdyHn7Ic/view" target="_blank" rel="noopener">20 questions</a> you can use to “interrogate” social media footage with the right level of healthy scepticism. Ultimately, if you’re in doubt, don’t share or repeat claims that haven’t been published by a reputable source such as an international news organisation. And consider using some of these <a href="https://www.aap.com.au/factcheck-resources/how-do-you-know-what-information-sources-to-trust/" target="_blank" rel="noopener">principles</a> when deciding which sources to trust. By doing this, you can help limit the influence of misinformation, and help clarify the true situation in Ukraine.<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; text-shadow: none !important;" src="https://counter.theconversation.com/content/177921/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/t-j-thomson-503845" target="_blank" rel="noopener">T.J. Thomson</a>, Senior Lecturer in Visual Communication & Media, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847" target="_blank" rel="noopener">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/daniel-angus-12403" target="_blank" rel="noopener">Daniel Angus</a>, Professor of Digital Communication, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847" target="_blank" rel="noopener">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/paula-dootson-129022" target="_blank" rel="noopener">Paula Dootson</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847" target="_blank" rel="noopener">Queensland University of Technology</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/fake-viral-footage-is-spreading-alongside-the-real-horror-in-ukraine-here-are-5-ways-to-spot-it-177921" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Technology

Why Queensland's top doctor has said the spread of COVID is "necessary"

Image: Getty Queensland's Chief Health Officer, John Gerrard, announced to a press conference on Thursday that the sudden and continued escalation of Omicron case numbers throughout the state is not just inevitable, but that it is "necessary". Queensland had just recorded 369 new Covid cases – the highest number of cases ever recorded in the state – as fears for the spread of the Omicron virus continue to grow apace. During the same mid-morning press conference, Qld Premier Annastacia Palaszczuk addressed the rising numbers, assuring everyone that the surge in numbers was expected and would likely get worse. "I want us to stay safe over Christmas and New Year but we will see an escalation of cases like we're seeing in other states," she said. "But the good news is, at the present time there is only one person in hospital and they have other medical issues, even though they do have COVID.” According to Premier Palaszczuk, the virus “is across Queensland” and residents must now learn to live with it. “This virus is here," she explained. "It is right throughout our community. We are living with this virus. This is the next stage of the pandemic. "Everyone wants to get on with their lives but we are going to see a big impact on those who are unvaccinated." CHO John Gerrard then said the latest strain of the virus (Omicron) is "extremely contagious" and will need to continue spreading in order to reach the "endemic phase". "Not only is the spread of this virus inevitable, it is necessary," he said. "In order for us to go from the pandemic phase to an endemic phase, the virus has to be widespread." "We all have to have immunity, you will all have to develop immunity and there's two ways you can do that: by being vaccinated or getting infected. "Once we've done that, once the virus is spreading, once we all have some degree of immunity, the virus becomes endemic and that is what is going to happen." Mr Gerrard also clarified that mask wearing will not rid the country of the virus but will give everyone better odds of slowing it down. “We're not going to stop it,” he said. "We're trying to slow it down a little bit to enable people to get third doses. We don't expect to stop it."

Caring

Common ingredient found to encourage aggressive cancer spread

New research has found that a fatty acid found in palm oil and dairy products contributes to the aggressive nature of tumours and allows them to spread. The study from Barcelona’s Institute for Research in Biomedicine (IRB) saw researchers expose samples of mouth and skin cancers to a diet rich in palmitic acid - a major component of palm oil - before transplanting the sample tumours into mice. Palm oil is the most widely consumed vegetable oil in the world and can be found in food, beauty products, and detergents, according to the <a rel="noopener" href="https://www.worldwildlife.org/pages/which-everyday-products-contain-palm-oil" target="_blank">World Wildlife Fund</a>. The team found that the tumours had a greater capacity to metastasize - meaning they were more likely to spread to other parts of the body. They also identified that the cancer cells were permanently changed after being exposed to palmitic acid and were able to maintain this improved ability to metastasize months after. When they compared palmitic acid to linoleic acid and oleic acid - found in ingredients such as olive oil and linseed oil - the team discovered that palmitic acid was the only one to have any effect on the tumours. <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CWGewZNIOOx/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CWGewZNIOOx/?utm_source=ig_embed&utm_campaign=loading" target="_blank">A post shared by IRBBarcelona (@irbbarcelona)</a> </div> </blockquote> They also found that the fatty acids didn’t increase the risk of developing cancer in the first place. “There is something very special about palmitic acid that makes it an extremely potent promoter of metastasis,” researcher Dr Salvador Aznar-Benitah told <a rel="noopener" href="https://www.theguardian.com/society/2021/nov/10/fatty-acid-found-in-palm-oil-linked-to-spread-of-cancer" target="_blank">The Guardian</a>. In previous work, the same team showed that there was a correlation between palmitic acid and increased risks of metastasis. “In 2017, we published a study indicating that palmitic acid correlates with an increased risk of metastasis, but we didn’t know the mechanism responsible for this,” Dr Aznar-Benitah <a rel="noopener" href="https://www.irbbarcelona.org/en/news/scientific/palmitic-acid-promotes-cancer-metastasis-and-leaves-more-aggressive-memory-tumour" target="_blank">explained</a>. In their latest study, published in <a rel="noopener" href="https://www.nature.com/articles/s41586-021-04075-0" target="_blank">Nature</a>, they identified that the altered, aggressive cancer cells attracted the attention of the body’s nervous system and led to the construction of a network of neurons around the tumour, which helps the cancer cells to keep growing and spreading. But, the team found that blocking Schwann cells - cells that surround and protect the neurons - could stop the network from developing and prevent metastasis. “This discovery paves the way for research into and the development of therapies that specifically block cancer metastasis, a process that is almost always the cause of death by cancer,” researcher Dr Gloria Pascual said. <blockquote class="twitter-tweet"> Dr. <a href="https://twitter.com/SalvadorAznar3?ref_src=twsrc%5Etfw">@SalvadorAznar3</a>: “In this study, we detail the process and reveal the involvement of a metastatic capacity “memory” factor and we point to a therapeutic approach to reverse it. This is promising”. <a href="https://t.co/DW1zOpaIk8">pic.twitter.com/DW1zOpaIk8</a> — IRB Barcelona (@IRBBarcelona) <a href="https://twitter.com/IRBBarcelona/status/1458464584113827845?ref_src=twsrc%5Etfw">November 10, 2021</a></blockquote> Helen Rippon, the chief executive at Worldwide Cancer Research, praised the work as a “huge breakthrough”. “This discovery is a huge breakthrough in our understanding of how diet and cancer are linked and, perhaps more importantly, how we can use this knowledge to start new cures for cancer,” she <a rel="noopener" href="https://7news.com.au/lifestyle/health-wellbeing/acid-found-in-palm-oil-encourages-cancer-spread-new-research-finds-c-4543186" target="_blank">said</a>. Ms Rippon said about 90 percent of cancer deaths across the world can be attributed to metastasis. “Learning more about what makes cancer spread and - importantly - how to stop it is the way forward to reduce those numbers.” Image: Getty Images / @worldwidecancerresearch (Instagram)

Body

"Like India": Epidemiologists warn about Delta outbreak

Australian infectious disease experts are warning that the country "could end up with a situation like India" if the Delta variant of COVID-19 is allowed to run throughout the community. This comes after NSW Health Minister Brad Hazzard suggested that the state might never control its current outbreak and will have to live with the virus "for good". Mr Hazzard said if people don’t do the right thing over the coming days, “then at some point we’re going to move to a stage where we’re going to have to accept that the virus has a life which will continue in the community”. Raina Macintyre from the Kirby Institute said that letting the virus continue would be "really risky". “I think for Australia, for NSW, that’s a different proposition to countries that have high vaccination rates and high levels of disease. We’ve got virtually no immunity in the community because very few people have been fully vaccinated, and very few people have been infected,” she said to ABC Breakfast. “So we are absolutely susceptible. If we let it spread in Sydney, it could impact the whole country and we could end up with a situation like we saw in India in March and April. “We can’t afford to relax until we’ve got the vaccination rates high.” Ms Macintyre said there would be at least a three-month wait until vaccine supplies in Australia became “adequate”. “It would be really risky to throw it all away without waiting that three months and doing everything that we can to crush this outbreak and to prevent further leaks from hotel quarantine and the international borders by mitigating airborne transmission more comprehensively than we have done,” she said.

News

Woman placed false QR check-in codes to spread anti-vax message

A Queensland woman has been charged after reportedly entering a country bar and displaying signs with fake QR codes that directed patrons to anti-vaccination sites. Customers were left confused when they tried to register their attendance at the Wondai drinking hole in May and instead found themselves being warned about the dangers of vaccination programs. <blockquote class="twitter-tweet"> So a woman in QLD was charged with putting fake QR code’s in a pub which directed patrons to an anti-vaccination website… she was charged not only for this but for also possessing dangerous drugs and drug utensils… <a href="https://twitter.com/hashtag/COVIDIOT?src=hash&ref_src=twsrc%5Etfw">#COVIDIOT</a> <a href="https://t.co/WiaSC9mvPC">pic.twitter.com/WiaSC9mvPC</a> — Mr Mister Jan (@Disco_box) <a href="https://twitter.com/Disco_box/status/1409691423545315332?ref_src=twsrc%5Etfw">June 29, 2021</a></blockquote> "It will be alleged she placed a number of false QR check-in codes around the premises," police told AAP. The woman, 43, has been charged with common nuisance, possessing dangerous drugs and possessing drug utensils. <img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7842090/qr-code-3.jpg" alt="" data-udi="umb://media/40d074ce7ddd4d4fad40797e1116344c" /> These alleged offences happened on May 16, in the rural town of Wondai in the South Burnett region. The woman is due to face the Murgon Magistrates Court on Tuesday. Images: Shutterstock

Legal

Alarming new way the Vic outbreak is spreading

Victorian authorities say people are becoming infected with COVID after just "brushing past" strangers with the virus. Testing Commander Jeroen Weimar said at least four of the state's 54 locally transmitted cases have come from "fleeting" contact between Victorians, “What we’re seeing now is people are brushing past each other in a small shop, they are going to a display home, they are looking at photos in a Telstra shop,” he said. “This is relatively speaking, relatively fleeting. They do not know each other’s names, and that is very different from what we have been before. “This is stranger to stranger transmission.” He said the ease with which the virus is spreading may be a feature of the Indian variant. “We are used with previous variants, we are more used to transmission roccurring in the home, in the workplace, where people know each other already, not all of those big social settings,” he said. “These are quite different.” “We have seen transmission in these places with very fleeting contact. We have transmission in places like the Telstra store in South Melbourne, JMD Grocers, the display home we talked about a few days ago, I’d add Craigieburn Central shopping centre. “They are all examples of transmission with very limited contact. With previous variants, we are more used to transmission occurring in the home, in the workplace, where people know each other already, not at all of those big social settings. These are quite different.” If anyone has been to any of the following sites in the past two weeks, they should come forward and get tested: • Craigieburn Central • Bay Street shops in Port Melbourne • Clarendon Street in the South Melbourne • Pacific Epping, also known as the Epping Plaza • The Epping North shopping centre • Broadway Reservoir

News

Pauline Hanson called out for spreading "dangerous disinformation"

Pauline Hanson has been slammed for spreading "dangerous disinformation" after revealing she will not be receiving the COVID-19 jab and questioning Australia's official death toll. Prime Minister Scott Morrison was part of the first group to be immunised in Australia, and has been followed by a range of public officials vaccinated publicly to boost confidence in the jab. But the One Nation senator said she will not get immunised against COVID-19, revealing she had never received a flu jab and had no plans to do so. “It’s my choice whether I want to have it. Don’t you be concerned; if you have your vaccine, you’re protected, you’re fine,” she told Sky News on Tuesday. Labor health spokesman Mark Butler accused Hanson of undermining confidence in the vaccine. “Just like Craig Kelly before her, Pauline Hanson is undermining the crucial advertising campaign for the vaccine rollout. There is no place for this dangerous disinformation,” he said. “Scott Morrison must stand up against Pauline Hanson’s dangerous and wrong health advice.” Australian Medical Association vice-president Chris Moy said given Ms Hanson’s following, her comments were “not leadership, they’re irresponsible”. “I think leadership which fails us by supporting conspiracy theories is not leadership,” he told NCA NewsWire. “The vaccines have been fully tested for safety and effectiveness by the Therapeutic Goods Administration. Australia has even had the extra benefit of being able to observe what’s happened overseas.” But Dr Moy also rejected Ms Hanson’s claim authorities had inflated the official death toll by listing people who died “with COVID, not from it”. “The recording of COVID-19 is no different to any other disease. A doctor would only list it as the underlying cause of death, or contributing cause, if they genuinely believed that,” he said. Ms Hanson had attempted to throw doubt on official numbers, saying anyone who died while COVID-positive was considered to have died from the disease. “If a person died in a car accident and they tested positive for COVID, that was a COVID death. That is wrong, that is deceiving the people,” she claimed.

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Fake viral footage is spreading alongside the real horror in Ukraine. Here are 5 ways to spot it

Why Queensland's top doctor has said the spread of COVID is "necessary"

Common ingredient found to encourage aggressive cancer spread

"Like India": Epidemiologists warn about Delta outbreak

Woman placed false QR check-in codes to spread anti-vax message

Alarming new way the Vic outbreak is spreading

Pauline Hanson called out for spreading "dangerous disinformation"

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