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

<a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Drugs like Ozempic are very <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.12932">effective</a> at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger. But does weight come back when you stop using it? The short answer is yes. Stopping <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">tirzepatide</a> and <a href="https://doi.org/10.1111/dom.14725">semaglutide</a> will result in weight regain in most people. So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far. <h2>It’s a long-term treatment, not a short course</h2> If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone. For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns. Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.) Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less. <h2>Why do people stop?</h2> Research trials show anywhere from <a href="https://asean-endocrinejournal.org/index.php/JAFES/article/view/1771">6%</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/35015037/">13.5%</a> of participants stop taking these drugs, primarily because of <a href="https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more">side effects</a>. But these studies don’t account for those forced to stop because of cost or <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">widespread supply issues</a>. We don’t know how many people have needed to stop this medication over the past few years for these reasons. Understanding what stopping does to the body is therefore important. <h2>So what happens when you stop?</h2> When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to <a href="https://pubmed.ncbi.nlm.nih.gov/30565096/">move out of your system</a>. As it does, a number of things happen: <ul> <li>you start feeling hungry again, because both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/">your brain and your gut</a> no longer have the medication working to make you feel full</li> </ul> <ul> <li> blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index">low glycemic index</a> to stabilise your blood sugars </li> <li> over the longer term, most people experience a return to their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/">previous blood pressure and cholesterol levels</a>, as the weight comes back </li> <li> weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle. </li> </ul> While you were on the medication, you will have lost <a href="https://academic.oup.com/jes/article/5/Supplement_1/A16/6240360">proportionally less skeletal muscle than fat</a>, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat. <h2>Is stopping and starting the medications a problem?</h2> People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">yo-yo dieting</a>. When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to <a href="https://www.jomes.org/journal/view.html?doi=10.7570/jomes.2017.26.4.237">deal with</a> spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-022-01735-x">stress</a> your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual. Interestingly, the risk to the body from weight fluctuations is greater for people who are <a href="https://jech.bmj.com/content/74/8/662">not obese</a>. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight. <h2>How can you avoid gaining weight when you stop?</h2> Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include: <ul> <li> getting quality <a href="https://www.hindawi.com/journals/ije/2010/270832/">sleep</a> </li> <li> exercising in a way that builds and maintains muscle. While on the medication, you will <a href="https://pubmed.ncbi.nlm.nih.gov/32628589/">likely have lost muscle</a> as well as fat, although this is not inevitable, especially if you <a href="https://www.europeanreview.org/article/34169">exercise regularly</a> while taking it </li> </ul> <ul> <li> addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2009.159491">fat-phobic and discriminates</a> against people in larger bodies </li> <li> eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes. </li> </ul> Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224972/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-when-i-stop-taking-a-drug-like-ozempic-or-mounjaro-224972">original article</a>.

Body

"I miss her hugs": British acting legend shares heartbreaking loss

Actor Warwick Davis has shared the heartbreaking news of his wife's death. The actor, known for his roles in Harry Potter and Star Wars, took to social media to share the news of his wife Samantha's death, who passed away at the age of 53. “Her passing has left a huge hole in our lives as a family. I miss her hugs”, Warwick, 54, said. He added, “She was a unique character, always seeing the sunny side of life she had a wicked sense of humour and always laughed at my bad jokes. “Without Sammy, there would have been no Tenable quiz show, no Willow series. No Idiot Abroad Series 3.” Warwick said Samantha was his “most trusted confidant and an ardent supporter of everything I did in my career”. The couple’s children, Harrison and Annabelle, added, “Mum is our best friend and we’re honoured to have received a love like hers “Her love and happiness carried us through our whole lives”. Warwick and Samantha met on the set of the movie Willow in 1988 and got married three years later. Samantha had achondroplasia, a bone growth disorder that causes disproportionate dwarfism. Warwick has previously opened up about his wife’s health after she was rushed to hospital with sepsis in 2018, and had to undergo several different surgeries to stabilise her condition. Warwick, co-founder of charity Little People UK, has often spoken out about the health battles related to his condition, as well his wife’s. He was born with Spondyloepiphyseal dysplasia congenita (SED), an extremely rare genetic form of dwarfism, which has been inherited by both their daughter Annabelle and son Harrison. Image credits: Getty Images

Caring

There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people. Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020. It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year. Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>. <h2>What goes into a flu vaccine?</h2> Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus. Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains. All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future. <h2>What’s different about new flu vaccines?</h2> There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad). Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely. However, there have been several enhancements to influenza vaccines in recent years. Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people. An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people. Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future. <h2>What should I do this year?</h2> Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life. Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>. In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need. <h2>Are there side effects?</h2> All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines. As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines. Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<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/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.

Body

Summer’s over, so how much sun can (and should) I get?

<a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a> As we slide of out summer, you might be wondering how careful you need to be about sun exposure. Excessive exposure causes <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/skin-cancer-statistics-and-issues/uv-radiation">skin cancer</a>, but sun exposure also has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">benefits</a>. How do you balance the two? A new <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">position statement</a> from cancer, bone health and other experts <a href="https://www.assc.org.au/wp-content/uploads/2023/01/Sun-Exposure-Summit-PositionStatement_V1.9.pdf">aims to help</a> Australians balance the good and bad effects of sun exposure by taking into account their skin colour, risk of skin cancer, and where they live. <h2>What are the benefits of sunlight?</h2> Ultraviolet (UV) radiation (the wavelengths in sunlight that cause skin cancer) also leads to vitamin D production. <a href="https://dermnetnz.org/topics/vitamin-d">Vitamin D</a> is very important for maintaining strong bones, and is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">multiple other health benefits</a>. But vitamin D probably isn’t the whole story. Sunshine, including UV radiation, is thought to affect health in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">other ways</a> such as improving our mood and reducing the risk of autoimmune diseases and infections. So for many people, avoiding the sun and taking a vitamin D supplement may not be the best approach. <h2>How much time does it take to make vitamin D?</h2> It’s complicated, but for most people and most of the year across most of Australia, it’s a lot less than you think. The <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">amount of time needed</a> depends on the amount of skin covered by clothing and the intensity of UV radiation (indicated by the UV index). More skin exposed and higher UV index equate to less time needed. Both the UV index and the amount of the year that UV radiation is high increase as you get closer to the equator. In summer, all of Australia is bathed in sunshine. But in winter, opposite ends of the country have <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">very different exposures</a>. In summer, everybody except those with deeply pigmented skin can make enough vitamin D in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">just five minutes</a> between 9am and 3pm, anywhere in Australia, provided they are wearing shorts and a T-shirt. In winter it’s a different story. In <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Darwin and Brisbane</a>, 5–10 minutes between 10am and 3pm will do the trick, but in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Hobart</a>, factoring in winter clothing, it will take nearly an hour in the middle of the day. Hover your mouse over the lines below to see the length of exposure needed at specific times of day. <iframe id="X5szQ" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/X5szQ/" width="100%" height="400px" frameborder="0"></iframe> Staying out for longer than needed doesn’t necessarily make more vitamin D, but it <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib25">does cause skin damage</a>. <h2>Hang on, what about those with darker skin?</h2> People with deeply pigmented, brown to black skin accumulate both vitamin D and DNA damage at a much slower rate than people with lighter skin tones. When UV radiation hits a DNA strand, it causes the DNA to become distorted. If the distortion isn’t fixed, it will cause a mistake when the DNA is copied for a new cell, causing a permanent mutation that sometimes leads to cancer. Melanin, the brown pigment in the skin, absorbs UV photons before that can happen, and the high melanin content in the darkest skin tones provides <a href="https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.201701472R">60 times</a> as much UV protection as the small amount in very fair skin. The flip side is the risk of vitamin D deficiency is much higher than the risk of skin cancer. The new statement accounts for this by putting people into <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">three groups</a> based on their risk of skin cancer, with specialised advice for each group. <h2>Highest skin cancer risk</h2> This includes people with very pale skin that burns easily and tans minimally, but also people with darker white or olive skin who can tan easily but have extra skin cancer risk factors because they: <ul> <li>have had skin cancer before</li> <li>have a family history of melanomas</li> <li>have many moles</li> <li>are taking immunosuppressant medications.</li> </ul> For these people, the harms of sun exposure almost certainly <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">outweigh the benefits</a>. These people should wear sunscreen every day the <a href="https://www.arpansa.gov.au/our-services/monitoring/ultraviolet-radiation-monitoring/ultraviolet-radiation-index">UV index</a> is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, and use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">five sunsmart steps</a> whenever the UV index is above three: <ul> <li>slip on clothing covering as much of the body as possible</li> <li>slop on SPF30+ sunscreen on areas that can’t be covered up</li> <li>slap on a hat</li> <li>seek shade</li> <li>slide on sunglasses.</li> </ul> They shouldn’t spend time outdoors deliberately to make vitamin D, but should discuss vitamin D supplements with their doctor. <h2>Intermediate skin cancer risk</h2> This means people with dark white/olive skin that sometimes burns but tans easily, and who don’t have other skin cancer risk factors. These people should still apply sunscreen as part of their usual routine on all days when the UV index is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, but they can spend enough time outdoors to get a “dose” of vitamin D on most days of the week. Once the time needed for their vitamin D dose is up, they should also use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> steps to avoid accumulating DNA damage. If they’re unable to do this because of health or lifestyle factors, like being housebound, working night shifts, or always covering up with clothing, they should see their doctor about whether they need vitamin D supplements. <h2>Lowest skin cancer risk</h2> This covers people with deeply pigmented brown to black skin that rarely or never burns. These people can <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib14">safely spend enough time outdoors</a> to make vitamin D and get the other benefits of sunshine. But because more time is needed, it can be difficult, particularly when the weather is cold. Vitamin D supplements might be needed. They don’t need to routinely protect their skin, but might need to <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> if they are outdoors for more than two hours. <h2>How do I get the feel-good effects of sunshine?</h2> Spending time outdoors in the early morning is the best way to get the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">feel-good effects</a> of sunshine. An early morning walk is a great idea for all of us, but it won’t make vitamin D.<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/224144/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, PhD Candidate, Dermatology Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, Principal research fellow, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/summers-over-so-how-much-sun-can-and-should-i-get-224144">original article</a>.

Body

“I told him not to open it": Flight attendant forced to hold plane door shut

A flight attendant was forced to hold an emergency exit door shut after an allegedly drunk passenger tried to open it shortly after takeoff. Footage shows a female flight attendant with one hand on the plane’s roof and another holding the lever of the emergency exit, after a man allegedly tried to pull it open during their flight from Qingdao, China on Saturday, according to the New York Post. “I told him not to open it,” the flight attendant said to another colleague in Chinese, according to JAM Press. Her colleague then asks the passenger: “Sir, did you open this?” The male passenger looked confused as he started gesturing at the lever. “Why did you open it? Didn’t you know it is prohibited to open this kind of thing?” the flight attendant asked again. But the passenger ignored him and looked down at his phone, as the male flight attendant continued to question him. The passenger eventually admitted that he had been drinking before he tried to grab the lever, and the man eventually had to change seats with another passenger sitting in the same row. He was allowed to remain on the flight, which managed to land safely at Harbin, China without incident. Images: New York Post

Travel Trouble

“I lost all ability to fly the plane”: Pilot's shock claim after plane drops mid-flight

At least 50 passengers have been injured with a dozen hospitalised after a Boeing 787 Dreamliner suddenly plunged about two hours into the flight from Sydney to Auckland on Monday. LATAM Airlines said that the plane experienced an unspecified "technical event during the flight which caused a strong movement." Passengers on board the flight have recalled the terrifying moment the plane took a nose-dive mid-flight. "The plane dipped so dramatically into a nose dive for a couple of seconds and around 30 people hit the ceiling hard," Daniel, who was travelling from London, told the NZ Herald. “None of us knew what had happened until after the flight, I was just trying to keep everyone calm. We never heard any announcement from the captain." He added that passengers were screaming and it was hard to tell whether blood or red wine was splattered through the cabin. Another passenger, Brian Jokat, told broadcaster RNZ that the incident took place in "split seconds". "There was no pre-turbulence, we were just sailing smoothly the whole way,” he said. “I had just dozed off and I luckily had my seatbelt on, and all of a sudden the plane just dropped. It wasn’t one of those things where you hit turbulence and you drop a few times … we just dropped.” He added that a passenger two seats away from him, who was not wearing his seatbelt, flew up into the ceiling and was suspended mid-air before he fell and broke his ribs. “I thought I was dreaming,” he said. “I opened my eyes and he was on the roof of the plane on his back, looking down on me. It was like The Exorcist.” Paramedics and more than 10 emergency vehicles were waiting for passengers when the plane landed in Auckland. Around 50 patients were treated, with 12 of them hospitalised and one in serious condition. At least three of those treated were cabin crew. Jokat told RNZ that after the plane landed, the pilot came to the back and explained what had happened. "He said to me, ‘I lost my instrumentation briefly and then it just came back all of a sudden,’” Jokat said. In another interview with Stuff.co.nz, Jokat recalled the pilot also saying: “My gauges just blanked out, I lost all of my ability to fly the plane.” The airline's final destination was Santiago, Chile, but it was landing at Auckland Airport in accordance with its normal flight path, according to Reuters. "LATAM regrets the inconvenience and injury this situation may have caused its passengers, and reiterates its commitment to safety as a priority within the framework of its operational standards," the airline said. Images: Brian Jokat/ News.com.au

Travel Trouble

Why do I need to get up during the night to wee? Is this normal?

<a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> It can be normal to wake up once or even twice during the night to wee, especially as we get older. One in three adults over 30 makes <a href="https://pubmed.ncbi.nlm.nih.gov/30085529">at least two</a> trips to the bathroom every night. Waking up from sleep to urinate on a regular basis is called <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">nocturia</a>. It’s one of the most commonly reported <a href="https://pubmed.ncbi.nlm.nih.gov/32249998/">bothersome urinary symptoms</a> (others include urgency and poor stream). So what causes nocturia, and how can it affect wellbeing? <h2>A range of causes</h2> Nocturia can be caused by a variety of <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">medical conditions</a>, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an <a href="https://www.nature.com/articles/s41598-023-44916-8">overactive bladder</a>, or gastrointestinal issues. Other causes include pregnancy, <a href="https://onlinelibrary.wiley.com/doi/10.1002/nau.24839">medications</a> and consumption of alcohol or caffeine before bed. While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055528/">insomnia</a>, can also cause nocturia. When we sleep, an antidiuretic hormone is released that slows down the rate at which our <a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">kidneys produce urine</a>. If we lie awake at night, less of this hormone <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00025.2023">is released</a>, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night. Stress, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153377/">anxiety</a> and watching television <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987">late into the night</a> are common causes of insomnia. <h2>Effects of nocturia on daily functioning</h2> The recommended amount of sleep for adults is between <a href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep">seven and nine hours</a> per night. The more times you have to get up in the night to go to the bathroom, the more this impacts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602727/#:%7E:text=Nocturia%20is%2C%20however%2C%20an%20important,(QoL)%20and%20general%20health.">sleep quantity and quality</a>. Decreased sleep can result in increased <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1251-5">tiredness</a> during the day, poor concentration, forgetfulness, changes in mood and impaired <a href="https://pubmed.ncbi.nlm.nih.gov/28425062/">work performance</a>. If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life. In more severe cases, nocturia has been compared to having a similar impact on <a href="https://www.racgp.org.au/getattachment/b43c05ba-e29e-47c3-b816-ec47ceeafe97/Nocturia-a-guide-to-assessment-and-management.aspx">quality of life</a> as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts. Nocturia not only upsets sleep, but also increases the risk of <a href="https://www.auajournals.org/doi/10.1097/JU.0000000000000459">falls</a> from moving around in the dark to go to the bathroom. Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed. <h2>Can you have a ‘small bladder’?</h2> It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is <a href="https://youtu.be/blVmyrBPves">smaller</a> relative to your other organs. If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often. <figure><iframe src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Can you have a small bladder?</figcaption></figure> If you find you are going to the bathroom quite a lot during the day and evening (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903463/">more than eight times</a> in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate. If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP. There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night. <h2>A happy and healthy bladder</h2> Here are some tips to maintain a happy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/">healthy</a> bladder, and reduce the risk you’ll be up at night: <ul> <li> make your <a href="https://theconversation.com/what-position-should-i-sleep-in-and-is-there-a-right-way-to-sleep-189873">sleep environment comfortable</a>, with a suitable mattress and sheets to suit the temperature </li> <li> get to bed early, and limit <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">screens</a>, or activites before bed </li> <li> limit foods and drinks that irritate the bladder, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811496/">coffee or alcohol</a>, especially before bedtime </li> <li> sit in a <a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">relaxed position</a> when urinating, and allow time for the bladder to completely empty </li> <li> practice <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor muscle exercises</a> </li> <li> drink an adequate amount of fluids during the day, and avoid becoming <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">dehydrated</a> </li> <li> maintain a healthy lifestyle, eat <a href="https://journals.physiology.org/doi/full/10.1152/advan.00052.2023">nutritious foods</a> and do not do anything harmful to the body such as smoking or using illicit drugs </li> <li> review your medications, as the time you take some <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">pharmaceuticals</a> may affect urine production or sleep </li> <li> if you have <a href="https://pubmed.ncbi.nlm.nih.gov/28675633/">swollen legs</a>, raise them a few hours before bedtime to let the <a href="https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management">fluid drain</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224160/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, Associate Professor of Science & Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, Senior Teaching Fellow, Medical Program, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-get-up-during-the-night-to-wee-is-this-normal-224160">original article</a>.

Body

How can I stop overthinking everything? A clinical psychologist offers solutions

<a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> As a clinical psychologist, I often have clients say they are having trouble with thoughts “on a loop” in their head, which they find difficult to manage. While rumination and overthinking are often considered the same thing, they are slightly different (though linked). <a href="https://www.apa.org/monitor/nov05/cycle">Rumination</a> is having thoughts on repeat in our minds. This can lead to overthinking – analysing those thoughts without finding solutions or solving the problem. It’s like a vinyl record playing the same part of the song over and over. With a record, this is usually because of a scratch. Why we overthink is a little more complicated. <h2>We’re on the lookout for threats</h2> Our brains are hardwired to look for threats, to make a plan to address those threats and keep us safe. Those perceived threats may be based on past experiences, or may be the “what ifs” we imagine could happen in the future. Our “what ifs” are usually negative outcomes. These are what we call “<a href="https://ccbhc.org/hot-thoughts-what-are-they-and-how-can-you-handle-them/">hot thoughts</a>” – they bring up a lot of emotion (particularly sadness, worry or anger), which means we can easily get stuck on those thoughts and keep going over them. However, because they are about things that have either already happened or might happen in the future (but are not happening now), we cannot fix the problem, so we keep going over the same thoughts. <h2>Who overthinks?</h2> Most people find themselves in situations at one time or another when they overthink. Some people are <a href="https://www.apa.org/monitor/nov05/cycle">more likely</a> to ruminate. People who have had prior challenges or experienced trauma may have come to expect threats and look for them more than people who have not had adversities. Deep thinkers, people who are prone to anxiety or low mood, and those who are sensitive or feel emotions deeply are also more likely to ruminate and overthink. Also, when we are stressed, our emotions tend to be stronger and last longer, and our thoughts can be less accurate, which means we can get stuck on thoughts more than we would usually. Being run down or physically unwell can also mean our thoughts are <a href="https://healthify.nz/hauora-wellbeing/m/mental-health-and-your-body/">harder to tackle</a> and manage. <h2>Acknowledge your feelings</h2> When thoughts go on repeat, it is helpful to use both emotion-focused and problem-focused <a href="https://link.springer.com/referencework/10.1007/978-1-4419-1005-9">strategies</a>. Being emotion-focused means figuring out how we feel about something and addressing those feelings. For example, we might feel regret, anger or sadness about something that has happened, or worry about something that might happen. Acknowledging those emotions, using self-care techniques and accessing social support to talk about and manage your feelings will be helpful. The second part is being problem-focused. Looking at what you would do differently (if the thoughts are about something from your past) and making a plan for dealing with future possibilities your thoughts are raising. But it is difficult to plan for all eventualities, so this strategy has limited usefulness. What is more helpful is to make a plan for one or two of the more likely possibilities and accept there may be things that happen you haven’t thought of. <h2>Think about why these thoughts are showing up</h2> Our feelings and experiences are information; it is important to ask what this information is telling you and why these thoughts are showing up now. For example, university has just started again. Parents of high school leavers might be lying awake at night (which is when rumination and overthinking is common) worrying about their young person. Knowing how you would respond to some more likely possibilities (such as they will need money, they might be lonely or homesick) might be helpful. But overthinking is also a sign of a new stage in both your lives, and needing to accept less control over your child’s choices and lives, while wanting the best for them. Recognising this means you can also talk about those feelings with others. <h2>Let the thoughts go</h2> A useful way to manage rumination or overthinking is “<a href="https://www.getselfhelp.co.uk/docs/Options.pdf">change, accept, and let go</a>”. Challenge and change aspects of your thoughts where you can. For example, the chance that your young person will run out of money and have no food and starve (overthinking tends to lead to your brain coming up with catastrophic outcomes!) is not likely. You could plan to check in with your child regularly about how they are coping financially and encourage them to access budgeting support from university services. Your thoughts are just ideas. They are not necessarily true or accurate, but when we overthink and have them on repeat, they can start to feel true because they become familiar. Coming up with a more realistic thought can help stop the loop of the unhelpful thought. Accepting your emotions and finding ways to manage those (good self-care, social support, communication with those close to you) will also be helpful. As will accepting that life inevitably involves a lack of complete control over outcomes and possibilities life may throw at us. What we do have control over is our reactions and behaviours. Remember, you have a 100% success rate of getting through challenges up until this point. You might have wanted to do things differently (and can plan to do that) but nevertheless, you coped and got through. So, the last part is letting go of the need to know exactly how things will turn out, and believing in your ability (and sometimes others’) to cope. <h2>What else can you do?</h2> A stressed out and tired brain will be <a href="https://mentalhealth.org.nz/resources/resource/stress-and-how-to-manage-it">more likely</a> to overthink, leading to more stress and creating a cycle that can affect your wellbeing. So it’s important to manage your stress levels by eating and sleeping well, moving your body, doing things you enjoy, seeing people you care about, and doing things that fuel your soul and spirit. Distraction – with pleasurable activities and people who bring you joy – can also get your thoughts off repeat. If you do find overthinking is affecting your life, and your levels of anxiety are rising or your mood is dropping (your sleep, appetite and enjoyment of life and people is being negatively affected), it might be time to talk to someone and get some strategies to manage. When things become too difficult to manage yourself (or with the help of those close to you), a therapist can provide tools that have been proven to be helpful. Some helpful tools to manage worry and your thoughts can also be found <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Anxiety">here</a>. When you find yourself overthinking, think about why you are having “hot thoughts”, acknowledge your feelings and do some future-focused problem solving. But also accept life can be unpredictable and focus on having faith in your ability to cope. <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/223973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, Associate Professor and Senior Clinical Psychologist, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-stop-overthinking-everything-a-clinical-psychologist-offers-solutions-223973">original article</a>.

Mind

Why and how often do I need to wash makeup brushes and sponges?

<a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rosalie-hocking-1428271">Rosalie Hocking</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> From the bristles of brushes to the porous surfaces of sponges, your makeup kit can harbour a host of bacteria and fungi. These potentially hazardous contaminants can originate not only from the cosmetics themselves, but also from the very surface of our skin. So, how can we keep things hygienic and avoid microbial growth on makeup brushes and sponges? Here’s what you need to know. <h2>How do germs and fungi get in my brushes and sponges?</h2> Germs and fungi can make their way into your makeup kit in lots of ways. Ever flushed a toilet with the lid open with your makeup brushes nearby? There’s a good chance <a href="https://theconversation.com/mobile-phones-are-covered-in-germs-disinfecting-them-daily-could-help-stop-diseases-spreading-135318">faecal particles</a> have landed on them. Perhaps a family member or housemate has used your eyeshadow brush when you weren’t looking, and transferred some microbes across in the process. Bacteria that trigger a pimple outbreak can be easily transferred from the surface of your skin to a makeup brush or sponge. And tiny little mites called Demodex mites, which have been linked to certain rashes and acne, live on your skin, as well, and so may end up in your sponge or brushes. Bacterial contamination of <a href="https://pubmed.ncbi.nlm.nih.gov/38020232/">lip cosmetics</a>, in particular, can pose a risk of skin and eye infections (so keep that in mind if you use lip brushes). Lipsticks are frequently contaminated with bacteria such as Staphylococcus aureus, E. coli, and Streptococcus pneumoniae. Low-quality cosmetics are more likely to have higher and more diverse microbial growth compared to <a href="https://www.sciencedirect.com/science/article/pii/S1319562X23002978?pes=vor">high-quality cosmetics</a>. Brushes exposed to sensitive areas like the eyes, mouth and nose are particularly susceptible to being potential sources of infection. The range of conditions caused by these microorganisms includes: <ul> <li> abscesses </li> <li> skin and soft tissue infections </li> <li> skin lesions </li> <li> rashes </li> <li> and dermatitis. </li> </ul> In severe cases, infections can lead to invasion of the bloodstream or deep tissues. Commercially available cosmetics contain varying amounts and types of preservatives aimed at inhibiting the growth of fungi and bacteria. But when you apply makeup, different cosmetics with unique formulations of preservatives can become mixed. When a preservative meant for one product mixes with others, it might not work as well because they have different water amounts or pH levels. So preservatives are not foolproof. We also need to observe good hygiene practices when it comes to brushes and other cosmetics applicators. <h2>Keeping brushes clean</h2> Start with the basics: never <a href="https://www.semanticscholar.org/paper/Isolation-of-Pathogenic-Microbes-from-Beauty-Salons-Hassan-Hamad/0199635290628fe326fcd04a2b8a2422884a8240">share makeup brushes or sponges</a>. Everyone carries different microbes on their skin, so sharing brushes and sponges means you are also sharing germs and fungi. If you need to share makeup, use something disposable to apply it, or make sure any shared brushes are washed and sterilised before the next person uses it. Clean makeup brushes by washing with hot soapy water and rinsing thoroughly. How often? Stick to a cleaning routine you can repeat with consistency (as opposed to a deep clean that is done annually). <a href="https://www.aad.org/public/everyday-care/skin-care-secrets/routine/clean-your-makeup-brushes#:%7E:text=To%20protect%20your%20skin%20and,every%207%20to%2010%20days.">Once a week</a> might be a good goal for some, while others may need to wash more regularly if they are heavy users of makeup. Definitely wash straight away if someone else has used your brushes or sponges. And if you’ve had an eye infection such as conjunctivitis, ensure you clean applicators thoroughly after the infection has resolved. You can use bactericidal soap, 70% ethanol or chlorhexidine solutions to wash. Just make sure you wash very thoroughly with hot water after, as some of these things can irritate your skin. (While some people online say alcohol can degrade brushes and sponges, opinion seems to be mixed; in general, most disinfectants are unlikely to cause significant corrosion.) For some brushes, heating or steaming them and letting them dry may also be an effective sterilisation method once they are washed with detergent. Microwaving sponges isn’t a good idea because while the heat generated by a domestic microwave would kill microbes, it would need temperatures approaching 100°C for a decent period of time (at least several minutes). The heat could melt some parts of the sponge and hot materials could be a scalding hazard. Once clean, ensure brushes and sponges are stored in a dry place away from water sources (and not near an open toilet). If you’re having makeup applied professionally, brushes and applicators should be sterilised or changed from person to person. <h2>Should I wash them with micellar water?</h2> No. Not only is this expensive, it’s unnecessary. The same benefits can be achieved with cheaper detergents or alcohol (just rinse brushes carefully afterwards). Disinfection methods such as using bactericidal soap, 70% ethanol, or chlorhexidine are all very good at reducing the amount of microbes on your brushes and sponges.<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/220280/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rosalie-hocking-1428271">Rosalie Hocking</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-and-how-often-do-i-need-to-wash-makeup-brushes-and-sponges-220280">original article</a>.

Beauty & Style

I want to eat healthily. So why do I crave sugar, salt and carbs?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> We all want to eat healthily, especially as we reset our health goals at the start of a new year. But sometimes these plans are sabotaged by powerful cravings for sweet, salty or carb-heavy foods. So why do you crave these foods when you’re trying to improve your diet or lose weight? And what can you do about it? There are many reasons for craving specific foods, but let’s focus on four common ones: <h2>1. Blood sugar crashes</h2> Sugar is a key energy source for all animals, and its taste is one of the most basic sensory experiences. Even without specific sweet taste receptors on the tongue, a strong preference for sugar can develop, indicating a mechanism beyond taste alone. Neurons <a href="https://www.nature.com/articles/s41593-021-00982-7">responding to sugar</a> are activated when sugar is delivered to the gut. This can increase appetite and make you want to consume more. Giving into cravings also drives an appetite for more sugar. In the long term, research suggests a high-sugar diet can affect <a href="https://www.bmj.com/content/369/bmj.m2382">mood</a>, digestion and <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a> in the <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">gut</a>. While there’s a lot of <a href="https://www.sciencedirect.com/science/article/pii/S0149763402000040?via%3Dihub#aep-section-id23">variation between individuals</a>, regularly eating sugary and high-carb foods can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">rapid spikes and crashes</a> in blood sugar levels. When your blood sugar drops, your body can respond by craving quick sources of energy, often in the form of sugar and carbs because these deliver the fastest, most easily accessible form of energy. <h2>2. Drops in dopamine and serotonin</h2> Certain neurotransmitters, such as <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a>, are involved in the reward and pleasure centres of the brain. Eating sugary and carb-rich foods can trigger the release of dopamine, creating a pleasurable experience and reinforcing the craving. Serotonin, the feel-good hormone, suppresses <a href="https://www.sciencedirect.com/science/article/pii/S1569733910700886">appetite</a>. Natural changes in serotonin can influence daily fluctuations in mood, energy levels and attention. It’s also associated with eating more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829131/">carb-rich snacks in the afternoon</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/21985780/">Low carb diets</a> may reduce serotonin and lower mood. However, a recent systematic review suggests little association between these diets and risk for <a href="https://www.sciencedirect.com/science/article/pii/S0165032722013933?via%3Dihub">anxiety and depression</a>. Compared to men, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189179/">women tend to crave more carb rich foods</a>. Feeling irritable, tired, depressed or experiencing carb cravings are part of premenstrual <a href="https://pubmed.ncbi.nlm.nih.gov/29218451/">symptoms</a> and could be <a href="https://www.ncbi.nlm.nih.gov/books/NBK560698/">linked to</a> reduced <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9928757/">serotonin levels</a>. <h2>3. Loss of fluids and drops in blood sugar and salt</h2> Sometimes our bodies crave the things they’re missing, such as hydration or even salt. A low-carb diet, for example, <a href="https://www.ncbi.nlm.nih.gov/books/NBK537084/">depletes</a> insulin levels, decreasing sodium and water retention. <a href="https://www.sciencedirect.com/science/article/pii/S1933287419302673">Very low-carb diets</a>, like ketogenic diets, induce “ketosis”, a metabolic state where the body switches to using fat as its primary energy source, moving away from the usual dependence on carbohydrates. Ketosis is often associated with increased urine production, further contributing to potential fluid loss, electrolyte imbalances and salt cravings. <h2>4. High levels of stress or emotional turmoil</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214609/">Stress</a>, boredom and emotional turmoil can lead to cravings for comfort foods. This is because stress-related hormones can impact our appetite, satiety (feeling full) and food preferences. The stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425607/">cortisol</a>, in particular, can drive cravings for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">sweet comfort foods</a>. A <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">2001 study</a> of 59 premenopausal women subjected to stress revealed that the stress led to higher calorie consumption. <a href="https://pubmed.ncbi.nlm.nih.gov/37295418/">A more recent study</a> found chronic stress, when paired with high-calorie diet, increases food intake and a preference for sweet foods. This shows the importance of a healthy diet during stress to prevent weight gain. <h2>What can you do about cravings?</h2> Here are four tips to curb cravings: 1) don’t cut out whole food groups. Aim for a well-balanced diet and make sure you include: <ul> <li> sufficient protein in your meals to help you feel full and reduce the urge to snack on sugary and carb-rich foods. Older adults should aim for 20–40g protein per meal with a particular focus on <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.12838">breakfast and lunch</a> and an overall daily protein intake of at least <a href="https://apps.who.int/iris/handle/10665/43411">0.8g</a> per kg of body weight for <a href="https://pubmed.ncbi.nlm.nih.gov/35187864/">muscle health</a> </li> <li> fibre-rich foods, such as vegetables and whole grains. These make you feel full and <a href="https://pubmed.ncbi.nlm.nih.gov/32142510/">stabilise your blood sugar</a> levels. Examples include broccoli, quinoa, brown rice, oats, beans, lentils and bran cereals. Substitute refined carbs high in sugar like processed snack bars, soft drink or baked goods for more complex ones like whole grain bread or wholewheat muffins, or nut and seed bars or energy bites made with chia seeds and oats </li> </ul> 2) manage your stress levels. Practise stress-reduction techniques like meditation, deep breathing, or yoga to manage emotional triggers for cravings. Practising <a href="https://pubmed.ncbi.nlm.nih.gov/30570305/">mindful eating</a>, by eating slowly and tuning into bodily sensations, can also reduce daily calorie intake and curb cravings and stress-driven eating 3) get enough sleep. Aim for <a href="https://pubmed.ncbi.nlm.nih.gov/33054337/">seven to eight</a> hours of quality sleep per night, with a minimum of seven hours. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031614/">Lack of sleep</a> can disrupt hormones that regulate hunger and cravings 4) control your portions. If you decide to indulge in a treat, control your portion size to avoid overindulging. Overcoming cravings for sugar, salt and carbs when trying to eat healthily or lose weight is undoubtedly a formidable challenge. Remember, it’s a journey, and setbacks may occur. Be patient with yourself – your success is not defined by occasional cravings but by your ability to manage and overcome them.<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/212114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-want-to-eat-healthily-so-why-do-i-crave-sugar-salt-and-carbs-212114">original article</a>.

Food & Wine

"I almost cried": Mum shocked by stranger's random act of kindness

A mother-of-two has almost been reduced to tears by a stranger's random act of kindness in a busy cafe. The mum, a woman named Tyne, was at a cafe in the Sunshine Coast suburb of Mooloolaba with her husband and two young sons, when she struck up a conversation with a woman reading a book nearby. She said she felt a wave of guilt that her rowdy children were disrupting the woman's peaceful morning, and leaned over to apologise. The woman assured the mother there was nothing to apologise for, with the woman's next act leaving the mum speechless. “A beautiful (and full on) weekend away with Mr 3.5y & Mr 1.5y my husband and I sat with coffees at a beautiful cafe waiting for breakfast for us,” Tyne wrote in a Facebook group called The Kindness Pandemic, where people share stories of their heartwarming interactions with strangers. “I immediately apologised to the lovely lady sitting near us as she had a book and I was afraid the boys wouldn’t be too peaceful." “We were chatting for a little and then she left after her breakfast.” When the mum went to pay for her family’s bill, the cashier informed her that the stranger had “taken care of it” and handed her a heartwarming note. “It was such a pleasure sharing my brekkie space with you,” the note read. “Please keep doing what you’re doing. You’ve got a beautiful family.” Tyne said she “almost cried” when she realised that the stranger had paid for her family’s entire breakfast. The cafe was situated close to one of the Sunshine Coast’s most popular attractions, Sea Life Aquarium, where the family had planned to spend their day. “Hopefully you can splurge a little more at Sea Life today,” the stranger added in the note, before signing off, “Love Em.” The mum said she was overwhelmed by the stranger’s incredible act of kindness, saying she "almost cried". “She paid for us … And her kind words were what I needed to hear.” Tyne said the stranger was an “amazing soul” and vowed to pay it forward”. “If you are Em staying in Mooloolaba for work and went to a quirky local that’s your favourite … YOU ARE AN AMAZING SOUL!” she said. People in the comments also shared their reactions to the heartfelt gesture. “Lovely lady. Your children would be being just that, children. Don’t apologise about them,” one wrote. “What a beautiful person Em clearly is. This was so gorgeous to read.” Image credits: Facebook

Family & Pets

Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial. UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom. Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year. They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area. Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments. <h2>Why are chronic UTIs so hard to treat?</h2> Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach. The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments. This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective. Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted. But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead. Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria. Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions. The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence. For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur. Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role. Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>. <h2>What treatments might we see in the future?</h2> Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu. Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus. Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves. Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response. Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<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/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.

Body

"I was not alone": Another royal diagnosed with cancer

Not long after King Charles announced his <a href="https://www.oversixty.com.au/health/caring/palace-reveals-king-charles-serious-health-diagnosis" target="_blank" rel="noopener">cancer diagnosis</a>, Crown Prince Alexander of Yugoslavia felt inspired by his "dear cousin and friend" and decided to go public with his own prostate cancer diagnosis. In a statement, Prince Alexander shared that he was moved by Charles’ courage in sharing his diagnosis with the public, as royal health matters are usually kept private. The 78-year-old royal then shared details of his own medical intervention. "The love of all of us who know him, and of his people, we deeply care for him, will support His Majesty in persevering and winning this most important battle. The news that it is early stage gives high hope," he said. "The unfortunate news about cancer is not something you wish to hear. "And I can say it personally, as I very well know how you feel once you hear it. How frightening and terrifying it is also for the family, how all the feelings get mixed up, and how you cannot think about anything else." He then revealed: "I can say it now because I only recently defeated cancer. "I had avoided speaking about it, as it is a personal matter concerning only me and my family, but King Charles' openness moved me and encouraged me to also speak up," he added. "I am sharing this now, because this kind of tragic news can encourage people to react and take care of their health." He added that news of King Charles' cancer diagnosis and his honesty about getting a check-up had resulted in a rise in online searches and appointments for medical check-ups in the UK. “That is why people should hear my story, to see it is something that can happen to all of us,” he said. “But when we are responsible, the outcome can be good.” He shared details of his own treatment, which began two years ago, after results from an MRI found a cancerous growth. "At that moment, I was terrified. But I was not alone. "I am not speaking about family and friends who knew this and shared their support, which meant so much and cannot be described in words, but also all the other people who are fighting this disease." He then underwent pre-intervention tests, surgery, and mandatory checkups, and has since received “the most joyous words from my doctor — ‘All is clear now’.” He then urged the public to be more vigilant about their health, and to not put of their doctors appointment any further. “Be responsible with yourself, listen to the doctor’s advice, and monitor your health,” he said. “Preserve it and nurture it as the greatest wealth and gift you will ever receive.” Images: Getty

Caring

"Am I being too sensitive?": Woman's dilemma after partner forgets 60th birthday

A woman has shared her dilemma on how to approach her partner of 30 years, after he forgot her 60th birthday. "It's my 60th birthday today, and my partner of 30 years has not acknowledged it. Should I tell him?" she titled her post on Reddit. "It's my actual birthday today, and whilst we have planned a big party for next weekend, when I woke up this morning I expected a 'Happy Birthday!' and a smile," she continued. "I didn't get anything. He started my coffee but he does that almost every morning. "At first I thought maybe he forgot but now I am thinking that he thinks he doesn't have to say anything because we are having a big party this weekend. "Am I being too sensitive? Should I tell him? If so, how?" she asked in her post. Hundreds of Reddit users took to the comments to share their thoughts on how to approach the situation, with a few sharing crafty solutions of their own. "I'd make a joke of it. 'I can't believe they moved my birthday!' Or 'I saw on the TV we should ask easy questions to check for dementia- I'll ask you first, when's my birthday?'" one user playfully suggested. "I'm going to say the absolute minimum I'd expect for ANY birthday is my wife wishing me a Happy Birthday. Don't let it fester and ruin your day - just ask him about it" another added. One user saw the bright side of things and said: "He's handed you the best birthday present of all - the opportunity to use this against him for the next twenty years. "I'd be rubbing my hands with glee. Happy Birthday!" "Happy Birthday. Go out and buy a large cake. Eat it all yourself. Nobody need ever know" to which she responded: "there is a Costco not that far away. Go big or go home." Another Redditor came up with an elaborate plan on how she could get her partner's attention. "Purchase this 'Acknowledge Me' t-shirt of WWE wrestle Roman Reigns. Then write 'Birthday' on a piece of card and use some tape to stick on the t-shirt. 'Acknowledge Me Birthday.' Then just wear it around the house," they said. The woman was onboard with the plan, but luckily she didn't need to apply any of their crafty solutions and shared an update. "He just came up to my home office and gave me a big hug, admitting he had forgotten because he was so focussed on both work and next weekend's party," she wrote. "He apologised sheepishly, which was exactly the best outcome possible. Now I have both my birthday acknowledged as well as a fine story and/or bit of ammo to be saved for another day. "So there you go. I've cancelled the 'acknowledge me' t-shirt order, and shall now share my Costco cake with him instead of eating it from across the table, glaring. "Thank you everyone for the very fine passive aggressive suggestions which made me smile. Much appreciated!" Image: Getty

Relationships

"I want answers": Simon Dorante-Day's cunning plan to prove royal connections

The Queensland man claiming to be the son of King Charles and Queen Camilla has shared his new plan to prove once and for all that he has royal family connections. Simon Dorante-Day has long claimed through his 30 years of research, he discovered that he is the illegitimate son of the monarch, and has attempted to prove his theory through various means. Now, his new plan to get his hands on royal DNA to unequivocally prove his family heritage involves another member of the royal family. Speaking with <a href="https://7news.com.au/lifestyle/aussie-man-claiming-to-be-charles-son-drops-new-prince-harry-dna-bombshell-c-13488374" target="_blank" rel="noopener">7News</a>, the 57-year-old said he and his wife have been told by a “trusted source” that Prince Harry could be amenable to helping them gather proof. “We got advice from a really good, really trusted source that we should approach Harry and make a connection there and ask for DNA,” Elvianna said. Simon added, “I was really taken aback when he said that. But it’s definitely something I’m going to do. I’ve long been a supporter of Harry and Meghan, I think it’s disgraceful the way they’ve been treated by the royal family." “The way they are treated on social media too, it’s just one big ‘Punch-Meghan-and-Harry-a-thon’, seriously. It’s really starting to annoy me." He said he is planning to "make contact with him and explore this as an opportunity," pointing out that the royal family's treatment of Harry could make him more willing to help. "At the end of the day, I feel like he just might be as keen as I am to expose what Charles and Camilla and the powers that be have done to me. The injustice." “It’s worth me pointing out that Charles and Camilla, Buckingham Palace, the entire royal family - not one of them has ever said my claims are not true. They’ve never denied what I believe, told me I’m wrong." Simon said “the wheels are in motion” in terms of making contact with Prince Harry, and that he’s hopeful of a positive outcome. “I want answers,” he said. “And I feel Prince Harry is the man to help me find them.” “And I think their silence speaks volumes.” Simon said “the wheels are in motion” in terms of making contact with Prince Harry, and that he’s hopeful of a positive outcome. “I want answers,” he said. “And I feel Prince Harry is the man to help me find them.” Image credits: Facebook / Getty Images

Family & Pets

How do I handle it if my parent is refusing aged care? 4 things to consider

<a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s a shock when we realise our parents aren’t managing well at home. Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed. You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what? Here are four things to consider. <h2>1. Start with more help at home</h2> Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move. Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both. Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety. Call <a href="https://www.myagedcare.gov.au/">My Aged Care</a> to discuss your options. <h2>2. Be prepared for multiple conversations</h2> Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made. Ideally, the older person feels supported rather than attacked during these conversations. Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice. Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”. <h2>3. Understand the options when help at home isn’t enough</h2> If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be <a href="https://academic.oup.com/gerontologist/article/60/8/1504/5863160">considering a nursing home</a> (also known as residential aged care in Australia). Every person has a legal right to <a href="https://humanrights.gov.au/our-work/9-your-right-choose-where-you-live">choose where we live</a> (unless they have lost capacity to make that decision). This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”. It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational). Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else? Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space. Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826495/">Research</a> suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control. Mum and Dad should be involved in the decision-making process about where they live, and when they might move. Some families start looking “just in case” as it often takes some time to <a href="https://www.abc.net.au/everyday/questions-to-ask-when-choosing-an-aged-care-home-for-a-loved-one/10302590">find the right nursing home</a> and there can be a wait. After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule. We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions. For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”. Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead. <h2>4. Understand the options if a parent has lost capacity to make decisions</h2> If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests. If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity. Mum or Dad may have appointed an <a href="https://www.tag.nsw.gov.au/wills/appoint-enduring-guardian/what-enduring-guardian">enduring guardian</a> to make decisions about their health and lifestyle decisions when they are not able to. An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves. If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can <a href="https://www.tag.nsw.gov.au/guardianship/information-about-guardianship">appoint</a> that person a private guardian (usually a family member, close friend or unpaid carer). If no such person is available to act as private guardian, a public official may be appointed as public guardian. <h2>Deal with your own feelings</h2> Families often feel <a href="https://link.springer.com/article/10.1007/s12144-023-04538-9">guilt and grief</a> during the decision-making and transition process. Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.<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/221210/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-handle-it-if-my-parent-is-refusing-aged-care-4-things-to-consider-221210">original article</a>.

What are ‘good’ and ‘bad’ debts, and which should I pay off first?

<a href="https://theconversation.com/profiles/angel-zhong-1204643">Angel Zhong</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> With the cost of living soaring and many struggling to get a pay rise, it’s not surprising people are using debt to navigate life’s financial twists and turns. Owing money can sometimes feel challenging, but not all debts should keep you awake at night. So which debts are good and which are bad? And in what order should you pay them off? As it all depends on your personal circumstances, all I can offer is general information and not financial advice. Ideally, you should seek guidance from an accredited financial adviser. But in the meantime, here are some ideas to consider. <h2>What is a ‘good debt’?</h2> Good debts can be strategic tools and help build a solid foundation for your future. They usually increase your net worth by helping you generate income or buy assets that increase in value. With good debts, you usually get back more than what you pay for. They usually have lower interest rates and longer repayment terms. But personal finance is dynamic, and the line between good and bad debt can be nuanced. If not managed properly, even good debts can cause problems. Some examples of “good debts” might include: Mortgages: A mortgage allows you to buy a house, which is an asset that generally increases in value over time. You may potentially get tax advantages, such as <a href="https://www.ato.gov.au/forms-and-instructions/rental-properties-2023/other-tax-considerations">negative gearing</a>, through investment properties. However, it’s crucial not to overstretch yourself and turn a mortgage into a nightmare. As a rule of thumb, try avoid spending <a href="https://www.cnbc.com/select/mortgage-affordability/">more than 30% of your income</a> per year on your mortgage repayments. Student loans: Education is an investment in yourself. Used well, student loans (such as <a href="https://www.studyassist.gov.au/help-loans/hecs-help">HECS-HELP</a>) can be the ticket to a higher-paying job and better career opportunities. <h2>What is a ‘bad debt’?</h2> “Bad debts” undermine your financial stability and can hinder your financial progress. They usually come with high interest rates and short repayment terms, making them more challenging to pay off. They can lead to a vicious cycle of debt. Examples of bad debts include: Payday loans: A payday loan offers a quick fix for people in a financial tight spot. However, their steep interest rates, high fees and tight repayment terms often end up worsening a person’s financial problems. The interest and fee you may end up paying can get close to the loan amount itself. Credit card debt: Credit cards can be like quicksand for your finances. If you don’t pay off your purchase on time, you’ll be subject to an annual interest rate of around <a href="https://www.rba.gov.au/statistics/tables/">19.94%</a>. For a A$3,000 credit card debt, for example, that could mean paying nearly $600 annual interest. Carrying credit card debt from month to month can lead to a seemingly never-ending debt cycle. Personal loans: People usually take personal loans from a bank to pay for something special, such as a nice holiday or a car. They often come with higher interest rates, averaging around <a href="https://www.finder.com.au/personal-loans">10%</a>. Spending money that you don’t have can lead to prolonged financial headaches. Buy-now-pay-later services: Buy-now-pay-later services often provide interest-free instalment options for purchases. This can be tempting, but the account fees and late payment fees associated with buy-now-pay-later services can lead to a long-term financial hangover. The convenience and accessibility of buy-now-pay-later services can also make it easy to get further and further into debt. <h2>So in what order should I pay off my debts?</h2> There is no one right answer to this question, but here are three factors to consider. Prioritise high-interest debts: Start by confronting the debts with the highest interest rates. This typically includes credit card debt and personal loans. Paying off high-interest debts first can save you money and reduce your total debt faster. Negotiate interest rates or switch lenders: Don’t be shy. A simple call to your lender requesting a lower rate can make a significant difference. You may also take advantage of sign-on offers and refinancing your loan with a new lender. In the banking business, customers are not usually rewarded for their loyalty. Consider different repayment strategies: Choose a debt repayment strategy that aligns with your preferences. Some people get a psychological boost from paying off smaller debts first (this is often called the “<a href="https://www.wellsfargo.com/goals-credit/smarter-credit/manage-your-debt/snowball-vs-avalanche-paydown/#:%7E:text=The%20%22snowball%20method%2C%22%20simply,all%20accounts%20are%20paid%20off.">snowball method</a>”). Others focus on high-interest debts (often known as the “<a href="https://www.wellsfargo.com/goals-credit/smarter-credit/manage-your-debt/snowball-vs-avalanche-paydown/#:%7E:text=The%20%22snowball%20method%2C%22%20simply,all%20accounts%20are%20paid%20off.">avalanche method</a>”). Find what works for you. The most important thing is to have a plan and stick to it. Review the terms of each debt carefully. Certain loans offer flexibility in repayment schedules, while others may impose penalties for early settlement. Take note of these conditions as you develop your repayment plan. Debt can be a useful tool or a dangerous trap, depending on how you use it. By understanding the difference between good and bad debts, and by having a smart strategy for paying them off, you can take charge of your financial future.<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/217779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/angel-zhong-1204643">Angel Zhong</a>, Associate Professor of Finance, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-good-and-bad-debts-and-which-should-i-pay-off-first-217779">original article</a>.

Money & Banking

"I was terrified": Law & Order star reveals traumatic past

Warning: This story contains graphic content. Mariska Hargitay, who plays Olivia Benson, a character that investigate rapists on Law & Order: Special Victims Unit, has revealed that she too is a victim of sexual assault. The actress opened up about her traumatic past in a powerful essay written for <a href="https://people.com/mariska-hargitay-experience-rape-renewal-reckoning-8424247" target="_blank" rel="noopener">People Magazine</a>, where she revealed that she was raped by “a friend" when she was in her thirties. "A man raped me in my thirties," she bravely revealed in the essay. "It wasn’t sexual at all. It was dominance and control. Overpowering control." The actress revealed that he was a friend who "made a unilateral decision" and recalled the fear she felt when the incident occurred. "He grabbed me by the arms and held me down. I was terrified," she said. "I didn’t want it to escalate to violence. I now know it was already sexual violence, but I was afraid he would become physically violent. "I went into freeze mode, a common trauma response when there is no option to escape. I checked out of my body," she recalled. Hargitay, who is the daughter of the late actress Jane Mansfield, said that she never thought of herself as a "survivor", and often "minimised" what happened to her when she talked about it with others. "My husband Peter remembers me saying, “I mean, it wasn’t rape," she wrote. "Then things started shifting in me, and I began talking about it more in earnest with those closest to me. They were the first ones to call it what it was." The actress said that she wants other survivors to feel "no shame" about sexual assault and wants "this violence to end." She added that justice "may look different for each survivor," but for her she wants "an acknowledgment and an apology" after what happened. "This is a painful part of my story. The experience was horrible. But it doesn’t come close to defining me, in the same way that no other single part of my story defines me," she concluded, adding that she feels for all sexual violence survivors. "I’m turning 60, and I’m so deeply grateful for where I am. I’m renewed and I’m flooded with compassion for all of us who have suffered. And I’m still proudly in process." Hargitay started her own foundation, the Joyful Heart Foundation, in 2004 to help survivors of sexual assault. Image: Getty

Caring

I have COVID. How likely am I to get long COVID?

<a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> EG.5 or the Eris COVID variant is dominant in parts of <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20231202.pdf">Australia</a>. Eris, along with other circulating strains, are descendants of Omicron. While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains. So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID? <h2>When COVID becomes ‘long COVID’</h2> For most people, long COVID means not getting better after a COVID infection. The World Health Organization <a href="https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">defines long COVID</a> as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis. The most <a href="https://link.springer.com/article/10.1007/s10654-022-00962-6">common symptoms</a> include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience <a href="https://www.sciencedirect.com/science/article/pii/S1684118222001864?via%3Dihub">a wide range</a> of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems. <h2>How common is long COVID?</h2> Australian data on long COVID <a href="https://www.mja.com.au/journal/2023/218/10/long-covid-australia-achieving-equitable-access-supportive-health-care">remains limited</a> compared to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">international data</a>, and estimates of its prevalence have varied. A report from Australia’s parliamentary inquiry into long COVID, <a href="https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf">published in April</a>, suggested 2%-20% of people may develop long COVID following an infection. A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants <a href="https://doi.org/10.3390/ijerph20186756">saw 10% of people</a> who caught COVID develop long COVID. Another recent study, yet to be peer-reviewed, found <a href="https://www.medrxiv.org/content/10.1101/2023.08.06.23293706v1">18.2%</a> of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods. The risk is lower in children. One Australian study indicated persistent symptoms in <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext">8% of children</a> who had COVID in 2020, while <a href="https://www.medrxiv.org/content/10.1101/2023.03.14.23287239v1">preliminary research</a> points to a slightly lower risk among children infected in 2021. But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway <a href="https://www.apprise.org.au/broad-research-area/insights-into-long-covid/">in Australia</a> to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes. Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will <a href="https://doi.org/10.1001/jamainternmed.2023.0750">increase a person’s chance</a> of getting long COVID. <h2>What’s different this time?</h2> Research shows COVID vaccines offer <a href="https://www.mdpi.com/1660-4601/19/19/12422">protection</a> against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially <a href="https://theconversation.com/could-antivirals-reduce-your-risk-of-long-covid-where-the-research-is-up-to-on-prevention-and-treatment-216529">less long COVID</a> than we saw earlier in the pandemic. But while the Omicron waves may lead to <a href="https://www.smh.com.au/national/newer-virus-strains-less-likely-to-cause-long-covid-20231123-p5emag.html">fewer cases of long COVID</a> than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">repeat infection</a> presents a new risk of prolonged symptoms. <h2>Long COVID can affect all aspects of life</h2> Long COVID can <a href="https://doi.org/10.1093/ije/dyad033">impact</a> a person’s life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks. Many people with long COVID submitted evidence to the recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report/Chapter_4_-_Lived_experiences_of_long_COVID">parliamentary inquiry</a> that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals. Evidence suggests many symptoms <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-77622200250-2/fulltext">will improve</a> in most people over <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00138-4/fulltext">12 to 18 months</a>, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to <a href="https://www.nature.com/articles/s41579-022-00846-2">resolve sooner than others</a>, such as cognitive symptoms. <h2>I think I have long COVID, what can I expect from my doctor?</h2> Long COVID is the kind of challenge Australia’s <a href="https://dx.doi.org/10.5694/mja2.51950">health system finds most difficult</a>. GPs are stretched and the small number of specialist <a href="https://www.abc.net.au/news/2023-12-12/long-covid-clinics-are-closing-as-us-clinic-expands/103186272">long COVID clinics</a> are struggling to maintain funding. Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition. As a result, support for long COVID in Australia is <a href="https://doi.org/10.3389/phrs.2023.1606084">hard to access</a>, expensive and patchy. However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should: <ul> <li> validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear </li> <li> diagnose and treat any other health conditions that are part of the picture </li> <li> support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue. </li> </ul> These steps are not a cure but they may improve a person’s ability to function in their day-to-day life, at work and to fulfil their caring responsibilities. <h2>We still need to focus on reducing COVID transmission</h2> The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means: <ul> <li> getting vaccinated or boosted, if you’re eligible </li> <li> staying home if you feel unwell </li> <li> wearing a mask to protect yourself and vulnerable community members </li> <li> testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve. </li> </ul> Long COVID is not going away, but we all have a role to play in preventing and responding to it. Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.<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/218808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, Professor of Allied Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, Senior Research Fellow, ANU College of Health and Medicine, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, Professor, Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, Associate Professor, Child and Adolescent Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">original article</a>.

Body

“I need a future”: New details on boy kidnapped for six years

When concerned motorist Fabien Accidini <a href="https://www.oversixty.co.nz/lifestyle/family-pets/missing-boy-found-alive-after-six-long-years" target="_blank" rel="noopener">happened upon Alex Batty</a> walking along a road in the foothills of the Pyrenees in France, he had no idea of the mysterious and tragic situation he had uncovered. “I said to myself, ‘That’s strange. It’s 3am in the morning, it’s raining, he’s all by himself on the road between two villages,’” Accidini told French news outlet BFMTV. Batty had gone missing from his home in England at the tender age of 11 back in 2017. Now 17, new details have emerged about the extraordinary six-year journey that unfolded since his disappearance. British and French authorities confirmed on Friday that the teenager discovered by Accidini was, indeed, Alex Batty. The initial family holiday to Spain turned into a six-year odyssey across Morocco, Spain and southwest France, as Alex and his family embraced a nomadic, off-the-grid lifestyle. French authorities revealed that Alex and his family moved from house to house, carrying their own solar panels, growing their own food, and living with other families in what the teenager described as a “spiritual community". However, last Wednesday marked a turning point as Alex suddenly appeared on a remote road in rural France, having parted ways with his mother. According to French prosecutor Antoine Leroy, Alex decided to strike out on his own when his mother expressed a desire to move yet again, this time to Finland. Leroy stated at a news conference in Toulouse, “When his mother indicated that she intended to leave for Finland with him, this young man understood that this journey had to stop.” Undeterred by the challenging circumstances, Alex walked for four nights, resting during the days and sustaining himself with whatever he could find in fields or gardens. It was during this solitary journey that Accidini spotted him on the rain-soaked road. Accidini offered assistance, and despite initial suspicion and a false name, Alex eventually opened up during the deliveryman's rounds. “He’d had enough. He said, ‘I am 17. I need a future.’ He didn’t see a future for himself there,” Accidini recounted. In an interview with La Depeche, Accidini shared more details about Alex's arduous journey: “He told me that he had been walking for four days, that he’d left from the mountains. He didn’t really know where.” Showing kindness, Accidini provided the thirsty teenager with water and allowed him to use his mobile phone to send a message to his grandmother. The message read, “Hello grandma, it is me, Alex. I am in France, Toulouse. I really hope that you receive this message. I love you. I want to come home.” Back in the UK, Greater Manchester Police confirmed that Alex had spoken with his grandmother, Susan Caruana, via video call. Assistant Chief Constable Chris Sykes stated, “Whilst she is content that this is indeed Alex, we have further checks to do when he returns to the United Kingdom. “Our main priority now is to see Alex returned home to his family in the UK.” Alex is expected to return to the UK in the coming days, as the investigation into the full circumstances of his disappearance continues. Images: Greater Manchester Police

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What are ‘good’ and ‘bad’ debts, and which should I pay off first?

"I was terrified": Law & Order star reveals traumatic past

I have COVID. How likely am I to get long COVID?

“I need a future”: New details on boy kidnapped for six years

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

"I miss her hugs": British acting legend shares heartbreaking loss

There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

Summer’s over, so how much sun can (and should) I get?

“I told him not to open it": Flight attendant forced to hold plane door shut

“I lost all ability to fly the plane”: Pilot's shock claim after plane drops mid-flight

Why do I need to get up during the night to wee? Is this normal?

How can I stop overthinking everything? A clinical psychologist offers solutions

Why and how often do I need to wash makeup brushes and sponges?

I want to eat healthily. So why do I crave sugar, salt and carbs?

"I almost cried": Mum shocked by stranger's random act of kindness

Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

"I was not alone": Another royal diagnosed with cancer

"Am I being too sensitive?": Woman's dilemma after partner forgets 60th birthday

"I want answers": Simon Dorante-Day's cunning plan to prove royal connections

How do I handle it if my parent is refusing aged care? 4 things to consider

What are ‘good’ and ‘bad’ debts, and which should I pay off first?

"I was terrified": Law & Order star reveals traumatic past

I have COVID. How likely am I to get long COVID?

“I need a future”: New details on boy kidnapped for six years

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