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How are racehorses really treated in the ‘sport of kings’?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/cathrynne-henshall-572585">Cathrynne Henshall</a>, <a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a></em></p> <p>It’s the time of year when shiny horses and colourful clothing fill our screens – the <a href="https://www.racing.com/spring-racing">Spring Racing Carnival</a>, which includes high profile races like The Everest, Melbourne Cup and Cox Plate.</p> <p>It’s also the time of year when questions are asked about the welfare of racehorses that compete in the so-called “<a href="https://www.amnh.org/exhibitions/horse/how-we-shaped-horses-how-horses-shaped-us/sport/sport-of-kings#:%7E:text=Thoroughbred%20racing%20began%20around%20300,Asia%2C%20and%20the%20Middle%20East.">sport of kings</a>”.</p> <p>Previously, <a href="https://www.news.com.au/sport/superracing/punters-life/how-many-horses-have-died-in-the-melbourne-cup-the-real-numbers/news-story/5f7e29011a7fbf3da9e0611e902d1ee6">high profile deaths during races</a>, the <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015622">use of whips</a> and <a href="https://www.abc.net.au/news/2015-02-17/making-a-killing/6127124">what happens to horses after racing</a> have been the focus of community concern.</p> <p>But recently, as we’ve come to know more about what makes a <a href="https://www.worldhorsewelfare.org/advice/welfare-wednesdays/how-to-provide-a-good-life-for-horses-friends-freedom-and-forage">good life for a horse</a>, questions are being raised about the daily lives of racehorses.</p> <p>Industry participants will point to the <a href="https://www.mamamia.com.au/dont-tell-me-the-horse-racing-industry-doesnt-care/">high level care</a> that racehorses receive – comfortable stables, specially formulated diets, the latest vet treatments and added extras such as massages and swimming sessions.</p> <p>But does this care translate into good welfare?</p> <h2>The theory of ‘telos’</h2> <p>Firstly, a quick primer on the difference between care and welfare.</p> <p>Care includes all the things that make sure racehorses get fit, stay fit and stay healthy. This care helps maximise the chance a horse will win races.</p> <p>Welfare is the animal’s subjective or individual experience of its life – <a href="https://pubmed.ncbi.nlm.nih.gov/33066335/">how it feels</a> – and there are a number of ways to assess this.</p> <p>One way is the concept of “telos”, originally developed by Ancient Greek philosopher <a href="https://plato.stanford.edu/entries/aristotle-causality/">Aristotle</a>.</p> <p>Telos is a <a href="https://link.springer.com/article/10.1007/s10806-012-9422-y">species’ anatomical, physiological, behavioural and cognitive characteristics</a> that have been shaped by millions of years of evolution.</p> <p>Telos helps us to identify what matters to animals – their behavioural, psychological and physiological needs.</p> <p>So to consider if racehorse care actually translates to good welfare, we can assess how closely it provides the animal with the things that matter to them, based on their telos.</p> <p>Equine telos involves living in groups, forming long-lived social relationships, grazing fibrous plants and being on the move for up to 18 hours a day, as well as staying safe by sensing danger and then moving away.</p> <p>It also involves living in variable environments to solve challenges, learn, engage in curiosity and play.</p> <p>Let’s compare that to the daily life of a racehorse.</p> <h2>Movement and feeding</h2> <p>Firstly, the vast majority of racehorses live in stables – sometimes up to 23 hours a day.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/17970632/">Multiple studies</a> have found continuous stabling harms horse welfare.</p> <p>Stables significantly restrict opportunities for voluntary movement, and studies show stabled horses spend <a href="https://pubmed.ncbi.nlm.nih.gov/37813129/">the majority of the time inactive</a>.</p> <p>Even though stables house horses communally, most designs limit horses’ opportunities for social interaction.</p> <p>Thirdly, there’s little for a horse to do in a stable other than eat, stand, drink or lie, and they often develop <a href="https://pubmed.ncbi.nlm.nih.gov/34670688/">abnormal behaviours</a> that are associated with stress. These are never seen in free-ranging horses.</p> <p>When racehorses do get to move, they have little say over how far, how fast and for how long they move.</p> <p>The kinds of physical exercise racehorses do are both significantly shorter in duration and at much higher speeds than horses voluntarily choose. It’s those speeds that place them at <a href="https://pubmed.ncbi.nlm.nih.gov/17910268/">risk of suffering a serious injury</a>.</p> <p>What about diet?</p> <p>Although a lot of time and effort is spent ensuring racehorses enjoy high quality diets, they are mostly comprised of concentrated energy sources such as grains, rather the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135103/">fibre horses evolved to eat</a>.</p> <p>Horses are <a href="https://madbarn.com/slow-feeders-for-horses/#:%7E:text=Horses%20are%20trickle%20feeders%20that,to%2025%20miles%20per%20day.">trickle feeders</a> (grazers), with small stomachs that continuously secrete digestive juices.</p> <p>In the wild, grazing keeps those stomachs full, which prevents the stomach lining from being damaged by digestive acids.</p> <p>In comparison, racehorses often consume their food very quickly – instead of spending up to 75% of their day eating, <a href="https://www.sciencedirect.com/science/article/pii/B9780702026348500137">they spend only 33%</a>.</p> <p>This means their stomachs are empty for most of the day, which is why up to <a href="https://pubmed.ncbi.nlm.nih.gov/37048517/">65% will get painful gastric ulcers</a>.</p> <p>And having to wait to be fed rather than eating when hungry, as happens in free-ranging horses, <a href="https://www.mdpi.com/2076-2615/3/3/663">can lead to frustration</a>.</p> <h2>Other difficulties</h2> <p>Racehorses <a href="https://www.theage.com.au/national/does-whipping-hurt-race-horses-20211102-p595br.html">may be whipped</a>, and <a href="https://beva.onlinelibrary.wiley.com/doi/10.1111/j.2042-3306.1982.tb02389.x">more than 50% </a> will experience some form of musculoskeletal injury during racing, of which between <a href="https://www.mdpi.com/2076-2615/11/2/270">7-49% are fatal</a>.</p> <p>Social relationships, in the limited form possible in a racing stable, are also frequently disrupted because horse populations are highly transient due to spelling, <a href="https://theconversation.com/black-caviars-death-has-prompted-uncomfortable-questions-about-how-champion-mares-spend-their-retirement-237039">retirement</a> or even just going to the races.</p> <p>So even if two horses are able to form a relationship of sorts, chances are one will be taken away. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=henshall+stress+repeated&amp;size=200">Separation distress is a significant stressor</a> for horses.</p> <p>Then there’s the gear that’s used to control them.</p> <p>Horses, like most animal species, escape and avoid painful stimuli.</p> <p>However, in racing (and many other equestrian activties) it is <a href="https://www.racingnsw.com.au/wp-content/uploads/NSWRules.pdf">mandatory to use</a> “bits” to control horses’ behaviour during riding and handling. Bits work by causing uncomfortable pressure and pain and may lead to mouth injuries.</p> <p>Studies have shown many people don’t understand how <a href="https://www.tandfonline.com/doi/full/10.1080/08927936.2023.2166713#abstract">to minimise the harm they can cause</a>. In addition, people also vary widely in their ability to read and <a href="https://www.mdpi.com/2076-2615/9/12/1124">interpret behavioural responses to stress</a>.</p> <p>So, racehorses may be repeatedly exposed to pain from bits and perform a range of behaviours to try to escape that pain, like bolting, mouth opening or head tossing.</p> <p>To remedy this, additional items of restrictive equipment, such as <a href="https://pubmed.ncbi.nlm.nih.gov/34056705/">tongue ties</a>, <a href="https://theconversation.com/dressing-up-for-melbourne-cup-day-from-a-racehorse-point-of-view-104771">nosebands, lugging bits or bit burs</a> may be used to control the horse.</p> <p>Racehorses frequently show signs of difficulty coping with the stressors of racing life, including “going off their feed”, aggression towards handlers, becoming hard to control when ridden and a range of stress behaviours and health issues, <a href="https://avmajournals.avma.org/downloadpdf/view/journals/javma/260/15/javma.22.08.0358.pdf">such as bleeding from the lungs</a>.</p> <h2>What about welfare?</h2> <p>Racehorse care is often directed towards managing issues that are the direct result of the demands of the racing environment.</p> <p>Fancy stables and aqua sessions are not important to horses, and may even cause harm.</p> <p>What matters to horses are opportunities to make meaningful choices, such as the freedom to move, form friendships and graze for the majority of the day.</p> <p>Current racing industry practices often deny horses the chance to make these choices.</p> <p>There’s no doubt people in racing care deeply about their horses. But to experience good welfare during racing, racehorses need more than just good care.<!-- 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/240998/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/cathrynne-henshall-572585">Cathrynne Henshall</a>, Post-doctoral Fellow, School of Agricultural, Environmental and Veterinary Sciences, <a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt 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/how-are-racehorses-really-treated-in-the-sport-of-kings-240998">original article</a>.</em></p> </div>

Family & Pets

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Pet owner fined $806 over simple mistake

<p>A poodle owner has been fined $806 over a 10-metre walk to the beach. </p> <p>John, who lives a few minutes away from Budd's Beach in Queensland, took his van down to the water's edge and walked roughly 10 metres across the shoreline with his dog Emma by his side. </p> <p>Little did he know that this common act would cost him $806 under new regulations that came into effect on July 31, where pet owners can get fined for not having a pet on a leash or not maintaining proper control of the leash while in public. </p> <p>"I thought that it was very unfair ...I was only traveling from my van to the water," John told <em>A Current Affair</em>. </p> <p>"I wasn't wandering along the footpath or in public areas or anywhere.</p> <p>"I was just passing, travelling from the car to the water... I really didn't think that I was doing anything wrong."</p> <p>John was fined for “failure to exercise effective control of a non regulated dog in a public place”. </p> <p>There are signs further up Budd's Beach that state dogs must be on a leash at all times, and John said he does use a lead when he takes his pup out for a walk. </p> <p>The massive fines are a part of the Queensland government's crackdown on dog attacks, with fines of up to $112,910 for more serious dog attack offences as well as up to three years imprisonment.</p> <p>“Changes were made to the AMCDA due to a rise in complaints about aggressive dogs and dog attacks, and the large number of dog-attack victims admitted to hospital each year in Queensland,” the Queensland government said in a statement online.</p> <p>Another Queensland resident has also been fined under the same laws for having her dog's lead under her foot during a coffee break. </p> <p>“It’s wrong, we are trying to survive and it is another stress I didn’t need,” the resident said. </p> <p>“She was on a lead and collar and she was behaving properly."</p> <p><em>Images: Nine</em></p>

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Five reasons why owning a pet is good for us

<p>With more pets than people, Australians have one of the world’s highest pet ownership rates with 62% of us owning at least one pet. And if you’re wondering why we’re so pet mad, research has shown the benefits include companionship, improved mental wellbeing, lower stress and better heart health.</p> <ol> <li><strong>Pets protect us from loneliness</strong></li> </ol> <p>We see our pet as part of the family. Their unconditional (and non-judgemental) love provides us companionship and help to lower stress and anxiety. Interacting with your pet increases feelings of social support and elevates mood. </p> <p>Dog walking increases opportunities for social interaction. When walking outside, fellow dog walkers love to say hello and introduce themselves and their dog to you. Some cafes and restaurants and hotels are dog-friendly venues too. When travelling alone, it’s  wonderful to be able to take your furry companion with you.</p> <ol start="2"> <li><strong>Pets are good for our mental and physical well-being</strong></li> </ol> <p>Pet ownership brings responsibility and the need for skills to know how to best take care of them. These skills will extend to other animals, and other people. Children who have pets develop better social skills when interacting with their friends.</p> <p>Dog owners enjoy lower blood pressure, lower cholesterol levels and less heart disease. While owning a dog is not fully protective, the benefit of all those dog walks are they keep you fitter, healthier and less stressed.</p> <p>If you are unlucky enough to have a heart attack, your long-term survival rate is assisted by having a dog. While interacting with a pet for 10-12 minutes will lower your blood pressure.</p> <p>One of the joys of owning a pet, is the pleasure they provide, and the feeling is mutual. Gazing into the eyes of your beloved pooch, boosts levels of oxytocin our bonding molecule. Our long-standing human-dog relationship was established over 30,000 years ago.</p> <p>Patting or stroking our pets is soothing, especially their silky ears. This is relaxing and how delightful is it when your pet reciprocates with loud purring or offers their tummy for a rub?</p> <ol start="3"> <li><strong>Pets are good for our immune system</strong></li> </ol> <p>You’ve probably heard about your gut microbiome that’s important to keep you healthy. Being a pet owner provides you a healthier microbiome and more robust immune system by promoting more of the beneficial bacteria and lowering the level of harmful, or pathogenic bacteria in our gut.</p> <p>Not only that, stroking your pet raises levels of immunoglobulin A in your body that forms a physical barrier in the gut to protect you against potential invading pathogens.</p> <p>In addition, pregnant mums with a pet in the household are less likely to have infants with childhood allergies, asthma or obesity.</p> <ol start="4"> <li><strong>Pets help us cope better with pain and recovery from illness</strong></li> </ol> <p>Owning a pet has been shown to help manage chronic pain. Pets often sense when their owner isn’t well or in pain and will stay close by, which is very soothing.</p> <p>Watching our pets play and their antics can serve as a useful distraction to our struggles with pain or illness. Having your pet with you (when allowed) in a hospital setting is reassuring and can lift your mood.</p> <p>Animals can help in the work or learning environment. Some workplaces have an office pet policy where you’re allowed to have you pet stay with you while you work. This has been shown to be great for boosting staff morale, collaboration and overall happiness, while keeping work stress lower.</p> <ol start="5"> <li><strong>Pets help us better manage our own self-care</strong></li> </ol> <p>Self-care is always important to stay fit and healthy but isn’t something we always find easy to do. This is where taking responsibility for a pet can help. Teenagers with type one diabetes when given goldfish to care for, did better in monitoring their own blood sugar levels, while having a pet have also been shown to help younger students stay focused and on task, and achieve higher academic results.</p> <p>Pets enrich our lives in so many ways from improved mental well-being to lower stress, elevated mood and greater social support. Whatever type of pet you choose, remember the benefits will work both ways.</p> <p><em><strong>Dr Jenny Brockis is a board-certified lifestyle medicine physician, workplace health and well-being consultant, and author of The Natural Advantage (Major Street Publishing). www.drjennybrockis.com</strong></em></p> <p><em><strong>Image credits: Shutterstock </strong></em></p> <p style="margin: 0px; font-style: normal; font-variant-caps: normal; font-stretch: normal; font-size: 12px; line-height: normal; font-family: Helvetica; font-size-adjust: none; font-kerning: auto; font-variant-alternates: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-position: normal; font-variant-emoji: normal; font-feature-settings: normal; font-optical-sizing: auto; font-variation-settings: normal; min-height: 14px;"> </p>

Family & Pets

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Readers response: What is your biggest travel pet peeve?

<p>When it comes to travelling, there are many different things that can go awry that can make even the most calm travellers irate.</p> <p>We asked our readers what their travel and holiday pet peeves are, and the response was overwhelming. Here's what they said. </p> <p><strong>Linda Woods</strong> - Getting kicked in the back of the seat on a plane. </p> <p><strong>Barbara Pearce</strong> - Distance to walk through airports to get to gates.</p> <p><strong>Judith Buttery</strong> - Lifting my baggage!!</p> <p><strong>Ralph G Smith</strong> - I get so annoyed at the seemingly random changes in flight times that have become like an epidemic in the last few years. I know that situations change, but in recent times it's become almost a given that if you book for a certain flight, it will be changed. It's not just the airlines, but trains and coaches too. </p> <p><strong>June Maynard</strong> - Travel movement at the airports. Queuing, passport checking, immigration, various checkpoints at the airport, etc.</p> <p><strong>Trish Moulton</strong> - Kids on planes.</p> <p><strong>Beverley Murphy</strong> - Waiting hours for a connecting flight.</p> <p><strong>Jenny Gordon</strong> - People who carry way too much/too large cabin baggage then expect to keep it near them when they board late. Airlines should enforce number of pieces, weight and size!</p> <p><strong>Eileen Pomeroy</strong> - Waiting at airports and their high prices for everything.</p> <p><strong>Margie Buckingham</strong> - The total disregard for disabled passengers.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Trouble

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Readers response: What are your driving pet peeves?

<p>When it comes to reckless driving, some specific actions can make anyone irate. </p> <p>We asked our readers what their driving pet peeves are, and the response was overwhelming. Here's what they said. </p> <p><strong>Robyn Kay</strong> - People who don’t indicate! And people who don’t know the road rules, and red light runners.</p> <p><strong>Clay Lorraine Sumsion</strong> - People who reverse out of a car parking space at a shopping centre when you are going past and think they have the right of way!</p> <p><strong>Karen Ambrose</strong> - When I’m diligently sticking to the speed limit on the highway and they keep whizzing past me. Oh well, they can get booked and I’ll be laughing.</p> <p><strong>Barbara Belmonte</strong> - (1) motorists who leave about 2 car lengths from the car in front at traffic lights preventing those who want to turn left. (2) motorists who don't know how to use roundabouts.</p> <p><strong>Ruth Hourigan</strong> - Drivers who drive 10 to 15 km hour under the speed limit then speed up to 5km hour over the speed limit the second you come to an overtaking lane.</p> <p><strong>Dotty Weary</strong> - People who daydream at traffic lights!!!</p> <p><strong>Dorrise Humes</strong> - Drivers who have their lights on high beam in lit up areas, especially in the city.</p> <p><strong>Jo Pollock</strong> - People driving too close behind me. It just makes me slow down.</p> <p><strong>Helen Johnson</strong> - Leaving trolleys in parking bays at supermarkets.</p> <p><strong>Judi Saunders</strong> - Tailgaters and drivers who weave in and out of all lanes.</p> <p><strong>Susan Vemer</strong> - People who don't use their indicators properly!</p> <p><em>Image credits: Shutterstock</em></p> <p> </p>

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"Treated as fools": Prime Minister hits out at supermarkets

<p>On Thursday night the Australian Competition and Consumer Commission (ACCC) released an interim report on its supermarket inquiry, and found the price of a typical basket of groceries has increased by more than 20 per cent since 2019. </p> <p>The report found that low-income households spent more than a fifth of their income on food. </p> <p>While prices across all grocery products have increased, the most considerable hikes were in staples such as dairy products by 32 per cent, bread and cereal items by 28 per cent and meat and seafood prices have increased by a fifth. </p> <p>The price of fruit and vegetables has increased by 19 per cent between the March 2019 quarter to the June 2024 quarter. </p> <p>The ACCC released the interim report after examining whether supermarket giants were dudding suppliers and ripping off customers due to a lack of competition. </p> <p>In a statement on Friday, Prime Minister Anthony Albanese has condemned major supermarkets. </p> <p>“Customers don’t deserve to be treated as fools by the supermarkets. They deserve better than that,” he said. </p> <p>“This is an important piece of work and we will study it closely.</p> <p>“My government is taking a range of actions to make sure Australians are paying a fair price at the checkout and Australian suppliers are getting a fair price for their goods.”</p> <p>Assistant Minister for Competition Andrew Leigh said this was the most comprehensive inquiry they've had in 15 years. </p> <p>“Businesses need to do the right thing by Australians,” he said.</p> <p>“Greater competition is critical for lifting dynamism, productivity and wages growth, putting downward pressure on prices and delivering more choice for Australians dealing with cost-of-living pressures.”</p> <p>The report also found that due to "excessive" prices, many shoppers were buying less food and focusing on cheaper products to stay within their budgets. Others were eating less frequently and have smaller meals, or changing their shopping habits by comparing online prices before going in store. </p> <p>As a result, ACCC deputy chair Mick Keogh said Australians were “losing trust in the sale price claims by supermarkets”.</p> <p>“These difficulties reportedly arise from some of the pricing practices of some supermarkets, such as frequent specials, short-term lowered prices, bulk-buy promotions, member-only prices and bundled prices,” he said. </p> <p>In Australia, Woolworths and Coles contribute to 67 per cent of supermarket sales, with Aldi accounting for 9 per cent and IGA contributing 7 per cent. </p> <p>The ACCC will release their recommendations in their final report due in February 2025. </p> <p>This follows the ACCC launching <a href="https://o60.me/2ssagq" target="_blank" rel="noopener">legal action</a> against Coles and Woolworths over allegations of misleading customers with fake discount prices. </p> <p><em>Image: Daria Nipot / Shutterstock.com/ </em><em>MICK TSIKAS/EPA-EFE/ Shutterstock Editorial</em></p>

Money & Banking

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Five signs in your senior pet you shouldn’t ignore

<p dir="ltr">Just like humans, pets can become susceptible to health complications as they age. </p> <p dir="ltr">Cats are considered senior at around 11 years, and many dogs are considered senior from about seven years old, depending on their breed. </p> <p dir="ltr">As your furry friends get older, it's important to look out for these five changes in your pet, because if caught early, addressing them promptly may significantly improve their well-being, lifespan and quality of life. </p> <p dir="ltr"><strong>Dramatic weight changes</strong></p> <p dir="ltr">If your pet either loses or gains weight dramatically, it’s time to book an appointment at the vets. </p> <p dir="ltr">Significant weight changes can signal issues such as heart disease, diabetes, liver disease, or alterations in metabolism and muscle tone, which are sometimes associated with ageing.</p> <p dir="ltr"><strong>Increased thirst</strong></p> <p dir="ltr">An increase in thirst, and in turn an increase in urination, could be the sign of several health conditions such as kidney disease or diabetes. </p> <p dir="ltr">Addressing these symptoms early can help manage the condition and drastically improve your pet's quality of life.</p> <p dir="ltr"><strong>Changes in appetite</strong></p> <p dir="ltr">Several health problems in pets can manifest in a change of appetite, whether it's a decrease or increase in hunger. </p> <p dir="ltr">Changes in appetite might be due to dental issues, gastrointestinal problems, diabetes or more severe conditions like cancer. </p> <p dir="ltr"><strong>Signs of chronic pain</strong></p> <p dir="ltr">Chronic pain can present in pets in many different ways, such as Repeated chewing, biting, or scratching at a specific area, altered activity levels, reluctance to move or jump, or poor response to medications.</p> <p dir="ltr">If your furry friend looks like they are struggling to move, or are slower when getting up and down, it's time to schedule a trip to the vet.</p> <p dir="ltr"><strong>Changes in demeanour </strong></p> <p dir="ltr">As pets age, they can experience similar symptoms to humans, such as changes in vision, hearing and general confusion. </p> <p dir="ltr">Some pets can even experience dementia, with symptoms including anxiety, aimless wandering, decreased appetite, and notable shifts in behaviour. </p> <p dir="ltr">Although there is no cure, management is possible through medication, dietary adjustments, and lifestyle changes and available under veterinary guidance.</p> <p dir="ltr"><em>Image credits: Shutterstock </em></p>

Family & Pets

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Why IBD is so hard to treat – and how scientists are making progress

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/falk-hildebrand-1490022">Falk Hildebrand</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>; <a href="https://theconversation.com/profiles/katarzyna-sidorczuk-1490026">Katarzyna Sidorczuk</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>, and <a href="https://theconversation.com/profiles/wing-koon-1490274">Wing Koon</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a></em></p> <p>Inflammatory bowel disease (IBD) is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478758/">life altering</a> chronic illness that is <a href="https://bmjopen.bmj.com/content/13/3/e065186">rising dramatically globally</a>. It is stubbornly difficult to treat, and many people find the treatments we have just don’t work for them.</p> <p>Over the last 30 years, there has been almost a 50% increase in cases – now affecting around 5 million people. Not to be confused with irritable bowel syndrome (IBS) which is a condition that affects the digestive system, IBD is more serious. It is the term for two severe illnesses called <a href="https://www.nhs.uk/conditions/crohns-disease/">Crohn’s disease</a> and <a href="https://www.nhs.uk/conditions/ulcerative-colitis/">ulcerative colitis</a>. More women are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958616/#:%7E:text=Male%20predominance%20in%20IBD.,%2C%202.32%3A1%20in%20CD.">diagnosed with Crohn’s disease</a> while more men are affected by ulcerative colitis.</p> <p>People with IBD can experience a variety of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106026/">symptoms</a>, ranging from diarrhoea and blood in the stool, to weight loss and belly aches. On paper, this may sound no worse than mild food poisoning, however, this is no normal stomach upset.</p> <p>Experiences are often extreme; people with IBD can suffer excruciating pain and in some cases, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963331/">require surgery</a> to remove parts of the bowel. This is done by redirecting the bowel to a hole in the abdomen, where faeces are collected in a <a href="https://www.nhs.uk/conditions/colostomy/">colostomy bag</a>.</p> <p>However, we still don’t fully understand the cause of IBD.</p> <h2>The impact of inflammation</h2> <p>The main symptom of IBD is excessive and uncontrolled <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805548/">inflammation</a> – normally a sign of the body fighting off an infection. Although inflammation is an important aspect of our immune system, in IBD it is happening when the body is not under attack. Since we don’t know what causes this over-the-top reaction, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720971/">treatments</a> are limited to managing the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964397/">derailed immune system</a>.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373857/">Inflammation is controlled</a> by cell signalling. Our cells detect bacteria using receptors that attach to parts of bacteria. This activates the receptor, causing it to send a signal to proteins, and each protein sends on more signals, creating a signal cascade. This is what tells the body it’s under attack.</p> <p>Many treatments follow the strategy of intercepting signals and preventing the signal cascade from starting. However, they are <a href="https://journals.lww.com/co-gastroenterology/abstract/2022/07000/management_of_refractory_inflammatory_bowel.6.aspx">not effective</a> for many people.</p> <p>Scientists are trying to target a different protein network, called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924159/">NOD2</a>, that often goes haywire in people with IBD but is not targeted by current treatments. A protein, called <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.650403/full">RIPK2</a>, seems like a promising target since it is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939834/">only found</a> in this network. Researchers from the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10485824/">European Molecular Biology Laboratory</a> are investigating its structure to help scientists design a new medication that will block the signals from this protein.</p> <h2>Importance of the microbiome</h2> <p>Another inspiration for new treatments comes from the bacteria residing in our guts. This community of bacteria, called the gut microbiome, has been associated with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314516/">all sorts of health conditions</a> ranging from asthma to obesity.</p> <p>Gut bacteria work closely with our bodies and play a vital role in digesting food and managing our <a href="https://www.nature.com/articles/s41422-020-0332-7">immune system</a>. In a healthy person, there is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143175/">fine balance</a> between gut bacteria and the immune system. Disruption of this balance can lead to disease, starting from minor discomfort to more severe, long-term conditions.</p> <p>Scientists are trying to understand how our bodies interact with gut bacteria, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102608/">what changes</a> when people develop IBD.</p> <p>The gut microbiome is an ecosystem. Just like a forest has animals eating different things, microbes can form a <a href="https://www.frontiersin.org/articles/10.3389/fevo.2019.00153/full">food web</a>. Some bacteria will use up one type of food, while others feed off other foods. Some rely on the waste of other bacteria after they’ve eaten. It is now believed that disruption to the gut microbiome is a characteristic of IBD and contributes to its development and progression.</p> <p>It’s a chicken and egg situation. Is there a change in the bacteria and food web that alters our bodies? Or does something else in the body, like our immune system, change the food web, subsequently limiting which bacteria can grow? Scientists aren’t sure of the answer.</p> <p>Instead of trying to figure out what happens first, a team at the <a href="https://www.nature.com/articles/s41467-023-42112-w">Hudson Institute of Medical Research</a> in Australia have focused on investigating which interactions in the food web are the most affected in IBD. This could help scientists to prioritise certain gut bacteria, or their food source, to restore the balance in the microbiome and improve patients’ symptoms.</p> <p>Hopefully, this specialised targeting of the microbiome will lead to more effective and longer lasting treatments.</p> <p>Although we have a long way to go before these ideas for treatments can become a reality, it is a step in the right direction. Targeting a new signalling pathway will hopefully control the inflammation in more patients. And studying the microbiome may reveal how we can reverse changes associated with IBD.</p> <p>Since they are key features of IBD, these developments could allow doctors to stop the disease in the early stages and reduce complications.<!-- 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/218307/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/falk-hildebrand-1490022">Falk Hildebrand</a>, Researcher in Bioinformatician, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>; <a href="https://theconversation.com/profiles/katarzyna-sidorczuk-1490026">Katarzyna Sidorczuk</a>, Research Scientist in Metagenomics, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>, and <a href="https://theconversation.com/profiles/wing-koon-1490274">Wing Koon</a>, PhD student in Bioinformatics, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a></em></p> <p><em>Image credits: Shutterstock  </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-ibd-is-so-hard-to-treat-and-how-scientists-are-making-progress-218307">original article</a>.</em></p> </div>

Body

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Pet cat lost in the outback ends in purr-fect reunion months later

<p>A beloved pet cat who went missing in the South Australian outback while on a road trip with his owner has been miraculously returned to his family months later.</p> <p>In June, Murry Rantall was travelling from Warnambook Victoria to Darwin in a caravan when he made a pit stop on the Stuart Hwy so his Burmese cat Raj could use the litter box. </p> <p>Rantall went for a walk and came back assuming that his 14-year-old feline friend was still inside so he drove off. </p> <p>It wasn't until 200km later, when he went to check on Raj, that he realised the cat was missing. </p> <p>“I was just about bawling … I knew he was in trouble,” Rantall said.</p> <p>Rantall who had recently lost his wife said that Raj was the only loved one he had left at home. </p> <p>“We were sort of looking after each other more or less,” Rantall said.</p> <p>He turned back to search for Raj, and even had his daughter, Katrina drive from Victoria to South Australia to help find the cat, but they had no luck. </p> <p>The feline was lost but not fur-gotten as Rantall's children put up Facebook posts about Raj missing in the South Australian outback. </p> <p>Two months later, the outback cat-astrophe ended with the purr-fect homecoming when Raj was found in Port Augusta, about 50km from where he ran away. </p> <p>Raj was found in Milla Dey’s backyard on Thursday, August 8.</p> <p>“I just saw that he was there and covered in prickles. We got him some food and water and he spent probably 15 to 20 minutes just eating,” Dey said.</p> <p>He was taken to a local vet to scan his microchip, but the details were outdated. </p> <p>Locals managed to track down Rantall's family on social media after seeing the Facebook posts about Raj, and they were reunited over the weekend. </p> <p>Rantall said Raj had lost a lot of weight but was content to be back in his arms.</p> <p>“We’ll feed him up, he’ll be all right,” Rantall said.</p> <p>Port Augusta City Council animal control officer Kylie McKerlie said the reunion was thanks to the care and dedication of the local community.</p> <p>“It’s just a really good town and a really good feeling for everyone,” she said.</p> <p>Rantall also thanked everyone who helped saying, “it’s unbelievable, the help I’ve had.” </p> <p><em>Images: 7News</em></p>

Family & Pets

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Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>Around <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">3.2 million</a> Australians live with depression.</p> <p>At the same time, <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">few</a> Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other?</p> <p>Our world-first trial, <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065%2824%2900136-6/fulltext">published this week</a>, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression.</p> <p>Previous studies (including <a href="https://link.springer.com/article/10.1186/s12916-017-0791-y">our own</a>) have found “lifestyle” therapies are effective for depression. But they have never been directly compared with psychological therapies – until now.</p> <p>Amid a nation-wide <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">shortage</a> of mental health professionals, our research points to a potential solution. As we found lifestyle counselling was as effective as psychological therapy, our findings suggest dietitians and exercise physiologists may one day play a role in managing depression.</p> <h2>What did our study measure?</h2> <p>During the prolonged COVID lockdowns, Victorians’ distress levels were <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50831">high and widespread</a>. Face-to-face mental health services were limited.</p> <p>Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful.</p> <p>We partnered with our <a href="https://www.barwonhealth.org.au/mhdas/">local mental health service</a> to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals.</p> <p>Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals:</p> <ul> <li>eating a wide variety of foods</li> <li>choosing high-fibre plant foods</li> <li>including high quality fats</li> <li>limiting discretionary foods, such as those high in saturated fats and added sugars</li> <li>doing enjoyable physical activity.</li> </ul> <p>The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2730724">groups and when delivered remotely</a>.</p> <p>In both groups, participants could continue existing treatments (such as taking antidepressant medication). We gave both groups <a href="https://link.springer.com/article/10.1186/s12888-022-03840-3">workbooks and hampers</a>. The lifestyle group received a food hamper, while the psychotherapy group received items such as a colouring book, stress ball and head massager.</p> <h2>Lifestyle therapies just as effective</h2> <p>We found similar results in each program.</p> <p>At the trial’s beginning we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program.</p> <p>Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful so we could conclude both treatments were as good as each other.</p> <p>There were some differences between groups. People in the lifestyle program improved their diet, while those in the psychotherapy program felt they had increased their social support – meaning how connected they felt to other people – compared to at the start of the treatment.</p> <p>Participants in both programs increased their physical activity. While this was expected for those in the lifestyle program, it was less expected for those in the psychotherapy program. It may be because they knew they were enrolled in a research study about lifestyle and subconsciously changed their activity patterns, or it could be a positive by-product of doing psychotherapy.</p> <p>There was also not much difference in cost. The lifestyle program was slightly cheaper to deliver: A$482 per participant, versus $503 for psychotherapy. That’s because hourly rates differ between dietitians and exercise physiologists, and psychologists.</p> <h2>What does this mean for mental health workforce shortages?</h2> <p>Demand for mental health services is increasing in Australia, while at the same time the workforce <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">faces worsening nation-wide shortages</a>.</p> <p>Psychologists, who provide <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">about half</a> of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap.</p> <p>Lifestyle therapies can be combined with psychology sessions for multi-disciplinary care. But diet and exercise therapies could prove particularly effective for those on waitlists to see a psychologists, who may be receiving no other professional support while they wait.</p> <p>Many dietitians and exercise physiologists already have advanced skills and expertise in motivating behaviour change. Most accredited practising dietitians are trained in managing <a href="https://link.springer.com/content/pdf/10.1007/978-3-030-67929-3_38-1.pdf">eating disorders</a> or <a href="https://www.nature.com/articles/s41572-020-0200-2">gastrointestinal conditions</a>, which commonly overlap with depression.</p> <p>There is also a cost argument. It is <a href="https://journals.sagepub.com/doi/full/10.1177/1355819616668202">overall cheaper</a> to train a dietitian ($153,039) than a psychologist ($189,063) – and it takes less time.</p> <h2>Potential barriers</h2> <p>Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite <a href="https://dietitiansaustralia.org.au/sites/default/files/2024-04/Dietitians%20Australia%20Mental%20Health%20Evidence%20Brief%202024.pdf">peak bodies</a> urging them to do so.</p> <p>Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues.</p> <p><a href="https://foodandmoodcentre.com.au/academy">Our training</a> and clinical <a href="https://www.tandfonline.com/doi/full/10.1080/15622975.2022.2112074">guidelines</a> are intended to help clinicians practising lifestyle-based mental health care within their scope of practice (activities a health care provider can undertake).</p> <h2>Future directions</h2> <p>Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running <a href="https://foodandmoodcentre.com.au/projects/the-harmone-trial/">a study</a> open to Australians with mental health conditions such as major depression or bipolar disorder.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<!-- 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/235952/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 --></em></p> <p><em><a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, Professor, Food &amp; Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, Associate Research Fellow, Food and Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image </em><em>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/food-and-exercise-can-treat-depression-as-well-as-a-psychologist-our-study-found-and-its-cheaper-235952">original article</a>.</em></p> </div>

Mind

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What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<!-- 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/227559/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/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

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Two young fundraising heroes treated to private party at Buckingham Palace

<p>Two fundraising heroes have been treated to a private tea party, hosted by Queen Camilla herself, after being forced to miss previous royal events.</p> <p>Tony Hudgell, nine, and Lyla O’Donovan, 11, were due to attend a garden party in May, but Hudgell got stuck in a major traffic jam, while Lyla was undergoing treatment for cancer. </p> <p>Tony — whose legs were amputated after horrific child abuse - was devastated to miss the royal event, as his adoptive mother Paula shared on X (formerly Twitter) how they spent two hours stuck behind a fire truck on a major highway. </p> <p>However, a response on the Royal Family indicated all was not lost, as they replied, “Sorry to hear this, Tony! We were looking forward to seeing you too. Fancy trying again another day? Leave it with us.”</p> <p>Two months on, the two youngsters arrived at Buckingham Palace for the rescheduled treat last week and were given a front-row spot to watch the Changing of the Guard.</p> <p>The two children and their families then enjoyed a private tea party with Queen Camilla, 76, in the palace garden’s Summer House.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">🫖 🍰 When Tony and Lyla came to tea … <a href="https://t.co/LTfLrPDjT7">pic.twitter.com/LTfLrPDjT7</a></p> <p>— The Royal Family (@RoyalFamily) <a href="https://twitter.com/RoyalFamily/status/1807667556120969625?ref_src=twsrc%5Etfw">July 1, 2024</a></p></blockquote> <p>The Queen then presented Tony with his British Empire Medal after his nomination in the 2024 New Year’s Honours.</p> <p>Tony, who lost his legs as a baby due to his parents’ cruelty, inspired the nation after doing a 10km walk, raising $2.4 million at age five.</p> <p>Paula said, “We were all extremely honoured and grateful to be invited for afternoon tea with the Queen. Everyone was so kind and thoughtful and made us feel comfortable and relaxed."</p> <p>“Tony chatted to the Queen as if they were old friends. She was lovely with him.</p> <p>“An exceptionally proud moment was when the Queen gave Tony his BEM. It was one of the most memorable days we’ll ever have.”</p> <p>Lyla has raised funds to grant wishes to children affected by cancer or lifelong illness. She said of the event, “Everyone made us feel so comfortable and made me feel super-special. We’re so grateful.”</p> <p>Dad Paul said, “It was an amazing moment for us. Lyla was gutted about missing the original Garden Party but she said she’s glad she missed it now as she’s got to meet the Queen."</p> <p>“There’s no one more important than her, apart from the King, of course.”</p> <p><em>Image credits: Buckingham Palace/WPA Pool/Shutterstock Editorial </em></p>

International Travel

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Common mistakes pet owners make

<p>While most pet owners have the best of intentions, sometimes not everyone is aware of the mistakes they are making or the things they could be doing better. Here’s a list of common mistakes pet owners make. How many are you guilty of?</p> <p><strong>Lack of exercise</strong><br />While each breed and species is different in reference to their specific exercise needs, one thing stays the same: every animal requires daily exercise. When working out what is the correct amount for your animal, you need to look at their age, species and breed.</p> <p>And before you go thinking of daily exercise at a chore, remember this: exercise should be fun! It can include play time, walks, jogs, runs, agility training and more. Always consult with your local vet if you want to know the specific exercise guidelines for your pet.</p> <p><strong>No behavioural training</strong><br />When bringing a new animal into your home and family, adequate training is so important. Does your animal know how to take commands? It’s important to be able to teach your pet things and that they respect you.</p> <p>Remember the saying: You can’t teach an old dog new tricks? Well, that’s right. Investing the time to go through behavioural training from the start will help save you time and frustration in the long run.</p> <p><strong>Your pet is bored often</strong><br />Just like humans, pets too get bored. Playing games with your furry friend – such as teaching them tricks or providing them with the toys and space to do interesting things – will do wonders in ensuring their mind is constantly developed.</p> <p>If your pet is stimulated, it should stop them from destroying the house, and your things, when you’re out.</p> <p><strong>Poorly looked after teeth</strong><br />A common mistake a lot of pet owners make, is not brushing often enough – or at all – their pet’s teeth. After all, dental hygiene is one of the most important health issues animals face. The good news is this is avoidable by regularly brushing your pet’s teeth and checking on their oral hygiene.</p> <p>Anything out of the ordinary may be an indication of infection, but when caught early, can be more easily treated. So ensure you book in regular visits at the vet to check your furry friend’s mouth too.</p> <p><strong>Not enough trips to the vet</strong><br />Just as it is important for humans to go to the dentist and doctor for check-ups and shots regularly, visiting the vet and keeping up with a vaccination schedule is equally as important.</p> <p>If not more so, as pets cannot tell you when something is wrong. Booking into to see the vet every so often will ensure your pet is healthy and blossoming for years to come. </p> <p><em>Image credits: Shutterstock </em></p>

Family & Pets

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Dog care below freezing − how to keep your pet warm and safe from cold weather, road salt and more this winter

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a></em></p> <p>Time outside with your dog in the spring, summer and fall can be lovely. Visiting your favorite downtown café on a cool spring morning, going to a favorite dog park on a clear summer evening or going on walks along a river when the leaves are changing color are all wonderful when the weather is favorable. But in much of the country, when winter rolls around, previously hospitable conditions can <a href="https://theconversation.com/is-winter-miserable-for-wildlife-108734">quickly turn chilly and dangerous</a> for people and pups alike.</p> <p>Winter brings some unique challenges for dog owners, since dogs still need activity and socialization during colder seasons. Studies have shown that dog owners are almost 50% less likely to walk their dogs <a href="https://doi.org/10.3390/ani11113302">when the weather gets cold</a>. Knowing the basics of winter safety is critical to maintaining a healthy lifestyle for your dog.</p> <p>I am an <a href="https://www.vetmed.ucdavis.edu/faculty/erik-olstad">assistant professor</a> at the University of California Davis School of Veterinary Medicine who weathered polar vortexes with my dog while living in Michigan early in my career. While I’ve since moved to sunny California, I’ve seen how quickly frigid temperatures can turn dangerous for pets.</p> <h2>Breed and age differences</h2> <p>Not all dogs have the same abilities to deal with cold weather. A short-coated dog like a Chihuahua is much more susceptible to the dangers of cold weather than a thick-coated husky. When the weather dips below 40 degrees Fahrenheit (4 degrees Celsius), the well-acclimated husky may be comfortable, whereas the Chihuahua would shiver and be at risk of hypothermia.</p> <p>Additionally, if your dog is used to warm weather, but you decide to move to a colder region, the dog will need time to acclimate to that colder weather, even if they have a thick coat.</p> <p>Age also affects cold-weather resilience. Puppies and elderly dogs can’t withstand the chill as well as other dogs, but every dog is unique – each may have individual health conditions or physical attributes that make them more or less resilient to cold weather.</p> <h2>When is my dog too cold?</h2> <p>Pet owners should be able to recognize the symptoms of a dog that is getting too cold. Dogs will shiver, and some may vocalize or whine. Dogs may resist putting their feet down on the cold ground, or burrow, or try to find warmth in their environment when they are uncomfortable.</p> <p>Just like people, <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">dogs can get frostbite</a>. And just like people, the signs can take days to appear, making it hard to assess them in the moment. The most common sites for frostbite in dogs are their ears and the tips of their tails. Some of the initial signs of frostbite are skin discoloring, turning paler than normal, or purple, gray or even black; red, blistered skin; swelling; pain at the site; <a href="https://www.britannica.com/science/ulcer">or ulceration</a>.</p> <p>Other <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">serious signs of hypothermia</a> include sluggishness or lethargy, and if you observe them, please visit your veterinarian immediately. A good rule to live by is if it is too cold for you, it is too cold for your dog.</p> <p>Getting your dog a <a href="https://www.cnn.com/cnn-underscored/pets/best-winter-dog-coats-jackets">sweater or jacket</a> and <a href="https://www.akc.org/expert-advice/vets-corner/protect-dogs-paws-snow-ice-salt/">paw covers</a> can provide them with protection from the elements and keep them comfortable. Veterinarians also recommend closely monitoring your dog and limiting their time outside when the temperature nears the freezing point or drops below it.</p> <h2>Road salt dangers</h2> <p>Road salt that treats ice on streets and sidewalks <a href="https://www.cbc.ca/news/canada/kitchener-waterloo/ice-salt-toxic-for-pets-1.5020088">can also harm dogs</a>. When dogs walk on the salt, the sharp, rough edges of the salt crystals can irritate the sensitive skin on their paws.</p> <p>Dogs will often lick their feet when they’re dirty, wet or irritated, and if they ingest any salt doing that, they may face GI upset, dehydration, kidney failure, seizures or even death. Even small amounts of pure salt can <a href="https://www.petpoisonhelpline.com/pet-tips/my-dog-ate-road-salt-will-they-be-okay/">disrupt critical body functions</a> in dogs.</p> <p>Some companies make pet-safe salt, but in public it can be hard to tell what type of salt is on the ground. After walking your dog, wash off their feet or boots. You can also keep their paw fur trimmed to prevent snow from balling up or salt collecting in the fur. Applying a thin layer of petroleum jelly or <a href="https://www.akc.org/expert-advice/lifestyle/how-to-make-your-own-paw-balm-for-winter/">paw pad balm</a> to the skin of the paw pads can also help protect your pet’s paws from irritation.</p> <h2>Antifreeze risks</h2> <p><a href="https://www.britannica.com/science/antifreeze-chemical-substance">Antifreeze, or ethylene glycol</a>, is in most vehicles to prevent the fluids from freezing when it gets cold out. Some people pour antifreeze into their toilets when away from their home to prevent the water in the toilet from freezing.</p> <p>Antifreeze is an exceptionally dangerous chemical to dogs and cats, as it tastes sweet but can be deadly when ingested. If a pet ingests even a small amount of antifreeze, the substance causes a chemical cascade in their body that results in severe kidney damage. If left untreated, the pet may have <a href="https://www.petpoisonhelpline.com/pet-owner-blog/antifreeze-poisoning/">permanent kidney damage or die</a>.</p> <p>There are safer antifreeze options on the market that use ingredients other than ethylene glycol. If your dog ingests antifreeze, please see your veterinarian immediately for treatment.</p> <p>When temperatures dip below freezing, the best thing pet owners can do is keep the time spent outside as minimal as possible. Try some <a href="https://www.akc.org/expert-advice/lifestyle/great-indoor-games-to-play-with-your-dog/">indoor activities</a>, like hide-and-seek with low-calorie treats, fetch or even an interactive obstacle course. Food puzzles can also keep your dog mentally engaged during indoor time.</p> <p>Although winter presents some unique challenges, it can still be an enjoyable and healthy time for you and your canine companion.<!-- 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/221709/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/erik-christian-olstad-1505284">Erik Christian Olstad</a>, Health Sciences Assistant Professor of Clinical Veterinary Medicine, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</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/dog-care-below-freezing-how-to-keep-your-pet-warm-and-safe-from-cold-weather-road-salt-and-more-this-winter-221709">original article</a>.</em></p> </div>

Family & Pets

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Outraged Qantas flyer captures "absolutely unacceptable" act

<p>Qantas staff have been condemned for leaving a pet crate abandoned on a Sydney tarmac in torrential rain. </p> <p>An outraged passenger captured the moment she saw the pet carrier, and a trolley full of suitcases, left in the rain at Sydney Airport on Friday, and shared it to social media. </p> <p>Sydney was hit with heavy rain on Friday, with some parts of New South Wales recording a month's worth of rainfall within a single day. </p> <p>After passengers had been loaded onto the Qantas aircraft, the concerned traveller noticed the animal had been abandoned in the rain.</p> <p>"Unfortunately the weather was unavoidable, but this luggage was left out in the open in Sydney for 30 mins and the animals for 15 minutes — one facing the rain," the furious passenger wrote on Facebook. </p> <p>Travellers on the same flight were quick to comment on the woman's post, saying their luggage had arrived soaking wet. </p> <p>"[I was on] on same flight, my luggage came home wet. Thinking a cover in these conditions would be nice," they wrote. </p> <p>Others expressed their concerns for the animal left in the crate in the rain, saying it was "animal abuse" to leave a furry friend in those conditions. </p> <p>"Those poor fur babies," one person wrote.</p> <p>"I'd report this if I saw it. Should have brought this to the attention of ground crew ASAP."</p> <p>A third added, "I'm unimpressed by the luggage but those pet carriers out there is absolutely unacceptable. I'd be fuming if my boy was stuck on the tarmac in a cage in torrential rain, making an already stressful situation even worse."</p> <p>"Disgusting to leave those fur babies out in the rain. Almost animal abuse," another said.</p> <p>A spokesperson from Qantas told <em><a href="https://au.news.yahoo.com/qantas-photo-catches-airline-in-unacceptable-act-id-be-fuming-222149288.html" target="_blank" rel="noopener">Yahoo News</a></em> that they are investigating the incident and that the airline "takes the safety and welfare of pets travelling with us very seriously".</p> <p><em>Image credits: Facebook</em></p>

Travel Trouble

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

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

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"Fly high sweet Nacho": Robert Irwin shares sad loss of beloved pet

<p>In a world often dominated by headlines of turmoil and strife, there's something oddly comforting about the internet rallying around the loss of a beloved pet chicken.</p> <p>Yes, you heard that right – a chicken named Nacho has captured the hearts of thousands, and her departure from this world has left a void in the Irwin family and beyond.</p> <p>Robert Irwin, the perpetually enthusiastic conservationist and wildlife warrior, took to Instagram to break the news of Nacho's sad passing. In a heartfelt video message, he shared the sorrowful tidings with his followers, who had grown fond of the feathery friend through their virtual interactions.</p> <p>“Hi guys, very sad news to report. Unfortunately, our gorgeous little chicken Nacho, who I know you all fell in love with, and we love so much, sadly passed away,” <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Robert lamented, his voice tinged with genuine sadness. </span>“She was a beautiful old chook who lived a lot of great years and we’re really, really, really, really sad to lose her.”</p> <p>And oh, what a life Nacho must have lived! Robert reminisced about her golden years, filled with clucking adventures and pecking escapades. </p> <p>But, amid the sorrow, there shone a glimmer of hope as Robert introduced two new feathered friends into the Irwin fold – Waffles and Mochi. With names as delightful as their predecessor's, these plucky newcomers are sure to fill the coop with joy once more.</p> <p>In the world of social media condolences, the outpouring of love and support was nothing short of heartwarming. Messages of sympathy flooded Robert's feed, with followers expressing their condolences for the loss of Nacho while warmly welcoming Waffles and Mochi into the fold.</p> <p>"Fly high, sweet Nacho," one commenter bid farewell, echoing the sentiments of many who had come to adore the quirky chicken.</p> <p>There were also words of encouragement and delight for the newest additions to the Irwin menagerie. "Waffles and Mochi are adorable, and I also love their fluffy feet!" exclaimed one enthusiastic follower, proving that even in times of loss, there's always room for a little bit of joy.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C4YEoIOill7/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C4YEoIOill7/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Robert Irwin (@robertirwinphotography)</a></p> </div> </blockquote> <p>This isn't the first time the Irwins have shared their grief over the loss of a beloved animal companion. Just a couple of years ago, they bid farewell to their cherished echidna, marking the passing of a creature who had been a part of their family for an impressive 38 years.</p> <p>In a world where bad news often seems to dominate the headlines, the simple story of a chicken named Nacho reminds us of the power of love and connection – even in the most unexpected of places. So here's to you, Nacho; may your wings carry you to chicken heaven, where the sun always shines, and the corn is always plentiful.</p> <p><em>Images: Instagram</em></p>

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Virgin Australia announces big news for pet owners

<p>Virgin Australia has made a major announcement for pet owners who worried about leaving their furry friends at home when they travel. </p> <p>Outgoing Virgin Australia CEO Jayne Hrdlicka announced on Thursday that they will be the first Australian airline to let small animals travel in the cabin. </p> <p>The revolutionary move is subject to regulatory approval, but if it gets through, Virgin will launch the pet flights on specific domestic routes within the next 12 months.</p> <p>Only small animals will be allowed to travel under the new rules, with specific rows on pet flights reserved for those travelling with their small dogs and cats. </p> <p>They will also be required to be held in a pet carrier under the seat in front of the owner for the duration of the flight, and will not be able to roam around freely or sit on people’s laps for the entirety of the journey.</p> <p>“Overwhelmingly, our guests tell us they want to travel with their pets, and we are now on a journey to make that a reality. It’s something that commonly happens overseas and is proven to work well,” Hrdlicka said.</p> <p>“Almost 70 per cent of Australian households have a pet, so this announcement is really significant for a large proportion of the country."</p> <p>“It’s also a great thing for pet-friendly accommodation providers who will benefit greatly from increased connectivity and the ease for travellers to fly with their pets. It really will be a whole new economy for pet travel in Australia.”</p> <p>This change will not affect existing arrangements for approved service animals, and passengers travelling with larger pets could still pay for them to be transported as cargo.</p> <p><em>Image credits: Virgin Australia</em></p>

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