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Why is pain so exhausting?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/michael-henry-1321395">Michael Henry</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>One of the most common feelings associated with persisting pain is fatigue and this fatigue can become overwhelming. People with chronic pain can report being drained of energy and motivation to engage with others or the world around them.</p> <p>In fact, a study from the United Kingdom on people with long-term health conditions found pain and fatigue are the <a href="https://weareundefeatable.co.uk/campaign-hub/latest-from-us/the-bridging-the-gap-report/">two biggest barriers</a> to an active and meaningful life.</p> <p>But why is long-term pain so exhausting? One clue is the nature of pain and its powerful effect on our thoughts and behaviours.</p> <h2>Short-term pain can protect you</h2> <p>Modern ways of thinking about pain emphasise its protective effect – the way it grabs your attention and compels you to change your behaviour to keep a body part safe.</p> <p>Try this. Slowly pinch your skin. As you increase the pressure, you’ll notice the feeling changes until, at some point, it becomes painful. It is the pain that stops you squeezing harder, right? In this way, pain protects us.</p> <p>When we are injured, tissue damage or inflammation makes our pain system become more sensitive. This pain stops us from mechanically loading the damaged tissue while it heals. For instance, the pain of a broken leg or a cut under our foot means we avoid walking on it.</p> <p>The concept that “pain protects us and promotes healing” is one of the most important things people who were in chronic pain tell us <a href="https://pubmed.ncbi.nlm.nih.gov/35934276/">they learned</a> that helped them recover.</p> <h2>But long-term pain can overprotect you</h2> <p>In the short term, pain does a terrific job of protecting us and the longer our pain system is active, the more protective it becomes.</p> <p>But persistent pain can <em>overprotect</em> us and <a href="https://onlinelibrary.wiley.com/doi/10.1111/jabr.12124">prevent recovery</a>. People in pain have called this “<a href="https://www.jpain.org/article/S1526-5900(22)00379-0/fulltext">pain system hypersensitivity</a>”. Think of this as your pain system being on red alert. And this is where exhaustion comes in.</p> <p>When pain becomes a daily experience, triggered or amplified by a widening range of activities, contexts and cues, it becomes a constant drain on one’s resources. Going about life with pain requires substantial and constant effort, and this makes us fatigued.</p> <p><a href="https://www.aihw.gov.au/reports/chronic-disease/chronic-pain-in-australia/summary">About 80%</a> of us are lucky enough to not know what it is like to have pain, day in day out, for months or years. But take a moment to imagine what it would be like.</p> <p>Imagine having to concentrate hard, to muster energy and use distraction techniques, just to go about your everyday tasks, let alone to complete work, caring or other duties.</p> <p>Whenever you are in pain, you are faced with a choice of whether, and how, to act on it. Constantly making this choice requires thought, effort and strategy.</p> <p>Mentioning your pain, or explaining its impact on each moment, task or activity, is also tiring and difficult to get across when no-one else can see or feel your pain. For those who do listen, it can become tedious, draining or worrying.</p> <h2>No wonder pain is exhausting</h2> <p>In chronic pain, it’s not just the pain system on red alert. Increased inflammation throughout the body (the immune system on red alert), disrupted output of the hormone cortisol (the endocrine system on red alert), and stiff and guarded movements (the motor system on red alert) also go <a href="https://www.noigroup.com/product/explain-pain-supercharged/">hand in hand</a> with chronic pain.</p> <p>Each of these adds to fatigue and exhaustion. So learning how to manage and resolve chronic pain often includes learning how to best manage the over-activation of these systems.</p> <p>Loss of sleep is also a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289983/">factor</a> in both fatigue and pain. Pain causes disruptions to sleep, and loss of sleep contributes to pain.</p> <p>In other words, chronic pain is seldom “just” pain. No wonder being in long-term pain can become all-consuming and exhausting.</p> <h2>What actually works?</h2> <p>People with chronic pain are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633893/">stigmatised, dismissed</a> and <a href="https://www.jpain.org/article/S1526-5900(13)01367-9/fulltext">misunderstood</a>, which can lead to them not getting the care they need. Ongoing pain may prevent people working, limit their socialising and impact their relationships. This can lead to a descending spiral of social, personal and economic disadvantage.</p> <p>So we need better access to evidence-based care, with high-quality education for people with chronic pain.</p> <p>There is good news here though. Modern care for chronic pain, which is grounded in first gaining a modern understanding of the underlying biology of chronic pain, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/abstract">helps</a>.</p> <p>The key seems to be recognising, and accepting, that a hypersensitive pain system is a key player in chronic pain. This makes a quick fix highly unlikely but a program of gradual change – perhaps over months or even years – promising.</p> <p>Understanding how pain works, how persisting pain becomes overprotective, how our brains and bodies adapt to training, and then learning new skills and strategies to gradually retrain both brain and body, offers scientifically based hope; there’s strong <a href="https://jamanetwork.com/journals/jama/article-abstract/2794765">supportive evidence</a> from <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/abstract">clinical trials</a>.</p> <h2>Every bit of support helps</h2> <p>The best treatments we have for chronic pain take effort, patience, persistence, courage and often a good coach. All that is a pretty overwhelming proposition for someone already exhausted.</p> <p>So, if you are in the 80% of the population without chronic pain, spare a thought for what’s required and support your colleague, friend, partner, child or parent as they take on the journey.</p> <hr /> <p><em>More information about chronic pain is available from <a href="https://www.painrevolution.org/painfacts">Pain Revolution</a>.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238417/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michael-henry-1321395">Michael Henry</a>, Physiotherapist and PhD candidate, Body in Mind Research Group, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-pain-so-exhausting-238417">original article</a>.</em></p> </div>

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Vegan raw food influencer dies of suspected "starvation and exhaustion"

<p>Zhanna Samsonova, a well-known vegan raw food influencer with a significant following on social media, has tragically passed away in Malaysia reportedly due to starvation and exhaustion resulting from her 'extreme' tropical fruit diet.</p> <p>For a decade, Zhanna, also known as Zhanna D'Art, had maintained a raw plant-based diet, which mainly consisted of exotic fruits, sunflower seed sprouts, fruit smoothies, and juices. Additionally, she occasionally practiced 'dry fasting,' abstaining from food and water for extended periods.</p> <p>The 39-year-old influencer, who had not consumed water for over six years, replaced it solely with fruit and vegetable juices. On July 21, she succumbed to what her mother described as a cholera-like infection exacerbated by her highly restrictive eating habits.</p> <p>At the time of her passing, Zhanna was in Malaysia, continuing her travels across Asia, which had spanned 17 years. Her family faced bureaucratic challenges in repatriating her body back to Russia, making the mourning process even more difficult. At the time of writing, her official cause of death has not yet been determined.</p> <p>Zhanna's mother, Vera Samsonova, expressed her disapproval of her daughter's extreme diet and had attempted to persuade her to adopt a more balanced approach, but her efforts were in vain.</p> <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/CtLLqS1PecT/?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/CtLLqS1PecT/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Raw food Creation by Zhanna D’art (@rawveganfoodchef)</a></p> </div> </blockquote> <p>Over time, the influencer transitioned from a vegan diet to a purely raw food diet, sharing what she believed were 'healthy' recipes on her Instagram profile. However, her social media presence started to reveal an increasingly emaciated appearance, raising concerns among her followers, friends, and family.</p> <p>Many of her loved ones warned her about the potential dangers of her extreme diet, but Zhanna remained steadfast in her convictions. Ultimately, her refusal to heed their advice led to a tragic outcome, with reports indicating that her raw food diet contributed significantly to her demise.</p> <p>In 2021, during a trip to Russia, Zhanna contracted COVID-19 and chose to handle it through an unorthodox method of dry fasting, lasting more than ten days. Despite initially claiming to have overcome the virus, her health may have been compromised, leading to further complications down the line.</p> <p>The passing of Zhanna Samsonova has sparked discussions about the importance of balanced and informed dietary choices. Her story serves as a cautionary tale, urging individuals to approach extreme diets with care and consideration for their overall well-being.</p> <p><em>Images: Instagram</em></p>

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"Exhausted" Premier Mark McGowan calls it quits

<p>Western Australia Premier Mark McGowan has announced he is stepping down as premier and member for Rockingham after six years, saying he is “exhausted”.</p> <p>McGowan announced his resignation after calling a snap press conference in Perth and read out a “brief statement” to reporters.</p> <p>"Today I am announcing that I will be stepping down as Premier and member for Rockingham," the statement read.</p> <p>"I was elected premier of Western Australia in March 2017, more than six years ago. Prior to that I served as Opposition Leader for more than six years.</p> <p>"Now is the right time to step away from the job I love.”</p> <p>McGowan said he is stepping down partly because he is confident Labor will win the next state election.</p> <p>"I'm tired, extremely tired. In fact, I'm exhausted," he said.</p> <p>"The role of political leadership does not stop, it is relentless, with huge responsibility but it is all consuming, each and every day. And combined with the COVID-19 years, it has taken it out of me.</p> <p>"I'm convinced WA Labor can win and will win the next election in 2025. But I just don't have the energy or drive that is required to continue in the role as Premier.”</p> <p>He revealed he had been considering stepping down for a while, and will take a break after he finishes.</p> <p>"It is not a decision I have taken lightly, I've been considering it for quite a while," he said.</p> <p>"I will leave Parliament and leave the role by the end of this week. It will be up to my colleagues to select my replacement.</p> <p>"I don't want to finish work completely. Once I am rested and recuperated, I will look for something else to do.”</p> <p>McGowan thanked his wife Sarah and three children, Samuel, Alexander and Amelia, for their support over the years.</p> <p>"To my family can I pass on my love and thanks, being Premier takes a huge toll on family life," he said.</p> <p>"Thank you for every thing over so many hard years.”</p> <p>The politician added that he is a “phone call away” should his successor ever need advice.</p> <p>Prime Minister Anthony Albanese said he had spoken to McGowan and congratulated him on his retirement, commending the work he’s done for Western Australia.</p> <p>"Mark leaves office as he led, on his own terms and as his own man. He has been a great Premier of his proud state, an extraordinary leader for WA Labor and a trusted friend," Albanese said.</p> <p>"Above all, Mark will be remembered for seeing the people of Western Australia safely through one of the most challenging crises in our nation's history. In unprecedented times, Mark always held to his convictions and always sought to do the right thing by his state.</p> <p>"I wish Mark, Sarah and their family all the very best for the next chapter of their lives.”</p> <p>Throughout his time as state leader, McGowan has faced several challenges including threats against himself and his family, and pressure over his strict handling of Covid-19.</p> <p>In November 2021, McGowan and his family had considered moving out of their home in Rockingham after threats were allegedly made against them.</p> <p>Police charged two men over phone calls made to the state premier, which allegedly included threats to behead his wife and children.</p> <p>“In terms of my own family, obviously it’s not pleasant. It’s not very nice and I just urge the people doing it to stop,” McGowan told reporters at the time.</p> <p>According to police, a 20-year-old from Canning Vale and an 18-year-old from Harrisdale allegedly called the premier personally and issued threats via voicemail.</p> <p>McGowan copped serious backlash for mandating vaccinations and locking down WA’s borders during the pandemic.</p> <p>Despite the criticism, the WA government continued to pursue a 90 per cent vaccination rate.</p> <p>“It’s not going to change our approach. We’re going to continue to work to get West Australians vaccinated,” he said.</p> <p>“We’re going to continue with the rules we’ve put in place because that is what is needed.”</p> <p>McGowan has also been approached and verbally abused by protesters on several occasions.</p> <p>He was confronted by Covid-19 protesters opposed to mandatory vaccinations, with a mob seen swarming his car.</p> <p>The encounter was captured on video and the premier is seen walking to his car before he was descended upon by a group shouting and holding signs.</p> <p>A woman attempted to approach the premier and his security, demanding he “give us our jobs back”.</p> <p>As the politician stepped into his car, the group called him a “f***ing coward” while banging on the vehicle’s windows.</p> <p>“Aren’t you down here to convince us?” one woman yelled.</p> <p>“We will rise up,” another remarked as he drove off.</p> <p>McGowan was also involved in a legal battle, with mining magnate Clive Palmer taking him and the state of WA to court multiple times during the pandemic.</p> <p>Both men fell short of a victory in the defamation trial after they sued each other in the NSW Federal Court, with $5,000 in damage awarded to Palmer and $20,000 to McGowan.</p> <p>“Both men went too far in their political jousting and both men litigated, but only one was willing to draw back and avoid the long and costly hearing,” Justice Michael Lee said after the trial.</p> <p>Palmer had claimed that the politician defamed him in multiple comments including that he was a “threat” to WA.</p> <p>McGowan countersued Palmer’s claims that he “lied” to the public about Covid-19, among several other comments.</p> <p>The defamation trial came about after Palmer lost his High Court battle with WA over its harsh border.</p> <p>Palmer sought $30 billion from the state after claiming that legislation introduced but WA Labor was unconstitutional.</p> <p>The bill amended a 2002 state agreement with Palmer’s Mineralogy company and was designed to bar him from suing over a decision by the previous Liberal government to not assess one of his mining projects.</p> <p>“Time and time again, Clive Palmer has attempted to bring our state down – first, by challenging the hard border that kept Western Australians safe through a pandemic, and then by launching an outrageous legal claim for damages,” the politician said in a social media post.</p> <p>Palmer responded to McGowan’s resignation on Twitter with, “Goodbye, Mark McGowan, Goodbye.”</p> <p>In addition to the considerable obstacles he’s faced, McGowan was also involved in a car accident.</p> <p>The premier was fortunately uninjured, and the woman who hit him was on her way to her first day at a new job.</p> <p>Despite hearing a large bang, McGowan said there was only minor damage to the car.</p> <p>“I’m fine. It wasn’t that bad,” he told <em>Seven West Media</em>.</p> <p>“We were just coming around a corner and another car sort of hit us, it felt worse than it was.</p> <p>“It was all very dramatic, I think, for her, but she was great. She was good-humoured, a bit shaken up, a bit shocked but we had a good chat.”</p> <p><em>Image credit: Getty</em></p>

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Moral injury: what happens when exhausted health workers can no longer provide the care they want for their patients

<p>Healthcare workers in New Zealand already face life-and-death decisions daily. But as multiple winter illnesses add pressure to a system already stretched by COVID, staff now also have to deal with <a href="https://www.stuff.co.nz/national/politics/local-democracy-reporting/300534812/covid19-union-and-frontline-worker-say-staff-at-middlemore-hospital-facing-increasing-abuse" target="_blank" rel="noopener">daily abuse</a>, acute <a href="https://www.newshub.co.nz/home/new-zealand/2022/05/christchurch-hospital-cancels-surgeries-as-it-hits-112-pct-capacity.html" target="_blank" rel="noopener">staff shortages</a> and <a href="https://www.1news.co.nz/2022/06/17/dhb-clashes-with-union-over-stretched-palmerston-north-ed/" target="_blank" rel="noopener">unsafe working conditions</a>. At times, they cannot provide the care they would like for their patients.</p> <p>The impact on health workers is often described as <a href="https://www.nzherald.co.nz/rotorua-daily-post/news/great-minds-health-workers-on-covid-19-frontlines-burnt-and-bled-by-two-years-of-virus/T7JXOXGXEKKCICUNOMUJYT4QWM/" target="_blank" rel="noopener">stress and burnout</a>. The consequences of this prolonged pressure can be seen in the number of <a href="https://www.nzdoctor.co.nz/article/undoctored/acem-welcomes-111b-health-nz-budget-urges-fixes-health-workforce-crisis" target="_blank" rel="noopener">doctors</a>, <a href="https://www.nzherald.co.nz/nz/nursing-shortage-nurses-broken-while-sector-faces-thousands-of-vacancies/L7NUXOPG4AB472OKXOH5QJSUMU/" target="_blank" rel="noopener">nurses</a> and other <a href="https://capsulenz.com/be/therapist-shortage-nz/" target="_blank" rel="noopener">health professionals</a> leaving their jobs for overseas positions and the private sector, or being lost to their professions completely.</p> <p>Many of these healthcare workers may well be suffering from a more serious form of psychological distress than burnout: moral injury.</p> <p><a href="https://www.phoenixaustralia.org/wp-content/uploads/2020/07/Moral-Stress-Healthcare-Workers-COVID-19-Guide-to-Moral-Injury.pdf" target="_blank" rel="noopener">Moral injury</a> refers to the psychological, social and spiritual impact of events on a person who holds strong values (such as caring for patients) and operates in high-stakes situations (hospital emergency care), but has to act in a way inconsistent with those values.</p> <p>Examples include having to turn patients away despite them being in pain or discomfort; being unable to provide adequate care due to staff shortages; having to care for a dying patient isolated from their loved ones while wearing full protective gear.</p> <p>Symptoms of moral injury can include strong feelings of guilt and shame (about not being able to uphold healthcare values, for example) as well as high levels of anger and contempt towards the system that prevents proper care.</p> <p>High levels of self-criticism, loss of trust in people and organisations and a weakening of personal relationships are further <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00113-9/fulltext" target="_blank" rel="noopener">symptoms</a> of moral injury.</p> <p>It can be viewed as a <a href="https://www.afta.org/wp-content/uploads/2019/07/Physicians-aren%E2%80%99t-%E2%80%98burning-out.%E2%80%99-They%E2%80%99re-suffering-from-moral-injury..pdf" target="_blank" rel="noopener">more severe form of burnout</a>. But while burnout can happen in most workplaces, moral injury requires the three core components listed above.</p> <p><strong>From war to the operating table</strong></p> <p>The term moral injury arose in <a href="https://www.ptsd.va.gov/professional/treat/cooccurring/moral_injury.asp" target="_blank" rel="noopener">military psychology</a> to refer to situations where, for example, soldiers were unable to intervene to save lives in case they risked breaching the rules of engagement. More recently, the term has been adapted to apply to healthcare.</p> <p>Viewing the experiences of health workers through this lens can help us understand why they may experience a seesawing emotional state and the confusing conflict of simultaneously wanting to be at work while wishing they were anywhere but.</p> <p>For healthcare workers, understanding the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752815/#:%7E:text=Over%20time%2C%20these%20repetitive%20insults,is%20in%20some%20way%20deficient" target="_blank" rel="noopener">concept of moral injury</a> may help reframe it as something that is happening to them rather than because they don’t have the skills to cope. The latter can sometimes be a mistaken implication of the term burnout.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/471254/original/file-20220627-22-u7c2tg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Exhausted nurse" /><figcaption><span class="caption">Staff shortages can take health workers beyond exhaustion and burnout.</span> <span class="attribution"><span class="source">Getty Images</span></span></figcaption></figure> <p>While healthcare workers are largely at the mercy of the organisations they work for, there are some steps individuals can take to alleviate moral injury. Firstly, simply recognising they may be suffering from this condition can reduce confusion and validate their experiences.</p> <p>Secondly, reconnecting back to an individual’s values and beliefs can help refocus and re-energise, at least temporarily. Reminding themselves why they got into this job in the first place is a useful place to start.</p> <p><strong>Organisational responses</strong></p> <p>Organisations and businesses must play a lead role in preventing and treating moral injury. Many of the factors leading to it (lack of resources or staff, a pandemic or peak flu season) are outside the control of individuals.</p> <p>Most modern businesses will be aware they have a legal responsibility under the 2015 <a href="https://www.legislation.govt.nz/act/public/2015/0070/latest/DLM5976660.html" target="_blank" rel="noopener">Health and Safety at Work Act</a> to look after their employees’ mental and physical well-being.</p> <p>At a high level, organisations can advocate for systemic change and increases in funding and resourcing, where needed. But these higher-level changes take time to achieve. In the meantime, it is important healthcare workers are protected and supported.</p> <p>Broad steps an organisation can take to prevent or reduce moral injury include removing the burden of difficult ethical decisions from frontline workers and instead adopting evidence-based policies to guide an organisation-wide response. Where possible, rotating staff between high and low-stress environments may help.</p> <p>Providing funding for workers to access professional psychological supervision is another practical step businesses can consider. At a team level, it can be helpful to have leaders who are visible, validating and can help make sense of the moral conflict. Leaders can also play a role in keeping alive professional values and modelling their own struggles with the situation.</p> <p>The general public also has a role to play in supporting healthcare workers. Any steps we can take to protect our own health and thereby reduce pressure on the system can have a cumulative effect on the well-being of doctors, nurses and allied health clinicians. The health of our nation rests with those who work in this field and it is in all our interest that their health is protected and prioritised.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/185485/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/dougal-sutherland-747623" target="_blank" rel="noopener">Dougal Sutherland</a>, Clinical Psychologist, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200" target="_blank" rel="noopener">Te Herenga Waka — Victoria University of Wellington</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/moral-injury-what-happens-when-exhausted-health-workers-can-no-longer-provide-the-care-they-want-for-their-patients-185485" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Caring

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Kate Langbroek reveals the “exhausting” reality of lockdown in Italy

<p>Kate Langbroek has opened up about the difficulties she and her family have been facing as Italy’s strict lockdown measures scale past a month.</p> <p>The radio star, 54, has said the streets have come to a “grind” since the country closed down nearly everything except their essential services on March 9.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B-mEHMYAIBb/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B-mEHMYAIBb/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Kate Langbroek (@katelangbroek)</a> on Apr 5, 2020 at 2:49am PDT</p> </div> </blockquote> <p>While speaking in the Channel Ten documentary<span> </span>Coronavirus Australia: Our Story, the personality said that “Australians now are where we were a few weeks ago.”</p> <p>“And the only way to sort of stop it seems to be by having a lockdown. The streets are reminiscent of some sort of Armageddon-ish movie starring Will Smith, I guess.'”</p> <p>Kate went on to say the lockdown was a welcomed relief at first, but her perception has changed over time.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B-PYSeKgMdS/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B-PYSeKgMdS/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Kate Langbroek (@katelangbroek)</a> on Mar 27, 2020 at 7:23am PDT</p> </div> </blockquote> <p>“When lockdown comes, and this will sound strange, but it's almost kind of a relief because it's a circuit break and the sudden stopping of everything is almost a form of respite,” she explained.</p> <p>However, she said the lockdown is now a “grind” and that the “days run together and inexplicably it becomes harder and harder to get out of bed. You try to maintain a routine. </p> <p>“And the interesting thing about it is how exhausting doing nothing can be.”</p> <p>The TV star revealed her husband, Peter Allen Lewis, is currently being sued by the city of Bologna for breaking lockdown rules.</p> <p>Kate told Triple M’s<span> </span>Moonman in the Morning<span> </span>that Peter had been seen riding his bicycle in public three weeks ago, entirely unaware of the strict restrictions put in place.  </p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B-PYSeKgMdS/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B-PYSeKgMdS/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Kate Langbroek (@katelangbroek)</a> on Mar 27, 2020 at 7:23am PDT</p> </div> </blockquote> <p>“You cannot leave the house. I've probably left the house five times probably. It's just very difficult,” she said, adding that Bologna residents are not even allowed to walk a dog.</p> <p>The pair have been home-schooling their children Lewis, Sunday, Artie and Jan for six weeks.</p> <p>Kate and Peter relocated from Melbourne to Italy with their children in early 2019 for what was supposed to be a “family gap year” but have since extended their stay by another 12 months. </p>

International Travel

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Why so many are "exhausted" of the bushfires

<p>It is only mid-November but we have to walk early to avoid the heat. A northerly wind picks up clouds of dust and pollen, sending dirty billows across the paddocks. The long limbs of the gum trees groan overhead. Leaves and twigs litter the road. We stop to pull a branch off to the side.</p> <p>Not even summer yet and already we are facing our first catastrophic fire rating of the season. Normally, I don’t even worry much about fires until after Xmas. In the southern states, it is January and February that are the most dangerous.</p> <p>We live in the Adelaide Hills and never schedule holidays away from home in those months, even though it is hot and unpleasant. Now I’m worried we will have to cancel our pre-Christmas holiday plans. Winter will be the only time we can leave.</p> <p>We cross paths with a friend walking her dog. We share mutual exclamations about the weather and the risk and she reminds me about the neighbourhood fire group meeting. I should go. I know, better than most people, just how important and lifesaving they can be. But I just don’t want to.</p> <p>On the weekend, my husband had made us start the fire pump. It’s good to make sure it is all working, but I harbour a vague, irrational resentment at having to be taught how to do it every year. I know why. Mike has all that mechanical knowledge embedded in his brain like a primary instinct, but the information trickles out of mine like water through sand. I cannot rely on remembering what to do in an emergency.</p> <p>I know my limitations. I’ve attached a laminated, labelled diagram to the pump with numbered instructions on it. Leave nothing to chance. My daughters are running through the pump this year too – in case they find themselves home alone.</p> <p>Fuel on, throttle on, choke on.</p> <p>I worry that the pull cord will be too hard, but my youngest yanks at it with practised determination and the pump starts first go.</p> <p>Choke off, throttle up, water on.</p> <p style="text-align: center;"><a href="https://images.theconversation.com/files/305086/original/file-20191204-70122-1hrgimn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/305086/original/file-20191204-70122-1hrgimn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">At the fire pump.</span> <span class="attribution"><span class="source">Author provided</span></span></p> <p>The sprinklers fire up a dull, thudding rhythm around the verandah, spraying a mist over the garden and the cat while Mike runs through the finer details of protecting the pump with a cover and sprinkler in the event of a fire.</p> <p>I watch the garden soaking up the unexpected bounty and notice that some of the plants have gone a bit leggy. Their undergrowth is woody with age. I’ll have to cut that back, prune off the old growth. Some of them may have to go. Much as I love Australian plants and their waterwise habits, I can’t have many in the garden. Most of them are just too flammable.</p> <p>Everything we do here, every decision we make, is shaped by fire risk: the garden, the house, our holidays, our movements, where we park the cars, our power and our water supply, even our telecommunications.</p> <p>It is relentless. A friend of mine who went through Ash Wednesday said she was just tired, after 45 years, of the constant worry. She wanted to move somewhere safer. But she couldn’t bring herself to leave the bush.</p> <p>Perhaps it would be easier not to know the risk, to live in ignorance.</p> <p style="text-align: center;"><a href="https://images.theconversation.com/files/305110/original/file-20191204-70133-1nkvveo.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img style="display: block; margin-left: auto; margin-right: auto;" src="https://images.theconversation.com/files/305110/original/file-20191204-70133-1nkvveo.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">Though the worry is constant, many people can’t bring themselves to leave the bush.</span> <span class="attribution"><span class="source">Author provided</span></span></p> <p style="text-align: left;"><strong>‘Too busy’</strong></p> <p>My local fire brigade had an open day a few weeks ago. The volunteers were busy for days, cleaning the shed, preparing the sausage sizzle. Lots of new people have moved into the area, mostly from the city, and chances are they don’t appreciate the risks of living in a bushfire-prone area.</p> <p>The brigade put up signs, distributed flyers and knocked on doors with invitations. On the open day, I wander over and ask how many people have turned up.</p> <p>“Oh about half a dozen,” says the captain brightly, before adding, “Well, maybe four actually. And only two of those are new.”</p> <p>Someone asks about a family who has moved into a property down the road, a younger couple with kids and a stay-at-home dad. Would he be interested in joining the fire brigade?</p> <p>“Said he was too busy. Maybe later when the kids are older.”</p> <p>There are more and more people moving into the high risk urban fringes of our major cities, where houses mingle with flammable vegetation. Fewer and fewer people have the time or inclination to join their local volunteer fire brigade.</p> <p>Many of them commute for work. They think fire-fighting is what happens when you ring 000. They don’t seem to realise that outside of the city, it is every community for itself. We have to fight our own fires.<a href="https://images.theconversation.com/files/305087/original/file-20191204-70144-4l4mik.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/305087/original/file-20191204-70144-4l4mik.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">Increasing population in the urban interface.</span> <span class="attribution"><span class="source">Author provided.</span></span></p> <p>I’m watching the news filled with images of the fires in New South Wales. Traumatised householders stand in front of the twisted wreckage of their homes. Tumbled masses of brick and iron are all that remain of a house full of memories.</p> <p>“We never expected….”</p> <p>“I’ve never seen….”</p> <p>“I never imagined….”</p> <p>No matter how well prepared we are for fires, we always underestimate the scale of the loss – the photos, the family pets, the mementos and heirlooms, or simply the decades of work building a house, a property, a business.</p> <p>Looking at the television screen, I can’t help but notice the blackened tree trunks next to the ruins of their homes. I worked for a while in community safety for the Country Fire Authority when we lived in Victoria, researching and writing <a href="https://www.researchgate.net/publication/270275555_Coping_with_fire_Psychological_preparedness_for_bushfires">reports</a>, and later <a href="https://www.ligatu.re/book/a-future-in-flames/">a book</a>, on how people respond to bushfires.</p> <p>I’m well versed in the risk factors – proximity to native vegetation, fuel loads, clearance around houses, house construction and maintenance and most importantly of all, human behaviour.</p> <p><strong>Leaving is not easy</strong></p> <p>I used to live in a forest too, with mature eucalypts surrounding my house. We always knew this was a risk. We cleared the undergrowth and removed any “ladders” of vegetation that could allow ground fires to climb the trees. We removed new saplings growing close to the house.</p> <p>We did as much as we could to make our 1970s home fire safe: installing sprinklers, sealing the roof, covering all the timber fascias in metal cladding.</p> <p>In an average fire, we probably would have been fine. But when the Kinglake fires approached from the north on Black Saturday, I was no longer sure we would survive. A last-minute wind change swept the fire away from our home.</p> <p>Like many people, in and around the impact zone, the fires uprooted us and disconnected us. There were so many deaths, so many people and houses gone. And yet so many are still living in the same risky buildings, often rebuilt in the same risky locations. As if we never learn.</p> <p>We no longer felt so attached to our home. When the opportunity to leave arose, we took it. When we moved to South Australia, we still wanted to live in the bush, despite the fire risk. But it seemed impossible to find a home that had been built for bushfire safety.</p> <p>A real estate agent showed me an elevated timber home that looked out to the south-west across vast hectares of native forest. A death trap if ever there was one.</p> <p>“Yes,” agreed the agent. “I’ll just have to find a buyer who doesn’t mind about that.”</p> <p>Our new house is built of stone, steel and iron, with double-glazed windows and a simple roofline surrounded by sprinklers and hard paving. Every crack and crevice is sealed. And it sits in the middle of a cleared paddock surrounded by a low-flammability garden. We look out over the bushland from a safer distance.</p> <p>When my children were small, I packed them up and took them into town on every or total fire ban day. It was the prevailing advice from fire authorities. I cannot recall anyone else who did so – it is too hard, too disruptive and too inconvenient. And what do you do with the pets and horses and sheep? Let alone farms and businesses whose assets are practically uninsurable.</p> <p>Besides, there are so many total fire ban days and they are getting more and more frequent. We’d be leaving for all of summer soon and not everyone has somewhere safer to go.</p> <p>My former colleagues at the CFA confirmed that <a href="https://www.sciencedirect.com/science/article/abs/pii/S037971120000014X">few people take this advice to leave on total fire ban days</a>. When the fire risk categories were upgraded to include “catastrophic”, people simply recalibrated their fire risk range to suit.</p> <p>Now total fire ban days are everyday, ordinary events and people only talk about leaving if the risk is catastrophic or “code red”. And even then, few of them do.</p> <p>That’s why fire agencies continue to put so much effort into teaching people how to stay and defend their homes – because that is where they are going to end up, no matter what they are told or what they say. After the shocking deaths on Black Saturday, urban politicians thundered in self-righteous fury.</p> <p>“Why don’t you just tell people to leave?”</p> <p>Like it is that easy.</p> <p><strong>Other people's fates</strong></p> <p>I’m reminded of the <a href="https://ajem.infoservices.com.au/items/AJEM-13-03-17">neighbourhood fire safety programs</a>. These are groups of neighbours in fire risk areas who meet up regularly to undertake training in fire preparation. They run in several states, such as <a href="https://www.cfa.vic.gov.au/plan-prepare/community-fireguard">Community Fireguard</a> in Victoria, <a href="https://www.cfs.sa.gov.au/site/resources/text_only/community_fire_safe.jsp">Community Fire Safe</a> in SA and <a href="https://www.fire.nsw.gov.au/page.php?id=133">Community Fire Units</a> in NSW.</p> <p>Some of the groups in Victoria have continued for years, often meeting annually just before the fire season to run through their plans and discuss issues they might be having. They share advice on how to protect properties, what to do when things go wrong, whose house offers the safest refuge, who is leaving and who is staying. They establish phone trees to warn everyone of imminent dangers and to stay in touch.</p> <p>I know <a href="https://www.researchgate.net/publication/337670275_A_review_of_the_role_of_Community_Fireguard_in_the_2009_Black_Saturday_bushfires">these programs work</a>. I surveyed many of the fireguard groups who survived Black Saturday and compared them to neighbours who weren’t in groups.</p> <p>The active members of fireguard groups were more likely to defend their houses. Active members’ houses were also more likely to survive, even when they were not defended. A handful felt their training had not prepared them for the severity of the fires they faced. In truth, I don’t think anyone, not even the most experienced firefighter, expected the severity of those fires. But the vast majority were certain their training helped, and had saved their lives.</p> <p>In every group, there are people who do the work and those who don’t. There are always neighbours who are too busy for the training and just ask for the notes, which they never read. They want to be on the phone tree, even though they have not prepared their property and have not thought about what they will do in an emergency. These “inactive” members do not seem to benefit from training. Their houses have the same loss rates as people who aren’t in fireguard groups.</p> <p>No matter how much other members of the group support them and encourage them, it does not help. I’ve tried to help before, running a fireguard group, but I don’t want to do it again. I don’t want to hold myself responsible for other people’s fates. It is enough to take responsibility for myself and my family.</p> <p>I remember the fireguard trainers who blamed themselves, who were blamed by others, when neighbourhoods they had worked with suffered deaths and house losses. They often targeted the riskiest locations, areas that were virtually indefensible. Their information was not always accepted.</p> <p>Trainers, some of whom had lost friends, neighbours and houses in the fires themselves, felt criticised for advice that had not been given, and also for advice that had not been taken. You cannot defend yourself against such angry grief, particularly when you are carrying so much of your own. You just have to listen. A court of law, which looks only for someone to blame, is no place to resolve the <a href="https://www.stockandland.com.au/story/3640945/bushfire-commission-lashes-government-failures/">complexities of bushfire tragedies</a>.</p> <p>I had originally thought, when I wrote <a href="https://www.ligatu.re/book/a-future-in-flames/">my book about bushfires</a>, that it would be a simple analysis of the lessons we had learnt. After the Black Saturday fires, I had to write a completely different book. I realised it wasn’t about lessons learnt (even though there are many), it was about our failure to learn from history, our astonishing capacity to repeat the mistakes of the past.</p> <p><strong>Harder and harder to protect people</strong></p> <p>“We never expected….”</p> <p>“I’ve never seen….”</p> <p>“I never imagined….”</p> <p>The same things are said after every fire. Blaming a lack of prescribed burning in distant parks when we know that preparation within 100 metres of our own homes is far more important.</p> <p>Waiting for an “official” warning, as an evil-looking, yellow-black cloud streams overhead and embers land sizzling in the pool beside you.</p> <p>Politicians with slick, easy point-scoring ways that divert attention from their own policy obstruction.</p> <p>The hopeful denial that bad things only happen to other people and won’t happen to us.</p> <p>We’ve just experienced the <a href="https://www.facebook.com/bureauofmeteorology/videos/1577380252402576/?t=16">hottest year on record, and the second driest year on record</a>. We have lost <a href="https://pursuit.unimelb.edu.au/articles/why-are-our-rainforests-burning">rainforests that have not burnt</a> for millennia and may not recover. With climate change, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785963/">fires have become more frequent</a> across all the Australian states, and with more extreme weather events, they are likely to become even <a href="https://theconversation.com/climate-change-will-make-fire-storms-more-likely-in-southeastern-australia-127225">less predictable and more dangerous</a>.</p> <p>There is no avoiding the fact that for the next few decades, we face an increasingly dangerous environment. We have more people living in more dangerous areas, in a worsening climate. Our volunteer firefighters are ageing, and local brigades struggle to entice new members to join. It’s getting harder and harder to protect people.</p> <p>It would be nice if there was a silver bullet to protect us. If broad-scale <a href="https://www.tandfonline.com/doi/abs/10.1080/08941920.2014.905894">prescribed burning in parks actually protected houses</a> and lives, or if we had enough fire trucks and water bombers to save us all.</p> <p>It would be great if we had a cohesive suite of integrated bushfire policies across states, strong enough to survive from one generation to the next. They could include adequate building standards and <a href="https://www.resorgs.org.nz/wp-content/uploads/2017/07/resource_challenges_for_housing.pdf">access to materials</a>, effective <a href="https://ajem.infoservices.com.au/items/AJEM-27-04-09">planning and development codes</a>, <a href="https://eprints.qut.edu.au/63845/">integrated municipal, state and federal strategies</a> incorporating education, health and safety campaigns. We could create a culture of fire-awareness, rather than panicked responses to disasters followed by a long, inevitable slide into apathy and ennui.</p> <p>Perhaps one day we will. But in the meantime, our best protection lies in our own hands, safeguarding our own property and making carefully considered plans in advance as to how to save our own lives. It is not an easy path, and one none of us wants to take. But in the end, we are the only ones who can do it.</p> <p><em>Views expressed are the author’s own and do not reflect or represent those of the CFA or any other fire agency.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/128093/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/danielle-clode-442877">Danielle Clode</a>, Senior Research Fellow in Creative Writing, <a href="http://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/friday-essay-living-with-fire-and-facing-our-fears-128093">original article</a>.</em></p>

Domestic Travel

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Fergie describes Christmas with the royals as “exhausting”

<p>Although Christmas with the Royal Family would be a celebration like no other, Sarah Ferguson has claimed the festive gathering at Sandringham is “exhausting”.</p> <p>The 59-year-old ex-wife of Prince Andrew and mother of Princess Beatrice and Princess Eugenie, spent many Decembers partaking in the family’s traditions while she was married into the family from 1986 until 1992.</p> <p>Despite many fans watching the royals’ annual parade to St Mary Magdalene Church in Norfolk on Christmas Day, Fergie has said that the day is less exciting than what it seems.</p> <p>According to <a href="https://www.newidea.com.au/"><strong><em><u>New Idea</u></em></strong></a>, Fergie said that Christmas celebrations were draining as the Queen didn’t relax on royal protocol and each guest is expected to follow strict rules.</p> <p>The Duchess of York said she had to change her outfit seven times over Christmas Eve and Christmas Day in order to wear a new outfit for each separate event.</p> <p>A change of outfit is reportedly required for the Christmas Eve banquet, Christmas Day breakfast, lunch, afternoon tea, dinner and casual change of clothes for walking the grounds.</p> <p>This Christmas also marks Duchess Meghan’s mum, Doria Ragland’s, first visit to Sandringham for the Christmas season.</p> <p>According to royal expert Jean Broke-Smith, Doria Ragland will have to prepare herself for a unique celebration.</p> <p>“There will be advisors on hand to help Meghan’s mum Doria Ragland, but it is going to be difficult,” the advisor and judge on <em>Australian Princess </em>told <em>New Idea</em>.</p> <p>“For one thing she will need to bring a trunk full of clothes from California.”</p> <p>The thoughtful gesture by the Queen to invite Doria to Christmas at the palace is a first for the royals, with the Middletons never receiving the invite before.</p> <p>“It’s a mark of the Queen’s respect for Meghan and an acknowledgement that she doesn’t have any other relations in this country – unlike Kate who has the support of a very close family,” the <em>Express</em> previously reported. </p>

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10 tips to save your holiday from jet lag

<p><em><strong>Joel Centano writes for <a href="http://blog.virtuoso.com/" target="_blank"><span style="text-decoration: underline;">Virtuoso Luxury Traveller</span></a>, the blog of a <a href="http://www.virtuoso.com/" target="_blank"><span style="text-decoration: underline;">global luxury travel network</span></a>, and he enjoys nothing more than taking a holiday.</strong></em></p> <p>It’s midday in the destination of your dreams. The sun is shining. Sites you’ve waited years to see are calling.</p> <p>But after a full night spent staring at your hotel room’s ceiling, your body is dragging. Your internal clock is signalling that it’s time to sleep.</p> <p>The modern miracle of air travel makes it possible to soar to the other side of the world in a matter of hours. But the swift traversing of time zones can take a serious toll, resulting in everything from insomnia and exhaustion to headaches, nausea, and disorientation.</p> <p>No doubt: Jet lag, aka “circadian desynchrony” in medical circles, can be a beast. But it’s one that can – and should – be tamed for the sake of your vacation. How? Follow these 10 simple steps, with sage advice from Virtuoso travel advisors.</p> <p><strong>1. Rest assured</strong></p> <p>To deal with jet lag, pre-emptive strikes are often the most potent. “Getting a good night’s sleep before the trip will dramatically help your body maintain its energy levels while traveling,” says Paôla Mansur, a Virtuoso travel advisor based in São Paulo.</p> <p>Also de-stress, exercise, and get your affairs in order before flying. All of those will help you sleep on the plane and in your hotel room when the time is right (read on).</p> <p><strong>2. Synchronize from the start</strong></p> <p>Jet lag rule of thumb number 1: For each time zone you cross, it can take your body up to one day to adjust to the local time. The cure?</p> <p>“Set your watch to your destination time when you board the plane and act as if you’re already in that time zone,” says Long Beach, California-based advisor John Oberacker. “If it’s night there, try to sleep. If it’s day, do your best to stay awake.”</p> <p>Sleep experts also recommend rising and going to bed earlier several days prior to a trip heading east and later when traveling west. To deal with jet lag, you can also shift meal times to sync with dining hours in your future destination.</p> <p><strong>3. Fly well to deal with jet lag</strong></p> <p>For any long-distance flight, comfort is key. The more R&amp;R you get in flight, the better you’ll deal with jet lag. “Flying business or first class will help you rest and be ready for your travels,” notes advisor Mary Ann Ramsey of Naples, Florida.</p> <p>Remember, too, that sleep aids such as eye masks, earplugs, neck pillows, and noise-reducing headphones are your friends. Need more help? “Consult your doctor about a light drowsy medication like Benadryl for an overnight flight,” recommends New York City-based advisor Jack Ezon. Natural remedies such as melatonin are also purported to induce sleep and speed up the resynchronization process in your new time zone.</p> <p><img width="500" height="250" src="https://oversixtydev.blob.core.windows.net/media/23095/shutterstock_203546308_500x250.jpg" alt="jetlag"/></p> <p><strong>4. Break up your itinerary</strong></p> <p>Lisa Leavitt, a Boston-based advisor and mother of two teenagers, also recommends (if it’s feasible) an overnight layover en route to your ultimate destination. “During my recent family vacation to Hawaii,” she notes, “I arranged flights with an overnight hotel stay in San Francisco, which significantly lessened our jet lag.”</p> <p><strong>5. Just say no</strong></p> <p>You may love your coffee after dinner. Or your glass of wine with dinner to take the edge off flying. But for 12 hours before, as well as during, your flight, “stay away from caffeine and alcohol,” says Phoenix-based advisor Judi Glass. “Both dehydrate you, which makes jet lag worse.”</p> <p>Instead, she advises, drink lots of water to deal with jet lag. Experts recommend at least eight ounces for every hour in flight. Other tips for staying hydrated? Carry on moisturizing lotion, lip balm, and a hydrating spray with essential oils. In TSA-approved sizes, of course.</p> <p><strong>6. Quit kidding around</strong></p> <p>“For younger children, bring pajamas on every overnight flight,” says Ezon, a father of four. “Not only will it help get kids into sleep mode, but it also helps them feel fresh when they wake and change clothes.”</p> <p>When it’s time for bed, he adds, “collect their iPads and shut off the personal TVs. And on shorter overnight flights, don’t even look at the movie list. Go right to sleep!”</p> <p><strong>7. Stick your landing</strong></p> <p>For daytime arrivals, stay active and, at all costs, wait until nighttime to sleep. Be sure to spend time in the sunlight as well. This will help you deal with jet lag by adjusting your internal clock to your new surroundings. “If you land in the morning,” adds Ramsey, “schedule a private car and driver so you can sightsee at your own pace.”</p> <p>To ward off potential meltdowns in little ones? “If you have access to a pool, hop in the water, or do a family hike or run,” says Ezon. “And though I normally forbid soda, I always keep a few Cokes on hand for a caffeine rush when my kids get tired and cranky the first few days. It’s a life saver.”</p> <p><strong>8. Hit the spa…</strong></p> <p>Massages and spa treatments – especially during (think airport massages) and at the beginning of your trip – are essential to deal with jet lag, advises Mansur. Many hotels also offer special jet-lag-centric treatments that promote circulation, detoxification, and relaxation. Consider the spa at Bulgari Hotel Milan. It provides a Jet Lag Recovery experience that includes a detoxifying salt scrub, Balinese hot-stone massage, hydrating eye treatment, and refining clay body wrap.</p> <p>At Park Hyatt New York, Spa Nalai’s new Jet Lag Therapy remedies swelling, bloating, and body water retention, along with shoulder and back pain built up over long flights. Light therapy can also be a savior to deal with jet lag. The Lucknam Park Hotel &amp; Spa in Bath, England helps banish it with Haslauer Reflective Sunlight Therapy. The treatment offers the benefits of natural sunlight and vitamin D.</p> <p><strong>9. …Then sleep on it</strong></p> <p>When it’s time to sleep, sleep with abandon. Ask your Virtuoso travel advisor to book hotels that are committed to helping you catch some Z’s, such as Las Vegas’ The Signature at MGM Grand. The hotel offers Stay Well rooms with dawn simulator alarm clocks, lighting that resets wake-sleep cycles, and aromatherapy diffusers.</p> <p>In Abu Dhabi, butlers at Qasr al Sarab Desert Resort by Anantara prepare candlelit evening baths infused with calming essential oils. The hotel also provides guests with eye masks, earplugs, and special beds that relieve pressure points.</p> <p><strong>10. Stay strong</strong></p> <p>There’s no sure-fire way to deal with jet lag. But taking the above steps should help lessen its effects. If all else fails, however, think mind over matter. Will yourself awake and remember: This may be the last time you’re in your dream destination. There will be plenty of time to sleep during your return flight home.</p> <p>Do you take any measures when you’re travelling to stave off jet lag? Do you agree with any of the suggestions made above?</p> <p>Share your thoughts in the comments.</p> <p><em>First appeared on Virtuoso. <a href="http://www.virtuoso.com/" target="_blank"><strong><span style="text-decoration: underline;">Click here</span></strong></a> to visit their website for more information.</em></p> <p><strong>Related links:</strong></p> <p><a href="/travel/travel-tips/2016/05/10-ways-to-beat-travel-sickness/"><span style="text-decoration: underline;"><em><strong>10 ways to beat travel sickness</strong></em></span></a></p> <p><a href="/travel/travel-tips/2016/06/23-items-you-must-have-in-your-carry-on-luggage/"><span style="text-decoration: underline;"><em><strong>23 items you must have in your carry-on luggage</strong></em></span></a></p> <p><a href="/travel/travel-tips/2016/06/5-things-to-do-to-avoid-getting-worst-seat-on-the-plane/"><strong><em><span style="text-decoration: underline;">5 things to do to avoid getting worst seat on the plane</span></em></strong></a></p>

Travel Tips

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Exhausted wallaby rescued at sea

<div class="yiv1372129280" id="yiv1372129280yui_3_16_0_1_1449783217967_65344"> <p>A group of marina biologists have rescued a wallaby almost a kilometre off the New South Wales north coast in Australia. The creature- whom they affectionately named "Swampy"- was confused and exhausted, found treading water out at sea.</p> <p>“We see this thing swimming – it’s like a hairy thing,” says Laura Sanchez-Peregrine, who spotted the stranded wallaby.</p> <p>“At first I thought it was a seal, but we came closer and it was a big wallaby, maybe a 25-kilogram wallaby — a big male,” she said in an interview with the Australian Women’s Weekly.</p> <p>Laura and her fellow students managed to hoist the exhausted wallaby on board their small tin boat, bobby off-shore in Coffs Harbour.</p> <p>“At first, it was very difficult: he was defensive (and wallabies have huge claws), and we almost gave up and left it all in hands of Natural Selection,” she said on her Instagram account. “But we tried hard and we managed to bring him up on board, tied his legs up with a rope, put a towel on his head to calm him down. And he was all calm and still on the way back to the shore, not complaining much.”</p> <p>When they got to the shore, it was clear the poor guy was exhausted. After a few moments of recovery, and no doubt glad to be on solid ground, he bounded away.</p> <p>“And then yeah, he just went- hopped off and waved goodbye.” </p> <p><strong>Related links:</strong></p> <p><strong><em><a href="http://www.oversixty.co.nz/lifestyle/family-pets/2015/11/clever-cop-saves-dog/">Clever cop saves dog with a moment of inspiration</a></em></strong></p> <p><strong><em><a href="http://www.oversixty.co.nz/lifestyle/family-pets/2015/12/happiest-dogs-in-the-world/">The happiest dogs in the world</a></em></strong></p> <p><strong><em><a href="http://www.oversixty.co.nz/lifestyle/family-pets/2015/11/interspecies-animal-friendships/">15 unlikely friendships that will melt your heart</a></em></strong></p> </div>

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