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What is methanol? How does it get into drinks and cause harm?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ian-musgrave-1808">Ian Musgrave</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Melbourne teenager Bianca Jones <a href="https://www.abc.net.au/news/2024-11-21/bianca-jones-dead-laos-methanol-poisoning/104630384">has died</a> and her friend Holly Bowles remains severely ill in hospital in Thailand, after experiencing suspected methanol poisoning while they were travelling in Laos. The pair are reportedly among <a href="https://x.com/Smartraveller/status/1858850858227954118">several foreign nationals</a> who became ill after unknowingly consuming alcoholic drinks containing methanol in the south-east Asian country. So what is methanol, and how does it make people sick? <h2>Methanol versus ethanol</h2> <a href="https://en.wikipedia.org/wiki/Methanol">Methanol</a> is an <a href="https://en.wikipedia.org/wiki/Alcohol_(chemistry)">alcohol</a>, like the familiar <a href="https://en.wikipedia.org/wiki/Ethanol">ethanol</a> we consume in alcoholic beverages. Like ethanol, methanol is a colourless, flammable liquid. It has a smell similar to ethanol as well. But the two have different chemical structures. Methanol is composed of only one carbon atom, while ethanol has two. <figure class="align-center "><img src="https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=300&fit=crop&dpr=1 600w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=300&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=300&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=377&fit=crop&dpr=1 754w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=377&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=377&fit=crop&dpr=3 2262w" alt="Models of methanol and ethanol depicted with balls and sticks." /><figcaption>Methanol (left) and ethanol (right) have differing chemical structures. Wikimedia Commons, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> That one carbon atom makes all the difference. It means methanol is processed differently in our bodies and is much more toxic than ethanol. Methanol is used in a <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Methanol">variety of industrial and household products</a>, such as windshield cleaning fluids, antifreeze and fuel. It’s not safe for human consumption. <h2>What makes methanol toxic?</h2> The difference is in how methanol is metabolised, or broken down in our bodies. Ethanol is metabolised into a chemical compound called acetaldehyde. Acetaldehyde is toxic, but is rapidly converted to acetate (also known as acetic acid, found in vinegar). Generating an acid may sound bad, but acetate actually <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6699882/">produces energy and makes important molecules</a> in the body. By contrast, methanol is metabolised into <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/formaldehyde">formaldehyde</a> (a chemical used in <a href="https://www.safework.nsw.gov.au/hazards-a-z/hazardous-chemical/priority-chemicals/formaldehyde">industrial glues</a> and for embalming corpses, for example) and then to <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Formic-Acid">formic acid</a> (the chemical in some ant bites that makes them hurt so much). Unlike acetate, which the body uses, formic acid <a href="https://pubmed.ncbi.nlm.nih.gov/1665561/">poisons the mitochondria</a>, the powerhouses of the cells. As a result, a person exposed to methanol can go into severe <a href="https://www.ncbi.nlm.nih.gov/books/NBK482121/">metabolic acidosis</a>, which is when too much acid builds up in the body. Methanol poisoning can cause nausea, vomiting, and abdominal pain. The acidosis then causes depression of the central nervous system which can cause people with methanol poisoning to fall unconscious and go into a coma, as well as retinal damage leading to vision loss. This is because the retinas are full of active mitochondria and sensitive to them being damaged. Death is not inevitable if only a small amount of methanol has been consumed, and rapid treatment will greatly reduce damage. However, permanent vision damage can occur even at <a href="https://www.ncbi.nlm.nih.gov/books/NBK482121/">non-lethal doses</a> if treatment is not administered quickly. <h2>What does treatment involve?</h2> <a href="https://www.ncbi.nlm.nih.gov/books/NBK482121/">Treatment</a> is mainly supportive care, such as intubation and mechanical ventilation to help the patient to breathe. But it can also involve drugs such as <a href="https://go.drugbank.com/drugs/DB01213">fomepizole</a> (which inhibits the generation of toxic formic acid) and dialysis to remove methanol and its metabolites from the body. <h2>How does methanol get into alcoholic drinks?</h2> Methanol can turn up in any alcoholic beverage, but it’s most likely in beverages with higher alcohol content, such as spirits, and traditionally brewed drinks, such as fruit wines. Methanol can get into alcoholic beverages in a number of ways. Sometimes it’s added <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8303512/">deliberately and illegally</a> during or after manufacturing as a cheaper way to increase the alcohol content in a drink. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5028366/">Traditional brewing methods</a> can also inadvertently generate methanol as well as ethanol and produce toxic levels of methanol depending on the microbes and the types of plant materials used in the fermentation process. We don’t yet know how the Australian teenagers came to be poisoned in this tragedy. But it is a good idea when travelling (particularly in areas with traditionally fremented drinks, such as south-east Asia, the Indian subcontinent and parts of Africa) to always be careful. The Australian government’s <a href="https://www.smartraveller.gov.au/before-you-go/safety/partying#methanol">Smartraveller website</a> advises that to avoid methanol poisoning you should be careful drinking cocktails and drinks made with spirits, drink only at reputable licensed premises and avoid home-made alcoholic drinks. Drinking only mass-produced commercial brews can be safer, though understandably people often want to try locally made drinks as part of their adventure.<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/244151/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-musgrave-1808">Ian Musgrave</a>, Senior lecturer in Pharmacology, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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-methanol-how-does-it-get-into-drinks-and-cause-harm-244151">original article</a>. </div>

Body

What causes the itch in mozzie bites? And why do some people get such a bad reaction?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Are you one of these people who loathes spending time outdoors at dusk as the weather warms and mosquitoes start biting? Female mosquitoes <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-ento-120811-153618">need blood</a> to develop their eggs. Even though they take a tiny amount of our blood, they can leave us with itchy red lumps that can last days. And sometimes something worse. So why does our body react and itch after being bitten by a mosquito? And why are some people more affected than others? <h2>What happens when a mosquito bites?</h2> Mosquitoes are attracted to warm blooded animals, including us. They’re attracted to the <a href="https://www.cambridge.org/core/journals/bulletin-of-entomological-research/article/abs/role-of-carbon-dioxide-in-hostfinding-by-mosquitoes-diptera-culicidae-a-review/2506B86EF63852B2D02EC3FCEE1E3B8B">carbon dioxide</a> we exhale, our body temperatures and, most importantly, <a href="https://www.abc.net.au/news/2024-11-08/mosquitoes-climate-change-skin/104548122">the smell of our skin</a>. The <a href="https://www.cell.com/trends/parasitology/abstract/S1471-4922(21)00237-3">chemical cocktail</a> of odours from bacteria and sweat on our skin <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(23)00532-8">sends out a signal</a> to hungry mosquitoes. <a href="https://www.sciencedirect.com/science/article/pii/S2667114X21000522">Some people’s</a> skin smells more appealing to mosquitoes, and they’re more likely to be bitten than others. Once the mosquito has made its way to your skin, things get a little gross. The mosquito pierces your skin with their “proboscis”, their feeding mouth part. But the proboscis isn’t a single, straight, needle-like tube. There are multiple tubes, <a href="https://www.npr.org/sections/health-shots/2016/06/07/480653821/watch-mosquitoes-use-6-needles-to-suck-your-blood">some designed</a> for sucking and some for spitting. Once their mouth parts have been inserted into your skin, the mosquito will inject some saliva. This contains a mix of chemicals that gets the blood flowing better. There has even been a suggestion that future medicines could be inspired by the <a href="https://www.sydney.edu.au/news-opinion/news/2018/03/29/mosquito-saliva-vital-to-the-discovery-of-future-drugs.html">anti-blood clotting properties</a> of mosquito saliva. It’s not the stabbing of our skin by the mosquito’s mouth parts that hurts, it’s the mozzie spit our bodies don’t like. <h2>Are some people allergic to mosquito spit?</h2> Once a mosquito has injected their saliva into our skin, a variety of reactions can follow. For the lucky few, nothing much happens at all. For most people, and irrespective of the type of mosquito biting, <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.1024559/full">there is some kind of reaction</a>. Typically there is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0161589023002304?via%3Dihub">redness and swelling of the skin</a> that appears within a few hours, but often more quickly, after just a few minutes. Occasionally, the reaction can cause pain or discomfort. Then comes the <a href="https://www.abc.net.au/news/health/2023-01-20/mosquito-bites-itchy-calamine-heat-ice-antihistamine-toothpaste/101652608">itchiness</a>. Some people do suffer severe reactions to mosquito bites. It’s a condition often referred to as “<a href="https://www.webmd.com/allergies/what-is-skeeter-syndrome">skeeter syndrome</a>” and is an allergic reaction caused by the protein in the mosquito’s saliva. This can cause large areas of swelling, blistering and fever. The chemistry of mosquito spit hasn’t really been well studied. But it has been shown that, for those who do suffer allergic reactions to their bites, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0091674904022183">reactions may differ</a> depending on the type of mosquito biting. We all probably get more tolerant of mosquito bites as we get older. Young children are certainly more likely to suffer more following mosquito bites. But as we get older, the reactions are less severe and may pass quickly without too much notice. <h2>How best to treat the bites?</h2> Research into treating bites <a href="https://linkinghub.elsevier.com/retrieve/pii/S0161589023002304">has yet to provide</a> a single easy solution. There are many <a href="https://www.healthline.com/health/outdoor-health/home-remedies-for-mosquito-bites">myths and home remedies</a> about what works. But there is little scientific evidence supporting their use. The best way to treat mosquito bites is by applying a cold pack to reduce swelling and to keep the skin clean to avoid any secondary infections. Antiseptic creams and lotions may also help. There is some evidence that <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10309056/">heat may alleviate</a> some of the discomfort. It’s particularly tough to keep young children from scratching at the bite and breaking the skin. This can form a nasty scab that may end up being worse than the bite itself. Applying an anti-itch cream may help. If the reactions are severe, <a href="https://www.healthdirect.gov.au/insect-bites-and-stings">antihistamine medications</a> may be required. <h2>To save the scratching, stop the bites</h2> Of course, it’s better not to be bitten by mosquitoes in the first place. Topical <a href="https://theconversation.com/insect-repellents-work-but-there-are-other-ways-to-beat-mosquitoes-without-getting-sticky-171805">insect repellents</a> are a safe, effective and affordable way to reduce mosquito bites. Covering up with loose fitted long sleeved shirts, long pants and covered shoes also provides a physical barrier. <a href="https://theconversation.com/are-mosquito-coils-good-or-bad-for-our-health-88548">Mosquito coils and other devices</a> can also assist, but should not be entirely relied on to stop bites. There’s another important reason to avoid mosquito bites: millions of people around the world suffer from mosquito-borne diseases. More than <a href="https://www.who.int/news-room/fact-sheets/detail/malaria">half a million people die</a> from malaria each year. In Australia, <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005070">Ross River virus</a> infects more than 5,000 people every year. And in recent years, there have been cases of serious illnesses caused by <a href="https://www.science.org/content/article/how-rains-pigs-and-waterbirds-fueled-shocking-disease-outbreak-australia">Japanese encephalitis</a> and <a href="https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1256149/full">Murray Valley encephalitis</a> viruses. <a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, Clinical Associate Professor and Principal Hospital Scientist, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-causes-the-itch-in-mozzie-bites-and-why-do-some-people-get-such-a-bad-reaction-243044">original article</a>. </div>

Body

Hotel booking sites actually make it hard to get cheap deals, but there’s a way around it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a> Booking a place to stay on holidays has become a reflex action. The first thing many of us do is open a site such as <a href="https://www.wotif.com/">Wotif</a>, <a href="https://au.hotels.com/?locale=en_AU">Hotels.com</a> or <a href="https://www.trivago.com.au/">trivago</a> (all of which are these days owned by the US firm <a href="https://www.accc.gov.au/media-release/accc-will-not-oppose-expedia%E2%80%99s-proposed-acquisition-of-wotif">Expedia</a>), or their only big competitor, <a href="https://www.booking.com/">Booking.com</a> from the Netherlands. Checking what rooms are available – anywhere – is wonderfully easy, as is booking, at what usually seems to be the lowest available price. But Australia’s Assistant Competition Minister Andrew Leigh is concerned there might be a reason the price seems to be the lowest available. It might be an <a href="https://ministers.treasury.gov.au/ministers/andrew-leigh-2022/media-releases/supporting-tourism-and-accommodation-providers-set-their">agreement not to compete</a>, or the fear of reprisals against hotel owners who offer better prices. <h2>Agreements to not compete</h2> Leigh has asked the treasury to investigate, and if that’s what it finds, it may be the booking sites have the perverse effect of keeping prices high, especially when the substantial fees they charge hotels are taken into account. For now, the treasury is seeking information. It has set a deadline of <a href="https://treasury.gov.au/consultation/c2022-338978">January 6</a> for hotel operators and booking sites to tell it: <ul> <li> the typical fees charged by online booking platforms </li> <li> the details of any agreements not to compete on price </li> <li> whether hotels that try to compete get ranked lower on booking sites. </li> </ul> What’s likely to come out of it is a ban on so-called price-parity clauses that prevent discounting, or a ban on “algorithmic punishment,” whereby hotels that do discount get pushed way down the rankings on the sites. But in the meantime, there are things we can do to get better prices, and they’ll help more broadly, as I’ll explain. <h2>Flight Centre precedent</h2> <figure class="align-right zoomable"></figure> Back in 2018, in a case that went all the way to the High Court, the Australian Competition and Consumer Commission (ACCC) forced <a href="https://www.accc.gov.au/media-release/flight-centre-ordered-to-pay-125-million-in-penalties">Flight Centre</a> to pay a penalty of A$12.5 million for attempting to induce airlines not to undercut it on ticket prices. That the ACCC eventually won the case might be an indication price-parity clauses are already illegal under Australian law. But it’s a difficult law to enforce. This is why the treasury is considering special legislation of the kind in force in France, Austria, Italy and Belgium. The ACCC has known for some time that Expedia and Booking.com have included clauses in their contracts preventing hotels offering the same room for any less than they do, even directly. Rather than take the big two to court, in 2016 the ACCC “reached agreement” with them to delete the clauses that prevented hotels offering better deals <a href="https://www.accc.gov.au/media-release/expedia-and-bookingcom-agree-to-reinvigorate-price-competition-by-amending-contracts-with-australian-hotels">face-to-face</a>. <h2>The concession that conceded little</h2> From then on, hotels were able to offer better deals than the sites over the phone or in person, but not on their own websites. Given we are less and less likely to walk in off the street or even use the phone to book a hotel, it wasn’t much of a concession. Then, in 2019, with the Commission under renewed pressure from hotel owners for another investigation, Expedia (but not Booking.com) reportedly <a href="https://www.smartcompany.com.au/business-advice/competition/expedia-allow-hotels-undercut-prices-online/">waived</a> the rest of the clauses, giving hotel owners the apparent freedom to advertise cheaper prices wherever they liked including on their own sites without fear of retribution. Except several appear to fear retribution, and very few seem to have jumped at the opportunity. <h2>Algorithmic punishment</h2> An Expedia spokesman gave an indication of what might be in store when he was quoted as saying a hotel that undercut Expedia might “find itself ranked <a href="https://www.smartcompany.com.au/business-advice/competition/expedia-allow-hotels-undercut-prices-online/">below its competitors</a>, just as it would if it had worse reviews or fewer high-quality pictures of its property”. Being ranked at the bottom of a site is much the same as not being ranked at all, something Leigh refers to as “algorithmic punishment”. It’s not at all clear the present law prevents it, which is why Leigh is open to the idea of legislating against it. Although you and I may not often think about what hotels are paying to be booked through sites such as Wotif and Booking.com, and although what’s charged to the hotel isn’t publicised, it appeard to be a large chunk of the cost of providing the room. One figure quoted is <a href="https://www.smartcompany.com.au/industries/tourism/online-travel-booking-fed-up-small-businesses-call-accc-action/">20%</a>. Leigh says hotel owners have told him the fees are in the “<a href="https://ministers.treasury.gov.au/ministers/andrew-leigh-2022/transcripts/interview-geraldine-doogue-abc-saturday-extra">double digits</a>”, something he says is quite a lot when you consider the sites don’t need to clean the toilets, change the sheets or help on the front desk. <h2>‘Chokepoint capitalism’</h2> What this seems to mean (the treasury will find out) is almost all bookings are more expensive than they need to be because firms that sit at the “<a href="https://theconversation.com/chokepoint-capitalism-why-well-all-lose-unless-we-stop-amazon-spotify-and-other-platforms-squeezing-cash-from-creators-194069">chokepoint</a>” between buyers and sellers are squeezing sellers. A hotel could always abandon the sites and offer much cheaper prices, but for a while – perhaps forever – it will be much harder to find. In their defence, the operators of the platforms might say they need to get the best offers from hotels in order to make it worthwhile for the operators to invest in their sites, an argument the treasury is inviting them to put. In the meantime, with some hotels reluctant to put their best rates on their websites, but with them perfectly able to offer better rates over the phone, there’s a fairly simple way we can all get a better deal – and help fix the broader problem by weight of numbers. If we look up the best deal wherever we want online, and then phone and ask for a better one (or a better room), we might well find we get it. We might be saving the owner a lot of money. Leigh reckons the more we do ring up, the more the sites might feel pressure to discount their own fees, helping bring prices down even before he starts to think about writing legislation.<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/196460/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National 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/hotel-booking-sites-actually-make-it-hard-to-get-cheap-deals-but-theres-a-way-around-it-196460">original article</a>. </div>

Travel Trouble

The latest COVID booster will soon be available. Should I get one? Am I eligible?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nathan-bartlett-1198187">Nathan Bartlett</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Australia’s <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">Therapeutic Goods Administration</a> (TGA) has recently approved a new COVID booster. The shot was developed by Pfizer and targets <a href="https://www.sbs.com.au/news/article/what-to-know-about-the-new-covid-19-vaccine-approved-in-australia/z7ev2u8qn">the JN.1 sub-variant</a> of Omicron. This is now <a href="https://theconversation.com/new-covid-vaccines-may-be-coming-to-australia-heres-what-to-know-about-the-jn-1-shots-237652">the fifth iteration</a> of the COVID vaccines, which have been updated regularly to keep up with the rapidly evolving virus, SARS-CoV-2. But nearly five years into the pandemic, you may be wondering, why do we need yet another type of COVID booster? And do we still need to be getting boosters at all? Here’s what to consider. <h2>Targeting the spike protein</h2> Pfizer’s JN.1 booster (and Moderna’s, though the TGA has <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">not approved</a> this one at this stage) is based on mRNA technology. This technology instructs our cells to produce a specific protein – in this case SARS-CoV-2’s spike, a protein on the surface of the virus that allows it to attach to our cells. This helps the immune system produce antibodies that recognise the spike protein and interfere with the virus getting into our cells. In response to our strengthened immune responses from vaccinations and previous infections (called immune pressure), SARS-CoV-2 has continued to evolve over the course of the pandemic, modifying the shape of its spike protein so our antibodies become less effective. Most recently we’ve faced a soup of Omicron sub-variants, including JN.1. Since JN.1 was first detected <a href="https://www.gavi.org/vaccineswork/seven-things-you-need-know-about-jn1-covid-19-variant">in August 2023</a>, this Omicron sub-variant has spawned a variety of further sub-variants, such as KP.2 (known as FLiRT), KP.3 (<a href="https://theconversation.com/from-flirt-to-fluqe-what-to-know-about-the-latest-covid-variants-on-the-rise-234073">known as FLuQE</a>) and <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">XEC</a>. The spike protein is made up of <a href="https://www.nature.com/articles/s41401-020-0485-4">1,273 amino acids</a>, a bit like molecular building blocks. Mutations to <a href="https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1228128/full">the spike protein</a> change individual amino acids. Certain amino acids are important for allowing neutralising antibodies to bind to the spike protein. This means changes can give the virus an edge over earlier variants, helping it evade our immune response. Scientists keep updating the COVID vaccines in an effort to keep up with these changes. The better matched the vaccine “spike” is to the spike protein on the surface of the virus trying to infect you, the better protection you’re likely to get. <h2>So who should get vaccinated, and when?</h2> Updating vaccines to deal with mutating viruses is not a new concept. It has been happening for the flu vaccine since <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">around 1950</a>. We’ve become accustomed to getting the annual flu vaccine in the lead-up to the winter cold and flu season. But, unlike influenza, COVID has not settled into this annual seasonal cycle. The frequency of COVID waves of infection has been fluctuating, with new waves emerging periodically. COVID is also <a href="https://academic.oup.com/jtm/article/29/8/taac108/6731971">more transmissible</a> than the flu, which presents another challenge. While numbers vary, a conservative estimate of the reproduction number (R0 – how many people will one person will go on to infect) for JN.1 is 5. Compare this to seasonal flu with an R0 of <a href="https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-480">about 1.3</a>. In other words, COVID could be four times more transmissible than flu. Add to this immunity from a COVID vaccination (or a previous infection) <a href="https://www.nature.com/articles/d41586-023-00124-y">begins to wane</a> in the months afterwards. So an annual COVID booster is not considered enough for some more vulnerable people. <iframe id="gOYwk" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/gOYwk/2/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> For adults <a href="https://www.health.gov.au/our-work/covid-19-vaccines/getting-your-vaccination">aged 65 to 74</a>, a booster is recommended every 12 months, but they’re eligible every six months. For adults over 75, a shot is recommended every six months. Adults aged 18 to 64 are eligible every 12 months, unless they have a severe immune deficiency. Many conditions can cause immunodeficiency, including genetic disorders, infections, cancer, autoimmune diseases, diabetes and lung disease, as well as having received an organ transplant. For this group, it’s recommended they receive a shot every 12 months, but they’re eligible every six. <h2>Making sense of the advice</h2> A vaccine that targets JN.1 should provide good protection against the Omicron sub-variants likely to be circulating in the coming months. A few things need to happen before the JN.1 shots become available, such as the Australian Technical Advisory Group on Immunisation providing guidance to the government. But we can reasonably expect they might be rolled out <a href="https://www.sbs.com.au/news/article/what-to-know-about-the-new-covid-19-vaccine-approved-in-australia/z7ev2u8qn">within the next month or so</a>. If they hit doctors’ offices and pharmacies before Christmas and you’re due for a booster, the holiday period might be added impetus to go and get one, especially if you’re planning to attend lots of family and social gatherings over summer. In the meantime, the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">XBB.1.5 vaccines</a> remain available. Although they’re targeted at an earlier Omicron sub-variant, they should still offer some protection. While young, healthy people might like to wait for the updated boosters, for those who are vulnerable and due for a vaccination, whether or not to hold out may be something to weigh up with your doctor. The advice on COVID boosters in Australia, with stronger wording (“recommended” versus “eligible”) used for more vulnerable groups, reflects what we know about COVID. People <a href="https://academic.oup.com/ageing/article/49/6/901/5862042">who are older</a> and medically vulnerable are more likely to become very unwell with the virus. For young, healthy people who may be wondering, “do I need a COVID booster at all?”, having one annually is sensible. Although you’re less likely to get very sick from COVID, it’s possible. And, importantly, vaccines also reduce the risk of <a href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(24)00082-1/fulltext">developing long COVID</a>. While COVID vaccines do a very good job of protecting against severe disease, they don’t necessarily stop you becoming infected. Evidence on whether they reduce transmission <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2116597">has been mixed</a>, and <a href="https://pubmed.ncbi.nlm.nih.gov/38820077/">changed over time</a>. We’ve come to appreciate that vaccination is not going to free us of COVID. But it’s still our best defence against severe illness.<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/239594/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nathan-bartlett-1198187">Nathan Bartlett</a>, Professor, School of Biomedical Sciences and Pharmacy, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-latest-covid-booster-will-soon-be-available-should-i-get-one-am-i-eligible-239594">original article</a>. </div>

Body

How to complain about aged care and get the result you want

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jacqueline-wesson-1331752">Jacqueline Wesson</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It can be hard to know what to say, or who to talk to, if you notice something isn’t right for you or a loved one in residential aged care. You might have concerns about personal or medical care, being adequately consulted about changes to care, or be concerned about charges on the latest bill. You could also be concerned about theft, neglect or abuse. Here’s how you can raise issues with the relevant person or authority to improve care and support for you or your loved one. <h2>Keep records</h2> You can complain about any aspect of care or service. For instance, if medical care, day-to-day support or financial matters do not meet your needs or expectations, you can complain. It is best to act as soon as you notice something isn’t right. This may prevent things from escalating. Good communication helps get better results. Make written notes about what happened, including times and dates, and take photos. Try to focus on facts and events. You can also keep a record of who was involved and their role. Keep track of how the provider responded or steps taken to resolve the issue. Write notes of conversations and keep copies of emails. <h2>Who do I complain to?</h2> Potential criminal matters If you have concerns about immediate, serious harm of a criminal nature then you should contact the police, and your provider immediately. These types of serious incidents include unreasonable use of force or other serious abuse or neglect, unlawful sexual contact, stealing or unexpected death. The provider may have already contacted you about this. They are required to report such <a href="https://www.agedcarequality.gov.au/consumers/serious-incident-response-scheme">serious incidents</a> to both the Aged Care Quality and Safety Commission within 24 hours, and to the police. Other matters For other matters, talk to the care staff involved. Try to find out more detail about what happened and why things went wrong. Think about what you expect in the situation. Then talk to the most senior person in charge, to see if they can make changes so things don’t go wrong in the future. This person may be called the nursing unit manager, care manager or care director. Providers must acknowledge and investigate your complaint, tell you their findings and actions taken, and follow up to see if you are satisfied. If you would like support to talk to the provider, the <a href="https://opan.org.au">Older Persons Advocacy Network</a> can help. This free service provides independent and confidential support to help find solutions with the aged-care provider. The network can also help you lodge a formal complaint. <h2>How to I lodge a formal complaint?</h2> If you are not satisfied with the way your provider responded, you can lodge a complaint with the <a href="https://www.agedcarequality.gov.au">Aged Care Quality and Safety Commission</a>. Be prepared to submit the facts and events, plus emails and correspondence, you have already collected. Think about what you want to happen to resolve the complaint. Each complaint is handled individually and prioritised depending on the risks to you or your loved one. The commission will start its processes within one business day when complaints are urgent. The resolution process took <a href="https://www.agedcarequality.gov.au/sites/default/files/media/acqsc-annual-report-2020-21.pdf">an average 40 days</a> in 2020-21. You can complain confidentially, or anonymously if you feel safer. But the commission may not be able to investigate fully if it’s anonymous. Also, there are limits to what the commission can do. It cannot ask providers to terminate someone’s employment, or provide direct clinical advice about treatment. Sometimes the commission has issued a “non-compliance” notice to the provider (for a failure to meet quality standards), and action may again <a href="https://www.abc.net.au/news/2022-05-02/aged-care-complaint-about-southern-cross-care-young/101009716">be limited</a>. So it is a good idea to check the <a href="https://www.myagedcare.gov.au/non-compliance-checker">non-compliance register</a> beforehand to see if your provider is listed. <h2>What do others complain about?</h2> From October to December 2021, <a href="https://www.agedcarequality.gov.au/sites/default/files/media/acqs-sector-performance-data-oct-dec-2021.pdf">about a third</a> of Australian nursing homes had a complaint made to the commission against them. Some had more than one complaint. More than half of these complaints were lodged by family, friends or other consumers. The top reasons for complaints were about: <ul> <li> adequacy of staffing </li> <li> medication administration or management </li> <li> infectious diseases or infection control </li> <li> personal and oral hygiene </li> <li> how falls are prevented and managed </li> <li> consultation or communication with representatives and/or family members. </li> </ul> <h2>What if I’m still not happy?</h2> If you’re not happy when you receive the commission’s outcome, you can request a review with 42 days. You can also request the <a href="https://www.ombudsman.gov.au">Commonwealth Ombudsman</a> to review the complaint if you’re not satisfied with the commission’s decision or the way the commission handled your complaint. <h2>Remember, you have a right to complain</h2> The <a href="https://agedcare.royalcommission.gov.au">Aged Care Royal Commission</a> spotlighted the neglect and substandard care that can occur in nursing homes. Despite attempts to <a href="https://www.health.gov.au/resources/publications/concepts-for-a-new-framework-for-regulating-aged-care">lift the standard of aged care</a>, we know residents and carers still have concerns. Residents, and their representatives or families, have a legal <a href="https://www.agedcarequality.gov.au/consumers/standards/resources">right to speak up and complain</a>, free from reprisal or negative consequences. This right is also reflected in the <a href="https://www.agedcarequality.gov.au/consumers/consumer-rights">Charter of Aged Care Rights</a>, which providers are legally required to discuss with you and help you understand. <h2>Moving to another facility</h2> If you have exhausted all avenues of complaint or feel conditions have not improved, you may decide to move to another provider or facility, if available. This option may not be possible in rural areas. This is a difficult decision. It takes time, as well as financial and emotional resources. Starting again with a new provider can also be disruptive for everyone, but sometimes it may be the right choice. <hr /> Contact the <a href="https://opan.org.au">Older Persons Advocacy Network</a> on 1800 700 600, the <a href="https://www.agedcarequality.gov.au">Aged Care Quality and Safety Commission</a> on 1800 951 822 or the <a href="https://www.ombudsman.gov.au">Commonwealth Ombudsman</a> on 1300 362 072.<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/180036/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacqueline-wesson-1331752">Jacqueline Wesson</a>, Senior Lecturer (Teaching and Research), Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-complain-about-aged-care-and-get-the-result-you-want-180036">original article</a>. </div>

Retirement Life

Fitness influencer gets lifetime ban from NYC marathon for filming content

A Texas social media influencer has been disqualified and banned from future races at the New York City marathon. Last weekend, fitness influencer Matthew Choi ran the race with his camera crew on e-bikes, endangering other runners. He finished the 42.2-kilometre course with a time of 2:57:15, about 50 minutes behind Abdi Nageeye, the winner of the men's race. Choi issued an apology to his 400,000 followers after receiving the lifetime ban. "I have no excuses, full-stop," he said on Wednesday AEDT. "I was selfish on Sunday to have my brother and my videographer follow me around on e-bikes, and it had serious consequences. "We endangered other runners, we impacted people going for PBs, we blocked people from getting water and with the New York City Marathon being about everyone else and the community, I made it about myself. "And for anyone I impacted, I'm sorry." He added that the decision "was 100 per cent on me" as he did not receive pressure to film content from any partners or sponsors. New York Road Runners, the organisers of the race, said in a statement that Choi's actions violated the code of conduct and competition rules. "One of the incidents brought to NYRR's attention was that Choi ran with the assistance of two unauthorised people riding the course on electric bicycles, obstructing runners," the group said. The fitness influencer posted several videos of him running the marathon on social media, which immediately drew backlash. "As a runner, seeing him was amazing. Gave me extra motivation to pass him and make sure I never had to see him and his dumb crew for the rest of the race," wrote one user on Reddit. He has since acknowledged the criticism and has vowed to stop the practice. "It won't happen again. My word is my bond." Images: Instagram

Travel Trouble

"I’m coming home from a party, and I don’t want to end up getting arrested": do driving apps help people break road rules?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</a> Apps such as Google Maps, Apple Maps and Waze can tell drivers when they are approaching speed cameras or random breath testing stations. Countries such as Germany, France and Switzerland have banned apps from displaying these enforcement locations. But what effect are these apps having in Australia – are they helping drivers break road rules? Our new <a href="https://www.sciencedirect.com/science/article/pii/S0925753524002972">paper</a>, published in the journal Safety Science, examined this question. We found this technology can, in some cases, contribute to people thinking they are invincible on the roads. However, we also found they can sometimes help people drive more safely. <h2>Being made aware of enforcement can help road safety</h2> We conducted focus groups and interviews with a total of 58 drivers from Queensland, to understand how the use of this technology influences perceptions of being caught for breaking road rules. One driver told us: "If I know it’s coming up, I’ll put my phone down. If I was, say, texting or checking something, but then like once a good few 100 metres away, I sort of pick it up again, depending though." Another said: "It sort of depends where I am driving, I guess. Like, if I am driving on a country road and there is a speed camera there I would probably slow down for the speed camera and then sort of speed up again once I am sort of past that; it sort of depends on the circumstances." We also found that, for some people, being made aware of enforcement locations can help drivers better regulate their speed. This helped them comply with road rules more consistently. Waze also shows the speed limit in the area, which further assisted some drivers to stick to the speed limit. One driver told us: "I’m a bit careful if I just look at the speedo and just double check that I’m on the right amount of speed." Another said: "It just gives you a warning like, ‘OK, you need to check your speed.’ Just to double-check you’re going on the right speed perhaps or when it’s a camera coming up." <h2>Concerning behaviours</h2> Concerningly, we also found some drivers who use these apps are looking at and touching their screens more than they otherwise would. This can distract drivers and increase their <a href="https://www.sciencedirect.com/science/article/pii/S0925753524001097">risk of crashing</a>. One driver told us they post traffic updates on the app they use while driving, “which I know is wrong.” Another said: "Just hit the button on the phone. Just two steps after I go past the camera." Another driver told us: "It’s so helpful […] Especially if it’s, say, late night and I’m coming home from a party, and I don’t want to end up getting arrested." One driver said: "I probably feel slightly more invincible, which is probably not a good thing." When asked why these apps are used, one driver said: "I guess the drug and the drink-driving." <h2>Apps can help and hinder road safety</h2> We know breaking road rules significantly contributes to <a href="https://www.who.int/teams/social-determinants-of-health/safety-and-mobility/global-status-report-on-road-safety-2023">crashes and road fatalities</a>, with deaths on Australian roads continuing to <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">increase</a> over time. On the one hand, when drivers are aware of enforcement measures like cameras and police, they are more likely to stop breaking the rules in those areas. That’s particularly true for behaviours such as speeding and using a phone while driving, we found. Using apps that flag where cameras and police are located also means drivers would be more exposed to enforcement activities than they otherwise would be on a normal drive. On the other hand, our results suggest some drivers are using these applications to break road rules more often in places where they think they won’t be caught. These apps are also not always completely accurate. For instance, even though Waze can display some police operation locations such as roadside breath testing, it can’t capture all on-road police activities. Further, camera locations are not always up to date or accurate. <h2>Weighing benefits against risks</h2> While these apps do have some benefits, it’s important to weigh these against the risks. It’s also important to recognise traffic enforcement isn’t just there to make you comply with road rules at a specific point; it is meant to remind you of the constant risk of being caught and to encourage consistent rule compliance. The goal is to ensure that drivers are following the traffic rules across the entire network, not just in isolated spots. With road fatalities at some of the <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">highest rates we’ve seen in recent years</a>, we need everyone to work together to stop more preventable deaths and injuries.<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/237664/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, Senior Research Fellow in Road Safety Research, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, A/Professor Responsible Risk Management, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-coming-home-from-a-party-and-i-dont-want-to-end-up-getting-arrested-do-driving-apps-help-people-break-road-rules-237664">original article</a>. </div>

Legal

Woman rescued after getting stuck in between two boulders

A NSW woman found herself stuck in between two boulders after trying to retrieve her phone from a rocky abyss in the Hunter Valley. Emergency services were called to the wine region after reports the woman slipped and got stuck between two boulders down a three-metre crevice. Her friends initially tried to rescue her for an hour before calling Triple Zero for help. Photos shared by NSW Ambulance on Facebook showed the woman's feet poking out as she was wedged inside the crevice. Paramedics had to remove the heavy rocks, including winching out a massive 500kg boulder to create a safe exit. The entire process took around seven hours as the woman had been stuck in a tight "S" bend which made it challenging for the rescue team. "In my 10 years as a rescue paramedic I had never encountered a job quite like this, it was challenging but incredibly rewarding," NSW Ambulance Specialist Rescue Paramedic Peter Watts said. "Every agency had a role, and we all worked incredibly well together to achieve a good outcome for the patient." NSW Ambulance confirmed that the woman was unable to get her phone back. Image: NSW Ambulance/ Facebook

Travel Trouble

How to choose a legal decision-maker as you get older – 3 things to consider

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/joseph-ibrahim-252671">Joseph Ibrahim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/amelia-grossi-1280226">Amelia Grossi</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> “It’s my life and I’ll do what I want,” <a href="https://www.youtube.com/watch?v=HNzmrEgz_GI">sang</a> Eric Burdon of The Animals to the baby boomer generation. Unfortunately, that’s not always the case. As we get older, sometimes we are no longer capable of making our own decisions. Diseases that affect the brain such as dementia, stroke and head injury can impair cognition and thinking. Some people may choose to appoint a <a href="https://www.legislation.vic.gov.au/in-force/acts/medical-treatment-planning-and-decisions-act-2016/008">medical treatment decision-maker</a> or an <a href="https://www.legislation.vic.gov.au/in-force/acts/powers-attorney-act-2014/007">enduring power of attorney</a> to make certain decisions on their behalf. Alternatively, a legal tribunal or court may appoint <a href="https://www.legislation.vic.gov.au/in-force/acts/guardianship-and-administration-act-2019/005">a guardian or trustee</a> to help guide decisions about health care, finances, accommodation and lifestyle. Who is the right person to take on this important role? Is it the family member or partner who knows you best? Or someone with time and energy? Perhaps someone who understands the services you need – like a nurse, accountant or real estate agent? The role of a decision-making representative has <a href="https://www.alrc.gov.au/publication/equality-capacity-and-disability-in-commonwealth-laws-alrc-report-124/3-national-decision-making-principles-2/will-preferences-and-rights-2/#:%7E:text=The%20'best%20interests'%20principle%20is,an%20equal%20basis%20with%20others">changed significantly</a> in recent years, shifting from a paternalistic approach to a more person-centred focus. Our <a href="https://pubmed.ncbi.nlm.nih.gov/35157838/">research</a> looks at the differences between these approaches and how subconscious bias can influence decision-making. <h2>Taking care</h2> These days, guardianship has <a href="https://www.legislation.vic.gov.au/in-force/acts/guardianship-and-administration-act-2019/005">moved</a> from deciding what’s deemed to be in the individual’s “best interests” to what best reflects their “will and preferences”. While <a href="https://www.legislation.vic.gov.au/repealed-revoked/acts/guardianship-and-administration-act-1986/089">previously</a>, decisions were made for the person by their guardian or representative, new laws require representatives to enact the person’s “will and preferences”. That is, to make decisions with them. This is an important difference. The newer model gives the represented person more autonomy over personal, financial and other decisions. It recognises that even though a person may struggle with aspects of decision-making, they should not be excluded from decisions about how they live their life. This fundamental shift was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313688/">earlier adopted</a> by the United Nations in the <a href="https://www.ohchr.org/en/hrbodies/crpd/pages/conventionrightspersonswithdisabilities.aspx">Convention on the Rights of Persons with Disability</a>, to which Australia is a signatory. <h2>Challenging in real world situations</h2> The will and preferences <a href="https://supporteddecisionmaking.com.au/wp-content/uploads/sites/4/2021/08/Realising-will-preferences-and-rights-reconciling-differences-on-best-practice-support-for-decision-making.pdf">framework</a> may sound simple, but it can be <a href="https://www.tandfonline.com/doi/full/10.1080/09687599.2021.1941781">challenging in practice</a>, when concepts of empowerment are tricky to define and the will of someone with cognitive difficulties is hard to discern. Representatives <a href="https://supporteddecisionmaking.com.au/wp-content/uploads/sites/4/2021/08/Realising-will-preferences-and-rights-reconciling-differences-on-best-practice-support-for-decision-making.pdf">bring their own biases, perceptions and lived experience</a> to the role of supporting another person to make decisions. This subjectivity is a natural and an inherent part of decision-making. The representative faces the challenge of setting aside their own opinion and, instead, stepping into the shoes of the represented person to give effect to what they want. A mismatch between the age, gender, ethnicity, religion or socioeconomic status of the representative and the represented person can exacerbate this challenge. An older able-bodied female, who is deeply religious and from a middle-to-high income background might find it difficult to represent a young man with a disability who is an atheist and from a working-class background. Now, imagine a scenario where the young man expresses a desire to go bungee-jumping or parachuting, despite previously showing a fear of heights. What’s his representative to do? Older people and women generally <a href="https://www.tandfonline.com/doi/abs/10.1080/1366987032000105315?journalCode=rjrr20">have a lower appetite for risk</a>, as do those who have a faith and with a high socioeconomic status. A heightened perception of danger or a feeling the activity as frivolous, may lead to the representative reframing the situation with their subconscious bias. They may fail to respect the younger person’s will and preferences. Understanding what might shape a representative’s approach to decision-making is essential. Especially when decisions involve <a href="https://theconversation.com/do-you-want-to-be-resuscitated-this-is-what-you-should-think-about-before-deciding-105506">health</a> or <a href="https://theconversation.com/theres-no-need-to-lock-older-people-into-nursing-homes-for-their-own-safety-73954">living arrangements</a>. <h2>3 things to look for when selecting a legal decision-making representative</h2> 1. Deep understanding An intimate understanding of your situation is crucial. An ideal representative is someone who actively listens and has a holistic view of your circumstances. This may come from discussions with you and your loved ones. The representative must be careful your views are not outweighed by those of family or friends who are often more vocal. They should have a deep sense of who you are as an individual. 2. Self-awareness The person you choose should be able to describe their personal views and values and understand how their perspective may influence their decisions. This is vital to mitigate the effects of pre-existing bias. They should be able to reflect on their own lived experiences, to understand how their history shapes their approach to decision-making. They should be able to assess whether what you would do is the same as what they think you should do, and why. 3. Effective documentation A record of conversations between the representative and represented person often helps to illuminate a person’s will and preferences. Writing or recording compels us to commit to an idea and explain what we mean. It helps to clarify what is intended far better than a one-time conversation that may be remembered differently by participants. Further research is needed to better match representatives with represented persons. Improved tools are needed to identify the role of bias in decision-making and evaluate whether the represented person’s wills and preferences are being respected.<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/177631/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joseph-ibrahim-252671">Joseph Ibrahim</a>, Professor, Health Law and Ageing Research Unit, Department of Forensic Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/amelia-grossi-1280226">Amelia Grossi</a>, , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-choose-a-legal-decision-maker-as-you-get-older-3-things-to-consider-177631">original article</a>. </div>

Legal

NRL legend calls for help to get newborn baby home

NRL legend Jesse Ramien and his partner Shell are pleading for help to get their newborn baby home after Shell's traumatic birth experience in Bali. The Cronulla Sharks player and his wife travelled to Bali for a friend's wedding while Shell was 33 weeks pregnant, who was cleared by her doctor before their trip. However, after just three days into their holiday, Shell went into early labour which quickly led to an emergency C-section, with mum under anaesthetic and baby boy Teo needing five minutes of resuscitation. Baby Teo was rushed into a neonatal intensive care unit, with his parents not able to meet him until the day after he was born. The family has been torn apart since with the parents still yet to hold Teo, who remains in an incubator, and older son Tallen returning home after Shell’s mother rushed to Bali to help. It is not known when the family can return to Australia, as Teo's condition is still unstable. “There’s just so much uncertainty here. We’ve been told by doctors it could be four weeks before our baby is okay to travel, but that could quickly change to five, six, or seven weeks, who knows,” Ramien told <a href="https://www.dailytelegraph.com.au/sport/nrl/sharks-star-jesse-ramiens-impassioned-plea-for-help-from-the-australian-government-to-source-flight-to-bring-baby-back-to-australia/news-story/1208830641c06ecb8c2450b95eeabece" target="_blank" rel="noopener" data-link-type="article-inline">News Corp</a>. “We’re doing everything to contact the Australian embassy to see how we can get home both as quickly as possible, so that our boy can get the medical attention he needs.” A family friend has set up a <a href="https://www.gofundme.com/f/need-your-help-to-fly-our-boy-teo-home" target="_blank" rel="noopener">GoFundMe</a> page to help the couple get home with their baby on an emergency flight, with $45,000 of their $100,000 goal already raised. “I’ll play for nothing just to get our baby boy home safely,” Ramien said. Shell, who received clearance from her obstetrician and the airline before travelling, ensured her pregnancy was covered by a top travel insurance package, however baby Teo’s medical costs — tallying more than $20,000 so far — are not included, while the total costs to get Baby Teo home could exceed $130,000. Ramien has been sharing updates on Instagram, posting a picture of his new son with the caption, “Home soon my boy,” while Shell added, “Won’t be long my boy, we'll be home soon.” Image credits: Instagram / GoFundMe

Caring

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

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

Caring

Daylight savings is about to start. But why do the days get longer?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/laura-nicole-driessen-892965">Laura Nicole Driessen</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The days are getting longer and in Australia, the switch to daylight saving time is almost upon us (for about 70% of the population, anyway). But why do we have longer days in summer and shorter days in winter? <h2>It’s all about the tilt</h2> Earth goes around the Sun in an almost circular orbit. But not everything is lined up perfectly. Earth’s axis is tilted by 23.44 degrees relative to its orbit around the Sun. Imagine Earth’s orbit as a flat frisbee with the Sun in the middle and Earth as a ball on a stick going around the edge. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/623235/original/file-20241003-16-xourdg.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Diagram of Earth's rotation around the sun." /></a><figcaption>Earth goes around the Sun in an almost circular orbit. <a class="source" href="https://www.shutterstock.com/image-vector/earths-orbit-earth-rotation-around-sun-2441275921">Angela Cini/Shutterstock</a></figcaption></figure> If Earth’s axis wasn’t tilted (if its tilt was zero degrees) the stick would be exactly perpendicular to the frisbee. If you grab that perpendicular stick and tip it 23.44 degrees sideways, that’s what Earth’s tilt looks like now. As Earth orbits the Sun, the tilt of the stick does not rotate relative to the Sun. If you were in outer space looking at the Sun and you watched from the exact same position for a whole year, you would see Earth go around the Sun while the stick stayed tilted the same direction. In other words, if the top of the stick was pointing to the right when you started watching Earth go around the Sun, it would stay pointing to the right the whole way around. This tilt gives us longer days in summer and shorter days in winter. Let’s set up the scenario so the Northern Hemisphere is the top of the planet and the Southern Hemisphere is the bottom of the planet. When Earth is on one side of the Sun, the top of the stick is pointed towards the Sun. This is summer in the Northern Hemisphere and winter in the Southern Hemisphere. Six months later, when Earth is on the other side of the Sun, the bottom of the stick is pointed towards the Sun – and the seasons are reversed. <h2>Solstices and equinoxes</h2> Those two points, when the top of the stick is pointing directly towards the Sun or directly away from the Sun, are the solstices. They are the longest and shortest days of the year, depending on your hemisphere. The shortest day of 2024 in Australia was June 21. Looking forward to sunnier times, the longest day of the year in 2024 will be December 21. In between the summer and winter solstice, we have the equinoxes – when days and nights are almost exactly the same length. Those are the days when the stick through Earth is “side-on” to the Sun. The equinox is also the day when the Sun passes directly over Earth’s equator. In 2024 this happened on March 20 at 2:06pm AEDT and September 22 at 10:43pm AEST. That means that since September 22, days have been getting longer than nights in the Southern Hemisphere. <h2>What does daylight savings do?</h2> Earth’s tilt means the Sun both rises earlier and sets later as we head towards summer. When the clocks (in some states) switch to daylight saving time, people in these states all get one hour less of sleep. However, the total length of the day doesn’t change just because we changed our clocks. For me, daylight savings means I need an extra cup of coffee in the morning for about a week before I adjust to the daylight savings-lag (like jet lag, but without the fun of travel). What it really gives us is more daylight in the evening, instead of more daylight in the morning. If you’re already a morning person, this isn’t the way to go. But if you prefer to have a long dinner in the summer sun it’s ideal. <h2>Has it always been this way?</h2> Earth’s axis hasn’t always been tilted at 23.44 degrees. It cycles from a minimum 22.1 degree tilt to a maximum 24.5 degree tilt and back again once every approximately 41,000 years. Earth’s axis also “precesses”, where the stick through it draws a circle once every approximately 26,000 years. You can see this in the animation below. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/622704/original/file-20241001-16-lh8pl9.gif?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="A gif of the Earth wobbling in a circle on its axis." /></a><figcaption>Demonstration of the precession of Earth’s axis. <a class="source" href="https://science.nasa.gov/resource/axial-precession-wobble/">NASA/JPL-Caltech</a></figcaption></figure> The length of a day on Earth hasn’t always been the same, either. At the moment, the length of a day is nearly exactly 24 hours. But it’s shifting all the time by tiny amounts. This is tracked very closely by a system of telescopes and satellites. These systems measure “<a href="https://ggos.org/item/earth-orientation-parameter/#:%7E:text=Accordingly%2C%20the%20EOP%20describe%20the,as%20tides%20and%20continental%20drift">Earth orientation parameters</a>” that describe Earth’s exact orientation compared to the position of stars in the sky. These are important to astronomers because the exact location of our telescopes is important for creating accurate maps of the sky. On top of all of this, the gravitational drag from the Moon causes days to become longer by around 2.3 milliseconds every 100 years. A few billion years ago, Earth’s day was a lot shorter – <a href="https://www.earthscope.org/news/a-day-is-not-always-24-hours-how-earths-shifting-systems-cause-day-length-variation/#:%7E:text=Billions%20of%20years%20ago%2C%20the,to%20the%20day%20every%20century">only 19 hours long</a>. Even though some of us are losing an hour of sleep this weekend, at least we get to enjoy 2.3 milliseconds longer every day than our great – and great-great – grandparents did.<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/240221/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-nicole-driessen-892965">Laura Nicole Driessen</a>, Postdoctoral researcher in radio astronomy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/daylight-savings-is-about-to-start-but-why-do-the-days-get-longer-240221">original article</a>. </div>

Domestic Travel

High-speed rail plans may finally end Australia’s 40-year wait to get on board

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/philip-laird-3503">Philip Laird</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Australia has debated and studied high-speed rail for four decades. The High Speed Rail Authority has begun <a href="https://www.hsra.gov.au/project">work on a project</a> that could finally deliver some high-speed rail in the 2030s. The Albanese government set up the authority in 2022. It also committed A$500 million to plan and protect a high-speed rail corridor between Sydney and Newcastle. This corridor was prioritised due to significant capacity constraints on the existing line, among other reasons. The ultimate plan is for a high-speed rail network to connect Brisbane, Sydney, Canberra, Melbourne and regional communities across the east coast. The network would help Australia in its urgent task to reduce greenhouse gas emissions from transport. These <a href="https://www.infrastructure.gov.au/infrastructure-transport-vehicles/towards-net-zero-transport-and-infrastructure">continue to increase</a> even as emissions from other sectors fall. The authority has now publicly outlined plans for the first stage of this east coast network. After a history of failed proposals dating back to 1984, the new plans provide some cause for optimism that Australia could have some high-speed rail by 2037. <h2>What is high-speed rail and why do we need it?</h2> The International Rail Union of Railways <a href="https://uic.org/passenger/highspeed">defines high-speed rail</a> as new lines designed for speeds of 250km/h or more and upgraded lines for speeds of at least 200km/h. High-speed rail could greatly reduce transport emissions by replacing <a href="https://theconversation.com/wondering-how-to-get-from-brisbane-to-melbourne-without-wrecking-the-climate-our-transport-choices-make-a-huge-difference-237396">air travel in particular</a>. For example, the <a href="https://www.bitre.gov.au/publications/ongoing/domestic_airline_activity-monthly_publications">7.92 million passengers</a> flying between Melbourne and Sydney in 2023-24 produced about 1.5 million tonnes of emissions. Including <a href="https://theconversation.com/how-air-travellers-can-cut-their-door-to-door-emissions-right-now-by-as-much-as-13-on-the-sydney-melbourne-route-211099">travel to and from airports</a> and other flight routes along the corridor (Sydney or Melbourne to Canberra, Albury etc), this adds up to about 2% of <a href="https://www.dcceew.gov.au/climate-change/strategies/annual-climate-change-statement-2023">annual domestic transport emissions</a>. A Sydney–Melbourne high-speed rail link could cut emissions to a fraction of those from <a href="https://theconversation.com/wondering-how-to-get-from-brisbane-to-melbourne-without-wrecking-the-climate-our-transport-choices-make-a-huge-difference-237396">air</a> and <a href="https://theconversation.com/we-compared-land-transport-options-for-getting-to-net-zero-hands-down-electric-rail-is-the-best-234092">road</a> transport. If Australia is to achieve <a href="https://www.dcceew.gov.au/climate-change/emissions-reduction/net-zero">net zero by 2050</a>, a <a href="https://theconversation.com/we-compared-land-transport-options-for-getting-to-net-zero-hands-down-electric-rail-is-the-best-234092">shift to rail will be essential</a>. High-speed city-to-city rail services will be needed to become an attractive alternative to air travel. <h2>What is the authority working on?</h2> Early this year the High Speed Rail Authority gained a new CEO, Tim Parker, with extensive experience in delivering mega-projects. In late August, the authority outlined its plans at an industry briefing in Newcastle. The authority has commissioned eight studies, including a business case for a Sydney–Newcastle line. Significantly, it will include the cost of future highway upgrades if high-speed rail does not proceed. This study, along with a report on how high-speed rail will proceed along Australia’s east coast, is due by the end of this year. Also under way is a <a href="https://minister.infrastructure.gov.au/c-king/media-release/all-aboard-high-speed-rail-accelerates-first-investigation-works">geotechnical study</a> that includes drilling 27 boreholes. It will help determine the proposed depths of two long rail tunnels and guide decisions on crossing the Hawkesbury River and the route to the Central Coast and on to Newcastle. All going well, including land acquisition and agreements with the New South Wales government (which could include funding), work could <a href="https://www.newcastleherald.com.au/story/8743698/newcastle-high-speed-rail-possible-by-2037-as-tunnel-plan-emerges">start in 2027 and be completed by 2037</a>. <h2>Many questions remain</h2> Given the time and money required to deliver a Sydney–Newcastle line, bipartisan support will be needed. However, the federal opposition is yet to make a clear commitment to high-speed rail. There are other uncertainties too. Will the trains be operated by the public or private sector? The latter was the intention for projects that were scrapped decades ago, such as the CSIRO-proposed Very Fast Train (<a href="http://www.repositoryofideas.com/VFT_information.html">VFT</a>) linking Sydney, Canberra and Melbourne, and the Sydney–Canberra <a href="https://trid.trb.org/View/1203853">Speedrail</a>. And how will the engineering projects be delivered? The new authority must learn from the project management <a href="https://www.infrastructure.gov.au/department/media/news/independent-review-inland-rail-released">problems in delivering the Inland Rail</a> freight line. The project is running late and costs have blown out. Some major federally funded government projects have worked well. These include upgrades of the national highway system (by state road authorities and contractors) and the new <a href="https://www.westernsydneyairport.gov.au/">Western Sydney International Airport</a>, which is nearing completion. <h2>And what about a full Sydney–Melbourne line?</h2> The big question is when work will start on a Sydney–Melbourne high-speed rail service. In 2019, International High-Speed Rail Association chairman <a href="https://ara.net.au/media-release/ausrailplus-2019-conference-exhibition-3-5-december-2019-in-sydney/">Masafumi Shukuri estimated</a> building this line could take 20 years. The present line is 60km longer than it should be as the route dates back to the steam age. It also has far too many tight curves. This means train travel on this line is slower than cars and trucks. As former NSW State Rail chief Len Harper <a href="https://theconversation.com/more-than-ever-its-time-to-upgrade-the-sydney-melbourne-railway-187169">said</a> in 1995, this railway was already “inadequate for current and future needs” even back then. When the VFT was proposed in 1984, questions were raised as to whether our population was big enough for such a project. Now, more than 15.5 million people live in NSW, Victoria and the Australian Capital Territory. Melbourne–Sydney is the <a href="https://www.smh.com.au/traveller/travel-news/the-world-s-busiest-flight-routes-and-airports-revealed-20231222-p5et7n.html">world’s fifth-busiest flight route</a>. Advocacy group Fastrack Australia <a href="https://www.fastrackaustralia.net/hsr-implementation-plan">has called</a> for a Sydney–Melbourne track built to high-speed standards and able to carry freight. The estimated travel time is four hours. This group and the <a href="https://www.railfutures.org.au/category/submissions/%20July%202024%20reducing%20emissions%20in%20freight">Rail Futures Institute</a> propose the line be built in stages, with priority given to the section from near Macarthur to Mittagong in NSW. This would reduce the current line’s length by about 18km and allow for better Sydney–Canberra train services. Urgent action is needed to protect the rail corridor from encroaching urban development. <h2>Australia needs to catch up</h2> In June 2023, when the new authority started work, I <a href="https://theconversation.com/can-the-new-high-speed-rail-authority-deliver-after-4-decades-of-costly-studies-206287">observed</a> that Australia must surely hold the world record for studies into high-speed rail with no construction. In stark contrast, this October marks the 60th anniversary of the world’s first dedicated high-speed rail line, the Tokaido Shinkansen in Japan linking Tokyo to Shin-Osaka. The network has since grown in stages to about 3,000km of lines. Today, high-speed rail <a href="https://uic.org/passenger/highspeed/article/high-speed-data-and-atlas">operates in 21 countries</a> over about 60,000km of lines – China has about 40,000km. Indonesia’s high-speed rail service between Jakarta and Bandung started running last year. India and Thailand are in the advanced stages of delivering high-speed rail. It’s also under construction in another 11 countries. Australia could finally join them in the next few years if it starts building the Sydney–Newcastle line.<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/238232/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/philip-laird-3503">Philip Laird</a>, Honorary Principal Fellow, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/high-speed-rail-plans-may-finally-end-australias-40-year-wait-to-get-on-board-238232">original article</a>. </div>

Domestic Travel

How you can get the official Australian portraits of The King and Queen

Royal fans nationwide can now request a special keepsake online for free. All Australians are entitled to their very own free portrait of King Charles and Queen Camilla. The way one can obtain the monarchy keepsake is through sending an email to their local federal MP requesting one. The initiative comes under the constituents' request program, which allows registered Australian voters to receive their own printed portrait of the royals. Official portraits of the King and Queen were provided to the Australian Government by Buckingham Palace in July and are available for public access. Photos available include a photo of the royal couple standing together, and seperate ones of the monarch and her majesty posing alone. In the photos the King and Queen both donned royal blue outfits and their Commonwealth Insignia, with the King wearing The Sovereign's Badge of the Order of Australia and the Queen wearing the Wattle Brooch. The portraits were taken by royal photographer Millie Pilkington in Buckingham Palace's White Drawing Room in June. The digital images can be downloaded for free from the Department of the Prime Minister and Cabinet <a href="https://www.pmc.gov.au/government/official-australian-portraits-king-and-queen" target="_blank" rel="noopener">website</a> for private use. Those who want a physical copy can request printed versions through their Federal Member of the House of Representatives or Senator in their state or territory via email. The government-funded program, introduced in the Parliamentary Entitles Act 1990, is available for Australian citizens only. Image: Department of the Prime Minister and Cabinet/ Millie Pilkington

Art

The internet is worse than it used to be. How did we get here, and can we go back?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> When it comes to our experience of the internet, “the times, <a href="https://en.wikipedia.org/wiki/The_Times_They_Are_a-Changin%27_(song)">they are a-changin’</a>”, as Bob Dylan would say. You can’t quite recall how, but the internet certainly feels different these days. To some, it is “<a href="https://www.npr.org/2024/01/16/1224878097/everyday-users-are-complaining-that-the-internet-is-more-chaotic-than-ever">less fun and less informative</a>” than it used to be. To others, online searches are made up of “<a href="https://www.theverge.com/c/23998379/google-search-seo-algorithm-webpage-optimization?src=longreads">cookie cutter</a>” pages that drown out useful information and are saturated with scams, spam and content generated by artificial intelligence (AI). Your social media feeds are full of eye-catching, provocative, hyper-targeted, or anger-inducing content, from <a href="https://theconversation.com/the-dead-internet-theory-makes-eerie-claims-about-an-ai-run-web-the-truth-is-more-sinister-229609">bizarre AI-generated imagery</a> to robot-like comments. You’re lucky if your video feeds are not solely made up of exhortations to “subscribe”. How did we get here? And can we claw our way back? <h2>Commercial interests rule</h2> One major factor contributing to the current state of the internet is its over-commercialisation: financial motives drive much of the content. This has arguably led to the prevalence of sensationalism, prioritising virality over information quality. Covert and deceptive advertising is widespread, blurring the line between commercial and non-commercial content to attract more attention and engagement. Another driving force is the dominance of tech giants like Google, Meta and Amazon. They reach billions worldwide and wield immense power over the content we consume. Their platforms use advanced tracking technologies and opaque algorithms to generate hyper-targeted media content, powered by extensive user data. This creates <a href="https://www.campaignasia.com/article/the-echo-chamber-effect-how-algorithms-shape-our-worldview/491762">filter bubbles</a>, where users are exposed to limited content that reinforces their existing beliefs and biases, and <a href="https://philarchive.org/archive/NGUECA">echo chambers</a> where other viewpoints are actively discredited. Bad actors like <a href="https://abcnews.go.com/Technology/ai-fuel-financial-scams-online-industry-experts/story?id=103732051">cyber criminals and scammers</a> have been an enduring problem online. However, evolving technology like generative AI has further empowered them, enabling them to create highly realistic fake images, deepfake videos and <a href="https://www.newyorker.com/science/annals-of-artificial-intelligence/the-terrifying-ai-scam-that-uses-your-loved-ones-voice">voice cloning</a>. AI’s ability to automate content creation has also flooded the internet with low-quality, misleading and harmful material at an unprecedented scale. In sum, the accelerated commercialisation of the internet, the dominance of media tech giants and the presence of bad actors have infiltrated content on the internet. The rise of AI further intensifies this, making the internet more chaotic than ever. <h2>Some of the ‘good’ internet remains</h2> So, what was the “good internet” some of us long for with nostalgia? At the outset, the internet was meant to be a free egalitarian space people were meant to “surf” and “browse”. Knowledge was meant to be shared: sites such as Wikipedia and The Internet Archive are continuing bastions of knowledge. Before the advent of filter bubbles, the internet was a creative playground where people explored different ideas, discussed varying perspectives, and collaborated with individuals from “outgroups” – those outside their social circles who may hold opposing views. Early social media platforms were built on the ethos of reconnecting with long-lost classmates and family members. Many of us have community groups, acquaintances and family we reach out to via the internet. The “connection” aspect of the internet remains as important as ever – as we all saw during the COVID pandemic. What else do we want to preserve? Privacy. A New Yorker cartoon joke in 1993 stated that “<a href="https://web.archive.org/web/20051029045942/http://www.unc.edu/depts/jomc/academics/dri/idog.html">on the internet, nobody knows you’re a dog</a>”. Now everyone – especially advertisers – wants to know who you are. To quote the <a href="https://www.oaic.gov.au/privacy/your-privacy-rights/your-personal-information/what-is-privacy">Office of the Australian Information Commissioner</a>, one of the tenets of privacy is “to be able to control who can see or use information about you”. At the very least, we want to control what big tech knows about us, especially if they could stand to profit from it. <h2>Can we ever go back?</h2> We can’t control “a changin’” times, but we can keep as much of the good parts as we can. For starters, we can vote with our feet. Users can enact change and bring awareness to problems on existing platforms. In recent times, we have seen this with the <a href="https://theconversation.com/thinking-of-breaking-up-with-twitter-heres-the-right-way-to-do-it-195002">exodus of users</a> from X (formerly Twitter) to other platforms, and the <a href="https://www.economist.com/the-economist-explains/2023/06/26/why-reddit-users-are-protesting-against-the-sites-leadership">platform-wide protest against Reddit</a> for changing its third-party data access policies. However, voting with our feet is only possible when there’s competition. In the case of X, various other platforms – from Mastodon to Threads to Bluesky – enable users to pick one that aligns with their preferences, values and social circles. Search engines have alternatives, too, such as DuckDuckGo or Ecosia. But competition can only be created by moving to decentralised systems and removing monopolies. This actually happened in the early days of the internet during the 1990s “<a href="https://thehistoryoftheweb.com/browser-wars/">browser wars</a>”, when Microsoft was eventually accused of illegally monopolising the web browser market in <a href="https://en.wikipedia.org/wiki/United_States_v._Microsoft_Corp.">a landmark court case</a>. As users of technology, all of us must remain vigilant about threats to our privacy and knowledge. With cheap and ubiquitous generative AI, misleading content and scams are more realistic as ever. We must exercise healthy scepticism and ensure those most at risk from online threats – such as children and older people – are educated about potential harms. Remember, the internet is not optimised for your best interests. It’s up to you to decide how much power you give to the tech giants who are fuelling theirs.<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/236513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, Senior Lecturer of Information Systems, School of Computing and Information Systems; and (Honorary) Senior Fellow, Melbourne Law School, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, Associate Professor in Media and Communications, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/the-internet-is-worse-than-it-used-to-be-how-did-we-get-here-and-can-we-go-back-236513">original article</a>. </div>

Technology

Outrage as Paralympian gets disqualified for "unfair" reason

Elena Congost, had just finished the T12/B2 run in third place, but was disqualified and had the bronze medal taken from her, for this one simple move. The 36-year-old was running in the vision-impaired category with guide Mia Carol Bruguera. When her guide faltered with a cramp in the final metres before the finish line, Congost instinctively helped him from falling over and let go of the rope that binds them together. This is not allowed within Paralympic rules as all runners must be connected to their guide via a tether. As a result, Japan’s Misato Michishita was elevated to the bronze medal after finishing fourth. In a heartbreaking interview after the race, a devastated Congost said: “It’s unfair, surreal.” “The next athlete was three minutes behind me. It was just a reflex action that any human being would have done – holding on to someone who is falling.” “But that doesn’t mean that there is any kind of benefit or help. In fact, it is clear that I stop dead. “I can’t find any explanation for this. It’s sad because, in addition, I had just been without a scholarship. And I’m not going to get one now. They will leave me out of everything again when I have shown everything I can do. “I have not been disqualified for cheating, but for being a person, for helping someone.” In a separate interview with Spanish outlet Marca, she said that despite being disqualified, she is proud of her actions. “I would like everyone to know that I have not been disqualified for cheating, but rather I have been disqualified for being a person and for an instinct that comes to you when someone is falling and is to help or support them,” she said. “I’m devastated, to be honest, because I had the medal. I’m super proud of everything I’ve done and in the end they disqualify me because 10 metres from the finish line I let go of the rope for a second because a person next to me fell face first to the ground and I grabbed the rope again and we crossed the finish line. “The next athlete is three minutes away from me, so it was a reflex action of any human being to hold on to a person who is falling next to you.” Fans around the world were outraged at the disqualification verdict and have called for officials to overturn it. “Shame on you. Give the medal back to Elena Congost,” one fan wrote on X, formerly Twitter. “Where is the Olympic spirit? Elena Congost was disqualified after running 42km and helping her guide not to fall to the ground. She has lost the bronze medal and her sports scholarship. Disgusting," another wrote. "Give the medal to Elena Congost. This decision ruins the paralympics. How can you be called inclusive if you can’t help a person from falling?” a third added. Image: X

Caring

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</a>.<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/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

Body

Strength training has a range of benefits for women. Here are 4 ways to get into weights

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment. This is more than just anecdotal. According to data from the <a href="https://app.powerbi.com/view?r=eyJrIjoiZGU1YWFhZDgtMmRhZi00YTgyLThhMzItYjc2ODk5NTg0MTg1IiwidCI6IjhkMmUwZjRjLTU1ZjItNGNiMS04ZWU3LWRhNWRkM2ZmMzYwMCJ9">Australian Sports Commission</a>, the number of women <a href="https://www.clearinghouseforsport.gov.au/research/ausplay/results#portal">participating in weightlifting</a> (either competitively or not) grew nearly five-fold between 2016 and 2022. Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles. <h2>Health benefits</h2> <a href="https://www.womenshealth.gov/a-z-topics/osteoporosis">Osteoporosis</a>, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">bone density</a>, a crucial factor for <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-47">preventing osteoporosis</a>, especially for women negotiating menopause. Strength training also improves <a href="http://link.springer.com/10.1007/s40279-015-0379-7">insulin sensitivity</a>, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better <a href="https://doi.org/10.1139/apnm-2020-0245">heart health</a> too. There’s a mental health boost as well. Strength training has been linked to reduced symptoms of <a href="https://doi.org/10.1001/jamapsychiatry.2018.0572">depression</a> and <a href="http://link.springer.com/10.1007/s40279-017-0769-0">anxiety</a>. <h2>Improved confidence and body image</h2> Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2019.1634127">conquer challenges</a>. This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S1755296623000194">recent study</a> found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym. Strength training also has the potential to positively impact <a href="https://journals.lww.com/nsca-jscr/abstract/2002/11000/Relations_of_Strength_Training_to_Body_Image_Among.25.aspx">body image</a>. In a world where women are often judged on appearance, lifting weights can shift the focus <a href="http://journals.sagepub.com/doi/10.1177/0193732502238256">to function</a>. Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success. Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative <a href="https://journals.humankinetics.com/view/journals/wspaj/aop/article-10.1123-wspaj.2022-0088/article-10.1123-wspaj.2022-0088.xml">research</a> I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us: <blockquote> I wanted something that would allow me to train that just didn’t have anything to do with how I looked. </blockquote> Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said: <blockquote> We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we? </blockquote> This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained: <blockquote> Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life. </blockquote> This newfound confidence often spills over into other areas of life. As one woman said: <blockquote> I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter. </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> 1. Take things slow Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">compound movements</a>, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient. 2. Prioritise proper form Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially. 3. Consistency is key Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else. 4. Find a community Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum. <h2>Are there any downsides?</h2> Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag. Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging. If you’re concerned about getting too “bulky”, it’s very difficult for <a href="https://journals.sagepub.com/doi/epub/10.1177/0031512520967610">women</a> to bulk up like male bodybuilders without pharmaceutical assistance. The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<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/221307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>. </div>

Body

Larry Emdur gets tattooed live on air

Larry Emdur has stayed true to his promise and tattooed the initials of the other Gold Logie nominees on his bum, live on The Morning Show. After being nominated for the coveted award, Emdur said last Thursday that he would get the <a href="https://oversixty.com.au/entertainment/tv/larry-emdur-s-crazy-pledge-ahead-of-logies" target="_blank" rel="noopener">tattoo</a>, saying: “I’m so confident I won’t win, I’ll happily get all the nominees’ name initials tattooed on my a*** on the show (The Morning Show) on Monday.” Emdur was up against Tony Armstrong, Andy Lee, Sonia Kruger, Robert Irwin, Julia Morris, and Asher Keddie for the highly-coveted award, but beat them all out to take home the accolade. On Monday, Emdur followed through with the outrageous promise, lazing on a massage bench in the studio. “Kylie, I can’t see what’s happening!” Larry said. <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-permalink="https://www.instagram.com/reel/C-1Q0KCvfpU/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C-1Q0KCvfpU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Morning Show On 7 (@morningshowon7)</a> </div> </blockquote> The design included the outline of a Logie, with the initials of all the other nominees in the plaque. Larry debuted the tattoo live on air after trying to keep cool during the tattoo process. During an interview on Sunrise earlier that morning, Emdur told Nat and Shirvo it was the “dumbest promise he was ever made” after his win, laughing off the challenge as he confirmed he would be going through with the ink. Reflecting on his Gold Logie speech, Larry said it was a “surreal” moment in his career. “I knew I needed to thank my work family and my family family — I knew I wanted to thank the other nominees,” Emdur said. “It was so surreal. I was standing up there just looking down at all these famous people. I was thinking it was really a moment. “I was so humbled, thrilled and honoured … you just go wow, all of TV is in this room. Everything I worked for and everything I wanted to be part of.” Image credits: The Morning Show

No, your aches and pains don’t get worse in the cold. So why do we think they do?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather. It’s a common idea, but a myth. When we looked at the evidence, <a href="https://www.sciencedirect.com/science/article/pii/S0049017224000337">we found</a> no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains. So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on. <h2>Weather can be linked to your health</h2> The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures <a href="https://pubmed.ncbi.nlm.nih.gov/27021573/">may worsen</a> asthma symptoms. Hot temperatures <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00117-6/fulltext">increase the risk</a> of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease. Many people are also convinced the weather is linked to their aches and pains. For example, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1479-8077.2004.00099.x?casa_token=jvpSbA4szqoAAAAA%3ATyHyGaqXmfevWyuJe6LW_3Pap3IPHC8HSMTl3RN63mFzNO0X7ozQjBb6Bi3yVFuPjqkrf-WlB-J5A1q1">two in every three</a> people with knee, hip or hand osteoarthritis <a href="https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-15-66">say</a> cold temperatures trigger their symptoms. Musculoskeletal conditions affect more than <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions-comorbidity-australia/summary">seven million Australians</a>. So we set out to find out whether weather is really the culprit behind winter flare-ups. <h2>What we did</h2> Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies. We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included. We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry). <h2>What we found</h2> We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis. The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain. In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis. It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather. The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions. Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up. <h2>Why do people blame the weather?</h2> The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain. For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know <a href="https://pubmed.ncbi.nlm.nih.gov/28700451/">prolonged sitting</a>, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. Likewise, changes in mood, often experienced in cold weather, trigger increases in both <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself. Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the <a href="https://link.springer.com/article/10.1186/s12891-018-1943-8">nocebo effect</a>. <h2>What to do about winter aches and pains?</h2> It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather). You can: <ul> <li> become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool </li> <li> lose weight if obese or overweight, as this is linked to <a href="https://jamanetwork.com/journals/jama/article-abstract/2799405">lower levels</a> of joint pain and better physical function </li> <li> keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep <a href="https://www.sciencedirect.com/science/article/pii/S0033350623003359">less well</a> in cold rooms </li> <li> maintain a healthy diet and <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">avoid smoking</a> or drinking high levels of alcohol. These are among <a href="https://ard.bmj.com/content/annrheumdis/82/1/48.full.pdf">key lifestyle recommendations</a> to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with <a href="https://pubmed.ncbi.nlm.nih.gov/36208321/">higher levels</a> of physical function.<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/235117/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, Rheumatologist and Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-your-aches-and-pains-dont-get-worse-in-the-cold-so-why-do-we-think-they-do-235117">original article</a>. </div>

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