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What are the most common symptoms of menopause? And which can hormone therapy treat?

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers. Adding to the uncertainty, a recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">series in the Lancet</a> medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate. So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says. <h2>Remind me, what exactly is menopause?</h2> Menopause, simply put, is complete loss of female fertility. Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause). Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months. Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder). <h2>What are the most common symptoms of menopause?</h2> <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">Our study</a> of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are: <ul> <li>hot flushes and night sweats (known as vasomotor symptoms)</li> <li>disturbed sleep</li> <li>musculoskeletal pain</li> <li>decreased sexual function or desire</li> <li>vaginal dryness and irritation</li> <li>mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.</li> </ul> However, none of these symptoms are menopause-specific, meaning they could have other causes. In <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">our study of Australian women</a>, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats. But the severity of these symptoms <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">varies greatly</a>. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55. So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are <a href="https://journals.lww.com/menopausejournal/fulltext/2022/05000/prevalence,_severity,_and_associated_factors_in.9.aspx">similarly affected</a>. Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span. The <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">most robust guidelines</a> do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of <a href="https://www.cell.com/cell/abstract/S0092-8674(23)00905-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867423009054%3Fshowall%3Dtrue">menopausal hormonal changes</a>. The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">Some studies</a> suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">have not been shown to change</a>. <h2>Who might benefit from hormone therapy?</h2> The Lancet papers <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">suggest</a> menopause hormone therapy <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02799-X/fulltext">alleviates</a> hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats). In contrast, the highest quality <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">clinical guidelines</a> consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy. Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency). However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”. Despite musculoskeletal pain being the most common menopausal symptom in <a href="https://journals.lww.com/menopausejournal/abstract/2016/07000/prevalence_and_severity_of_vasomotor_symptoms_and.6.aspx">some populations</a>, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied. Some guidelines, such as an <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Australian endorsed guideline</a>, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease. <h2>What are the risks?</h2> The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot. Oestrogen-only menopause hormone therapy is <a href="https://www.nice.org.uk/guidance/ng23">consistently considered</a> to cause little or no change in breast cancer risk. Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, <a href="https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Women%20Health/CPG_Management_of_Menopause_2022_e-version-1.pdf">has been associated with a small increase</a> in the risk of breast cancer, although any <a href="https://www.bmj.com/content/bmj/371/bmj.m3873.full.pdf">risk appears to vary</a> according to the type of therapy used, the dose and duration of use. Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels <a href="https://www.bmj.com/content/bmj/364/bmj.k4810.full.pdf">prescribed at standard doses</a> <h2>What if I don’t want hormone therapy?</h2> If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats. In Australia, most of these options are “off-label”, although the new medication <a href="https://australianprescriber.tg.org.au/articles/management-of-menopause.html">fezolinetant</a> has just been <a href="https://www.tga.gov.au/resources/artg/401401">approved</a> in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat). Unfortunately, most over-the-counter treatments promoted for menopause are either <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">ineffective or unproven</a>. However, cognitive behaviour therapy and hypnosis <a href="https://journals.lww.com/menopausejournal/abstract/2023/06000/the_2023_nonhormone_therapy_position_statement_of.4.aspx">may provide symptom relief</a>. The Australasian Menopause Society has useful <a href="https://www.menopause.org.au/health-info/fact-sheets">menopause fact sheets</a> and a <a href="https://www.menopause.org.au/health-info/find-an-ams-doctor">find-a-doctor</a> page. The <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Practitioner Toolkit for Managing Menopause</a> is also freely available.<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/225174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <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/what-are-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">original article</a>.

Body

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

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

Body

What is a relationship ‘boundary’? And how do I have the boundary conversation with my partner?

<a href="https://theconversation.com/profiles/raquel-peel-368041">Raquel Peel</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Text messages showing actor Jonah Hill asking his ex-girlfriend Sarah Brady to consider a dot point list of relationship “boundaries” have sparked an important conversation. <blockquote class="twitter-tweet"> Jonah Hill’s ex-girlfriend Sarah Brady accuses him of emotional abuse. 🔗: <a href="https://t.co/LwSnkpnehT">https://t.co/LwSnkpnehT</a> <a href="https://t.co/3B6I86uwNV">pic.twitter.com/3B6I86uwNV</a> — Pop Crave (@PopCrave) <a href="https://twitter.com/PopCrave/status/1677755077249859586?ref_src=twsrc%5Etfw">July 8, 2023</a></blockquote> Two different interpretations of these texts are dominating the discussion. Some have understood Hill’s dot points as a reasonable set of relationship expectations or “preferences” for a partner. Others see Hill’s list of relationship deal-breakers as a controlling behaviour. So what is a relationship “boundary” and how do you have this conversation with your partner? <h2>What are relationship boundaries?</h2> Boundaries are personal and influenced by one’s values. They can be emotional, physical, sexual, spiritual and cultural. The purpose of creating, understanding and respecting boundaries is to ensure one’s mental health and well-being are protected. Used well, they can keep relationships healthy and safe. Setting boundaries can also reinforce values and priorities important to you. <h2>Some ‘boundaries’ are controlling and go too far</h2> That said, relationship boundaries can become unsafe for the people involved. Some cross the line into coercive control. For instance, one might be able to justify to themselves they need to know where their partner is at all times, monitor their communications and keep tabs on their partner’s friendships because they just want to keep their partner safe. But these are not boundaries; this is coercive control. If your partner is describing these as their relationship boundaries, you should feel comfortable to say you are not OK with it. You should also feel comfortable explaining what boundaries you need to set for yourself and your relationship to feel safe. In fact, <a href="https://www.tandfonline.com/doi/abs/10.1080/01639625.2017.1304801">research</a> has found that even cyberstalking offenders might struggle to acknowledge how their behaviour can be perceived as intrusive by their partner. They may also have trouble understanding how it contributed to their break-up. My research on how people can sabotage their own relationships revealed a <a href="https://link.springer.com/article/10.1186/s40359-021-00644-0#Tab1">lack of relationship skills</a> is often a key factor in relationship issues. The same <a href="https://www.cambridge.org/core/journals/journal-of-relationships-research/article/abs/defining-romantic-selfsabotage-a-thematic-analysis-of-interviews-with-practising-psychologists/35531B41927851905281C7D815FE4199">research</a> highlighted how people who fear their relationship is at risk can end up indulging in controlling behaviours such as partner monitoring, tracking how a partner spends their money and emotional manipulation. In other words, people can sometimes employ unhealthy behaviours with the intention of keeping their partner but end up pushing them away. <h2>Understanding partner and relationship expectations</h2> We might have a vision in mind of an “<a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-3514.91.4.662">ideal partner</a>”. But it’s highly improbable one person can ever meet such high standards. Rigid partner and relationship standards, just like unreasonable boundaries, can cause distress, hopelessness and resentment. So healthy romantic relationships need clear communication and negotiation. Sometimes, that involves being flexible and open to hearing what the other person has to say about your proposed boundaries. Relationship boundaries are a life skill that needs constant learning, practice and improvement. <h2>Having a conversation about healthy relationship boundaries</h2> Some mistakenly believe having any relationship boundaries at all is unreasonable or a form of abuse. That’s not the case. In my <a href="https://www.tandfonline.com/doi/full/10.1080/15332691.2020.1795039">research</a> on relationship sabotage, many people spoke about how being able to clearly communicate and set relationship expectations has helped them maintain their relationships over the long term and dispel <a href="https://scholarworks.uni.edu/facpub/1397/">unrealistic</a> standards. Communicating expectations can also help people deal with common relationship fears, such as getting hurt, being rejected and feeling disrespected. But for an important conversation about boundaries to take place, you first need the environment for an open, honest and trusting discussion. Partners should feel they can talk freely and without fear about what they are comfortable with in a relationship. And, be able to discuss how they feel about a boundary their partner has proposed. <h2>Clarify and discuss</h2> If you’re having the boundary conversation with your partner, clarify what you mean by your boundary request and how it might work in practice. Examples can help. Understanding the nuances can help your partner decide if your boundary request is reasonable or unreasonable for them. Second, negotiate which boundaries are hard and which are soft. This will involve flexibility and care, so you’re not undermining your or your partner’s, freedom, mental health and wellbeing. A hard boundary is non-negotiable and can determine the fate of the relationship. A soft boundary can be modified, as long as all parties agree. What constitutes a healthy boundary is different for each individual and each relationship. Regardless, it is a conversation best had in person, not by text message (which can easily be taken out of context and misunderstood). If you really must have the discussion over text, be specific and clarify. Before setting boundaries, seek insight into what you want for yourself and your relationship and communicate with your partner openly and honestly. If you’re fearful about how they’ll react to the discussion, that’s an issue. An open and honest approach can foster a productive collaboration that can strengthen relationship commitment.<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/209856/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/raquel-peel-368041">Raquel Peel</a>, Adjunct Senior Lecturer, University of Southern Queensland and Senior Lecturer, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT 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/what-is-a-relationship-boundary-and-how-do-i-have-the-boundary-conversation-with-my-partner-209856">original article</a>.

Relationships

Essential money conversations retirees should have with family

Discussions about funding retirement, aged care and inheritances may be uncomfortable. However, not having them risks your wishes going unmet and family conflicts where details aren’t clear. Hence having discussions about money while you are able to is one of the best (and cheapest!) investments you can make – for both you and your family. Precisely what those discussions entail will depend on your circumstances – and theirs. Yet many points apply almost universally: What matters to you Even the best laid plans mean nothing if those responsible for enacting them don’t know what they are or understand your reasoning behind them. Your will provides a legal overview of who gets what upon your death, while nominated beneficiaries determine how assets are divided from superannuation and some other structures. A separate letter of wishes can informally share your wishes, covering more than just legalities. Sharing this before your death allows family to clarify your wishes and ask questions. Go through: <ul> <li>How your money should be managed now and longer term (e.g., you may want money set aside for grandchildren’s education, or have instructions for a dependent’s ongoing care).</li> <li>Funeral arrangements; cremation or burial; where you will be laid to rest.</li> <li>Plans for anyone other than direct family, charities etc.</li> <li>Any non-negotiables among your wishes.</li> </ul> Partner protections Ensure your partner knows how they will be looked after if they outlive you. Similarly, your kids should know what if any support they will need to provide – especially important for blended families. Where beneficiaries have divorced/separated, will you exclude their ex from your estate? Are your records updated to reflect this? Ensure everyone knows the difference between joint tenants and tenants in common for property owners – only one automatically leaves your share of the property to your co-owner. Health matters How do you want to be looked after in your final years? Don’t assume your loved ones already know everything. Communicate your wishes, small and large – medications, dietary requirements, retirement living, palliative care, resuscitation. Discuss whether power of attorney and enduring guardianship are needed should you be unable to make decisions over your health and finances (e.g., due to dementia or stroke), and who will assume those responsibilities. Family legacy Consider the legacy you want to leave and whether this aligns with your family’s expectations. Is dividing assets equally among your children really fair if one is well-off while another struggles or has complex needs? Do your plans on inheritance unwittingly create headaches for the recipients – such as leaving property to someone who cannot afford to maintain it, or tax liabilities that eat into any financial gain? Discuss non-financial legacy too: do your offspring know about your (and hence their) heritage? Are there special family mementos/stories to pass on? This knowledge may be lost if you don’t share it now. Place to call home Given their financial, logistical, and emotional implications, living arrangements are crucial to discuss before things need to change (and change can be imposed suddenly, such as by a health emergency). Consider: <ul> <li>Where would you want to go if you need high-level care?</li> <li>Is your current home suitable in your advanced years? How would any required modifications be paid for?</li> <li>Would you move nearer your kids? Downsize, upsize or sea/treechange?</li> <li>If you move, would you need to sell your current home? Could it be retained somehow?</li> <li>Do you want/expect kids to care for you? Are they capable of doing so? </li> <li>Could/would you live with one of your children? If so – such as paying to build a granny flat on their property – how does this affect your will? Would they be forced to sell so their siblings receive their inheritance?</li> </ul> Team united Having everyone on the same page helps things to run smoothly – especially during difficult times such as a death or serious illness in the family. Stay aligned by: <ul> <li>Introducing adult children to your financial adviser, lawyer, and accountant.</li> <li>Ensuring everyone knows where to find your will and who is your executor.</li> <li>Disclosing what is and is not up to date.</li> <li>Providing contingency access to passwords, important documents, keys etc.</li> <li>Sharing relevant policy details (e.g., life insurance).</li> </ul> These discussions may be sensitive and difficult to initiate, but are crucial to ensure your wishes are known and enacted. Plus, they may encourage your loved ones to think about their own wishes – and give you all peace of mind for the future! Helen Baker is a licensed Australian financial adviser and author of the new book, On Your Own Two Feet: The Essential Guide to Financial Independence for all Women (Ventura Press, $32.99). Helen is among the 1% of financial planners who hold a master’s degree in the field. Proceeds from book sales are donated to charities supporting disadvantaged women and children. Find out more at <a href="http://www.onyourowntwofeet.com.au">www.onyourowntwofeet.com.au</a> Image credits: Getty Images

Retirement Income

Fun ways to boost memory in seniors

Memory issues can seriously deteriorate the quality of life for seniors. To reverse the typically progressive process of memory loss, many solutions have been put forward. These include creative leisure activities aimed to work on the senior’s brain while providing relaxation. To work on a senior’s memory, it’s optimal to have them work on a project, focusing and seeing the work being done. There are plenty of games and activities available to help memory. Paint by Numbers Paint by Numbers is a creative art form that involves painting a pre-drawn sketch on a linen canvas with reference numbers. It helps stimulate the intellect and senses. They’re available in colour books as well, you can find them at your local Kmart and select supermarkets. Diamond painting Diamond painting is a manual activity where the senior creates beautiful pictures using rhinestones to stick onto a self-adhesive canvas. It calls for concentration, reflection, memorisation, and patience from the practitioner, which is beneficial for working on memory. Scratch painting Scratch painting is a fun activity that involves scratching a picture with a coin or stylus, like a lottery scratch-off. It requires interest and concentration from the individual, who will enjoy the final picture and benefit their memory. Music therapy Music therapy is used to treat and alleviate disorders, such as relational, behavioural, and communication difficulties. It also has benefits for seniors with memory problems, as it allows them to mobilise concentration, emotions, and memory in a playful way. Image credit: Shutterstock

Mind

Aussie patient given new drug worth $5 million per dose

A potential cure for a rare genetic disease is being trialled, and it comes with a hefty price tag. Sydney’s Royal Prince Alfred Hospital is part of a groundbreaking new trial aimed at potentially curing haemophilia B – a hereditary bleeding disorder. Patients with haemophilia B have a mutation on the F9 gene, which causes excessive bleeding and damage to joins as they lack the protein that helps blood to clot. A mere 40 patients worldwide will be infused with the gene therapy, with each dose the equivalent of $5 million, or over $1,000 a drop. A safe virus carrying the F9 gene is infused into the body, sending it to the liver cells, where doctors hope the protein is made for the rest of the patient’s life. Professor John Rasko, Head of Cell and Molecular Therapies at RPA, said the process is a “thrilling moment in the history of gene therapy” "We are pushing the boundaries of medical technology hoping to bring cures to individuals," he said. "It's a massive international effort that takes time and money and ultimately the manufacturing alone costs millions and millions of dollars." Haemophilia B patients currently require three injections a week. This revolutionary treatment could mean just one infusion in a lifetime. The infusion on May 22 was the culmination of more than two decades of work. Image credit: Shutterstock

Caring

Conversation starters for solo travellers

We all know of stranger danger but when you’re a solo traveller the ability to talk to strangers (safely, though) is one of the most important skills to have under your belt. Chatting with strangers will not only add to your travel experience but it might even lead to life-long friendships. Here are a few conversation starters to keep up your sleeve. A note on safety: Don’t be afraid to tell people you are a solo traveller. People are often more keen to chat and talk to those travelling alone, however it’s important to exercise caution. Look for clues to see if the person can be trusted and stay in public places. When eating out, sit at a communal table or at the bar. Chat to people sitting next to you. If they are a local, you can ask them about the restaurant and any local recommendations. If they are a fellow traveller, ask them where they’re from and how their trip is going. Ask someone to take your photo. Be mindful of the fact there are some scammers targeting tourist destinations to steal cameras so use your judgement but this is an easy and natural way to strike up a conversation. A family or a group of tourist can usually be trusted and counted on to take your Start with the sight you’re getting photographed. Comment on a tourist destination. If you’re wandering around a museum/gallery/popular site, keep a look out for other solo travellers. Keep it simple and introduce yourself, following up questions about how their enjoying where you both are. Be aware that not everyone wants to chat but most solo travellers have an open mind and want to meet new people. Image credits: Getty Images

Travel Tips

Don’t let financial shame be your ruin: open conversations can help ease the burden of personal debt

Nearly <a href="https://www.ipsos.com/en-nz/19th-ipsos-new-zealand-issues-monitor">two-thirds of New Zealanders</a> are worried about the cost of living, and a quarter are worried about <a href="https://www.canstar.co.nz/wp-content/uploads/2023/03/Consumer-Pulse-Report-NZ-2023-Final-4.pdf">putting food on the table</a>. But the <a href="https://visionwest.org.nz/food-hardship-part-one/">shame</a> that can come with financial stress is preventing some people from seeking help. According to a recent survey, a third of New Zealanders were not completely truthful with their family or partners about the state of their finances, and 12% <a href="https://www.stuff.co.nz/business/money/129477493/financial-infidelity-research-finds-kiwis-hiding-debts-from-their-partners">actively hid their debt</a>. This shame and worry about money can spill over into <a href="https://www.nzherald.co.nz/bay-of-plenty-times/news/concerns-buy-now-pay-later-schemes-could-fuel-addiction-as-kiwis-spend-17b-last-year/VOV3VIDIG2MZBGJEGPMLGWDMJI/">addiction</a>, <a href="https://www.newsroom.co.nz/i-had-serious-concussion-bad-credit-and-15000-debt-abuse-survivor">violence</a> and <a href="https://corporate.dukehealth.org/news/financial-strains-significantly-raise-risk-suicide-attempts">suicide</a>. Considering the effect of financial stress on our wellbeing, it is clear we need to overcome the financial stigma that prevents us from getting help. We also <a href="https://www.apa.org/topics/money/family-financial-strain">owe it to our kids</a> to break the taboo around money by communicating our worries and educating them on how to manage finances better. <h2>The burden of growing debt</h2> <a href="https://www.stuff.co.nz/business/money/300817697/mortgage-pain-homeowners-facing-repayment-hikes-of-up-to-900-a-fortnight">Ballooning mortgage repayments</a> are compounding the financial distress of many New Zealanders. At the beginning of 2023, an estimated 11.9% of home owners were behind on loan payments, with more than <a href="https://www.rnz.co.nz/news/business/485045/data-shows-430-000-new-zealanders-behind-in-credit-repayments-in-january">18,400 mortgagees in arrears</a>. <div data-id="17"> </div> Given the <a href="https://www.treasury.govt.nz/publications/an/an-21-01-html">majority of household wealth</a> in New Zealand is in property, our financial vulnerability is closely linked to the ebbs and flows of the <a href="https://content.knightfrank.com/research/84/documents/en/global-house-price-index-q2-2021-8422.pdf">second most overinflated property market</a> in the world. There are also cultural reasons for growing financial distress. Many households have taken on significant debt to “<a href="https://www.stuff.co.nz/business/7616361/Keeping-up-with-the-Joneses">keep up with the Joneses</a>” and to pursue the quintessential <a href="https://www.interest.co.nz/property/99890/westpac-commissioned-survey-suggests-many-new-zealanders-still-pine-quarter-acre">quarter-acre dream</a>. Social comparison and peer pressure act as powerful levers contributing to problem debt and over-indebtedness. The average household debt in New Zealand is more than <a href="https://tradingeconomics.com/new-zealand/households-debt-to-income">170% of gross household income</a>. That is higher than the United Kingdom (133%), Australia (113%) or Ireland (96%). <h2>The rise of problem debt</h2> And we are digging a deeper hole. Over the past year, <a href="https://www.rnz.co.nz/news/business/485045/data-shows-430-000-new-zealanders-behind-in-credit-repayments-in-january">demand for credit cards increased by 21.7%</a>. The use of personal debt such as personal loans and deferred payment schemes <a href="https://www.nzherald.co.nz/business/demand-for-personal-credit-rises-arrears-also-up-as-cost-of-living-bites/YCEM74CII5FQBPJXO3UOG4Y3GY/">is also climbing</a>. There is a real risk this debt could become problem debt. Problem debt can have severe and wide-reaching consequences, including <a href="https://theconversation.com/over-300-000-new-zealanders-owe-more-than-they-own-is-this-a-problem-173497">housing insecurity</a>, <a href="http://www.socialinclusion.ie/publications/documents/2011_03_07_FinancialExclusionPublication.pdf">financial exclusion</a> (the inability to access debt at affordable interest rates), <a href="https://www.tandfonline.com/doi/full/10.1080/07409710.2012.652016?journalCode=gfof20">poor food choices</a> and a plethora of <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-489">health problems</a>. Yet, the hidden <a href="https://spssi.onlinelibrary.wiley.com/doi/10.1111/sipr.12074">psychological</a> and <a href="https://link.springer.com/article/10.1007/s11205-008-9286-8">social cost of financial distress</a>remains often unspoken, overlooked and underestimated. Even before the pandemic, <a href="https://www.scoop.co.nz/stories/BU1909/S00616/research-shows-financial-stress-impacts-mental-wellbeing.htm">69% of New Zealanders were worried</a>about money. The share of people worrying about their financial situation was higher for women (74%), and particularly women aged 18-34 (82%). It is no coincidence that the latter are particularly at risk of problem debt through so-called <a href="https://acfr.aut.ac.nz/__data/assets/pdf_file/0008/691577/Gilbert-and-Scott-Study-2-Draft-v10Sept2022.pdf">“buy now, pay later” schemes</a>. The stigma of financial distress extends beyond the vulnerable and the marginalised in our society. A growing number of <a href="https://www.rnz.co.nz/news/political/467417/middle-income-families-hoping-for-help-in-budget-as-rising-costs-sting">middle-class New Zealanders </a> are quietly suffering financial distress, isolated by financial stigma and the taboos around discussing money. When pressed, one in two New Zealanders would rather <a href="https://www.scoop.co.nz/stories/BU2203/S00384/research-shows-wed-rather-talk-about-politics-than-our-finances.htm">talk politics over money</a>. <h2>Time to talk about money</h2> Navigating financial distress and <a href="https://digitalcommons.law.seattleu.edu/cgi/viewcontent.cgi?article=2526&context=sulr">stigma</a> can feel overwhelming. Where money is a taboo subject, it may feel safer to withdraw, maintain false appearances, be secretive or shun social support. This tendency to avoid open discussions and suffer in silence can lead to <a href="https://loneliness.org.nz/lonely/at-home/financially-struggling/">feelings of isolation</a> and contribute to <a href="https://theconversation.com/how-financial-stress-can-affect-your-mental-health-and-5-things-that-can-help-201557">poor mental health</a>, such as depression, anxiety and emotional distress. Sadly, the trauma of living in financial distress can also <a href="http://irep.ntu.ac.uk/id/eprint/39442/1/1307565_Wakefield.pdf">break up families</a>. Losing the symbols of hard-gained success and facing the prospect of a reduced lifestyle can be tough. It often triggers feelings of personal failure and self doubt that deter us from taking proactive steps to talk openly and seek help. But what can families do to alleviate some of this distress? <h2>Seek help</h2> First, understand that <a href="https://www.ft.com/content/86767aac-98e0-4dae-8c5a-d3301b030703">you are not alone</a>. Over 300,000 New Zealanders <a href="https://theconversation.com/over-300-000-new-zealanders-owe-more-than-they-own-is-this-a-problem-173497">owe more than they earn</a>. Second, seek help. There are many services that help people work through their financial situation and formulate a plan. In the case of excessive debts, debt consolidation or <a href="https://goodshepherd.org.nz/debtsolve/">debt solution loans</a> may help reduce the overall burden and simplify your financial situation. For those struggling with increasing interest on their mortgages, reaching out to your bank early is critical. During the 2008 recession, banks in New Zealand <a href="https://www.beehive.govt.nz/release/banks-exchange-letters-crown-support-distressed-mortgage-borrowers">worked with customers</a> to avoid defaulting on mortgages, including reducing servicing costs, capitalising interest and moving households to interest-only loans. It is essential to understand that the <a href="https://www.stuff.co.nz/life-style/homed/real-estate/130677426/are-we-on-the-brink-of-a-wave-of-mortgagee-sales">banks do not want mortgagees to fail</a>, and that options exist. To help future generations avoid debt traps, we need open communication about money – also known as “<a href="https://link.springer.com/article/10.1007/s10834-020-09736-2">financial socialisation</a>”. This includes developing values, sharing knowledge and promoting behaviours that help build <a href="https://files.eric.ed.gov/fulltext/EJ1241099.pdf">financial viability and contribute to financial wellbeing</a>. The lessons about handling money from family and friends are crucial for <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.02162/full">improving our children’s financial capability</a>, helping them be <a href="https://www.fsc.org.nz/it-starts-with-action-theme/growing-financially-resilient-kids">more financially resilient</a> and better able to survive the stresses we are experiencing now – and those <a href="https://www.stuff.co.nz/business/money/300836616/heres-how-much-household-costs-are-expected-to-increase">yet to come</a>. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/dont-let-financial-shame-be-your-ruin-open-conversations-can-help-ease-the-burden-of-personal-debt-202496" target="_blank" rel="noopener">The Conversation</a>.

Retirement Income

Ed Sheeran shoots for the stars with daughter’s name reveal

When Ed Sheeran and his wife Cherry Seaborn announced the birth of their second child in May 2022, they kept things simple. In a post to social media, Sheeran shared a picture of socks on a crochet blanket, with a caption reading “Want to let you all know we’ve had another beautiful baby girl. We are both so in love with her, and over the moon to be a family of 4”. The couple shared no ‘face reveal’ - opting to keep their children far removed from the public eye - and did not share their youngest daughter’s name with Sheeran’s 42.8m followers. But in a March interview with Rolling Stone, the 32-year-old singer-songwriter took everyone by surprise, opening up about his family life, and revealing the out-of-this-world moniker bestowed upon their youngest, Jupiter. “Me and Cherry were talking earlier about how it’s so lovely,” he told the publication, opening up about the little things in life that he and his family cherish the most. “We had an entire day. We did nothing but this. It’s so nice and wholesome having family on tour. “On the last tour, I’d party till 7 am, sleep till 4 pm, get up, and do the gig. But I was like, 26. It’s very different.” Jupiter’s birth, and establishing their new “lovely” life, were no easy feats for the couple. In February 2022 - a month that was already proving determined to knock Sheeran down - when Cherry was six months along in her pregnancy, she was diagnosed with a tumour. Surgery was required, but couldn’t be performed until she had given birth. As Sheeran wrote in a post outlining plans for his album Subtract, “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. My best friend Jamal, a brother to me, died suddenly, and I found myself standing in court defending my integrity and career as a songwriter. “I was spiralling through fear, depression and anxiety. I felt like I was drowning, head below the surface, looking up but not being able to break through for air.” “There’s nothing you can do about it,” he confessed to Rolling Stone. “You feel so powerless.” Over the course of his interview, Sheeran toyed with a chain bracelet - one gifted to him by his wife, with their daughters’ name engraved. “It felt symbolic,” he said of the swap to the silver from the rubber bands that had previously adorned his wrist, “to take off those bracelets and put on one for my family.” After the slew of tragedies to hit Sheeran in such a short span of time, it was Cherry who realised that he was in need of professional help, leading to the singer seeking out a therapist. “No one really talks about their feelings where I come from,” he said. “People think it’s weird getting a therapist in England … I think it’s very helpful to be able to speak with someone and just vent and not feel guilty about venting. Obviously, like, I’ve lived a very privileged life. So my friends would always look at me like, ‘Oh, it’s not that bad.’ ” “The help isn’t a button that is pressed, where you’re automatically okay,” he added. “It is something that will always be there and just has to be managed.” And as Sheeran himself <a href="https://www.oversixty.com.au/health/caring/writing-songs-is-my-therapy-ed-sheeran-reveals-further-heartbreak">wrote in his Subtract post</a>, “Writing songs is my therapy. It helps me make sense of my feelings … in just over a week I replaced a decade’s worth of work with my deepest darkest thoughts.” Images: Getty

Family & Pets

"Writing songs is my therapy": Ed Sheeran reveals further heartbreak

In the wake of the tragic news of the <a href="https://www.oversixty.com.au/news/news/tragedy-strikes-ed-sheeran-tour" target="_blank" rel="noopener">heartbreaking loss</a> suffered by his co-writer and touring partner, Ed Sheeran has taken to Instagram to share his struggle following a series of life-changing events – and how this has altered the course of his new album, Subtract. The singer shared how he “spiralled” into depression last year after his wife, Cherry, was diagnosed with a tumour during her second pregnancy, which couldn’t be treated until after she gave birth. The star explained that he was "trying to sculpt the perfect acoustic album" for almost a decade, when the series of events changed everything. “Writing songs is my therapy. It helps me make sense of my feelings. I wrote without thought of what the songs would be, I just wrote whatever tumbled out. “And in just over a week, I replaced a decade’s worth of work with my deepest darkest thoughts," he captioned. “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. “My best friend Jamal [Edwards], a brother to me, died suddenly and I found myself standing in court defending my integrity and career as a songwriter. I was spiralling through fear, depression and anxiety. “I felt like I was drowning, head below the surface, looking up but not being able to break through for air". <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ed Sheeran (@teddysphotos)</a> </div> </blockquote> The four-time Grammy award winner shared that this album was a "trapdoor" into his soul, and a way for him to make sense of everything he's been through. Sheeran announced the birth of his second daughter, Jupiter, in May of last year. Subtract will be released on the 5th of May 2023, through Asylum/Atlantic. Image: Getty

Caring

Hugh Jackman reveals why he is now in therapy

Hugh Jackman has revealed he is undergoing therapy to help him come to terms with the trauma he experienced as a child. The Aussie actor opened up about his healing process in a new interview with Who magazine, telling the publication he recently began treatment. "I just started it recently. It's helped me a lot," he said. "We all need a village." "You need a friend you can unload everything – having someone really smart, who's a little a bit removed from your world can be really helpful." In his sessions, Jackman discussed his longstanding pain from being abandoned by his mother, Grace, and sisters Zoe and Sonya, who left Australia for the UK when he was just eight. Jackman remained in Sydney with his father, Christopher, and brothers Ian and Ralph. It wasn't until he was about 12 years old that he realised she was not coming home. However, therapy has allowed Jackman to accept the past and make peace with loved ones. "Understanding my past and how it's informing my thinking unconsciously – getting to really understand some of the patterns that I was unconsciously just repeating," he said. However, Jackman has been fortunate enough to reconnect with his mother over the years, previously telling The Sun: "As I grew older I gained an understanding of why Mum did leave … and we have definitely made our peace, which is important. I was always quite connected with my mum. I have a good relationship with her." Sadly, Jackman's father passed away in September last year, on Father's Day in Australia. Images: Instagram

Mind

"An arts engagement that’s changed their life": the magic of arts and health

In 2007, a life-changing encounter at South Australia’s Flinders Medical Centre became the catalyst and symbol for a national arts and health movement. A young woman, Becky Corlett, was being transported through the hospital where an artist-in-residence, Rebecca Cambrell, was painting a mural. Becky had suffered a stroke and cardiac failure. She had stopped eating and was non-responsive even to family. When Becky passed the mural, however, she made a noise of interest. Cambrell instinctively drew Becky closer and gave her a paint brush. To everyone’s surprise, Becky started adding dabs of paint to the canvas, and then she smiled. The wonder of this moment only dawned on Cambrell when she turned around. “Her parents were convinced that the moment she touched that paintbrush, something was triggered inside Becky that made her want to live”, remembers Cambrell. Becky’s story is just one of many collected in our new report <a href="https://apo.org.au/node/321047">Telling the Story of Arts in Health in South Australia</a>. <h2>What is ‘arts and health’?</h2> Arts and health is broadly defined as using arts practice to deliver health outcomes, be they specifically targeted interventions or general wellbeing benefits. Arts and health work comes in many forms. It can be <a href="https://statetheatrecompany.com.au/shows/euphoria/">play</a> about mental health issues in rural areas. It can be a <a href="https://www.visualisingmentalhealth.com/">university competition</a> to design solutions to community wellbeing challenges. It can be the <a href="https://celsus.net.au/a-hospital-within-a-park/">integration</a> of art throughout an entire hospital to create a calming environment. In an interview with us, design researcher Jane Andrew said the breadth of arts and health work means participant involvement can range “from passively viewing to making to being in the environment”. The benefits are diverse. A <a href="https://www.who.int/europe/publications/i/item/9789289054553">2019 World Health Organisation study</a> looking at over 900 peer-reviewed publications found arts and health can do everything from encouraging health-promoting behaviours to supporting end-of-life care. The diversity of the arts and health field is represented by the perspectives of our report’s 47 interviewees. We spoke to arts therapists, managers of hospital-based arts and health programs, government arts agency staff, CEOs of local health networks and former ministers. We asked them about their past experiences with arts and health, the present challenges and opportunities for the field, and how best to advance this work in the future. <h2>Art and health in Australia</h2> Although benefits of the arts to health have been recognised <a href="https://academic.oup.com/book/9415/chapter/156246455">for millennia</a>, the formal field of arts and health work <a href="https://www.tandfonline.com/doi/abs/10.1080/17533010903421484">first emerged</a> across South Australia and the rest of the nation through the community arts movement of the 1970s and the rise of health promotion in the 1980s. The establishment of the Flinders Medical Centre’s Arts in Health program in the late 1990s provided a major step for the field into health settings, and the program remains an <a href="https://anmj.org.au/the-art-of-healing-inside-flinders-medical-centres-pioneering-arts-in-health-program/">innovative leader today</a>. The former director of the program, Sally Francis, recalled how, “on a regular basis” the program would have “three, four, five stories of someone who has been critically ill and had an arts engagement that’s changed their life.” But Becky Corlett’s story had, as Francis describes it, a “huge and far-reaching effect” on arts and health in Australia. Days after Becky’s first painting experience, former South Australian Minister of Health and Assistant Arts Minister, John Hill, visited the hospital "I was just walking along, and I saw the painting going on and there was this little girl busily doing art. […] Her parents came up to me and had tears in their eyes. […] She was reconnected with life." Inspired by this encounter, Hill and Francis led a push to have arts and health formally recognised by the state and then federal government. The <a href="https://www.arts.qld.gov.au/images/documents/artsqld/Research/National-Arts-and-Health-Framework-May-2014.pdf">National Arts and Health Framework</a> was officially endorsed in 2014. This historic statement declared the Australian federal, state and territory governments’ recognition of and support for the field. The framework aimed to raise awareness of arts and health, and to encourage government departments and agencies across the country to integrate arts and health work into their services. However, it did not make any funding or legislative requests, meaning no permanent arts and health policy followed its endorsement. <h2>What next for arts and health?</h2> Next year marks ten years since the framework’s endorsement. While there is continuing good work in this space across the country, our interviewees believe arts and health remains underutilised. Community artist Lisa Philip-Harbutt told us there is a lack of “connection between all the various things that people are doing” – different arts and health projects often aren’t speaking to each other. To regain momentum for the field, interviewees recommend developing educational pathways for prospective arts and health workers, conducting a review and update of the National Arts and Health Framework to embed it in policy, and establishing research partnerships between universities and arts and health programs. The hope is that the next generation of leaders will be inspired by witnessing arts and health’s life-changing power. According to Deborah Mills, a key driver of the National Arts and Health Framework, "If you want passionate advocates, they have to have a visceral understanding of what creative activity does." Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/an-arts-engagement-thats-changed-their-life-the-magic-of-arts-and-health-196212" target="_blank" rel="noopener">The Conversation</a>.

Art

Sounds great: Scientists are manipulating dreams to prevent nightmares

It’s estimated that at any given time, around 4% of adults suffer <a href="https://cosmosmagazine.com/health/one-side-of-your-brain-might-be-giving-you-nightmares/" target="_blank" rel="noreferrer noopener">chronic nightmares</a> but researchers in Switzerland have a new approach which will be music to the ears of night-terror-sufferers. Basing their study on the relationship between the types of <a href="https://cosmosmagazine.com/science/biology/nightmares-and-night-terrors-in-kids-when-do-they-stop-being-normal/" target="_blank" rel="noreferrer noopener">emotions experienced in dreams</a> and our emotional well-being, researchers have investigated how to help people by manipulating emotions in their dreams. Traditional methods to help chronic nightmare patients involves ‘imagery rehearsal therapy’, during which they are coached to rehearse the dream scenario during the day and redirect it towards a more positive ending. A <a href="https://link.springer.com/article/10.1007/s11818-021-00320-w" target="_blank" rel="noreferrer noopener">2021 study</a> of 28 participants showed 3 in 5 patients benefitted from this approach, however, it doesn’t work for everyone. <div class="newsletter-box"> <div id="wpcf7-f6-p220659-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.62 spai-bg-prepared init" action="/health/sounds-great-preventing-nightmares/#wpcf7-f6-p220659-o1" method="post" novalidate="novalidate" data-status="init"> <input class="wpcf7-form-control wpcf7-text referer-page" name="referer-page" type="hidden" value="https://cosmosmagazine.com/health/" data-value="https://cosmosmagazine.com/health/" aria-invalid="false" /> </form> </div> </div> In a <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01477-4" target="_blank" rel="noreferrer noopener">study from Geneva University</a>, over a two-week period, researchers asked a group of 18 patients to create an association between the positively redirected version of their dream and a sound during an imagination exercise. The patients then wore wireless headbands during night which would play the specific sound during the REM (Rapid Eye Movement) stage of sleep – when <a href="https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515" target="_blank" rel="noreferrer noopener">nightmares typically occur</a>. When compared to 18 patients who undertook only the image rehearsal therapy, those who received the combined rehearsal and sound therapy had fewer nightmares. This trend continued even after three months post-intervention, with those receiving combination therapy also reporting experiencing more positive emotions such as ‘joy’ in their dreams. “We were positively surprised by how well the participants respected and tolerated the study procedures, for example performing imagery rehearsal therapy every day and wearing the sleep headband during the night,” says Lampros Perogamvros, senior author of the study and a psychiatrist at the Sleep Laboratory of the Geneva University Hospitals and the University of Geneva. “We observed a fast decrease of nightmares, together with dreams becoming emotionally more positive. For us, researchers and clinicians, these findings are very promising both for the study of emotional processing during sleep and for the development of new therapies.”  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=220659&title=Sounds+great%3A+Scientists+are+manipulating+dreams+to+prevent+nightmares" width="1" height="1" />  <div id="contributors"> <a href="https://cosmosmagazine.com/health/sounds-great-preventing-nightmares/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Clare Kenyon. Image: Getty Images </div>

Mind

New study to “give hope” to childhood trauma survivors with depression

A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression. Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions. The study, published in <a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma. While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent. The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma. Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma). But, they found that both groups experienced an improvement in symptoms at a similar rate. Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope. “Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said. “Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.” Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients. “This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said. “However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.” According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood. But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective. If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380. Image: Getty Images

Mind

The truth behind the healing power of music

If you’ve suffered anything from a bad day to a devastating loss, you probably know that one of the first and best places to turn to is music. According to recent studies, there’s a reason for that: it’s scientifically proven to be healing and cathartic. According to a study performed by the University of Missouri, people are actually able to lift themselves out of a low emotional state by playing contrastingly cheerful music if they consciously attempt to feel happier while doing so. Significantly, study participants who were instructed to attempt to raise their moods while listening to upbeat music were able to achieve this in the immediate short term period and even increased their overall happiness over the course of two weeks. On the other end of the spectrum, another study, conducted by the University of California and Berkely, found that even sad songs can help to heal a “broken” heart. According to the researchers, "Under certain circumstances, consumers in negative moods might choose aesthetic experiences consistent with their mood even when more pleasant alternatives are also available." So basically, music can be a self-indulgent means of experiencing and working through our emotions. So whether your choice of music is The Rolling Stones’ melancholy Out of Tears, Zeppelin’s heart breaking, Baby Come on Home, The Beatles’ optimistic Getting Better, or Clapton’s rebellious Cocaine, your impulse to turn to music in hard times is actually backed up by science. Image credits: Getty Images

Music

How nurses are changing the conversation around medicinal cannabis

For many years, those with chronic conditions and ailments have had limited options for pain-relieving treatments, with varying opioids and anti-inflammatories the usual go-to for relief. However, in recent years the use of medicinal cannabis in Australia has <a href="https://www1.racgp.org.au/newsgp/clinical/research-shows-medicinal-cannabis-boom-in-australi">increased</a> exponentially, giving patients a new lease on life. While more people are turning to this natural source of treatment, accessing medicinal cannabis is still not easy. This accessibility issue has prompted the Australian Nursing and Midwifery Federation (ANMF), which has more than 310,000 members, and NSW and QLD nurse associations to lobby for medicinal cannabis education to be introduced into the curriculum for all schools of nursing and midwifery in Australia, so they can administer in hospitals. For former Queensland nurse Lucy Haslam, the accessibility and affordability is a cause close to her heart, as she saw first-hand how medicinal cannabis helped her son, Dan, during his battle with stage 4 bowel cancer. For me personally, medicinal cannabis is a topic I have been interested in for years. As a patient with a chronic condition with very limited treatment options, the accessibility hurdle is one I have long been fighting to jump over. However, to long-term pain patients like myself, this new initiative by the ANMF is bringing newfound hope that accessibility and affordability is at the forefront of the medicinal cannabis conversation. Australian Natural Therapeutic Group (ANTG) Chief Scientific Officer Justin Sinclair said this will be a game-changer for patients, as nurses are on the frontline of care with close relationships with patients. This comes as new <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/australias-attitudes-and-perceptions-towards-drugs/contents/about">data</a> from the Australian Institute of Health and Welfare shows almost half the population support legalising cannabis, given its recent boom in success for treating patients with both physical and mental conditions. According to Justin Sinclair, medicinal cannabis is being used to treat a variety of conditions with outstanding results. He told OverSixty, “According to data from the Therapeutic Goods Administration, the main clinical indication that medicinal cannabis is being used for in Australia is chronic pain, with over 115,000 prescriptions being issued to date.” “That being said, there are a wide range of other clinical indications that Australian patients are also using medicinal cannabis for, and includes examples such as anxiety, sleep disorders, migraine, fibromyalgia, epilepsy, palliative care, multiple sclerosis and cancer pain and symptom management.” For many patients with a chronic condition, overuse of traditional pain-relievers can lead to more complex health issues, which can, in some circumstances, make medicinal cannabis a safer long-term solution. When it comes to the difference between medicinal cannabis and traditional pain-relievers, Dr Joel Wren, who is the President of the Society of Cannabis Clinicians Australian Chapter (SCCAC), believes medicinal cannabis is a superior option. He told OverSixty, “The significant differences of medicinal cannabis compared to other treatments is twofold; firstly it can be a multi-target medicine helping not only with pain, but possibly also sleep and anxiety all at the same time.” “The second difference is the variability; cannabis contains hundreds of botanical compounds which may contribute to the therapeutic benefits in different ways. Another huge difference is safety - there have been NO lethal overdoses on record that have ever been attributed 100% to cannabis.” As the ANMF and the Australian Medicinal Cannabis Association (AMCA) continue to campaign for wider distribution of medicinal cannabis, along with making the drug more affordable for those in need, Dr Joel Wren told OverSixty that patients should talk to their doctor about trialling medicinal cannabis through the current pathways. He said, “Australian patients need to speak with their doctor about possibly getting a prescription for medicinal cannabis. There has to be a clear medical reason, and conventional therapies and medications must be trialled first. If the doctor is confident, they can prescribe or alternatively they may refer to another doctor who can.” Image credits: Getty Images

Body

How to be more articulate: 8 must-follow secrets to improve your speech

<div class="slide-image" style="box-sizing: border-box; border: 0px; font-family: Raleway, sans-serif, Arial; font-size: 16px; font-style: normal; font-weight: 400; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; color: #444444; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> </div> <h2>Listen to yourself speak</h2> We know it’s terrifying, but nothing will squash those verbal ticks quite like listening to yourself speak. Record yourself in a natural conversation; for example, replay a conference call or have a friend interview you on tape. Listen for technical issues, such as filler words, up talk, monotone, and run-on sentences, as well as any habits that sound awkward or uncomfortable. Identifying the problem is the first step toward tackling it. <h2>Monitor your speed</h2> Not sure if you’re speaking too fast or too slow? Try this: copy and paste a 160-word passage into a word processor. Read the passage aloud (at your standard conversational speed) while recording yourself on a tape recorder. How long did it take you? It should be near the minute mark, says communications coach, Dr Carol A. Fleming. “Aim for about 155 to 175 words per minute for normal conversation,” she writes. If you’re reciting background information or summarising something, pick up the pace. If you’re explaining something more technical, slow it down. <div> </div> <h2>Eliminate filler words</h2> If you’re wondering how to be more articulate, it’s probably because you’ve caught yourself over-utilising words such as ‘um,’ ‘like,’ and ‘ahh,’ which can make you sound unsure and inarticulate. Replace these fillers with more eloquent transitions, suggests Forbes contributor Selena Rezvani. “One of the functions of ‘Um’ is to tell your audience that you’re not done talking yet and need to gather your thoughts,” she writes. ‘Let’s move on to…’, ‘Another important consideration is…’, and ‘Let’s transition to talking about…’ are great replacements. <h2>Focus on the final sound</h2> Avoid trailing off or mumbling by making a conscious effort to fully pronounce each syllable. Pay special attention to the Ts in contractions and the final words of sentences. <h2>Study other speakers</h2> Articulate speakers learn from other articulate speakers. Need inspiration? Find a radio show or podcast you enjoy, and analyse the host’s speech. He or she has likely squashed any verbal ticks, and can help you identify effective patterns of speech. <h2>Speak with confidence</h2> How to be more articulate? Speak with confidence. Even if you’re talking on the phone, the way you hold yourself impacts the way people perceive your ideas. Extend your vocal cords by keeping your chin parallel to the floor and sitting up straight, and avoid moving your hands too much (studies show keeping them folded on the table projects trustworthiness). <h2>Think before you speak</h2> Perhaps the most important trick for more articulate speech? Know what you’re talking about. Having a clear idea of what you want to say will allow you to organise your thoughts into a coherent structure. It’s that simple. <h2>Address your weaknesses</h2> Once you’ve identified your weaknesses, create a plan for addressing them. One strategy is to tackle a specific issue each day. For example, focus on eliminating filler words on Monday, and on completing your sentences on Tuesday. Repeat the process each week until speaking clearly becomes second nature. This article originally appeared on <a href="https://www.readersdigest.com.au/culture/how-to-be-more-articulate-8-must-follow-secrets-to-improve-your-speech" target="_blank" rel="noopener">Reader’s Digest</a>. Image: Shutterstock

Caring

Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say?

Physiotherapists are increasingly offering needling therapies in addition to their standard care. Many Australian <a href="https://australian.physio/research/prf/translation/five-facts-about-acupuncture-and-dry-needling-musculoskeletal-pain" target="_blank" rel="noopener">physiotherapists</a> in private practice now offer dry needling or Western medical acupuncture as part of a treatment approach. Is it just a fad or does science support it? <h2>Needling, three ways</h2> Physiotherapists can be trained to use dry needling, Western acupuncture and/or traditional acupuncture. <a href="https://pubmed.ncbi.nlm.nih.gov/23801002/" target="_blank" rel="noopener">Dry needling</a> involves penetrating the skin with needles to altered or dysfunctional tissue in order to improve or restore function. This often involves needling muscle trigger points to activate a reflexive relaxation of the muscle. <a href="https://pubmed.ncbi.nlm.nih.gov/28739020/" target="_blank" rel="noopener">Western acupuncture</a> uses traditional needling <a href="https://www.sciencedirect.com/science/article/pii/S2005290110600143" target="_blank" rel="noopener">meridians</a> (the ancient idea of energy channels through the body) and trigger points. But these ideas are applied to Western understandings of anatomy. In Western acupuncture, points are stimulated to create local tissue changes, as well as spinal and brain effects. The goals is to trigger pain-relieving chemicals, muscle activation or relaxation. Even though traditional acupuncture points are used with this style of needling, Western acupuncture is not viewed as traditional Chinese medicine. <a href="https://healthtimes.com.au/hub/pain-management/44/research/kk1/acupuncture-for-pain-management/1581/" target="_blank" rel="noopener">Traditional acupuncture</a> uses meridian lines or other points based on traditional Chinese medicine assessment methods and approaches. All physiotherapists trained in either acupuncture or dry needling meet safety standards which are viewed as within scope by the <a href="https://www.ahpra.gov.au/" target="_blank" rel="noopener">Australian Health Practitioners Regulatory Agency</a> and the <a href="https://www.physiotherapyboard.gov.au/" target="_blank" rel="noopener">Physiotherapy Registration Board</a>. These standards cover the level of training required, registration to practice and safety standards that include needle safety and hygiene to protect the public. Minor reported <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015026/#:%7E:text=Examples%20of%20minor%20adverse%20reactions,pain%20during%20or%20after%20treatment." target="_blank" rel="noopener">side effects</a> related to acupuncture including pain and bleeding or bruising from needle insertion are fairly common. But major adverse events – pneumothorax (collapsed lung), excessive bleeding, prolonged aggravation – are rare. <h2>What’s needling good for?</h2> Research into the effectiveness of acupuncture and dry needling is variable. Some studies show comparable results between dry needling and acupuncture, while others show more favourable results for one or the other depending on the condition being treated. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedling" target="_blank" rel="noopener">review</a> that assessed the effects of acupuncture and dry needling for the treatment of low-back pain found they may be useful add-on therapies but could not make firm conclusions due to a lack of quality trials. Another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600071/#CIT0034" target="_blank" rel="noopener">review</a> reported the growing popularity of dry needling world wide and across disciplines and points out that many questions still remain regarding the use of needling. For <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001218.pub3/full?highlightAbstract=acupuncture%7Cmigraine%7Cmigrain%7Cacupunctur" target="_blank" rel="noopener">migraine</a> and <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007587.pub2/full?highlightAbstract=acupuncture%7Cheadach%7Ctension%7Cacupunctur%7Cheadache%7Ctype" target="_blank" rel="noopener">tension</a> headaches, experts say acupuncture seems to reduce the frequency and intensity of attacks – though more research is needed to compare it to other treatments. Acupuncture and dry needling may reduce pain and improve function for people with <a href="https://pubmed.ncbi.nlm.nih.gov/17224820/" target="_blank" rel="noopener">neck pain</a>. A systematic review found significant differences between acupuncture and “sham acupuncture” (which is performed away from acupuncture points) when used to treat <a href="https://pubmed.ncbi.nlm.nih.gov/22965186/" target="_blank" rel="noopener">certain types of chronic pain</a>. However, some research only shows <a href="https://pubmed.ncbi.nlm.nih.gov/33066556/" target="_blank" rel="noopener">small and temporary</a> relief for neck pain with dry needling. Results from randomised control trials support the use of needling for <a href="https://pubmed.ncbi.nlm.nih.gov/27062955" target="_blank" rel="noopener">shoulder pain</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/32301166/" target="_blank" rel="noopener">tennis elbow</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32186030/" target="_blank" rel="noopener">osteo arthritic knee pain</a>. But a recent systemic review of research reported only weak evidence to support needling to treat <a href="https://pubmed.ncbi.nlm.nih.gov/33760098/" target="_blank" rel="noopener">plantarfasciitis and chronic ankle instability</a>. <h2>Not just for sporting injuries</h2> Similarly, small randomised control trials have shown acupuncture and dry needling might reduce <a href="https://pubmed.ncbi.nlm.nih.gov/17095133/" target="_blank" rel="noopener">problematic jaw pain</a> (<a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/temporomandibular-disorder-tmd#:%7E:text=Temporomandibular%20disorders%20(TMD)%20are%20disorders,may%20result%20in%20temporomandibular%20disorder." target="_blank" rel="noopener">temporo mandibular disorder</a>) and improve mouth opening. Systematic reviews have reported needling and acupuncture were safe and effective recommendations for the treatment of broad conditions of <a href="https://www.healthline.com/health/tendinopathy" target="_blank" rel="noopener">tendinopathy</a> (the breakdown of collagen in tendons) and <a href="https://pubmed.ncbi.nlm.nih.gov/30787631/#:%7E:text=At%20follow%2Dup%20in%20the,for%20the%20management%20of%20FM." target="_blank" rel="noopener">fibromyalgia</a> (chronic pain in the muscles and bones). For women’s health, acupuncture has been shown to be effective for reducing pain with <a href="https://pubmed.ncbi.nlm.nih.gov/29879061/" target="_blank" rel="noopener">periods</a>, compared to no treatment or non-steroidal pain relief medications – but the research had design limitations. Though <a href="https://www.cochrane.org/CD002962/PREG_acupuncture-or-acupressure-induction-labour#:%7E:text=Acupuncture%20involves%20the%20insertion%20of,with%20onset%20of%20labour%20contractions." target="_blank" rel="noopener">widely used</a> in pregnancy, research into the use of acupuncture to <a href="https://pubmed.ncbi.nlm.nih.gov/32032444/" target="_blank" rel="noopener">induce labour</a> reports it may increase satisfaction with pain management and reduce pain intensity. But it may have little to no effect on the rates of caesarean or assisted vaginal birth. In summary, it appears needling techniques – whether dry needling or acupuncture – generally show positive effects over no treatment or “sham” treatments, but more research and high quality trials are needed. <h2>Just one part of a treatment program</h2> Needling <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedlin" target="_blank" rel="noopener">may be useful</a> as part of multimodal care – that is, when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780149/" target="_blank" rel="noopener">more than one treatment</a> is used in conjunction to treat a problem. Physiotherapists may combine needling therapies with exercise prescription, hands-on care including massage, mobilisations and manipulations, and taping techniques. They may also employ therapies that apply external energy such as ultrasound, laser, transcutaneous (under the skin) electrical nerve stimulation and biofeedback. Finally, while the various needling techniques all use a filiform needle (with a solid filament as opposed to a hollow bore needle), the styles with each can be quite different. Ask what style of needling is being employed to treat you, and if you have a history of finding one style works better for you, discuss this with your practitioner. This article originally appeared on <a href="https://theconversation.com/physio-dry-needling-and-acupuncture-whats-the-difference-and-what-does-the-evidence-say-181939" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

What happens when a petting zoo visits an aged care home

In June 2022, residents, families and team members at Arcare North Lakes had an a-moo-sing time with the beloved animals from mobile petting zoo, Amazing Animals. Residents had the opportunity to feed and pat the farm animals which included ducks, chickens, rabbits, guinea pigs, goats, sheep and baby animals such as piglets, a one-month-old calf and a three-week-old goat. While holding onto the baby goat, resident Joyce Crawford said, “I love you! I would take you home in a flash; I just need a bag big enough to steal him,” Joyce’s husband John, who is also a resident at Arcare North Lakes and is visually impaired, spent quality time with the animals as the Lifestyle team made sure to bring them close to him. He fed and cuddled them and enjoyed the sensory experience. “I had a great time with the animals and I’m glad we could spend time with them today,” John said. The residents enjoyed their visit so much that they have already booked them in for another visit. “Animal therapy is a wonderful way to support aged care residents as it promotes confidence, supports sensory and tactile stimulation and enables them to relive memories as many of the residents grew up on farms. One question was asked time and time again "can we keep them!" it was such a special moment for them to enjoy.” - Lifestyle Coordinator Maree said. “There were smiles, laughs and enthusiasm as resident’s shared stories and fond memories of their own experiences working on their farms,” lifestyle Coordinator Maree said. Check out the adorable gallery below.

Retirement Life

Holy renovation: unique church conversion wows viewers

A true one-of-a-kind church conversion is now for sale in the bright inner-Melbourne suburb of Fitzroy. The asking price sits between $5.7 million to $6.2 million. Situated in the heart of the cosmopolitan locale, just minutes away from some of Melbourne's most desirable bars, restaurants and cafes, this property is a unique offering. Part of a boutique living complex that utilises the structure and the grounds of a gorgeous bluestone church, the residence spans multiple levels. Boasting three bedrooms, three bathrooms, one off-street parking space on title and a total footprint of 443-square-metres, space, this property is a once in a life time find. Occupying the entire top floor of the church and benefitting from stunning beamed, vaulted ceilings and stained glass windows, the living, dining and kitchen area is minimalistic, tasteful and bright. However, best of all is that one entire side of the church's tiled roof has been replaced with large glass panels, creating a mesmerising window feature that soaks up and bathes the space in natural light. Walking through an aperture in the creative window display leads occupants to an expansive outdoor timber deck that provides sweeping views across rooftops toward Melbourne's CBD. While the architecturally designed space is unquestionably the abode's crowning glory, it doesn’t stop there with the rest of the stylish pad ensconced in solid wood panelling throughout. Other benefits include a generous master suite that occupies the entire first floor, an elevated loft and plenty of storage space. Images: Domain

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Holy renovation: unique church conversion wows viewers

Our Partners

News

Shop

Catalogues

Newspaper

Contests

Entertainment

Travel

Health

Lifestyle

Finance

Property

Compare

Games

Information

Keep up to date

Search

What are the most common symptoms of menopause? And which can hormone therapy treat?

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

What is a relationship ‘boundary’? And how do I have the boundary conversation with my partner?

Essential money conversations retirees should have with family

Fun ways to boost memory in seniors

Aussie patient given new drug worth $5 million per dose

Conversation starters for solo travellers

Don’t let financial shame be your ruin: open conversations can help ease the burden of personal debt

Ed Sheeran shoots for the stars with daughter’s name reveal

"Writing songs is my therapy": Ed Sheeran reveals further heartbreak

Hugh Jackman reveals why he is now in therapy

"An arts engagement that’s changed their life": the magic of arts and health

Sounds great: Scientists are manipulating dreams to prevent nightmares

New study to “give hope” to childhood trauma survivors with depression

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How nurses are changing the conversation around medicinal cannabis

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Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say?

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Holy renovation: unique church conversion wows viewers

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