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What are heart rate zones, and how can you incorporate them into your exercise routine?

<a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537749/">Heart rate zones</a> reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute. But what are the different heart rate zones, and how can you use these zones to optimise your workout? <h2>The three-zone model</h2> While there are several models used to describe heart rate zones, the most common model in the scientific literature is the <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">three-zone model</a>, where the zones may be categorised as follows: <ul> <li> zone 1: 55%–82% of maximum heart rate </li> <li> zone 2: 82%–87% of maximum heart rate </li> <li> zone 3: 87%–97% of maximum heart rate. </li> </ul> If you’re not sure what your maximum heart rate is, it can be calculated using <a href="https://www.jacc.org/doi/full/10.1016/S0735-1097%2800%2901054-8">this equation</a>: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute. There are also other models used to describe heart rate zones, such as the <a href="https://journals.humankinetics.com/view/journals/ijspp/14/8/article-p1151.xml">five-zone model</a> (as its name implies, this one has five distinct zones). These <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">models</a> largely describe the same thing and can mostly be used interchangeably. <h2>What do the different zones involve?</h2> The three zones are based around a person’s <a href="https://link.springer.com/article/10.2165/00007256-200939060-00003">lactate threshold</a>, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic. Aerobic exercise <a href="https://www.healthline.com/health/fitness-exercise/difference-between-aerobic-and-anaerobic">uses oxygen</a> to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time. On average your lactate threshold tends to sit around <a href="https://www.tandfonline.com/doi/full/10.2147/OAJSM.S141657">85% of your maximum heart rate</a>, although this varies from person to person, and can be <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00043.2013">higher in athletes</a>. In the three-zone model, each zone loosely describes <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2015.00295/full">one of three types of training</a>. Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace. Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences. Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3. <h2>Striking a balance</h2> To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout. While zone 3 is thought to produce the largest improvements in <a href="https://www.sciencedirect.com/science/article/pii/S1440244018309198">maximal oxygen uptake</a> – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much. Training in different heart rate zones improves <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=38c07018c0636422d9d5a77316216efb3c10164f">slightly different physiological qualities</a>, and so by spending time in each zone, you ensure a <a href="https://link.springer.com/article/10.1007/bf00426304">variety of benefits</a> for performance and health. <h2>So how much time should you spend in each zone?</h2> Most <a href="https://www.frontiersin.org/articles/10.3389/fspor.2023.1258585/full">elite endurance athletes</a>, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3. Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate <a href="https://journals.humankinetics.com/view/journals/ijsnem/22/5/article-p392.xml?content=pdf">more than 250 kilometres per week</a>, which would be impossible to recover from if it was all performed in zone 2 or 3. Of course, most people are not professional athletes. The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization</a> recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week. If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines. <h2>What if I don’t have a heart rate monitor?</h2> If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training. The three heart rate zones discussed in this article can also be prescribed based on feel using a simple <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2004.00418.x">10-point scale</a>, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce. With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10. Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.<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/228520/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, Lecturer in Exercise Science, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-heart-rate-zones-and-how-can-you-incorporate-them-into-your-exercise-routine-228520">original article</a>.

Body

What is childhood dementia? And how could new research help?

<a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> “Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around <a href="https://doi.org/10.1093/brain/awad242">1,400 Australian children and young people</a> live with currently untreatable childhood dementia. Broadly speaking, childhood dementia is caused by any one of <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">more than 100</a> rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same. <a href="https://doi.org/10.1093/brain/awad242">Half</a> of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">before turning 18</a>. Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure. <h2>More about the causes</h2> Most types of childhood dementia are <a href="https://academic.oup.com/brain/article/146/11/4446/7226999">caused</a> by <a href="https://www.genome.gov/genetics-glossary/Mutation">mutations</a> (or mistakes) in our <a href="https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid">DNA</a>. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia. <a href="https://doi.org/10.1093/brain/awad242">Two-thirds</a> of childhood dementia disorders are caused by “<a href="https://www.ncbi.nlm.nih.gov/books/NBK459183/">inborn errors of metabolism</a>”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail. As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs. <h2>What happens to children with childhood dementia?</h2> Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia <a href="https://doi.org/10.1016/j.pediatrneurol.2023.09.006">progressively lose</a> all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning. Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures. The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around <a href="https://doi.org/10.1093%2Fbrain%2Fawad242">two years old</a>. The symptoms are caused by significant, progressive brain damage. <h2>Are there any treatments available?</h2> Childhood dementia treatments currently <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">under evaluation</a> or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, <a href="https://doi.org/10.1002/jmd2.12378">gene-modified cell therapy</a> and protein or <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1712649">enzyme replacement therapy</a>. Enzyme replacement therapy is available in Australia for <a href="https://australianprescriber.tg.org.au/articles/cerliponase-alfa-for-neuronal-ceroid-lipofuscinosis-type-2-disease.html">one form of childhood dementia</a>. These therapies attempt to “fix” the problems causing the disease, and have shown promising results. Other experimental therapies include ones that <a href="https://doi.org/10.3390/life12050608">target</a> faulty protein production or <a href="https://doi.org/10.1056/nejmoa2310151">reduce inflammation</a> in the brain. <h2>Research attention is lacking</h2> Death rates for Australian children with cancer <a href="http://www.childhooddementia.org/getasset/2WX39O">nearly halved</a> between <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">1997 and 2017</a> thanks to research that has enabled the development of multiple treatments. But over recent decades, <a href="http://www.childhooddementia.org/getasset/2WX39O">nothing has changed</a> for children with dementia. In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for <a href="https://www.childhooddementia.org/getasset/2WX39O">childhood dementia</a>. This is despite childhood dementia causing a <a href="https://doi.org/10.1093/brain/awad242">similar number of deaths</a> each year as childhood cancer. The success <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">for childhood cancer sufferers</a> in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes. Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">analysis</a> published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia. Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves. That said, we’ve seen a slowing in the establishment of <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">clinical trials</a> for childhood dementia across the world in recent years. In addition, we know from <a href="https://www.childhooddementia.org/join-us/professionals/impacts">consultation with families</a> that current care and support systems <a href="https://www.childhooddementia.org/getasset/44MLP8">are not meeting the needs</a> of children with dementia and their families. <h2>New research</h2> Recently, we were awarded <a href="https://www.premier.sa.gov.au/media-releases/news-items/major-funding-boost-for-research-into-childhood-dementia">new funding</a> for <a href="https://www.flinders.edu.au/giving/our-donors/impact-of-giving/improving-the-lives-of-children-with-dementia">our research</a> on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments. More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions. Dr Kristina Elvidge, head of research at the <a href="https://www.childhooddementia.org/our-people">Childhood Dementia Initiative</a>, and Megan Maack, director and CEO, 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/228508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, Head, Paediatric Neurodegenerative Diseases Research Group, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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-is-childhood-dementia-and-how-could-new-research-help-228508">original article</a>.

Mind

What’s the difference between ADD and ADHD?

<a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Around <a href="https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd#:%7E:text=Around%201%20in%20every%2020,have%20symptoms%20as%20an%20adult.">one in 20 people</a> has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood. ADHD is <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">diagnosed</a> when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home. Some people call the condition attention-deficit disorder, or ADD. So what’s the difference? In short, what was previously called ADD is now known as ADHD. So how did we get here? <h2>Let’s start with some history</h2> The <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">first clinical description</a> of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still <a href="https://pubmed.ncbi.nlm.nih.gov/26740929/">presented</a> a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate. Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions. The first DSM, published in 1952, did not include a specific related child or adolescent category. But the <a href="https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420355.dsm-ii">second edition</a>, published in 1968, <a href="https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1009310">included a section</a> on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder. In the early 1980s, the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">third DSM</a> added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity. However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today: <ul> <li>predominantly inattentive</li> <li>predominantly hyperactive-impulsive</li> <li>combined.</li> </ul> <h2>Why change ADD to ADHD?</h2> ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons. First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">initially named</a>, little research had been done to determine the similarities and differences between the two sub-types. The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions? Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours <a href="https://academic.oup.com/shm/article/30/4/767/2919401">may not necessarily be</a> disruptive and challenging but are more likely to be forgetful and daydreamers. <h2>Why do some people use the term ADD?</h2> There was a <a href="https://academic.oup.com/shm/article/30/4/767/2919401">surge of diagnoses</a> in the 1980s. So it’s understandable that some people still hold onto the term ADD. Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits. Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed. <h2>How is ADHD currently diagnosed?</h2> The three sub-types of ADHD, outlined in the DSM-5 are: <ul> <li> predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions </li> <li> predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control </li> <li> combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive. </li> </ul> ADHD diagnoses <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/children-mental-illness">continue to rise</a> among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses. However, some international experts <a href="https://academic.oup.com/shm/article/30/4/767/2919401">contest</a> the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors. Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.<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/225162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, Program Director for the Bachelor of Education, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith 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/whats-the-difference-between-add-and-adhd-225162">original article</a>.

Mind

The dos and don’ts of caring for your hearing aids

Proper care and maintenance of your hearing aids is important. It will ensure you to get the most out of your aids, prevent problems and maintain optimum hearing conditions. Here are some guidelines to help you care for them. DO: clean your hearing aids regularly with a dry cloth or tissue. DON’T: get your hearing aids wet. That means no wearing them in the shower or when swimming. If they happen to get wet, dry it off immediately. DO: put your hearing aids in their case when you’re not using them DON’T: wear your aids when using aftershave, hairspray, perfume, sunscreen, insect repellent and so on. They contain chemicals that could damage it. Allow time for drying before putting back on hearing aids. DO: use a moisture protection kit/anti-humidity kit. They help with moisture problems (which can affect performance of hearing aids) and extend life of hearing aids. DO: keep out of reach of pets and visiting grandkids. Dogs have been known to chew them up and if swallowed by either pet or grandkid, can be very dangerous. DON’T: expose your device to extreme heats. Don’t leave them in a parked car, near a heater or wear while using a hairdryer. DO: Store your hearing aid in a safe place that's dry and cool. DON’T: leave your hearing aids switched on when you’re not using them. DO: change batteries often so you won’t be stuck with aids that have suddenly run out of power. DON’T: ever insert anything into the sound outlet as it could damage the receiver. If you can’t clean it properly, ask your hearing professional. DO: remove any earwax that gets into your hearing aid. It could cause permanent damage. Image credits: Getty Images

Hearing

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

Surgery won’t fix my chronic back pain, so what will?

<a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> This week’s ABC Four Corners episode <a href="https://www.abc.net.au/news/2024-04-08/pain-factory/103683180">Pain Factory</a> highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain. The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain. <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">One in five</a> Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">A$139 billion a year</a>, including $12 billion in direct health-care costs. The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work? <h2>Opioids and invasive procedures</h2> Treatments offered to people with chronic pain include strong pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/30561481/">opioids</a> and invasive procedures such as <a href="https://pubmed.ncbi.nlm.nih.gov/36878313/">spinal cord stimulators</a> or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120">spinal fusion surgery</a>. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm. <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8">Spinal fusion surgery</a> and <a href="https://privatehealthcareaustralia.org.au/consumers-urged-to-be-cautious-about-spinal-cord-stimulators-for-pain/#:%7E:text=Australian%20health%20insurance%20data%20shows,of%20the%20procedure%20is%20%2458%2C377.">spinal cord stimulators</a> are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual. <h2>Addressing the contributors to pain</h2> Recommendations from the latest <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard">Australian</a> and <a href="https://www.who.int/publications/i/item/9789240081789">World Health Organization</a> clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as: <ul> <li>education</li> <li>advice</li> <li>structured exercise programs</li> <li>physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.</li> </ul> Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain. The interventions have minimal side effects and are cost-effective. In the <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">RESOLVE</a> trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move. In the <a href="https://pubmed.ncbi.nlm.nih.gov/37146623/">RESTORE</a> trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it. <h2>Why isn’t everyone with chronic pain getting this care?</h2> While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session <a href="https://www.sira.nsw.gov.au/__data/assets/pdf_file/0005/1122674/Physiotherapy-chiropractic-and-osteopathy-fees-practice-requirements-effective-1-February-2023.pdf">can cost</a> $90–$150. In contrast, <a href="https://www.servicesaustralia.gov.au/chronic-disease-individual-allied-health-services-medicare-items">Medicare</a> provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions. Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs. Access to trained clinicians is another barrier. This problem is particularly evident in <a href="https://www.ruralhealth.org.au/15nrhc/sites/default/files/B2-1_Bennett.pdf">regional and rural Australia</a>, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited. Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/data-file-57-opioid-medicines-dispensing-2016-17-third-atlas-healthcare-variation-2018">rate of opioid use</a>, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas. <h2>So what can we do about it?</h2> We need to reform Australia’s health system, private and <a href="https://www.health.gov.au/sites/default/files/documents/2020/12/taskforce-final-report-pain-management-mbs-items-final-report-on-the-review-of-pain-management-mbs-items.docx">public</a>, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments. Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian <a href="https://pubmed.ncbi.nlm.nih.gov/38461844/">trial</a>, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain. Advocacy and <a href="https://pubmed.ncbi.nlm.nih.gov/37918470/">improving the public’s understanding</a> of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.<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/227450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/surgery-wont-fix-my-chronic-back-pain-so-what-will-227450">original article</a>.

Body

Do optimists really live longer? Here’s what the research says

<a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, <a href="https://theconversation.com/institutions/durham-university-867">Durham University</a> Do you tend to see the glass as half full, rather than half empty? Are you always looking on the bright side of life? If so, you may be surprised to learn that this tendency could actually be good for your health. A <a href="https://content.apa.org/record/2020-71981-001">number of studies</a> have shown that optimists enjoy higher levels of wellbeing, better sleep, lower stress and even better cardiovascular health and immune function. And now, <a href="https://pubmed.ncbi.nlm.nih.gov/35674052/">a recent study</a> has shown that being an optimist is linked to longer life. To conduct their study, researchers tracked the lifespan of nearly 160,000 women aged between 50 to 79 for a period of 26 years. At the beginning of the study, the women completed a <a href="https://local.psy.miami.edu/people/faculty/ccarver/availbale-self-report-instruments/lot-r/">self-report measure of optimism</a>. Women with the highest scores on the measure were categorised as optimists. Those with the lowest scores were considered pessimists. Then, in 2019, the researchers followed up with the participants who were still living. They also looked at the lifespan of participants who had died. What they found was that those who had the highest levels of optimism were more likely to live longer. More importantly, the optimists were also more likely than those who were pessimists to live into their nineties. Researchers refer to this as “exceptional longevity”, considering the average lifespan for women is about 83 years in developed countries. What makes these findings especially impressive is that the results remained even after accounting for other factors known to predict a long life – including education level and economic status, ethnicity, and whether a person suffered from depression or other chronic health conditions. But given this study only looked at women, it’s uncertain whether the same would be true for men. However, <a href="https://www.pnas.org/doi/abs/10.1073/pnas.1900712116">another study</a> which looked at both men and women also found that people with the highest levels of optimism enjoyed a lifespan that was between 11% and 15% longer than those who were the least optimistic. <h2>The fountain of youth?</h2> So why is it that optimists live longer? At first glance it would seem that it may have to do with their healthier lifestyle. For example, <a href="https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.117.310828">research from several studies</a> has found that optimism is linked to eating a healthy diet, staying physically active, and being less likely to smoke cigarettes. These healthy behaviours are well known to improve heart health and <a href="https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases">reduce the risk</a> for cardiovascular disease, which is a <a href="https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)">leading cause of death</a> globally. Adopting a healthy lifestyle is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857242/">important for reducing the risk</a> of other potentially deadly diseases, such as diabetes and cancer. But having a healthy lifestyle may only be part of the reason optimists live a longer than average life. This latest study found that lifestyle only accounted for 24% of the link between optimism and longevity. This suggests a number of other factors affect longevity for optimists. Another possible reason could be due to the way optimists manage stress. When faced with a stressful situation, optimists tend to deal with it head-on. They <a href="https://pubmed.ncbi.nlm.nih.gov/16859439/">use adaptive coping strategies</a> that help them resolve the source of the stress, or view the situation in a less stressful way. For example, optimists will problem-solve and plan ways to deal with the stressor, call on others for support, or try to find a “silver lining” in the stressful situation. All of these approaches are well-known to reduce feelings of stress, as well as the biological reactions that occur when we feel stressed. It’s these <a href="https://www.apa.org/topics/stress/body">biological reactions to stress</a> –- such as elevated cortisol (sometimes called the “stress hormone”), increased heart rate and blood pressure, and impaired immune system functioning –- that can take a toll on health over time and increase the risk for developing <a href="https://www.sciencedirect.com/science/article/pii/S0889159115004316?via%3Dihub">life-threatening diseases</a>, such as cardiovascular disease. In short, the way optimists cope with stress may help protect them somewhat against its harmful effects. <h2>Looking on the bright side</h2> Optimism is typically viewed by researchers as a relatively stable personality trait that is determined by both <a href="https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/sex-differences-in-the-genetic-architecture-of-optimism-and-health-and-their-interrelation-a-study-of-australian-and-swedish-twins/58F21AA11943D44B4BA4C63A966E6AC7">genetic</a> and early childhood influences (such as having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541423/">secure and warm relationship</a> with your parents or caregivers). But if you’re not naturally prone to seeing the glass as half full, there are some ways you can increase your <a href="https://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1221122?journalCode=rpos20">capacity to be optimistic</a>. Research shows optimism can change over time, and can be cultivated by engaging in simple exercises. For example, visualising and then writing about your “<a href="https://www.psychologytoday.com/us/blog/what-matters-most/201303/what-is-your-best-possible-self">best possible self</a>” (a future version of yourself who has accomplished your goals) is a technique that studies have found can <a href="https://www.tandfonline.com/doi/full/10.1080/17439760.2016.1221122">significantly increase optimism</a>, at least temporarily. But for best results, the goals need to be both positive and reasonable, rather than just wishful thinking. Similarly, simply <a href="https://www.tandfonline.com/doi/abs/10.3200/SOCP.149.3.349-364">thinking about positive future events</a> can also be effective for boosting optimism. It’s also crucial to temper any expectations for success with an accurate view of what you can and can’t control. Optimism is reinforced when we experience the positive outcomes that we expect, and <a href="https://psycnet.apa.org/record/1970-20680-001">can decrease</a> when these outcomes aren’t as we want them to be. Although more research is needed, it’s possible that regularly envisioning yourself as having the best possible outcomes, and taking realistic steps towards achieving them, can help develop an optimistic mindset. Of course, this might be easier said than done for some. If you’re someone who isn’t naturally optimistic, the best chances to improve your longevity is by <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003332">living a healthy lifestyle</a> by staying physically active, eating a healthy diet, managing stress, and getting a good night’s sleep. Add to this cultivating a more optimistic mindset and you might further increase your chances for a long life.<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/184785/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, Professor in Social & Health Psychology, <a href="https://theconversation.com/institutions/durham-university-867">Durham 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/do-optimists-really-live-longer-heres-what-the-research-says-184785">original article</a>.

Caring

Do parolees really ‘walk free’? Busting common myths about parole

<a href="https://theconversation.com/profiles/monique-moffa-1380936">Monique Moffa</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/alyssa-sigamoney-1375881">Alyssa Sigamoney</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/greg-stratton-161122">Greg Stratton</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/jarryd-bartle-441602">Jarryd Bartle</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/michele-ruyters-18446">Michele Ruyters</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Parole is a hot topic in politics and in the media at the moment, fuelled by several high-profile parole applications. Recently, <a href="https://www.sbs.com.au/news/article/no-parole-for-convicted-baby-killer-keli-lane/xoykrtvxe?cid=testtwitter">Keli Lane’s</a> attempt to be released on parole after years in jail for the murder of her baby daughter was unsuccessful. <a href="https://www.heraldsun.com.au/truecrimeaustralia/police-courts-victoria/how-frankston-serial-killer-paul-denyer-will-apply-for-bail/news-story/4613d1b3fced1f4aeaa9c4e08e8b81e0">Paul Denyer</a>, known as the “Frankston Serial Killer” for murdering three women in the 90s was also denied parole. Meanwhile, Snowtown accomplice <a href="https://www.adelaidenow.com.au/truecrimeaustralia/police-courts-sa/bodies-in-the-barrels-helper-mark-haydon-released-on-parole/news-story/fdfbbbe7b59267d8009c6910249de585">Mark Haydon</a> was granted parole with strict conditions, but is <a href="https://www.abc.net.au/news/2024-04-01/snowtown-accomplice-mark-haydon-still-in-custody-after-parole/103653934">yet to be</a> released. Some media coverage of such well-known cases is littered with myths about what parole is, how it’s granted and what it looks like. Here’s what the evidence says about three of the most common misconceptions. <h2>Myth 1: people on parole walk free</h2> Parole is the conditional release of an incarcerated person (parolee) by a parole board authority, after they have served their non-parole period (minimum sentence) in jail. This isn’t always reflected in headlines. <a href="https://www.9news.com.au/national/snowtown-murders-bodies-in-barrels-murders-mark-haydon-release-south-australia/f4b62a72-ec3d-4238-94d2-64697fbcdef3">Some coverage</a> suggests people on parole are released early and “walk free” without conditions. This is not true. According to the <a href="https://www.adultparoleboard.vic.gov.au/what-parole/purpose-and-benefits">Adult Parole Board of Victoria</a>: "Parole provides incarcerated people with a structured, supported and supervised transition so that they can adjust from prison back into the community, rather than returning straight to the community at the end of their sentence without supervision or support." Parole comes with strict conditions and requirements, such as curfews, drug and alcohol testing, electronic monitoring, program participation, to name a few. People with experience of parole highlight its punitivism and continued extension of surveillance. <h2>Myth 2: most parolees reoffend</h2> Another myth is that the likelihood all parolees reoffend is high. Research over a number of years has consistently found parole reduces reoffending. For example, <a href="https://journals.sagepub.com/doi/abs/10.1177/0004865815585393?journalCode=anja">a 2016 study in New South Wales</a> found at the 12 month mark, a group of parolees reoffended 22% less than an unsupervised cohort. A <a href="https://www.bocsar.nsw.gov.au/Publications/CJB/2022-Report-Effect-of-parole-supervision-on-recidivism-CJB245.pdf">2022 study</a> by the NSW Bureau of Crime Statistics and Research found parole was especially successful in reducing serious recidivism rates among incarcerated people considered to be at a high risk of reoffending. More recently in Victoria, <a href="https://www.adultparoleboard.vic.gov.au/system/files/inline-files/Adult%20Parole%20Board%20Annual%20Report%202022-23_0.pdf">the Adult Parole Board</a> found over 2022–23, no parolees were convicted of committing serious offences while on parole. In contrast, unstructured and unconditional release increases the risk of returning to prison. <h2>Myth 3: parole is easy to get</h2> While the number of parolees reoffending has dropped, so too has the total number of people who are exiting prison on parole. Over a decade ago, Victoria underwent significant parole reforms, largely prompted by high-profile incidents and campaigns. In just five years following Jill Meagher’s tragic death in 2012, the Victorian government passed <a href="https://www.tandfonline.com/doi/full/10.1080/10345329.2018.1556285">13 laws reshaping parole</a>. The result is the number of people on parole in Victoria has halved since 2012, despite incarceration numbers remaining steady. <iframe id="maNRy" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/maNRy/" width="100%" height="400px" frameborder="0"></iframe> These reforms have made it more difficult for people convicted of serious offences to get parole, as well as preventing individuals or specific groups from being eligible for parole (such as police killers, <a href="https://theconversation.com/no-body-no-parole-laws-could-be-disastrous-for-the-wrongfully-convicted-191083">“no body, no parole” prisoners</a>, and certain high-profile murderers). Similar laws can be found in other states. For example, no body, no parole was introduced in all other Australian states and territories, except for Tasmania and the Australian Capital Territory. As a consequence, more people are being released at the end of their full sentence. This can be detrimental not only for the incarcerated person but the wider community, because they are not receiving the reintegration support parole provides. Aside from restricted access due to political intervention, parole is facing a new crisis, which has nothing to do with eligibility or suitability. Last year, 40% of Victorian parole applications were denied, often due to reasons <a href="https://www.adultparoleboard.vic.gov.au/system/files/inline-files/Adult%20Parole%20Board%20Annual%20Report%202022-23_0.pdf">unrelated to suitability</a>. Housing scarcity played a significant role, with 59% of rejections (or 235 applications) citing a lack of suitable accommodation as one of the reasons parole was denied. This is playing out <a href="https://www.abc.net.au/news/2023-08-11/women-on-bail-parole-increased-risk-of-homelessness-qld/102717002">across the country</a>. Parole is vulnerable to community and media hype, and political knee-jerk reactions in response to high profile incidents involving a person on parole. Because of the actions of a few, parole as a process has been restricted for many. While the wider community are active in advocacy efforts to restrict parole from certain people or groups (for example, this petition for <a href="https://www.change.org/p/lyns-law-no-body-no-parole">Lyn’s Law in NSW</a>), public efforts to restrict parole seem at odds with its purposes. Despite this, research suggests when the public are educated about the purposes and intent of parole, they are more likely to be <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3125829">supportive of it</a>. The susceptibility of parole to media and community influence results in frequent, impactful changes affecting individuals inside and outside prisons. Headlines such as “walking free” have the potential to mislead the public on the purpose and structure of parole. Coverage should portray parole beyond mere early termination of a sentence by accurately reflecting its purpose and impact.<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/226607/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/monique-moffa-1380936">Monique Moffa</a>, Lecturer, Criminology & Justice, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/alyssa-sigamoney-1375881">Alyssa Sigamoney</a>, Associate Lecturer in Criminology and Justice Studies, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/greg-stratton-161122">Greg Stratton</a>, Lecturer - Criminology and Justice Studies, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/jarryd-bartle-441602">Jarryd Bartle</a>, Associate Lecturer, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/michele-ruyters-18446">Michele Ruyters</a>, Associate Dean, Criminology and Justice Studies, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT 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/do-parolees-really-walk-free-busting-common-myths-about-parole-226607">original article</a>.

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Silent cancers: here’s what you need to know when there are no obvious symptoms

<a href="https://theconversation.com/profiles/justin-stebbing-1405462">Justin Stebbing</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> The recent revelations about the Princess of Wales’s <a href="https://www.bbc.com/news/uk-68640917">cancer diagnosis</a> highlight a crucial aspect of cancer detection – the disease’s sometimes silent nature. Silent cancers are those without noticeable symptoms. They pose a unique challenge in early detection and treatment. Contrary to common perception, cancer does not always announce its presence through overt symptoms or obvious signs. Many people receive a <a href="https://academic.oup.com/clinchem/article-abstract/70/1/179/7283928">cancer diagnosis incidentally</a>, when it’s found during routine medical examinations or investigations for unrelated health concerns – as seems to be the case for both <a href="https://www.wsj.com/health/kate-middleton-catherine-cancer-what-is-preventative-chemotherapy-9625370d">the princess</a> and <a href="https://www.bbc.co.uk/news/health-68171163">King Charles III</a>. While even silent cancers can sometimes be <a href="https://pubmed.ncbi.nlm.nih.gov/22584215/">aggressive and advance rapidly</a>, they can also remain <a href="https://pubmed.ncbi.nlm.nih.gov/20363069/">dormant</a> for years or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819710/">even decades</a>. Some <a href="https://ascopubs.org/doi/10.14694/EdBook_AM.2012.32.98">prostate</a>, <a href="https://ascopubs.org/doi/10.14694/EdBook_AM.2012.32.301">breast</a> and <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.571421/full">thyroid</a> cancers, for example, <a href="https://www.tmlep.com/clinical-learning/2023-01-23-when-did-this-tumour-start-the-need-for-a-gompertzian-understanding-of-tumour-growth-kinetics">often evolve slowly</a> without obvious symptoms or spreading beyond the original area. Research suggests that some of these cancers are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.571421/full">overtreated</a>. Sometimes patients are best left alone or treated much more gently, perhaps even without medical intervention, using a <a href="https://www.nejm.org/doi/full/10.1056/nejmoa1311593">“watch and wait”</a> strategy. This approach may be taken with prostate cancer in the elderly, for example. <h2>The importance of early diagnosis</h2> Whatever the cancer, it’s always important to get an early diagnosis though – and for silent cancers, this is obviously a challenge. Some cancer symptoms <a href="https://pubmed.ncbi.nlm.nih.gov/36702593/">can be vague</a> and easily mistaken for benign ailments. Fatigue, unexplained weight loss and persistent pain are among the nonspecific symptoms that may signal an underlying malignancy. But such symptoms can be misinterpreted or easily dismissed, which contributes to delayed diagnosis and treatment. <figure><iframe src="https://www.youtube.com/embed/MGMy6BzBvp0?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Fortunately, in many countries including the UK, we have <a href="https://www.england.nhs.uk/cancer/early-diagnosis/screening-and-earlier-diagnosis/">screening</a> tests for diseases like breast or colon cancer, to increase early diagnoses. Early diagnosis is a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.32887">key factor</a> for successful cancer treatment. Detecting cancer in its silent phase offers a window of opportunity for early intervention and improved outcomes. The discovery of asymptomatic cancers through diagnostic imaging or screening tests underscores the importance of these proactive healthcare measures. Identifying cancer at an early stage means the disease is confined to its site of origin, smaller and potentially easier to cure. Diagnosing a smaller cancer often means that if an operation is needed, it may be a less invasive surgery. There may also be a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825992/">lower chance</a> of needing post-operative preventative chemotherapy, to mop up any residual cells. Colorectal cancer (CRC) is a good example to show the critical importance of screening. Studies show that patients who participate in CRC <a href="https://www.nice.org.uk/guidance/dg56/chapter/1-Recommendations">screening</a>, such as colonoscopies or tests that look for blood in the stool, are more likely to be diagnosed while asymptomatic and have more positive prognoses after treatment. Those diagnosed with CRC after showing symptoms, such as rectal bleeding or changes in bowel habits, tend to have more <a href="https://bmjopengastro.bmj.com/content/4/1/e000146%20">advanced tumors and poorer outcomes</a>. <figure><iframe src="https://www.youtube.com/embed/nA9_Io3LDpA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Public health initiatives aimed at raising awareness about the importance of both cancer screening and symptom recognition play a pivotal role in reducing diagnostic delays. Empowering people to engage in <a href="https://healthcaredelivery.cancer.gov/prevention/#:%7E:text=Cancer%20can%20be%20prevented%20through,they%20are%20more%20easily%20treated.">preventive healthcare measures</a> such as HPV vaccinations and lifestyle changes that decrease risk can facilitate early detection and intervention, potentially altering the trajectory of the disease. <h2>Biomarker discovery</h2> The latest advances in diagnostic technologies, often known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012218/#:%7E:text=During%20biomarker%20discovery%2C%20evaluation%20of,design%20of%20future%20validation%20studies.">“biomarker discovery”</a>, hold promise for improving early detection rates and refining treatment strategies for silent cancers. From <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/molecular-profiling">molecular profiling</a> to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922467/">liquid biopsy techniques</a> (blood tests to diagnose cancer), innovative approaches are reshaping the landscape of cancer diagnosis, offering new avenues for personalised and precision medicine. For example, I worked with a team using blood tests to identify cancers in more than <a href="https://www.nature.com/articles/s41388-023-02591-z">1,000 women recalled after screening for mammography</a>. We looked at the DNA that tumour cells release – so-called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496721/">cell-free DNA</a> – and also metabolomics (rare markers related to metabolism in the blood). From this information, we found healthy patients, benign disease, pre-cancer and breast cancer. Although there’s increasing awareness and use of this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1769721218307110">approach in Europe</a>, it isn’t standard in the UK. Asymptomatic cancers represent a formidable challenge for patient care. But, by encouraging patients to adopt preventive lifestyles and engage with screenings and tests, asymptomatic cancers don’t have to be a hidden threat to health.<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/226536/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/justin-stebbing-1405462">Justin Stebbing</a>, Professor of Biomedical Sciences, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin 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/silent-cancers-heres-what-you-need-to-know-when-there-are-no-obvious-symptoms-226536">original article</a>.

Body

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

Eating some chocolate really might be good for you – here’s what the research says

<a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> Although it always makes me scoff slightly to see Easter eggs making their first appearance in supermarkets at the end of December, there are few people who aren’t delighted to receive a bit of chocolate every year. It makes sense that too much chocolate would be bad for you because of the high fat and sugar content in most products. But what should we make of common claims that eating some chocolate is actually good for you? Happily, there is a fair amount of evidence that shows, in the right circumstances, chocolate may be both beneficial for your heart and good for your mental state. In fact, chocolate – or more specifically cacao, the raw, unrefined bean – is a medicinal wonder. It contains many different active compounds which can evoke pharmacological effects within the body, like medicines or drugs. Compounds that lead to neurological effects in the brain have to be able to cross the <a href="https://link.springer.com/chapter/10.1007/978-3-642-13443-2_7">blood-brain barrier</a>, the protective shield which prevents harmful substances – like toxins and bacteria – entering the delicate nervous tissue. One of these is the compound <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/">theobromine</a>, which is also found in tea and contributes towards its bitter taste. Tea and chocolate also contain caffeine, which theobromine is related to as part of the purine family of chemicals. These chemicals, among others, contribute to chocolate’s addictive nature. They have the ability to cross the blood-brain barrier, where they can influence the nervous system. They are therefore known as <a href="https://pubmed.ncbi.nlm.nih.gov/15549276/">psychoactive</a> chemicals. <figure><iframe src="https://www.youtube.com/embed/HloqayQdR6M?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> What effects can chocolate have on mood? Well, <a href="https://academic.oup.com/nutritionreviews/article/71/10/665/1931144?login=false">a systematic review</a> looked at a group of studies which examined the feelings and emotions associated with consuming chocolate. Most demonstrated improvements in mood, anxiety, energy and states of arousal. Some noted the feeling of guilt, which is perhaps something we’ve all felt after one too many Dairy Milks. <h2>Health benefits of cocoa</h2> There are other organs, aside from the brain, that might benefit from the medicinal effects of cocoa. For centuries, chocolate has been used as a medicine to treat a <a href="https://pubmed.ncbi.nlm.nih.gov/10917925/">long list of diseases</a> including anaemia, tuberculosis, gout and even low libido. These might be spurious claims but there is evidence to suggest that eating cacao has a positive effect on the cardiovascular system. First, it can prevent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068178/">endothelial dysfunction</a>. This is the process through which arteries harden and get laden down with fatty plaques, which can in turn lead to heart attacks and strokes. Eating dark chocolate may also reduce <a href="https://www.sciencedirect.com/science/article/pii/S1537189115001135?via%3Dihub">blood pressure</a>, which is another risk factor for developing arterial disease, and prevent formation of clots which block up blood vessels. <figure><iframe src="https://www.youtube.com/embed/8VUcPCbSSCY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Some studies have suggested that dark chocolate might be useful in adjusting ratios of <a href="https://pubmed.ncbi.nlm.nih.gov/20968113/">high-density lipoprotein cholesterol</a>, which can help protect the heart. Others have examined insulin resistance, the phenomenon associated with Type 2 diabetes and weight gain. They suggest that the <a href="https://www.sciencedirect.com/science/article/pii/S0963996900000697#:%7E:text=Cocoa%20is%20rich%20in%20polyphenols%20particularly%20in%20catechins,and%20cocoa%20powder%20have%20been%20published%20only%20recently.">polyphenols</a> – chemical compounds present in plants – found in foodstuffs like chocolate may also lead to <a href="https://pubmed.ncbi.nlm.nih.gov/29993262/">improved control of blood sugars</a>. <h2>Chocolate toxicity</h2> As much as chocolate might be considered a medicine for some, it can be a poison for others. It’s well documented that the ingestion of caffeine and theobromine is highly toxic for domestic animals. Dogs are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801869/">particularly affected</a> because of their often voracious appetites and generally unfussy natures. The culprit is often dark chocolate, which can provoke symptoms of agitation, rigid muscles and even seizures. In certain cases, if ingested in high enough quantities, it can lead to comas and abnormal, even fatal heart rhythms. Some of the compounds found in chocolate have also been found to have potentially negative effects in humans. Chocolate is a source of oxalate which, along with calcium, is one of the main components of <a href="https://pubmed.ncbi.nlm.nih.gov/20301742/">kidney stones</a>. Some clinical groups have advised against consuming oxalate rich foods, such as spinach and rhubarb – and chocolate, for those who suffer from recurrent kidney stones. So, what should all this mean for our chocolate consumption habits? Science points in the direction of chocolate that has as high a cocoa solid content as possible, and the minimum of extras. The potentially harmful effects of chocolate are more related to fat and sugar, and may counteract any possible benefits. A daily dose of 20g-30g of plain or dark chocolate with cocoa solids above 70% – rather than milk chocolate, which contains fewer solids and white chocolate, which contains none – could lead to a greater health benefit, as well as a greater high. But whatever chocolate you go for, please don’t share it with the dog.<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/226759/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</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/eating-some-chocolate-really-might-be-good-for-you-heres-what-the-research-says-226759">original article</a>.

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Why do airlines charge so much for checked bags? This obscure rule helps explain why

<a href="https://theconversation.com/profiles/jay-l-zagorsky-152952">Jay L. Zagorsky</a>, <a href="https://theconversation.com/institutions/boston-university-898">Boston University</a> Five out of the six <a href="https://www.oag.com/blog/biggest-airlines-in-the-us">biggest U.S. airlines</a> have <a href="https://www.cnbc.com/2024/03/05/delta-is-the-latest-airline-to-raise-its-checked-bag-fee.html">raised their checked bag fees</a> since January 2024. Take American Airlines. In 2023, it cost US$30 to check a standard bag in with the airline; <a href="https://www.usatoday.com/story/travel/airline-news/2024/02/20/american-airlines-bag-fees-mileage-earning/72669245007/">today, as of March 2024, it costs $40</a> at a U.S. airport – a whopping 33% increase. As a <a href="https://www.bu.edu/questrom/">business school</a> <a href="https://www.bu.edu/questrom/profile/jay-zagorsky/">professor who studies travel</a>, I’m often asked why airlines alienate their customers with baggage fees instead of bundling all charges together. <a href="https://www.vox.com/2015/4/16/8431465/airlines-carry-on-bags">There are</a> <a href="https://www.usatoday.com/story/travel/columnist/2023/06/21/bag-fees-will-stay-a-while-cruising-altitude/70338849007/">many reasons</a>, but an important, often overlooked cause is buried in the U.S. tax code. <h2>A tax-law loophole</h2> Airlines pay the federal government <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D">7.5% of the ticket price</a> when <a href="https://www.pwc.com/us/en/services/tax/library/aircraft-club-nov-2023-air-transport-excise-tax-rates-for-2024.html">flying people domestically, alongside other fees</a>. The airlines dislike these charges, with their <a href="https://www.airlines.org/dataset/government-imposed-taxes-on-air-transportation/">trade association arguing</a> that they boost the cost to the consumer of a typical air ticket by around one-fifth. However, the U.S. Code of Federal Regulations <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D/section-49.4261-8">specifically excludes baggage</a> from the 7.5% transportation tax as long as “the charge is separable from the payment for the transportation of a person and is shown in the exact amount.” This means if an airline charges a combined $300 to fly you and a bag round-trip within the U.S., it owes $22.50 in tax. If the airline charges $220 to fly you plus separately charges $40 each way for the bag, then your total cost is the same — but the airline only owes the government $16.50 in taxes. Splitting out baggage charges saves the airline $6. Now $6 might not seem like much, but it can add up. Last year, passengers took <a href="https://www.transtats.bts.gov/Data_Elements.aspx?Data=1">more than 800 million trips on major airlines</a>. Even if only a fraction of them check their bags, that means large savings for the industry. How large? The government has <a href="https://www.bts.dot.gov/topics/airlines-and-airports/baggage-fees-airline-2023">tracked revenue from bag fees</a> for decades. In 2002, airlines charged passengers a total of $180 million to check bags, which worked out to around 33 cents per passenger. Today, as any flyer can attest, bag fees are a lot higher. Airlines collected over 40 times more money in bag fees last year than they did in 2002. When the full data is in for 2023, <a href="https://www.bts.dot.gov/baggage-fees">total bag fees</a> will likely top $7 billion, which is about $9 for the average domestic passenger. <a href="https://viewfromthewing.com/the-real-reason-airlines-charge-checked-bag-fees-and-its-not-what-you-think">By splitting out the cost of bags</a>, airlines avoided paying about half a billion dollars in taxes just last year. In the two decades since 2002, flyers paid a total of about $70 billion in bag fees. This means separately charging for bags saved airlines about $5 billion in taxes. <iframe id="88MYD" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/88MYD/2/" width="100%" height="400px" frameborder="0"></iframe> It seems clear to me that tax savings are one driver of the unbundling of baggage fees because of a quirk in the law. The U.S. government doesn’t apply the 7.5% tax to <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D/section-49.4261-3">international flights that go more than 225 miles</a> beyond the nation’s borders. Instead, there are fixed <a href="https://www.airlines.org/dataset/government-imposed-taxes-on-air-transportation">international departure and arrival taxes</a>. This is why major airlines charge $35 to $40 <a href="https://www.aa.com/i18n/travel-info/baggage/checked-baggage-policy.jsp">for bags if you’re flying domestically</a>, but don’t charge a bag fee when you’re flying to Europe or Asia. <h2>Do travelers get anything for that money?</h2> This system raises an interesting question: Do baggage fees force airlines to be more careful with bags, since customers who pay more expect better service? To find out, I checked with the Bureau of Transportation Statistics, which has been <a href="https://www.bts.gov/content/mishandled-baggage-reports-filed-passengers-largest-us-air-carriersa">tracking lost luggage for decades</a>. For many years, it calculated the number of mishandled-baggage reports per thousand airline passengers. The government’s data showed mishandled bags peaked in 2007 with about seven reports of lost or damaged luggage for every thousand passengers. That means you could expect your luggage to go on a different trip than the one you are taking about once every 140 or so flights. By 2018, that estimate had fallen to once every 350 flights. In 2019, the government <a href="https://www.bts.gov/topics/airlines-and-airports/number-30a-technical-directive-mishandled-baggage-amended-effective-jan">changed how it tracks</a> mishandled bags, calculating figures based on the total number of bags checked, rather than the total number of passengers. The new data show about six bags per thousand checked get lost or damaged, which is less than 1% of checked bags. Unfortunately, the data doesn’t show improvement since 2019. Is there anything that you can do about higher bag fees? Complaining to politicians probably won’t help. In 2010, two senators <a href="https://www.nj.com/business/2010/04/us_senators_present_bill_to_ba.html">tried to ban bag fees</a>, and their bill went nowhere. Given that congressional action failed, there’s a simple way to avoid higher bag fees: <a href="https://www.cnn.com/travel/article/packing-expert-travel-world-handbag/index.html">travel light</a> and <a href="https://www.nytimes.com/2023/07/08/opinion/carry-on-packing-airlines-lost-luggage.html">don’t check any luggage</a>. It may sound tough not to have all your belongings when traveling, but it might be the best option as bag fees take off.<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/225857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jay-l-zagorsky-152952">Jay L. Zagorsky</a>, Associate Professor of Markets, Public Policy and Law, <a href="https://theconversation.com/institutions/boston-university-898">Boston University</a> 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-airlines-charge-so-much-for-checked-bags-this-obscure-rule-helps-explain-why-225857">original article</a>.

Travel Trouble

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

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers. Adding to the uncertainty, a recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">series in the Lancet</a> medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate. So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says. <h2>Remind me, what exactly is menopause?</h2> Menopause, simply put, is complete loss of female fertility. Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause). Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months. Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder). <h2>What are the most common symptoms of menopause?</h2> <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">Our study</a> of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are: <ul> <li>hot flushes and night sweats (known as vasomotor symptoms)</li> <li>disturbed sleep</li> <li>musculoskeletal pain</li> <li>decreased sexual function or desire</li> <li>vaginal dryness and irritation</li> <li>mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.</li> </ul> However, none of these symptoms are menopause-specific, meaning they could have other causes. In <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">our study of Australian women</a>, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats. But the severity of these symptoms <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">varies greatly</a>. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55. So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are <a href="https://journals.lww.com/menopausejournal/fulltext/2022/05000/prevalence,_severity,_and_associated_factors_in.9.aspx">similarly affected</a>. Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span. The <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">most robust guidelines</a> do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of <a href="https://www.cell.com/cell/abstract/S0092-8674(23)00905-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867423009054%3Fshowall%3Dtrue">menopausal hormonal changes</a>. The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">Some studies</a> suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">have not been shown to change</a>. <h2>Who might benefit from hormone therapy?</h2> The Lancet papers <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">suggest</a> menopause hormone therapy <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02799-X/fulltext">alleviates</a> hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats). In contrast, the highest quality <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">clinical guidelines</a> consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy. Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency). However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”. Despite musculoskeletal pain being the most common menopausal symptom in <a href="https://journals.lww.com/menopausejournal/abstract/2016/07000/prevalence_and_severity_of_vasomotor_symptoms_and.6.aspx">some populations</a>, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied. Some guidelines, such as an <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Australian endorsed guideline</a>, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease. <h2>What are the risks?</h2> The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot. Oestrogen-only menopause hormone therapy is <a href="https://www.nice.org.uk/guidance/ng23">consistently considered</a> to cause little or no change in breast cancer risk. Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, <a href="https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Women%20Health/CPG_Management_of_Menopause_2022_e-version-1.pdf">has been associated with a small increase</a> in the risk of breast cancer, although any <a href="https://www.bmj.com/content/bmj/371/bmj.m3873.full.pdf">risk appears to vary</a> according to the type of therapy used, the dose and duration of use. Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels <a href="https://www.bmj.com/content/bmj/364/bmj.k4810.full.pdf">prescribed at standard doses</a> <h2>What if I don’t want hormone therapy?</h2> If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats. In Australia, most of these options are “off-label”, although the new medication <a href="https://australianprescriber.tg.org.au/articles/management-of-menopause.html">fezolinetant</a> has just been <a href="https://www.tga.gov.au/resources/artg/401401">approved</a> in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat). Unfortunately, most over-the-counter treatments promoted for menopause are either <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">ineffective or unproven</a>. However, cognitive behaviour therapy and hypnosis <a href="https://journals.lww.com/menopausejournal/abstract/2023/06000/the_2023_nonhormone_therapy_position_statement_of.4.aspx">may provide symptom relief</a>. The Australasian Menopause Society has useful <a href="https://www.menopause.org.au/health-info/fact-sheets">menopause fact sheets</a> and a <a href="https://www.menopause.org.au/health-info/find-an-ams-doctor">find-a-doctor</a> page. The <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Practitioner Toolkit for Managing Menopause</a> is also freely available.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> 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-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">original article</a>.

Body

What if there was a hearing aid that understood your listening intentions?

<div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column">Hearing conversations in noisy environments can be especially hard for people with impaired hearing. Unfortunately, traditional hearing aids adopt a ‘one-size-fits-all’ approach to processing sounds, regardless of the listening needs of individual users. This may make listening and engaging with others more difficult. Users may also experience a lack of sound clarity and be reluctant to engage in conversations with others.</div> <div class="column"> </div> <div class="column">Hearing aid manufacturer <a href="https://www.oticon.co.nz/hearing-aid-users" target="_blank" rel="noopener">Oticon</a> is taking the next important step on the journey to solve the No.1 challenge for people with hearing loss – hearing speech in noise2. With new groundbreaking 4D Sensor technology, <a href="https://www.oticon.co.nz/hearing-aid-users/hearing-aids/products/intent" target="_blank" rel="noopener">Oticon Intent</a> is capable of understanding the user’s listening intentions by recognising what they want and need to listen to, in order to deliver truly personalised support.</div> <div class="column"> </div> <div class="column">The Brain And Sound</div> <div class="column"> </div> <div class="column">Our ears gather the sounds around us, but the true hero in sound processing is the brain, as it is constantly working to make sense of sound. Oticon uses their BrainHearingTM philosophy to develop technology that provides the brain with access to the full sound environment.</div> <div class="column"> </div> <div class="column">The latest <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://www.oticon.co.nz/hearing-aid-users/hearing-loss/understand-hearing-loss/how-hearing-works" target="_blank" rel="noopener">BrainHearingTM</a> insights reveal that people’s communication behaviour reflects their listening needs and intentions at a given moment via head and body movements. In conversation, users tend to keep their heads still to engage with a single person or move their heads in a group conversation to engage with different people. When struggling to hear what someone is saying, users are likely to lean in to listen.</div> <div class="column"> </div> <div class="column">The technology in Oticon Intent understands and adapts to the user through sensors that monitor head and body movements, conversation activity and the acoustic environment. Oticon Intent helps users move beyond just hearing and listening, helping them to communicate and fully engage in life.</div> <div class="column"> </div> <div class="column">Ease Of Communication</div> <div class="column"> </div> <div class="column">In challenging, noisy environments, Oticon Intent makes it possible to: <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <ul> <li>Move through a crowd with seamless awareness, while orienting to the surrounding sounds.</li> <li>Begin chatting with a group of people, thanks to heightened access to voices and balanced background sounds so they are not intrusive, while still accessible.</li> <li>Start an intimate conversation with one person, easily hearing the speaker’s voice amid the noise all around.</li> </ul> </div> </div> </div> </div> </div> </div> </div> </div> <img class="alignnone size-full wp-image-50989" src="https://oversixtydev.blob.core.windows.net/media/2024/03/Oticon_Intent_HA_In_Hand_Hero3_KC_1321_Expires_On_2_8_2029_1280.jpg" alt="" width="1280" height="720" /> Engage More In Life “If you have a hearing loss, you can actually protect your brain from cognitive decline by using active hearing aids which enable you to connect with others and let you engage in life to the fullest,” says Thomas Behrens, Vice President of Audiology at Oticon. “You can also enjoy future-proof, next- generation connectivity technology, crafted into the smallest form factor we have designed to date within this category.” Open Up The Digital World Offering easy connection to compatible smart devices through Bluetooth® Low Energy technology, Oticon Intent also enables users to engage in the digital world like never before. It allows a detailed, high-quality sound experience for hands-free calls and delivers direct streaming of music, audio book and much more3. With up to 20 hours of battery life, users will never have to worry about running out of battery. When they need a recharge, they’d simply drop the hearing aids into the charger for just 30 minutes for up to 8 hours of battery life4. Your hearing matters. Take a step towards better hearing by contacting your nearest <a href="https://www.oticon.co.nz/hearing-aid-users/find-audiologist" target="_blank" rel="noopener">hearing care professional</a>. To explore this revolutionary hearing aid that helps users to engage in life like never before, visit <a href="https://www.oticon.co.nz/oticon-intent" target="_blank" rel="noopener">www.oticon.co.nz/oticon-intent</a> For more information and to find your nearest hearing clinic, visit <a href="https://www.oticon.co.nz" target="_blank" rel="noopener">oticon.co.nz</a> *4D Sensor technology only available in Oticon Intent 1 & 2. [2.] Jorgensen, L., & Novak, M. (2020). Factors Influencing Hearing Aid Adoption. Seminars in hearing, 41(1), 6–20. [3.] Hands-free communication is available on select devices. See which hearing aids and devices are compatible here: oticon.co.nz/compatibility. [4.] Expected use time for rechargeable battery depends on use pattern, active feature set, hearing loss, sound environment, battery age and use of wireless accessories. Images: Supplied. This is a sponsored article produced in partnership with Oticon.

Hearing

What’s the difference between autism and Asperger’s disorder?

<a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Swedish climate activist Greta Thunberg describes herself as having <a href="https://www.theguardian.com/environment/2019/sep/02/greta-thunberg-responds-to-aspergers-critics-its-a-superpower">Asperger’s</a> while others on the autism spectrum, such as Australian comedian Hannah Gatsby, <a href="https://www.theguardian.com/stage/2022/mar/19/hannah-gadsby-autism-diagnosis-little-out-of-whack">describe</a> themselves as “autistic”. But what’s the difference? Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD. Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges. When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of <a href="https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder">autism spectrum disorder</a> is made. <h2>Where do the definitions come from?</h2> The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders. Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4. In 2013, the DSM-5 collapsed both diagnoses into one <a href="https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">autism spectrum disorder</a>. <h2>How did we used to think about autism?</h2> The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder. Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress. Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism. The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech. Today, as a legacy of the recognition of the autism itself, the <a href="https://www.aihw.gov.au/reports/disability/autism-in-australia/contents/autism">majority of people</a> diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability. <h2>What changed with ‘autism spectrum disorder’?</h2> The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term. It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things. The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”. The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in. <h2>Why do some people prefer the old terminology?</h2> Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism. The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, <a href="https://xminds.org/resources/Documents/Web%20files/Aspie%20Criteria%20by%20Attwood.pdf">Tony Attwood and Carol Gray</a>, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges. <h2>What about identity-based language?</h2> A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”. The neurodiversity rights movement describes its aim to <a href="https://researchonline.jcu.edu.au/71531/1/JCU_71531_AAM.pdf">push back</a> against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism. The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments. However the social model contrasts itself against a very outdated medical or clinical model. Current clinical thinking and practice focuses on <a href="https://www.collegianjournal.com/article/S1322-7696(22)00122-6/fulltext">targeted</a> supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism. A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.<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/223643/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, Professor of Nursing, School of Health and Human Sciences, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-autism-and-aspergers-disorder-223643">original article</a>.

Mind

Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

<a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.” “My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video. No further details have been released about the Princess of Wales’ treatment. But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment. <h2>It’s not the same as preventing cancer</h2> To <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">prevent cancer developing</a>, lifestyle changes such as diet, exercise and sun protection are <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">recommended</a>. Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at <a href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353">high risk of breast cancer</a>. Aspirin <a href="https://www.cancer.gov/about-cancer/causes-prevention/research/aspirin-cancer-risk">can also be used</a> for those at high risk of bowel and other cancers. <h2>How can chemotherapy be used as preventive therapy?</h2> In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning. If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer. If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate <a href="https://www.healthline.com/health/cancer/metastatic-cancer">around the body</a> . The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer <a href="https://www.verywellhealth.com/adjuvant-therapy-5198903">coming back</a>. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later. With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back. If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer. <h2>How effective is preventive therapy?</h2> The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy. Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564362/">first chemotherapy tested</a> improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%. Preventive chemotherapy is usually given for three to six months. <h2>How does chemotherapy work?</h2> Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations. Chemotherapy is not selective for cancer cells. It kills any dividing cells. But cancers consist of a higher proportion of dividing cells than the normal body cells. A <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment/chemotherapy/how-does-chemotherapy-work#:%7E:text=Chemotherapy%20works%20by%20killing%20cells%20that%20are%20rapidly,cells%20can%20repair%20the%20damage%20and%20can%20recover.">greater proportion of the cancer is killed</a> with each course of chemotherapy. Normal cells can recover between courses, which are usually given three to four weeks apart. <h2>What are the side effects?</h2> The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells. The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection. Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance. Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet. There are also generalised symptoms such as <a href="https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html">fatigue</a>. Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.<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/226461/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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/kate-middleton-is-having-preventive-chemotherapy-for-cancer-what-does-this-mean-226461">original article</a>.

Body

6 major benefits of doing yoga every day, from experts

<h2>Positive effects of yoga</h2> Sometimes it’s the simplest daily practice that can have the biggest impact on your health, and yoga is proof of that. Although most forms of yoga aren’t considered to be as intense as other workout regimens (think your average cycling class!), practising yoga on a daily basis has been scientifically demonstrated to help you mentally and physically. Through breath work, meditation and holding poses that increase strength and flexibility, the body and mind reap benefits from yoga that positively impact your long-term health. It’s no wonder people have been practising yoga for over 5000 years, and that the number of Australians practising yoga doubled between 2008 and 2017 to over two million, according to the Australian Bureau of Statistics. In order to get the full scope of what practising yoga daily can really do for your body, we spoke with several experts who have seen the ways yoga has positively benefited their students, patients… and even themselves. <a href="https://gaiam.innovations.co.nz/p/gaiam-yoga/mats?affiliate=GAIAM60" target="_blank" rel="noopener">Keen to try? You’ll need a mat. There’s a range of mats to suit every yoga level, check out these we recommend.</a> <h2>Yoga assists with mood regulation</h2> <img src="https://oversixtydev.blob.core.windows.net/media/2024/03/6benefitsyoga_getty2.jpg" alt="" width="1280" height="720" /> Yoga teacher, Jenni Tarma, shares, “We have a wealth of research demonstrating that a regular mindfulness practice – the act of paying attention to the sensation in the body, thoughts and emotions without judgment – can reduce stress and help us to feel calmer, more productive, and generally more even-keeled in our daily lives.” After evaluating yoga history and research, one 2014 review published in Frontiers in Human Neouroscience concluded that regular yoga practice can help facilitate self-regulation (the ability to understand and manage your behaviour and reactions). Another study of adolescents between the ages of 13 and 18 found that practising yoga positively benefited emotional regulation and self-esteem. “Movement releases beneficial neurotransmitters in the brain, which helps us feel good as well as assist in mood regulation,” says yoga instructor, Evan Lawrence. “One of the things that I like about yoga specifically is that there is simultaneously a focus on physical movement and breathing.” <a href="https://www.readersdigest.co.nz/culture/23-instant-mood-boosters-you-wont-want-to-live-without" target="_blank" rel="noopener">Don’t miss these instant mood boosters you won’t want to live without.</a> <h2>Yoga builds up your core strength</h2> <img src="https://oversixtydev.blob.core.windows.net/media/2024/03/6benefitsyoga_shutterstock3.jpg" alt="" width="1280" height="720" /> Personal trainer and yoga teacher, Gina Newton, says, “From a physical perspective, yoga is so great for increasing our core strength, which should be a non-negotiable part of every human’s workout.” Newton adds, “We all need our core – and especially women who have been pregnant or had children, our core strength is something we need to care for and nurture to hold us up.” According to Harvard Medical School, a stronger core benefits the body in multiple ways, including providing better posture, balance, stability, relief for lower back pain, and support through daily tasks like cleaning, working, and athletic activities or exercise. Wearing comfortable yoga gear will help you get the most out of your workout. <a href="https://gaiam.innovations.co.nz/p/gaiam-apparel/apparel?affiliate=GAIAM60" target="_blank" rel="noopener">Check out these yoga clothes from Gaiam.</a> <h2>Yoga reduces stress</h2> <img src="https://oversixtydev.blob.core.windows.net/media/2024/03/6benefitsyoga_getty4.jpg" alt="" width="1280" height="720" /> “Yoga and meditation are powerful tools for stress resilience and strengthening mental health,” says holistic healthcare practitioner and yoga instructor, Nicole Renée Matthews. “Doing yoga regularly promotes mental clarity and calmness, centres and relaxes the mind, helps to relieve stress patterns and anxiety, and boosts concentration and focus.” One 2010 study from the Journal of Alternative and Complementary Medicine concluded that practising yoga can improve mood and decrease anxiety even more than a regular walking practice after participants finished a 12-week program. Researchers have also found that the breath-taking techniques involved with yoga can be part of what benefits decreased anxiety during practice. “Breath awareness, another key component of yoga, has been shown to reduce physiological markers of stress, especially when using techniques such as ‘belly breathing’ – breathing deeply so that the abdomen expands, rather than exclusively using a shallow chest breath – and elongating the exhalation,” says Tarma. “These techniques help to activate the parasympathetic nervous system, which in turn leads to less anxiety, jitteriness, and improved sleep; all things that can improve our mental health on a day-to-day basis.” <a href="https://www.readersdigest.co.nz/healthsmart/conditions/mental-health/10-science-backed-ways-to-lower-your-stress-this-instant-really" target="_blank" rel="noopener">Don’t miss these science-backed ways to lower your stress this instant (really!).</a> <h2>Yoga improves brain health</h2> <img src="https://oversixtydev.blob.core.windows.net/media/2024/03/6benefitsyoga_getty5.jpg" alt="" width="1280" height="720" /> According to associate professor of psychiatry, Dr Gail Saltz, practising yoga “improves overall blood flow to the body, including the brain, [which is] helpful for cognition and memory.” One 2019 review published in Brain Plasticity concluded that behavioural interventions like yoga can help “mitigate age-related and neurodegenerative decline” due to the positive effects a daily practice has on different parts of the functioning brain, like the hippocampus (which plays a major role in learning and memory) and the prefrontal cortex (cognitive control functions). Staying hydrated is key to maintaining optimum brain health. <a href="https://gaiam.innovations.co.nz/p/takeya/water-bottles-actives-range?affiliate=GAIAM60" target="_blank" rel="noopener">These drink bottles can help you keep your water intake up throughout the day.</a> <h2>Yoga improves flexibility and mobility</h2> <img src="https://oversixtydev.blob.core.windows.net/media/2024/03/6benefitsyoga_shutterstock6.jpg" alt="" width="1280" height="720" /> “Physically, daily yoga practice allows us to engage our muscles and move through larger ranges of joint motion than we do typically moving through life,” says Lawrence. “This helps to keep us limber and flexible.” “Dedicated, daily yoga practice helps with flexibility and strength, which can help improve your posture, as well as balance,” says yoga instructor, Samantha Hoff. “On the physical side, it also helps with joint mobility since you’ll take your joints through most – or all – of their ranges of motion.” <a href="https://www.readersdigest.co.nz/healthsmart/12-best-yoga-poses-to-strengthen-bones" target="_blank" rel="noopener">Here are the best yoga poses to strengthen bones.</a> <h2>Yoga strengthens muscle and endurance</h2> <img src="https://oversixtydev.blob.core.windows.net/media/2024/03/6benefitsyoga_getty7.jpg" alt="" width="1280" height="720" /> “From a musculoskeletal perspective,” says Tarma, “yoga loads our bodies and joints in a wide variety of positions and scenarios: think longer static holds in poses that challenge our tissues’ endurance, or controlled transitions between shapes that develop strength, control and coordination. These different facets of our movement capabilities all contribute to better overall function and load-tolerance capacity. As an added bonus, because most styles of yoga are bodyweight only and move at a very moderate speed, yoga is also a generally very accessible and safe movement modality.” Yoga is the ultimate self-care activity. <a href="https://gaiam.innovations.co.nz/p/gaiam-yoga/accessories/27-73312-gaiam-performance-hold-everything-yoga-backpack-bag?affiliate=GAIAM60" target="_blank" rel="noopener">Whether you do it at a studio or in the park, this handy yoga backpack bag stores everything you need for a calm yoga workout.</a> This article, written by Kiersten Hickman, originally appeared on <a href="https://www.readersdigest.co.nz/culture/6-major-benefits-of-doing-yoga-every-day-from-experts" target="_blank" rel="noopener">Reader's Digest</a>. Images: Shutterstock | Getty

Body

What are the four waves of feminism? And what comes next?

<a href="https://theconversation.com/profiles/sharon-crozier-de-rosa-122804">Sharon Crozier-De Rosa</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> In Western countries, feminist history is generally packaged as a story of “waves”. The so-called first wave lasted from the mid-19th century to 1920. The second wave spanned the 1960s to the early 1980s. The third wave began in the mid-1990s and lasted until the 2010s. Finally, some say we are experiencing a fourth wave, which began in the mid-2010s and continues now. The first person to use “waves” was journalist Martha Weinman Lear, in her 1968 New York Times article, <a href="https://www.nytimes.com/1968/03/10/archives/the-second-feminist-wave.html">The Second Feminist Wave</a>, demonstrating that the women’s liberation movement was another <a href="https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-fourth">“new chapter</a> in a grand history of women fighting together for their rights”. She was responding to anti-feminists’ framing of the movement as a “<a href="https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-fourth">bizarre historical aberration</a>”. <a href="https://www.journals.uchicago.edu/doi/abs/10.1086/718868">Some feminists</a> criticise the usefulness of the metaphor. Where do feminists who preceded the first wave sit? For instance, Middle Ages feminist writer <a href="https://blogs.loc.gov/bibliomania/2023/08/30/christine-de-pizan/">Christine de Pizan</a>, or philosopher <a href="https://plato.stanford.edu/entries/wollstonecraft/">Mary Wollstonecraft</a>, author of <a href="https://www.penguin.com.au/books/a-vindication-of-the-rights-of-woman-9780141441252">A Vindication of the Rights of Woman</a> (1792). Does the metaphor of a single wave <a href="https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-fourth">overshadow</a> the complex variety of feminist concerns and demands? And does this language exclude the <a href="https://www.journals.uchicago.edu/doi/abs/10.1086/718868">non-West</a>, for whom the “waves” story is meaningless? Despite these concerns, countless feminists <a href="https://www.researchgate.net/publication/317322421_Finding_a_Place_in_History_The_Discursive_Legacy_of_the_Wave_Metaphor_and_Contemporary_Feminism">continue to use</a> “waves” to explain their position in relation to previous generations. <h2>The first wave: from 1848</h2> The first wave of feminism refers to the campaign for the vote. It began in the United States in 1848 with the <a href="https://www.loc.gov/exhibitions/women-fight-for-the-vote/about-this-exhibition/seneca-falls-and-building-a-movement-1776-1890/">Seneca Falls Convention</a>, where 300 gathered to debate Elizabeth Cady Stanton’s Declaration of Sentiments, outlining women’s inferior status and demanding suffrage – or, the right to vote. It continued over a decade later, in 1866, in Britain, with the presentation of a <a href="https://www.parliament.uk/about/living-heritage/transformingsociety/electionsvoting/womenvote/parliamentary-collections/1866-suffrage-petition/presenting-the-petition/">suffrage petition</a> to parliament. This wave ended in 1920, when women were granted the right to vote in the US. (Limited women’s suffrage had been introduced in Britain two years earlier, in 1918.) First-wave activists believed once the vote had been won, women could use its power to enact other much-needed reforms, related to property ownership, education, employment and more. White leaders dominated the movement. They included longtime president of the the International Woman Suffrage Alliance <a href="https://cattcenter.iastate.edu/home/about-us/carrie-chapman-catt/">Carrie Chapman Catt</a> in the US, leader of the militant Women’s Social and Political Union <a href="https://www.britannica.com/biography/Emmeline-Pankhurst">Emmeline Pankhurst</a> in the UK, and <a href="https://adb.anu.edu.au/biography/spence-catherine-helen-4627">Catherine Helen Spence</a> and <a href="https://adb.anu.edu.au/biography/goldstein-vida-jane-6418">Vida Goldstein</a> in Australia. This has tended to obscure the histories of non-white feminists like evangelist and social reformer <a href="https://www.britannica.com/biography/Sojourner-Truth">Sojourner Truth</a> and journalist, activist and researcher <a href="https://www.womenshistory.org/education-resources/biographies/ida-b-wells-barnett">Ida B. Wells</a>, who were fighting on multiple fronts – including anti-slavery and anti-lynching – as well as feminism. <h2>The second wave: from 1963</h2> The second wave coincided with the publication of US feminist Betty Friedan’s <a href="https://www.penguin.com.au/books/the-feminine-mystique-9780141192055">The Feminine Mystique</a> in 1963. Friedan’s “<a href="https://www.smithsonianmag.com/smithsonian-institution/powerful-complicated-legacy-betty-friedans-feminine-mystique-180976931/">powerful treatise</a>” raised critical interest in issues that came to define the women’s liberation movement until the early 1980s, like workplace equality, birth control and abortion, and women’s education. Women came together in “consciousness-raising” groups to share their individual experiences of oppression. These discussions informed and motivated public agitation for <a href="https://www.berghahnbooks.com/title/HaeberlenPolitics">gender equality and social change</a>. Sexuality and gender-based violence were other prominent second-wave concerns. Australian feminist Germaine Greer wrote <a href="https://www.harpercollins.com.au/9780007205011/the-female-eunuch/">The Female Eunuch</a>, published in 1970, which <a href="https://theconversation.com/friday-essay-the-female-eunuch-at-50-germaine-greers-fearless-feminist-masterpiece-147437">urged women to</a> “challenge the ties binding them to gender inequality and domestic servitude” – and to ignore repressive male authority by exploring their sexuality. Successful lobbying saw the establishment of refuges for women and children fleeing domestic violence and rape. In Australia, there were groundbreaking political appointments, including the world’s first Women’s Advisor to a national government (<a href="https://www.nma.gov.au/audio/landmark-women/transcripts/landmark-women-elizabeth-reid-181013.mp3-transcript">Elizabeth Reid</a>). In 1977, a <a href="https://www.whitlam.org/women-and-whitlam">Royal Commission on Human Relationships</a> examined families, gender and sexuality. Amid these developments, in 1975, Anne Summers published <a href="https://theconversation.com/damned-whores-and-gods-police-is-still-relevant-to-australia-40-years-on-mores-the-pity-47753">Damned Whores and God’s Police</a>, a scathing historical critique of women’s treatment in patriarchal Australia. At the same time as they made advances, so-called women’s libbers managed to anger earlier feminists with their distinctive claims to radicalism. Tireless campaigner <a href="https://adb.anu.edu.au/biography/rich-ruby-sophia-14202">Ruby Rich</a>, who was president of the Australian Federation of Women Voters from 1945 to 1948, responded by declaring the only difference was her generation had called their movement “<a href="https://nla.gov.au/nla.obj-296328435/findingaid">justice for women</a>”, not “liberation”. Like the first wave, mainstream second-wave activism proved largely irrelevant to non-white women, who faced oppression on intersecting gendered and racialised grounds. African American feminists produced their own critical texts, including bell hooks’ <a href="https://www.routledge.com/Aint-I-a-Woman-Black-Women-and-Feminism/hooks/p/book/9781138821514">Ain’t I a Woman? Black Women and Feminism</a> in 1981 and Audre Lorde’s <a href="https://www.penguinrandomhouse.com/books/198292/sister-outsider-by-audre-lorde/">Sister Outsider</a> in 1984. <h2>The third wave: from 1992</h2> The third wave was announced in the 1990s. The term is popularly attributed to Rebecca Walker, daughter of African American feminist activist and writer <a href="https://alicewalkersgarden.com/about/">Alice Walker</a> (author of <a href="https://www.hachette.com.au/alice-walker/the-color-purple-now-a-major-motion-picture-from-oprah-winfrey-and-steven-spielberg">The Color Purple</a>). Aged 22, Rebecca proclaimed in a 1992 Ms. magazine <a href="https://web.archive.org/web/20200404030632/http:/heathengrrl.blogspot.com/2007/02/becoming-third-wave-by-rebecca-walker.html">article</a>: “I am not a post-feminism feminist. I am the Third Wave.” Third wavers didn’t think gender equality had been more or less achieved. But they did share <a href="https://journals.sagepub.com/doi/10.1177/1464700119842555">post-feminists</a>’ belief that their foremothers’ concerns and demands were obsolete. They argued women’s experiences were now shaped by <a href="https://www.tandfonline.com/doi/full/10.1080/14680777.2016.1190046">very different</a> political, economic, technological and cultural conditions. The third wave has been described as “an <a href="https://www.smh.com.au/lifestyle/beauty/meet-the-woman-who-coined-the-term-third-wave-feminism-20180302-p4z2mw.html">individualised feminism</a> that can not exist without diversity, sex positivity and intersectionality”. Intersectionality, <a href="https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=1052&context=uclf">coined</a> in 1989 by African American legal scholar Kimberlé Crenshaw, recognises that people can experience intersecting layers of oppression due to race, gender, sexuality, class, ethnicity and more. Crenshaw notes this was a “lived experience” before it was a term. In 2000, Aileen Moreton Robinson’s <a href="https://www.uqp.com.au/books/talkin-up-to-the-white-woman-indigenous-women-and-feminism-20th-anniversary-edition">Talkin’ Up to the White Woman: Indigenous Women and Feminism</a> expressed Aboriginal and Torres Strait Islander women’s frustration that white feminism did not adequately address the legacies of dispossession, violence, racism, and sexism. Certainly, the third wave accommodated <a href="https://paromitapain.com/wp-content/uploads/2019/12/10.10072F978-3-319-72917-6.pdf#page=112%22">kaleidoscopic views</a>. Some scholars claimed it “grappled with fragmented interests and objectives” – or micropolitics. These included ongoing issues such as sexual harassment in the workplace and a scarcity of women in positions of power. The third wave also gave birth to the <a href="https://www.nme.com/blogs/nme-blogs/brief-history-riot-grrrl-space-reclaiming-90s-punk-movement-2542166">Riot Grrrl</a> movement and “girl power”. Feminist punk bands like <a href="https://bikinikill.com/about/">Bikini Kill</a> in the US, <a href="https://www.theguardian.com/music/2022/nov/28/pussy-riot-beaten-jailed-exiled-taunting-putin">Pussy Riot</a> in Russia and Australia’s <a href="https://www.vice.com/en/article/mbknev/little-ugly-girls-tractor-album-single-premiere-2018">Little Ugly Girls</a> sang about issues like homophobia, sexual harassment, misogyny, racism, and female empowerment. Riot Grrrl’s <a href="https://www.historyisaweapon.com/defcon1/riotgrrrlmanifesto.html">manifesto</a> states “we are angry at a society that tells us Girl = Dumb, Girl = Bad, Girl = Weak”. “Girl power” was epitomised by Britain’s more sugary, phenomenally popular Spice Girls, who were accused of peddling “<a href="https://www.theguardian.com/tv-and-radio/2021/sep/14/spice-girls-how-girl-power-changed-britain-review-fabulous-and-intimate">‘diluted feminism’ to the masses</a>”. <figure><iframe src="https://www.youtube.com/embed/tAbhaguKARw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Riot Grrrrl sang about issues like homophobia, sexual harassment, misogyny and racism.</figcaption></figure> <h2>The fourth wave: 2013 to now</h2> The fourth wave is epitomised by “<a href="https://vc.bridgew.edu/jiws/vol25/iss2/10/">digital or online feminism</a>” which gained currency in about <a href="https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-fourth">2013</a>. This era is marked by mass online mobilisation. The fourth wave generation is connected via new communication technologies in ways that were not previously possible. Online mobilisation has led to spectacular street demonstrations, including the #metoo movement. #Metoo was first founded by Black activist <a href="https://www.womenshistory.org/education-resources/biographies/tarana-burke">Tarana Burke</a> in 2006, to support survivors of sexual abuse. The hashtag #metoo then went viral during the 2017 Harvey Weinstein <a href="https://www.npr.org/2022/10/28/1131500833/me-too-harvey-weinstein-anniversary">sexual abuse scandal</a>. It was used at least <a href="https://www.sciencedirect.com/science/article/abs/pii/S0747563221002193">19 million times</a> on Twitter (now X) alone. In January 2017, the <a href="https://www.womensmarch.com/">Women’s March</a> protested the inauguration of the decidedly misogynistic Donald Trump as US president. <a href="https://www.britannica.com/event/Womens-March-2017">Approximately 500,000</a> women marched in Washington DC, with demonstrations held simultaneously in <a href="https://www.routledge.com/Remembering-Womens-Activism/Crozier-De-Rosa-Mackie/p/book/9781138794894">81 nations</a> on all continents of the globe, even Antarctica. In 2021, the <a href="https://catalogue.nla.gov.au/catalog/8564388">Women’s March4Justice</a> saw some 110,000 women rallying at more than 200 events across Australian cities and towns, protesting workplace sexual harassment and violence against women, following high-profile cases like that of Brittany Higgins, revealing <a href="https://www.theguardian.com/australia-news/2023/nov/29/brittany-higgins-bruce-lehrmann-defamation-trial-evidence-stand-rape-allegations-liberal-party-ntwnfb#:%7E:text=Bruce%20Lehrmann%20has%20brought%20a,Wilkinson%20are%20defending%20the%20case.">sexual misconduct</a> in the Australian houses of parliament. Given the prevalence of online connection, it is not surprising fourth wave feminism has reached across geographic regions. The Global Fund for Women <a href="https://www.globalfundforwomen.org/movements/me-too/">reports</a> that #metoo transcends national borders. In China, it is, among other things, #米兔 (translated as “<a href="https://www.ft.com/content/61903744-9540-11e8-b67b-b8205561c3fe">rice bunny</a>”, pronounced as “mi tu”). In Nigeria, it’s <a href="https://www.youtube.com/watch?v=we-F0Gi0Lqs">#Sex4Grades</a>. In Turkey, it’s #<a href="https://ahvalnews.com/sexual-harrasment/dozens-turkish-womens-organisations-issue-statement-backing-latest-metoo-movement">UykularınızKaçsın</a> (“may you lose sleep”). In an inversion of the traditional narrative of the Global North leading the Global South in terms of feminist “progress”, Argentina’s “<a href="https://www.auswhn.com.au/blog/colour-green/">Green Wave</a>” has seen it decriminalise abortion, as has Colombia. Meanwhile, in 2022, the US Supreme Court <a href="https://theconversation.com/us-supreme-court-overturns-roe-v-wade-but-for-abortion-opponents-this-is-just-the-beginning-185768">overturned historic abortion legislation</a>. Whatever the nuances, the prevalence of such highly visible gender protests have led some feminists, like <a href="https://www.tandfonline.com/doi/abs/10.1080/14680777.2020.1804431">Red Chidgey</a>, lecturer in Gender and Media at King’s College London, to declare that feminism has transformed from “a dirty word and publicly abandoned politics” to an ideology sporting “a new cool status”. <h2>Where to now?</h2> How do we know when to pronounce the next “wave”? (Spoiler alert: I have no answer.) Should we even continue to use the term “waves”? The “wave” framework was first used to demonstrate feminist continuity and solidarity. However, whether interpreted as disconnected chunks of feminist activity or connected periods of feminist activity and inactivity, represented by the crests and troughs of waves, some believe it encourages binary thinking that produces <a href="https://www.tandfonline.com/doi/full/10.1080/14680777.2016.1190046">intergenerational antagonism</a>. Back in 1983, Australian writer and second-wave feminist Dale Spender, who died last year, <a href="https://www.historyworkshop.org.uk/feminism/radical-books-dale-spender-theres-always-been-a-womens-movement-this-century-1983/">confessed her fear</a> that if each generation of women did not know they had robust histories of struggle and achievement behind them, they would labour under the illusion they’d have to develop feminism anew. Surely, this would be an overwhelming prospect. What does this mean for “waves” in 2024 and beyond? To build vigorous varieties of feminism going forward, we might reframe the “waves”. We need to let emerging generations of feminists know they are not living in an isolated moment, with the onerous job of starting afresh. Rather, they have the momentum created by generations upon generations of women to build on.<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/224153/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sharon-crozier-de-rosa-122804">Sharon Crozier-De Rosa</a>, Professor, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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-the-four-waves-of-feminism-and-what-comes-next-224153">original article</a>.

Caring

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

<a href="https://theconversation.com/profiles/janet-bednarek-144872">Janet Bednarek</a>, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</a> Long lines at security checkpoints, tiny plastic cups of soda, small bags of pretzels, planes filled to capacity, fees attached to every amenity – all reflect the realities of 21st century commercial air travel. It’s no wonder that many travelers have become nostalgic for the so-called “golden age” of air travel in the United States. During the 1950s, airlines promoted commercial air travel as glamorous: stewardesses served full meals on real china, airline seats were large (and frequently empty) with ample leg-room, and passengers always dressed well. After jets were introduced in the late 1950s, passengers could travel to even the most distant locations at speeds unimaginable a mere decade before. An airline trip from New York to London that could take up to 15 hours in the early 1950s could be made in less than seven hours by the early 1960s. But airline nostalgia can be tricky, and “golden ages” are seldom as idyllic as they seem. Until the introduction of jets in 1958, most of the nation’s commercial planes were propeller-driven aircraft, like the DC-4. Most of these planes were unpressurized, and with a maximum cruising altitude of 10,000 to 12,000 feet, they were unable to fly over bad weather. Delays were frequent, turbulence common, and air sickness bags often needed. Some planes were spacious and pressurized: the <a href="http://everythingnice.org/wp-content/uploads/2009/07/PanAm-cutawayS.jpg">Boeing Stratocruiser</a>, for example, could seat 50 first class passengers or 81 coach passengers compared to the DC-3’s 21 passengers. It could cruise at 32,000 feet, which allowed Stratocruiser to fly above most bad weather it encountered. But only 56 of these planes were ever in service. While the later DC-6 and DC-7 were pressurized, they still flew much lower than the soon-to-appear jets – 20,000 feet compared to 30,000 feet – and often encountered turbulence. The piston engines were bulky, complex and difficult to maintain, which contributed to frequent delays. For much of this period, the old saying “Time to spare, go by air” still rang true. Through the 1930s and into the 1940s, almost everyone flew first class. Airlines did encourage more people to fly in the 1950s and 1960s by introducing coach or tourist fares, but the savings were relative: less expensive than first class, but still pricey. In 1955, for example, so-called “bargain fares” from New York to Paris were the equivalent of just over $2,600 in 2014 dollars. Although the advent of jets did result in lower fares, the cost was still out of reach of most Americans. The most likely frequent flier was a white, male businessman traveling on his company’s expense account, and in the 1960s, airlines – with young attractive stewardesses in short skirts – clearly catered to their most frequent flyers. The demographics of travelers did begin to shift during this period. More women, more young people, and retirees began to fly; still, airline travel remained financially out-of-reach for most. If it was a golden age, it only was for the very few. <figure><iframe src="https://www.youtube.com/embed/bKqQgNZylLw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Jet planes were introduced in the late 1950s, resulting in shorter flight times. But their ticket prices out of reach for the average traveler.</figcaption></figure> People also forget that well into the 1960s, air travel was far more dangerous than it is today. In the 1950s and 1960s US airlines experienced at least a half dozen crashes per year – most leading to fatalities of all on board. People today may bemoan the crowded airplanes and lack of on-board amenities, but the number of fatalities per million miles flown has dropped dramatically since since the late 1970s, especially compared to the 1960s. Through at least the 1970s, airports even prominently featured kiosks selling flight insurance. And we can’t forget hijackings. By the mid-1960s so many airplanes had been hijacked that <a href="http://www.latinamericanstudies.org/hijackers/flying-high.htm">“Take me to Cuba”</a> became a punch line for stand-up comics. In 1971 <a href="http://nymag.com/news/features/39593/index2.html">D.B. Cooper</a> – a hijacker who parachuted from a Boeing 727 after extorting $200,000 – might have been able to achieve folk hero status. But one reason US airline passengers today (generally) tolerate security checkpoints is that they want some kind of assurance that their aircraft will remain safe. And if the previous examples don’t dull the sheen of air travel’s “golden age,” remember: in-flight smoking was both permitted and encouraged.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/34177/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/janet-bednarek-144872">Janet Bednarek</a>, Professor of History, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</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/longing-for-the-golden-age-of-air-travel-be-careful-what-you-wish-for-34177">original article</a>.

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>.

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What are heart rate zones, and how can you incorporate them into your exercise routine?

What is childhood dementia? And how could new research help?

What’s the difference between ADD and ADHD?

The dos and don’ts of caring for your hearing aids

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

Surgery won’t fix my chronic back pain, so what will?

Do optimists really live longer? Here’s what the research says

Do parolees really ‘walk free’? Busting common myths about parole

Silent cancers: here’s what you need to know when there are no obvious symptoms

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

Eating some chocolate really might be good for you – here’s what the research says

Why do airlines charge so much for checked bags? This obscure rule helps explain why

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

What if there was a hearing aid that understood your listening intentions?

What’s the difference between autism and Asperger’s disorder?

Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

6 major benefits of doing yoga every day, from experts

What are the four waves of feminism? And what comes next?

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

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

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