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Hospice nurse reveals people's last words before they die

<p>A hospice nurse has revealed the number one thing people say in their final moments before they die. </p> <p>Healthcare expert Julie McFadden, who makes online videos discussing death to help break the taboo around dying, has shared the three most common regrets patients share on their death beds. </p> <p>Speaking to NHS surgeon Dr Karan Rajan on his podcast, Julie said these final discussions tend to centre around what they've taken for granted. </p> <p>"The first one I hear all the time is that they regret not appreciating their health while they had it," Ms McFadden said, reflecting on her 15 years of working in the health sector. </p> <p>"That's the number one thing people say to me, I wish I would have understood how amazing it is to have a working body."</p> <p>The second regret she often hears is people admitting they "worked too much" and wish they hadn't worked their life away, and rather spent time doing things that brought them joy. </p> <p>Finally, she revealed in the clip shared to Instagram, that many dying patients have regrets about relationships. </p> <p>The nurse explained people either wish they had maintained certain relationships and friendships, or regret holding grudges.</p> <p>Dr Rajan responded to Ms McFadden's insight with a story of a young patient that made him realise we are not 'immortal' and we should not take our life "for granted". </p> <p>In the clip shared with his 1.5million followers he said, "A few years ago when I saw a young woman come in with pancreatitis in her 20s, within three hours this young woman is in the intensive care unit, she's intubated, ventilated, and the next day, she had passed away."</p> <p>"That just made me think wow, I'm in my 30s now, I'm 34, life can just go in a flash. So yes, truly don't take it for granted, we sometimes have this tendency to walk around like we're immortal."</p> <p><em>Image credits: YouTube</em></p>

Caring

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What washing machine settings can I use to make my clothes last longer?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/alessandra-sutti-1513345">Alessandra Sutti</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/amol-patil-1513347">Amol Patil</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/maryam-naebe-1513346">Maryam Naebe</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>Orbiting 400 kilometres above Earth’s surface, the astronauts on the International Space Station live a pretty normal social life, if not for one thing: they happily wear their unwashed clothes <a href="https://www.nasa.gov/centers-and-facilities/glenn/nasa-glenn-interns-take-space-washing-machine-designs-for-a-spin/">for days and weeks at a time</a>. They can’t do their laundry <a href="https://www.esa.int/Enabling_Support/Space_Engineering_Technology/Keeping_your_underwear_clean_on_the_Moon">just yet</a> because water is scarce up there.</p> <p>But down here on Earth, washing clothes is a large part of our lives. <a href="https://bigee.net/media/filer_public/2013/03/28/bigee_domestic_washing_machines_worldwide_potential_20130328.pdf">It’s estimated</a> that a volume of water equivalent to 21,000 Olympic swimming pools is used every day for domestic laundry worldwide.</p> <p>Fibres from our clothes make their way into the environment via the air (during use or in the dryer), water (washing) and soil (lint rubbish in landfill). Most of this fibre loss is invisible – we often only notice our favourite clothing is “disappearing” when it’s too late.</p> <p>How can you ensure your favourite outfit will outlast your wish to wear it? Simple question, complex answer.</p> <h2>Washing machines are not gentle</h2> <p>When you clean the filters in your washing machine and dryer, how often do you stop to think that the lint you’re holding <a href="https://theconversation.com/uk-laundry-releases-microfibres-weighing-the-equivalent-of-1-500-buses-each-year-199712"><em>was</em>, in fact, your clothes</a>?</p> <p>Laundering is harsh on our clothes, and <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250346">research confirms this</a>. Several factors play a role: the type of washing machine, the washing cycle, detergents, temperature, time, and the type of fabric and yarn construction.</p> <p>There are two types of domestic washing machines: top-loader and front-loader. Mechanical agitation (the way the machine moves the clothes around) is one of the things that helps ease dirt off the fabric.</p> <p>Top-loaders have a vertical, bucket-like basket with a paddle, which sloshes clothes around in a large volume of water. Front-loaders have a horizontal bucket which rotates, exposing the clothes to a smaller volume of water – it takes advantage of gravity, not paddles.</p> <p>Top-loading machines <a href="https://link.springer.com/article/10.1007/s12541-010-0047-7">tend to be more aggressive</a> towards fabrics than front-loaders due to the different mechanical action and larger volumes of water.</p> <p>Washing machine panels also present many choices. Shorter, low-temperature programs <a href="https://clevercare.info/more-eco-temperature-tips">are usually sufficient for everyday stains</a>. Choose longer or <a href="https://iprefer30.eu/animations/UK/wash-brochure-uk.pdf">high-temperature programs</a> only for clothing you have concerns about (healthcare uniforms, washable nappies, etc.).</p> <p>Generally, washing machine programs are carefully selected combinations of water volume, agitation intensity and temperature recommended by the manufacturer. They take into consideration the type of fabric and its level of cleanliness.</p> <p>Select the wrong program and you can say goodbye to your favourite top. For example, high temperatures or harsh agitation may cause some fibres to weaken and break, causing holes in the garment.</p> <h2>Some fabrics lose fibres more easily than others</h2> <p>At a microscopic level, the fabric in our clothes is made of yarns – individual fibres twisted together. The nature and length of the fibres, the way they are twisted and the way the yarns form the fabric can determine how many fibres will be lost during a wash.</p> <p>In general, if you want to lose fewer fibres, you should wash less frequently, but some fabrics are affected more than others.</p> <p>Open fabric structures (knits) with loose yarns <a href="https://www.nature.com/articles/s41598-021-98836-6">can lose more fibres</a> than tighter ones. Some sports clothing, like running shirts, are made of continuous filament yarn. These fibres are less likely to come loose in the wash.</p> <p>Cotton fibres are only a few centimetres long. Twisted tightly together into a yarn, they can still escape.</p> <p>Wool fibres are also short, but have an additional feature: scales, which make wool clothes much more delicate. Wool fibres can come loose like cotton ones, but also tangle with each other during the wash due to their scales. This last aspect is what causes wool garments to shrink when <a href="https://journals.sagepub.com/doi/abs/10.1177/004051756403400303">exposed to heat</a> and agitation.</p> <h2>Go easy on the chemicals</h2> <p>The type of detergent and other products you use also makes a difference.</p> <p>Detergents contain a soap component, enzymes to make stains easier to remove at low temperature, and fragrances. Some contain harsher compounds, such as bleaching or whitening agents.</p> <p>Modern detergents are very effective at <a href="https://www.choice.com.au/home-and-living/laundry-and-cleaning/laundry-detergents/review-and-compare/laundry-detergents">removing stains such as food</a>, and you don’t need to use much.</p> <p>An incorrect choice of wash cycles, laundry detergent and bleaching additives could cause disaster. Certain products, like bleach, can <a href="https://site.extension.uga.edu/textiles/textile-basics/understand-your-fibers/">damage some fibres like wool and silk</a>.</p> <p>Meanwhile, research on <a href="https://www.sciencedirect.com/science/article/pii/S0269749120366872?via%3Dihub">fabric softeners and other treatments</a> <a href="https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0233332&amp;type=printable">continues</a> – there’s no one-size-fits-all answer about their potential impact on our clothes.</p> <h2>Just skip laundry day</h2> <p>So, how to ensure your clothes last longer? The main tip is to wash them less often.</p> <p>When it’s time for a wash, carefully read and follow the care labels. In the future, our washing machines will <a href="https://www.teknoscienze.com/tks_article/trends-in-laundry-by-2030/">recognise fabrics and select the wash cycle</a>. For now, that’s our responsibility.</p> <p>And the next time you throw your shirt into the dirty laundry basket, stop. Think of the astronauts orbiting above Earth and ask yourself: if they can go without clean laundry for a few days, maybe I can too? (Although we don’t recommend just burning your dirty undies, either.)<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224064/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <figure><iframe src="https://www.youtube.com/embed/C1j6KLP492E?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p><em><a href="https://theconversation.com/profiles/alessandra-sutti-1513345">Alessandra Sutti</a>, Associate Professor, Institute for Frontier Materials, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/amol-patil-1513347">Amol Patil</a>, Research Engineer, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/maryam-naebe-1513346">Maryam Naebe</a>, Associate professor, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-washing-machine-settings-can-i-use-to-make-my-clothes-last-longer-224064">original article</a>.</em></p> </div>

Home & Garden

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Charles III will be the first king of Australia to visit our shores. He could also be the last

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jess-carniel-99739">Jess Carniel</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a></em></p> <p>King Charles III and Queen Camilla’s upcoming visit to Australia is significant for several reasons. It is Charles’ first visit since ascending to the throne – as well as the first time a British male head of state has visited Australia.</p> <p>Some observers are also wondering whether it might be one of the last royal tours, as debates about Australia potentially <a href="https://www.theguardian.com/australia-news/2024/oct/13/republican-debate-flares-ahead-of-king-charles-first-visit-to-australia-as-monarch">becoming a republic</a> are reignited.</p> <p>As the monarchy tries to “modernise” alongside growing support for republicanism, this visit will be one to watch.</p> <h2>The curse of the Antipodes?</h2> <p>As Prince of Wales, Charles had a long and successful track record of royal tours to Australia, having visited 16 times. The visits included a term attending <a href="https://www.bbc.com/news/world-australia-64113876">Geelong Grammar School</a> in 1966, as well as the <a href="https://www.townandcountrymag.com/society/tradition/g33926226/princess-diana-prince-charles-australia-royal-tour-1983-photos/">1983 tour</a> with Princess Diana that saw Australians caught up in Di-mania – and Charles reportedly <a href="https://www.abc.net.au/news/2020-11-29/princess-diana-princess-charles-australia-1983-the-crown/12914130">gripped by jealousy</a>.</p> <p>But Charles’ royal predecessors weren’t as lucky in their trips down under. His own grandfather, King George VI, <a href="https://collectionswa.net.au/items/202bce46-f056-413e-bc74-ddf4d2f8e999#:%7E:text=Planning%20for%20this%20royal%20visit,after%20her%20father's%20untimely%20death.">planned to visit</a> Australia in the late 1940s with Queen Elizabeth and Princess Margaret, but the tour was postponed due to his poor health. While he had previously visited as the <a href="https://collections.museumsvictoria.com.au/articles/2053#:%7E:text=They%20had%20two%20daughters%2C%20Elizabeth,Canberra%20on%209%20May%201927.">Duke of York</a>, George VI never made it here as king.</p> <p>The very first royal visit to Australia – Prince Alfred’s <a href="https://www.nma.gov.au/defining-moments/resources/first-royal-visit">1867 tour</a> – had all appearance of being cursed. One of his crew members drowned during the first stop in South Australia. Several more people died in a major fire accident and a Catholic-Protestant skirmish in Melbourne.</p> <p>Most memorably – certainly for Alfred – was <a href="https://theconversation.com/royal-visits-to-australia-can-be-disaster-magnets-in-the-first-one-the-prince-barely-made-it-out-alive-233103">an assassination attempt</a> on the prince in Sydney. This, interestingly, is an experience King Charles has also had.</p> <p>During Charles’ 1994 visit, student protester David Kang fired blanks from a starter pistol in protest of Australia’s treatment of Cambodian refugees. The then Prince of Wales wasn’t harmed and Kang went on to <a href="https://www.smh.com.au/national/he-shot-at-a-prince-now-hes-a-barrister-20050206-gdkmyp.html">become a barrister</a>.</p> <p>For non-British royals, however, Sydney has been a lucky location. King Frederick X’s decidedly modern romance <a href="https://www.womensweekly.com.au/royals/princess-mary/crown-princess-mary-crown-prince-frederik-love-story/">with Tasmania-born Queen Mary</a> famously began when they met at a bar during the Sydney Olympics in 2000.</p> <h2>Prince or king – does it matter?</h2> <p>This will be Charles’ seventeenth visit to Australia, but his first as reigning monarch. This means he is visiting not on behalf of the head of state, but as the head of state.</p> <p>The royal couple’s planned <a href="https://www.royal.uk/news-and-activity/2024-09-10/the-king-and-queen-will-visit-australia-and-samoa">Australian engagements</a> are as strategic as they are symbolic. They reflect carefully curated and ostensibly “non-political” issues such as environmental sustainability, cancer research and family violence.</p> <p>The visit also includes a meeting with Indigenous representatives. Notably, it is the first royal tour <a href="https://www.smh.com.au/politics/federal/royal-walkabout-shelved-due-to-cultural-sensitivities-20240911-p5k9n1.html">to not use the term “walkabout”</a> to describe public meet-and-greets, as this term had been criticised as cultural appropriation.</p> <p>It seems Charles’ modernised monarchy is seeking to distance itself from overtly colonial language – as much as a foreign monarchy can, anyway. The king has yet to respond to Indigenous leaders <a href="https://theconversation.com/should-king-charles-apologise-for-the-genocide-of-first-nations-people-when-he-visits-australia-239092">calling for an apology</a> for British colonisers’ genocides of First Nations peoples.</p> <p>Although the Australian media has focused on the stops in Canberra and Sydney, the main purpose of the tour is for the king to attend the Commonwealth Heads of Government Meeting <a href="https://samoachogm2024.ws/">in Samoa</a> between October 21 and 26.</p> <p>It is the first time the meeting will be hosted by a Pacific Island state. The talks are an important opportunity for the king to highlight issues such as climate change, to which small island states in the Pacific <a href="https://www.csiro.au/en/research/environmental-impacts/climate-change/pacific-climate-change-info">are particularly vulnerable</a>.</p> <h2>Are people happy about the visit?</h2> <p>All six state premiers have declined their invitations to meet the king at his welcome reception in Canberra, citing other commitments. Their excuses might be genuine in some cases. For example, Queensland Premier Steven Miles is in the last few weeks of an election campaign.</p> <p>However, critics from the monarchist camp have viewed the move as <a href="https://www.politico.eu/article/king-charles-iii-snubbed-australia-state-leaders-visit-insult-uk/">a political response</a> to debates over whether Australia should remain a constitutional monarchy with the king as its head of state.</p> <p>A <a href="https://au.yougov.com/politics/articles/46044-one-year-king-charles-reign-where-do-australian-at">YouGov Australia poll</a> published on the first anniversary of Charles’s ascension showed Australians are divided on republicanism. While 32% want to become a republic “as soon as possible”, 35% preferred to remain a constitutional monarchy and 12% wanted to become a republic after the king’s death. The remaining respondents didn’t know.</p> <p>Notably, the poll found republican sentiment had increased since Queen Elizabeth II’s death in September 2022.</p> <p>The Albanese government established an assistant minister for the republic upon entering office in 2022 (although the portfolio was abolished with <a href="https://www.theguardian.com/australia-news/article/2024/jul/29/albaneses-new-lineup-signposts-labors-areas-of-greatest-weakness-and-effectively-concede-he-made-mistakes">this year’s reshuffle</a>). Upon taking the role, assistant minister Matt Thistlethwaite <a href="https://www.theguardian.com/australia-news/2022/jun/01/minister-republic-twilight-queen-reign-good-opportunity-next-for-australia">suggested</a> the “twilight of [Queen Elizabeth’s] reign” presented “a good opportunity for a serious discussion about what comes next for Australia”.</p> <p>Charles doesn’t seem to be taking all this too personally. In a letter responding to the Australian Republican Movement in March this year, his private secretary said the king <a href="https://www.theguardian.com/australia-news/2024/oct/13/republican-debate-flares-ahead-of-king-charles-first-visit-to-australia-as-monarch">viewed this</a> as “a matter for the Australian public to decide”.</p> <p>The royal tour and the meeting in Samoa will be important opportunities for the monarchy to connect with Australia and other Commonwealth nations.</p> <p>By presenting itself as a modern institution engaged with contemporary issues such as climate change, the monarchy will also have to engage with the possibility of new political identities for its former colonies.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241345/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/jess-carniel-99739"><em>Jess Carniel</em></a><em>, Associate professor in Humanities, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/charles-iii-will-be-the-first-king-of-australia-to-visit-our-shores-he-could-also-be-the-last-241345">original article</a>.</em></p> </div>

Travel Trouble

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Controversial suicide capsule applications suspended amid investigation

<p>Advocacy groups behind the suicide capsule have suspended the process of taking applications amid a criminal investigation into its first use in Switzerland. </p> <p>In a statement on Sunday, they said that 371 people were “in the process of applying” to use the device, known as the Sarco, as of September 23 and applications were suspended after its first use. </p> <p>The Sarco capsule is designed to allow the person inside to push a button that injects nitrogen gas from a tank underneath into the sealed chamber, allowing the person to fall asleep and then die of suffocation in a few minutes. </p> <p>On September 23, an unidentified 64-year-old woman from the US Midwest, became the first person to use the device in a forest in the northern Schaffhausen region. </p> <p>The president of Switzerland-based The Last Resort, Florian Willet, said at the time that the woman's death was "peaceful, fast, and dignified", although those claims could not be independently verified. </p> <p>On the same day as the woman's death, Swiss Health Minister Elisabeth Baume-Schneider told parliament that use of the Sarco would not be legal.</p> <p>Willet and several others were taken into custody following her death and prosecutors opened an investigation on suspicion of incitement and accessory to suicide.</p> <p>Willet is currently being held in pretrial detention, according to The Last Resort and Exit International, an affiliate founded in Australia over a quarter-century ago. The others who were detained were released from custody. </p> <p>Exit International also clarified that their lawyers in Switzerland believed the use of the device is legal.</p> <p>“Only after the Sarco was used was it learned that Ms Baume-Schneider had addressed the issue,” the advocacy groups said in the statement Sunday.</p> <p>“The timing was a pure coincidence and not our intention.”</p> <p>Switzerland has some of the most permissive laws when it comes to assisted suicide, but the first use of the Sarco has prompted debate among lawmakers. </p> <p>Laws in the country permit assisted suicide, as long as the person takes their own life with no “external assistance” and those who help the person die do not do so for “any self-serving motive”. </p> <p><em>Image: Exit International</em></p> <p> </p>

Legal

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Tony Armstrong jokes about "moonlighting" controversy on last ABC show

<p>Tony Armstrong has made a joke about the recent "<a href="https://oversixty.com.au/finance/legal/tony-armstrong-called-out-by-media-watch-for-moonlighting" target="_blank" rel="noopener">moonlighting</a>" controversy on his final show with <em>ABC News Breakfast</em>. </p> <p>On Monday, Armstrong was called out by <em>Media Watch</em> host Janine Perrett who said she was "stunned" that he failed to get the all-clear from network bosses before he became the voice of NRMA Insurance. </p> <p>Perrett launched into a blistering tirade over Armstrong's advertising gig with the insurance company, claiming the job was "strongly discouraged" by the public broadcaster. </p> <p>On Friday, Armstrong made light of the claims on his final show with <em>ABC News Breakfast</em>, after announcing he would be leaving the show after three years. </p> <p>While farewelling his co-hosts, the <em>News Breakfast</em> team gave him flowers and a big tin of coffee during his final broadcast, with Armstrong joking he wouldn’t name the coffee brand before back pedalling.</p> <p>“We won’t name the brand … Actually I don’t care, I’ve already been done by <em>Media Watch</em> — Nescafe!” Armstrong laughed.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/DArqPr_SrrX/?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/DArqPr_SrrX/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by PEDESTRIAN.TV (@pedestriantv)</a></p> </div> </blockquote> <p>Armstrong went on to thank the <em>ABC News Breakfast</em> team in his final goodbye, saying “it takes a village” to get the show on air.</p> <p>“Look at this team around me. This is everyone that makes this show work. We are just the lucky presenters that get to go out there and present all of the hard work,” Armstrong said.</p> <p>“It takes a village. We do it understaffed and under resourced, and every day everybody rocks up with a smile on their face doing the work of four or five people. </p> <p>“So yes, I’m just an instrument that is part of a team.”</p> <p><em>Image credits: ABC News Breakfast</em></p>

Retirement Life

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Readers response: Are there any particular museums or historical sites that have made a lasting impression on you?

<p>When travelling around the world, some museums, attractions and historical sites can have more of a lasting impact than others. </p> <p>We asked our readers if there are any particular places that have had a lasting impression on them while travelling, and the response was overwhelming. Here's what they said. </p> <p><strong>Anne Hare</strong> - The Alhambra in Granada, Spain. Absolutely beautiful. Don't miss it!</p> <p><strong>Sandra Beckett</strong> - Seemingly little known, but the British Library in London has an absolutely jaw-dropping permanent exhibition of literature. Original handwritten manuscripts from famous authors through the ages. Wonderful for book lovers.</p> <p><strong>Jackie A Morris</strong> - St Paul's Cathedral London. Not being one to get into churches, but I went there as my son asked me to. I was in awe, managed the climb to the spire as well. Etched in my memory.</p> <p><strong>Christine Taylor</strong> - The Pantheon is certainly up there.</p> <p><strong>Tony Hallam</strong> - The Colosseum in Rome. I was in awe knowing i was standing in the place where gladiators had stood and fought 2000 years ago.</p> <p><strong>Pamela Rigby</strong> - In Flanders Fields, Ypres, Belgium.</p> <p><strong>Kris White</strong> - Killing Fields in Cambodia, chilling and desperately sad.</p> <p><strong>Gayle Morris</strong> - Stonehenge and the Cliffs of Moher.</p> <p><strong>George Jamieson</strong> - The statue of David in Florence, out of this world!!!</p> <p><strong>Jim Janush</strong> - Museo De La Revolución, Havana, Cuba.</p> <p><strong>Margie Buckingham</strong> - The Uluṟu rock base at sunset- its eerie silence is unnerving.</p> <p><strong>Steve Gerreyn</strong> - Cathedral of Seville. Magnificent.</p> <p><em>Image credits: Shutterstock </em></p> <div style="font-family: inherit;"> <div class="x1rg5ohu xxymvpz x17z2i9w" style="display: inline-block; vertical-align: middle; width: 22px; font-family: inherit;"> <div class="html-div xdj266r x11i5rnm xat24cr xexx8yu x4uap5 x18d9i69 xkhd6sd x1hy63sm xg01cxk xhva3ql" style="margin: 0px 0px 0px 11px; padding: 0px; opacity: 0; font-family: inherit;" aria-hidden="false"> </div> </div> </div> <div class="x6s0dn4 x3nfvp2" style="font-family: inherit; align-items: center; display: inline-flex; min-width: 447px;"> <ul class="html-ul xe8uvvx xdj266r x4uap5 x18d9i69 xkhd6sd x1n0m28w x78zum5 x1wfe3co xat24cr xsgj6o6 x1o1nzlu xyqdw3p" style="list-style: none; margin: 0px -8px 0px 4px; padding: 3px 0px 0px; display: flex; min-height: 15px; line-height: 12px; caret-color: #1c1e21; color: #1c1e21; font-family: system-ui, -apple-system, BlinkMacSystemFont, '.SFNSText-Regular', sans-serif; font-size: 12.000001px;" aria-hidden="false"> <li class="html-li xdj266r xat24cr xexx8yu x4uap5 x18d9i69 xkhd6sd x1rg5ohu x1emribx x1i64zmx" style="display: inline-block; padding: 0px; margin: 0px 8px;"> </li> </ul> </div>

Travel Trouble

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Chaos erupts over last-minute cruise itinerary change

<p>Passengers onboard a Carnival Cruise have demanded refunds after their travel itinerary changed once they had already boarded the ship. </p> <p>Guests aboard Carnival’s Vista had booked the eight-night Southern Caribbean cruise out of Port Florida on August 10th intending to stop in Aruba, Curacao and Turks and Cacaos, with the eight-day cruise averaging $11,700 per person.</p> <p>However, as boarding was taking place, the cruise line sent passengers a notification saying their had been a change of plans due to an engine problem.</p> <p>Carnival crew members had discovered a “technical issue affecting the ship’s cruising speed” which forced the cruise line to alter the itinerary, the cruise line told the New York Post, with Vista instead traveling to the Bahamas, making stops at Nassau, Princess Cays, Freeport, and Half Moon Cay. </p> <p>While a cruise worker was trying to explain the situation to passengers, some started chanting "Give us our money!" while staff tried to diffuse the situation.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C_OYKHVvIIh/?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_OYKHVvIIh/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Only in Florida (@onlyinfloridaa)</a></p> </div> </blockquote> <p>“Ladies and gentlemen, the way you’re going about this with the noise and chaos isn’t going to solve any issues,” one cruise employee explained to the passengers, according to video obtained by Inside Edition.</p> <p>The passengers were given several choices once the cruise line determined the need for an itinerary change, as the cruise line said in a statement. </p> <p>“We communicated directly with guests on board regarding their options for the sailing,” Carnival said.</p> <p>“Those that sailed were given an on-board credit as well as a future cruise credit toward another cruise to make up for the unexpected change, and those who preferred not to sail were offered a 100 per cent refund.” </p> <p>Even with the choice of not cruising to the Bahamas, passengers were still frustrated with Carnival for the last-minute announcement.</p> <p>“They knew about the problem prior to us getting onto the ship,” Ashley Ball told the outlet. “They just didn’t say that until we were already on the ship, and, you know, went through customs and the lines and securities and all that, and then decided to display that information.”</p> <p><em>Image credits: Instagram</em></p>

Travel Trouble

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How long does back pain last? And how can learning about pain increase the chance of recovery?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p> </div>

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The gift of a lifetime: How one busy mum found peace of mind and left a lasting legacy

<p>Anita lives in Sydney with her husband and three sons. She recently chose to include a gift to Lifeline Australia when writing her Will with an online Will-writing service called <a href="https://www.gatheredhere.com.au/c/lifeline-au?gh_cuid=Oxs_YC7byb&gh_cch=%40campaign%2Fchannel%2Fnews" target="_blank" rel="noopener"><span style="text-decoration: underline;">Gathered Here</span></a>.</p> <p>“My Will has been in the making for the last five years and it has always been pushed down on the prioritisation list due to the high cost of seeing a solicitor and us being a very busy family with young kids,” says Anita.</p> <p>“When I found out about Gathered Here, I thought I may as well check it out, and after 10 minutes I had a Will! The process was simple and straightforward without any complicated legal jargon to cut through.</p> <p>“Within the Will-writing process, summarising my wishes was an important and practical step for me. I want to ease the situation for my loved ones I leave behind by providing emotional and financial certainty in a time of confusion and grief.</p> <p>“There is also an opportunity to nominate and leave gifts to my favourite charities. I have three young boys and having some insight into the mental health challenges in Australia made my decision of allocating a portion of my estate to Lifeline Australia very easy.</p> <p>“Seeing an organisation like Lifeline continuously dedicate their effort, time and professionalism at the highest level to ensure that no one is ever alone in crisis provides me with hope of a better world for my children.”</p> <p>Lifeline is a national charity providing people in Australia experiencing emotional distress with access to 24-hour crisis support and suicide prevention services.</p> <p>Tragically, over 3,000 people in Australia lose their lives to suicide every year. This year, Lifeline will receive well over 1 million contacts from people in crisis. Every 30 seconds, someone in Australia reaches out to Lifeline.</p> <p>Lifeline exists to ensure that no person in Australia has to face their toughest moments alone, and believes that through connection, hope can be found.</p> <p>Lifeline Australia has partnered with Gathered Here to offer you the opportunity to <span style="text-decoration: underline;"><a href="https://www.gatheredhere.com.au/c/lifeline-au?gh_cuid=Oxs_YC7byb&gh_cch=%40campaign%2Fchannel%2Fnews" target="_blank" rel="noopener">write your Will online for free</a></span> this Include a Charity Week, which runs from the 2nd – 8th September and is dedicated to raising awareness of how anyone can make a lasting impact to causes that they care about with a gift in their Will. You’ll also be able to make free and unlimited changes to your Will for life.</p> <p>Gathered Here provides end-of-life services through probate, funerals and online Wills. They are supported by an in-house legal team of highly experienced Wills and estate lawyers who have reviewed and vetted the Will writing process.</p> <p>Gathered Here's online Will-writing service allows you to appoint guardians for your children and pets, set out how you want to divide your estate and leave gifts to charities that mean the most to you - like Lifeline.</p> <p>After you've provided for those closest to you, <span style="text-decoration: underline;"><a href="https://www.gatheredhere.com.au/c/lifeline-au?gh_cuid=Oxs_YC7byb&gh_cch=%40campaign%2Fchannel%2Fnews" target="_blank" rel="noopener">leaving a gift to Lifeline Australia is a lasting and meaningful way that you can have an impact for years to come</a></span>. You will be helping to prevent suicide and save lives in future generations.</p> <p>Gifts in Wills make a phenomenal difference to charities, including Lifeline. This is why a growing number of people understand that once they have provided for their loved ones, leaving a gift in their Will is one of the most powerful ways they can support Lifeline, without incurring any financial costs during their lifetime.</p> <p>If you would like to learn more, please do not hesitate to get in touch with Lifeline Australia’s Gifts in Wills Specialist Abi Steiner via email at <a href="mailto:giftsinwills@lifeline.org.au" target="_blank" rel="noopener">giftsinwills@lifeline.org.<span style="text-decoration: underline;">au</span></a> or phone on 02 8099 1974.</p> <p>If you, or someone you know, are feeling distressed or overwhelmed, we encourage you to connect with Lifeline in the way you feel most comfortable. For 24/7 crisis support, you can phone Lifeline to speak to a Crisis Supporter on 13 11 14, text 0477 131 114, chat to Lifeline online or access the Support Toolkit to self-manage what you’re going through at <span style="text-decoration: underline;"><a href="http://www.lifeline.org.au/" target="_blank" rel="noopener">www.lifeline.org.au</a></span>.</p> <p><em>This is a sponsored article produced in partnership with Lifeline Australia.</em></p> <p><em>Image: Lifeline Australia</em></p>

Money & Banking

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Australia’s IV fluids shortage will likely last all year. Here’s what that means for surgeries

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722"><em>The University of Melbourne</em></a></em></p> <p>The current <a href="https://www.tga.gov.au/about-IV-fluids-shortages">shortage of sterile intravenous (IV) fluids</a> is a serious ongoing concern for doctors across Australia. During surgery, these sterile fluids are essential to administer drugs and hydrate patients intravenously (via the veins).</p> <p>But supplies of two of the most common solutions are critically low.</p> <p>The Australian government has recently moved to <a href="https://www.theguardian.com/australia-news/article/2024/aug/16/australia-iv-fluid-shortage-government-distribution">coordinate supplies</a> of IV fluids to increase manufacturing and ensure distribution. Despite this, supplies are not expected to return to normal levels <a href="https://www.health.gov.au/sites/default/files/2024-08/joint-statement-on-iv-fluids-health-ministers-meeting-16-august-2024.pdf">until the end of the year</a>.</p> <p>So, what will this mean for surgery in Australia? And are there any alternatives?</p> <h2>Why do we need IV fluids for surgery?</h2> <p>IV fluids are used before, during and after surgery to maintain blood volume and the body’s normal functions. They also combat dehydration, which can happen in a number of ways.</p> <p>Before surgery, patients may become dehydrated from illnesses that cause vomiting or diarrhoea. They are also asked to stop eating and drinking for several hours before surgery. This is to minimise the risk of stomach contents being regurgitated and inhaled into the lungs – a <a href="https://my.clevelandclinic.org/health/diseases/21954-aspiration-pneumonia">complication that can cause injury or death</a>. But it can also make them more dehydrated.</p> <p>During surgery, the body continues to lose fluid through normal processes such as sweating and making urine. But some aspects of surgery also exacerbate dehydration, for example, through blood loss or when internal organs are exposed and lose more fluid through evaporation.</p> <p>After the operation, IV fluids may be required for some days. Many patients may still be unable to eat and drink until the function of the gut returns to normal.</p> <p>Multiple research studies, including <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1801601">a trial </a>of 3,000 patients who underwent major abdominal surgery, have demonstrated the importance of adequate fluid therapy throughout all stages of surgery to avoid kidney damage.</p> <p>Apart from hydration, these sterile fluids – prepared under strict conditions so they contain no bacteria or viruses – are used in surgery for other reasons.</p> <p>Anaesthetists commonly use fluid infusions to slowly deliver medications into the bloodstream. There is some evidence this method of maintaining anaesthesia, compared to inhalation, can improve patients’ experience of “waking up” after the procedure, <a href="https://medcast.com.au/blog/total-intravenous-anaesthesia-tiva">such as being clearer headed and having less nausea and vomiting</a>.</p> <p>Surgeons also use sterile fluids to flush out wounds and surgical sites to prevent infection.</p> <h2>Are there workarounds?</h2> <p>Fluid given intravenously needs to closely resemble the salts in the blood to prevent additional problems. The safest and cheapest options are:</p> <ul> <li>isotonic saline, a solution of water with 0.9% table salt</li> <li>Hartmann’s solution (compound sodium lactate), which combines a range of salts such as potassium and calcium.</li> </ul> <p>Both are <a href="https://www.tga.gov.au/about-IV-fluids-shortages">in short supply</a>.</p> <p>One way to work around the shortage is to minimise how much IV fluid is used during the procedure. This can be achieved by ensuring those admitted to surgery are as well hydrated as possible.</p> <p>Many people presenting for minor surgery can safely drink water up until an hour or so before their operation. A recent initiative termed “<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15855">sip ‘til send</a>” has shown it is safe for patients to drink small amounts of fluid until the operating theatre team “sends” for them from the waiting room or hospital ward.</p> <p>However, this may not be appropriate for those at higher risk of inhaling stomach contents, or patients who take medications including <a href="https://www.journal.acorn.org.au/cgi/viewcontent.cgi?article=1291&amp;context=jpn">Ozempic</a>, which delay the stomach emptying. Patients should follow their anaesthetist’s advice about how to prepare for surgery and when to stop eating and drinking.</p> <p>Large research trials have also helped establish protocols called “<a href="https://www.bjanaesthesia.org/article/S0007-0912(17)53976-8/fulltext">enhanced recovery after surgery</a>”. They show that using special hydrating, carbohydrate-rich drinks before surgery can improve patients’ comfort and speed up healing.</p> <p>These protocols are common in <a href="https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/736617/ERAS-Key-principles-for-colorectal-surgery.pdf">major bowel surgery</a> in Australia but not used universally. Widespread adoption of these processes may reduce the amount of IV fluids needed during and after large operations, and help patients return to normal eating and drinking earlier. Medications reducing nausea and vomiting are now also routinely administered after surgery to help with this.</p> <h2>What will the shortage mean for surgeries?</h2> <p>The Australian and New Zealand College of Anaesthetists <a href="https://www.anzca.edu.au/news/guidance-on-sparing-of-intravenous-fluid-use">has advised anaesthetists</a> to reduce the consumption of fluid during operations where there might be limited or minimal benefit. This means that the fluid will only be used for people who need it, without a change to the quality and safety of anaesthetic care for any patient.</p> <p>Even with these actions, there is still a chance that some planned surgeries may <a href="https://www.abc.net.au/news/2024-08-15/iv-fluid-shortage-elective-urgery-delays/104225280">need to be postponed</a> in the coming months.</p> <p>If needed, these cancelled operations will likely be ones requiring large volumes of fluid and ones that would not cause unacceptable risks if delayed. Similar to cancellations during the height of the COVID pandemic, emergency operations and surgery for cancers are unlikely to be affected.</p> <p>Monitoring of the supplies and ongoing honest and open dialogue between senior health managers and clinicians will be crucial in minimising the disruption to surgical services.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, Associate Professor, Department of Critical Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australias-iv-fluids-shortage-will-likely-last-all-year-heres-what-that-means-for-surgeries-237009">original article</a>.</em></p> </div>

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Last Australian 'Rat of Tobruk' dies age 102

<p>Thomas Pritchard, Australia's last "Rat of Tobruk" has passed away at the age of 102. </p> <p>Pritchard was part of the famous garrison who held the eponymous Libyan port against a furious Nazi siege in World War II.</p> <p>The Rats of Tobruk Association announced Pritchard's death on Saturday, honouring his service to his country.</p> <p>"Tommy was a stalwart member of our association and a most humble veteran, having served with the 2/5th field ambulance throughout the Middle East and the South West Pacific," the association wrote in a post.</p> <p>"We as an Association are extremely grateful to have had Tommy for so long yet we mourn his loss and the last direct linkage with some 14,000 Australian servicemen who served in Tobruk."</p> <p>The post added that Pritchard would be farewelled in a private family funeral, as was Tommy's wishes. </p> <p>However, they added that a public memorial for all Rats of Tobruk will take place in Melbourne, with the date yet to be confirmed. </p> <p>The Rats of Tobruk were an Allied garrison of about 26,000 soldiers, including 14,000 Australians, commanded by Australian Lieutenant-General Leslie Morehead.</p> <p>They were besieged by the Nazi Afrika Korps, comprised of German and Italian troops, from April 10th to November 27th 1941.</p> <p>The Africa Korps, under the leadership of Nazi general Erwin Rommel, had never known defeat, until he faced the Rats for 231 days, who denied Rommel a port on the Libyan coast as the Nazis were unable to take control of Tobruk. </p> <p>The nickname came from American-born Nazi propagandist William Joyce, who, when he heard the Allied soldiers were taking cover in the pre-existing below-ground defences of the city, derided them as living like "rats".</p> <p>However, Aussies took the nickname with pride as they celebrated their victory. </p> <p><em>Image credits: Rats of Tobruk Association</em></p>

Caring

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Why Ray Martin is planning his own funeral

<p>Ray Martin is planning his own funeral as he prepares for his 'Last Goodbye', as part of an eye-opening new series. </p> <p>The veteran journalist will be planning his memorial service for an upcoming SBS documentary series which explores cultural traditions surrounding death.</p> <p>The three-part series, called <em>Ray Martin: The Last Goodbye</em>, will explore various taboos surrounding death with comedic and witty anecdotes. </p> <p>The series will investigate various funeral trends and rituals around the world and will address some deep questions, including why people choose certain ceremonies, songs and resting places, and how geography, religion and social class impacts these choices. </p> <p>At 79 years old, Ray said in a statement that statistically he is only four years away from his own death and wants to explore the topic with a serious yet funny nature. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C9QoU-goAtY/?utm_source=ig_embed&amp;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/C9QoU-goAtY/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by SBS Australia (@sbs_australia)</a></p> </div> </blockquote> <p>Martin will also have a range of special guests on the show, including veteran presenter Gretel Killeen, 61, and comedian Alex Lee.</p> <p>SBS Commissioning Editor Bethan Arwel-Lewis said, "At SBS we aren't scared to tackle those subjects that are sometimes provocative or difficult in our programming."</p> <p>"So an exploration of death – one of our last taboos is the perfect subject for us to lift the lid on, and who better to take us into this world and get us talking and even laughing about death, than Ray Martin."</p> <p>Last year, Martin insisted that he still has a lot of life left in him, as he grows older gracefully and continues to work. </p> <p>"I'm never going to retire. David Attenborough is in his 90s and he's my role model. He says you've got to keep doing what you love," he told <em>Woman's Day</em> magazine.</p> <p><em>Ray Martin: The Last Goodbye</em> will premiere on Wednesday, August 14 at 8.30pm on SBS and SBS On Demand.</p> <p><em>Image credits: SBS</em></p>

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Haunting last pictures of Charlise Mutten revealed

<p>The haunting last photos of nine-year-old Charlise Mutten have been released just hours after her step-father was found guilty of her murder. </p> <p>On Wednesday, Justin Stein was <a href="https://oversixty.com.au/finance/legal/jury-decides-fate-of-accused-murderer-justin-stein" target="_blank" rel="noopener">found guilty</a> for the murder of Charlise, who was killed in January 2022 while visiting her mother and step-father for Christmas. </p> <p>The jury reached their conclusion of Stein's guilt in just shy of two weeks following the four week trial, finding that Stein had killed Charlise at a Mount Wilson property owned by his parents before he wrapped her body and dumped it in a barrel down near the Colo River.</p> <p>Following the guilty verdict, a series of photos were released by the court, which document some of the final days of Charlise's life. </p> <p>In the photos, Charlise can be seen holding a pair of dolls and smiling for the camera as her mother, Kallista, snapped the image of her daughter. </p> <p>Kallista then sent the photo to her mother and Charlise's grandmother Deborah on Christmas morning 2021. </p> <p>“Thanks for the present and Merry Christmas from us all,” Kallista said to Deborah via Facebook.“Thanks for the present and Merry Christmas from us all,” Kallista said to Deborah via Facebook.</p> <p>Deborah and her husband Clinton were Charlise's main guardians, as Charlise had been living with them on the Gold Coast.</p> <p>Charlise can also be seen in a picture on January 8th, just days before she was killed, swimming in a pool, and on January 10th, she was photographed by her mother poking a face next to a broken window.</p> <p>The photo was sent to Stein by Kallista along with a message saying, “I’m sorry I’m such a screw up can we still get married”.</p> <p>Just two days later on January 12th, Charlise was killed. </p> <p>Stein will face a sentence hearing in August, where he faced life in prison for murder. </p> <p><em>Image credits: NSW Police / Facebook</em></p>

Caring

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"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

<p>An emotional final message from rugby legend Rob Burrow has been released in the days after his death. </p> <p>The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. </p> <p>Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled <em>There's Only One Burrow</em>, only agreeing to appear in the program on the condition it only be used after his death.</p> <p>In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research.</p> <p>"I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video.</p> <p>"In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C7xPgSxM6lY/?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/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a></p> </div> </blockquote> <p>His pre-recorded final words were shown to his friends and family on screen, reacting to his words.</p> <p>"I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said.</p> <p>"I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home."</p> <p>Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them."</p> <p>In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease.</p> <p>"I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled.</p> <p>When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." </p> <p>"I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them."</p> <p>Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this."</p> <p>"I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration."</p> <p>"My final message to you is whatever your personal battle to be brave and face it."</p> <p>"Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out."</p> <p><em>Image credits: BBC</em></p>

Caring

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"It loses its value": Calls for the Last Post to be canned from Anzac Day footy

<p>A radio host has called for the Last Post to be canned from the majority of Anzac Day football games, saying it has lost its meaning over the years, leaving people with "bugle fatigue". </p> <p>An Anzac Day AFL match has taken place every year at the MCG on Anzac Day since 1995, with Collingwood and Essendon going head to head year after year.</p> <p>It was the brainchild of then Essendon coach Kevin Sheedy who had also served in the Australian Army during his playing days for Richmond.</p> <p>The game started as a one off-match, which quickly snowballed into an entire round of games, while the NRL also joined in and created their own Anzac Day matches.</p> <p>Traditionally, each game starts with a ceremony of recognition of our veterans and a performance of the Last Post. before the game kicks off. </p> <p>The addition of the several extra games, all which begin with the Last Post, prompted radio host Greg 'Marto' Martin from Brisbane's <em>Triple M Breakfast with Marto, Margaux & Dan</em> to call for The Last Post to be scrapped from all matches, except the annual fixture between Essendon and Collingwood. </p> <p>"Football has now turned [The Last Post] into a gimmick," he said.</p> <p>"Back in 1995 when Kevin Sheedy, the coach of Essendon, he said, 'Let's have an Anzac Day clash at the MCG,' I reckon it's the most… spine tingling three minutes or so." </p> <p>"97,000 at the MCG… not one person yelling out while that's being played and, the honour that they give to all serving soldiers and returned soldiers is quite extraordinary."</p> <p>"But now what's happened, as football always does, and I'm not just talking AFL I'm talking rugby league as well, they've taken a wonderful thing and they've gone, 'Oh that's good —'"</p> <p>Margaux interrupted saying: "How can we capitalise!"</p> <p>Marto continued, "So what's going to happen this week in all eight games of the AFL and all eight games of the rugby league… every single one of them will play this [The Last Post] and you'll get ANZAC - you'll get bugle fatigue."</p> <p>"We have to stop it somewhere."</p> <p>Margaux said, "It gets saturated, so it loses its value. They all think they are doing the right thing, but all they are doing is turning it into a mockery."</p> <p>The AFL has confirmed that all nine matches across round seven will hold special Anzac observance ceremonies ahead of each game, with AFL General Manager Commercial Peta Webster saying, "Anzac Day is one of our country's most important national occasions so I'd encourage all fans attending matches throughout the round to arrive early to soak up the atmosphere and pre-match formalities that will no doubt be another moving tribute to the sacrifices of our past and present service men and women."</p> <p><em>Image credits: Getty Images </em></p>

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"Last chance, Mr Banducci": Woolies CEO threatened with jail time

<p>Outgoing Woolworths CEO Brad Banducci has been threatened with jail time for refusing to answer questions about price gouging at a fiery Senate enquiry. </p> <p>The parliamentary probe into supermarket prices has seen Banducci be grilled by senators about how the supermarket raked in record-breaking profits during the ongoing cost of living crisis. </p> <p>During the enquiry on Tuesday, Banducci was repeatedly warned by committee chair and Greens senator Nick McKim about giving evasive answers when asked about his company's return on equity.</p> <p>Banducci repeatedly told the committee that return on equity was not his focus, and Woolworths is instead more interested in return on investment, refusing the question and prompting a 15-minute adjournment. </p> <p>When the enquiry resumed, a similar exchange occurred, leading to another warning for the Woolworths chief executive.</p> <p>"Last chance, Mr Banducci," McKim said.</p> <p>"Do you accept that return on equity is an accepted measure of the financial profitability of a company?"</p> <p>When Banducci replied that "we measure return on investment", the committee was suspended.</p> <p>Its return immediately saw another round of the same questions and answers, with McKim warning Banducci about the consequences of not answering questions clearly.</p> <p>"It is open to the Senate to hold you in contempt, and that carries potential sanctions including up to six months imprisonment for you," he said after saying the Woolworths boss could simply say he didn't know the answer and take the question on notice.</p> <p>"That's why this is a critical matter so I'd just ask you to address your mind with absolute clarity, please, to the question I am asking."</p> <p>"I put it to you the reason you don't want to focus on return on equity is because you don't like the story that it's telling, which is that you are basically profiteering and making off with massive profits at the expense of farmers at the expense of your workers and at the expense of Australian shoppers who you are price gouging," Greens senator McKim said.</p> <p>The enquiry is still ongoing, with Coles counterpart Leah Weckert set to address the same Senate committee later on Tuesday as the government continues to probe allegations of price gouging.</p> <p><em>Image Credits: ABC - Four Corners</em></p>

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How long does menopause last? 5 tips for navigating uncertain times

<p><em><a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>Around half of the world’s population are women or people who menstruate – yet the way their body works can be a mystery, even to them.</p> <p>Most women will experience periods roughly every month, many will go through childbirth and those who live into midlife will experience menopause.</p> <p>While menopause is a significant time of change, it isn’t talked about much, other than as a punchline. This may contribute to keeping it a <a href="https://www.theguardian.com/membership/2019/sep/21/breaking-the-menopause-taboo-there-are-vital-stories-we-should-continue-to-pursue">taboo topic</a>.</p> <p>So, what happens during menopause? How do you know when it is happening to you? And – the thing most women want to know – how long will it last?</p> <h2>What is menopause?</h2> <p>Menopause is <a href="https://www.nia.nih.gov/health/what-menopause">defined</a> as the permanent cessation of menstruation, which is medically determined to be one year after the final menstrual period. After this time women are considered to be postmenopausal.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/26598775/">average age</a> of “natural menopause” (that is not caused by a medical condition, treatment or surgery) is considered to be around 51 years.</p> <p>However, natural menopause does not occur suddenly. <a href="https://www.researchgate.net/profile/Riitta-Luoto/publication/46425690_Prevalence_of_menopause_symptoms_and_their_association_with_lifestyle_among_Finnish_middle-aged_women/links/5c5704ac458515a4c7553c7b/Prevalence-of-menopause-symptoms-and-their-association-with-lifestyle-among-Finnish-middle-aged-women.pdf">Changes can begin</a> a number of years before periods stop and most often occur in a woman’s 40s but they can be earlier. Changes <a href="https://pubmed.ncbi.nlm.nih.gov/25686030/">can continue</a> for 10 years or more after periods have stopped.</p> <p>Using hormones such as the oral contraceptive pill or hormone intrauterine devices may make it more <a href="https://pubmed.ncbi.nlm.nih.gov/31934948/">difficult to determine</a> when changes start.</p> <p>Menopause that occurs <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">before 45</a> is called “early menopause”, while menopause before 40 is called “premature menopause”.</p> <h2>What about perimenopause?</h2> <p>Various <a href="https://www.menopause.org.au/hp/information-sheets/glossary-of-terms">terms</a> are used to describe this period of change, including “menopause” or “the menopause”, “menopausal transition”, “perimenopause” or “<a href="https://pubmed.ncbi.nlm.nih.gov/12188398/">climacteric</a>”.</p> <p>These terms tend to refer to the period before and after the final menstrual period, when changes are considered to be related to menopause.</p> <p>The difficulty with the definition of menopause is it can only be decided retrospectively. Yet women can experience changes many years before their periods stop (a lead up usually called “perimenopause”). Also, any <a href="https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0889854518300627/first-page-pdf">changes noticed</a> may not be associated with menopause (because people might not be aware of what to expect) or changes may be associated with a combination of factors such as stress, being busy or other health issues.</p> <h2>So, what is going on?</h2> <p>Through a feminist lens, menopause can be seen as a <a href="https://www.researchgate.net/publication/354652248_The_volcano_within_a_study_of_women's_lived_experience_of_the_journey_through_natural_menopause">complex and diverse experience</a>, influenced by biological, psychological, social and cultural aspects of women’s lives.</p> <p>However, it is usually viewed from the biomedical perspective. This sees it as a biological event, marked by the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">decline</a> in ovarian hormone levels leading to a reduction in reproductive function.</p> <p>The female reproductive system operates because of a finely tuned balance of hormones managed by the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466056/#:%7E:text=The%20hypothalamic%2Dpituitary%2Dovarian%20(HPO)%20axis%20must%20be,priming%20the%20endometrium%20for%20implantation.">hypothalamic-pituitary-ovarian axis</a>. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/">experts</a> have developed a staging system for female reproductive ageing, with seven stages from “early reproductive” years to “late postmenopause”.</p> <p>However, female reproductive hormones do not just affect the reproductive system but <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">other aspects</a> of the body’s function. These include the <a href="https://pubmed.ncbi.nlm.nih.gov/26007613/">neurological system</a>, which is linked to hot flushes and night sweats and disrupted sleep. Hormones may also affect the <a href="https://www.nature.com/articles/nrdp20154">heart and body’s blood circulation</a>, bone health and potentially the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">immune system</a>.</p> <p>Menopausal hormone changes may <a href="https://www.thewomens.org.au/health-information/menopause-information/menopause-symptoms/">cause</a> hot flushes, night/cold sweats, mood swings, sleep disruption and tiredness, vaginal dryness.</p> <p>Medical confirmation of menopausal changes in women over 45 years is based on two biological indicators: vasomotor symptoms (those hot flushes and night sweats again) and an <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">irregular menstrual cycle</a>.</p> <p>In early perimenopause the changes to the menstrual cycle may be subtle. Women may not recognise early indicators, unless they keep a record and know what to watch for.</p> <h2>How long does it last?</h2> <p>The body demonstrates an amazing ability to change over a lifetime. In a similar way to adolescence where long-lasting changes occur, the outcome of menopause is also change.</p> <p>Research suggests it is difficult to give an exact time frame for how long menopausal changes occur – the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">average</a> is between four and eight years.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">Penn Ovarian Ageing Study</a> found 79% of the 259 participants experienced hot flushes starting before the age of 50, most commonly between 45 and 49 years of age.</p> <p>A later report on the same study found one third of women studied experienced <a href="https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-016-0014-2">moderate to severe hot flushes</a> more than ten years after their periods had stopped. A <a href="https://journals.lww.com/menopausejournal/Abstract/2017/03000/Cultural_issues_in_menopause__an_exploratory.11.aspx">2017 study</a> found a small number of women continued to experience hot flushes and other symptoms into their 70s.</p> <p>So overall, the research cannot offer a specific window for perimenopause, and menopause does not appear to mark the end of changes for everyone.</p> <h2>5 tips for uncertain times</h2> <p>Shifts and changes can be recognised early by developing knowledge, paying attention to changes to our bodies and talking about menopause and perimenopause more openly.</p> <p>Here are five tips for moving from uncertainty to certainty:</p> <p><strong>1.</strong> talk to people and find out as much information as you can. The experiences of mothers and sisters may help, for some women there are familial similarities</p> <p><strong>2.</strong> notice any changes to your body and make a note of them, this will help you recognise changes earlier. There are <a href="https://www.redonline.co.uk/wellbeing/a36980118/menopause-apps/">menopause tracking apps</a> available</p> <p><strong>3.</strong> keep a note of your menstrual cycle: start date, duration, flow and note any changes. Again, an app might help</p> <p><strong>4.</strong> if you are worried, seek advice from a GP or nurse that specialises in women’s health. They may suggest ways to help with symptoms or refer to a specialist</p> <p><strong>5.</strong> remember changes are the indicator to pay attention to, not time or your age.</p> <p>Menopause is a natural process and although we have focused here on the time frame and “symptoms”, it can also be a time of freedom (particularly from periods!), reflection and a time to focus on yourself.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/195211/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <figure><iframe src="https://www.youtube.com/embed/lhosPUwWhfI?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Women speak about their experiences of menopause.</span></figcaption></figure> <p><em><a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, Nurse &amp; Lecturer, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-menopause-last-5-tips-for-navigating-uncertain-times-195211">original article</a>.</em></p>

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An emotional Scott Morrison delivers his last speech to parliament

<p>In a poignant and somewhat unexpected farewell, former Prime Minister Scott Morrison bid adieu to federal parliament, leaving behind a legacy tinged with tears – and a surprising tribute to pop sensation Taylor Swift.</p> <p>As he marked his exit, Morrison delivered a heartfelt address, reflecting on his political journey, acknowledging his colleagues, and offering insights into his future endeavours.</p> <p>Flashing a Swiftie friendship bracelet emblazoned with the nickname "ScoMo" beneath the sleeve of his suit, Morrison's speech was a blend of personal anecdotes, political reflections and nods to popular culture. Surrounded by his family – his mother Marion, wife Jenny, and daughters Abby and Lily – Morrison addressed a gallery that, while not at full capacity, held a significant emotional weight for the departing leader.</p> <p>With a touch of humour, Morrison recounted his daughters' suggestion of incorporating references to Taylor Swift albums into his remarks, a challenge he gamely accepted. Seamlessly weaving Swift's song titles into his speech, Morrison painted a picture of his political journey, acknowledging the challenges he faced and the steadfast support of his loved ones, particularly his wife Jenny, whom he affectionately referred to as his "Lover":</p> <p><em>"It is true that my political opponents have often made me see <strong>Red</strong>.</em></p> <p><em>Often when subjected to the <strong>Tortured Poets</strong> who would rise to attack my Reputation. </em></p> <p><em>In response, I always thought it important to be <strong>Fearless</strong> and <strong>Speak Now</strong>. </em></p> <p><em>Or forever hold my silence and allow those attacks to become <strong>Folklore</strong>. </em></p> <p><em>Ever since leaving university in <strong>1989</strong> this has always been my approach.</em></p> <p><em>My great consolation has always been my <strong>Lover</strong>, Jen, who has always been there for me whenever I needed her from dawn, and beyond the many <strong>Midnights</strong> we have shared together.</em></p> <p><em>See? I'm actually a <strong>True Romantic</strong> after all.</em></p> <p><em>I can assure there is no <strong>Bad Blood</strong>, as I've always been someone who has been able to … <strong>Shake It Off</strong>."</em></p> <p>Reflecting on his tenure as Australia's 30th prime minister from 2018 to 2020, Morrison expressed gratitude to the Indigenous community and the defence personnel, emphasising their contributions to the nation's freedom and prosperity. He cautioned against what he termed a "drift of secularism" and advocated for a reconnection with traditional Christian values, underlining the importance of faith in his own life.</p> <p>Amid tears, Morrison thanked his staff, household personnel and security detail, acknowledging their dedication and sacrifice – particularly recalling two individuals injured while protecting him. “I want to specially mention Travis Ford and Jen McCrae," he said, "who were <a href="https://www.oversixty.com.au/news/news/dangerous-traffic-crash-rocks-scott-morrison" target="_blank" rel="noopener">terribly injured in the line of duty</a> protecting me … in a terrible car accident in Tasmania. I will always be grateful for your sacrifice.”</p> <p>Emotionally addressing his family, Morrison expressed profound gratitude to his wife and daughters, recognising the challenges they endured due to his public role.</p> <p>In a magnanimous gesture, Morrison extended well wishes to his political opponents and congratulated Prime Minister Albanese on his recent engagement. He also expressed appreciation for his party colleagues, including former Prime Minister Malcolm Turnbull and Peter Dutton, highlighting their support and camaraderie.</p> <p>Touching upon his role in the AUKUS nuclear submarine deal and Australia's stance against Chinese coercion, Morrison underscored the importance of standing firm in the face of geopolitical challenges. He warned against complacency and urged vigilance in safeguarding national interests against external threats.</p> <p>Closing on a deeply personal note, Morrison reaffirmed his faith in Jesus Christ, acknowledging his own imperfections and the power of forgiveness. Quoting scripture, he embraced his Christian beliefs unapologetically, emphasising the strength derived from his faith.</p> <p>The solemnity of the moment was then relieved somewhat when Morrison ended his speech with the words "And, as always, up, up, Cronulla!", as colleagues from across the political spectrum approached to bid him farewell.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Morrison made a point of highlighting the main lessons he says he's learned during his political career, which we have summarised here:</span></p> <p><strong>1. Without a strong economy, you cannot achieve your goals as a nation</strong></p> <p>He said there have been strong contributions made in this respect by both sides of politics, and Australia must be careful not to "reinstitutionalise our economy" and crush entrepreneurial spirit.</p> <p><strong>2. Threats are out there, and they are real</strong></p> <p>Morrison talked about a new era of strategic competition, in which the old rules-based international order is being challenged by "a new arc of autocracy" ranging from Pyongyang to Beijing to Tehran and Moscow.</p> <p>He cited AUKUS, the Quad and new trading and defence relationships as key achievements of his government in this arena, but said that "continued vigilance and the connection between all spheres of police" is required going forward.</p> <p><strong>3. Judeo-Christian values shouldn't be forgotten in the 'increasing Western embrace of secularism'</strong></p> <p>"Individual liberty, the rule of law, equality of opportunity, responsible citizenship, morality, liberty of speech, thought, religion and association. All of these stem from the core principle of respect for individual human dignity," Morrison said. "So does representative democracy. And even market-based capitalism. This is a unique Judeo-Christian principle."</p> <p><em>Image: ABC News</em></p> <p> </p>

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How long does back pain last? And how can learning about pain increase the chance of recovery?

<p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p>

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Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>.</p> <p><a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment.</p> <p>Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.</p> <h2>Walk, run, lift, or dance away depression</h2> <p>We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together.</p> <p>We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.</p> <p>Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants.</p> <p>But of these exercises, people were most likely to stick with strength training and yoga.</p> <p><iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing.</p> <p>Still, our evidence shows that if you have depression, you should get a psychologist <em>and</em> an exercise plan, whether or not you’re taking antidepressants.</p> <h2>Join a program and go hard (with support)</h2> <p>Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.”</p> <p>But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression.</p> <p>We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results.</p> <h2>Yes, it’s hard to keep motivated</h2> <p>We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results.</p> <p>Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free.</p> <p>We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.</p> <p>Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.</p> <p>Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult.</p> <p>A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted.</p> <p>Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it.</p> <p>So, when starting out, it seems wise to avoid going it alone. Instead:</p> <ul> <li> <p>join a fitness group or yoga studio</p> </li> <li> <p>get a trainer or an exercise physiologist</p> </li> <li> <p>ask a friend or family member to go for a walk with you.</p> </li> </ul> <p>Taking a few steps towards getting that support makes it more likely you’ll keep exercising.</p> <h2>Let’s make this official</h2> <p>Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”.</p> <p>Based on our research, this recommendation is withholding a potent treatment from many people who need it.</p> <p>In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression.</p> <p>Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression.</p> <p><em>I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.</em></p>

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