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

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722"><em>The University of Melbourne</em></a></em></p> <p>When it comes to our experience of the internet, “the times, <a href="https://en.wikipedia.org/wiki/The_Times_They_Are_a-Changin%27_(song)">they are a-changin’</a>”, as Bob Dylan would say. You can’t quite recall how, but the internet certainly feels different these days.</p> <p>To some, it is “<a href="https://www.npr.org/2024/01/16/1224878097/everyday-users-are-complaining-that-the-internet-is-more-chaotic-than-ever">less fun and less informative</a>” than it used to be. To others, online searches are made up of “<a href="https://www.theverge.com/c/23998379/google-search-seo-algorithm-webpage-optimization?src=longreads">cookie cutter</a>” pages that drown out useful information and are saturated with scams, spam and content generated by artificial intelligence (AI).</p> <p>Your social media feeds are full of eye-catching, provocative, hyper-targeted, or anger-inducing content, from <a href="https://theconversation.com/the-dead-internet-theory-makes-eerie-claims-about-an-ai-run-web-the-truth-is-more-sinister-229609">bizarre AI-generated imagery</a> to robot-like comments. You’re lucky if your video feeds are not solely made up of exhortations to “subscribe”.</p> <p>How did we get here? And can we claw our way back?</p> <h2>Commercial interests rule</h2> <p>One major factor contributing to the current state of the internet is its over-commercialisation: financial motives drive much of the content. This has arguably led to the prevalence of sensationalism, prioritising virality over information quality.</p> <p>Covert and deceptive advertising is widespread, blurring the line between commercial and non-commercial content to attract more attention and engagement.</p> <p>Another driving force is the dominance of tech giants like Google, Meta and Amazon. They reach billions worldwide and wield immense power over the content we consume.</p> <p>Their platforms use advanced tracking technologies and opaque algorithms to generate hyper-targeted media content, powered by extensive user data. This creates <a href="https://www.campaignasia.com/article/the-echo-chamber-effect-how-algorithms-shape-our-worldview/491762">filter bubbles</a>, where users are exposed to limited content that reinforces their existing beliefs and biases, and <a href="https://philarchive.org/archive/NGUECA">echo chambers</a> where other viewpoints are actively discredited.</p> <p>Bad actors like <a href="https://abcnews.go.com/Technology/ai-fuel-financial-scams-online-industry-experts/story?id=103732051">cyber criminals and scammers</a> have been an enduring problem online. However, evolving technology like generative AI has further empowered them, enabling them to create highly realistic fake images, deepfake videos and <a href="https://www.newyorker.com/science/annals-of-artificial-intelligence/the-terrifying-ai-scam-that-uses-your-loved-ones-voice">voice cloning</a>.</p> <p>AI’s ability to automate content creation has also flooded the internet with low-quality, misleading and harmful material at an unprecedented scale.</p> <p>In sum, the accelerated commercialisation of the internet, the dominance of media tech giants and the presence of bad actors have infiltrated content on the internet. The rise of AI further intensifies this, making the internet more chaotic than ever.</p> <h2>Some of the ‘good’ internet remains</h2> <p>So, what was the “good internet” some of us long for with nostalgia?</p> <p>At the outset, the internet was meant to be a free egalitarian space people were meant to “surf” and “browse”. Knowledge was meant to be shared: sites such as Wikipedia and The Internet Archive are continuing bastions of knowledge.</p> <p>Before the advent of filter bubbles, the internet was a creative playground where people explored different ideas, discussed varying perspectives, and collaborated with individuals from “outgroups” – those outside their social circles who may hold opposing views.</p> <p>Early social media platforms were built on the ethos of reconnecting with long-lost classmates and family members. Many of us have community groups, acquaintances and family we reach out to via the internet. The “connection” aspect of the internet remains as important as ever – as we all saw during the COVID pandemic.</p> <p>What else do we want to preserve? Privacy. A New Yorker cartoon joke in 1993 stated that “<a href="https://web.archive.org/web/20051029045942/http://www.unc.edu/depts/jomc/academics/dri/idog.html">on the internet, nobody knows you’re a dog</a>”. Now everyone – especially advertisers – wants to know who you are. To quote the <a href="https://www.oaic.gov.au/privacy/your-privacy-rights/your-personal-information/what-is-privacy">Office of the Australian Information Commissioner</a>, one of the tenets of privacy is “to be able to control who can see or use information about you”.</p> <p>At the very least, we want to control what big tech knows about us, especially if they could stand to profit from it.</p> <h2>Can we ever go back?</h2> <p>We can’t control “a changin’” times, but we can keep as much of the good parts as we can.</p> <p>For starters, we can vote with our feet. Users can enact change and bring awareness to problems on existing platforms. In recent times, we have seen this with the <a href="https://theconversation.com/thinking-of-breaking-up-with-twitter-heres-the-right-way-to-do-it-195002">exodus of users</a> from X (formerly Twitter) to other platforms, and the <a href="https://www.economist.com/the-economist-explains/2023/06/26/why-reddit-users-are-protesting-against-the-sites-leadership">platform-wide protest against Reddit</a> for changing its third-party data access policies.</p> <p>However, voting with our feet is only possible when there’s competition. In the case of X, various other platforms – from Mastodon to Threads to Bluesky – enable users to pick one that aligns with their preferences, values and social circles. Search engines have alternatives, too, such as DuckDuckGo or Ecosia.</p> <p>But competition can only be created by moving to decentralised systems and removing monopolies. This actually happened in the early days of the internet during the 1990s “<a href="https://thehistoryoftheweb.com/browser-wars/">browser wars</a>”, when Microsoft was eventually accused of illegally monopolising the web browser market in <a href="https://en.wikipedia.org/wiki/United_States_v._Microsoft_Corp.">a landmark court case</a>.</p> <p>As users of technology, all of us must remain vigilant about threats to our privacy and knowledge. With cheap and ubiquitous generative AI, misleading content and scams are more realistic as ever.</p> <p>We must exercise healthy scepticism and ensure those most at risk from online threats – such as children and older people – are educated about potential harms.</p> <p>Remember, the internet is not optimised for your best interests. It’s up to you to decide how much power you give to the tech giants who are fuelling theirs.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, Senior Lecturer of Information Systems, School of Computing and Information Systems; and (Honorary) Senior Fellow, Melbourne Law School, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, Associate Professor in Media and Communications, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-internet-is-worse-than-it-used-to-be-how-did-we-get-here-and-can-we-go-back-236513">original article</a>.</em></p> </div>

Technology

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Your gas stove might be making your asthma worse. Here’s what you can do about it

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>We may think of air pollution as an outdoor problem, made up of car exhaust and smog. But if the air inside our homes is polluted, this can also affect our health.</p> <p>In Australia, around 12% of childhood asthma can <a href="https://pubmed.ncbi.nlm.nih.gov/29642816/">be attributed</a> to gas stoves and the toxic chemicals they release into the air. And while there’s a growing push to phase out gas indoors, some 38% of Australian households <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">rely on natural gas</a> for cooking.</p> <p>Recommended interventions – such as replacing a gas stove with electric – may not be possible for those who are renting or struggling with the cost of living. This is important because, as our <a href="https://ghrp.biomedcentral.com/articles/10.1186/s41256-024-00361-2">research</a> shows, childhood asthma is more common in socioeconomically disadvantaged areas.</p> <p>If you’re living with gas, here’s how it can affect you or your child’s asthma, and what you can do to improve air quality.</p> <h2>What is asthma?</h2> <p>Asthma is the most common chronic condition in Australian children. The respiratory condition affects <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">almost</a> 400,000 of those aged aged 14 and under – close to 9% of that age group.</p> <p>Asthma narrows the airways and obstructs airflow, making it hard to breath. Many people manage the condition with inhalers and <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma action plans</a>. But it can be serious and even fatal. Australian emergency departments saw <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">56,600 presentations</a> for asthma in 2020-21.</p> <p>While there is no single cause for asthma, both indoor and outdoor air pollution play a <a href="https://pubmed.ncbi.nlm.nih.gov/38247719/">significant role</a>.</p> <p>Being exposed to small <a href="https://aafa.org/asthma/asthma-triggers-causes/air-pollution-smog-asthma/#:%7E:text=Air%20pollution%20can%20increase%20your,if%20you%20already%20have%20asthma.&amp;text=Small%20airborne%20particles%2C%20found%20in,%E2%80%9Cparticulate%20matter%E2%80%9D%20or%20PM.">airborne particles</a> increases your risk of getting asthma, and can aggravate symptoms if you already have it.</p> <h2>Gas stoves release nitrogen dioxide</h2> <p>The gas stoves commonly found in Australian homes release toxic chemicals into the air. They include carbon monoxide (CO), PM₂.₅ (small particles, often from <a href="https://www.epa.vic.gov.au/for-community/environmental-information/air-quality/pm25-particles-in-the-air">smoke</a>), benzene, formaldehyde and nitrogen dioxide (NO₂). All are harmful, but nitrogen dioxide in particular is <a href="https://go.gale.com/ps/i.do?id=GALE%7CA656312383&amp;sid=googleScholar&amp;v=2.1&amp;it=r&amp;linkaccess=abs&amp;issn=00220892&amp;p=AONE&amp;sw=w&amp;userGroupName=anon%7E7027bb9f&amp;aty=open-web-entry">associated</a> with asthma developing and getting <a href="https://www.atsjournals.org/doi/10.1164/rccm.200408-1123OC">worse</a>.</p> <p>Gas heaters can also <a href="https://pubmed.ncbi.nlm.nih.gov/9731022/">produce</a> nitrogen dioxide.</p> <p>As nitrogen dioxide is a tasteless, invisible gas, it’s difficult to know how much is in your air at home unless you have an air monitor. However one US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662932/">study</a> showed houses with gas stoves can have nitrogen dioxide levels three times higher than houses with electric stoves.</p> <p>This is particularly concerning for households with children, given children tend to spend <a href="https://pubmed.ncbi.nlm.nih.gov/11477521/">most</a> of their time indoors.</p> <h2>Banning gas</h2> <p>There is a growing push across Australia to replace gas stoves with electric stoves, which are more energy efficient and can reduce indoor air pollution.</p> <p><a href="https://www.premier.vic.gov.au/new-victorian-homes-go-all-electric-2024">Victoria</a> and the <a href="https://www.climatechoices.act.gov.au/energy/canberras-electrification-pathway/preventing-new-gas-network-connections">Australian Capital Territory</a> have announced bans on gas connections in new homes from 2024. Sydney’s Waverley council recently made a similar <a href="https://www.waverley.nsw.gov.au/environment/climate_resilience_and_reducing_emissions/go_electric">move</a>.</p> <p>But until a ban on using household gas appliances is implemented across the country, the problem persists for children who are currently living in old homes or rented properties with gas stoves.</p> <h2>Do exhaust fans in the kitchen help?</h2> <p>Using a high-efficiency <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">exhaust hood</a> placed over an existing gas cooktop can be effective. They can <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">capture</a> more than 75% of air pollutants and direct them outside.</p> <p>Cooking on the back burner – rather than the front burner – can also <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">improve their efficiency</a>.</p> <p>However exhaust hoods with lower flow rates, or hoods that don’t vent the air outside, are less effective.</p> <p>And an exhaust hood only improves air quality if you use it. One <a href="https://pubmed.ncbi.nlm.nih.gov/10520075/">study</a> in Melbourne found more than 40% of people didn’t use an exhaust hood regularly while cooking.</p> <p>For many people, installing high-efficiency exhaust hoods will not be practical – especially for those renting or experiencing socio-economic disadvantage.</p> <h2>Natural ventilation</h2> <p>There is a free way to ventilate your home. Keeping windows open during and after cooking will increase air flow and <a href="https://pubmed.ncbi.nlm.nih.gov/32970538/">evidence shows</a> this can improve overall air quality.</p> <p>However this is not always possible, especially during cooler months of the year which can be especially chilly in places such as Victoria and Tasmania.</p> <p>Unfortunately, people are also more likely to use gas heaters during those cooler months.</p> <h2>What about heaters?</h2> <p>There are two kinds of gas heaters, flued and unflued.</p> <p>Like cooking with gas, unflued gas heaters release air pollutants including nitrogen dioxide directly into the home. Flued heaters are better for air quality because they use a chimney, or “flue”, to send emissions outside.</p> <p>If you can, replacing your unflued gas heater with a flued one – or even better, an electric heater – can significantly <a href="https://pubmed.ncbi.nlm.nih.gov/15075170/">alleviate</a> asthma symptoms.</p> <p>If you can’t replace your unflued gas heater, <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/unflued-gas-heaters.aspx">do not use it overnight</a> in the room where you or your children sleep.</p> <p>Asthma can’t be cured, but its symptoms can be controlled by managing triggers – and this may be easier to do indoors than out. Improving air quality, even in a rented or old property, can help people with asthma breathe more easily.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238787/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, Senior Lecturer, School of Clinical Medicine, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-gas-stove-might-be-making-your-asthma-worse-heres-what-you-can-do-about-it-238787">original article</a>.</em></p> </div>

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

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather.</p> <p>It’s a common idea, but a myth.</p> <p>When we looked at the evidence, <a href="https://www.sciencedirect.com/science/article/pii/S0049017224000337">we found</a> no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains.</p> <p>So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on.</p> <h2>Weather can be linked to your health</h2> <p>The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures <a href="https://pubmed.ncbi.nlm.nih.gov/27021573/">may worsen</a> asthma symptoms. Hot temperatures <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00117-6/fulltext">increase the risk</a> of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease.</p> <p>Many people are also convinced the weather is linked to their aches and pains. For example, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1479-8077.2004.00099.x?casa_token=jvpSbA4szqoAAAAA%3ATyHyGaqXmfevWyuJe6LW_3Pap3IPHC8HSMTl3RN63mFzNO0X7ozQjBb6Bi3yVFuPjqkrf-WlB-J5A1q1">two in every three</a> people with knee, hip or hand osteoarthritis <a href="https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-15-66">say</a> cold temperatures trigger their symptoms.</p> <p>Musculoskeletal conditions affect more than <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions-comorbidity-australia/summary">seven million Australians</a>. So we set out to find out whether weather is really the culprit behind winter flare-ups.</p> <h2>What we did</h2> <p>Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies.</p> <p>We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included.</p> <p>We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry).</p> <h2>What we found</h2> <p>We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis.</p> <p>The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain.</p> <p>In order words, there is no <em>direct</em> link between the weather and back, knee or hip pain, nor will it give you arthritis.</p> <p>It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather.</p> <p>The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions.</p> <p>Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up.</p> <h2>Why do people blame the weather?</h2> <p>The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain.</p> <p>For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know <a href="https://pubmed.ncbi.nlm.nih.gov/28700451/">prolonged sitting</a>, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain.</p> <p>Likewise, changes in mood, often experienced in cold weather, trigger increases in both <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain.</p> <p>So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself.</p> <p>Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the <a href="https://link.springer.com/article/10.1186/s12891-018-1943-8">nocebo effect</a>.</p> <h2>What to do about winter aches and pains?</h2> <p>It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather).</p> <p>You can:</p> <ul> <li> <p>become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool</p> </li> <li> <p>lose weight if obese or overweight, as this is linked to <a href="https://jamanetwork.com/journals/jama/article-abstract/2799405">lower levels</a> of joint pain and better physical function</p> </li> <li> <p>keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep <a href="https://www.sciencedirect.com/science/article/pii/S0033350623003359">less well</a> in cold rooms</p> </li> <li> <p>maintain a healthy diet and <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">avoid smoking</a> or drinking high levels of alcohol. These are among <a href="https://ard.bmj.com/content/annrheumdis/82/1/48.full.pdf">key lifestyle recommendations</a> to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with <a href="https://pubmed.ncbi.nlm.nih.gov/36208321/">higher levels</a> of physical function.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235117/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, Rheumatologist and Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-your-aches-and-pains-dont-get-worse-in-the-cold-so-why-do-we-think-they-do-235117">original article</a>.</em></p> </div>

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Ambulance ramping is getting worse in Australia. Here’s why – and what we can do about it

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jonathan-karnon-290">Jonathan Karnon</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/andrew-partington-93821">Andrew Partington</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>We’ve seen countless <a href="https://www.heraldsun.com.au/leader/ballarat/ambulance-ramping-leaves-paramedics-unable-to-respond-to-emergencies-says-union/news-story/54b6fee380eb7b7f1c9b2784edf3d2cd">media reports</a> in recent days, weeks and months about the <a href="https://www.couriermail.com.au/news/queensland/qld-politics/worst-cases-of-ambulance-ramping-at-queensland-hospitals-revealed/news-story/bcf4833b5197774329cf983029d77cb4">ramping of ambulances</a> at <a href="https://thewest.com.au/news/health/ambulance-ramping-reaches-record-levels-in-june-as-hospitals-struggle-with-surging-winter-demand-c-15192504">hospital emergency departments</a> (EDs) around Australia.</p> <p>Ambulance ramping occurs when paramedics are made to wait at the hospital’s entrance and are unable to transfer their patient into the emergency department within an appropriate time frame – defined as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/our+performance/ambulance+waiting+times">30 minutes</a> in South Australia.</p> <p>Ramping is an indicator of hospital stress. It means patients are waiting longer to receive care in the emergency department, and patients requiring inpatient care are waiting longer to access a hospital bed.</p> <p>Research suggests <a href="https://www.mja.com.au/journal/2022/217/5/influence-ambulance-offload-time-30-day-risks-death-and-re-presentation-patients">ambulance ramping</a> and <a href="https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.13699">having to wait longer</a> for a hospital bed are associated with a greater risk of patients dying up to 30 days after their initial presentation.</p> <p>So why is ambulance ramping still a problem? And what can we do to fix it?</p> <h2>Ramping is getting worse</h2> <p>Available data indicate the problem has become worse over time. In <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/our+performance/ambulance+waiting+times">South Australia</a>, for example, ramping has been steadily increasing since 2017, from around 500 hours “ramped” per month to around 4,000 hours per month in 2024. This is the sum of the time ambulances spend waiting beyond 30 minutes after arriving at the hospital.</p> <p>In <a href="https://www.bhi.nsw.gov.au/data-portal">New South Wales</a>, we calculate the numbers of patients being ramped increased from around 44,000 patients per month in early 2022 to more than 50,000 in early 2024.</p> <h2>What’s driving the increase in ramping?</h2> <p>The ambulance ramping bottleneck reflects an imbalance between the number of people presenting at emergency departments and the capacity to treat patients and transfer those requiring inpatient care to a ward.</p> <p>Potential drivers of this imbalance are increased emergency department presentations and reduced availability of inpatient beds. The latter may reflect increased demand for beds, including longer hospital stays.</p> <p>Between the financial years 2018–19 and 2022–23 (the latest period for which figures are available), Australian Institute of Health and Welfare data show the numbers of more serious presentations (triage categories 1 to 3) increased by <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/emergency-department-care">almost 700,000</a> across Australia.</p> <p>Some 100,000 fewer patients who presented to an emergency department were <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">admitted as inpatients</a> during this period, but the additional presentations will nonetheless have contributed to more ramping.</p> <p>In the same period, admissions to inpatient beds that did not come through an emergency department increased by <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">almost 400,000</a> across the country. These include admissions for the management of chronic conditions (such as diabetes, heart disease, asthma and so on) and infections and viruses (COVID, flu, RSV and others).</p> <p>Further, COVID and other viruses are likely to have contributed to increased hospital stress via <a href="https://www.aihw.gov.au/reports/workforce/health-workforce">workforce shortages</a>. This has possibly led to delays in seeing patients in the emergency department and in discharging patients from hospital.</p> <p>There has not been a significant increase in <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">patients’ time in hospital</a> receiving required care, but there appear to be increasing numbers of patients waiting for placement in an aged care facility or for home care services after their treatment <a href="https://www.ama.com.au/sites/default/files/2023-02/Hospital%20exit%20block%20-%20a%20symptom%20of%20a%20sick%20health%20system_Final.pdf">has finished</a>.</p> <h2>Many admissions may be preventable</h2> <p>Increased vaccination rates could reduce the impact of viruses. For example, only <a href="https://www.aihw.gov.au/reports/australias-health/immunisation-and-vaccination">21% of Australians</a> aged 65 to 74 received the 2023 COVID booster recommended for their age group.</p> <p>We know there were significant increases in people delaying or avoiding seeing a GP <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">due to cost</a> in 2022–23, which can put extra pressure on hospitals. The government is trying to address this issue by increasing <a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments">incentives to GPs</a> to reduce costs to patients.</p> <p>Meanwhile, government health departments may not have been provided with enough funding to meet increasing demand for health care. Year on year the gap between supply and demand grows. <a href="https://www.theguardian.com/australia-news/article/2024/jun/27/victoria-hospitals-recruitment-freeze-cost-cuts-premier-jacinta-allan">Victorian hospitals</a> are reportedly scrambling to reduce spending in light of proposed budget cuts.</p> <h2>What are the solutions?</h2> <p>The creation of new hospital beds is not the only option for increasing capacity. Governments should design, implement and scale up services that free up hospital capacity by providing appropriate and cost-effective out-of-hospital care.</p> <p>For example, there is further scope to care for patients admitted to hospital in their own homes with the support of digital technologies. Programs such as <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/services/hospitals/my+home+hospital/my+home+hospital">My Home Hospital</a> in South Australia aim to provide an alternative to inpatient care.</p> <p>Across Australia, such “hospital in the home” care was provided 150,000 times in 2022–23, compared to <a href="https://www.aihw.gov.au/reports-data/myhospitals/sectors/admitted-patients">6.8 million episodes of care</a> in public hospitals.</p> <p>Virtual ED services are a growing phenomenon across Australia, using <a href="https://theconversation.com/what-is-a-virtual-emergency-department-and-when-should-you-visit-one-228098">virtual consultations</a> to identify patients for whom urgent care can be provided outside hospital. The Victorian virtual ED service is targeting a capacity of <a href="https://www.afr.com/policy/health-and-education/meet-the-two-doctors-revolutionising-emergency-healthcare-20240415-p5fjud">1,000 consults</a> per day.</p> <p>Longer-term solutions require co-operation between state and territory governments and the federal government to prevent and better manage chronic conditions, such as diabetes and heart disease, outside hospital. This includes boosting access to GPs and improving communication between GPs and hospitals.</p> <p>Greater investment in well-designed policies and programs to support healthy ageing would also likely help, as well as improving access to required out-of-hospital aged care and disability services for patients waiting to leave hospital.</p> <p>All these measures could ease the pressure on hospitals and reduce the likelihood of patients waiting in an ambulance, unable to get inside and receive the care they need.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232720/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jonathan-karnon-290">Jonathan Karnon</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/andrew-partington-93821">Andrew Partington</a>, Research Fellow (Health Economics), <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ambulance-ramping-is-getting-worse-in-australia-heres-why-and-what-we-can-do-about-it-232720">original article</a>.</em></p> </div>

Caring

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Are some routes more prone to air turbulence? Will climate change make it worse? Your questions answered

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/doug-drury-1277871">Doug Drury</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p>A little bit of turbulence is a common experience for air travellers. Severe incidents are rare – but when they occur they can be deadly.</p> <p>The recent Singapore Airlines flight SQ321 from London to Singapore shows the danger. An <a href="https://apnews.com/article/singapore-airlines-flight-turbulence-5a9a268e1a6a6fb9ece7e58b5ea9231b">encounter with extreme turbulence</a> during normal flight left one person dead from a presumed heart attack and several others badly injured. The flight diverted to land in Bangkok so the severely injured passengers could receive hospital treatment.</p> <p>Air turbulence can happen anywhere, but is far more common on some routes than on others.</p> <p>Climate change is expected to boost the chances of air turbulence, and make it more intense. In fact, <a href="https://www.nature.com/articles/s41586-019-1465-z">some research</a> indicates turbulence <a href="https://theconversation.com/aviation-turbulence-soared-by-up-to-55-as-the-world-warmed-new-research-207574">has already worsened</a> over the past few decades.</p> <h2>Where does turbulence happen?</h2> <p>Nearly every flight experiences turbulence in one form or another.</p> <p>If an aircraft is taking off or landing behind another aircraft, the wind generated by the engine and <a href="https://www.faa.gov/air_traffic/publications/atpubs/aim_html/chap7_section_4.html">wingtips</a> of the lead aircraft can cause “wake turbulence” for the one behind.</p> <p>Close to ground level, there may be turbulence due to strong winds associated with weather patterns moving through the area near an airport. At higher altitudes, there may be wake turbulence again (if flying close to another aircraft), or turbulence due to updraughts or downdraughts from a thunderstorm.</p> <p>Another kind of turbulence that occurs at higher altitudes is harder to predict or avoid. So-called “<a href="https://agupubs.onlinelibrary.wiley.com/doi/10.1029/2023gl103814">clear-air turbulence</a>” is invisible, as the name suggests. It is often caused by warmer air rising into cooler air, and is generally expected to get worse due to climate change.</p> <p>At the most basic level turbulence is the result of two or more wind events colliding and creating eddies, or swirls of <a href="https://www.nationalgeographic.com/travel/article/what-is-turbulence-explained">disrupted airflow</a>.</p> <p>It often occurs near mountain ranges, as wind flowing over the terrain accelerates upward.</p> <p>Turbulence also often occurs at the edges of the <a href="https://www.nationalgeographic.com/travel/article/what-is-turbulence-explained">jet streams</a>. These are narrow bands of strong, high-altitude winds circling the globe. Aircraft often travel in the jet streams to get a speed boost – but when entering or leaving the jet stream, there may be some turbulence as it crosses the boundary with the slower winds outside.</p> <h2>What are the most turbulent routes?</h2> <p>It is possible to <a href="https://turbli.com/maps/world-turbulence-map/">map turbulence patterns</a> over the whole world. Airlines use these maps to plan in advance for alternate airports or other essential contingencies.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=430&fit=crop&dpr=1 600w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=430&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=430&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=541&fit=crop&dpr=1 754w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=541&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=541&fit=crop&dpr=3 2262w" alt="Map showing air turbulence." /></a><figcaption><span class="caption">A map of estimated clear-air turbulence around the world, current as of 3:00PM AEST (0500 UTC) on May 22 2024.</span> <span class="attribution"><a class="source" href="https://turbli.com/maps/world-turbulence-map/">Turbli</a></span></figcaption></figure> <p>While turbulence changes with weather conditions, some regions and routes are more prone to it than others. As you can see from the list below, the majority of the most turbulent routes travel close to mountains.</p> <p><iframe id="EktuH" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/EktuH/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>In Australia, the <a href="https://turbli.com/historical-data/most-turbulent-flight-routes-of-2023/">highest average turbulence in 2023</a> occurred on the Brisbane to Sydney route, followed by Melbourne to Sydney and Brisbane to Melbourne.</p> <h2>Climate change may increase turbulence</h2> <p>How will climate change affect the future of aviation?</p> <p>A <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2023GL103814">study published last year</a> found evidence of large increases in clear-air turbulence between 1979 and 2020. In some locations severe turbulence increased by as much as 55%.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=253&fit=crop&dpr=1 600w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=253&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=253&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=318&fit=crop&dpr=1 754w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=318&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=318&fit=crop&dpr=3 2262w" alt="A map of the world with different areas shaded in red." /></a><figcaption><span class="caption">A map showing changes in the chance of clear-air turbulence across the globe between 1979 and 2020. Darker red indicates a higher chance of turbulence.</span> <span class="attribution"><a class="source" href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2023GL103814">Prosser et al. (2023), Geophysical Research Letters</a></span></figcaption></figure> <p>In 2017, a <a href="https://agupubs.onlinelibrary.wiley.com/doi/10.1002/2017GL074618">different study used climate modelling</a> to project that clear-air turbulence may be four times as common as it used to be by 2050, under some climate change scenarios.</p> <h2>What can be done about turbulence?</h2> <p>What can be done to mitigate turbulence? <a href="https://safetyfirst.airbus.com/optimum-use-of-weather-radar/">Technology to detect turbulence</a> is still in the research and development phase, so pilots use the knowledge they have from weather radar to determine the best plan to avoid weather patterns with high levels of moisture directly ahead of their flight path.</p> <p>Weather radar imagery shows the pilots where the most intense turbulence can be expected, and they work with air traffic control to avoid those areas. When turbulence is encountered unexpectedly, the pilots immediately turn on the “fasten seatbelt” sign and reduce engine thrust to slow down the plane. They will also be in touch with air traffic control to find better conditions either by climbing or descending to smoother air.</p> <p>Ground-based meteorological centres can see weather patterns developing with the assistance of satellites. They provide this information to flight crews in real time, so the crew knows the weather to expect throughout their flight. This can also include areas of expected turbulence if storms develop along the intended flight route.</p> <p>It seems we are heading into more turbulent times. Airlines will do all they can to reduce the impact on planes and passengers. But for the average traveller, the message is simple: when they tell you to fasten your seatbelt, you should listen.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230666/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/doug-drury-1277871"><em>Doug Drury</em></a><em>, Professor/Head of Aviation, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-some-routes-more-prone-to-air-turbulence-will-climate-change-make-it-worse-your-questions-answered-230666">original article</a>.</em></p> </div>

Travel Trouble

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Could my glasses be making my eyesight worse?

<p><em><a href="https://theconversation.com/profiles/james-armitage-399647">James Armitage</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/nick-hockley-1517162">Nick Hockley</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>So, you got your eyesight tested and found out you need your first pair of glasses. Or you found out you need a stronger pair than the ones you have. You put them on and everything looks crystal clear. But after a few weeks things look blurrier without them than they did before your eye test. What’s going on?</p> <p>Some people start to wear spectacles for the first time and perceive their vision is “bad” when they take their glasses off. They incorrectly interpret this as the glasses making their vision worse. Fear of this might make them <a href="https://www.bbc.com/future/article/20140513-do-glasses-weaken-your-eyesight#:%7E:text=A%20study%20from,they%20are%20right%3F">less likely to wear their glasses</a>.</p> <p>But what they are noticing is how much better the world appears through the glasses. They become <a href="https://www.tandfonline.com/doi/full/10.1080/2576117X.2022.2033588">less tolerant</a> of a blurry world when they remove them.</p> <p>Here are some other things you might notice about eyesight and wearing glasses.</p> <h2>Lazy eyes?</h2> <p>Some people sense an increasing reliance on glasses and wonder if their eyes have become “lazy”.</p> <p>Our eyes work in much the same way as an auto-focus camera. A flexible lens inside each eye is controlled by muscles that let us <a href="https://www.aao.org/museum-eye-openers/how-does-eye-focus">focus on objects</a> in the distance (such as a footy scoreboard) by relaxing the muscle to flatten the lens. When the muscle contracts it makes the lens steeper and more powerful to see things that are much closer to us (such as a text message).</p> <p>From the age of about 40, the lens in our eye <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">progressively hardens</a> and loses its ability to change shape. Gradually, we lose our capacity to focus on near objects. This is called “<a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/presbyopia">presbyopia</a>” and at the moment there are no treatments for this lens hardening.</p> <p>Optometrists correct this with prescription glasses that take the load of your natural lens. The lenses allow you to see those up-close images clearly by providing extra refractive power.</p> <p>Once we are used to seeing clearly, our tolerance for blurry vision will be lower and we will reach for the glasses to see well again.</p> <h2>The wrong glasses?</h2> <p>Wearing old glasses, the wrong prescription (or even someone else’s glasses) won’t allow you to see as well as possible for day-to-day tasks. It could also cause <a href="https://headaches.org/readers-mail-glasses-causing-headache/">eyestrain and headaches</a>.</p> <p>Incorrectly prescribed or dispensed prescription glasses can lead to vision impairment in children <a href="https://iovs.arvojournals.org/article.aspx?articleid=2126392">as their visual system is still in development</a>.</p> <p>But it is more common for kids to develop long-term vision problems as a result of <a href="https://www.cera.org.au/wp-content/uploads/2021/08/Healthy-Young-Eyes-Guide-ACC.pdf">not wearing glasses when they need them</a>.</p> <p>By the time children are about 10–12 years of age, wearing incorrect spectacles is less likely to cause their eyes to become lazy or damage vision in the long term, but it is likely to result in <a href="https://www.cera.org.au/wp-content/uploads/2021/08/Healthy-Young-Eyes-Guide-ACC.pdf">blurry or uncomfortable vision</a> during daily wear.</p> <p><a href="https://goodvisionforlife.com.au/">Registered optometrists in Australia</a> are trained to assess refractive error (whether the eye focuses light into the retina) as well as the different aspects of ocular function (including how the eyes work together, change focus, move around to see objects). All of these help us see clearly and comfortably.</p> <h2>What about dirty glasses?</h2> <p>Dirty or scratched glasses can give you the impression your vision is worse than it actually is. Just like a window, the dirtier your glasses are, the more difficult it is to see clearly through them. <a href="https://www.optometry.org.au/wp-content/uploads/GVFL/Brochure_PDFs/Care-for-Glasses-2018-A4-single-page-final.pdf">Cleaning glasses regularly</a> with a microfibre lens cloth will help.</p> <p>While dirty glasses are not commonly associated with eye infections, some research suggests dirty glasses can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207238">harbour bacteria</a> with the remote but theoretical <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628431/#:%7E:text=59%2C60%5D.-,S.,39%2C40%2C41%5D.">potential to cause eye infection</a>.</p> <p>To ensure best possible vision, people who wear prescription glasses every day should clean their lenses at least every morning and twice a day where required. Cleaning frames with alcohol wipes can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207238">reduce bacterial contamination by 96%</a> – but care should be taken as alcohol can damage some frames, depending on what they are made of.</p> <h2>When should I get my eyes checked?</h2> <p><a href="https://goodvisionforlife.com.au/faqs/">Regular eye exams</a>, starting just before school age, are important for ocular health. Most prescriptions for corrective glasses <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD16%2F20156&amp;dbid=AP&amp;chksum=676U2aH1QM4XJ6ICVAVaKg%3D%3D">expire within two years</a> and contact lens prescriptions often expire after a year. So you’ll need an eye check for a new pair every year or so.</p> <p>Kids with ocular conditions such as progressive myopia (short-sightedness), strabismus (poor eye alignment), or amblyopia (reduced vision in one eye) will need checks at least every year, but likely more often. Likewise, people over 65 or who have known eye conditions, such as <a href="https://goodvisionforlife.com.au/vision-problems/glaucoma/">glaucoma</a>, will be recommended more frequent checks.</p> <p>An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706420/">online prescription estimator</a> is no substitute for a full eye examination. If you have a valid prescription then you can order glasses online, but you miss out on the ability to check the fit of the frame or to have them adjusted properly. This is particularly important for multifocal lenses where even a millimetre or two of misalignment can cause uncomfortable or blurry vision.</p> <p>Conditions such as <a href="https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html#:%7E:text=Diabetic%20retinopathy%20is%20caused%20when,vision%20or%20stopping%20blood%20flow.">diabetes</a> or <a href="https://www.ncbi.nlm.nih.gov/books/NBK525980/">high blood pressure</a>, can affect the eyes so regular eye checks can also help flag broader health issues. The vast majority of eye conditions can be treated if caught early, highlighting the importance of regular preventative care.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225169/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/james-armitage-399647">James Armitage</a>, Associate Professor in Vision Science, Optometry Course Director, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/nick-hockley-1517162">Nick Hockley</a>, Lecturer in Optometric Clinical Skills, Director Deakin Collaborative Eye Care Clinic, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-my-glasses-be-making-my-eyesight-worse-225169">original article</a>.</em></p>

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Fear of ageing is really a fear of the unknown – and modern society is making things worse

<p><em><a href="https://theconversation.com/profiles/chao-fang-1010933">Chao Fang</a>, <a href="https://theconversation.com/institutions/university-of-liverpool-1198">University of Liverpool</a> and <a href="https://theconversation.com/profiles/alastair-comery-1501915">Alastair Comery</a>, <a href="https://theconversation.com/institutions/university-of-bath-1325">University of Bath</a></em></p> <p>For the first time in human history, we have entered an era in which reaching old age is taken for granted. Unlike in ages past, when living to an older age was a luxury afforded mainly to the privileged, globally around <a href="https://data.worldbank.org/indicator/SP.DYN.TO65.FE.ZS?locations=1W">79% of women</a> and <a href="https://data.worldbank.org/indicator/SP.DYN.TO65.MA.ZS?locations=1W">70% of men</a> can expect to reach the age of 65 and beyond.</p> <p>Despite longer life expectancy, many people in the contemporary west see growing old as undesirable and <a href="https://www.theguardian.com/science/2023/apr/02/ageing-and-the-mortality-alarm-i-started-panicking-about-future-me">even scary</a>. Research shows, however, that anxiety about ageing may in fact be <a href="https://journals.sagepub.com/doi/abs/10.1177/0164027500225004">fear of the unknown</a>.</p> <p>Society’s <a href="https://www.psychologytoday.com/intl/articles/199409/learning-love-growing-old">focus on youthfulness</a> and <a href="https://www.apa.org/ed/precollege/psychology-teacher-network/introductory-psychology/ableism-negative-reactions-disability">capability</a> can cause anxiety about becoming weak and unwanted. Adverts for anti-ageing products <a href="https://theconversation.com/how-20th-century-rejuvenation-techniques-gave-rise-to-the-modern-anti-ageing-industry-133569">are everywhere</a>, reinforcing the idea that growing older is inherently unattractive.</p> <p>Some people fear ageing so much that it becomes a pathological condition <a href="https://mind.help/topic/gerascophobia/">called gerascophobia</a>, leading to irrational thoughts and behaviour, for example, a fixation on health, illness and mortality and a preoccupation with hiding the signs of ageing.</p> <p>We frequently hear about attempts to reverse ageing, often by the super rich. For example, <a href="https://fortune.com/well/2023/01/26/bryan-johnson-extreme-anti-aging/">Bryan Johnson</a>, a 45-year-old American entrepreneur, is spending millions of dollars a year to obtain the physical age of 18.</p> <p>While the desire to reverse ageing is not a new phenomenon, advancements in biomedicine have brought it closer.</p> <p>Work published by genetics professor <a href="https://lifespanbook.com/">David Sinclair</a> at Harvard University in 2019 suggests that it may be possible to challenge the limits of cell reproduction to extend our lifespan, for example. His <a href="https://www.nature.com/articles/s43587-023-00527-6">information theory of ageing</a> argues that <a href="https://epigeneticsandchromatin.biomedcentral.com/articles/10.1186/1756-8935-6-3">reprogramming DNA</a> can improve damaged and old tissues, and delay or even reverse ageing. However, these new possibilities can also heighten our fear of ageing.</p> <h2>From the unproductive to undervalued</h2> <p>People haven’t always dreaded growing older. In many societies, older people used to be widely regarded as wise and important – and in some they still are.</p> <p>In ancient China, there was a <a href="https://www.jstor.org/stable/605890">culture</a> of respecting and seeking advice from older family members. There is still an ethos of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363941/">filial piety</a> (showing reverence and care for elders and ancestors) today, even if it’s not as pronounced as it used to be. The same went for <a href="https://www.cambridge.org/core/journals/ageing-and-society/article/abs/old-age-in-the-dark-ages-the-status-of-old-age-during-the-early-middle-ages/3699DC4100DE852BDA1E1B3BBF33DDBC">medieval Europe</a>, where older people’s experiences and wisdom were highly valued.</p> <p>However, the industrial revolution in the west from the 18th century led to a cultural shift where older people <a href="https://link.springer.com/article/10.1023/A:1014358415896">became excluded from society</a> and were considered unproductive. People who had surpassed the age to work, alongside those with incurable diseases, were regarded by society as <a href="https://www.tandfonline.com/doi/abs/10.1080/13607860903228762">“evils”</a> in need of assistance.</p> <p>The treatment of older people has taken a different form since the early 20th century. The introduction of <a href="https://www.nytimes.com/2018/12/30/business/retirement/why-the-world-needs-to-rethink-retirement.html">universal pension systems</a> made ageing a central concern in welfare systems. But as the demands for social and health care have increased, journalists increasingly portray ageing as a <a href="https://www.ageuk.org.uk/latest-news/archive/older-people-feel-a-burden-to-society/">burden</a> on society.</p> <p>Consequently, growing older is often associated with managing the risk of ill health and alleviating the onus of care from younger relatives. This can result in the <a href="https://utpjournals.press/doi/abs/10.3138/utq.90.2.09">institutionalisation</a> of older people in residential facilities that keep them hidden, sequestered from the awareness of younger generations.</p> <p><a href="https://journals.sagepub.com/doi/abs/10.1177/0164027500225004">Research</a> analysing the responses of 1,200 US adults from the American Association of Retired Persons’ Images of Ageing survey shows that much of the perceived fear of ageing is closely aligned with the fear of the unknown, rather than the ageing process itself. This fear is only exacerbated by the largely separate lives lived by older and younger generations.</p> <p>The prevalence of nuclear families and the decline of <a href="https://www.cpc.ac.uk/docs/BP45_UnAffordable_housing_and_the_residential_separation_of_age_groups.pdf">traditional mixed-generational communities</a> have deprived younger people of the opportunity to more fully understand the experiences of older people. Plus, the rapid increase in <a href="https://news.sky.com/story/why-its-more-difficult-for-young-people-to-buy-a-house-now-than-it-was-fifty-years-ago-12537254">house prices</a> means many young people cannot afford to live near their older relatives.</p> <p>The separation of older people from children and young people has sparked generational conflicts that seemingly continue to <a href="https://www.economist.com/britain/2017/05/04/britains-generational-divide-has-never-been-wider">grow wider than ever</a>. Older people are frequently portrayed in the media as conservative and privileged, <a href="https://www.theguardian.com/commentisfree/2020/jan/12/old-young-gap-britain-generation-dysfunctional-family">making it difficult</a> for younger generations to comprehend why older people act and think the way they do.</p> <h2>Intergenerational interactions</h2> <p>Academics suggest that creating <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2022.996520/full">a system</a> for older and younger generations to interact in everyday settings is vital.</p> <p>A set of three <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5031197/#bjso12146-bib-0004">UK-based studies</a> in 2016 analysed and compared the effects of direct contact, extended contact and interactions between younger (aged 17 to 30) and older people (65 and over). The findings indicated that good quality direct intergenerational contact can improve young people’s attitudes towards older adults (especially when sustained over time).</p> <p>Intergenerational programmes have been adopted globally, including mixed and <a href="https://www.cohousing.org/multigenerational-cohousing/">intergenerational housing</a>, <a href="https://www.nurseryinbelong.org.uk/intergenerational-choir-hits-high-note-at-belong-chester/">community choirs</a> and <a href="https://www.shareable.net/how-sharing-can-bring-japans-elderly-and-youth-together/">senior volunteers reading to young children in nurseries</a>.</p> <p><a href="https://link.springer.com/article/10.1007/s10433-018-00497-4">Studies show</a> that these activities can not only enhance the wellbeing of older people but also help younger people gain an appreciation of ageing as a valuable and fulfilling life stage.</p> <p>Getting worried about growing older is normal, just as we experience anxieties in other stages of life, such as adolescence and marriage. But here’s the thing – instead of seeing ageing as a looming figure, it is important to realise it is just a part of life.</p> <p>Once we understand ageing as a regular experience, <a href="https://www.psychologytoday.com/gb/blog/changepower/202106/do-you-have-fogo-taming-the-fear-getting-old">we can let go</a> of these worries and approach the journey through different life stages with a positive attitude and a fortified will to enrich our lives and the lives of those around us.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/220925/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/chao-fang-1010933"><em>Chao Fang</em></a><em>, Lecturer in Sociology, Deputy Director of the Centre for Ageing and the Life Course, <a href="https://theconversation.com/institutions/university-of-liverpool-1198">University of Liverpool</a> and <a href="https://theconversation.com/profiles/alastair-comery-1501915">Alastair Comery</a>, PhD Candidate, Sociology, Centre for Death and Society, <a href="https://theconversation.com/institutions/university-of-bath-1325">University of Bath</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/fear-of-ageing-is-really-a-fear-of-the-unknown-and-modern-society-is-making-things-worse-220925">original article</a>.</em></p>

Beauty & Style

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Think potholes on our roads are getting worse? You’re right – and here’s why

<p><em><a href="https://theconversation.com/profiles/marion-terrill-169480">Marion Terrill</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/natasha-bradshaw-1358801">Natasha Bradshaw</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p>If you’re a driver, particularly in the country, you could be forgiven for thinking potholes have become a design feature of Australia’s local roads.</p> <p>You would certainly know they are in a state of disrepair. And you have every reason to be fed up, because bad roads are dangerous, they increase your travel time, and they force you to spend more on fuel and on car maintenance.</p> <p>They are getting worse because we’re not spending enough to maintain them.</p> <p>Three-quarters of our roads are managed by local councils.</p> <p>Every year, those councils spend A$1 billion less on maintenance than is needed to keep those roads in their current condition – let alone improve them.</p> <p>The underspend is largest in regional and remote areas.</p> <p>New <a href="https://grattan.edu.au/report/potholes-and-pitfalls-how-to-fix-local-roads/">Grattan Institute research</a> finds the typical regional area has a funding shortfall of more 40%. In remote areas, it’s more than 75%.</p> <h2>Federal funding is falling behind</h2> <p>One reason for this underspend is that untied federal government grants to local councils haven’t kept pace with soaring costs.</p> <p>Councils raise most of their own revenue – 80% on average. But in large parts of the country, there are a lot of roads and not enough ratepayers to pay for them.</p> <p>Rural and remote councils have limited ability to raise more revenue from ratepayers. Their ratepayers already pay higher rates than those in cities, despite having lower average incomes.</p> <p>Rate caps in place in New South Wales and Victoria also make it difficult for councils to raise more revenue.</p> <hr /> <hr /> <p>Councils receive top-up grants from the federal and state governments. The primary grants from the federal government, available for councils to spend as they see fit – including on roads – are called <a href="https://www.infrastructure.gov.au/territories-regions-cities/local-government/financial-assistance-grant-local-government">Financial Assistance Grants</a>.</p> <p>These are worth about $3 billion a year.</p> <p>But their value has not kept pace with rising costs. If they had kept pace, on our estimates they would be 20% higher, at $3.6 billion per year.</p> <hr /> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=303&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=303&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=303&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=381&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=381&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/561231/original/file-20231123-27-oa4fn0.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=381&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="attribution"><a class="source" href="https://grattan.edu.au/report/potholes-and-pitfalls-how-to-fix-local-roads/">Grattan Institute, 2023</a></span></figcaption></figure> <hr /> <h2>Road use is growing, but maintenance isn’t</h2> <p>Another reason for the underspend is that even as funding dries up, we’re using roads more.</p> <p>A growing population means both more cars on our roads and more trucks needed to keep our shelves stocked.</p> <p>But despite the extra damage to our roads, spending on maintenance has stalled.</p> <hr /> <hr /> <h2>Councils are spending more on other things</h2> <p>Another reason roads are underfunded is that councils are coming under increasing pressure to fund other services.</p> <p>The legislation governing councils doesn’t clearly define what councils are responsible for, and there is no shortage of services communities want.</p> <p>Spending on transport has fallen from almost half of local government spending in the 1960s to 21% today.</p> <p>Environmental protection was only identified as its own area of spending for councils in 2018, but it now makes up 15% of all council spending.</p> <hr /> <hr /> <h2>Delaying will cost us more</h2> <p>If we don’t act now and start spending more to fix our roads, the pothole plague is going to spread. Australia is getting hotter, with more rain and floods.</p> <p>The Local Government Association expects the cost of repairing flood and rain-damaged roads in the eastern states and South Australia to top <a href="https://alga.com.au/building-better-roads-will-prevent-another-3-8-billion-blowout/">$3.8 billion</a>.</p> <p>Tight budgets make it tempting to delay maintenance.</p> <p>But delaying will only end up costing more in the long run, leaving taxpayers paying more to fix more badly damaged roads.</p> <h2>Finally, a circuit-breaker</h2> <p>Some might argue that now is not the time for more spending on roads, given pressures on the budget. But plenty is being spent on big roads and new roads.</p> <p>Infrastructure Minister Catherine King’s recent announcement of a <a href="https://minister.infrastructure.gov.au/c-king/media-release/significant-boost-road-safety">funding boost</a> of for local roads is a very welcome circuit-breaker.</p> <p>She announced the Roads to Recovery program will increase gradually from $500 million to $1 billion per year, the Black Spot program from $110 million to $150 million per year, and funding for an amalgamated Bridges Renewal and Heavy Vehicle Safety and Productivity program will climb form $150 million to $200 per year.</p> <p>This decision is important. Not only will councils receive more funding for maintenance, but it will be predictable funding, enabling better stewardship of long-lived assets. The money can’t start flowing soon enough.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217784/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/marion-terrill-169480"><em>Marion Terrill</em></a><em>, Transport and Cities Program Director, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/natasha-bradshaw-1358801">Natasha Bradshaw</a>, Associate, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/think-potholes-on-our-roads-are-getting-worse-youre-right-and-heres-why-217784">original article</a>.</em></p>

Travel Trouble

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Instagram is making you a worse tourist – here’s how to travel respectfully

<p><em><a href="https://theconversation.com/profiles/lauren-a-siegel-1416907">Lauren A. Siegel</a>, <a href="https://theconversation.com/institutions/university-of-greenwich-1298">University of Greenwich</a></em></p> <p>Travel is back in full swing this summer, and so is bad behaviour by tourists.</p> <p>Popular destinations have seen an uptick in incidents involving tourists in <a href="http://darwin.cnn-travel-vertical.ui.cnn.io/travel/article/tourists-behaving-badly/index.html?gallery=0">recent years</a>. Reports of a <a href="https://www.euronews.com/culture/2023/06/30/hunt-for-tourist-who-carved-name-in-colosseum-intensifies">man defacing</a> the Colosseum in Rome shows that behaviour has deteriorated even in places that rarely had problems in the past.</p> <p>What’s behind these abhorrent acts? One answer, <a href="https://ertr-ojs-tamu.tdl.org/ertr/article/view/541/178">my research shows</a>, is social media. Instagram and TikTok have made it easy to find “hidden gem” restaurants and discover new destinations to add to your bucket list. But this democratisation of travel has had other consequences.</p> <p>Because people now see their social media connections from their home environment travelling in an exotic location, they assume (consciously or not) that behaviour they ordinarily carry out at home is also acceptable in that holiday destination.</p> <p>This is known as <a href="https://fs.blog/mental-model-social-proof/">social proof</a>, when we look to the behaviours of others to inform our own actions. People are likely to act more <a href="https://journals.sagepub.com/doi/10.1177/0013916508319448">hedonistically while on holiday</a>. Now, travellers also look to social media for proof of how others behave. If their peers from home are throwing caution to the wind while on holiday, this can cause a domino effect of bad behaviour.</p> <p>I’ve identified other bad travel attitudes and habits that have emerged as a result of <a href="https://www.sciencedirect.com/science/article/pii/S2212571X23000045?via%3Dihub">social media-driven tourism</a>.</p> <p>For example, the <a href="https://thedecisionlab.com/biases/identifiable-victim-effect">identifiable victim effect</a>, which explains how people are more likely to sympathise with victims of tragedies when they know who those victims are. Because tourists are often sheltered in hotels and resorts away from local communities, they might (wrongly) think that travelling to a place far from home is an opportunity for consequence-free bad behaviour. They underestimate or ignore the effect their actions can have on locals or the economy.</p> <h2>The Instagram effect</h2> <p>When people travel to a beautiful place, the temptation to post photos and videos to social media is high. But, as <a href="https://www.tandfonline.com/doi/full/10.1080/13683500.2022.2086451">I have argued</a>, this creates a cycle that contributes to more self-indulgent travel.</p> <p>First, tourists see their friends post photos from a place (revealed through geotags). They then want to visit the same places and take the same sorts of photos of themselves there. Eventually they post them on the same social networks where they saw the initial photos.</p> <p>Being able to travel to and post about visiting the same places as one’s social group or online connections can be a form of <a href="https://www.tandfonline.com/doi/full/10.1080/10548408.2018.1499579?casa_token=mVH_AlLB_4kAAAAA%3Ahdz29HMEh5aCiK4TopW8WBS3lY2ZJ2n6CZQWhL5aH7d-ZK3lpsvUlowHtdy4Pa-e7ergNJgcGfI">social status</a>. But it means that, in some cases, travellers will put more energy into creating content than they will to exploration, discovery or being respectful to local customs.</p> <h2>Hotspots respond</h2> <p>Bali is one destination with a reputation for social media-induced tourism. The photogenic island, replete with yoga retreats, is a huge draw for influencers.</p> <p>In response to tourist misbehaviour, Bali <a href="https://thebalisun.com/balis-much-anticipated-list-of-dos-and-donts-for-tourists-revealed/">introduced new guidelines</a> for visitors in June 2023. These include rules about proper behaviour in the sacred temples, around the island and with locals, and respecting the natural environment.</p> <p>Tourists now need a <a href="https://thebalisun.com/bali-warns-tourists-must-have-international-driving-license-to-drive-scooters-on-the-island">licence</a> for motorbike rentals, and may not set foot on any mountain or volcano in Bali due to their sacred nature. Travellers must only stay in registered hotels and villas (which will impact a number of Airbnb properties). Bali has introduced a “tourist task force” to enforce the restrictions, through raids and investigations if necessary.</p> <p>One new guideline is to not act aggressively or use harsh words towards locals, government officials or other tourists both while in Bali, or, notably, online. This speaks to the role of social media as part of the problem when it comes to bad tourist behaviour.</p> <p>Other destinations have taken similar steps. <a href="https://pledge.visiticeland.com">Iceland</a>, <a href="https://mauitourism.org/Videos/malama-pledge.htm">Hawaii</a>, <a href="https://palaupledge.com">Palau</a>, <a href="https://www.tiakinewzealand.com">New Zealand</a>, <a href="https://costarica-sanctuary.com/make-it-happen/">Costa Rica</a> and others have adopted pledges for visitors to abide by local laws and customs. Campaigns like Switzerland’s <a href="https://www.youtube.com/watch?v=wXcBGfXXL4w">No Drama</a>, Austria’s <a href="https://www.youtube.com/watch?v=Pgn3Y7kvJXE">See Vienna – not #Vienna</a>, Finland’s <a href="https://www.theguardian.com/travel/2019/oct/17/finland-be-more-like-finn-campaign-tourism-pledge-initiatives">Be more like a Finn</a> and the Netherlands’ <a href="https://www.forbes.com/sites/dariosabaghi/2023/03/31/amsterdam-launches-stay-away-campaign-targeting-wild-party-behavior-of-young-british-tourists/">How to Amsterdam</a> are aimed at attracting well-behaved tourists.</p> <p>Where such efforts aren’t successful, some places such as Thailand’s famous Maya Bay have taken it further and fully closed to tourists, <a href="https://edition.cnn.com/travel/article/maya-bay-thailand-recovery-c2e-spc-intl/index.html">at least temporarily</a>.</p> <h2>Travel respectfully</h2> <p>Remember you are a guest of the host communities when you travel. Here are some ways to ensure that you will be asked back.</p> <p><strong>1. Do your research</strong></p> <p>Even if you’re a seasoned traveller, you may not realise the impact your actions have on local communities. But a bit of information – from your own research or provided by local governments – might be enough to help you act more appropriately. Before you go, look up guidelines or background information on local cultural or safety norms.</p> <p>Whether you agree with the customs or not is irrelevant. If it is a more conservative place than you are used to, you should be mindful of that – unlike the two influencers who were <a href="https://www.telegraph.co.uk/news/2019/08/16/bali-warns-misbehaving-tourists-will-sent-home-instagram-influencers/">arrested</a> for explicit behaviour in a temple in Bali.</p> <p><strong>2. Put down your phone…</strong></p> <p>Research shows that when travelling, <a href="https://www.sciencedirect.com/science/article/abs/pii/S016073831730097X">people can become alienated</a> from their surroundings if they are more focused on their devices than the destination.</p> <p>Often the most memorable travel experiences will be when you have a meaningful connection with someone, or learn something new that you’ve never experienced before. That becomes harder if you’re constantly looking at your phone.</p> <p><strong>3. …or use your influence for good</strong></p> <p>In popular “Instagram v reality” <a href="https://matadornetwork.com/read/instagram-vs-reality-tuscany-switzerland/">posts</a>, influencers are revealing the huge crowds and queues behind the most Instagrammable locations.</p> <p>Showing the less-than-glamorous conditions behind those iconic shots could influence your own social media connections to rethink their personal travel motivations – are they just going somewhere to get the perfect selfie? Having more evidence of these conditions circulating online could lead to a larger societal shift away from social media-induced tourism.</p> <p>If you have the urge to post, try to promote smaller businesses and make sure you are demonstrating proper (and legal) etiquette on your holiday.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/209272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lauren-a-siegel-1416907">Lauren A. Siegel</a>, Lecturer, <a href="https://theconversation.com/institutions/university-of-greenwich-1298">University of Greenwich</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/instagram-is-making-you-a-worse-tourist-heres-how-to-travel-respectfully-209272">original article</a>.</em></p>

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Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Opioids are the one of the most prescribed pain-relief for people with low back and neck pain. In Australia, around <a href="https://link.springer.com/article/10.1007/s00586-017-5178-4">40% of people</a> with low back and neck pain who present to their GP and <a href="https://qualitysafety.bmj.com/content/28/10/826">70% of people</a> with low back pain who visit a hospital emergency department are prescribed opioids such as oxycodone.</p> <p>But our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext">new study</a>, published today in the Lancet medical journal, found opioids do not relieve “acute” low back or neck pain (lasting up to 12 weeks) and can result in worse pain.</p> <p>Prescribing opioids for low back and neck pain can also cause <a href="https://www.healthdirect.gov.au/taking-opioid-medicines-safely">harms</a> ranging from common side effects – such as nausea, constipation and dizziness – to <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/opioid-harm-in-australia/summary">misuse, dependency, poisoning and death</a>.</p> <p>Our findings show opioids should <em>not</em> be recommended for acute low back pain or neck pain. A change in prescribing for low back pain and neck pain is urgently needed in <a href="https://www.tga.gov.au/resources/publication/publications/addressing-prescription-opioid-use-and-misuse-australia">Australia</a> and <a href="https://www.thelancet.com/commissions/opioid-crisis">globally</a> to reduce opioid-related harms.</p> <h2>Comparing opioids to a placebo</h2> <p>In our trial, we randomly allocated 347 people with acute low back pain and neck pain to take either an opioid (oxycodone plus naloxone) or <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo</a> (a tablet that looked the same but had no active ingredients).</p> <p>Oxycodone is an opioid pain medicine which can be given orally. <a href="https://www.nps.org.au/radar/articles/oxycodone-with-naloxone-controlled-release-tablets-targin-for-chronic-severe-pain">Naloxone</a>, an opioid-reversal drug, reduces the severity of constipation while not disrupting the pain relieving effects of oxycodone.</p> <p>Participants took the opioid or placebo for a maximum of six weeks.</p> <p>People in the both groups also received <a href="https://www.sciencedirect.com/science/article/pii/S1836955321000941">education and advice</a> from their treating doctor. This could be, for example, advice on returning to their normal activities and avoiding bed rest.</p> <p>We assessed their outcomes over a one-year period.</p> <h2>What did we find?</h2> <p>After six weeks of treatment, taking opioids did not result in better pain relief compared to the placebo.</p> <p>Nor were there benefits to other outcomes such as physical function, quality of life, recovery time or work absenteeism.</p> <p>More people in the group treated with opioids experienced nausea, constipation and dizziness than in the placebo group.</p> <p>Results at one year highlight the potential long-term harm of opioids even with short-term use. Compared to the placebo group, people in the opioid group experienced slightly worse pain, and reported a higher risk of <a href="https://academic.oup.com/painmedicine/article/20/1/113/4728236#129780622">opioid misuse</a> (problems with their thinking, mood or behaviour, or using opioids differently from how the medicines were prescribed).</p> <p>More people in the opioid group reported pain at one year: 66 people compared to 50 in the placebo group.</p> <h2>What will this mean for opioid prescribing?</h2> <p>In recent years, international low back pain guidelines have shifted the focus of treatment from drug to non-drug treatment due to <a href="https://www.thelancet.com/article/S0140-6736(18)30489-6/fulltext">evidence</a> of limited treatment benefits and concern of medication-related harm.</p> <p>For acute low back pain, <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">guidelines</a> recommend patient education and advice, and if required, anti-inflammatory pain medicines such as ibuprofen. Opioids are <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">recommended only</a> when other treatments haven’t worked or aren’t appropriate.</p> <p>Guidelines for <a href="https://pubmed.ncbi.nlm.nih.gov/33064878/">neck</a> pain similarly discourage the use of opioids.</p> <p>Our latest research clearly demonstrates the benefits of opioids do not outweigh possible harms in people with acute low back pain and neck pain.</p> <p>Instead of advising opioid use for these conditions in selected circumstances, opioids should be discouraged without qualification.</p> <h2>Change is possible</h2> <p>Complex problems such as opioid use need smart solutions, and another study we recently conducted provides convincing data opioid prescribing can be successfully reduced.</p> <p>The <a href="https://qualitysafety.bmj.com/content/30/10/825">study</a> involved four hospital emergency departments, 269 clinicians and 4,625 patients with low back pain. The intervention comprised of:</p> <ul> <li>clinician education about <a href="https://aci.health.nsw.gov.au/networks/musculoskeletal/resources/low-back-pain">evidence-based management</a> of low back pain</li> <li>patient education using posters and handouts to highlight the benefits and harms of opioids</li> <li>providing heat packs and anti-inflammatory pain medicines as alternative pain-management treatments</li> <li>fast-tracking referrals to outpatient clinics to avoid long waiting lists</li> <li>audits and feedback to clinicians on information about opioid prescribing rates.</li> </ul> <p>This intervention reduced opioid prescribing from <a href="https://qualitysafety.bmj.com/content/30/10/825">63% to 51% of low back pain presentations</a>. The <a href="https://emj.bmj.com/content/early/2023/04/02/emermed-2022-212874">reduction was sustained for 30 months</a>.</p> <p>Key to this successful approach is that we worked with clinicians to develop suitable pain-management treatments without opioids that were feasible in their setting.</p> <p>More work is needed to evaluate this and other interventions aimed at reducing opioid prescribing in other settings including GP clinics.</p> <p>A nuanced approach is often necessary to avoid causing <a href="https://theconversation.com/opioid-script-changes-mean-well-but-have-left-some-people-in-chronic-pain-156753">unintended consequences</a> in reducing opioid use.</p> <p>If people with low back pain or neck pain are using opioids, especially at higher doses over an extended period of time, it’s important they seek advice from their doctor or pharmacist before stopping these medicines to avoid <a href="https://www.healthdirect.gov.au/opioid-withdrawal-symptoms">unwanted effects when the medicines are abruptly stopped</a>.</p> <p>Our research provides compelling evidence opioids have a limited role in the management of acute low back and neck pain. The challenge is getting this new information to clinicians and the general public, and to implement this evidence into practice.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203244/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, Postdoctoral Research Associate in Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/opioids-dont-relieve-acute-low-back-or-neck-pain-and-can-result-in-worse-pain-new-study-finds-203244">original article</a>.</em></p>

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3 little-known reasons why plastic recycling could actually make things worse

<p><em><a href="https://theconversation.com/profiles/pascal-scherrer-230971">Pascal Scherrer</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>This week in Paris, negotiators from around the world are <a href="https://www.unep.org/events/conference/second-session-intergovernmental-negotiating-committee-develop-international">convening</a> for a United Nations meeting. They will tackle a thorny problem: finding a globally binding solution for plastic pollution.</p> <p>Of the staggering <a href="https://stats.oecd.org/viewhtml.aspx?datasetcode=PLASTIC_USE_6&amp;lang=en">460 million tonnes of plastic used globally in 2019 alone</a>, much is used only once and thrown away. About <a href="https://www.oecd.org/environment/plastic-pollution-is-growing-relentlessly-as-waste-management-and-recycling-fall-short.htm">40% of plastic waste</a> comes from packaging. Almost two-thirds of plastic waste comes from items with lifetimes of less than five years.</p> <p>The plastic waste that escapes into nature persists and breaks up into smaller and smaller pieces, <a href="https://www.science.org/doi/10.1126/sciadv.1700782">eventually becoming microplastics</a>. Plastics now contaminate virtually every environment, from <a href="https://www.theguardian.com/environment/2020/nov/20/microplastic-pollution-found-near-summit-of-mount-everest">mountain peaks to oceans</a>. Plastic has entered vital systems such as our food chain and even the human <a href="https://www.theguardian.com/environment/2022/mar/24/microplastics-found-in-human-blood-for-first-time">blood stream</a>.</p> <p>Governments and industry <a href="https://www.un.org/en/climatechange/nations-agree-end-plastic-pollution">increasingly acknowledge</a> the urgent need to reduce plastic pollution. They are introducing <a href="https://apco.org.au/the-australian-packaging-covenant">rules and incentives</a> to help businesses stop using single-use plastics while also encouraging collection and recycling.</p> <p>As a sustainability researcher, I explore opportunities to <a href="https://www.scu.edu.au/research/zerowaste/">reduce plastic waste </a>in sectors such as tourism, hospitality and meat production. I know how quickly we could make big changes. But I’ve also seen how quick-fix solutions can create complex future problems. So we must proceed with caution.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">The best way to tackle plastic pollution is to prevent it in the first place.</p> <p>Governments, businesses, civil society, and academia can all be part of the solution to <a href="https://twitter.com/hashtag/BeatPlasticPollution?src=hash&amp;ref_src=twsrc%5Etfw">#BeatPlasticPollution</a>.</p> <p>Join in this <a href="https://twitter.com/hashtag/WorldEnvironmentDay?src=hash&amp;ref_src=twsrc%5Etfw">#WorldEnvironmentDay</a>: <a href="https://t.co/ENu9UG82kz">https://t.co/ENu9UG82kz</a> <a href="https://t.co/1p5G0183uh">pic.twitter.com/1p5G0183uh</a></p> <p>— UN Environment Programme (@UNEP) <a href="https://twitter.com/UNEP/status/1660873190577680384?ref_src=twsrc%5Etfw">May 23, 2023</a></p></blockquote> <h2>Plastic avoidance is top priority</h2> <p>We must urgently eliminate waste and build a so-called “<a href="https://ellenmacarthurfoundation.org/topics/circular-economy-introduction/overview">circular economy</a>”. For plastics, that means reuse or recycling back into the same type of plastic, not lower grade plastic. The plastic can be used to make similar products that then can be recycled again and again.</p> <p>This means plastics should only be used where they can be captured at their end of life and recycled into a product of the same or higher value, with as little loss as possible.</p> <p>Probably the only example of this to date is the recycling of PET (polyethylene terephthalate) soft-drink bottles in Norway and Switzerland. They boast recovery rates of <a href="https://phys.org/news/2020-02-norway-bottles-plastic-fantastic.html">97%</a> and <a href="https://houseofswitzerland.org/swissstories/environment/switzerland-leads-way-pet-recycling">95%</a> respectively.</p> <p>The <a href="https://wastewise.be/2014/11/ad-lansink/">waste management pyramid</a> below shows how to prioritise actions to lessen the waste problem. It is particularly relevant to single-use plastics. Our top priority, demanding the biggest investment, is prevention and reduction through redesign of products.</p> <p>Where elimination is not yet achievable, reuse solutions or recycling to the same or higher-level products can be sought to make plastics circular.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=406&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=406&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=406&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=510&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=510&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/527407/original/file-20230522-21-y07zqy.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=510&amp;fit=crop&amp;dpr=3 2262w" alt="Inverted pyramid diagram showing waste management priorities" /><figcaption><span class="caption">In the inverted pyramid of waste management priorities, downcycling is almost the last resort.</span> <span class="attribution"><span class="source">Pascal Scherrer</span></span></figcaption></figure> <p>Unfortunately, a lack of high-quality reprocessing facilities means plastic waste keeps growing. In Australia, plastic is largely “downcycled”, which means it is recycled into lower quality plastics.</p> <p>This can seem like an attractive way to deal with waste-plastic stockpiles, particularly after the recent collapse of soft-plastics recycler <a href="https://theconversation.com/redcycles-collapse-is-more-proof-that-plastic-recycling-is-a-broken-system-194528">RedCycle</a>. But downcycling risks doing more harm than good. Here are three reasons why:</p> <h2>1. Replacing wood with recycled plastics risks contaminating our wildest natural spaces</h2> <p>An increasing number of benches, tables, bollards and boardwalks are being made from recycled plastic. This shift away from timber is touted as a sustainable step - but caution is warranted when introducing these products to pristine areas such as national parks.</p> <p>Wood is naturally present in those areas. It has a proven record of longevity and, when degrading, does not introduce foreign matter into the natural system.</p> <p>Swapping wood for plastic <a href="https://www.sciencedirect.com/science/article/abs/pii/S0269749122019510?via%3Dihub">may introduce microplastics</a> into the few remaining places relatively free of them. Replacing wood with downcycled plastics also risks plastic pollution through weathering or fire.</p> <h2>2. Taking circular plastics from their closed loop to meet recycled-content targets creates more waste</h2> <p>Clear PET bottles used for beverages are the most circular plastic stream in Australia, approaching a 70% recovery rate. When these bottles are recycled back into clear PET bottles, they are circular plastics.</p> <p>However, the used PET bottles are increasingly being turned into meat trays, berry punnets and <a href="https://www.praise.com.au/faqs-100-recycled-bottles">mayonnaise jars</a> to help producers meet the <a href="https://apco.org.au/national-packaging-targets">2025 National Packaging Target</a> of 50% recycled content (on average) in packaging.</p> <p>The problem is the current industry <a href="https://anzpacplasticspact.org.au/wp-content/uploads/2021/06/Recovered-Polymer-Specifications_FINAL_June2021d.pdf">specifications for plastics recovery</a> allow only downcycling of these trays, punnets and jars. This means that circular PET is removed from a closed loop into a lower-grade recovery stream. This leads to non-circular downcycling and more plastic sent to landfill.</p> <h2>3. Using “compostable” plastics in non-compostable conditions creates still more plastic pollution</h2> <p>Increasingly, plastics are labelled as compostable and biodegradable. However, well-intended use of compostable plastics can cause long-term plastic pollution.</p> <p>At the right temperature with the right amount of moisture, compostable plastics breakdown into soil. But if the conditions are not “just right”, they won’t break down at all.</p> <p>For example, when a landscape architect or engineer uses a “compostable” synthetic fabric instead of a natural alternative (such as coir or jute mats) they can inadvertently introduce persistent plastics into the environment. This is because the temperature is not hot enough for the synthetic mat to break down.</p> <p>We must also <a href="https://documents.packagingcovenant.org.au/public-documents/Considerations%20for%20Compostable%20Packaging">differentiate</a> between “home compostable” and “commercially compostable”. Commercial facilities are more effective at composting because they operate under more closely controlled conditions.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Plastic pollution could reduce by 80% by 2040 if governments and companies make policy and market shifts using existing technologies.</p> <p>OUT NOW – UNEP’s new report provides a pathway for nations to <a href="https://twitter.com/hashtag/BeatPlasticPollution?src=hash&amp;ref_src=twsrc%5Etfw">#BeatPlasticPollution</a>: <a href="https://t.co/dcfBkZaOfN">https://t.co/dcfBkZaOfN</a> <a href="https://t.co/iSQ9QSpYC1">pic.twitter.com/iSQ9QSpYC1</a></p> <p>— UN Environment Programme (@UNEP) <a href="https://twitter.com/UNEP/status/1658419925638152192?ref_src=twsrc%5Etfw">May 16, 2023</a></p></blockquote> <h2>Learning from our mistakes</h2> <p>Clearly, we need to reduce our reliance on plastics and shift away from linear systems – including recycling into lower-grade products.</p> <p>Such downcycling may have a temporary role in dealing with existing plastic in the system while circular recycling capacity is being built. But we must not develop downcycling “solutions” that need a long-term stream of plastic waste to remain viable.</p> <p>What’s more, downcycling requires constantly finding new markets for their lower-grade products. Circular systems are more robust.</p> <p>So, to the negotiators in Paris, yes the shift to a circular plastics economy is urgent. But beware of good intentions that could ultimately make things worse.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/206060/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/pascal-scherrer-230971">Pascal Scherrer</a>, Senior Lecturer, Faculty of Business, Law and Art, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/3-little-known-reasons-why-plastic-recycling-could-actually-make-things-worse-206060">original article</a>.</em></p>

Home Hints & Tips

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12 trusted home remedies that will only make you worse

<p><strong>Proceed with caution</strong></p> <p>Any herbal supplement or remedy could potentially cause liver or kidney failure or have dangerous interactions with other medications you may be taking. That’s why physician Dr Ehsan Ali, recommends you ask your doctor before popping any herbal pill or natural cure.</p> <p>“All patients of all ages should check with their doctor first about what home remedy they want to try,” says Dr Ali. “Better to be safe than sorry!”</p> <p><strong>St. John's Wort</strong></p> <p>This herb is touted as a treatment for depression, but comprehensive studies are lacking. Dangers can arise when patients are already taking other medications. There have been incidents of St. John’s Wort interfering with birth control pills, leading to unintended pregnancies.</p> <p>The National Center for Complementary and Integrative Health warns that St. John’s Wort can disrupt the action of many medications, including warfarin, antidepressants, and anti-rejection drugs following organ transplants.</p> <p><strong>Kava</strong></p> <p>This herb, grown on South Pacific islands is often suggested for anxiety. It has been found to have a calming effect similar to Valium. Research, including a study published in 2015 in the journal Trialssuggests that kava may be an effective treatment for generalised anxiety disorder.</p> <p>However, heavy consumption of the herb is linked with heart problems and eye irritation.</p> <p><strong>Kitchen cures for burns</strong></p> <p>Kitchen cures can seem harmless and certainly, food products can make gentle and effective beauty treatments (think: avocado or honey masks for skin and hair). But when someone has an injury or disease, natural products can do more harm than good.</p> <p>Dr Svetlana Kogan, a holistic physician, has heard many potentially dangerous cures for injuries, including applying egg whites to burns. Egg whites, especially organic ones, can be full of bacteria – including salmonella – which could lead to serious infections. Instead, minor burns can be treated at home with cool water and acetaminophen for pain.</p> <p><strong>Gargling with mouthwash</strong></p> <p>The common cold continues to confound doctors and there isn’t much sufferers can do except stay hydrated. But when the symptoms progress to an inflamed throat, indulging in the common practice of gargling with mouthwash can do more harm than good.</p> <p>“Gargling inflamed tonsils with mouthwash is actually very irritating to the area and does not have any effect on potential strep throat,” says Dr Kogan. Her recommendation for a sore throat? Warm liquids to soothe the inflamed area and get plenty of rest.</p> <p><strong>Money</strong></p> <p>The best use for money when it comes to your health is paying your medical bills. But some people use currency to try and cure ailments. For years, placing a coin or other hard, flat object on a baby’s belly to help heal an umbilical hernia has been a common practice in many cultures – a very unsafe practice: “An umbilical hernia is a gap in the layer of muscle in the abdominal wall (called the rectus abdominis muscle),” explains Dr Danelle Fisher, a paediatrician.</p> <p>“The muscle usually grows together and the hernia goes away on its own in more than 90 per cent of babies who are born with it. Having an object strapped to the baby’s belly is not advisable because it can cause a skin infection and it doesn’t change the hernia or hasten its healing.” (Not to mention that coins can be pretty dirty and are a choking hazard for your baby.) So what should you do if your baby has an umbilical hernia? Nothing, aside from watchful waiting and consulting with your child’s paediatrician.</p> <p><strong>Breast milk</strong></p> <p>Mother’s milk is the best possible natural food for babies. Although many mothers claim their milk clears up skin conditions, there’s no scientific proof of this, warns Dr Sarah Yamaguchi, an obstetrician and gynecologist. “Breast milk can transmit infectious diseases such as HIV and pumped breast milk if not stored properly can be contaminated and can actually introduce bacteria into an already infected area,” says Dr Yamaguchi.</p> <p>Instead, she advises, patients suffering from infections or inflamed skin should try to keep the area clean and dry and seek medical attention.</p> <p><strong>Castor oil</strong></p> <p>In her work as an obstetrician, Dr Yamaguchi has seen her fair share of women in the final stages of pregnancy who just cannot wait to have their baby. She has seen many women take castor oil believing it will jump-start labour.</p> <p>“Castor oil may help if you are constipated and need to pass a bowel movement, but it’s not going to help you go into labour and it tastes awful,” she says.</p> <p><strong>Syrup of Ipecac</strong></p> <p>This syrup, made from the roots of a South American plant, is often kept in the home by parents to act as a counter treatment for accidental poisoning, as it induces vomiting. However, this form of treatment is incredibly dangerous, warns Dr Fisher.</p> <p>Many poisons do further damage when they make their way out of the body, damaging the oesophagus and potentially causing breathing problems. Dr Fisher advises parents not to use syrup of ipecac at all. The only appropriate reaction to a child swallowing something poisonous, she says, is to call your local Poison Control immediately and seek medical treatment.</p> <p><strong>Charcoal</strong></p> <p>Some people believe that activated charcoal, often derived from coconut shells, is thought to trap and remove dangerous toxins from the body. It is often recommended for treating bloat and constipation. However, it is a controversial treatment.</p> <p>Dr Kogan has heard of patients swallowing activated charcoal for detoxification purposes, which she strongly discourages. “It is dangerous because it can cause life-threatening intestinal obstructions and severe dehydration,” she says. Eating well and drinking plenty of water can have similar, but safer, detoxification effects on the body.</p> <p><strong>Blowing on or licking a wound</strong></p> <p>Parents everywhere are known for spitting on a tissue and using it to clean their children’s faces and sometimes even to clean a wound. Blowing on or introducing saliva to a cut is very dangerous.</p> <p>“Our breath and saliva have tons of bacteria which can contaminate the wound and lead to an infection,” says Dr Kogan. Instead, use fresh water and consult a doctor if needed.</p> <p><strong>Vitamins</strong></p> <p>As long as you follow a healthy diet, you’ll get all the vitamins and minerals you need. That’s good because sliding into the habit of trying to make up supposed deficiencies with supplements can quickly lead to trouble, warns Dr Kogan.</p> <p>The danger comes when people ignore the recommended doses and take too much of a particular vitamin. Too much vitamin D, for instance, can cause liver and heart problems, while an overabundance of B6 can lead to nerve toxicity; a vitamin A overdose can even cause death in extreme cases.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/12-trusted-home-remedies-that-will-only-make-you-worse?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Body

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Do aches and pains get worse in the cold?

<p><em><strong>Andrew Lavender, Lecturer, School of Physiotherapy and Exercise Science, Curtin University, asks if joint and muscle aches get worse in the cold.</strong></em></p> <p>The winter chill is often associated with an increase in aches and pains for many older people, particularly in the joints, but also in the muscles. Some <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Strusberg+I+Mendelberg" target="_blank" rel="noopener">recent studies</a></strong></span> have shown an increase in general aches and pain in older men and women, and in particular a correlation between joint pain and weather conditions in patients with <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/27633622" target="_blank" rel="noopener">rheumatoid arthritis</a></strong></span> or <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/26329341" target="_blank" rel="noopener">osteoarthritis</a></strong></span>.</p> <p>For those without these conditions, any experience of pain with cold or wet weather may be related to changes in physical activity and diet.</p> <p><strong>How does the cold affect our muscles and joints?</strong></p> <p>In investigating a link between weather and joint pain, <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/11838853" target="_blank" rel="noopener">studies have examined</a></strong></span> temperature, barometric pressure, precipitation, humidity and sunshine for their links to pain. The results are somewhat inconclusive because they vary greatly. This is largely because pain is subjective and it’s difficult to isolate a particular cause.</p> <p>Other factors like exercise, mood and diet also have an influence on pain perception. <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/19714599" target="_blank" rel="noopener">Some research focused on the idea</a></strong></span> that atmospheric pressure may have the greatest effect. This is because there are gasses and fluids within joints, and if atmospheric pressure reduces, these gasses and fluids might expand, putting pressure on surrounding nerves causing pain. But this has not been shown clearly.</p> <p>A <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Savage+rheumatoid+arthritis+pain+2015" target="_blank" rel="noopener">recent study found</a></strong></span> the combination of temperature, sunlight exposure and humidity correlates with joint pain in patients with rheumatoid arthritis. But the authors were quick to point out the variability in pain perception and other factors, like exercise and diet, means a clear link still can’t be drawn with confidence.</p> <p><strong>How we can prevent aches in winter</strong></p> <p>There are some things that can help reduce pain during the colder months.</p> <p><strong>Exercise:</strong> joint pain is <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/28355375" target="_blank" rel="noopener">often associated with excess weight</a></strong></span>, so a weight-loss exercise program will help to take the pressure off the joints. Exercise also helps to improve metabolism and blood flow through muscles and joints, which can reduce inflammation, stiffness and pain.</p> <p>Many people tend to be more active in the warmer months when the weather is pleasant and it’s comfortable to be outside. It’s important to continue exercise into winter as a reduction in physical activity in winter for more than two weeks <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Colliander+detraining" target="_blank" rel="noopener">results in loss of muscle strength</a></strong></span> and mass as well as reduced bone density. Being inactive for long periods can lead to a gain in fat mass and overall body weight which puts <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/28142365" target="_blank" rel="noopener">excess pressure on joints that can lead to injury</a></strong></span>.</p> <p>Movements that include large muscles of the legs, arms and torso such as squats, sit-ups and push-ups can be done in a fairly small space, and so are ideal inside during winter. Resistance exercise of this type is important for muscle and bone strength. Like muscles, bones adapt to the stimulus of repeated load bearing making them stronger and less prone to injury. This is <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Beavers+Martin+CHnge+bone+mineral+density+2017" target="_blank" rel="noopener">particularly important</a></strong></span> for older individuals.</p> <p>This doesn’t mean you need to go to a gym and lift heavy weights, although you may consider joining a gym for individual or group exercise sessions. You can get enough stimulation for maintenance of muscle and bone strength through daily tasks and home workouts.</p> <p><strong>Vitamin D:</strong> exercising regularly can help to reduce symptoms in the long term, and getting outdoors for longer periods more often provides <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/27258303" target="_blank" rel="noopener">vitamin D for healthier bones and joints</a></strong></span>.</p> <p>When daylight hours are limited, vitamin D supplements are a good way to continue to get the benefits of this vitamin, which has an important role in bone mineralisation, muscle function and nerve growth. Studies have found daily supplementation with vitamin D <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/22592290" target="_blank" rel="noopener">reduces the risk of bone fracture</a></strong></span> and improves muscle strength for older people.</p> <p>It’s recommended adults get at least 200 to 600 international units (IU) of Vitamin D daily if they’re getting some exposure to sunlight most days. It’s not easy to get vitamin D through diet, but in a country like Australia, where sunlight is available even in winter, this presents less of a problem than for people living in regions that have limited sunlight in winter.</p> <p>The best foods for vitamin D include fatty fish like sardines, mackerel and herring, milk, margarine and vitamin D-fortified soy drinks. But it’s important to remember dietary sources alone are not sufficient to provide enough vitamin D. Sunlight is an important source and supplementation should be considered for those who have limited exposure to the sun in winter.</p> <p><strong>Glucosamine and chondroitin:</strong> glucosamine and chondroitin sulphate help to provide nourishment to cartilage to improve joint function. They make movement of the joint smoother by <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/26881338" target="_blank" rel="noopener">reducing the friction produced</a></strong></span> between the articulating surfaces of the bones. Crustaceans provide a good source of glucosamine, while chondroitin sulphate can be obtained from cartilage of animal bones. Supplementation of these is <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/26881338" target="_blank" rel="noopener">prescribed for patients</a></strong></span> with osteoarthritis to help restore cartilage.</p> <p><strong>Heat therapy:</strong> heat therapy can help greatly when you do have pain. Warm baths or showers, particularly in the morning <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/27403866" target="_blank" rel="noopener">can make a big difference</a></strong></span> to the level of pain and stiffness. Warming the body increases elasticity of the tissue and improves blood flow making movement easier. It also activates neural pathways that <span style="text-decoration: underline;"><strong><a href="http://www.tandfonline.com/doi/full/10.1080/00325481.2015.992719" target="_blank" rel="noopener">reduce the brain’s perception of pain</a></strong></span>.</p> <p><em>Written by Andrew Lavender. Republished with permission of <a href="http://theconversation.com/" target="_blank" rel="noopener"><strong><span style="text-decoration: underline;">The Conversation</span></strong></a>.</em><img src="https://counter.theconversation.com/content/81260/count.gif?distributor=republish-lightbox-advanced" alt="The Conversation" width="1" height="1" /></p> <p><em>Images: Getty</em></p>

Body

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9 medical reasons your short-term memory is getting worse

<p><strong>What is short-term memory?</strong></p> <p>Short-term memory is the type of memory you need to accomplish your immediate goals, explains Dr Patrick Lyden, chair of the department of neurology at Cedars-Sinai Hospital. That may be working your way through tasks during the workday, remembering someone’s name, email, or phone number, or recalling where you tossed your keys when you got home.</p> <p><strong>Where is it located in the brain?</strong></p> <p>When someone rattles off their phone number, you file it away in brain circuits that include the hippocampus (your memory centre) and the amygdala (your emotional hub). Depending on how important the short-term memory item may be (your address, someone you call all the time), it can be converted into long-term memory, says Dr Lyden.</p> <p><strong>How does short-term memory work?</strong></p> <p>Short-term memory isn’t just about being able to quickly recall new info; there are three phases. “You have to register the information, store the information, and retrieve the information,” says Dr Lyden. Registering means that you’re paying attention in the first place. Storing the info means you’ve filed it away in your brain. Retrieval is the ability to access the memory again. Any of these steps can break down, he says.</p> <p><strong>Is your memory okay?</strong></p> <p>Many people assume they have a memory problem when the explanation is something else entirely, says Dr Lyden. Maybe you’re not paying attention because you’re gazing at your phone or texting, for example. The first step to figuring out if something is going on is to “pay closer attention,” he says. Repeat the new information three times to commit it to memory.</p> <p><strong>When it may be time to worry</strong></p> <p>If you can’t pass the “pay attention test” despite repeating the information, your next step, advises Dr Lyden, is to determine if your problem is storing new memories or retrieving them. If you’re having a problem remembering a new acquaintance’s name, ask them to give you three choices – like Carrie, Lauren, or Janet. If your problem is storing new memories, you won’t be able to remember. But if your problem is retrieval, you’ll remember that her name is Janet once you hear the correct name.</p> <p>Having trouble with retrieving a short-term memory isn’t as serious as being unable to store them. “The storage problem is a serious problem, and you should see a neurologist,” he says.</p> <p><strong>Inactivity</strong></p> <p>Blood flow is good for your brain – it keeps it young. “Exercising boosts blood flow to your brain. If you stay active, you’ll have a better memory,” says Dr Daniel G. Amen, author of <em>Memory Rescue: Supercharge Your Brain, Reverse Memory Loss, and Remember What Matters Most</em>. Dr Lyden suggests daily exercise and it doesn’t have to be intense. “A one-kilometre run daily is better than a 10-kilometre run one day a week,” he says.</p> <p><strong>Substance abuse</strong></p> <p>According to Dr Amen, marijuana a toxin that impairs memory. “Marijuana lowers every area of the brain and ages it. On average, pot smokers have brains three years older than non-smokers,” he says. Alcohol abuse can also harm your memory.</p> <p><strong>Mental health conditions</strong></p> <p>People tend to miss their own depression. But if you’re suffering from depression, anxiety, or chronic stress, get help or your memory can also pay the price. “These conditions may all hurt the brain,” says Dr Amen. Getting relief will not only improve your life and outlook but save your brain.</p> <p><strong>Lack of sleep</strong></p> <p>When considering short-term memory loss causes, poor sleep is a big one. “If you don’t sleep seven hours a night or more, you’ll be in trouble. Your brain cleans itself at night. When you don’t get enough, it’s like the garbage collectors didn’t come to clean up,” says Dr Amen.</p> <p><strong>Dementia</strong></p> <p>Before you panic, there’s some good news: “The vast majority of people who are healthy will not have a degenerative neurological condition causing short-term memory loss,” says Dr Lyden. But dementia or Alzheimer’s is a possibility in some groups. If you’re over 60 and have risk factors like diabetes, high blood pressure, or obesity, then you may be more prone to problems and need to be evaluated, he says.</p> <p><strong>Medication</strong></p> <p>If you lead a healthy lifestyle, eat right, exercise, and go easy on alcohol and other substances that can harm memory, yet you still feel like your memory if failing, talk to your doctor about your medications – prescription and over-the-counter, advises Dr Lyden. Cholesterol drugs, painkillers, high blood pressure pills, and sleeping pills are among the drugs that can trigger memory issues.</p> <p><strong>Hypothyroidism</strong></p> <p>When you have an under-active thyroid, everything in your body runs slower. Your digestion will slow and you can become constipated; cell growth slows and can lead to hair loss; your metabolism becomes sluggish, triggering weight gain. And you may be plagued by muddied thinking or forgetfulness. Often, medication to restore thyroid hormones can help alleviate symptoms and help you feel better all over.</p> <p><strong>A poor diet</strong></p> <p>Inflammation is bad for your body and your brain. “The higher the inflammation levels in your body, the worse your memory will be,” says Dr Amen. Eating an anti-inflammatory diet, like the Mediterranean diet, and avoiding foods that increase it (highly processed foods, loads of sugar) is key. He also recommends taking fish oil and probiotics.</p> <p><strong>Lyme disease</strong></p> <p>Lyme disease is transmitted through a tick bite, and causes early symptoms like fever, chills, headache, and fatigue, according to the Centers for Disease Control and Prevention (CDC). Later on, without treatment, some people also may notice short-term memory problems. Dr Amen points out this may include trouble with attention, focus, and organisation. Keep in mind that the types of tick that carry the bacteria are not native to Australia and it’s not likely you can catch Lyme disease in Australia.</p> <p><strong>When to seek help</strong></p> <p>Along with the self-test mentioned earlier, think about how you perceive your short-term memory. Ask yourself: Is it getting progressively worse? Is it worse than 10 years ago? Are other people noticing a problem? “Those are things you should take seriously,” says Dr Amen.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/9-medical-reasons-your-short-term-memory-is-getting-worse-2?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Mind

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Readers Respond: What improvements have actually made life worse?

<p dir="ltr">A lot of things in life have changed…some for the better, others for the worst. </p> <p dir="ltr">Technology is possibly one of the greatest things to improve life among other things. </p> <p dir="ltr">But some people will argue the opposite wishing to go back to the good ‘ol days. </p> <p dir="ltr">So it got us thinking to ask our OverSixty readers to share what are some improvements that have instead made life worse.</p> <p dir="ltr">Check out some of your responses below. </p> <p dir="ltr">Amber Young - Online banking offers some convenience but also has led to many people being hacked or scammed out of their savings.</p> <p dir="ltr">Herman Zirkzee - Privatisation of essential utilities. They`ve become millionaires because of the CEOs.</p> <p dir="ltr">Suzanne Stovel - Mobile phones and video games. Mobile phones are great for emergencies but people have forgotten to communicate directly. Video games are fun, but what about playing outside with friends.</p> <p dir="ltr">Linda Scantlebury - Mobile phones have cut normal conversation off at the knees. Heck people even need a mobile to cross the fricking road.</p> <p dir="ltr">Jennifer McKillop - Social media in all its forms.</p> <p dir="ltr">Gary Sturdy - Work. Life was so much easier before work.</p> <p dir="ltr">Ruth Marshall - The ability for marketers and scammers to cold call you.</p> <p dir="ltr">Amber Young - Aircraft, specifically flight training. If you live anywhere near a secondary airport that caters to foreign flight training. It was such a difference during the latter part of COVID when we enjoyed the sounds of almost silence.</p> <p dir="ltr">Gigi Chanco-Bongay - Emails at work. Communication with colleagues is lessened, and there is no friendly chit chat. </p> <p dir="ltr">Ann Bedson - Mobile phones. Video games and people who change simple nursery rhymes. </p> <p dir="ltr">Tell us what improvement has made life worse <a href="https://www.facebook.com/oversixtys/posts/pfbid02V8urY7WeTRmaBCobZdpfmcMuZbbK7cHomwBpBA1BSEYctgbi4eMoXoUJDhyFfhqcl" target="_blank" rel="noopener">here</a>. </p> <p dir="ltr"><em>Image: Shutterstock</em></p>

Retirement Life

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Women who suffer domestic violence fare much worse financially after separating from their partner

<p>We recently published <a href="https://paulramsayfoundation.org.au/wp-content/uploads/2022/07/TheChoice-violence-or-poverty-web.pdf">two</a> <a href="https://csrm.cass.anu.edu.au/sites/default/files/docs/2022/5/HILDAResultsMay122022.pdf">reports</a> that highlight the devastating financial consequences borne by women who leave their partners after suffering domestic violence.</p> <p>We found women who experienced domestic violence fared much worse financially after separating from their partner compared to those who didn’t face such violence, for women both with and without children.</p> <p>Before separation, mothers who experienced domestic violence had about the same household income as mothers who didn’t. But after separation, the mothers who experienced domestic violence on average suffered a significantly higher drop in income of 34%, compared with a 20% decrease for mothers who didn’t experience domestic violence.</p> <p>It’s the first time in Australia (to the best of our knowledge) that we have specific data on what happens financially to these women.</p> <p>Our results highlight the terrible option facing those who are experiencing domestic violence: to stay in a violent relationship, or leave and face a major decline in financial wellbeing.</p> <h2>What we studied</h2> <p>The first report, <a href="https://www.violenceorpoverty.com/">The Choice: Violence or Poverty</a> by Anne Summers, presents previously unreported data from the Australian Bureau of Statistics (ABS) 2016 Personal Safety Survey.</p> <p>The data reveal that of all women who’d ever been in a partnership, 22% have experienced violence from a current or previous partner. And, of single mothers living with children under 18 years of age, a staggering 60% had experienced physical violence, and 70% emotional abuse, from a partner they had previously cohabited with.</p> <p>The data also show 50% of these now single mothers live in poverty, relying on government benefits such as JobSeeker as their main source of income.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">'I left with the kids and ended up homeless with them': the nightmare of housing wait lists for people fleeing domestic violence <a href="https://t.co/nSRbGGL6ZW">https://t.co/nSRbGGL6ZW</a> via <a href="https://twitter.com/ConversationEDU?ref_src=twsrc%5Etfw">@ConversationEDU</a></p> <p>— Sunanda Creagh (@sunanda_creagh) <a href="https://twitter.com/sunanda_creagh/status/1555433771951738880?ref_src=twsrc%5Etfw">August 5, 2022</a></p></blockquote> <p>It’s important to note the ABS figures come from what’s known as a “cross-section”, which means they reflect circumstances at a given point in time (2016). They can’t tell us what happens to women over time, or the immediate effects of domestic violence on their separation and/or income. This is a critical issue for domestic violence policy.</p> <p>Understanding the dynamics of the financial situation of victim-survivors requires what’s known as “panel data”. This issue is addressed in the <a href="https://csrm.cass.anu.edu.au/sites/default/files/docs/2022/5/HILDAResultsMay122022.pdf">second report</a> by Bruce Chapman and Matthew Taylor, where we analyse the Household Income and Labour Dynamics of Australia (HILDA) survey. HILDA is Australia’s best longitudinal data set, meaning it surveys the same people over time. To date, HILDA has followed around 19,000 people from 2002 to 2021.</p> <p>We analysed HILDA data looking at the financial consequences for women likely to have experienced domestic violence. We covered both mothers and women who don’t have children.</p> <p>HILDA doesn’t ask questions about the origins of violence experienced directly. So we had to devise a method of identifying separation due to domestic violence by linking the date of separation to reporting of an incident of violence: the presumption being that the incident was domestic violence (rather than, say, a street crime).</p> <p>The report uses averages before and after separation of the three income categories, all measured in annual terms:</p> <ul> <li>the partner’s contribution to household income</li> <li>the woman’s wages and salaries</li> <li>and total government financial support received by women.</li> </ul> <h2>What we found</h2> <p>In dollar terms, the drop in household income (which measures the total of all income) for mothers who experienced domestic violence after separation was from $54,648 to $35,921 a year.</p> <p>There was also a fall in the household income for separating mothers not subject to domestic violence. But this fall is about $7,500 less compared to mothers who experienced domestic violence.</p> <p>We also looked at the changes to a particular component of household income, the wages and salaries of the mothers (again, following separation). Similarly, we found those who’d gone through domestic violence fared far worse than those who didn’t.</p> <p>It was expected the wages and salaries of women would increase on average after separation because of their need to compensate for the loss of the former partner’s income. But the extent to which this happened is quite different depending on whether or not the women experienced domestic violence.</p> <p>Specifically, the wage and salary increase for mothers who’d experienced domestic violence was just 19% (from $11,526 to $13,747). But the wage and salary increase for mothers who hadn’t experienced domestic violence was much greater at 45% (from $14,414 to $20,838).</p> <p>This means that these now single mothers who experienced domestic violence are considerably worse off financially than single mothers who didn’t face such violence.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">“It’s not just that women and children are often impoverished by <a href="https://twitter.com/hashtag/familyviolence?src=hash&amp;ref_src=twsrc%5Etfw">#familyviolence</a>. <br />What’s also clear is that many perpetrators are enriched by it: </p> <p>75 per cent of single mothers left property and assets behind.” <a href="https://t.co/9S2HVJI7ao">https://t.co/9S2HVJI7ao</a></p> <p>— SRPassesItOn (@SallyRMelb) <a href="https://twitter.com/SallyRMelb/status/1552919705593483265?ref_src=twsrc%5Etfw">July 29, 2022</a></p></blockquote> <p>When the pre- and post-separation incomes of women without children are examined, the findings are similar to those for mothers, but with even greater losses for childless women who’d experienced domestic violence compared to childless women who hadn’t. Childless women who experienced domestic violence suffered an extraordinary 45% drop in household incomes, compared with 18% for childless women who didn’t experience domestic violence.</p> <p>The relatively large loss in household income for childless women is the result of significant differences in the post-separation income levels between childless women, depending on their experience of domestic violence.</p> <p>Childless women who hadn’t experienced domestic violence had an average increase of 68% in their wage and salary incomes (to about $38,000) after separation. But childless women who’d experienced domestic violence had an actual decrease in wage and salary incomes of around 20% on average (to about $13,000).</p> <p>A different way of illustrating the issue is the recognition that experiencing domestic violence doubles the likelihood of victim-survivors ending up in the bottom quarter of the income distribution.</p> <p>We found around 50% of the women included in the data who have faced domestic violence and separated from their partners end up in the bottom quarter of the income distribution.</p> <p>The <a href="https://paulramsayfoundation.org.au/wp-content/uploads/2022/07/TheChoice-violence-or-poverty-web.pdf">ABS data</a> reports a similar outcome, with 48.1% of now single mothers with children being in the lowest fifth of the income distribution.</p> <h2>More research and better data needed</h2> <p>These two reports have dug deeply into available data and unearthed findings of tremendous significance, results that reinforce each other.</p> <p>While these findings have been rigorously tested and found to be statistically significant, the sample sizes for the longitudinal data are small.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Three Charts On: How Emotional and Economic Abuse Go Hand-in-hand <a href="https://twitter.com/hashtag/AbuseComesInManyForms?src=hash&amp;ref_src=twsrc%5Etfw">#AbuseComesInManyForms</a> <a href="https://twitter.com/hashtag/raiseawareness?src=hash&amp;ref_src=twsrc%5Etfw">#raiseawareness</a> <a href="https://twitter.com/hashtag/emotionalabuse?src=hash&amp;ref_src=twsrc%5Etfw">#emotionalabuse</a>+economicabuse <a href="https://t.co/D2JwRM0sja">https://t.co/D2JwRM0sja</a></p> <p>— DASACC (@DASACCWCNJ) <a href="https://twitter.com/DASACCWCNJ/status/1028763153579089920?ref_src=twsrc%5Etfw">August 12, 2018</a></p></blockquote> <p>This is currently the best available longitudinal data capturing incomes. But as both reports have highlighted, data collection in the field of domestic violence needs to be expanded considerably if we’re to have more comprehensive information on longer-term outcomes.</p> <p>We urgently need a national longitudinal study of social behaviour and experience that probes the consequences of domestic violence (with respect to perpetrators as well as victims) and the financial, employment and health outcomes for all concerned, including the children caught up in these violent relationships.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/women-who-suffer-domestic-violence-fare-much-worse-financially-after-separating-from-their-partner-new-data-190047" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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Low iron is a health risk made worse by COVID

<p>“Beauty is an iron mine,” once remarked the Australian mining magnate, Gina Reinhart. She was talking about a precious resource, but iron is also profoundly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464783/" target="_blank" rel="noopener">important to living organisms</a>: from bacteria and fungi, to mammals like us.</p> <p>Iron acts as a key to numerous metabolic functions within our bodies. But iron deficiency remains as <a href="https://cdn.who.int/media/docs/default-source/nutritionlibrary/focusing-on-anaemia_970a28fe-a055-4e63-b3ba-11be7b940b16.pdf?sfvrsn=9ab36bdb_6&amp;download=true" target="_blank" rel="noopener">one of the top global health risks</a> recognised by the World Health Organization (WHO).</p> <p>Iron deficiency has become the most prevalent micronutrient disorder worldwide, and COVID may be worsening the problem.</p> <h2>Iron is hard to get</h2> <p>The type of iron we mine is different from the “free-form” iron that can be used biologically. Free-form iron has a propensity to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842161/" target="_blank" rel="noopener">jump between two chemical states</a>, allowing it to bind to various molecules, and participate in all sorts of essential reactions within our bodies.</p> <p>But we see a different story again during food digestion. Inside our upper small intestine where iron is most effectively absorbed, free-form iron tends to bind to oxygen, other minerals and food components. This often results in rock-like, insoluble clumps (which are like the ones we mine!). These are too big to pass through or between our cells.</p> <p>This means that even when we consume enough iron, <a href="https://www.ncbi.nlm.nih.gov/books/NBK448204/#:%7E:text=Heme%20iron%2C%20derived%20from%20hemoglobin,and%20is%20less%20well%20absorbed." target="_blank" rel="noopener">typically only ~15–35% of it is absorbed</a>. It also means iron availability can be <a href="https://ift.onlinelibrary.wiley.com/doi/10.1111/1541-4337.12669" target="_blank" rel="noopener">improved, or inhibited</a> depending on how we eat it or what we eat it with.</p> <p>For example, heme iron from animal flesh has a <a href="https://omlc.org/spectra/hemoglobin/hemestruct/heme-struct.gif" target="_blank" rel="noopener">cage-like structure</a>, which carries the iron in a soluble form that prevents it from clumping during absorption. In many Western countries, heme iron only accounts for <a href="https://academic.oup.com/metallomics/article/3/2/103/6016197?login=true#219037456" target="_blank" rel="noopener">10% of the iron eaten, but two thirds</a> of the total iron absorbed.</p> <h2>More of us are at risk of deficiency</h2> <p>Getting sufficient iron sounds like simple maths: we want to add enough to our dietary intake to make up for the iron being lost from the body, such as through faeces, skin shedding, menstruation (for women) and sweat. But the two sides of the equation can change depending on who and where we are throughout our lifetime.</p> <p>Generally, iron deficiency occurs when our body’s stores of iron are depleted from not having consumed or absorbed enough iron to meet our needs.</p> <p>This can happen when people restrict their diets, such as for religious, social or medical reasons. Some people also have a tough time keeping up when their iron needs increase, such as <a href="https://www.nature.com/articles/s41430-019-0400-6" target="_blank" rel="noopener">pregnant women</a> and <a href="https://academic.oup.com/ajcn/article/106/suppl_6/1681S/4823199" target="_blank" rel="noopener">growing children</a>.</p> <p>But iron deficiency can also happen when the body has enough iron, <a href="https://onlinelibrary.wiley.com/doi/10.1111/bjh.12311" target="_blank" rel="noopener">but can’t effectively transport it into cells</a>. This is common in those with both acute and chronic infections, heart and autoimmune conditions, and cancers. In these cases, the underlying disease needs to be treated first, rather than improving iron intake.</p> <p>The table below summarises some common causes of iron deficiency. Sometimes multiple causes may occur simultaneously – for example, for many elite athletes (<a href="https://link.springer.com/article/10.1007/s00421-019-04157-y" target="_blank" rel="noopener">35% of women and 11% of men</a>), iron deficiency results from reduced absorption due to inflammation, on top of increased loss through sweat and breakdown of blood cells.</p> <h2>COVID hasn’t helped</h2> <p>The ongoing COVID epidemic has also introduced multiple risk factors for iron deficiency.</p> <p>We know severe infection with SARS-CoV-2 (the virus that causes COVID) may change the way some people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305218/" target="_blank" rel="noopener">metabolise iron</a>, leading to lower iron levels up to two months after infection. This <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.26774" target="_blank" rel="noopener">contributes to symptoms</a> commonly reported after infection, such as fatigue and lethargy.</p> <p>Recovery from the pandemic itself has also exacerbated <a href="https://www.oecd.org/coronavirus/policy-responses/food-supply-chains-and-covid-19-impacts-and-policy-lessons-71b57aea/" target="_blank" rel="noopener">food supply issues</a>, as well as the <a href="https://blogs.worldbank.org/developmenttalk/global-income-inequality-and-covid-19-pandemic-three-charts" target="_blank" rel="noopener">rising global income inequality</a>.</p> <p>This means more people face barriers to food security – and the nutrient-dense foods that help boost our iron intake like red meat or leafy greens may be unavailable or unaffordable for them.</p> <h2>Before you pick up a pill</h2> <p>It may be tempting to pick up one of the many widely available iron supplements to attempt to boost your intake. However, we have to keep in mind that conventional iron supplementation is <a href="https://www.tandfonline.com/doi/full/10.1185/03007995.2012.761599" target="_blank" rel="noopener">associated with some negative side effects</a>.</p> <p>These include damage to our gut lining, nausea, diarrhoea and constipation. Iron supplementation has also been linked to changes in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400826/" target="_blank" rel="noopener">gut microbiome</a>, a critical determinant of health.</p> <p>The WHO has recommended <a href="https://cdn.who.int/media/docs/default-source/micronutrients/gff-part-1-en.pdf?sfvrsn=afc1c426_2" target="_blank" rel="noopener">two other approaches</a>: diet diversification and food fortification.</p> <p><a href="https://cdn.who.int/media/docs/default-source/anaemia/areacop-webinar---24-september-2020/areacop-webinar-nancyaburto-presentation.pdf?sfvrsn=7abd1427_4" target="_blank" rel="noopener">Diet diversification</a> is exactly as it sounds: having a diet with a variety of wholefoods such as fruits and vegetables, grains and legumes, meat, dairy, and nuts and seeds.</p> <p>This approach not only ensures sufficient levels of iron are found in the foods we eat, but also that they come with different forms or “vehicles” to improve absorption. This approach works <a href="https://apps.who.int/iris/bitstream/handle/10665/349086/WHO-EURO-2021-4007-43766-61591-eng.pdf?sequence=1&amp;isAllowed=y" target="_blank" rel="noopener">even with plant-based foods</a>.</p> <p>Food fortification, where iron is added to processed foods, is also a fairly safe yet accessible option due to its lower dose. In Australia, iron is commonly fortified in products such as bread, cereals and ready-to-drink mixes.</p> <p>It can be challenging to get the iron into our body and where it’s needed. But before turning to supplements, we must remind ourselves that food sources should always be first-in-line. In cases of diagnosed deficiencies, your healthcare professional will provide you with further information where supplements are necessary.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/low-iron-is-a-health-risk-made-worse-by-covid-how-to-get-more-without-reaching-for-supplements-185020" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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Why capping food prices won’t work – and will actually make things worse

<p>Australian shoppers are facing a crisis in the fresh-food aisles.</p> <p>Iceberg lettuces that cost $2.80 a year ago have doubled, or <a href="https://www.abc.net.au/news/rural/2022-06-08/lettuce-shortage-continues-and-fruit-and-vegetable-prices-rise/101133906" target="_blank" rel="noopener">tripled</a>, in price. Brussel sprouts that cost <a href="https://www.sydneymarkets.com.au/recipes-and-produce/market-report/28-june-4-july-2021.html" target="_blank" rel="noopener">$4 to $6 a kilogram</a> are now <a href="https://www.sydneymarkets.com.au/recipes-and-produce/market-report/6-12-june-2022.html" target="_blank" rel="noopener">$7 to $14</a>. Beans that cost <a href="https://www.sydneymarkets.com.au/recipes-and-produce/market-report/28-june-4-july-2021.html" target="_blank" rel="noopener">$5 to $6 a kilogram</a> are now more than double – and <a href="https://www.abc.net.au/news/2022-06-13/fresh-produce-too-expensive-remote-living-cost-of-living-crisis/101057668" target="_blank" rel="noopener">five times as much</a> in remote areas.</p> <p>That’s if you can even find such produce. Supermarket shelves for leafy greens are often bare.</p> <p>This is a strong hint as to why prices have risen so much. As well as growers facing higher input costs – in line with pressures pushing up food prices globally – these price hikes are being driven by lack of supply – with crops and <a href="https://www.theguardian.com/australia-news/2022/mar/04/weve-run-out-of-lettuce-supermarkets-and-restaurants-face-fresh-food-shortage-after-nsw-and-queensland-floods" target="_blank" rel="noopener">stores</a> wiped out by rain and floods in eastern Australia.</p> <p>The price hikes have led to calls for supermarkets to impose <a href="https://www.abc.net.au/news/rural/2022-06-17/call-supermarket-cap-price-fresh-produce/101156252" target="_blank" rel="noopener">price caps</a> to ensure shoppers can still afford to feed their families healthy food.</p> <p>But price ceilings on goods or services rarely, if ever, work. Prices play an important role in allocating resources efficiently. They send a signal to both customers and suppliers. To arbitrarily reduce prices would only increase shortages – both now and in the longer term.</p> <h2>Supply, demand and market equilibrium</h2> <p>The laws of supply and demand are fundamental concepts in economics. The law of demand says buyers will demand less of an economic good the higher its price. The law of supply says sellers will supply more of a good the higher the price. There are some rare exceptions, but generally these laws describe all markets.</p> <p>British economist Alfred Marshall was the first to illustrate the interaction of these two laws graphically, in his 1890 book <a href="https://opentextbc.ca/principlesofeconomics/" target="_blank" rel="noopener">Principles of Economics</a>. Market equilibrium (balance) occurs at the price and quantity where demand equals supply.</p> <p>If the quantity supplied falls, the market response is for prices to rise, achieving a new equilibrium. If the quantity supplied falls but prices remain the same, demand will outstrip supply, leading to shortages.</p> <p>Fresh fruit and vegetables are particularly prone to significant price fluctuations because they are perishable and cannot be easily stored for a long time. This why seasonal price fluctuations are common.</p> <p>Higher prices provide a signal both to consumers and producers. They tell consumers to buy less and switch to alternatives. They provide an incentive for producers to grow more – though this process is fairly slow given the time needed to grow and harvest fruit and vegetables.</p> <p>But eventually, if the market is left to its own devices, prices will eventually return to “normal”, consistent with historical prices.</p> <p>Capping the price, on the other hand, will benefit those lucky enough to grab supplies when they available. But it will likely reduce supply even further, by affecting the decision of producers unwilling to supply at below-market prices.</p> <p>It could also lead to a “black market”, with some customers sourcing supplies by other means at higher uncapped prices.</p> <h2>Evidence from rent controls</h2> <p>The economic theory of price caps is well supported by empirical evidence. The best-known involve rent controls, which are used in US cities such as New York City and Los Angeles, and <a href="https://www.jonesday.com/en/insights/2020/10/mapping-out-rental-controls-across-europe" target="_blank" rel="noopener">in European cities</a> such as Stockholm, Berlin and Dublin.</p> <p>Rent controls mean some are lucky enough to find an affordable apartment. Many others miss out – or engage in “deals” with landlords to get around the controls. The most disadvantaged tend to lose out most since landlords can discriminate in favour of what they consider the “more desirable” tenants.</p> <p>As Stanford University economist Rebecca Diamond <a href="https://www.brookings.edu/research/what-does-economic-evidence-tell-us-about-the-effects-of-rent-control/" target="_blank" rel="noopener">has written</a>:</p> <blockquote> <p>While rent control appears to help current tenants in the short run, in the long run it decreases affordability, fuels gentrification, and creates negative spillovers on the surrounding neighborhood.</p> </blockquote> <p>As with housing, so too with broccoli and cabbage.</p> <h2>We’ve seen this all before</h2> <p>So generally price caps are to be avoided.</p> <p>If there are suspicions of wholesalers or retailers exploiting shortages, this is best handled by the Australian Consumer and Competition Commission. Though “price gouging” <a href="https://www.accc.gov.au/media-release/accc-response-to-covid-19-pandemic" target="_blank" rel="noopener">is generally not illegal</a>, the consumer watchdog can prosecute companies for makes misleading claims about the reasons for price increases and for unconscionable conduct (in the case of extreme gouging for an essential good).</p> <p>What else can be done? Only what consumers have always done, which is to substitute relatively cheaper goods for those becoming more expensive.</p> <p>We’ve seen this before. Queensland’s floods in 2011 destroyed vast crops of bananas and watermelons, causing prices to skyrocket. Shoppers switched to other fruits. Banana farmers recovered. Prices dropped.</p> <p>These high prices for lettuce and such now may be a shock, but they are not a sign of market failure requiring intervention. If we let the market do its thing, shortages will end and prices return to “normal” – at least until the next natural disaster.</p> <p><em><strong><span id="docs-internal-guid-872c756f-7fff-bbdc-6911-4ed4a37e0bfb">This article originally appeared on <a href="https://theconversation.com/why-capping-food-prices-wont-work-and-will-actually-make-things-worse-185492" target="_blank" rel="noopener">The Conversation</a>.</span></strong></em></p> <p><em>Image: Shutterstock</em></p>

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16 signs your heart palpitations could be something way worse

<h2>What are heart palpitations?</h2> <p>That odd sensation in the middle of your chest can be alarming, but often it’s just a misfire in your heart rhythm. A series of electrical impulses keep your heart pumping; when one of the impulses is mistimed, you’ll feel palpitations in your chest. Most of the time it’s nothing, but they can be a sign of something dangerous. There are numerous types of heart rhythm disorders, says cardiologist, Dr Denice Hodgson-Zingman. “Some of them make the heart beat irregularly, and this can be perceived as a sensation of ‘flip-flops,’” she says.</p> <h2>Symptoms to watch for</h2> <p>If those electrical impulses fire in the wrong order, you can have the sensation of neck fullness and heart pounding, says Dr Hodgson-Zingman. “Other rhythm disorders consist of intermittent single extra beats or runs of beats. Because these extra beats are too fast to allow the heart to pump blood efficiently, it can feel as if your heart is skipping beats.” According to cardiologist, Dr Joe Lau, palpitations may also feel like a fluttering or racing sensation.</p> <p>“Palpitations are a symptom, so there’s no way to generally define what they feel like because, like all symptoms, the way that it feels varies from one patient to another,” says electrophysiologist, Dr Emily Zeitler. She says palpitations require a diagnostic evaluation by your doctor.</p> <h2>Sign: you often have palpitations</h2> <p>“Depending on the exact causes, some patients may have symptoms infrequently, while others may have several continuous episodes a day, sometimes with each episode lasting for several minutes at a time,” Dr Lau says. Chances are, if palpitations are only occurring rarely, you don’t need to rush to the doctor. Less serious causes for palpitations can include stress, anxiety, caffeine, alcohol, illness, or pregnancy, he says.</p> <h2>Sign: you have chest pain</h2> <p>Go right to the emergency room (or call an ambulance) if you get chest pain with palpitations, warns Dr Zeitler. This is a classic sign that your heart’s in serious trouble.</p> <h2>Sign: you’re having trouble catching your breath</h2> <p>In fact, you probably shouldn’t even wait for a doctor’s appointment if you’re experiencing this, as you may be having a cardiac event. When experiencing palpitations, “if you feel like you might pass out or you actually do pass out then you probably need to be seen right away in an urgent care or an emergency department,” she says.</p> <h2>Sign: you passed out</h2> <p>While most people would know something’s wrong with fainting, if your loss of consciousness is preceded by or followed by palpitations, you have even more reason to get medical attention stat, warns Dr Zeitler. This could indicate some sort of cardiac event, she says. Dr Lau says dizziness and leg swelling with palpitations can also signal serious heart trouble.</p> <h2>Sign: you have stroke symptoms</h2> <p>“Any stroke-like symptoms such as asymmetric weakness, facial droop, confusion, word-finding difficulty, or visual changes, would be worrisome,” Dr Hodgson-Zingman says.</p> <h2>Sign: you can’t get through your day</h2> <p>Even if you’re not having very scary symptoms, if you just feel generally terrible or need to stay in bed due to the weird sensations in your chest, you could benefit from treatment, says Dr Zeitler. Although the cause itself may be benign, it needs to be addressed so that you can function. “Atrial fibrillation [AF], a very frequent cause of palpitations, comes from the top chamber of the heart, the atrium, and it causes the bottom chamber of the heart to squeeze in an irregular way; the heart rhythm is chaotic,” Dr Zeitler says. “You don’t have to treat AF, but doctors often do because it makes people feel really bad and we can make people feel better with medications or with procedures such as ablation.”</p> <h2>Sign: you’ve had palpitations for a long time</h2> <p>Another reason palpitations can be dangerous is that they can weaken the heart muscle. “Heart rhythm abnormalities, if they remain untreated and persist for weeks to months, can result in the heart muscle becoming weak, which is called cardiomyopathy,” Dr Hodgson-Zingman says. “Fortunately, this form of cardiomyopathy is often completely reversible once the heart rhythm disorder is corrected.” In addition, even less dangerous conditions like AF can have long-term consequences. “This rhythm is not fatal, but it is associated with a much higher risk of stroke and can cause cardiomyopathy if not recognised and treated,” she says.</p> <h2>Sign: your heart starts beating really fast</h2> <p>Normally, you won’t even notice your heartbeat – but if you do and it’s speeding up, it could mean your blood pressure is dropping. “When blood pressure is low, the heart compensates by beating faster and harder, and that can feel like a pounding or racing heart,” says Dr Hodgson-Zingman. If it’s temporary, it could stem from being startled or experiencing strong emotions. However, see your primary care doctor if it keeps happening.</p> <h2>Sign: you already have heart problems</h2> <p>If you already have a heart condition, any rhythm problems can be more serious. “A person with a weakened heart, or cardiomyopathy, may also be predisposed to have extra ventricular beats [from the bottom chambers of the heart],” explains Dr Lau. “When these heartbeats become frequent and fast, they are termed ‘ventricular tachycardia’, and in a weakened heart that may lead to cardiac arrest.”</p> <h2>Sign: you’ve had a heart attack</h2> <p>Heart muscle damaged from a heart attack will have scarring, and that can also predispose you to the extra contractions of ventricular tachycardia, says Dr Lau. Dr Zeitler says such patients should be treated immediately. “I would be more aggressive in making a diagnosis and treating with either medications, procedures, or with an implantable defibrillator,” she says. Dr Hodgson-Zingman says heart disease patients should be evaluated and monitored for rhythm abnormalities regularly.</p> <h2>Sign: You have other health issues</h2> <p>Besides prior heart disease, other health conditions could make palpitations more dangerous – and even though common heart rhythm problems like atrial fibrillation are generally not serious, in some people they can be. “If the patient has other risk factors such as diabetes, high blood pressure, and vascular conditions, their risk of stroke may be high because atrial fibrillation may lead to the formation of blood clots within the heart that can travel to the brain and cause a stroke,” Dr Lau says. If you have other health issues, alert your doctor if you’re having palpitations.</p> <h2>Sign: you’re getting older</h2> <p>Like many conditions, palpitations may be more common, and more serious, in older people. “Another common problem that occurs with age is the wearing out of the normal heart electrical system,” Dr Hodgson-Zingman says. “This can cause pauses or irregularity in the heart rhythm and may be a sign that you need a pacemaker.” Also, some types of heart rhythm disorders are more common as you age. “Atrial fibrillation occurs in like 20 per cent of people over the age of 80, and it’s increasingly common as we get older,” Dr Zeitler says. According to the Australian Institute of Health and Welfare an estimated five per cent of the population aged 55 and over have AF.</p> <h2>Sign: You have a family history of sudden death</h2> <p>Regardless of your age, if you have a family history of sudden death before age 50 – or a family member with cardiomyopathy – you should pay close attention to any heart palpitations, Dr Hodgson-Zingman says. Talk to your doctor about your symptoms and your family history.</p> <h2>Sign: another condition is triggering the trouble</h2> <p>It’s possible that your palpitations are not directly related to your heart. With anaemia, “the heart has to work extra hard to pump blood to increase cardiac output so that the body tissues can get enough blood, and therefore oxygen,” Dr Lau says. Or with overactive thyroid, for example: “Thyroid hormone can overstimulate the heart and make it beat faster,” he says. A blood workup can help identify these problems when you see your doctor about your palpitations.</p> <h2>Sign: your fitness tracker detects an issue</h2> <p>Use technology to your advantage – your doctor will likely even commend your Apple Watch for detecting an irregular heart rhythm. “Some of those commercially available tools are really good and have been validated scientifically for being accurate at detecting heart rhythm disorders,” Dr Zeitler says. “If somebody comes to me with palpitations and a tracing from their iWatch that is suggestive of a heart rhythm disorder, it’s pretty likely that I’m going to be doing a diagnostic workup.”</p> <h2>Sign: you feel like something’s not right</h2> <p>Dr Zeitler advises following your intuition – if you feel like your heart is beating strangely, it’s best to get it checked out. “It’s one of those situations where you have to listen to your body,” she says. “If it feels like you’re dying or you might die, or you pass out or you have an accident because you’re passing out, those are reasons to seek attention in an emergency room. Otherwise, you can generally wait to see your primary care doctor, which would be a really good first step. Your primary care doctor can decide when the right time is to refer you to a cardiologist or a heart rhythm specialist.”</p> <p><em><strong><span id="docs-internal-guid-b1a6b4af-7fff-65a3-af1e-5139290cd372">This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/16-signs-your-heart-palpitations-could-be-something-way-worse" target="_blank" rel="noopener">Reader’s Digest</a>.</span></strong></em></p> <p><em>Image: Shutterstock</em></p>

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"It's blown up in our face": Estate agent's festive suggestion could NOT have gone worse

<p><span style="font-weight: 400;">A real estate agent has been the subject of intense backlash, after asking his tenants whether they wished to buy their landlords a pricey Christmas gift.</span></p> <p><span style="font-weight: 400;">Michael Kanik of Brisbane’s Kanik and Co sent a letter to renters with the offer to send Christmas hampers to their landlords on their behalf.</span></p> <p><span style="font-weight: 400;">Prices started at $50 for a basic White Wine Grazing Box and peaked at $115 for the All Things Golden hamper. Alternatives included a $55 Festive Sweets, $70 Self Care and $99 Foodies Hamper.</span></p> <p><img style="width: 0px; height: 0px;" src="https://oversixtydev.blob.core.windows.net/media/7846338/brisbane-landlord-christmas-present-1.jpg" alt="" data-udi="umb://media/c92bb31d954c4c4e85a8f12cdea4e451" /></p> <p><em><span style="font-weight: 400;">Image: Reddit</span></em></p> <p><span style="font-weight: 400;">In a screenshot of the email, shared on </span><a rel="noopener" href="https://www.reddit.com/r/brisbane/comments/rej48y/local_real_estate_encouraging_rental_tenants_to/" target="_blank"><span style="font-weight: 400;">Reddit</span></a><span style="font-weight: 400;">, the agency wrote: “This year has been particularly difficult for both our tenants and property owners alike and we understand some tenants would like to thank their property owners for everything in 2021.</span></p> <p><span style="font-weight: 400;">“Our team are happy to facilitate the purchasing of a gift and have it delivered to the property owner with a handwritten note to say thank you, directly from you.”</span></p> <p><span style="font-weight: 400;">The agent said tenants who wished to take part would be issued an invoice which would need to be paid within seven days.</span></p> <p><span style="font-weight: 400;">The letter </span><a rel="noopener" href="https://www.pedestrian.tv/news/real-estate-renter-landlord-christmas-gift/" target="_blank"><span style="font-weight: 400;">sparked</span></a><span style="font-weight: 400;"> a furious reaction online, especially as one-third of Australians relying on a national scheme reducing the costs of rental properties live in Queensland, as reported by </span><em><a rel="noopener" href="https://thewest.com.au/news/housing-advocates-warn-queensland-will-be-crunched-by-support-scheme-expiration-c-4167432" target="_blank"><span style="font-weight: 400;">The West Australian</span></a></em><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">One Twitter user who shared the screenshot on the platform wrote: “This agency is in Logan, where the average weekly rent has increased by 30 per cent in the last 5 years and the vacancy rate is 1 per cent”.</span></p> <p><span style="font-weight: 400;">Both tenants and landlords shared their disapproval of the gesture.</span></p> <blockquote class="twitter-tweet" data-conversation="none"> <p dir="ltr">Capitalism finally flowering into full-blown feudalism.</p> — Ancient Spoonbill (@AncientSpoonbil) <a href="https://twitter.com/AncientSpoonbil/status/1470177074379833347?ref_src=twsrc%5Etfw">December 12, 2021</a></blockquote> <p><span style="font-weight: 400;">“As a property owner who reduced rent and upgraded the internet connection at the property during COVID lockdown, I say WTF??” one user shared.</span></p> <p><span style="font-weight: 400;">“As another who did similar (instigated a rent-free period of three months and then reduced the rent going forward on the next lease), I just cannot get my head around this agent’s gift collection. If I was the LL [landlord] I’d be taking my property elsewhere for management,” another commented.</span></p> <blockquote class="twitter-tweet"> <p dir="ltr">Right!?<br /><br />I initially read it as the RE Agent giving *owners* a choice of hampers to gift to their *tenants*. I thought, oh that’s nice.<br /><br />When I realised it was backwards my mind blew 🤯</p> — Damon O’Hara (@hara_damon) <a href="https://twitter.com/hara_damon/status/1470527004772499459?ref_src=twsrc%5Etfw">December 13, 2021</a></blockquote> <p><span style="font-weight: 400;">“Oh god real estate agents really are something else. Like do they not realise we actually like them LESS than we like our landlords?” a third said.</span></p> <p><span style="font-weight: 400;">“This is outrageous- it should be the other way around, thanking their loyal customers,” another added.</span></p> <blockquote class="twitter-tweet" data-conversation="none"> <p dir="ltr">Thank you me lord and lady for allowing me to work the farm fields with me plough and beast. Please accept a bushel as a sign of my gratitude</p> — righteous_bot (@BotRighteous) <a href="https://twitter.com/BotRighteous/status/1470214503564337154?ref_src=twsrc%5Etfw">December 13, 2021</a></blockquote> <p><span style="font-weight: 400;">On Monday, Mr Kanik admitted that he had made a mistake in sending the email out. However he insisted that he also sent a letter to landlords with the same offer directed to their tenants.</span></p> <p><span style="font-weight: 400;">“It was done with the best of intentions but it’s blown up in our face,” he told </span><em><a rel="noopener" href="https://www.dailymail.co.uk/news/article-10303311/Michael-Kanik-Queensland-real-estate-agent-asks-tenants-buy-landlords-Christmas-hampers.html" target="_blank"><span style="font-weight: 400;">Daily Mail Australia</span></a></em><span style="font-weight: 400;">. “We thought it would be a nice gesture.</span></p> <p><span style="font-weight: 400;">“It’s quite disheartening. We’ve already had quite a few calls about it today.</span></p> <p><span style="font-weight: 400;">“We sent out that blanket email saying if you want to participate, but there’s no obligation at all. We were just purely trying to do a nice thing.”</span></p> <p><span style="font-weight: 400;">He added: “In hindsight, it was probably a mistake to send it to the tenants, but owners sending tenants a hamper is definitely a good thing.</span></p> <p><span style="font-weight: 400;">“All our landlords that come back to us are happy to do so. But some tenants have taken it the wrong way.”</span></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p>

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