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Readers response: What’s your top travel tip for staying comfortable on long journeys?

<p>When it comes to a long travel day, getting comfortable can often be a mammoth task. </p> <p>We asked our readers to share their favourite tips and tricks to stay comfy on a long haul flight, car ride or train journey, and the response was overwhelming. Here's what they said.</p> <p><strong>Amy Cardino</strong> - Long-haul journeys (to me longer than 8hrs), you need to save up or upgrade your ticket if you have mileage benefits, into business class. </p> <p><strong>Ester Cibasek</strong> - My own blowup pillow and blanket (long enough to cover my head), noise reducing ear phones and keep my eyes closed so I dose in and out of sleep all the way.</p> <p><strong>Valerie Keily</strong> - A neck pillow is essential and an eye shade. Keep hydrated and remember to move around if possible.</p> <p><strong>Di Richardson</strong> - Memory neck pillow. Recovery sleeves on my calves. One departure drink then limit alcohol or coffee. Window seat and sleep when possible. Bliss.</p> <p><strong>Anita Thornton</strong> - Go business class. </p> <p><strong>Chrissie Martini</strong> - Break the journey by staying overnight in a hotel. Takes longer to get there but you practically eliminate jet lag and the worry of DVTs. On the way to Europe, two overnight stops helps me.</p> <p><strong>Lyn Goodman</strong> - Keep warm and wear loose fitting clothes.</p> <p><strong>June Debono</strong> - Stretch jeans and socks (as well as other clothes of course). Plus, eye shade and ear plugs.</p> <p><strong>Ingrid Plueckhahn</strong> - Take a good book, break up the journey with a fave movie, and just get in the zone and relax. It’s just a day!</p> <p><em>Image credits: Shutterstock </em></p>

Travel Tips

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Incredible reason behind Aussie woman's 5,500km outback ride

<p>Sarah Wheeler has been travelling through the New South Wales outback for the last four and a half months, doing it entirely on horseback. </p> <p>The 26-year-old Aussie plans to ride  5,500 kilometres through outback Queensland and New South Wales to raise awareness about the rare cancer that killed her mum in 2022, a little over a decade after her father passed away. </p> <p>With around four months left on her trip, Wheeler and her two horses, Shifty and Sally, are slowly trekking across some of the most remote and rugged parts of the country in a trip that has never been done before. </p> <p>"I'd always thought about doing something like this throughout my life," Wheeler told <em>Yahoo News</em>. </p> <p>"So after my parents died, I went out and bought two horses and, yeah, set off on a five-and-a-half-thousand-kilometre horse ride to honour and remember, and grieve."</p> <p>Wheeler set off with her horses from her hometown Rowena in western NSW in May, and has since travelled across long stretches of highways, desolate plains and rocky terrain and has now passed the halfway mark. </p> <p>She explained that in recent weeks she has also been trekking on foot and has contact with other people only when she stops in towns for supplies or when she feeds her horses, using a support vehicle. </p> <p>"The car travels 10 kilometres at a time so that I can keep replenishing my horses, with both food and water. Ten kilometres takes me two hours, sometimes a bit longer, and I'm usually in the saddle for six to eight hours a day," she told the publication. </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/C89KIgsxb_A/?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/C89KIgsxb_A/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Sarah Wheeler - The Outback Long Ride (@_beneaththebrim)</a></p> </div> </blockquote> <p>"The most challenging thing has probably been the saddles and saddle pads and cleanliness — that's all so important. I have to wash my saddle blankets every second day. Otherwise, things just start happening, like fungus type of stuff."</p> <p>She added that while "this has been one of the hardest things I have ever done", the friendliness and support of locals has been a highlight of her trip. </p> <p>"Everyone's so lovely and inviting and, yeah, I just I didn't think that I was going to see that to this extent," she said. "People want to invite me in and feed me, they just want to help me as much as they can."</p> <p>Remembering her late parents' legacy, Wheeler said she wants everyone to know just how "remarkable" they both were.</p> <p>"They were like everything this world needed and more," she said. "They were very kind and genuine and humble."</p> <p>Wheeler's ride is raising awareness and funds for two key charities: <a href="https://pancare-gi-cancer.raisely.com/sarah-wheeler" target="_blank" rel="noopener">Pancare Foundation</a>, the lead organisation supporting families and funding research for upper gastrointestinal (GI) cancer, which claimed the life of her mother, and A Daughter’s Way, her own charity supporting rural families experiencing grief. </p> <p><em>Images: Instagram</em></p>

Domestic Travel

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Snakes are waking up. What should you do if you’re bitten? And what if you’re a long way from help?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/hamish-bradley-2217649">Hamish Bradley</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>; <a href="https://theconversation.com/profiles/alice-richardson-252002">Alice Richardson</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>, and <a href="https://theconversation.com/profiles/breeanna-spring-1545193">Breeanna Spring</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a></em></p> <p>From the creeks that wind through inner city Melbourne to the far outback in Western Australia, snake season is beginning.</p> <p>Over the cooler months snakes have been in state of <a href="https://youtu.be/FjXOzNjZjoU?si=Mc0eeayVk4VU9906">brumation</a>. This is very similar to hibernation and characterised by sluggishness and inactivity. As warmer conditions return both snakes and humans become more active in the outdoors, leading to an increased likelihood of interaction. This may happen when people are hiking, dog-walking or gardening.</p> <p>The risk of being bitten by a snake is exceptionally small, but knowing basic first aid could potentially save your, or another person’s, life.</p> <h2>When a snake bites</h2> <p>Snake bite envenomation (when venom enters the blood stream) is a significant issue in Australia, with <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja17.00094">3,000 cases annually and an average of two deaths</a>.</p> <p>Snake bite should always be <a href="https://stjohnwa.com.au/online-resources/first-aid-information-and-resources/snake-bite">treated</a> as a life-threatening emergency, and if you are bitten in rural or remote Australia, you will often receive an air medical emergency pick up to a regional or metropolitan hospital for advanced care.</p> <p>The effects of snake bites vary, depending on the species of snake and first aid measures undertaken.</p> <p>Australian <a href="https://www.healthdirect.gov.au/snake-bites">standard first aid guidelines</a> include:</p> <ul> <li>calling for help (dialing 000 or activating an emergency beacon)</li> <li>applying a pressure immobilisation bandage</li> <li>resting.</li> </ul> <h2>Why pressure is important</h2> <p>Snake venom is carried within the <a href="https://theconversation.com/what-are-lymph-nodes-and-can-a-massage-really-improve-lymphatic-drainage-209334">lymphatic system</a>. This is a collection of tiny tubes throughout the body that return fluid outside of blood vessels back to the blood stream.</p> <p>Muscles act as a “<a href="https://theconversation.com/pneumatic-compression-therapy-can-it-really-help-olympians-or-you-recover-after-exercise-236228">pump</a>” to help the fluid move through this system. That’s why being still, or immobilisation, is vital to slow the spread of venom.</p> <p>A firm pressure immobilisation bandage, applied as tight as you would for a sprained ankle, will compress these tubes and help limit the venom’s spread.</p> <p>Ideally bandage the entire limb on which the bite occurred and apply a splint to help further with immobilisation. It is very important that the blood supply to the limb is not limited by this bandage.</p> <p>Never attempt to capture or kill the snake for identification. This risks further bites and is not required for specialist care. The decision about when to give antivenom (if any) is based on the geographical location, symptoms, the results of blood tests and discussion with a toxicologist.</p> <h2>The tyranny of distance</h2> <p>People living in rural and remote locations may also have limited access to health care, including access to ambulance services, <a href="https://www.tandfonline.com/doi/full/10.1080/10871209.2020.1769778">snake bite first aid</a> such as bandages and splints, and to antivenom.</p> <p>Availability and the prompt use of antivenom have been identified as <a href="https://www.sciencedirect.com/science/article/pii/S2590171022000558">crucial factors in the effective treatment</a> of snake envenomation – but not studied in detail.</p> <p>Over one year (as a component of a larger three-year study) we collected information on the pre-hospital care and in-flight care with the Royal Flying Doctors Service Western Operations.</p> <p>During this time, 85 people from regional, rural, remote and very remote Western Australia were flown by Royal Flying Doctor Service to hospital for suspected or confirmed snake bites. Reassuringly, only five of these patients (6%) ultimately received a toxicologist’s diagnosis of envenomation.</p> <h2>To move or not to move?</h2> <p>Troublingly, 38 (45%) of the 85 snake bite victims continued to move around and be active following their suspected snake bite. This raises questions about whether people lack knowledge of first-aid guidelines, or whether this is a consequence of being isolated, with limited access to health care.</p> <p>Either way, our as-yet-unpublished research highlights the vulnerability of Australia’s rural and remote people. All patients eventually received a pressure immobilisation bandage, with an average time from bite to application of 38 minutes. Three quarters of the patients made their way to health-care site by foot, or private car, arriving on average 65 minutes after the bite.</p> <h2>What needs to change?</h2> <p>Our results indicate rural and remote Australians need innovative health-care solutions beyond the metropolitan guidelines, particularly when outside ambulance service areas.</p> <p>Basic snake bite first aid education needs to be not only reiterated but also a pragmatic approach is required in these geographically isolated locations. This would involve being vigilant, staying safe and, when isolated, always carrying emergency technology to call for help.</p> <hr /> <p><em>The authors wish to acknowledge the efforts required through this research project as it continues, including by Fergus Gardiner, Kieran Hennelly, Rochelle Menzies, James Anderson, Alex McMillan and John Fisher. Hamish Bradley is an Aeromedical Retrieval Specialist and Principal Investigator in this project.</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/234365/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/hamish-bradley-2217649">Hamish Bradley</a>, Adjunct Lecturer, Anaesthetist and Aeromedical Retrieval Specialist, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>; <a href="https://theconversation.com/profiles/alice-richardson-252002">Alice Richardson</a>, Associate professor and lead of Statistical Support Network, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>, and <a href="https://theconversation.com/profiles/breeanna-spring-1545193">Breeanna Spring</a>, PhD student, Molly Wardaguga Institute for First Nations Birth Rights, Faculty of Health, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin 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/snakes-are-waking-up-what-should-you-do-if-youre-bitten-and-what-if-youre-a-long-way-from-help-234365">original article</a>.</em></p> </div>

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Parents under fire for taking their sick toddler on a long-haul flight

<p>A couple has come under fire after documenting their experience online of boarding a long-haul flight with their toddler, despite the child being sick. </p> <p>Alina and her husband were excited to go on their long-awaited holiday to Thailand with their one-year-old son in tow, taking off on their first big family trip. </p> <p>However, shortly before they were set to take off, their child developed a raging fever, and they decided to go on the trip anyway. </p> <p>Taking the experience to social media, Alina said her son’s temperature soared to around 40 degrees, with their little boy’s condition escalating so rapidly that the parents were considering calling off their entire trip. </p> <p>“My husband and I even wanted to cancel the flight,” she confessed in the video, which has received around 1.4 million views.</p> <p>However, after realising they would be out of pocket by several thousands of dollars if they cancelled the trip at such short notice, they decided to take the risk and board the plane. </p> <p>“Our tickets would have been wasted, and the trip that cost us $3,000 would have been wasted,” the mum wrote. "One plus of this flight was that the flight was at night, and the child could sleep and recover.”</p> <p>In the clip, the parents were seen walking their son around the plane, cradling the sick toddler as he cried uncontrollably.</p> <p>Luckily, the parents “managed to bring down the temperature”, but they weren’t convinced their son would keep quiet for the rest of the trip. </p> <p>“We were so worried about how the baby would feel on an eight-hour flight,” she continued, walking the baby up and down the corridors of the airport, trying to calm him down. </p> <p>As they tried to settle the child, they realised that their hopes that he would sleep the whole way were misguided. </p> <p>“The flight turned out to be difficult,” Alina confessed. “The baby kept waking and crying.” </p> <p>In the middle of the night, their son’s fever returned, which forced the parents to “bring the temperature down again” and left them “very worried” about their son’s health. </p> <p>Their baby’s fever took a toll on the parents as well, who complained of feeling “squeezed like a lemon” while trying to keep his temperature down, as Alina recalled, “We took turns looking after the baby so each of us could sleep.”</p> <p>In a later video, the parents defended their choice to take their son on the flight despite his intense fever and blamed it on his teething, not sickness. </p> <p>“Our baby wasn’t sick, he was teething, and that’s why he had a fever,” she said. “If our child had been sick, we would have cancelled everything … I consider myself a wonderful mother.”</p> <p>Despite the mother's clarification of her son's fever, the parents were slammed for even considering taking a sick child on such a long flight. </p> <p>“It’s OK, don’t worry about making anyone else on that flight sick,” a sarcastic comment read. “This is so tremendously selfish, you are appalling for doing this to him and others.” </p> <p>“I was in the same situation,” another parent said. “I lost all bookings, but who cares, my daughter comes first always and forever, no matter the amount of money!”</p> <p>“Trips come and go; your baby’s health is priceless!” read another comment. “Forty degrees is a hospital admission! Not a flight to Thailand!”</p> <p>However, not everyone was as judgmental, with many parents extending their sympathies to the first-time parents, as one person wrote, “You know what’s best for your baby. Everyone will say things. But only you will know when you are in that situation.”</p> <p>“Everyone is a first-time parent,” another defended. “This was a lesson learned. A baby’s health is of utmost importance. No holiday is more important than that. I hope he is OK now.”</p> <p><em>Image credits: TikTok</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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John Boland’s battle against prostate cancer and the urgent need for reform

<p>John Boland, a 74-year-old retired Navy Reserve Lieutenant Commander, found himself at a crossroads – a place where hope and despair often meet in the lives of those battling life-threatening illnesses like prostate cancer. </p> <p>Diagnosed five years ago, John’s journey has been a relentless fight against a disease that, despite medical advancements, still claims the lives of 10 men in Australia every day.</p> <p>After undergoing surgery and 37 rounds of radiation therapy, John’s battle was far from over. His PSA (Prostate-Specific Antigen) levels, an indicator of prostate cancer activity, were not dropping sufficiently, signalling that the fight was only getting tougher. It was then that John was introduced to a groundbreaking treatment: Lutetium-177 PSMA therapy (LuPSMA), a targeted radionuclide therapy with pinpoint accuracy to attack cancer cells.</p> <p>This innovative treatment offered a glimmer of hope, a chance to strike at the heart of the disease that had disrupted his life. But there was a catch – the cost. Each round of LuPSMA treatment costs $10,000, and while some patients may require up to eight rounds, John’s doctors recommended two based on his response. Even so, the financial burden was immense, forcing John to dip into his superannuation, ultimately spending $60,000 on the treatment that was not covered by insurance.</p> <p>Despite the financial strain, the results were nothing short of miraculous. After just the first round, John’s PSA levels dropped by a staggering 95%. After the second, they fell to nearly zero. The treatment had not only attacked the cancer but had also restored his quality of life, allowing him to once again enjoy the simple pleasures – time with family, daily activities and even golf. It was a victory that brought renewed hope and confidence for the future, a victory that made the $60,000 investment worth every cent.</p> <p>“My case was remarkably successful after the second treatment, which are eight weeks apart, after the scan had no cancer, and my PSA was effective to zero. So it was a reliable result for me and a huge boost, but unfortunately, they're $10,000 a time, and you can require up to eight treatments,” says John. “Fortunately we were able to fund it from our superannuation pension account, the $20,000, but I imagine that a lot of people, they can’t find that $20,000.”</p> <p>But John’s story, while inspiring, also highlights a grim reality: many Australians are not as fortunate. The LuPSMA treatment that worked so well for John remains out of reach for many others due to its prohibitive cost. And this isn’t just an isolated issue; it’s a systemic problem affecting thousands of men across the country.</p> <p>A new report, the <a href="https://www.pcfa.org.au/media/nbennwom/aus-np-1123-80001-amgen-access-gap-report_april-2024-data-final-approved.pdf" target="_blank" rel="noopener">Australian Patient Access Gap Report</a>, has shed light on the alarming delay in the public availability of new medicines in Australia. The report reveals that Australians with life-threatening illnesses are waiting an average of 591 days – more than 18 months – for access to new, potentially life-saving medicines. For some, the wait can be as long as three years. These delays are not just statistics; they represent real people, real lives hanging in the balance.</p> <p>The Prostate Cancer Foundation of Australia (PCFA), the country’s leading organisation in the fight against prostate cancer, is calling for urgent reform. They argue that the current system, which often requires multiple rounds of review before new treatments are approved for public use, is failing Australians. </p> <p>PCFA CEO Anne Savage points out that while 10 men die from prostate cancer every day, the approval process for new treatments drags on, leaving patients like John Boland to fend for themselves – often at great financial and emotional cost. “In almost every instance, Australians are being denied access to new medicines that can extend and save their lives, simply because our approval systems have not kept up with the pace of change,” she says. </p> <p>“In relation to prostate cancer, applications typically undergo two or three rounds of review before achieving a positive recommendation, while 10 men die a day from the disease. It’s simply not good enough.”</p> <p>John’s story serves as a strong call to action. His successful treatment with LuPSMA is a testament to the power of modern medicine, but it also underscores the urgent need for change. No one should have to choose between their life savings and their life; it’s time for Australia to modernise its pharmaceutical benefits scheme, ensuring that all Australians, regardless of their financial situation, have access to the treatments they need.</p> <p>As we move forward, the PCFA is urging Australians to take part in initiatives like <a href="https://www.thelongrun.org.au/" target="_blank" rel="noopener">The Long Run</a> during Prostate Cancer Awareness Month in September, raising awareness and funds to support the fight against this devastating disease. </p> <p>For John Boland, and for the thousands of others who share his struggle, we must work towards a future where no one is left behind in the fight against cancer.</p> <p><em>Image: Courtesy of John Boland.</em></p>

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Major update in long-delayed William Tyrrell inquest

<p>Almost 10 years after William Tyrrell went missing, an inquest into his disappearance is finally set to resume. </p> <p>The three-year-old disappeared from his foster grandmother’s home in Kendall on September 12th 2014, in what has become one of Australia’s most notorious missing persons cases.</p> <p>For 18 long months, an inquest before Deputy State Coroner Harriet Grahame examined William’s disappearance and suspected death, before it was adjourned in October 2020.</p> <p>Ms Grahame’s findings were due to be handed down in June 2021, but the inquest was pushed back indefinitely as prosecutors grappled with evidence concerning the missing boy’s foster mother.</p> <p>As the investigation into William's disappearance continues, his body has never been found and his foster parents have persistently denied having any involvement.</p> <p>Now, after three years of delays, a directions hearing at the NSW Coroner’s Court in Western Sydney on Tuesday confirmed a final block of hearings will commence later in the year. </p> <p>Starting the weeks of November 4th and December 16th, witnesses will be recalled to the stand as the inquest is formally recommenced, with the court saying that the witness list and list of issues was set to be finalised within a few days.</p> <p>No one has been charged in the case of William's disappearance and a $1 million reward for information still stands.</p> <p><em>Image credits: NSW Police </em></p>

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Long COVID puzzle pieces are falling into place – the picture is unsettling

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</a></em></p> <p>Since 2020, the condition known as long COVID-19 has become a <a href="https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/guidance-long-covid-disability/index.html">widespread disability</a> affecting the health and quality of life of millions of people across the globe and costing economies billions of dollars in <a href="https://www.oecd.org/en/publications/the-impacts-of-long-covid-across-oecd-countries_8bd08383-en.html">reduced productivity of employees and an overall drop in the work force</a>.</p> <p>The intense scientific effort that long COVID sparked has resulted in <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22long+covid%22+or+%22pasc%22+or+%22post-acute+sequelae+of+covid-19%22+or+%22postacute+sequelae+of+covid-19%22+or+%22post-acute+sequelae+of+SARS-CoV-2%22+or+%22postacute+sequelae+of+SARS-CoV-2%22+or+%22post+covid+condition%22+or+%22post+covid+conditions%22+or+%E2%80%9Cchronic+covid-19%E2%80%9D+or+%E2%80%9Cpost+covid-19+condition%E2%80%9D+or+%E2%80%9Cpost+covid-19+conditions%E2%80%9D+or+%E2%80%9Cpost-covid+condition%E2%80%9D+or+%E2%80%9Cpost-covid+conditions%E2%80%9D+or+%E2%80%9Clong+covid-19%E2%80%9D+or+%28%22long-term%22+and+%22COVID-19%22%29+or+%28%22longterm%22+and+%22COVID-19%22%29+or+%28%22long-term%22+and+%22SARS-CoV-2%22%29+or+%28%22longterm%22+and+%22SARS-CoV-2%22%29+or+%E2%80%9Cpostcovid+condition%E2%80%9D+or+%E2%80%9Cpostcovid+conditions%E2%80%9D+&amp;sort=date">more than 24,000 scientific publications</a>, making it the most researched health condition in any four years of recorded human history.</p> <p><a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">Long COVID</a> is a term that describes the <a href="https://www.yalemedicine.org/conditions/long-covid-post-covid-conditions-pcc">constellation of long-term health effects</a> caused by infection with the SARS-CoV-2 virus. These range from persistent respiratory symptoms, such as shortness of breath, to debilitating fatigue or brain fog that limits people’s ability to work, and conditions such as heart failure and diabetes, which are known to last a lifetime.</p> <p>I am a physician scientist, and I have been deeply immersed in studying long COVID since the early days of the pandemic. I have testified before the U.S. Senate as an <a href="https://www.help.senate.gov/imo/media/doc/baf4e4e7-b423-6bef-7cb4-1b272df66eb8/Al-Aly%20Testimony.pdf">expert witness on long COVID</a>, have <a href="https://scholar.google.com/citations?hl=en&amp;user=DtuRVcUAAAAJ">published extensively on it</a> and was named as one of <a href="https://time.com/6966812/ziyad-al-aly/">Time’s 100 most influential people in health in 2024</a> for my research in this area.</p> <p>Over the first half of 2024, a <a href="https://www.nationalacademies.org/our-work/long-term-health-effects-stemming-from-covid-19-and-implications-for-the-social-security-administration#sl-three-columns-afa91458-20e0-42ab-9bd6-55e3c8262ecc">flurry of reports</a> and <a href="https://doi.org/10.1056/NEJMoa2403211">scientific papers</a> on long COVID added clarity to this complex condition. These include, in particular, insights into how COVID-19 can still wreak havoc in many organs years after the initial viral infection, as well as emerging evidence on viral persistence and immune dysfunction that last for months or years after initial infection.</p> <h2>How long COVID affects the body</h2> <p>A new study that my colleagues and I published in the New England Journal of Medicine on July 17, 2024, shows that the <a href="https://doi.org/10.1056/NEJMoa2403211">risk of long COVID declined</a> over the course of the pandemic. In 2020, when the ancestral strain of SARS-CoV-2 was dominant and vaccines were not available, about 10.4% of adults who got COVID-19 developed long COVID. By early 2022, when the omicron family of variants predominated, that rate declined to 7.7% among unvaccinated adults and 3.5% of vaccinated adults. In other words, unvaccinated people were more than twice as likely to develop long COVID.</p> <p>While researchers like me do not yet have concrete numbers for the current rate in mid-2024 due to the time it takes for long COVID cases to be reflected in the data, the flow of new patients into long COVID clinics has been on par with 2022.</p> <p>We found that the decline was the result of two key drivers: availability of vaccines and changes in the characteristics of the virus – which made the virus less prone to cause severe acute infections and may have reduced its ability to persist in the human body long enough to cause chronic disease.</p> <p>Despite the decline in risk of developing long COVID, even a 3.5% risk is substantial. New and repeat COVID-19 infections translate into millions of new long COVID cases that add to an already staggering number of people suffering from this condition.</p> <p>Estimates for the first year of the pandemic suggests that at <a href="https://doi.org/10.1038/s41579-023-00896-0">least 65 million people</a> globally have had long COVID. Along with a group of other leading scientists, my team will soon publish updated estimates of the global burden of long COVID and its impact on the global economy through 2023.</p> <p>In addition, a major new report by the National Academies of Sciences Engineering and Medicine details all the <a href="https://nap.nationalacademies.org/catalog/27756/long-term-health-effects-of-covid-19-disability-and-function">health effects that constitute long COVID</a>. The report was commissioned by the Social Security Administration to understand the implications of long COVID on its disability benefits.</p> <p>It concludes that long COVID is a complex chronic condition that can result in more than 200 health effects across multiple body systems. These include new onset or worsening:</p> <ul> <li><a href="https://doi.org/10.1038/s41591-022-01689-3">heart disease</a></li> <li><a href="https://doi.org/10.1038/s41591-022-02001-z">neurologic problems</a> such as <a href="https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216">cognitive impairment</a>, strokes and <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>. This is a category of disorders that affect the body’s <a href="https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system">autonomic nervous system</a> – nerves that regulate most of the body’s vital mechanisms such as blood pressure, heart rate and temperature.</li> <li><a href="https://www.cdc.gov/me-cfs/hcp/clinical-care/treating-the-most-disruptive-symptoms-first-and-preventing-worsening-of-symptoms.html">post-exertional malaise</a>, a state of severe exhaustion that may happen after even minor activity — often leaving the patient unable to function for hours, days or weeks</li> <li><a href="https://doi.org/10.1038/s41467-023-36223-7">gastrointestinal disorders</a></li> <li><a href="https://doi.org/10.1681/ASN.2021060734">kidney disease</a></li> <li>metabolic disorders such as <a href="https://doi.org/10.1016/S2213-8587(22)00044-4">diabetes</a> and <a href="https://doi.org/10.1016/S2213-8587(22)00355-2">hyperlipidemia</a>, or a rise in bad cholesterol</li> <li><a href="https://doi.org/10.1038/s41590-023-01724-6">immune dysfunction</a></li> </ul> <p>Long COVID can affect people across the lifespan from children to older adults and across race and ethnicity and baseline health status. Importantly, <a href="https://doi.org/10.1126/science.adl0867">more than 90% of people with long COVID</a> had mild COVID-19 infections.</p> <p>The National Academies report also concluded that long COVID can result in the inability to return to work or school; poor quality of life; diminished ability to perform activities of daily living; and decreased physical and cognitive function for months or years after the initial infection.</p> <p>The report points out that many health effects of long COVID, such as post-exertional malaise and chronic fatigue, cognitive impairment and autonomic dysfunction, are not currently captured in the <a href="https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm">Social Security Administration’s Listing of Impairments</a>, yet may significantly affect an individual’s ability to participate in work or school.</p> <figure><iframe src="https://www.youtube.com/embed/9kJ5GWb2wzw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Many people experience long COVID symptoms for years following initial infection.</span></figcaption></figure> <h2>A long road ahead</h2> <p>What’s more, health problems resulting from COVID-19 can last years after the initial infection.</p> <p>A large study published in early 2024 showed that even people who had a <a href="https://doi.org/10.1038/s41591-024-02987-8">mild SARS-CoV-2 infection still experienced new health problems</a> related to COVID-19 in the third year after the initial infection.</p> <p>Such findings parallel other research showing that the <a href="https://doi.org/10.1016/S1473-3099(24)00171-3">virus persists</a> in various organ systems for months or years after COVID-19 infection. And research is showing that immune responses to the infection are <a href="https://doi.org/10.1126/scitranslmed.adk3295">still evident two to three years</a> after a mild infection. Together, these studies may explain why a SARS-CoV-2 infection years ago could still cause new health problems long after the initial infection.</p> <p>Important progress is also being made in understanding the pathways by which long COVID wreaks havoc on the body. Two preliminary studies <a href="https://doi.org/10.1101/2024.06.18.24309100">from the U.S.</a> and <a href="https://doi.org/10.1101/2024.05.30.596590">the Netherlands</a> show that when researchers transfer auto-antibodies – antibodies generated by a person’s immune system that are directed at their own tissues and organs – from people with long COVID into healthy mice, the animals start to experience long COVID-like symptoms such as muscle weakness and poor balance.</p> <p>These studies suggest that an abnormal immune response thought to be responsible for the generation of these auto-antibodies may underlie long COVID and that <a href="https://doi.org/10.1126/science.zbzipqn">removing these auto-antibodies</a> may hold promise as potential treatments.</p> <h2>An ongoing threat</h2> <p>Despite overwhelming evidence of the wide-ranging risks of COVID-19, a great deal of messaging suggests that it is no longer a threat to the public. Although there is no empirical evidence to back this up, this misinformation has permeated the public narrative.</p> <p>The data, however, tells a different story.</p> <p><a href="https://covid.cdc.gov/covid-data-tracker/#datatracker-home">COVID-19 infections</a> continue to <a href="https://www.cdc.gov/flu/weekly/index.htm">outnumber flu cases</a> and lead to <a href="https://www.cdc.gov/resp-net/dashboard/index.html">more hospitalization</a> and <a href="https://doi.org/10.1001/jama.2024.7395">death</a> than the flu. COVID-19 also leads to <a href="https://doi.org/10.1016/S1473-3099(23)00684-9">more serious long-term health problems</a>. Trivializing COVID-19 as an inconsequential cold or <a href="https://www.theatlantic.com/health/archive/2024/02/covid-anniversary-flu-isolation-cdc/677588/">equating it with the flu</a> does not align with reality.<!-- 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/233759/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/ziyad-al-aly-513663">Ziyad Al-Aly</a>, Chief of Research and Development, VA St. Louis Health Care System. Clinical Epidemiologist, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</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/long-covid-puzzle-pieces-are-falling-into-place-the-picture-is-unsettling-233759">original article</a>.</em></p> </div>

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Attempted assassination of Trump: The long history of violence against U.S. presidents

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/thomas-klassen-1171638">Thomas Klassen</a>, <a href="https://theconversation.com/institutions/york-university-canada-1610">York University, Canada</a></em></p> <p>Political assassinations in the United States have a long and disturbing history.</p> <p>The <a href="https://apnews.com/article/trump-vp-vance-rubio-7c7ba6b99b5f38d2d840ed95b2fdc3e5">attempted assassination of Donald Trump</a>, who narrowly escaped death when a bullet grazed his right ear while he was speaking at a campaign rally in Pennsylvania on Saturday, highlights the danger of those seeking votes in a country whose constitution guarantees citizens the right to bear arms.</p> <p>Trump joins a not-so-exclusive club of U.S. presidents, former presidents and presidential candidates who have been the target of bullets. Of the 45 people who have served as president, four have been <a href="https://abcnews.go.com/US/wireStory/us-presidents-assassinated-targeted-presidential-candidates-111920908">assassinated while in office</a>.</p> <p>Given the near mythic status of U.S. presidents, and the nation’s superpower role, political assassinations strike at the very heart of the American psyche.</p> <p><a href="https://www.loc.gov/collections/abraham-lincoln-papers/articles-and-essays/assassination-of-president-abraham-lincoln/">Abraham Lincoln</a>’s killing in 1865 and that of <a href="https://theconversation.com/jfk-assassination-60-years-on-seven-experts-on-what-to-watch-see-and-read-to-understand-the-event-and-its-consequences-216203">John F. Kennedy</a> in 1963 are key moments in the history of the United States. <a href="https://www.history.com/news/the-assassination-of-president-james-a-garfield">James Garfield</a> (1881) and <a href="https://www.history.com/news/the-assassination-of-president-william-mckinley">William McKinley</a> (1901) are less remembered, but their deaths nonetheless rocked the nation at the time.</p> <h2>Secret Service provides protection</h2> <p>It was after McKinley’s assassination that the U.S. Secret Service was given <a href="https://www.secretservice.gov/about/history/150-years#:%7E:text">the job of providing full-time protection to presidents</a>.</p> <p>The last American president to be shot was Ronald Reagan, <a href="https://www.reaganlibrary.gov/permanent-exhibits/assassination-attempt">who was seriously wounded and required emergency surgery in 1981</a>.</p> <p>Reagan was leaving a Washington hotel after giving a speech when gunman John Hinckley Jr. fired shots from a .22-calibre pistol. One of the bullets ricocheted off the president’s limousine and hit him under the left armpit. Reagan spent 12 days in hospital before returning to the White House.</p> <p>Other presidents have been shot at, but luckily, not injured.</p> <p>In 1933, <a href="http://www.fdrlibraryvirtualtour.org/page03-06.asp">a gunman fired five shots at the car of then President-Elect Franklin D. Roosevelt</a>. Roosevelt wasn’t hit but the mayor of Chicago, Anton Cermak, who was speaking to Roosevelt after the newly elected president had made some brief remarks to the public, was injured and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297642/">died 19 days later</a>.</p> <h2>Two attempts in one month</h2> <p>In September of 1975, President Gerald Ford survived <a href="https://www.fordlibrarymuseum.gov/avproj/assassinations.asp">two separate assassination attempts — both by women</a>. The first came on Sept. 5 when Lynette (Squeaky) Fromme, a follower of cult leader Charles Manson, tried to shoot Ford as he was walking through a park in Sacramento, Calif., but her gun misfired and didn’t go off. On Sept. 22, Sara Jane Moore, a woman with ties to left-wing radical groups, got one shot off at Ford as he left a hotel in San Francisco but it missed the president.</p> <p>Presidential candidates have not been exempt from assassination attempts, including most notably Senator <a href="https://www.npr.org/2023/06/05/1179430014/robert-kennedy-rfk-assassination-anniversary">Robert F. Kennedy</a> killed in 1968 and <a href="https://www.wsfa.com/2024/07/14/son-late-alabama-gov-george-wallace-reacts-trump-rally-shooting/">George Wallace</a> shot and left paralyzed in 1972.</p> <p>In 1912, former president Theodore Roosevelt <a href="https://blogs.loc.gov/headlinesandheroes/2019/07/the-pocket-items-that-saved-the-life-of-theodore-roosevelt/">was hit in the chest by a .38-calibre bullet</a> as he was campaigning to regain the White House. But most of the impact of the bullet was absorbed by objects in the chest pocket of Roosevelt’s jacket. Even though he had been shot, Roosevelt went on to make a campaign speech with the bullet still in his chest.</p> <h2>The violence of 1968</h2> <p>Other figures with significant — if unelected — political power have also had their lives cut short by gunfire, most notably <a href="https://theconversation.com/mlks-vision-matters-today-for-the-43-million-americans-living-in-poverty-92380">Martin Luther King Jr.</a> in 1968, just a few months before Bobby Kennedy’s death.</p> <p>In a country with <a href="https://www.washingtonpost.com/news/wonk/wp/2018/06/19/there-are-more-guns-than-people-in-the-united-states-according-to-a-new-study-of-global-firearm-ownership/">more guns than people</a>, and with firearms easily available, it is not surprising that invariably shootings are the preferred means of killing or attempting to kill political office holders.</p> <p>Like Trump, most assassination attempts occur when candidates and politicians are in public spaces with crowds of people nearby. There is a long history of politicians insisting, against the advice of their security advisers, to “press the flesh” in events that jeopardize their safety. Trump was extraordinarily fortunate to escape with only minor injuries.<!-- 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/234630/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/thomas-klassen-1171638">Thomas Klassen</a>, Professor, School of Public Policy and Administration, <a href="https://theconversation.com/institutions/york-university-canada-1610">York University, Canada</a></em></p> <p><em>Image credits: Xinhua News Agency/Shutterstock Editorial </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/attempted-assassination-of-trump-the-long-history-of-violence-against-u-s-presidents-234630">original article</a>.</em></p> </div>

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The world’s longest cruises

<p dir="ltr">If you’re looking for your next cruising adventure, there are a multitude of time frames you can pick from for your next holiday. </p> <p dir="ltr">While many cruise-goers tend to opt for just a week or two at sea, there are other voyages that can see you spend months travelling the world. </p> <p dir="ltr">Here are ten of the longest cruise journeys that are available for the most dedicated travellers. </p> <p dir="ltr"><strong>Queen Anne - 107 days</strong></p> <p dir="ltr">In 2025, new Cunard ship Queen Anne will embark on her maiden World Voyage which includes her first visit to Australia and New Zealand.</p> <p dir="ltr">The 107-day journey starts with a transatlantic crossing before sailing to destinations in the Americas, Australasia, Asia, the Arabian Gulf and finally the Mediterranean.</p> <p dir="ltr"><strong>Crown Princess - 113 days </strong></p> <p dir="ltr">The Crown Princess is set to embark on an epic around the world cruise next year, and you can get on in Australia or New Zealand.</p> <p dir="ltr">From there, the voyage will visit 49 destinations in 28 countries over 113 days, crossing the equator twice, and sailing 33,500 nautical miles.</p> <p dir="ltr"><strong>MSC Magnifica - 119 days</strong></p> <p dir="ltr">MSC's World Cruise 2026 lasts 119 days, with options to book the entire round-the-world itinerary for the most dedicated travellers. </p> <p dir="ltr">The trip starts in Italy, and takes in the Mediterranean before heading across the Atlantic to the Caribbean and South America, before it then sails to California before crossing the Pacific for Hawaii, New Zealand and Australia.</p> <p dir="ltr"><strong>Seabourn Sojourn - 129 days </strong></p> <p dir="ltr">Seabourn's 2026 World Cruise sets sail on January 6th 2026 from LA, before taking in Hawaii, South Pacific islands, New Zealand, Australia and the Far East and Asia before heading Alaska and concluding in Vancouver, Canada.</p> <p dir="ltr">That's a total of 63 ports in 14 countries with seven overnight stays.</p> <p dir="ltr"><strong>Volendam - 133 days</strong></p> <p dir="ltr">Holland America’s lengthy journey, titled Pole to Pole, takes a round trip from Fort Lauderdale in Florida it visits spots as diverse as Costa Rica, Antarctica, Morocco, France and Canada.</p> <p dir="ltr"><strong>Crystal Serenity - 135 days</strong></p> <p dir="ltr">Crystal's 2026 World Cruise is an epic 135-day journey travelling to 72 destinations throughout 27 countries.</p> <p dir="ltr">Departing Los Angeles, Crystal Serenity will traverse the waters of the Pacific taking in the Marquesas Islands, Bora Bora, New Zealand and Sydney, as well as travelling to Hong Kong, Mumbai and Dubai.</p> <p dir="ltr"><strong>Seven Seas Splendour - 140 days </strong></p> <p dir="ltr">Guests onboard the Regent Seven Seas Cruises will visit 40 countries over six continents, spending 140 nights onboard the luxurious ship. </p> <p dir="ltr">The voyage visits locations such as Panama, Sri Lanka and Spain, visiting 71 ports around the world. </p> <p dir="ltr"><strong>Silver Dawn - 149 days</strong></p> <p dir="ltr">Silversea Cruises' Silver Dawn will explore 80 destinations, covering 35 countries on five continents, including 11 overnight stays. </p> <p dir="ltr"><strong>Viking Sky - 163 days </strong></p> <p dir="ltr">The cruise ship Viking Sky will sail for an impressive 163 days on its World Voyage II, taking in 34 countries, with 79 guided tours. </p> <p dir="ltr">Ports of note include Rarotonga in the Cook Islands, Darwin Australia, Colombo Sri Lanka, Cape Town, South Africa and the Shetland Islands in Scotland.</p> <p dir="ltr"><strong>Oceana Vista - 197 days</strong></p> <p dir="ltr">The 2026 World Odyssey voyage of Vista will circumnavigate the world, visiting over 100 ports across 43 countries.</p> <p dir="ltr">The voyage visits over 80 UNESCO World Heritage sites across 101 destinations, with 11 overnight stays.</p> <p dir="ltr"><em>Image credits: Shutterstock</em></p>

Cruising

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‘Sleep tourism’ promises the trip of your dreams. Beyond the hype plus 5 tips for a holiday at home

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/dean-j-miller-808724">Dean J. Miller</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p>Imagine arriving at your hotel after a long flight and being greeted by your own personal sleep butler. They present you with a pillow menu and invite you to a sleep meditation session later that day.</p> <p>You unpack in a room kitted with an AI-powered smart bed, blackout shades, blue light-blocking glasses and weighted blankets.</p> <p>Holidays are traditionally for activities or sightseeing – eating Parisian pastry under the Eiffel tower, ice skating at New York City’s Rockefeller Centre, lying by the pool in Bali or sipping limoncello in Sicily. But “<a href="https://www.smh.com.au/traveller/inspiration/pillow-menus-and-sleep-gummies-the-new-hotel-trend-that-s-putting-guests-to-sleep-20230823-p5dyu5.html">sleep tourism</a>” offers vacations for the sole purpose of getting good sleep.</p> <p>The emerging trend extends out of the global wellness tourism industry – reportedly worth more than <a href="https://www.forbes.com/sites/rogersands/2023/11/17/the-global-wellness-tourism-sector-surpasses-814-billion-market-share/">US$800 billion globally</a> (A$1.2 trillion) and <a href="https://www.statista.com/statistics/1018497/global-market-size-of-the-wellness-tourism-industry/">expected to boom</a>.</p> <p>Luxurious sleep retreats and sleep suites at hotels are popping up <a href="https://www.countryandtownhouse.com/style/health-and-beauty/sleep-retreats/">all over the world</a> for tourists to get some much-needed rest, relaxation and recovery. But do you really need to leave home for some shuteye?</p> <h2>Not getting enough</h2> <p>The rise of sleep tourism may be a sign of just how chronically sleep deprived we all are.</p> <p>In Australia more than one-third of adults are not achieving the recommended <a href="https://www.sciencedirect.com/science/article/pii/S2352721816301292?via%3Dihub">7–9 hours</a> of sleep per night, and the estimated cost of this inadequate sleep is <a href="https://academic.oup.com/sleep/article/41/8/zsy083/5025924">A$45 billion</a> each year.</p> <p>Inadequate sleep is linked to <a href="https://www.tandfonline.com/doi/full/10.2147/NSS.S134864">long-term health problems</a> including poor mental health, heart disease, metabolic disease and deaths from any cause.</p> <h2>Can a fancy hotel give you a better sleep?</h2> <p>Many of the sleep services available in the sleep tourism industry aim to optimise the bedroom for sleep. This is a core component of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400203/?ref=askdoctorjad.com">sleep hygiene</a> – a series of healthy sleep practices that facilitate good sleep including sleeping in a comfortable bedroom with a good mattress and pillow, sleeping in a quiet environment and relaxing before bed.</p> <p>The more people follow sleep hygiene practices, the better their <a href="https://www.tandfonline.com/doi/abs/10.1080/08964280209596396">sleep quality and quantity</a>.</p> <p>When we are staying in a hotel we are also likely away from any stressors we encounter in everyday life (such as work pressure or caring responsibilities). And we’re away from potential nighttime disruptions to sleep we might experience at home (the construction work next door, restless pets, unsettled children). So regardless of the sleep features hotels offer, it is likely we will experience improved sleep when we are away.</p> <h2>What the science says about catching up on sleep</h2> <p>In the short-term, <a href="https://theconversation.com/is-it-possible-to-catch-up-on-sleep-we-asked-five-experts-98699#:%7E:text=We%20can%20catch%20up%20on,and%20we%20cannot%20resist%20sleep.">we can catch up on sleep</a>. This can happen, for example, after a short night of sleep when our brain accumulates “<a href="https://www.tandfonline.com/doi/abs/10.3109/07420528.2012.675256">sleep pressure</a>”. This term describes how strong the biological drive for sleep is. More sleep pressure makes it easier to sleep the next night and to sleep for longer.</p> <p>But while a longer sleep the next night can relieve the sleep pressure, it does not reverse the <a href="https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.26918">effects of the short sleep on our brain and body</a>. Every night’s sleep is important for our body to recover and for our brain to process the events of that day. Spending a holiday “catching up” on sleep could help you feel more rested, but it is not a substitute for prioritising regular healthy sleep at home.</p> <p>All good things, including holidays, must come to an end. Unfortunately the perks of sleep tourism may end too.</p> <p>Our bodies do not like variability in the time of day that we sleep. The most common example of this is called “<a href="https://www.mdpi.com/2072-6643/13/12/4543">social jet lag</a>”, where weekday sleep (getting up early to get to work or school) is vastly different to weekend sleep (late nights and sleep ins). This can result in a sleepy, grouchy start to the week on Monday. Sleep tourism may be similar, if you do not come back home with the intention to prioritise sleep.</p> <p>So we should be mindful that as well as sleeping well on holiday, it is important to optimise conditions at home to get consistent, adequate sleep every night.</p> <h2>5 tips for having a sleep holiday at home</h2> <p>An AI-powered mattress and a sleep butler at home might be the dream. But these features are not the only way we can optimise our sleep environment and give ourselves the best chance to get a good night’s sleep. Here are five ideas to start the night right:</p> <p><strong>1.</strong> avoid bright artificial light in the evening (such as bright overhead lights, phones, laptops)</p> <p><strong>2.</strong> make your bed as comfortable as possible with fresh pillows and a supportive mattress</p> <p><strong>3.</strong> use black-out window coverings and maintain a cool room temperature for the ideal sleeping environment</p> <p><strong>4.</strong> establish an evening wind-down routine, such as a warm shower and reading a book before bed or even a “<a href="https://theconversation.com/turns-out-the-viral-sleepy-girl-mocktail-is-backed-by-science-should-you-try-it-222151">sleepy girl mocktail</a>”</p> <p><strong>5.</strong> use consistency as the key to a good sleep routine. Aim for a similar bedtime and wake time – even on weekends.<!-- 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/231718/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/charlotte-gupta-347235">Charlotte Gupta</a>, Senior postdoctoral research fellow, Appleton Institute, HealthWise research group, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/dean-j-miller-808724">Dean J. Miller</a>, Adjunct Research Fellow, Appleton Institute of Behavioural Science, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity 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/sleep-tourism-promises-the-trip-of-your-dreams-beyond-the-hype-plus-5-tips-for-a-holiday-at-home-231718">original article</a>.</em></p> </div>

Travel Trouble

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Long-serving ABC star calls it quits

<p>Paul Barry, the veteran host of <em>Media Watch</em>, who has made a career out of poking the media bear, has announced his departure from the ABC show in December. After an illustrious (and occasionally infamous) tenure that would make a soap opera look like a nap, Barry is hanging up his microphone at the ripe age of 72.</p> <p>“I’ve been in the hot seat for 11 years and it’s time to give someone else a go,” Barry remarked, possibly while the hot seat sighed in relief. Indeed, hosting Media Watch is no small feat – it's a bit like riding a roller coaster while simultaneously refereeing a brawl. But Barry has certainly done it with aplomb, panache and a fair amount of flair.</p> <p>His announcement has left viewers with mixed feelings – a blend of gratitude for his unyielding service and a tinge of sadness, akin to the bittersweet end of a beloved TV series. Barry promised to stay with us until December, giving us ample time to stock up on popcorn and enjoy the remaining episodes. "Lots of fun to be had before then," he teased, hinting at some final rounds of media mischief.</p> <p>For those who might be wondering what Barry plans to do next, well, that's still a mystery. Perhaps he'll take up knitting, but knowing him, it’ll likely be with barbed wire.</p> <p>Barry first commandeered <em>Media Watch</em> in 2000 before returning in 2013, making a grand comeback that rivalled any reality TV show. Over the years, he has ruffled enough feathers to fill a sizeable pillow factory. Commercial media outlets, politicians and even his own network – as <em>Media Watch</em> famously runs independently of the ABC – have all been on the receiving end of his sharp critiques. His fearless approach has made him a hero to many and a headache to some.</p> <p>One of Barry’s most memorable moments came in 2013 during a spat with columnist Andrew Bolt. When Bolt provocatively asked Barry to reveal his salary on air, Barry did just that – $191,259, to be precise. It was a jaw-dropping moment that left viewers stunned and Bolt, presumably, a bit flummoxed.</p> <p>In between his stints at <em>Media Watch</em>, Barry has donned many hats – investigative reporter for the <em>Sydney Morning Herald</em>, correspondent for <em>60 Minutes</em>, and author of several books, including a controversial unauthorised biography of James Packer. His career has been a veritable smorgasbord of journalism, controversy and unflinching honesty.</p> <p>An ABC spokesperson paid tribute to Barry, highlighting his “track record of independent commentary, analysis, and robust discussion about the media industry and its ethics – or lack thereof.” Barry has indeed been the watchdog’s watchdog, never shying away from calling out malpractice, no matter where it reared its head.</p> <p>As the ABC gears up to announce a new host, the shoes left behind are large ones to fill. Barry’s departure marks the end of an era – one filled with wit, grit and an unwavering commitment to holding the media accountable.</p> <p>So, here’s to Paul Barry – the feather-ruffler, the truth-seeker, the man who made us laugh, gasp and, most importantly, think. As he steps down from <em>Media Watch</em>, we wish him the very best in his next adventure, whether that’s taking on new journalistic endeavours or finally perfecting that tricky scarf pattern.</p> <p>Bravo, Mr Barry. You will be missed.</p> <p><em>Image: Media Watch</em></p>

TV

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"Ruined our trip": Mum shell-shocked by $130k fine

<p>A mother has been slapped with a hefty fine after her children were caught in a seemingly innocent act while on a beach holiday. </p> <p>Charlotte Russ took her five kids on a trip to Pismo Beach in California, where her children started enthusiastically collecting what they thought were ordinary seashells. </p> <p>"My kids they thought they were collecting seashells, but they were actually collecting clams, 72 to be exact,"  Russ told local news outlet <em><a href="https://abc7.com/post/fresno-woman-fined-88k-after-kids-collect-clams/14859295/" target="_blank" rel="nofollow noreferrer noopener">ABC 7</a></em>.</p> <p>Clamming is highly regulated in California, meaning if you don't have a fishing license, you cannot catch the small sea creatures. </p> <p>She received a citation right there on the beach and was later notified she has to pay close to $89,000, or $133,000 AUD, for her kids' seemingly innocent treasure hunt. </p> <p>"It made me really sad and depressed, and it kind of ruined our trip," said Russ.</p> <p>Department of Fish and Wildlife's Lieutenant Matthew Gil defended the fine, saying there are rules in place for a reason. </p> <p>"The reason we got it we have these regulations is because we have to let them get to 4 and a half inches so they can spawn so they can have they can have offspring every year, and they have juvenile clams," said Lt. Gil.</p> <p>Russ said her kids have learned their lesson, saying, "They know now at the beach don't touch anything, but they know now what a clam is, compared to what a seashell is now, I've had to explain that to them."</p> <p>The mother was able to plead her case with a San Luis Obispo County Judge, who reduced her fine to $500 dollars, and after she "won" her case, Russ got a shellfish tattoo to commemorate the incident.</p> <p>"It was definitely one expensive trip to Pismo, unforgettable," said Russ.</p> <p><em>Image credits: ABC 7</em></p>

Travel Trouble

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Would you be happy as a long-term single? The answer may depend on your attachment style

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/christopher-pepping-1524533">Christopher Pepping</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/geoff-macdonald-1527971">Geoff Macdonald</a>, <a href="https://theconversation.com/institutions/university-of-toronto-1281">University of Toronto</a>; <a href="https://theconversation.com/profiles/tim-cronin-415060">Tim Cronin</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/yuthika-girme-1494822">Yuthika Girme</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>Are all single people insecure? When we think about people who have been single for a long time, we may assume it’s because single people have insecurities that make it difficult for them to find a partner or maintain a relationship.</p> <p>But is this true? Or can long-term single people also be secure and thriving?</p> <p>Our <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jopy.12929">latest research</a> published in the Journal of Personality suggests they can. However, perhaps unsurprisingly, not everybody tends to thrive in singlehood. Our study shows a crucial factor may be a person’s attachment style.</p> <h2>Singlehood is on the rise</h2> <p>Singlehood is on the rise around the world. In Canada, single status among young adults aged 25 to 29 has increased from <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713b-eng.htm">32% in 1981 to 61% in 2021</a>. The number of people <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713a-eng.htm">living solo</a> has increased from 1.7 million people in 1981 to 4.4 million in 2021.</p> <p>People are single for many reasons: <a href="https://www.ucpress.edu/ebook/9780520971004/happy-singlehood">some choose</a> to remain single, some are focusing on <a href="https://link.springer.com/article/10.1007/s12147-020-09249-0">personal goals and aspirations</a>, some report <a href="https://www.pewresearch.org/social-trends/2020/08/20/nearly-half-of-u-s-adults-say-dating-has-gotten-harder-for-most-people-in-the-last-10-years/">dating has become harder</a>, and some become single again due to a relationship breakdown.</p> <p>People may also remain single due to their attachment style. Attachment theory is a popular and well-researched model of how we form relationships with other people. An <a href="https://www.amazon.com.au/s?k=attachment+theory">Amazon search for attachment theory</a> returns thousands of titles. The hashtag #attachmenttheory has been viewed <a href="https://www.cnbc.com/2022/08/20/why-attachment-theory-is-trending-according-to-dr-amir-levine.html">over 140 million times</a> on TikTok alone.</p> <h2>What does attachment theory say about relationships?</h2> <p>Attachment theory suggests our relationships with others are shaped by our degree of “anxiety” and “avoidance”.</p> <p>Attachment anxiety is a type of insecurity that leads people to feel anxious about relationships and worry about abandonment. Attachment avoidance leads people to feel uncomfortable with intimacy and closeness.</p> <p>People who are lower in attachment anxiety and avoidance are considered “securely attached”, and are comfortable depending on others, and giving and receiving intimacy.</p> <p>Single people are often stereotyped as being <a href="https://journals.sagepub.com/doi/full/10.1177/01461672231203123">too clingy or non-committal</a>. Research comparing single and coupled people also suggests single people have <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-6494.2012.00793.x?casa_token=6iiCm5PjHgkAAAAA:0kBeofx3M-72YrkVppmNxdWBIAImFwm3lAakCnuiNXL20SVP1zaW7UeDIahW_43imAjSRXgtyN0hLVI">higher levels of attachment insecurities</a> compared to people in relationships.</p> <p>At the same time, evidence suggests many single people are choosing to remain single and <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221136119">living happy lives</a>.</p> <h2>Single people represent a diverse group of secure and insecure people</h2> <p>In our latest research, our team of social and clinical psychologists examined single people’s attachment styles and how they related to their happiness and wellbeing.</p> <p>We carried out two studies, one of 482 younger single people and the other of 400 older long-term singles. We found overall 78% were categorised as insecure, with the other 22% being secure.</p> <p>Looking at our results more closely, we found four distinct subgroups of singles:</p> <ul> <li> <p>secure singles are relatively comfortable with intimacy and closeness in relationships (22%)</p> </li> <li> <p>anxious singles question whether they are loved by others and worry about being rejected (37%)</p> </li> <li> <p>avoidant singles are uncomfortable getting close to others and prioritise their independence (23% of younger singles and 11% of older long-term singles)</p> </li> <li> <p>fearful singles have heightened anxiety about abandonment, but are simultaneously uncomfortable with intimacy and closeness (16% of younger singles and 28% of older long-term singles).</p> </li> </ul> <h2>Insecure singles find singlehood challenging, but secure singles are thriving</h2> <p>Our findings also revealed these distinct subgroups of singles have distinct experiences and outcomes.</p> <p>Secure singles are happy being single, have a greater number of non-romantic relationships, and better relationships with family and friends. They meet their sexual needs outside romantic relationships and feel happier with their life overall. Interestingly, this group maintains moderate interest in being in a romantic relationship in the future.</p> <p>Anxious singles tend to be the most worried about being single, have lower self-esteem, feel less supported by close others and have some of the lowest levels of life satisfaction across all sub-groups.</p> <p>Avoidant singles show the least interest in being in a romantic relationship and in many ways appear satisfied with singlehood. However, they also have fewer friends and close relationships, and are generally less satisfied with these relationships than secure singles. Avoidant singles also report less meaning in life and tend to be less happy compared to secure singles.</p> <p>Fearful singles reported more difficulties navigating close relationships than secure singles. For instance, they were less able to regulate their emotions, and were less satisfied with the quality of their close relationships relative to secure singles. They also reported some of the lowest levels of life satisfaction across all sub-groups.</p> <h2>It’s not all doom and gloom</h2> <p>These findings should be considered alongside several relevant points. First, although most singles in our samples were insecure (78%), a sizeable number were secure and thriving (22%).</p> <p>Further, simply being in a romantic relationship is not a panacea. Being in an unhappy relationship is linked to <a href="https://doi.org/10.1371/journal.pmed.1000316">poorer life outcomes</a> than being single.</p> <p>It is also important to remember that attachment orientations are not necessarily fixed. They are open to <a href="https://www.sciencedirect.com/science/article/pii/S2352250X18300113">change</a> in response to life events.</p> <p>Similarly, <a href="https://journals.sagepub.com/doi/full/10.1177/0963721413510933">sensitive and responsive behaviours</a> from close others and <a href="https://doi.org/10.1177/02654075231162390">feeling loved and cared about</a> by close others can soothe underlying attachment concerns and foster attachment security over time.</p> <p>Our studies are some of the first to examine the diversity in attachment styles among single adults. Our findings highlight that many single people are secure and thriving, but also that more work can be done to help insecure single people feel more secure in order to foster happiness.<!-- 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/227595/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/christopher-pepping-1524533">Christopher Pepping</a>, Associate Professor in Clinical Psychology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/geoff-macdonald-1527971">Geoff Macdonald</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-toronto-1281">University of Toronto</a>; <a href="https://theconversation.com/profiles/tim-cronin-415060">Tim Cronin</a>, Lecturer in Clinical Psychology, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/yuthika-girme-1494822">Yuthika Girme</a>, Associate Professor, Department of Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser 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/would-you-be-happy-as-a-long-term-single-the-answer-may-depend-on-your-attachment-style-227595">original article</a>.</em></p> </div>

Relationships

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Peter Brock's long-time partner passes away aged 77

<p>The motorsport community is mourning the loss of Bev Brock, a formidable figure whose unwavering support and dedication were instrumental in the legendary career of her former long-time partner, Peter Brock.</p> <p>Bev, aged 77, passed away at her Melbourne home on Sunday morning after bravely battling stage 4 cancer for two years.</p> <p>For almost three decades, Bev stood as a steadfast presence by Peter's side, both on and off the racetrack. While they were never married, their bond was undeniable, marking a partnership that transcended mere labels. From 1977 until their separation in 2005, Bev played an integral role in shaping Peter's remarkable motorsport journey, becoming synonymous with his successes and enduring legacy.</p> <p>Born on January 15, 1947, just outside Perth, Bev's early years hinted at the strength of character and resilience that would define her life. Among seven siblings, she cultivated a spirit of determination and compassion that would later leave an indelible mark on those around her. Following her passion for education, Bev pursued a career in teaching, imparting knowledge in science and home economics to countless students.</p> <p>Bev's life took a new trajectory when she met Peter Brock. Together, they navigated the highs and lows of motorsport, sharing a journey that was as exhilarating as it was demanding. Despite the challenges, Bev remained a pillar of support, balancing multiple roles with grace, intelligence and purpose. Her commitment to Peter's racing career was unwavering, whether she was managing logistics, offering counsel, or simply cheering from the sidelines.</p> <p>Beyond her contributions to motorsport, Bev's philanthropic endeavours reflected her generous spirit and compassionate nature – and her involvement with various charities culminated in the prestigious Order of Australia in 2016. From supporting The Skyline Foundation to her active engagement with Melbourne Rotary, Bev's impact extended far beyond the confines of the racetrack.</p> <p>In a heartfelt tribute, Bev's son, James Brock, honoured his mother's legacy:</p> <p>“Bev was a dedicated parent, always making time to make a costume for a play or help out on a school camp,” he wrote. “She dedicated her life to helping Peter’s racing career taking on multiple roles, all met with skill, smarts and purpose.</p> <p>“Bev was also involved with multiple charities earning her an Order of Australia in 2016.</p> <p>“Over the last few years she focused her time and passion on The Skyline Foundation, Melbourne Rotary, public speaking and her ever expanding family.</p> <p>“She leaves behind her three children, seven cherished grandchildren and a host of loved ones she wrapped into her life as though they were her own.</p> <p>“Her loss will be immense as her presence, wisdom and support can never be matched.”</p> <p>Universally known as "Bevo," she was not only the driving force behind Peter's success but also a cherished friend who selflessly cared for others. Despite her own battle with cancer, Bev remained a source of strength and inspiration, offering support and guidance to countless friends and acquaintances.</p> <p>As the motorsport community comes together to mourn Bev's passing, we reflect on a life lived with purpose, passion and unwavering dedication.</p> <p>Bev Brock may have left this world, but her spirit will forever race on in the hearts of those who knew and loved her.</p> <p><em>Images: Getty</em></p>

Caring

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William Shatner shocks hosts simply by revealing his age

<p>In a world where time ticks mercilessly onward, one man has defied the very essence of ageing: the legendary William Shatner, the man who boldly went where no nonagenarian has gone before.</p> <p>As Shatner prepares to celebrate his 93rd trip around the sun, fans worldwide are scratching their heads in disbelief. The reason? Well, it seems that Captain Kirk himself has stumbled upon the fountain of youth and decided to keep it all to himself. </p> <p>The commotion started when Shatner made a <a href="https://www.tiktok.com/@todayshow/video/7347749279865490734?_r=1&_t=8koli3bKC49" target="_blank" rel="noopener">guest appearance</a> on the <em>US Today Show</em>, looking fresher than a daisy in springtime. Fans took to social media to express their shock, with one incredulous viewer commenting, "Damn, he's still sharp and has his hair. I would never have guessed 93." And another chimed in with, "I would've guessed 67 or 68."</p> <p>Forget "live long and prosper"; it seems the new motto is "live long and confound the heck out of everyone".</p> <p>Even the hosts of the<em> Today Show</em> were left flabbergasted by Shatner's youthful glow. They couldn't resist asking the man himself for his secret to longevity. And what pearls of wisdom did he impart? "Don't tell anybody [your age]." Ah, sage advice indeed. It seems the real secret to ageing gracefully is to maintain an air of mystery.</p> <p>But let's rewind to 2021 when Shatner was grilled by a journalist about whether he'd had any "serious work" done. His response? A witty comeback, of course. "No, have you?" Touché, Shatner, touché. And when pressed further, he simply attributed his youthful appearance to good genes, lots of horseback riding and a healthy dose of bewilderment about the world. </p> <p>Despite his apparent disdain for the number 90 ("It's disgusting," he once declared in an interview), Shatner finds himself hurtling towards the ripe old age of 93 with all the grace and poise of a starship navigating through a meteor shower. And if his recent TV appearance is anything to go by, he's showing no signs of slowing down.</p> <p>So let's all take a leaf out of Shatner's playbook, shall we? If anyone asks for the secret to your eternal youth, just give them that trademark Shatner smirk and say: "It's classified."</p> <p><em>Images: NBC | Wikimedia | Tik Tok</em></p>

Body

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Longing for the ‘golden age’ of air travel? Be careful what you wish for

<p><em><a href="https://theconversation.com/profiles/janet-bednarek-144872">Janet Bednarek</a>, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</a></em></p> <p>Long lines at security checkpoints, tiny plastic cups of soda, small bags of pretzels, planes filled to capacity, fees attached to every amenity – all reflect the realities of 21st century commercial air travel. It’s no wonder that many travelers have become nostalgic for the so-called “golden age” of air travel in the United States.</p> <p>During the 1950s, airlines promoted commercial air travel as glamorous: stewardesses served full meals on real china, airline seats were large (and frequently empty) with ample leg-room, and passengers always dressed well.</p> <p>After jets were introduced in the late 1950s, passengers could travel to even the most distant locations at speeds unimaginable a mere decade before. An airline trip from New York to London that could take up to 15 hours in the early 1950s could be made in less than seven hours by the early 1960s.</p> <p>But airline nostalgia can be tricky, and “golden ages” are seldom as idyllic as they seem.</p> <p>Until the introduction of jets in 1958, most of the nation’s commercial planes were propeller-driven aircraft, like the DC-4. Most of these planes were unpressurized, and with a maximum cruising altitude of 10,000 to 12,000 feet, they were unable to fly over bad weather. Delays were frequent, turbulence common, and air sickness bags often needed.</p> <p>Some planes were spacious and pressurized: the <a href="http://everythingnice.org/wp-content/uploads/2009/07/PanAm-cutawayS.jpg">Boeing Stratocruiser</a>, for example, could seat 50 first class passengers or 81 coach passengers compared to the DC-3’s 21 passengers. It could cruise at 32,000 feet, which allowed Stratocruiser to fly above most bad weather it encountered. But only 56 of these planes were ever in service.</p> <p>While the later DC-6 and DC-7 were pressurized, they still flew much lower than the soon-to-appear jets – 20,000 feet compared to 30,000 feet – and often encountered turbulence. The piston engines were bulky, complex and difficult to maintain, which contributed to frequent delays.</p> <p>For much of this period, the old saying “Time to spare, go by air” still rang true.</p> <p>Through the 1930s and into the 1940s, almost everyone flew first class. Airlines did encourage more people to fly in the 1950s and 1960s by introducing coach or tourist fares, but the savings were relative: less expensive than first class, but still pricey. In 1955, for example, so-called “bargain fares” from New York to Paris were the equivalent of just over $2,600 in 2014 dollars. Although the advent of jets did result in lower fares, the cost was still out of reach of most Americans. The most likely frequent flier was a white, male businessman traveling on his company’s expense account, and in the 1960s, airlines – with young attractive stewardesses in short skirts – clearly catered to their most frequent flyers.</p> <p>The demographics of travelers did begin to shift during this period. More women, more young people, and retirees began to fly; still, airline travel remained financially out-of-reach for most.</p> <p>If it was a golden age, it only was for the very few.</p> <figure><iframe src="https://www.youtube.com/embed/bKqQgNZylLw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Jet planes were introduced in the late 1950s, resulting in shorter flight times. But their ticket prices out of reach for the average traveler.</span></figcaption></figure> <p>People also forget that well into the 1960s, air travel was far more dangerous than it is today. In the 1950s and 1960s US airlines experienced at least a half dozen crashes per year – most leading to fatalities of all on board. People today may bemoan the crowded airplanes and lack of on-board amenities, but the number of fatalities per million miles flown has dropped dramatically since since the late 1970s, especially compared to the 1960s. Through at least the 1970s, airports even prominently featured kiosks selling flight insurance.</p> <p>And we can’t forget hijackings. By the mid-1960s so many airplanes had been hijacked that <a href="http://www.latinamericanstudies.org/hijackers/flying-high.htm">“Take me to Cuba”</a> became a punch line for stand-up comics. In 1971 <a href="http://nymag.com/news/features/39593/index2.html">D.B. Cooper</a> – a hijacker who parachuted from a Boeing 727 after extorting $200,000 – might have been able to achieve folk hero status. But one reason US airline passengers today (generally) tolerate security checkpoints is that they want some kind of assurance that their aircraft will remain safe.</p> <p>And if the previous examples don’t dull the sheen of air travel’s “golden age,” remember: in-flight smoking was both permitted and encouraged.<!-- 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/34177/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/janet-bednarek-144872"><em>Janet Bednarek</em></a><em>, Professor of History, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</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/longing-for-the-golden-age-of-air-travel-be-careful-what-you-wish-for-34177">original article</a>.</em></p>

Travel Trouble

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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>

Body

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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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Funding for refugees has long been politicized − punitive action against UNRWA and Palestinians fits that pattern

<p><em><a href="https://theconversation.com/profiles/nicholas-r-micinski-207353">Nicholas R. Micinski</a>, <a href="https://theconversation.com/institutions/university-of-maine-2120">University of Maine</a> and <a href="https://theconversation.com/profiles/kelsey-norman-862895">Kelsey Norman</a>, <a href="https://theconversation.com/institutions/rice-university-931">Rice University</a></em></p> <p>At least a dozen countries, including the U.S., have <a href="https://news.un.org/en/story/2024/01/1145987">suspended funding to the UNRWA</a>, the United Nations agency responsible for delivering aid to Palestinian refugees.</p> <p>This follows allegations made by Israel that <a href="https://www.wsj.com/world/middle-east/at-least-12-u-n-agency-employees-involved-in-oct-7-attacks-intelligence-reports-say-a7de8f36">12 UNRWA employees participated</a> in the Oct. 7, 2023, Hamas attack. The UNRWA responded by <a href="https://www.reuters.com/world/middle-east/un-palestinian-refugee-agency-investigates-staff-suspected-role-israel-attacks-2024-01-26/">dismissing all accused employees</a> and opening an investigation.</p> <p>While the seriousness of the accusations is clear to all, and the U.S. has been keen to <a href="https://www.nytimes.com/2024/01/30/us/politics/aid-gaza-israel.html">downplay the significance</a> of its pause in funding, the action is not in keeping with precedent.</p> <p>Western donors did not, for example, defund other U.N. agencies or peacekeeping operations amid accusations of <a href="https://www.hrw.org/news/2020/01/11/un-peacekeeping-has-sexual-abuse-problem">sexual assault</a>, <a href="https://www.justice.gov/usao-sdny/pr/former-un-general-assembly-president-and-five-others-charged-13-million-bribery-scheme">corruption</a> or <a href="https://www.hrw.org/legacy/summaries/s.bosnia9510.html">complicity in war crimes</a>.</p> <p>In real terms, the funding cuts to the UNRWA will affect <a href="https://www.unrwa.org/where-we-work/gaza-strip">1.7 million Palestinian refugees in Gaza</a> along with an additional 400,000 Palestinians without refugee status, many of whom benefit from the UNRWA’s infrastructure. Some critics have gone further and said depriving the agency of funds <a href="https://jacobin.com/2024/01/unrwa-defunding-gaza-israel">amounts to collective punishment</a> against Palestinians.</p> <p>Refugee aid, and humanitarian aid more generally, is theoretically meant to be neutral and impartial. But as experts in <a href="https://www.cambridge.org/core/books/reluctant-reception/558E2A93FF99B8F295347A8FA2053698">migration</a> <a href="https://www.routledge.com/UN-Global-Compacts-Governing-Migrants-and-Refugees/Micinski/p/book/9780367218836">and</a> <a href="https://press.umich.edu/Books/D/Delegating-Responsibility">international relations</a>, we know funding is often used as a foreign policy tool, whereby allies are rewarded and enemies punished. In this context, we believe the cuts in funding for the UNRWA fit a wider pattern of the politicization of aid to refugees, particularly Palestinian refugees.</p> <h2>What is the UNRWA?</h2> <p>The UNRWA, short for the U.N. Relief and Works Agency for Palestine Refugees in the Near East, was established two years after about <a href="https://theconversation.com/the-nakba-at-75-palestinians-struggle-to-get-recognition-for-their-catastrophe-204782">750,000 Palestinians were expelled or fled from their homes</a> during the months leading up to the creation of the state of Israel in 1948 and the subsequent Arab-Israeli war.</p> <p>Prior to the UNRWA’s creation, international and local organizations, many of them religious, provided services to displaced Palestinians. But after <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">surveying the extreme poverty</a> and dire situation pervasive across refugee camps, the U.N. General Assembly, including all Arab states and Israel, voted to create the UNRWA in 1949.</p> <p>Since that time, <a href="https://www.unrwa.org/what-we-do">the UNRWA has been the primary aid organization</a> providing food, medical care, schooling and, in some cases, housing for the 6 million Palestinians living across its five fields: Jordan, Lebanon, Syria, as well as the areas that make up the occupied Palestinian territories: the West Bank and Gaza Strip.</p> <p>The mass displacement of Palestinians – known as the <a href="https://theconversation.com/the-nakba-at-75-palestinians-struggle-to-get-recognition-for-their-catastrophe-204782">Nakba, or “catastrophe</a>” – occurred prior to the <a href="https://www.unhcr.org/about-unhcr/who-we-are/1951-refugee-convention">1951 Refugee Convention</a>, which defined refugees as anyone with a well-founded fear of persecution owing to “events occurring in Europe before 1 January 1951.” Despite a <a href="https://www.unhcr.org/sites/default/files/legacy-pdf/4ec262df9.pdf">1967 protocol extending the definition</a> worldwide, Palestinians are still excluded from the primary international system protecting refugees.</p> <p>While the UNRWA is responsible for providing services to Palestinian refugees, the United Nations also created the U.N. Conciliation Commission for Palestine in 1948 to seek a <a href="https://www.refworld.org/docid/4fe2e5672.html">long-term political solution</a> and “to facilitate the repatriation, resettlement and economic and social rehabilitation of the refugees and the payment of compensation.”</p> <p>As a result, the UNRWA does not have a mandate to push for the traditional durable solutions available in other refugee situations. As it happened, the conciliation commission was active only for a few years and has since been sidelined in favor of the U.S.-brokered peace processes.</p> <h2>Is the UNRWA political?</h2> <p>The UNRWA has been <a href="https://www.migrationpolicy.org/article/palestinian-refugees-dispossession">subject</a> to political headwinds since its inception and especially during periods of heightened tension between Palestinians and Israelis.</p> <p>While it is a U.N. organization and thus ostensibly apolitical, it has <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">frequently been criticized</a> by Palestinians, Israelis as well as donor countries, including the United States, for acting politically.</p> <p>The UNRWA performs statelike functions across its five fields – including education, health and infrastructure – but it is restricted in its mandate from performing political or security activities.</p> <p>Initial Palestinian objections to the UNRWA stemmed from the organization’s early focus on economic integration of refugees into host states.</p> <p>Although the UNRWA officially adhered to the U.N. General Assembly’s <a href="https://www.unrwa.org/content/resolution-194">Resolution 194</a> that called for the return of Palestine refugees to their homes, U.N., U.K. and U.S. <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">officials searched</a> for means by which to resettle and integrate Palestinians into host states, viewing this as the favorable political solution to the Palestinian refugee situation and the broader Israeli-Palestinian conflict. In this sense, Palestinians perceived the UNRWA to be both highly political and actively working against their interests.</p> <p>In later decades, the UNRWA <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">switched its primary focus</a> from jobs to education at the urging of Palestinian refugees. But the UNRWA’s education materials were <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">viewed</a> by Israel as further feeding Palestinian militancy, and the Israeli government insisted on checking and approving all materials in Gaza and the West Bank, which it has occupied since 1967.</p> <p>While Israel has <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">long been suspicious</a> of the UNRWA’s role in refugee camps and in providing education, the organization’s operation, which is internationally funded, <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/242-unrwas-reckoning-preserving-un-agency-serving-palestinian-refugees">also saves</a> Israel millions of dollars each year in services it would be obliged to deliver as the occupying power.</p> <p>Since the 1960s, the U.S. – UNRWA’s primary donor – and other Western countries have <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">repeatedly expressed their desire</a> to use aid to prevent radicalization among refugees.</p> <p>In response to the increased presence of armed opposition groups, the <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">U.S. attached a provision</a> to its UNRWA aid in 1970, requiring that the “UNRWA take all possible measures to assure that no part of the United States contribution shall be used to furnish assistance to any refugee who is receiving military training as a member of the so-called Palestine Liberation Army (PLA) or any other guerrilla-type organization.”</p> <p>The UNRWA adheres to this requirement, even publishing an annual list of its employees so that host governments can vet them, but it also <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/242-unrwas-reckoning-preserving-un-agency-serving-palestinian-refugees">employs 30,000 individuals</a>, the vast majority of whom are Palestinian.</p> <p>Questions over the links of the UNRWA to any militancy has led to the rise of Israeli and international <a href="https://cufi.org/issue/unrwa-teachers-continue-to-support-antisemitism-terrorism-on-social-media-un-watch/">watch groups</a> that document the social media activity of the organization’s large Palestinian staff.</p> <h2>Repeated cuts in funding</h2> <p>The United States has used its money and power within the U.N. to block criticism of Israel, vetoing at least <a href="https://www.un.org/depts/dhl/resguide/scact_veto_table_en.htm">45 U.N. resolutions</a> critical of Israel.</p> <p>And the latest freeze is not the first time the U.S. has cut funding to the UNRWA or other U.N. agencies in response to issues pertaining to the status of Palestinians.</p> <p>In 2011, the <a href="https://www.reuters.com/article/idUSTRE79U5ED/#:%7E:text=WASHINGTON%20(Reuters)%20%2D%20The%20United,grant%20the%20Palestinians%20full%20membership.">U.S. cut all funding to UNESCO</a>, the U.N. agency that provides educational and cultural programs around the world, after the agency voted to admit the state of Palestine as a full member.</p> <p>The Obama administration defended the move, claiming it was required by a 1990s law to defund any U.N. body that admitted Palestine as a full member.</p> <p>But the impact of the action was nonetheless severe. Within just four years, UNESCO was <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1758-5899.12459">forced to cut its staff in half</a> and roll back its operations. President Donald Trump later <a href="https://www.pbs.org/newshour/politics/u-s-and-israel-officially-withdraw-from-unesco">withdrew the U.S. completely from UNESCO</a>.</p> <p>In 2018, the Trump administration paused its <a href="https://www.nytimes.com/2018/08/31/us/politics/trump-unrwa-palestinians.html">US$60 million contribution to the UNRWA</a>. Trump claimed the pause would create political pressure for Palestinians to negotiate. President Joe Biden restarted U.S. contributions to the UNRWA in 2021.</p> <h2>Politicization of refugee aid</h2> <p>Palestinian are not the only group to suffer from the politicization of refugee funding.</p> <p>After World War II, states established different international organizations to help refugees but strategically excluded some groups from the refugee definition. For example, the U.S. funded the <a href="https://www.nationalww2museum.org/war/articles/last-million-eastern-european-displaced-persons-postwar-germany">U.N. Relief and Rehabilitation Administration to help resettle displaced persons after World War II</a> but resisted Soviet pressure to forcibly repatriate Soviet citizens.</p> <p>The U.S. also created a separate organization, <a href="https://academic.oup.com/ijrl/article-abstract/1/4/501/1598187">the precursor to the International Organization for Migration</a>, to circumvent Soviet influence. In many ways, the UNRWA’s existence and the exclusion of Palestinian refugees from the wider refugee regime parallels this dynamic.</p> <p>Funding for refugees has also been politicized through the earmarking of voluntary contributions to U.N. agencies. Some agencies receive funding from U.N. dues; but the UNRWA, alongside the U.N. High Commissioner for Refugees and the International Organization for Migration, receive the majority of their funding from voluntary contributions from member states.</p> <p>These contributions can be earmarked for specific activities or locations, leading to donors such as the <a href="https://www.peio.me/wp-content/uploads/2019/01/PEIO12_paper_107.pdf">U.S. or European Union dictating which refugees get aid and which do not</a>. Earmarked contributions amounted to nearly <a href="https://unsceb.org/fs-revenue-agency">96% of the UNHCR’s budget, 96% of the IOM’s budget and 74% of UNRWA funding in 2022</a>.</p> <p>As a result, any cuts to UNRWA funding will affect its ability to service Palestinian refugees in Gaza – especially at a time when so many are <a href="https://www.cnn.com/2024/01/30/middleeast/famine-looms-in-gaza-israel-war-intl/index.html">facing hunger, disease and displacement</a> as a result of war.<!-- 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/222263/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/nicholas-r-micinski-207353"><em>Nicholas R. Micinski</em></a><em>, Assistant Professor of Political Science and International Affairs, <a href="https://theconversation.com/institutions/university-of-maine-2120">University of Maine</a> and <a href="https://theconversation.com/profiles/kelsey-norman-862895">Kelsey Norman</a>, Fellow for the Middle East, Rice University's Baker Institute for Public Policy, <a href="https://theconversation.com/institutions/rice-university-931">Rice 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/funding-for-refugees-has-long-been-politicized-punitive-action-against-unrwa-and-palestinians-fits-that-pattern-222263">original article</a>.</em></p>

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