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Don’t give mum chocolates for Mother’s Day. Take on more housework, share the mental load and advocate for equality instead

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/leah-ruppanner-106371">Leah Ruppanner</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> With Mother’s Day right around the corner, many grateful and loving families are thinking about what to give mum to show their appreciation. Should you give her chocolate? Nope. Fancy soaps? Nope. Fuzzy slippers, pyjamas, scented candles? No, no and no. On this Mother’s Day, keep your cash and give your wonderful mother gifts that will actually have a long-term impact on her health and well-being. <h2>1. Do a chore that mum hates and hold onto it … forever</h2> Research <a href="https://www.tandfonline.com/doi/full/10.1080/13545701.2020.1831039">shows</a> men have increased the amount of time spent on housework and childcare and that mothers, over time, are doing less (hooray!). But, women <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1741-3737.2008.00479.x">still do more housework</a> than men, especially when <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/gwao.12497?fbclid=IwAR2dp04p2sFqbDqdehXmXgDSfTYwX3GRzP7ScMJhSOrMePTGQVErR2TTX88">kids are in the home</a>. Further, <a href="https://journals.sagepub.com/doi/abs/10.1177/0891243205285212">men tend to pick up the more desirable tasks</a>, like <a href="https://www.jstor.org/stable/3598304">cooking and playing with the kids</a>, leaving mothers to do the less pleasurable chores (think cleaning toilets and clearing out fridges). The chore divide in same-sex relationships is generally found to be more equal, but some critique suggests equality may suffer <a href="https://www.nytimes.com/2018/05/16/upshot/same-sex-couples-divide-chores-much-more-evenly-until-they-become-parents.html">once kids are involved</a>. This year give your mum (or mums) the gift of equal housework and childcare sharing – start by taking the most-hated tasks and then hold onto them… forever. <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/gwao.12727">Research</a> shows housework inequality is bad for women’s mental health. Undervaluing women’s housework and unequal sharing of the chores deteriorates <a href="https://link.springer.com/article/10.1007/s11199-022-01282-5">relationship quality</a>, and <a href="https://journals.sagepub.com/doi/full/10.1177/0038038516674664">leads to divorce</a>. Housework and childcare take up valuable time to keep the family happy, harmonious and thriving, often at the expense of mum’s health and well-being. So, skip the chocolates and show mum love by doing the worst, most drudgerous and constant household chores (hello, cleaning mouldy showers!) and keep doing these… forever. <h2>2. Initiate a mental unload</h2> The <a href="https://www.abc.net.au/news/health/2017-09-14/the-mental-load-and-what-to-do-about-it/8942032">mental load</a> is all of the planning, organising and management work necessary to keep the family running. The mental load is often perceived as list making or allocating tasks to family members. But, it’s so much more – it is the <a href="https://theconversation.com/planning-stress-and-worry-put-the-mental-load-on-mothers-will-2022-be-the-year-they-share-the-burden-172599">emotional work</a> that goes with this thinking work. The mental load is the worry work that never ends and can be done <a href="https://www.tandfonline.com/doi/abs/10.1080/13668803.2021.2002813">anywhere, anytime and with anyone</a> (in, for example, said mouldy shower). Because the mental load is performed inside our heads, it is invisible. That means we don’t know when we or others are performing this labour unless we really tune in. In fact, it is often when we tune in through quiet time, relaxation or meditation that the mental load rears its ugly head. Suddenly you remind yourself to buy oranges for the weekend soccer game, organise a family movie night and don’t forget to check in on nanna. Women in heterosexual relationships are <a href="https://journals.sagepub.com/doi/abs/10.1177/0003122419859007">shown to do more</a> of the mental load with serious consequences for their mental health. But we don’t have a comprehensive measurement of how much women do it nor how it is allocated in same-sex couples. So, on this mothers’ day spend some time talking about, cataloguing, and equalising the family’s mental load. This isn’t just making a list about what has to be done but also understanding <a href="https://www.abc.net.au/news/health/2017-09-14/the-mental-load-and-what-to-do-about-it/8942032">how the mental load</a> connects to the emotional health of the family, and the person carrying this <a href="https://www.newamerica.org/better-life-lab/blog/making-the-mental-load-visible/">invisible labour, worry and stress</a>. <h2>3. Speak up for your mum and all caregivers</h2> Families alone cannot bear the brunt of the caregiving necessary to keep us thriving. Governments, workplaces and local communities also play a critical role. For this mothers’ day, pick an issue impacting mothers (for example, equal pay, affordable childcare or paid family leave) and do one thing to help move the needle. Write a letter to your boss, your local MP, or donate money to an advocacy organisation advancing gender equality. Or, role model these behaviours yourself – normalise caregiving as a critical piece of being an effective worker, create policies and practices that support junior staff to care for themselves, their families and their communities and use these policies. <a href="https://journals.sagepub.com/doi/abs/10.1177/0891243216649946">Research</a> shows men want to be equal carers and sharers but often fear what taking time off for caregiving will signal to their employer despite evidence that fathers who request flexible work are perceived more <a href="https://academic.oup.com/sf/article-abstract/94/4/1567/2461609?login=false">favourably</a>. Appearing to be singularly devoted to work was shown to be impossible during the pandemic with kids, spouses, partners, and pets home all day long. Learning to create more care-inclusive workplaces and communities is critical. Paid parental leave, affordable and accessible high-quality childcare, flexibility in how, when and where we work and greater investments in paid sick leave, long-term disability support and aged care are just a few policies that would strengthen the care safety net. We will all be called upon to care at some point in our lives – let’s create the environments that support caregiving for all, not just mum.<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/182330/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leah-ruppanner-106371">Leah Ruppanner</a>, Professor of Sociology and Founding Director of The Future of Work Lab, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Getty Images 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/dont-give-mum-chocolates-for-mothers-day-take-on-more-housework-share-the-mental-load-and-advocate-for-equality-instead-182330">original article</a>. </div>

Family & Pets

"Not good enough": Karl takes aim at airline cancellation

Karl Stefanovic has ripped into Aussie airline Bonza, who cancelled all their flights at the last minute and left people stranded all across the country. One of the travellers who were left abandoned was Tracy Hilbert, who was due to fly out of Melbourne on Tuesday morning to see her family after her father suddenly died on Monday night. However, instead of being with her mother and brother, she instead spent the day stuck inside the airport after a fellow passenger informed her their flight had been cancelled with no warning. Tracy spoke to Karl Stefanovic and Sarah Abo on Today to share how let down she felt by the airline, as they failed to communicate the cancellation with their customers. “I text my husband. He said, ‘yes, it’s been cancelled’ and sent me all the details,” Ms Hilbert told Today. “Then the crew came in and about a 5.45am they said that it’s been cancelled.” Ms Hilbert fought back tears as she told Karl and Sarah the heartbreaking reason why she was so desperate to make her flight. “I’ve actually had my father pass away last night, so I needed to get up there because my brother text me and said that he’s not in a good way.” Ms Hilbert’s husband quickly booked her a flight with the budget airline last night, not realising that as of this morning, services will be “temporarily suspended”. “I’ve never had this problem with them before,” Ms Hilbert said. “It’s only a two-hour flight but now it’s going to take me all day to get up there.” Thankfully for Ms Hilbert, along with thousands of other stranded passengers, Virgin and Jetstar said those who were affected by the cancellation would be assisted to get to their destination. “We are aware of the temporary suspension of Bonza flights,” Virgin posted on X. “We will immediately support any passengers stranded mid-journey by offering complimentary seats on Virgin Australia-operated flights to the airport nearest to their final planned Bonza destination.” While wondering if she would receive a refund for her cancelled flight, Ms Hilbert said she was frustrated with the lack of communication with Bonza, saying, "You can’t talk to anybody, it’s all through emails.” Ms Hilbert said it’s all been “very hard” as she should have been with her mother, brother and other family now. “Oh, sweetheart. Hey, Tracy, we’ll let you go,” Karl quickly responded as Ms Hilbert continued to break down in tears. “Obviously there’s going to be a lot of people who are inconvenienced. You’re inconvenienced in a whole lot more emotional away. And it’s such a big thing for you to be handling right now. And we’re so sorry for your loss.” Karl hit out at the airline saying the very least they can do is communicate with travellers who have been left in the lurch. “It’s not good enough just to say something is cancelled. They might be going through the most, you know, horrible business morning of their lives, but that shouldn’t stop you from communicating with people." “It’s just a basic human necessity. And especially for people like Tracy.” On Tuesday, Bonza CEO Tim Jordan said services will be “temporarily suspended” while discussions surrounding the “viability of the business” take place. Image credits: Today

Travel Trouble

As you travel, pause and take a look at airport chapels

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/wendy-cadge-343734">Wendy Cadge</a>, <a href="https://theconversation.com/institutions/brandeis-university-1308">Brandeis University</a> Flying home? It is very likely there is a chapel or meditation room tucked away somewhere in one of the airports you’ll pass through. <a href="http://www.pewresearch.org/fact-tank/2015/07/06/most-of-the-busiest-u-s-airports-have-dedicated-chapels/">Sixteen of the country’s 20 largest airports</a> have chapels, as do many more around the world. I am a <a href="http://www.wendycadge.com/">sociologist</a> of contemporary American religion and have written <a href="http://www.wendycadge.com/publications/airport-chapels-and-chaplains/">two recent articles</a> about airport chaplains and chapels. My interest in airport chapels started as simple curiosity – why do airports have chapels and who uses them? After visiting a few – including the chapel at Logan, my home airport here in Boston – I have concluded that they reflect broader changing norms around American religion. <h2>How airports came to have chapels</h2> The country’s first airport chapels were intended for staff rather than passengers and were established by Catholic leaders in the 1950s and 1960s to make sure their parishioners could attend mass. The first one in the U.S., Our Lady of the Airways, was built by Boston Archbishop Richard J. Cushing at Logan airport in 1951 and it was explicitly meant for people working at the <a href="https://doi.org/10.1093/socrel/srx025">airport</a>. A neon light pointed to the chapel and souvenir cards handed out at the dedication read, “We fly to thy patronage, O Holy Mother of God; despise not our petitions in our necessities, but deliver us away from all dangers, O glorious and blessed virgin.” Our Lady of the Airways inspired the building of the country’s second airport chapel, Our Lady of the Skies at what was then Idlewild – and is today John F. Kennedy airport in New York City. Protestant chapels came later. The first was in New York – again at JFK. It was designed in the shape of a Latin cross and was joined by a Jewish synagogue in the 1960s. These chapels were located at a distance from the terminals: Passengers wishing to visit them had to go outside. They were <a href="https://books.google.com/books/about/Exploring_Interfaith_Space.html?id=on5YNwAACAA">later razed</a> and rebuilt in different area of JFK. In the 1970s and 1980s, Protestant chapels opened in Atlanta, and in several terminals of the Dallas airport in Texas. <h2>Becoming more inclusive</h2> By the 1990s and 2000s, single faith chapels had become a <a href="http://www.tciarchive.org/4534.article">“dying breed.”</a> Most started to welcome people from all religions. And many were transformed into spaces for reflection, or meditation for weary travelers. The chapel at San Francisco International Airport, for example, known as the <a href="https://www.flysfo.com/content/berman-reflection-room-0">Berman Reflection Room</a> for Jewish philanthropist Henry Berman who was a former president of the San Francisco Airport Commission, looks like a quiet waiting room filled with plants and lines of connected chairs. A small enclosed space without any religious symbols or obvious connections to things religious or spiritual is available for services. The scene at the <a href="http://www.atlchapel.org/">Atlanta</a> airport chapel is similar, with only a few chairs and clear glass entrances, to provide space for quiet reflection. Some airports, such as JFK, continue with their “Our Lady” names, indicating their faith-based origins. Others include religious symbols and objects from a range of religious traditions. The chapel in <a href="https://cltairportchapel.org/">Charlotte</a>, North Carolina, for example, has multiple religious texts alongside prayer rugs, rosary beads and artistically rendered quotes from the world’s major religions. Pamphlets on topics ranging from grief to forgiveness are available for visitors to take with them at the Charlotte airport. <h2>Different airports, different rules</h2> As these examples show, <a href="https://doi.org/10.1093/socrel/srx025">no two airports</a> have negotiated chapel space in the same way. What is permissible in one city is often not in another. Often, it is local, historical and demographic factors, including the religious composition of the region, that influence decisions. These could even be based on who started the chapel, or how much interreligious cooperation there is in a city. Certain airports such as Chicago’s <a href="http://www.airportchapels.org/">O'Hare</a> have strict rules regarding impromptu religious gatherings whether inside the chapel or out. Some use their public address systems to announce religious services. Others prohibit such announcements and do not even allow airport chaplains to put out any signs that could indicate a religious space. If they are included in airport maps, chapels tend to be designated by the symbol of a person bent in prayer. But even then, they can be difficult to spot. About half of the existing chapels are on the pre-security side of the airport and the other half accessible only after passengers pass through security. <a href="https://doi.org/10.1093/socrel/srx025">Only four large American airports</a> – Las Vegas, Los Angeles, Philadelphia and New York’s LaGuardia – do not have chapel spaces, although opening such a space is under consideration. In the interim, at LaGuardia, a Catholic chaplain holds mass in a conference room. <h2>What’s the future?</h2> The reasons for these spaces and their variations are idiosyncratic and intensely local. These chapels reveal a range of approaches to contemporary American religion and spirituality. So on your travels, keep an eye out for these chapels. Note their similarities and differences and recognize how important local histories are to how church-state issues are resolved – at airports and beyond.<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/87578/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/wendy-cadge-343734">Wendy Cadge</a>, Professor of Sociology and Women's, Gender and Sexuality Studies, <a href="https://theconversation.com/institutions/brandeis-university-1308">Brandeis University</a> Image credits: Getty Images 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/as-you-travel-pause-and-take-a-look-at-airport-chapels-87578">original article</a>. </div>

Travel Tips

Love is in the air! Pilot proposes to flight attendant girlfriend before take off

A pilot has proposed to his flight attendant girlfriend just minutes before take off in a heart-warming display of love. Polish pilot Konrad Hanc was captured emerging from the cockpit before embarking on a flight to Kraków to make a surprising announcement over the PA system. Hanc introduced himself to the passengers before explaining the real reason for his message. “On today’s flight there is a very special person," he began. “Ladies and gentlemen, about one and a half years ago in this job I met the most wonderful person that completely changed my life." “You are most precious to me. You are my greatest dream come true. This is why I have to ask you a favour, honey." <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C6EHHyQskLc/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C6EHHyQskLc/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by LOT Polish Airlines (@flylot)</a> </div> </blockquote> “Will you marry me?” he asked while getting down on one knee, as another flight attendant handed him a bouquet of flowers. His girlfriend, Paula, sprinted up the aisle of the plane before leaping into the arms of her future husband. Passengers watched on in anticipation for her answer with one yelling, “Did she say yes?” to which the beaming captain responded: “She said yes!” Hanc explained that he chose to pop the question on the flight to the Polish city as he met Paula on the same flight just 18 months ago. As the pair embraced in a hug and kiss, passengers erupted in applause, with many taking to the now viral Facebook post to send them well wishes. “I love this! Sweet couple!” one person wrote. ”TOTALLYYYYY LOVE IN THE AIR,” another enthusiastic person commented, to which the airline responded: “YES, love IS in the air!” Image credits: LOT Polish Airlines

Relationships

Could not getting enough sleep increase your risk of type 2 diabetes?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes. So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex. <h2>The study</h2> Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade. The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk. As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets. Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category. The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours. One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less. Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations. <h2>Why might short sleep increase diabetes risk?</h2> In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body. We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes. Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>. This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses. These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours. While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes. Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase. The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>. <h2>Good sleep, healthy diet</h2> Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes. Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle. While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health. The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk. In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<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/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images 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/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>. </div>

Body

What happens when I stop taking a drug like Ozempic or Mounjaro?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Drugs like Ozempic are very <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.12932">effective</a> at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger. But does weight come back when you stop using it? The short answer is yes. Stopping <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">tirzepatide</a> and <a href="https://doi.org/10.1111/dom.14725">semaglutide</a> will result in weight regain in most people. So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far. <h2>It’s a long-term treatment, not a short course</h2> If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone. For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns. Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.) Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less. <h2>Why do people stop?</h2> Research trials show anywhere from <a href="https://asean-endocrinejournal.org/index.php/JAFES/article/view/1771">6%</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/35015037/">13.5%</a> of participants stop taking these drugs, primarily because of <a href="https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more">side effects</a>. But these studies don’t account for those forced to stop because of cost or <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">widespread supply issues</a>. We don’t know how many people have needed to stop this medication over the past few years for these reasons. Understanding what stopping does to the body is therefore important. <h2>So what happens when you stop?</h2> When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to <a href="https://pubmed.ncbi.nlm.nih.gov/30565096/">move out of your system</a>. As it does, a number of things happen: <ul> <li>you start feeling hungry again, because both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/">your brain and your gut</a> no longer have the medication working to make you feel full</li> </ul> <ul> <li> blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index">low glycemic index</a> to stabilise your blood sugars </li> <li> over the longer term, most people experience a return to their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/">previous blood pressure and cholesterol levels</a>, as the weight comes back </li> <li> weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle. </li> </ul> While you were on the medication, you will have lost <a href="https://academic.oup.com/jes/article/5/Supplement_1/A16/6240360">proportionally less skeletal muscle than fat</a>, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat. <h2>Is stopping and starting the medications a problem?</h2> People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">yo-yo dieting</a>. When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to <a href="https://www.jomes.org/journal/view.html?doi=10.7570/jomes.2017.26.4.237">deal with</a> spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-022-01735-x">stress</a> your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual. Interestingly, the risk to the body from weight fluctuations is greater for people who are <a href="https://jech.bmj.com/content/74/8/662">not obese</a>. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight. <h2>How can you avoid gaining weight when you stop?</h2> Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include: <ul> <li> getting quality <a href="https://www.hindawi.com/journals/ije/2010/270832/">sleep</a> </li> <li> exercising in a way that builds and maintains muscle. While on the medication, you will <a href="https://pubmed.ncbi.nlm.nih.gov/32628589/">likely have lost muscle</a> as well as fat, although this is not inevitable, especially if you <a href="https://www.europeanreview.org/article/34169">exercise regularly</a> while taking it </li> </ul> <ul> <li> addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2009.159491">fat-phobic and discriminates</a> against people in larger bodies </li> <li> eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes. </li> </ul> Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<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/224972/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images 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-when-i-stop-taking-a-drug-like-ozempic-or-mounjaro-224972">original article</a>. </div>

Body

"What has to happen?" Kyle Sandilands' controversial take after knife attacks

Kyle Sandilands has shared his controversial opinion on arming security guards in the wake of two violent stabbing attacks in Sydney. On Saturday, six people were killed at the hands of Joel Cauchi who went on a stabbing rampage through Bondi Junction Westfield, while on Monday night, a teenage boy stabbed a bishop and a priest during a church service in western Sydney. One of Joel Cauchi's victims was Faraz Tahir, a security guard at the shopping centre, while another guard was injured during the rampage. In the days after the eastern suburbs tragedy, Kyle, who has a <a href="https://oversixty.com.au/health/caring/kyle-sandilands-family-member-among-first-victims-stabbed-in-bondi" target="_blank" rel="noopener">connection</a> to one of the people injured during Cauchi's attack, launched into a tirade live on-air, calling for security guards to be given firearms. "I saw the [NSW] premier [Chris Minns] last night on TV saying firearms for security guards are not on the agenda. And I was like, 'Well, what has to happen before a security guard can actually secure the place for us?'" Sandilands raged. "Every shopping centre and every school should have armed security guards, trained specialists, not just some guy getting a little firearms licence. I mean, proper trained." Most retail security staff in NSW are unarmed, with batons classified as prohibited weapons that require special licensing and training. "There's people that work at Westfield, for example, women that work in shops that have told their husbands, 'I ain't never going back to Westfield. I'm never going back to work again'," Sandilands continued, adding that those retail workers are "traumatised forever" following Saturday's stabbings. Sandilands' opinions have been echoed by fellow controversial broadcaster Ray Hadley, who on Monday demanded on his 2GB Sydney radio show that security guards be armed across the state. "For years I've been arguing that all security guards in the state in hospitals and shopping centres should be better equipped," he said. "And these poor security guards, unarmed, unable to do what they should do - protecting the people that they are there to protect." Image credits: KIISFM

Legal

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”. As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”. We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out. Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise. <h2>How does it work?</h2> Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better. GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars. GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating. <iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe> GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action. Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more. GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection. <h2>What can users expect? What does the research say?</h2> Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly). A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs. Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up. Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>. Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up. <h2>Who is eligible for semaglutide?</h2> Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes. However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use. The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia. When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications. <h2>What else do you need to do during Ozempic treatment?</h2> Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials. Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week. STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling. A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>. <h2>But what are the side effects?</h2> Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain. In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos. More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions. To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term. Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<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/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.

Body

Millions of phones at risk of being cut off from calling triple-0

Over a million Aussies may be unable to contact triple-0 as two major telcos cut their 3G networks. Telstra's network will be closed on June 30 this year followed by Optus, which will shut their 3G network in September. While most late model phones are now serviced by either 4G or 5G networks, there are many devices that still rely on 3G. Approximately 113,000 Telstra customers have not upgraded their 3G handsets, while Optus have not disclosed a figure. The greater concerns lie for older 4G-enabled handsets that may not be able to call triple-0 once the 3G networks are switched off, because of the way those phones are configured. In March, Communications Minister Michelle Rowland was informed that 740,000 Australians were in that category. A month later, that figure was revised to over a million. "I welcome the industry’s first report to government but am concerned around their disclosure of around one million potentially impacted consumers,” the minister said. “I am considering the detail provided and next steps, and the government will have more to say about the 3G switchover soon.” She also said that they were open to delaying the switchover "if warranted in the public interest”. “Options exist under law for the government to consider proposals to delay the planned switchover, subject to consultation and procedural processes,” she said. Telstra has informed customers about what to do if they are affected, and how they could check. “If your mobile device doesn’t have Voice over LTE (VoLTE) technology, even if it uses 4G data, it will not be able to make voice calls on our network after 30 June 2024,” they informed their customers. “Not all VoLTE enabled devices support emergency VoLTE calling, meaning they will not be able to make an emergency call to triple-0 once 3G closes." “Without taking the recommended action you won’t be able to connect to a network after 30 June 2024,” they warned. Customers who are worried that they might be impacted, are encouraged to text 3 to the number 3498, so that the telco can inform the customer on their connection status. Optus have also encouraged customers to contact them if they think they may be affected. Image: Getty

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94-year-old grandma takes on huge travel challenge

"Grandma Joy" Ryan was 91 when she first got her passport, and she hasn't stopped travelling since. Now aged 94, she is embarking on a new global challenge with her grandson Brad Ryan, 42, with the intergenerational duo planning to travel to all seven continents in the world together. "I don't have many years left, [so] you hop to it," Grandma Joy told CNN Travel. "If you slow down, you don't get anything done." The pair, who are from the US, have already travelled to three continents, visiting Banff National Park in Canada last year to "represent North America well beyond just our own country", and Africa in 2023, visiting both Amboseli National Park and Maasai Mara National Reserve in Kenya. Their most recent trip was to South America, where they travelled to Ecuador, and spent time in the Galapagos Islands, as well as Chile. "It was amazing to see those huge tortoises," Grandma Joy recalled. "They could raise their shells up just like a convertible or something." Prior to travelling the world together, the grandma-grandson duo were actually estranged for around a decade due to a family rift that occurred after Ryan's parents divorced. After reconnecting in 2010, Ryan was telling his grandma about his previous hiking adventures on the Appalachian Trail and Mount Kilimanjaro, when he learnt that his grandmother "had never set eyes on a mountain." "That was one of her lifelong regrets," he said. "Her travel had been limited to just a few road trips to Florida with my grandfather when he was alive. "Her view of the world was always what she saw on the Travel Channel or just on the news." That conversation stuck with him and the pair embarked on their first journey together in 2015, when Ryan decided to take a weekend road trip to the Great Smoky Mountains National Park. "At 85, she saw her first mountain, climbed her first mountain and went camping for the first time and fell off the air mattress a couple of times and didn't complain," he said. He added, that having to move more slowly as he was travelling with his grandma, meant that he was able to appreciate everything in a more meaningful way. "I wasn't rushing through the places that I was visiting. I was really taking the time to appreciate smaller details. "The lens through which she is seeing the world is very different to most people my age. She doesn't visit a place thinking, 'Well, I'll be back again,' so there's more presence." They kept the adventure going and decided to travel to the 62 other US National Parks, and while it took them almost eight years with two-month long breaks between each trip, Grandma Joy made history last year. She became the oldest person to visit all 63 National Parks in the US. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CsU_w4-rqyP/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CsU_w4-rqyP/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Grandma Joy’s Road Trip — Brad and Joy Ryan (@grandmajoysroadtrip)</a> </div> </blockquote> "Being an old person sitting on the porch, this makes you feel like, 'Well maybe I did accomplish something.' So I enjoyed every bit of it," she said. Ryan himself is very proud of his grandmother's achievement, and after going viral with their national parks quest in 2023, he said that travelling with her has been a life-changing experience. "She shattered my preconceived notions about what it means to be an older person," he said. "Because she wasn't just sitting in the passenger seat looking out the window, although we did that too." He then described how Grandma Joy went ziplining at New River Gorge National Park and Preserve in West Virginia and whitewater rafting at Wrangell St. Elias National Park in Alaska at the age of 91, and how she reminded him of all the possibilities that come with getting older. "I think we all have this sort of innate dread about getting older," he said. "And we think about the limitations instead of the possibilities. She [Grandma Joy] reminds us of the possibilities that still exist." While the pair are currently "still recovering" from their latest trip to South America, they shared their plan to visit Australia later this year, and hope to "hop over to Asia" after. Once they've ticked off Australia and Asia off their list, they plan to visit Europe and hope to end their trip in Antarctica. "Antarctica is the one that's like the wildcard," Ryan said. "We would love that, but getting there is challenging. "I'd like to end big, and I think Antarctica would be the cherry on top of this adventure." The duo document all their adventures on their Instagram account, <a href="https://www.instagram.com/grandmajoysroadtrip/" target="_blank" rel="noopener">grandmajoysroadtrip</a> and despite people wondering when they would wrap it up, Grandma Joy's "willing spirit" keeps her going. "I just take one step at a time, one day at a time, and thank the Lord every morning for giving me one more day," she said. "I try to be an optimist. The glass is half full, not half empty. And the people that you meet along the way lift your spirits. "You see people in worse shape than you, and I just think 'I've got a lot to be thankful for.' "Not everybody's lucky enough to have a grandson that's willing to drag them around." Images: Instagram

International Travel

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs. As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns. But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug. <h2>Potential benefits</h2> 1) It’s likely to help you lose weight The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity. The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight). In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg. Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication. 2) It may reduce your chronic disease risk factors When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases. In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels. In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels. 3) It might improve your quality of life, emotional wellbeing or sense of achievement The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health. Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image. <h2>What about the risks?</h2> 1) You may experience gastrointestinal symptoms In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%). In the UK study, nausea and diarrhoea were also commonly reported. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living. Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study. 2) You might feel fatigued Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants. 3) You might be among the minority who don’t tolerate the drug Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia. In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing. More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period. A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period. Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions. 4) It might be difficult to access Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024. To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication. 5) You might not always get clear information from vested interests Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>. Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications. <h2>Bottom line</h2> Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.<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/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images 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/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.

Body

Undernourished, stressed and overworked: cost-of-living pressures are taking a toll on Australians’ health

<a href="https://theconversation.com/profiles/nicole-black-103425">Nicole Black</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/anthony-harris-7148">Anthony Harris</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/danusha-jayawardana-1406565">Danusha Jayawardana</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/david-johnston-1126643">David Johnston</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> For the past few years, it has been impossible to escape the impact of inflation. Meeting our most basic needs – such as food, housing and health care – now costs significantly more, and wage increases <a href="https://futurework.org.au/post/for-most-workers-wages-are-still-failing-to-keep-up-with-inflation/">haven’t kept up</a>. There are signs relief could be on the horizon. Inflation has fallen to its <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/consumer-price-index-australia/latest-release">lowest levels</a> since January 2022. But Australia now also finds itself in the midst of an <a href="https://theconversation.com/prepare-to-hear-about-an-official-recession-unofficially-weve-been-in-one-for-some-time-224963">economic downturn</a>, putting further pressure on households. Rising prices have an obvious negative impact on our financial health. But they can also have a profound effect on our physical and mental wellbeing, which is often overlooked. Australians may continue to feel the health effects of high inflation for quite some time. <h2>It’s costing more to live well</h2> Between March 2021 and March 2023, the price of goods and services <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/consumer-price-index-australia/jun-quarter-2023">rose substantially</a>, marking a period of high <a href="https://www.rba.gov.au/education/resources/explainers/inflation-and-its-measurement.html">inflation</a>. <iframe id="5vFeh" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/5vFeh/" width="100%" height="400px" frameborder="0"></iframe> Worryingly, the prices of basic needs that are important for staying healthy – nutritious food, health care, housing and utilities – rose between 11% and 36%. <h2>Who is affected the most?</h2> Higher prices on essentials are virtually impossible to dodge, but they impact certain groups of people more than others. Wealthier households have managed their higher expenses by <a href="https://www.rba.gov.au/publications/fsr/2023/oct/pdf/financial-stability-review-2023-10.pdf">cutting back on discretionary spending and dipping into savings</a>. However, lower income households spend <a href="https://www.rba.gov.au/publications/fsr/2023/oct/household-business-finances-in-australia.html#:%7E:text=Lower%20income%20households%2C%20including%20many,than%20households%20on%20higher%20incomes.">a much larger portion of their income</a> on housing and other essentials. Without a savings buffer, these households experience severe financial strain and poor health outcomes. <h2>Financial stress affects our health</h2> Our research shows that high inflation has <a href="https://www.vichealth.vic.gov.au/resources/resource-download/high-inflation-and-implications-for-health">a range of effects</a> on people’s health. These effects fall into three main groups: material hardship, psychosocial, and behavioural. 1. Material hardship People facing material hardship can’t meet their basic needs because they can’t afford to pay for them. Material hardship can present itself in a variety of ways: <ul> <li><a href="https://theconversation.com/how-many-australians-are-going-hungry-we-dont-know-for-sure-and-thats-a-big-part-of-the-problem-195360">food insecurity</a> – not getting adequate nutrition</li> <li><a href="https://theconversation.com/1-in-4-households-struggle-to-pay-power-bills-here-are-5-ways-to-tackle-hidden-energy-poverty-204672">energy poverty</a> – struggling to pay for electricity and gas</li> <li>deferred health care – putting off medical treatment</li> <li>housing insecurity – struggling to find a stable place to live.</li> </ul> Between August 2022 and February 2023, when inflation hit its highest levels in 33 years, over half (53%) of surveyed Australians reported <a href="https://melbourneinstitute.unimelb.edu.au/data/taking-the-pulse-of-the-nation-2022/2023/australians-face-challenging-budgetary-constraints">struggling to afford</a> their basic needs. Finding ourselves in this situation can have far-reaching implications for our health. For example, food insecurity is linked to <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">an increased risk of poor nutrition, obesity and chronic illness</a>, as households facing cost-of-living pressures shift towards cheaper, lower-quality food options. Energy poverty is linked to <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">physical and mental health problems</a> as people struggle to keep warm in wintertime, and cool in the summer. Delaying health care <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">increases</a> the risk of facing severe health problems, staying in hospital for longer, and being admitted to the emergency department. This isn’t just worse for individuals, it’s also far more costly for our health care system. 2. Psychosocial effects Psychosocial effects are the ways in which cost-of-living pressures impact our mind and social relationships. Difficulties in meeting our basic needs are strongly associated with <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">increased levels of psychological distress</a>, including symptoms of anxiety and depression. This impact can worsen over time if individuals experience sustained financial stress. By undermining our ability to work well, the psychosocial effects of prolonged financial stress can initiate a “vicious cycle”, leading to reduced productivity and lower earnings. Financial stress can also have a detrimental impact on spousal relationships, which can affect the mental health of other household members such as children. 3. Behavioural effects Cost-of-living pressures can also cause a number of changes in the way we behave. For many, these pressures have become a reason to work longer hours and gain additional income. Last year, Australians collectively worked 4.6% longer, an <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia/aug-2023">extra 86 million hours</a>. But working longer hours <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_High-Inflation-Paper_FINAL_1.pdf">reduces people’s overall health</a>, especially among parents of young children facing greater time constraints. It also leaves less time for activities that help to keep people healthy, such as getting regular exercise and cooking healthy meals. <h2>How can policymakers respond?</h2> In theory, the Reserve Bank of Australia’s primary tool for combating inflation – raising interest rates – should help. By reducing aggregate spending in the economy, it is designed to put downward pressure on prices. But by bluntly increasing the cost of borrowing, it also puts significant short-term financial pressure on both lower-income mortgage holders and renters. Better acknowledgement of this fact, and of inflation’s broader impact on people’s physical and mental health, would be a great start. When formulating policy responses to high inflation, governments could factor health and wellbeing impacts into their assessment of the trade-offs between alternative policy responses. This could help minimise any policy’s long-term negative health consequences and its impact on the health care system. Policymakers could also focus on making sure affordable and timely access to health care, especially mental health support, is made available to those most vulnerable to cost-of-living pressures.<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/223625/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nicole-black-103425">Nicole Black</a>, Associate Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/anthony-harris-7148">Anthony Harris</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/danusha-jayawardana-1406565">Danusha Jayawardana</a>, Research Fellow in Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/david-johnston-1126643">David Johnston</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images 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/undernourished-stressed-and-overworked-cost-of-living-pressures-are-taking-a-toll-on-australians-health-223625">original article</a>.

Money & Banking

Taking expensive medicines or ones unavailable in Australia? Importing may be the answer

<a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> The cost-of-living crisis may be driving some Australians to look for cheaper medicines, especially if those medicines are not subsidised or people don’t have a Medicare card. Options can include buying their medicines from overseas, in a process called “<a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation</a>”. Others also use this option to import medicine that is not available in Australia. Here’s what’s involved and what you need to know about the health and legal risks. <h2>Cost-of-living crisis bites</h2> Many Australians, particularly those with long-term illnesses, are finding it increasingly hard to afford health care. The <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">Australian Bureau of Statistics</a> reports the proportion of people who delayed or did not see a GP due to cost doubled in 2022-23 (7%) compared with 2021-22 (3.5%). A <a href="https://australianhealthcareindex.com.au/wp-content/uploads/2022/11/Australian-Healthcare-Index-Report-Nov-22.pdf">survey</a> published in 2022 of over 11,000 people found more than one in five went without a prescription medicine due to the cost. For those with a Medicare card it’s usually best (and cheapest) to get medicines locally, especially if you also have a concession card. However, for some high-cost medicines, personal importation may be cheaper. That’s when an individual arranges for medicine to be sent to them directly from an overseas supplier. A 2023 study found <a href="https://www.publish.csiro.au/AH/AH23143?jid=AHv47n6&xhtml=5AA1F839-38C8-45E8-A458-79DCDB7597FB">1.8%</a> of Australians aged 45 or older had imported prescription medicines in the past 12 months. That indicates potentially hundreds of thousands of Australians are importing prescription medicines each year. Almost half of the survey respondents indicated they would consider importing medicines to save money. <h2>What’s involved?</h2> Australia’s drug regulator, the Therapeutic Goods Administration (TGA), allows individuals to import up to three months’ supply of medicines for their own personal use (or use by a close family member) under the <a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation scheme</a>. This often involves ordering a medicine through an overseas website. If the medicine would require a prescription in Australia, you must also have a legally valid prescription to import it. Selling or supplying these medicines to others outside your immediate family is strictly prohibited. <h2>How could this help?</h2> For some high-cost medicines, personal importation may be cheaper than having the medicine dispensed in Australia. This is most likely for medicines not subsidised by the <a href="https://www.pbs.gov.au/info/about-the-pbs">Pharmaceutical Benefits Scheme</a> (the PBS). People who do not hold a Medicare card may also find it cheaper to import certain medicines as they do not have access to PBS-subsidised medicines. For example, for people with a specific type of leukaemia, treatment with sorafenib is not covered by the PBS. For these patients it could be up to about ten times more expensive to have their treatment dispensed in Australia as it is to import. That’s because there is a cheaper generic version available overseas. Personal importation may also allow you to access medicines that are available overseas but are not marketed in Australia. <h2>What are the risks?</h2> All medicines carry risks, and medicine sold online can pose additional dangers. The TGA does not regulate medicines sold overseas, so the safety and quality of such medicines can be uncertain; they may not be produced to <a href="https://www.tga.gov.au/what-tga-regulates">Australian standards</a>. While similar regulatory agencies exist in other countries, when ordering medicines from overseas websites it can be difficult to determine if the product you are buying has been assessed to ensure it is safe and will do what it says it will do. The medicines purchased could be counterfeit or “fake”. Products bought through unverified or overseas websites may have undisclosed ingredients, contain a dose that differs from that on the label, or lack the active ingredient entirely. <a href="https://www.tga.gov.au/importing-therapeutic-goods">Not all medicines</a> can be legally imported through the personal importation scheme. Certain medicines are never allowed to be imported into Australia, and others can only be imported by a medical professional on behalf of a patient. So if you attempt to import a restricted medicine, the Australian Border Force <a href="https://www.abf.gov.au/entering-and-leaving-australia/can-you-bring-it-in/categories/medicines-and-substances">may seize it</a>. Not only would you lose your medicine, but you could also receive a fine or face <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use#:%7E:text=If%20you%20try%20to%20import,a%20fine%20or%20jail%20time.">jail time</a>. As with any purchase from an overseas business, there is also a risk you may lose your money and you might not be protected by Australian consumer laws. If you do choose to import medicines by buying them from an overseas website, you should also consider what could happen if delivery is delayed and you don’t get your medicine in time. <h2>Where can I get more advice?</h2> If you are thinking about importing medicines you should first discuss this with a health professional, such as your GP or pharmacist. They can help you determine if personal importation is permitted for the medicine you need. You can also discuss if this is the best option for you. If you are having difficulty covering the cost of your medicines your doctor or pharmacist can also explore other potential alternatives to ensure you are receiving the most cost-effective treatment available in Australia. <h2>Where do I go online?</h2> If you then decide to import, here are some reputable sites to help navigate the global online medicines market: <ul> <li> <a href="https://everyone.org/">everyone.org</a> helps people everywhere in the world access the latest medicines not available in their own countries </li> <li> <a href="https://buysaferx.pharmacy/">Alliance for Safe Online Pharmacies</a> is a not-for-profit organisation that collates information on how to find safe online pharmacies based in different regions of the world </li> <li> <a href="https://www.pharmacychecker.com/accredited-online-pharmacies/">PharmacyChecker</a> has also collated a list of trusted online pharmacies that ship medicines internationally. </li> </ul> Australian government websites about importing medicines include those from <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use">the TGA</a> and on what to consider when buying medicines online from <a href="https://www.healthdirect.gov.au/buying-medicines-online#overseas">overseas</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219394/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, Senior Lecturer in Pharmacy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images 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/taking-expensive-medicines-or-ones-unavailable-in-australia-importing-may-be-the-answer-219394">original article</a>.

Caring

Why are so many Australians taking antidepressants?

<a href="https://theconversation.com/profiles/jon-jureidini-1609">Jon Jureidini</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Around <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">one in seven Australians</a> take antidepressants; more than <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">3.5 million</a> of us had them dispensed in 2021–22. This is <a href="https://www.mja.com.au/journal/2016/204/9/unfulfilled-promise-antidepressant-medications#:%7E:text=Summary,is%20lower%20than%20previously%20thought.">one of the highest</a> antidepressant prescribing rates in the world. Guidelines mostly recommend antidepressants for <a href="https://www.nice.org.uk/guidance/ng222">more severe depression</a> and <a href="https://www.nice.org.uk/guidance/cg113/resources/generalised-anxiety-disorder-and-panic-disorder-in-adults-management-pdf-35109387756997">anxiety</a> but not as first-line treatment for less severe depression. Less commonly, antidepressants may be <a href="https://www.ncbi.nlm.nih.gov/books/NBK538182/">prescribed for</a> conditions such as chronic pain and migraine. Yet prescription rates continue to increase. Between 2013 and 2021, the antidepressant prescription rate in Australia <a href="https://www.publish.csiro.au/PY/pdf/PY23168">steadily increased</a> by 4.5% per year. So why are so many Australians taking antidepressants and why are prescriptions rising? The evidence suggests they’re over-prescribed. So how did we get here? <h2>Enter the antidepressant ‘blockbusters’</h2> In the 1990s, pharmaceutical companies <a href="https://www.nature.com/articles/d41573-022-00213-z">heavily promoted</a> new selective serotonin reuptake inhibitor (SSRI) antidepressants, including Prozac (fluoxetine), Zoloft (sertraline) and Lexapro (escitalopram). These drugs were thought to be less dangerous in overdoses and seemed to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/">fewer side effects</a> than the tricyclic antidepressants they replaced. Pharmaceutical companies marketed SSRIs energetically and often exaggerated their benefits, including by paying “key opinion leaders” – <a href="https://www.bmj.com/content/336/7658/1402">high-status clinicians</a> to promote them. This prompted <a href="https://www.mja.com.au/journal/2004/181/7/making-new-choices-about-antidepressants-australia-long-view-1975-2002">substantial growth</a> in the market. SSRIs earned billions of dollars for their manufacturers when on patent. While now relatively cheap, they still prove <a href="https://www.prnewswire.com/news-releases/antidepressant-drugs-market-to-reach-15-98-bn-by-2023-globally-at-2-1-cagr-says-allied-market-research-873540700.html">lucrative</a> because of high prescribing levels. <h2>Why are antidepressants prescribed?</h2> The majority (85%) of antidepressants are prescribed in <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">general practice</a>. Some are prescribed for more severe depression and anxiety. But contrary to clinical guidelines, GPs also <a href="https://www1.racgp.org.au/ajgp/2021/december/antidepressant-prescribing-in-general-practice">prescribe</a> them as a first-line treatment for less severe depression. GPs also prescribe antidepressants to patients experiencing distress but who don’t have a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504011/#:%7E:text=Among%20antidepressant%20users%2C%2069%25%20never,current%20physical%20problems%20(e.g.%2C%20loss">psychiatric diagnosis</a>. A friend dealing with her husband’s terminal illness, for example, was encouraged to take antidepressants by her long-term GP, even though her caring capacity wasn’t impaired. Another, who cried when informed she had breast cancer, was immediately offered a prescription for antidepressants. There are several reasons why someone may take antidepressants when they’re not needed. A busy GP might be looking for a convenient solution to a complex and sometimes intractable problem. Other times, patients request a prescription. They may be encouraged by an <a href="https://www.theaustralian.com.au/inquirer/seratonin-theory-of-depression-under-attack-amid-to-push-to-deprescribe-antidepressants/news-story/f74ca1a6018110e3d680b8d5ce01bc2c">acquaintance’s good experience</a> or looking for other ways to <a href="https://www.penguinrandomhouse.com/books/321259/listening-to-prozac-by-peter-d-kramer/">improve their mental health</a>. Most patients believe antidepressants restore a chemical imbalance that underpins depression. This is <a href="https://www.nature.com/articles/s41380-022-01661-0">not true</a>. Antidepressants are emotional (and sexual) <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/">numbing agents</a> – sometimes sedating, sometimes energising. Those effects suit some people, for example, if their emotions are too raw or they lack energy. For others, they come with <a href="https://www.healthdirect.gov.au/antidepressants">troubling side effects</a> such as insomnia, restlessness, nausea, weight gain. Around half of users have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007725/">impaired sexual function</a> and for some, this <a href="https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-023-00447-0">sexual dysfunction persists</a> after stopping antidepressants. <h2>How long do people take antidepressants?</h2> Most experts and <a href="https://www.nice.org.uk/guidance/ng222">guidelines</a> recommend specific prescribing regimes of antidepressants, varying from months to two years. However, most antidepressants are consumed by two categories of people. Around half of patients who start antidepressants don’t like them and <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-9-38#:%7E:text=Medication%20possession%20rates&text=Although%20the%20mean%20MPR%20of,group%20difference%20(Table%203).">stop within weeks</a>. Of those who do take them for months, many continue to use them indefinitely, often for many years. <a href="https://www1.racgp.org.au/ajgp/2021/december/antidepressant-prescribing-in-general-practice">Long-term use</a> (beyond 12 months) is driving much of the increase in antidepressant prescribing. Some people try to stop taking antidepressants but are prevented from doing so by <a href="https://www.sciencedirect.com/science/article/abs/pii/S221503661930032X">withdrawal symptoms</a>. Withdrawal symptoms – including “<a href="https://pubmed.ncbi.nlm.nih.gov/35144325/">brain zaps</a>”, dizziness, restlessness, vertigo and vomiting – can cause significant distress, impaired work function and relationship breakdown. Across 14 studies that examined antidepressant withdrawal, around 50% of users <a href="https://www.sciencedirect.com/science/article/abs/pii/S221503661930032X">experienced withdrawal symptoms</a> when coming off antidepressants, which can be mistaken for recurrence of the initial problem. We are conducting a <a href="https://adelaideuniwide.qualtrics.com/jfe/form/SV_3QqWrY5TBNUP1YO">survey</a> to better understand the experience in Australia of withdrawing from antidepressants. Antidepressants should not be stopped abruptly but gradually tapered off, with smaller and smaller doses. The recent release in Australia of the <a href="https://www.wiley.com/en-ca/The+Maudsley+Deprescribing+Guidelines%3A+Antidepressants%2C+Benzodiazepines%2C+Gabapentinoids+and+Z+drugs-p-9781119823025">Maudsley Deprescribing Guidelines</a> provides guidance for the complex regimes required for the tapering of antidepressants. <h2>We need to adjust how we view mental distress</h2> Overprescribing antidepressants is a symptom of our lack of attention to the <a href="https://onlinelibrary.wiley.com/doi/10.1002/wps.21160">social determinants of mental health</a>. It’s depressing to be poor (especially when your neighbours seem rich), unemployed or in an awful workplace, inadequately housed or fearful of family violence. It’s wrong to locate the problem in the individual when it belongs to society. Overprescribing is also symptomatic of medicalisation of distress. Most diagnoses of depression and anxiety are <a href="https://karger.com/psp/article-pdf/37/6/259/3489408/000081981.pdf">descriptions masquerading as explanations</a>. For each distressed person who fits the pattern of anxiety or depression, the meaning of their presentation is different. There may be a medical explanation, but most often meaning may be found in the person’s struggle with difficult feelings, their relationships and other life circumstances such as terrible disappointments or grief. GPs’ overprescribing reflects the pressures they experience from workload, unrealistic expectations of their capacity and misinformation from pharmaceutical companies and key opinion leaders. They need better support, resources and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822978/">evidence</a> about the limited <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">benefits</a> of antidepressants. GPs also need to ensure they discuss with their patients the potential adverse effects of antidepressants, and when and how to safely stop them. But the fundamental problem is social and can only be properly addressed by meaningfully addressing inequality and changing community attitudes to distress.<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/221857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jon-jureidini-1609">Jon Jureidini</a>, Research Leader, Critical and Ethical Mental Health research group, Robinson Research Institute, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">original article</a>.

Mind

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

<a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person. The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors. Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s. The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million. <h2>What’s CJD got to do with Alzehimer’s?</h2> CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell. Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s. <h2>Human growth hormone used to come from donated organs</h2> Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue. But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>. An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people. hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk. <h2>What are the latest findings about Alzheimer’s disease?</h2> The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission. The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease. They considered other explanations for the findings but concluded donated hGH was the likely cause. Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease. Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible. However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident. <h2>When was this process used in Australia?</h2> In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility. <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch. The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small. Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution. <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide. Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk. The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<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/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images 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/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.

Mind

"Your GPS is wrong": Hilarious outback sign causes double takes

In the ongoing battle between technology and good old-fashioned road signs, it seems the good people of Quairading, a tiny town in Western Australia, have taken matters into their own hands. The battleground? Old Beverley Road, a path that might be best described as the Bermuda Triangle of rural routes. A local Facebook post revealed the existence of at least two signs urging drivers to defy their GPS and embark on a detour through the town. The signs don't beat around the bush either, bluntly stating, "Your GPS is wrong, this is not the best route to Perth". It's a brave move, considering most people tend to trust their navigation apps more than their own instincts (or road signs). The post quickly became a social media sensation, garnering over 15,000 likes and hundreds of comments. One person couldn't contain their excitement, proclaiming, "Finally vindicated, I've been telling my GPS they're wrong for years!" Some conspiracy theorists speculated that this was all part of an elaborate marketing scheme by Quairading to boost tourism. "I think it's a clever ploy by Quairading to make tourists drive through their town," one person suggested. "Maybe stop for coffee, etc. Marketing 101." If it is intentional, hats off to Quairading for the creativity; they've managed to turn road safety into a guerrilla marketing campaign. Quairading Shire president Jo Haythornthwaite responded to the comments by setting the record straight, explaining that Google and GPS suggest Old Beverley Road as a shortcut to Perth, but in reality, it's a slippery, gravel-covered disaster waiting to happen. According to her, "What Google does not recognise is that their suggestion of taking the Old Beverley Road leads travellers and tourists onto a low-lying road that has 15kms of gravel, is very slippery when wet, and is prone to flooding." To combat the persistent GPS misguidance, the Shire tried the diplomatic route, requesting that Google update its algorithm to favour the safer alternative. Unfortunately, it seems Google was either too busy directing people to non-existent streets or enjoying a virtual road trip to pay attention. Frustrated but undeterred, the signs were erected as a last-ditch effort to send a clear message: "Turn around! Or prepare for an off-road adventure you didn't sign up for!" The signs, much like a seasoned comedian, delivered the punchline: a noticeable decrease in traffic along Old Beverley Road. While Quairading might not have exact numbers, they've declared victory in their quest to keep road users safe. As Ms Haythornthwaite put it, "So, without knowing specific numbers, we believe that, although some continue to use the less safe route of the Old Beverley Road, many travellers are taking notice and following the signage." And so, the small town of Quairading triumphs in the great GPS versus road sign showdown. Perhaps, in the grand scheme of things, we all need a little more trust in the wisdom of quirky road signs. After all, who knows the terrain better than the locals who've been there, done that, and put up the signs to prove it?

Travel Trouble

Selfie-taking tourists launched from Venice gondola after refusing to sit down

A group of rowdy tourists have ended up in the waters of a Venice canal after causing a ruckus onboard the boat. Six passengers were travelling on a canal in the Italian hotspot when the boat was heading towards a low bridge that they needed to pass under. The gondolier explained to the tourists that they needed to sit down and be still as the boat passed under the bridge, explaining that a change in weight would cause an issue. Despite the gondolier's warning, the tourists continued to stand up and move around the narrow vessel to take selfies of their journey. Predictably, ignoring the requests of the gondolier caused the vessel to capsize, sending the tourists into the freezing water as the gondolier jumped to safety. <iframe style="border: none; overflow: hidden;" src="https://www.facebook.com/plugins/video.php?height=314&href=https%3A%2F%2Fwww.facebook.com%2FSkyNewsAustralia%2Fvideos%2F854034223389998%2F&show_text=false&width=560&t=0" width="560" height="314" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe> No one was injured in the mishap, as the tourists swam to safety at the bank of the canal, before seeking refuge at La Fenice theatre, according to Venice police. According to a spokesman for the city’s gondola association, the gondola was not damaged, although the upholstered furniture in the vessel was ruined by the water. The spokesperson went on to confirm that the gondolier had instructed the tourists not to move around or stand up to take selfies during the manoeuvre, but due to a language barrier, the tourists did not comply. A video of the incident was posted to an Instagram page called Venezia Non è Disneyland (Venice Is Not Disneyland), an account run by young locals to chronicle tourism in the city, with the video being flooded with comments about the misbehaved tourists. Many Italian locals were quick to point out how rowdy the tourists must've been to cause the incident, with many pointing out they "didn't know it was possible to capsize a gondola". Image credits: Facebook

Travel Trouble

Passenger slammed as he takes "manspreading to ANOTHER LEVEL"

A frequent flyer has sparked outrage online after posting a video of one man's poor plane etiquette. Claire Zhu, 27, who has gained a following while documenting her travels with boyfriend Peter Ovendorf, 29, after quitting their nine-to-five in what they call their "corporate gap year", shared the video on TikTok. "Goodbye," she captioned the clip, with a text overlay that read: "The way this man took manspreading to ANOTHER LEVEL on my flight." At the start of the clip, Claire showed herself covering her mouth in shock, before panning over to the man sitting across from her, with his legs spread so wide that it crossed the aisle and reached her seat. His other foot was sitting so close to the passenger next to him, that even they could barely move. <div class="embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Figtree, Roboto, 'Noto Sans Hebrew', 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;"><iframe class="embedly-embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border-width: 0px; border-style: initial; vertical-align: baseline; width: 580px; max-width: 100%; outline: none !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7307690077772172587&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40claireandpeter%2Fvideo%2F7307690077772172587&image=https%3A%2F%2Fp19-sign.tiktokcdn-us.com%2Fobj%2Ftos-useast5-p-0068-tx%2FoovOIIFx0GSNezDUDCDAQEa7R5lgQBDEliE7fV%3Fx-expires%3D1701982800%26x-signature%3DNXp8xnv9BnN83wAEogQY%252BWxMv3Q%253D&key=59e3ae3acaa649a5a98672932445e203&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> People flooded to the comments to express their anger. "I would lose my mind," wrote one person. "That isn't man spreading, that's literally splitting," another quipped. "Absolutely not," added another. "Bestie you got to step on his foot. This is the final straw," commented a fourth. A few others were concerned that his actions might be hazardous. "He will trip someone!" one wrote. "Not only across the aisle but made it into your floor space..." another added. One commenter even shared their own horrific experience with another passenger taking over their space. "A lady did this to me on a long haul flight except I felt something on my thigh AND IT WAS HER FOOT," they said. Images: TikTok

Travel Trouble

Bring a plate! What to take to Christmas lunch that looks impressive (but won’t break the bank)

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/amy-kirkegaard-1401256">Amy Kirkegaard</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/breanna-lepre-1401257">Breanna Lepre</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Christmas lunch is at your friend’s house this year, and they’ve asked you to bring a plate. Money is tight. So, you find yourself wondering, “What’s cheap, healthy but also looks impressive?” While a tray of mangoes would certainly be a cheap, healthy and colourful contribution, you want to look as if you’ve put in a bit of effort. If you’re struggling for inspiration, here are some tried and tested ideas. <h2>First, choose your ingredients</h2> Check your pantry for inspiration or ingredients. Crackers, dried fruit or nuts are great ideas for a charcuterie board. You can use herbs and spices to add flavour to dishes, or you could use up packets of dried pasta to make a <a href="https://nomoneynotime.com.au/healthy-easy-recipes/salmon-and-pasta-salad">pasta salad</a>. This is also a great way to clean out your pantry. Focus on fruit and vegetables that are in season, so are cheaper and more readily available. Keep an eye out at your local fruit and veggie shop or market as it will usually have in-season fruit and vegetables in bulk quantities at reduced prices. Check out <a href="http://seasonalfoodguide.com/australia-general-seasonal-fresh-produce-guide-fruits-vegetables-in-season-availability.html">this seasonal food guide</a> to help you plan your Christmas menu. Ask around for deals by chatting to your local butcher, fishmonger or grocer and let them know your budget. They may suggest cheaper cuts of meat (such as, <a href="https://www.australianbutchersguild.com.au/the-blog/the-abg-blog/underrated-cuts-of-beef/">oyster</a>, <a href="https://www.australianbeef.com.au/know-your-meat/beef-cuts/">blades, rump caps</a>). Try cooking <a href="https://www.bestrecipes.com.au/recipes/slow-cooker-corned-beef-mustard-sauce-recipe/z47lwrbv?r=entertaining/9clz7475&h=entertaining">corned beef</a> or <a href="https://www.bbcgoodfood.com/recipes/slow-cooker-roast-chicken">roast chicken</a> in a slow cooker with lots of vegetables. Slow-cooked meals can be frozen and can come in handy for left-overs. Lean into <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608274/">legumes</a>. These are packed with fibre, protein, vitamins and minerals. They are also budget-friendly and a great way to add texture to salads. Tinned chickpeas, or cannellini, kidney, or butter beans are quick and easy additions that can make filling dishes go further. You could even turn tinned chickpeas into homemade hommus for a healthy and delicious side dish. Check out these healthy legume <a href="https://nomoneynotime.com.au/healthy-easy-recipes/filter/keywords--legumes">recipes</a>. <h2>7 ways to keep food costs down this Christmas</h2> 1. Plan ahead Plan your menu by asking how many people are coming and checking for any food preferences or dietary requirements. Check for items you already have at home, and make a shopping list for only what you <a href="https://www.emerald.com/insight/content/doi/10.1108/BFJ-12-2017-0726/full/html">need</a>. 2. Use free recipes Use free online recipe collections and e-books tailored for budget cooking that can help you design your Christmas menu to meet your budget. This <a href="https://nomoneynotime.com.au/uploads/Our-Guide-to-the-Perfect-Christmas-Feast.pdf">one</a> was created by a group of <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitians</a> and has healthy, budget friendly recipes and ideas. You could also try this budget friendly collection of Christmas recipes from <a href="https://www.taste.com.au/recipes/collections/budget-christmas-recipes">taste</a>. 3. Involve the family Get together with other family members and make it a challenge to see who can make the cheapest, most delicious dish. Get the kids involved in fun activities, such as making a DIY gingerbread house or putting together mixed skewers for the barbecue. 4. Pool your resources Larger quantities of a single dish will be cheaper than multiple different dishes (and easier to prepare). 5. Frozen is fine Use frozen fruits and vegetables if you need to. These can have just as <a href="https://pubmed.ncbi.nlm.nih.gov/25526594/">many vitamins and minerals</a> as fresh, are often cheaper than fresh produce and last longer. Try using frozen berries to decorate the pavlova or add them to your favourite cake, muffin or pie. 6. Make your own drinks You could make your own drinks, such as home-brewed iced tea. See if anyone in your family has a soda stream you can borrow to make sparkling mineral water. Add some freshly squeezed lemon or lime for extra flavour. 7. Reduce waste Use your own crockery and re-use leftovers to reduce waste. After all, washing up is cheaper than buying plastic or paper plates and better for the environment. Remember to save any leftovers and re-use them. Leftover fresh vegetables could be used to make a hearty soup or chutney. <h2>It doesn’t have to be perfect</h2> Christmas comes and goes quickly. If your cooking ideas don’t work out, it’s not the end of the world. Choosing healthy foods on a budget is important all year around, so you may like to think about trying these tips throughout the years to come. <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/196565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/amy-kirkegaard-1401256">Amy Kirkegaard</a>, Postdoctoral Research Fellow, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/breanna-lepre-1401257">Breanna Lepre</a>, Research Fellow, Mater Research Institute, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian and Researcher, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images 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/bring-a-plate-what-to-take-to-christmas-lunch-that-looks-impressive-but-wont-break-the-bank-196565">original article</a>.

Food & Wine

It’s beginning to look a lot like burnout. How to take care of yourself before the holidays start

<a href="https://theconversation.com/profiles/sophie-scott-1462197">Sophie Scott</a>, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> and <a href="https://theconversation.com/profiles/gordon-parker-94386">Gordon Parker</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> It’s getting towards the time of the year when you might feel more overwhelmed than usual. There are work projects to finish and perhaps exams in the family. Not to mention the pressures of organising holidays or gifts. Burnout is a real possibility. Burnout is defined by the <a href="https://www.who.int/standards/classifications/frequently-asked-questions/burn-out-an-occupational-phenomenon#:%7E:text=Burn%2Dout%20is%20defined%20in,has%20not%20been%20successfully%20managed.">World Health Organization</a> (WHO) as having three main symptoms – exhaustion, loss of empathy and reduced performance at work. Australian <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">research</a> argues for a broader model, particularly as the WHO’s third symptom may simply be a consequence of the first two. So what is burnout really? And how can you avoid it before the holidays hit? <h2>More than being really tired</h2> The Australian research model endorsed exhaustion as the primary burnout symptom but emphasised burnout should not be simply equated with exhaustion. The second symptom is loss of empathy (or “compassion fatigue”), which can also be experienced as uncharacteristic cynicism or a general loss of feeling. Nothing much provides pleasure and joie de vivre is only a memory. The third symptom (cognitive impairment) means sufferers find it <a href="https://www.abc.net.au/news/2023-02-13/gordon-parker-says-the-burnout-definition-needs-to-broaden/101920366">difficult to focus</a> and retain information when reading. They tend to scan material – with some women reporting it as akin to “baby brain”. Research <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">suggests</a> a fourth symptom: insularity. When someone is burnt out, they tend to keep to themselves, not only socialising less but also obtaining little pleasure from interactions. A potential fifth key feature is an unsettled mood. And despite feeling exhausted, most individuals report insomnia when they’re burnt out. In severe cases, immune functioning can be compromised (so that the person may report an increase in infections), blood pressure may drop and it may be difficult or impossible to get out of bed. Predictably, such features (especially exhaustion and cognitive impairment) do lead to compromised work performance. Defining burnout is important, as rates have <a href="https://dspace.library.uu.nl/bitstream/handle/1874/420608/Burnout_Fatigue_Exhaustion.pdf?sequence=1&isAllowed=y">increased</a> in the last few decades. <h2>‘Tis the season</h2> For many, the demands of the holidays cause exhaustion and risk burnout. People might feel compelled to shop, cook, entertain and socialise more than at other times of year. While burnout was initially defined in those in formal employment, we now recognise the same pattern can be experienced by those meeting the needs of children and/or elderly parents – with such needs typically increasing over Christmas. Burnout is generally viewed according to a simple stress-response model. Excessive demands lead to burnout, without the individual bringing anything of themselves to its onset and development. But the Australian <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">research</a> has identified a richer model and emphasised how much personality contributes. Formal carers, be they health workers, teachers, veterinarians and clergy or parents – are <a href="https://www.taylorfrancis.com/books/mono/10.4324/9781003333722/burnout-gordon-parker-gabriela-tavella-kerrie-eyers">more likely</a> to experience burnout. But some other professional groups – such as lawyers – are also at high risk. In essence, “good” people - who are dutiful, diligent, reliable, conscientious and perfectionistic (either by nature or work nurture) – are at the <a href="https://journals.lww.com/jonmd/Abstract/2020/06000/A_Qualitative_Reexamination_of_the_Key_Features_of.4.aspx">greatest risk</a> of burnout. <h2>6 tips for avoiding seasonal burnout</h2> You may not be able to change your personality, but you can change the way you allow it to “shape” activities. Prioritising, avoiding procrastination, decluttering and focusing on the “big picture” are all good things to keep in mind. Managing your time helps you regain a sense of control, enhances your efficiency, and reduces the likelihood of feeling overwhelmed by responsibilities. 1. Prioritise tasks Rank tasks based on urgency and importance. The Eisenhower Matrix, <a href="https://www.amazon.com.au/7-Habits-Highly-Effective-People/dp/0743269519">popularised</a> by author Stephen R Covey, puts jobs into one of four categories: <ul> <li> urgent and important </li> <li> important but not urgent </li> <li> urgent but not important </li> <li> neither urgent nor important. </li> </ul> This helps you see what needs to be top priority and helps overcome the illusion that everything is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159458/">urgent</a>. 2. Set realistic goals Break down large goals into smaller, manageable tasks to be achieved each day, week, or month – to prevent feeling overwhelmed. This could mean writing a gift list in a day or shopping for a festive meal over a week. Use tools such as calendars, planners or digital apps to schedule tasks, deadlines and appointments. 3. Manage distractions Minimise <a href="https://psycnet.apa.org/record/2023-66900-001">distractions</a> that hinder productivity and time management. <a href="https://www.journals.uchicago.edu/doi/full/10.1086/691462">Research</a> finds people complete cognitive tasks better with their phones in another room rather than in their pockets. People with phones on their desks performed the worst. Setting specific work hours and website blockers can limit distractions. 4. Chunk your time Group similar tasks together and allocate specific time blocks to focus on them. For example, respond to all outstanding emails in one stint, rather than writing one, then task-switching to making a phone call. This approach <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075496/">increases efficiency</a> and reduces the time spent transitioning between different activities. 5. Take breaks A <a href="https://psycnet.apa.org/record/2022-90592-001">2022 systematic review</a> of workplace breaks found taking breaks throughout the day improves focus, wellbeing and helps get more work done. 6. Delegate Whether at home or work, you don’t have to do it all! Identify tasks that can be effectively delegated to others or automated. To finish the year feeling good, try putting one or more of these techniques into practice and prepare for a restful break.<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/216175/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sophie-scott-1462197">Sophie Scott</a>, Associate Professor (Adjunct), Science Communication, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> and <a href="https://theconversation.com/profiles/gordon-parker-94386">Gordon Parker</a>, Scientia Professor, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images 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/its-beginning-to-look-a-lot-like-burnout-how-to-take-care-of-yourself-before-the-holidays-start-216175">original article</a>.

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Don’t give mum chocolates for Mother’s Day. Take on more housework, share the mental load and advocate for equality instead

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"Your GPS is wrong": Hilarious outback sign causes double takes

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Passenger slammed as he takes "manspreading to ANOTHER LEVEL"

Bring a plate! What to take to Christmas lunch that looks impressive (but won’t break the bank)

It’s beginning to look a lot like burnout. How to take care of yourself before the holidays start

Our Partners

News

Shop

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Newspaper

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Entertainment

Travel

Health

Lifestyle

Finance

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Keep up to date

Search

Don’t give mum chocolates for Mother’s Day. Take on more housework, share the mental load and advocate for equality instead

"Not good enough": Karl takes aim at airline cancellation

As you travel, pause and take a look at airport chapels

Love is in the air! Pilot proposes to flight attendant girlfriend before take off

Could not getting enough sleep increase your risk of type 2 diabetes?

What happens when I stop taking a drug like Ozempic or Mounjaro?

"What has to happen?" Kyle Sandilands' controversial take after knife attacks

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

Millions of phones at risk of being cut off from calling triple-0

94-year-old grandma takes on huge travel challenge

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

Undernourished, stressed and overworked: cost-of-living pressures are taking a toll on Australians’ health

Taking expensive medicines or ones unavailable in Australia? Importing may be the answer

Why are so many Australians taking antidepressants?

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

"Your GPS is wrong": Hilarious outback sign causes double takes

Selfie-taking tourists launched from Venice gondola after refusing to sit down

Passenger slammed as he takes "manspreading to ANOTHER LEVEL"

Bring a plate! What to take to Christmas lunch that looks impressive (but won’t break the bank)

It’s beginning to look a lot like burnout. How to take care of yourself before the holidays start

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