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

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

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Hugh Jackman reveals skin cancer results

<p dir="ltr">Hugh Jackman has shared an update on his skin cancer scare just <a href="https://www.oversixty.com.au/health/caring/hugh-jackman-s-health-scare">two days after revealing he had undergone two biopsies</a> to determine whether or not he had basal cell carcinomas. </p> <p dir="ltr">At the time, Hugh explained “basal cell” to be “the least dangerous of them all” when it came to skin cancers, and that he would get his results in a matter of days. It’s also the most commonly occurring, and typically approached with surgery if the biopsy doesn’t remove the cancer first.</p> <p dir="ltr">And now, Hugh has shared his good news, informing his 31.1 million followers on Instagram that his “biopsies came back NEGATIVE!!!” </p> <p dir="ltr">“Thank you ALL for the love,” he continued in his story post, “I feel it! And to the media for helping get this very important message out.”</p> <p dir="ltr">He concluded his statement by reminding everyone to “wear sunscreen with a high level of SPF (no matter the season)”. </p> <p dir="ltr">It was an important message that echoed what he’d told his supporters just two days before, when he explained that “I know you’ve heard me talk about my basal cell carcinomas before. I’m going to keep talking about them, if need be.</p> <p dir="ltr">“And if it reminds even one person to put on sunscreen with a high SPF, then I’m happy.”</p> <p dir="ltr">He went on to add that no matter how much someone might want to tan, it wasn’t worth it, and that his scares were the result of “stuff that happened 25 years ago”.</p> <p dir="ltr">In 2015, Hugh explained to <em>ABC News</em> that his childhood was spent outdoors, and that his “dad or mum ever bought it [sunscreen] or made us put it on”.</p> <p dir="ltr">And in another clip posted to Instagram during one of his previous cancer scares - of which Hugh has had numerous - he urged followers again to take care of their skin health, and prioritise their approach to being in the sun.</p> <p dir="ltr">“If you’re like me and you didn’t really know any better when you were young, and you didn’t wear sunscreen, and you were in the Australian sun, then you need to get a check-up even more.</p> <p dir="ltr">“I just had mine done, I just had a little biopsy. It’s precancerous, it’s not much, but I’m really glad I went.”</p> <p dir="ltr">In total, the <em>Wolverine</em> and upcoming <em>Deadpool 3 </em>star has had six skin cancer removals from his face - all of which took place in 2017 - and another biopsy in 2021. The latter returned an inconclusive result for the actor, when the worst he could have faced was also basal cell carcinomas.</p> <p dir="ltr"><em>Images: Instagram</em></p>

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Madeleine McCann's parents speak out after DNA test results

<p>Madeleine McCann's parents have spoken out after the results of Julia Faustyna's DNA test have returned. </p> <p>Julia Faustyna, a 21-year-old Polish woman, has been claiming to be the missing British child in a high-profile campaign that has seen her undergo a DNA test to prove her identity.</p> <p>The DNA results determined that Julia is not Maddie, despite Julia's claims of having similar facial features, suffering an abusive childhood and had starting to question her parentage as a result. </p> <p>Private detective Dr Fia Johansson arranged for Julia to give samples in the US for extensive DNA tests - including a DNA test similar to a 23andMe test, which established she is not Madeleine.</p> <p>The test looked into her heritage, and showed that she is from Poland, with some Lithuanian and Romanian heritage, <a href="https://www.thesun.co.uk/news/21808585/who-julia-wendell-madeleine-mccann/" target="_blank" rel="noopener"><em>The Sun</em></a> reported, but nothing to suggest any link to the McCann's. </p> <p>In response, a spokesman for Madeleine’s parents Kate and Gerry McCann said, “There isn’t anything to report at this time. If and when there is, it will come from The Metropolitan Police.”</p> <p>Julia is also facing a nervous wait for the results of further health tests as doctors fear she <a href="https://oversixty.co.nz/news/news/sad-health-news-for-woman-claiming-to-be-madeleine-mccann" target="_blank" rel="noopener">may have leukaemia</a>, Dr Johansson - with Julia’s permission - revealed to <em>The Sun</em>.</p> <p>She said, “Her health is very poor she has bad asthma and she suffers lots of pain in her bones."</p> <p>“She is booked in for a CT and MRI scan because of the pain in her bones."</p> <p>“Her blood work is also abnormal so my doctor here in the US is investigating whether she could have leukaemia so we are awaiting the results of that."</p> <p>“And if she needs any treatment we will make sure she gets that.”</p> <p><em>Image credits: Getty Images</em></p>

News

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Why loneliness is both an individual thing and a shared result of the cities we create

<p>If you’re feeling lonely, you’re not alone. Loneliness is an <a href="https://www.ipsos.com/en/loneliness-increase-worldwide-increase-local-community-support">increasingly common experience</a>, and it can have severe consequences. People who feel lonely are at <a href="https://doi.org/10.1007/s12160-010-9210-8">higher risk of serious health issues</a>, including heart disease, immune deficiency and depression.</p> <p>Traditionally, loneliness has been viewed as an individual problem requiring individual solutions, such as psychological therapy or medication. Yet loneliness is caused by feeling disconnected from society. It therefore makes sense that treatments for loneliness should focus on the things that help us make these broader connections. </p> <p>The places where we live, work and play, for example, can promote meaningful social interactions and help us build a sense of connection. Careful planning and management of these places can create <a href="https://www.gov.uk/government/publications/loneliness-annual-report-the-third-year/tackling-loneliness-annual-report-february-2022-the-third-year">population-wide improvements in loneliness</a>.</p> <p>Our research team is investigating how the way we design and plan our cities impacts loneliness. We have just published a <a href="https://authors.elsevier.com/c/1gNq14pqpjtIuw">systematic review</a> of research from around the world. Overall, we found many aspects of the built environment affect loneliness. </p> <p>However, no single design attribute can protect everyone against loneliness. Places can provide opportunities for social interactions, or present barriers to them. Yet every individual responds differently to these opportunities and barriers.</p> <h2>What did the review look at?</h2> <p>Our review involved screening over 7,000 published studies covering fields such as psychology, public health and urban planning. We included 57 studies that directly examined the relationship between loneliness and the built environment. These studies covered wide-ranging aspects from neighbourhood design, housing conditions and public spaces to transport infrastructure and natural spaces.</p> <p>The research shows built environments can present people with options to do the things we know help reduce loneliness. Examples include chatting to the people in your street or neighbourhood or attending a community event.</p> <p>However, the link between the built environment and loneliness is complex. Our review found possibilities for social interaction depend on both structural and individual factors. In other words, individual outcomes depend on what the design of a space enables a person to do as well as on whether, and how, that person takes advantage of that design.</p> <p>Specifically, we identified some key aspects of the built environment that can help people make connections. These include housing design, transport systems and the distribution and design of open and natural spaces.</p> <h2>So what sort of situations are we talking about?</h2> <p>Living in small apartments, for example can increase loneliness. <a href="https://link.springer.com/article/10.1007/s10901-020-09816-7">For some people</a>, this is because the smaller space reduces their ability to have people over for dinner. Others who live in <a href="https://doi.org/10.1017/S0144686X15000112">poorly maintained housing</a> report similar experiences.</p> <p>More universally, living in areas with good access to <a href="https://doi.org/10.1017/S0144686X19001569">community centres</a> and <a href="https://doi.org/10.1093/ije/dyab089">natural spaces</a> helps people make social connections. These spaces allow for both planned and unexpected social interactions.</p> <p>Living in environments with good access to destinations and transport options also protects against loneliness. In particular, it benefits individuals who are able to use <a href="https://doi.org/10.1093/gerona/glu069">active transport (walking and cycling) and high-quality public transport</a>. </p> <p>This finding should make sense to anyone who walks or takes the bus. We are then more likely to interact in some way with those around us than when locked away in the privacy of a car.</p> <p>Similarly, built environments <a href="https://doi.org/10.1002/jcop.21711">designed to be safe</a> — from crime, traffic and pollution — also enable people to explore their neighbourhoods easily on foot. Once again, that gives them more opportunities for social interactions that can, potentially, reduce loneliness.</p> <p>Environments where people are able to express themselves were also found to protect against loneliness. For example, residents of housing they could personalise and “make home” reported feeling less lonely. So too did those who felt able to “<a href="https://doi.org/10.7870/cjcmh-2002-0010">fit in</a>”, or identify with the people living close by.</p> <h2>Other important factors are less obvious</h2> <p>These factors are fairly well defined, but we also found less tangible conditions could be significant. For example, studies consistently showed the importance of socio-economic status. The interplay between economic inequalities and the built environment can deny many the right to live a life without loneliness.</p> <p>For example, <a href="https://doi.org/10.1080/19491247.2021.1940686">housing tenure</a> can be important because people who rent are less able to personalise their homes. People with lower incomes can’t always afford to <a href="https://doi.org/10.1177/1440783320960527">live close to friends</a> or in a neighbourhood where they feel accepted. Lower-income areas are also notoriously under-serviced with <a href="https://doi.org/10.1016/j.jtrangeo.2020.102869">reliable public transport</a>, <a href="https://link.springer.com/article/10.1186/1471-2458-14-292">well-maintained natural spaces</a> and <a href="https://doi.org/10.1016/j.healthplace.2007.11.002">well-designed public spaces</a>.</p> <p>Our review reveals several aspects of the built environment that can enhance social interactions and minimise loneliness. Our key finding, though, is that there is no single built environment that is universally “good” or “bad” for loneliness. </p> <p>Yes, we can plan and build our cities to help us meet our innate need for social connection. But context matters, and different individuals will interpret built environments differently.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/why-loneliness-is-both-an-individual-thing-and-a-shared-result-of-the-cities-we-create-198069" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Caring

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Researchers puzzled by results of anti-inflammatory medications for osteoarthritis

<p>Researchers in the US are calling for a re-evaluation of the way some well known painkillers are prescribed after research showed they may actually lead to a worsening of inflammation over time in osteoarthritis-affected knee joints.</p> <p>NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen and naproxen are designed to reduce inflammation for the estimated 2.2 million Australians suffering from the sometimes debilitating effects of osteoarthritis.</p> <p>Osteoarthritis is a degenerative condition affecting joints in the body – most commonly hips, knees, ankles, spine and hands – which results from the degradation of cartilage on the ends of bones within the joints. As the cartilage wears away, the bones rub together resulting in swelling, pain and restricted movement.</p> <p>To combat this pain and swelling, NSAIDs are commonly prescribed, however the long-term impact of this type of medication is unclear, including its effect on the progression of the condition.</p> <p>“To date, no curative therapy has been approved to cure or reduce the progression of knee osteoarthritis,” said the study’s lead author, Johanna Luitjens, from the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. “NSAIDs are frequently used to treat pain, but it is still an open discussion of how NSAID use influences outcomes for osteoarthritis patients.</p> <p>Surprisingly the report says: “…the impact of NSAIDs on synovitis, or the inflammation of the membrane lining the joint, has never been analysed using MRI-based structural biomarkers.”</p> <p>The study compared 793 participants with moderate to severe osteoarthritis of the knee who did not use NSAIDs, with 277 patients who received sustained treatment with NSAIDs for more than a year. Each patient underwent Magnetic Resonance Imaging (MRI) scans of the joint, which were then repeated after four years.</p> <p>The researchers were able to assess the images for indications of inflammation and arthritis progression including cartilage thickness and composition.</p> <p>The data showed the group using NSAIDs, had worse joint inflammation and cartilage quality than those not using NSAIDs, at the time of the initial MRI scan. And the follow-up imaging showed the conditions had worsened for the NSAID group.</p> <p>“In this large group of participants, we were able to show that there were no protective mechanisms from NSAIDs in reducing inflammation or slowing down progression of osteoarthritis of the knee joint,” said Luitjens.</p> <p>According to Luitjens, the common practice of prescribing NSAIDs for osteoarthritis should be revisited as there doesn’t appear to be any evidence they have a positive impact on joint inflammation nor do they slow or prevent synovitis or degenerative changes in the joint.</p> <p>There is also a possibility that NSAIDs simply mask the pain. Despite adjusting the study’s model for individual levels of patient physical activity, “patients who have synovitis and are taking pain-relieving medications may be physically more active due to pain relief, which could potentially lead to worsening of synovitis,” said Luitjens.</p> <p>Luitjens hopes future studies will better characterise NSAIDs and their impact on osteoarthritic inflammation. With one in three people over the age of 75 in Australia suffering from osteoarthritis and an estimated one in 10 women and one in 16 men set to develop it in the future, unlocking treatment options for this crippling condition is an imperative.</p> <p><strong>This article originally appeared on <a href="https://cosmosmagazine.com/science/osteoarthritis-puzzled-antiinflammatory/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Clare Kenyon.</strong></p> <p><em>Image: Shutterstock</em></p>

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"Dramatic result": New drug shows hope for slowing down Alzheimer's disease

<p>A trial drug has shown "significant" results in slowing down Alzheimer's disease, with Australian healthcare experts hopeful in where this breakthrough can take their research. </p> <p>The drug, known as Lecanemab, has been proven to reduce cognitive decline by 27 per cent compared to placebo, according to an overseas study. </p> <p>More than 1,700 patients with mild cognitive impairment were enrolled in the study and the results were collected over 18 months.</p> <p>"Functionally and cognitively, it seems they did better and so that is a dramatic result," Dr Lawrence Honig, one of the study investigators from Columbia University Medical Centre, said.</p> <p>The drug works by removing the build-up of amyloid plaques in the brain which is one of the hallmarks of the disease, which featured in the scans of each study participant. </p> <p>Australian experts are excited about the findings, and how this can further their research. </p> <p>"This is the first time we've seen a drug like this have these kinds of effects," Professor Sharon Naismith, Clinical Neuropsychologist &amp; NHMRC Dementia Leadership Fellow at the University of Sydney, said.</p> <p>"The results of this trial have massive implications for our resourcing."</p> <p>Naismith warns there's a need to spend more money on better diagnosing patients with mild cognitive impairment.</p> <p>"In the past there has been a lot of reluctance from healthcare physicians to diagnose or ask about cognitive impairment, even in primary care," she said.</p> <p>She said being able to access a drug that can slow cognitive decline will change the paradigm and conversation around Alzheimer's disease. </p> <p>"I do think we're going to get a real avalanche of people coming to GPs and coming to memory clinics for that reason," she said.</p> <p>Professor Kathryn Goozee, Director of KaRa Minds at Macquarie Park said the study showed using an antibody to target amyloid in the brain can help with cognition.</p> <p>"To date there has been no disease-modifying medication so we want to be offering studies that can potentially change that trajectory," Goozee said.</p> <p>The full details of the results will be presented at an international conference of experts in the US in late November.</p> <p><em>Image credits: 9News</em></p>

Mind

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Anne Heche's blood test results revealed after horror smash

<p dir="ltr">An investigation of Anne Heche’s blood results have detected “the presence of drugs” following <a href="https://www.oversixty.com.au/news/news/new-details-of-actor-anne-heche-s-fiery-crash" target="_blank" rel="noopener">her horror smash</a>.</p> <p dir="ltr">The US actress was pulled out of her burning car after she smashed into a mansion in Los Angeles while driving a terrifying 140km/h on August 5.</p> <p dir="ltr">The 53-year-old suffered severe injuries and soon after the crash fell into a coma and has not regained consciousness since. </p> <p dir="ltr">Almost a week after the incident, a Los Angeles Police Department Public Information Officer confirmed there was a “presence of drugs” in Anne’s blood system. </p> <p dir="ltr">“Based on the blood draw, it revealed the presence of drugs, however additional testing is required to rule out any substances that were administered at the hospital as part of her medical treatment,” they told <a href="https://www.foxnews.com/entertainment/anne-heche-blood-test-revealed-presence-of-drugs" target="_blank" rel="noopener">Fox News Digital</a>.</p> <p dir="ltr">"Any secondary drugs [takes] up to 30 days for [a] secondary test to come back.” </p> <p dir="ltr">TMZ previously reported that Anne had cocaine in her system upon arrival at the hospital, but that is yet to be confirmed. </p> <p dir="ltr">The crash is currently being investigated by the LAPD who have confirmed that if Anne is found to have been drunk she would face significant charges. </p> <p dir="ltr">"If found intoxicated, [Heche] could be charged with misdemeanour DUI hit and run. No arrests have been made so far,” a representative said. </p> <p dir="ltr">Anne’s representative has confirmed that she is in an “extreme critical condition”.</p> <p dir="ltr">“She has a significant pulmonary injury requiring mechanical ventilation and burns that require surgical intervention,” her representative said. </p> <p dir="ltr">“She is in a coma and has not regained consciousness since shortly after the accident.”</p> <p dir="ltr"><em>Image: Getty</em></p>

Caring

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How kids are getting positive COVID test results with orange juice

<p><span style="font-weight: 400;">Teenagers in the UK have figured out how to “fake” positive results on COVID-19 tests - prompting at least one school to issue a warning to parents.</span></p> <p><span style="font-weight: 400;">The trick has taken off on social media, as teens use orange juice or soft drinks to generate a false positive result on lateral flow Covid tests.</span></p> <p><span style="font-weight: 400;">It is not known whether any students have used it to successfully get time off school.</span></p> <p><span style="font-weight: 400;">Gateacre School in Belle Vale, Liverpool, asked students in years 7-10 to stay home from school after some positive COVID-19 test results were discovered in the school community, and warned parents to be vigilant about the social media trend.</span></p> <p><span style="font-weight: 400;">“Nationally, some school students have discovered that placing droplets of orange juice or other fruit juice on an LFD test gets a false ‘positive’ result,” </span><a rel="noopener" href="https://www.liverpoolecho.co.uk/news/liverpool-news/schools-warning-children-using-fruit-20896618?_ga=2.269013617.1871628857.1625379206-1709235865.1625379206" target="_blank"><span style="font-weight: 400;">the warning email read</span></a><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">“In light of this, can you be extra vigilant when your child is doing their LFD tests. Also, remind them that a positive LFD test must be followed by a confirmatory PCR test.”</span></p> <p><strong>How it happens</strong></p> <p><span style="font-weight: 400;">The false positive occurs due to the acidity of the juice or soft drink, rather than the beverage containing the virus, which essentially breaks the test.</span></p> <p><span style="font-weight: 400;">However, Mark Lorch, a professor of science communication and chemistry at the University of Hull, </span><a rel="noopener" href="https://theconversation.com/covid-19-kids-are-using-soft-drinks-to-fake-positive-tests-ive-worked-out-the-science-and-how-to-spot-it-163739" target="_blank"><span style="font-weight: 400;">has said</span></a><span style="font-weight: 400;"> it is possible to spot “fake” positive tests by washing them with a buffer solution that restores the correct pH to the testing device. Once this happens, the “positive” line disappears to reveal the negative result.</span></p> <p><strong>A selfish thing to do</strong></p> <p><span style="font-weight: 400;">Jon Deeks, a professor of biostatistics at the University of Birmingham, has criticised the practice and discouraged teens from trying it.</span></p> <p><span style="font-weight: 400;">“False positives affect not just that child but their family and their bubble at school, so [it is a] pretty selfish thing to do. There are less harmful ways to fake a day off school,” he said.</span></p> <p><span style="font-weight: 400;">Professor Lorch instead encouraged students to help him publish his findings.</span></p> <p><span style="font-weight: 400;">“Children, I applaud your ingenuity, but now that I’ve found a way to uncover your trickery I suggest you use your cunning to devise a set of experiments and test my hypothesis,” he said.</span></p> <p><span style="font-weight: 400;">“Then we can publish your results in a peer-reviewed journal.”</span></p> <p><em><span style="font-weight: 400;">Image: Mark Loch</span></em></p>

Body

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Positive results from new COVID vaccine

<p><span>A vaccine for COVID-19 has been developed by scientists at Oxford University who claim they have seen positive results in healthy volunteers.</span><br /><br /><span>Researchers say in the journal <em>Lancet</em> that they trialled an experimental vaccine — labelled ChAdOx1 nCoV-19 — on more than 1000 people and prompted a protective immune response in those aged 18 to 55.</span><br /><br /><span>"We hope this means the immune system will remember the virus, so that our vaccine will protect people for an extended period," study lead author Andrew Pollard of the University of Oxford said.</span><br /><br /><span>"However, we need more research before we can confirm the vaccine effectively protects against SARS-CoV-2 (COVID-19) infection, and for how long any protection lasts."</span><br /><br /><span>AstraZeneca's is among the leading vaccine candidates against COVID-19.</span><br /><br /><span>It has claimed more than 600,000 lives worldwide, alongside others in mid and late-stage trials.</span><br /><br /><span>AstraZeneca has signed agreements with governments around the world to supply the vaccine should it prove effective and gain regulatory approval.</span><br /><br /><span>British Prime Minister Boris Johnson said the announcement was "very positive news", but also warned there are still further trials to take place.</span><br /><br /><span>"There are no guarantees, we're not there yet &amp; further trials will be necessary — but this is an important step in the right direction," he tweeted.</span><br /><br /><span>Researchers have also cautioned the public that the project was still at an early stage.</span><br /><br /><span>"There is still much work to be done before we can confirm if our vaccine will help manage the COVID-19 pandemic," vaccine developer Sarah Gilbert said.</span><br /><br /><span>"We still do not know how strong an immune response we need to provoke to effectively protect against SARS-CoV-2 infection," she said, adding researchers needed to learn more about COVID-19 and continue late stage trials which have already commenced.</span><br /><br /><span>AstraZeneca has said it will not seek to profit from the vaccine during the pandemic.</span><br /><br /><span>“We are seeing good immune response in almost everybody,” Dr Hill explained to the Associated Press.</span><br /><br /><span>“What this vaccine does particularly well is trigger both arms of the immune system,” Dr Hill said.</span><br /><br /><span>Researchers say “preliminary findings show that the candidate vaccine given as a single dose was safe and tolerated”.</span><br /><br /><span>“No serious adverse reactions ... occurred. The majority of adverse events reported were mild or moderate in severity, and all were self-limiting.</span><br /><br /><span>“We show that a single dose of ChAdOx1 nCoV-19 elicits an increase in spike-specific Antibodies by day 28 and neutralising antibody in all participants after a booster dose.</span><br /><br /><span>“Further studies are required to assess the vaccine in various population groups including older age groups, those with comorbidities, and in ethnically and geographically diverse populations.</span><br /><br /><span>“We will also evaluate the vaccine in children, once sufficient safety data have been accumulated in adult studies. Phase 3 trials are now underway in Brazil, South Africa, and the UK and will evaluate vaccine efficacy in diverse populations.”</span><br /><br /><span>The trial took place between April 23 and May 21.</span></p>

Caring

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Survey results revealed: Should Prince Charles step aside for William

<p>According to a survey conducted by<span> </span><a rel="noopener" href="https://honey.nine.com.au/royals/prince-charles-abdication-one-in-3-people-believe-it-is-the-right-thing/d81c5df7-f89a-4368-8fe1-f3b7dc3b014d" target="_blank">Nine.com.au</a>, one in three people that Prince Charles should step aside in favour of his son Prince William when he is handed the role as King.</p> <p>The survey was completed by 829 participants and saw that 32 per cent of people agreed that abdication of the throne was the best course of action for the Prince of Wales.</p> <p>As Prince Charles is the eldest child of Queen Elizabeth, it is expected that he takes on the role of King when it is time.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/B0vA-fQFQgb/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="margin: 8px 0 0 0; padding: 0 4px;"><a style="color: #000; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none; word-wrap: break-word;" rel="noopener" href="https://www.instagram.com/p/B0vA-fQFQgb/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">Wishing a very happy birthday to The Duchess of Sussex today! 🎈</a></p> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;">A post shared by <a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px;" rel="noopener" href="https://www.instagram.com/kensingtonroyal/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank"> Kensington Palace</a> (@kensingtonroyal) on Aug 4, 2019 at 1:01am PDT</p> </div> </blockquote> <p>Whether the Queen will abdicate her throne or pass it onto her son naturally is a different question entirely as she is the longest reigning monarch in the world.</p> <p>By law, tradition and by expectation, the next King or Queen of the United Kingdom and the rest of the Commonwealth realms will always be the eldest child of the current reigning monarch.</p> <p>This was disappointing to survey respondents as there are also reports that the Queen has been using her time to train Prince Charles and Camilla, Duchess of Cornwall.</p> <p>It is understood that when Prince Charles becomes king, the Duchess of Cornwall will not take the usual title of Queen consort and will be recognised as Princess consort instead.</p> <p>This is because the Duchess of Cornwall has made it clear that she has no interest in taking the future role of Queen, which is also a view that was held by Princess Diana of Wales.</p> <p>41 per cent have expressed that Prince Charles deserves to serve his time, but a further 27 per cent expressed that they had no interest in the matter at all.</p>

Travel Trouble

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6 search results that prove Google has a sense of humour

<p>Seems like the brains behind search engine Google have a pretty good sense of humour to include these hidden tricks and japes.</p> <div id="section"><strong>1. It can do a barrel roll!</strong></div> <div> <p>Type "do a barrel roll" into Google, click search, and your browser window will do a 360-degree spin.</p> </div> <div> <p>It's a geeky reference to Nintendo's Star Fox series, in which a wise old rabbit named Peppy (an intergalactic fighter pilot) advises your character to avoid enemy fire by pulling said maneuver.</p> <p>You can get the same fun Google tricks effect by typing "z or r twice" in reference to the controller buttons you'd press in the game. </p> <p><strong>2. It's a word nerd!</strong></p> <p>Google "anagram" and the search engine will suggest "nag a ram."</p> <p>Very cute.</p> <p><strong>3. It can read images!</strong></p> <p>Looking for something specific, but don't have the right keywords to describe it?</p> <p>This is one of the more useful fun Google tricks.</p> <p>You can "<a href="https://support.google.com/images/answer/1325808?p=searchbyimagepage&amp;hl=en" title="" data-original-title="">reverse image search</a>" at <a rel="noopener" href="http://images.google.com/" target="_blank" title="" data-original-title="">images.google.com</a> by clicking the camera icon, uploading an image, and then getting results of pictures that look similar.</p> <p>(Make sure you're okay with your photos floating around the web first.)</p> <p><strong>4. It speaks secret languages!</strong></p> <p>On the top of your Google homepage, hit the nine squares at the top and go to My Account.</p> <p>Scroll to the bottom to find Language &amp; Input Tools under Account Preferences. </p> <p>You can change your language to fun ways of speaking like Muppets (Bork, bork, bork!), Elmer Fudd (Ewmew Fudd), Klingon, and pirate. For instance, with that last one you'll find "moorr" instead of "more."</p> <p><strong>5. It can boost brainpower!</strong></p> <p>ZDNet offers a handy <a rel="noopener" href="http://www.zdnet.com/photos/10-google-search-secrets_p10/6349203#photo" target="_blank" title="" data-original-title="">tip</a> to sift through university research: first type "site:edu" to limit the query to educational institutions, then try "intitle:" before your topic.</p> <p>For example, site:edu intitle:"American magazines" brings up results from Harvard, the University of Michigan, and more. You can also search get results from a specific website a similar way.</p> <p><strong>6. It likes to get specific!</strong></p> <p>Thought "once in a blue moon" was just a vague expression? Not according to Google.</p> <p>Search that phrase and you'll get a very specific frequency: 1.16699016 × 10-8 hertz.</p> <p>It's a play off the fact that blue moons happen every 2.71 years.</p> <p>Did you know these facts about Google? Let us know in the comments!</p> <p class="p1"><em>Written by Damon Beres. This article first appeared in <a href="http://www.readersdigest.com.au/true-stories-lifestyle/humour/19-search-results-prove-google-has-sense-humour">Reader’s Digest</a>. For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRN87V">here’s our best subscription offer</a>.</em></p> <p><img style="width: 100px !important; height: 100px !important;" src="https://oversixtydev.blob.core.windows.net/media/7820640/1.png" alt="" data-udi="umb://media/f30947086c8e47b89cb076eb5bb9b3e2" /></p> </div>

Technology

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Why you should change your exercise routine

<p>My family is rather partial to a habit. My brother has eaten the same cereal for breakfast every day since he was about six (he's now nearly 40), while I tend to run the same route at the same pace every time.</p> <p>Let's leave his (questionable) cereal-eating habits alone for now, and look at the routine of exercise. It can be comforting and easy and meditative to do the same thing day in and day out, but if you want to improve (anything – your strength, your speed, your range of motion, your abilities, your body weight or shape) you need to shake it up.</p> <p>Thankfully, for the Groundhog-dayers among us, not all the time. Keep up what you love, but inject novelty into your workouts as our bodies adapt or the same exercise becomes less effective.</p> <p>The good news is that we don't need to go harder to get results, you just need to go differently.</p> <p>It could be lighter weights with more reps or just changing the exercise – curls, rows, shoulder presses and tricep kickbacks. It could mean changing your stance or the bar position or going from sets and reps to time on/time off.</p> <p>"Every eight to 12 weeks shake your training up and do something different, get rid of the machine weights, barbells and move, throw, flip and drag something heavy for your training, use tyres, kettle bells, sandbags, sleds, prowlers and medicine balls," suggests Kevin Toonen, strength and conditioning coach for the Special Forces.</p> <p>"Muck about and do something completely different."</p> <p>This goes for cardio too, so we maximise oxygen levels in the blood and get all our large muscle groups firing.</p> <p>You might add in some short, sharp sprints, add a jog to your walk or find a hill or set of stairs to race up.</p> <p>Toonen suggests spending between two to four weeks shaking up your routine, having fun and getting into the great outdoors for a run, cycle or swim to "test your engine".</p> <p>Any longer than one month and you're likely to lose the gains you've made during your training program. But, for a short period it allows us to see how our training translates to the "real" world and "unloads your body and unloads your mind".</p> <p>This doesn't mean you can't inject some spice into your exercise routine mid-program.</p> <p>"Try new things each week or at least fortnight," suggests strength and conditioning coach, Clint Hill. "Our bodies are made to move so try activities that you can have fun with take a surf lesson, learn to sing or go horse-riding."</p> <p>Some of the most challenging novel workouts I've done recently have been the most fun, from dancing at a No Lights, No Lycra class, burning to the core at Barre Attack to turning it upside down at a handstand class and acrobalance class.</p> <p>It's not just our bodies that benefit, Hill says.</p> <p>"Challenging our central nervous system (CNS) with new activities stimulates hormones in our body to repair, renew and rebalance our endocrine system – which in simple terms 'balances' us out from a hectic, high-stress life," explains Hill, also an expert for Bodyscience's #FitJanuary campaign.</p> <p>He adds that the more muscles we activate, the more we switch on our CNS. That said, it is possible to shake it up too much.</p> <p>"To see improvements, you have to have some consistency," Hill advises. "It's making sure you change things up enough to keep your body guessing but do things consistently enough to keep your form right. I tell people if they're doing the same thing for longer than six to eight weeks, they need a big change."</p> <p>This applies even to those who aren't training for a specific goal, but simply to maintain fitness. “Progress stops as soon as your body has adapted," explains Toonen, "It's running neutral, so you need to step it up."</p> <p><em>Written by Sarah Berry. First appeared on <a href="http://www.stuff.co.nz/"><strong><span style="text-decoration: underline;">Stuff.co.nz</span></strong></a>.</em></p> <p><strong>Related links:</strong></p> <p><a href="http://www.oversixty.co.nz/health/body/2017/02/why-we-gain-weight-as-we-age/"><span style="text-decoration: underline;"><em><strong>The reason why we gain weight as we age</strong></em></span></a></p> <p><a href="http://www.oversixty.co.nz/health/body/2017/01/right-way-to-run/"><span style="text-decoration: underline;"><em><strong>Is there a right way to run?</strong></em></span></a></p> <p><a href="http://www.oversixty.co.nz/health/body/2017/01/exercise-machines-explained/"><span style="text-decoration: underline;"><em><strong>3 exercise machines explained</strong></em></span></a></p>

Body

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Results on dementia research smartphone game

<p>Last year, we discovered <a href="http://www.oversixty.com.au/health/caring/2016/05/this-mobile-game-is-helping-fight-dementia/"><strong><span style="text-decoration: underline;">Sea Hero Quest</span></strong></a>, a smartphone app initiated by Alzheimer’s Research UK. Disguised as any other fun mobile game, Sea Hero Quest had a very noble ulterior motive – dementia research.</p> <p>Upon its release, researchers were excited about the “unprecedented chance to study how many thousands of people from different countries and cultures navigate space,” as decreased special awareness is one of the first signs of dementia.</p> <p>Late last year, months on from its release, the researchers behind the game have unveiled their incredible findings from its 2.4 million users – the data collected from whom would equate to about 9,400 years in the lab – at the Neuroscience 2016 conference.</p> <p>The game involved players navigating their way through waterways and sending a flare back “home”. It also featured a challenge asking players to memorise the locations of ocean buoys then sail around them using only their memory.</p> <p>Users at the age of 19 were 74 per cent accurate when sending the flare back to home, but this rate decreased year over year, hitting just 46 per cent accuracy for users aged 75.</p> <p>Researchers found a few other surprising performance indicators, including that men, healthy people, people who live in Nordic countries and coastal nations had a slight advantage in retaining their navigational skills with age.</p> <p>Dr Hugo Spiers, a researcher at University College London is hopeful that the game could function as an early diagnostic tool in the future. “The value of a future test built from Sea Hero Quest is that we will be able to provide a diagnostic for Alzheimer's dementia and a tool that allows us to monitor performance in drug trials,” he told the <a href="http://www.bbc.com/news/health-37988197"><strong><span style="text-decoration: underline;">BBC</span></strong></a>.</p> <p>Tell us in the comments below, have you been playing the game?</p> <p><strong>Related links:</strong></p> <p><a href="http://www.oversixty.co.nz/health/caring/2016/05/this-mobile-game-is-helping-fight-dementia/"><span style="text-decoration: underline;"><em><strong>This mobile game is helping fight dementia</strong></em></span></a></p> <p><a href="http://www.oversixty.co.nz/health/caring/2017/01/diet-to-defeat-dementia/"><span style="text-decoration: underline;"><em><strong>The everyday diet to defeat dementia</strong></em></span></a></p> <p><a href="http://www.oversixty.co.nz/health/caring/2016/12/first-sign-of-alzheimers-disease/"><span style="text-decoration: underline;"><em><strong>This could be the first sign of Alzheimer’s disease</strong></em></span></a></p>

Caring

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Polls predict result of EU referendum

<p>Polling stations around the UK have just closed their doors, and by 7am tomorrow (7pm this evening in New Zealand), we will know once and for all if British citizens wish to stay in the European Union or leave.</p> <p>Despite fierce debate on both sides, polls are predicting voters will choose to remain in the EU – but only just. YouGov polled 5,000 people and found 52 per cent were in favour of remain versus 48 per cent for leave. Two other polls by campaign group Leave.EU and Ipsos Mori returned the same result.</p> <p>Voters surveyed both before and after going to the voting booths were found to have edged more towards a “remain” vote in the YouGov survey. “The survey found a small move to Remain and based on these results we expect the United Kingdom to continue as a member of the European Union,” predicts political researcher Joe Twyman.</p> <p>A colourful Twitter exchange between UKIP leader Nigel Farage and Sir Nicholas Soames, grandson of Winston Churchill, highlights just how many Brits are feeling in the approach to the big decision.</p> <p>“If you want your borders back, if you want your democracy back, if you want your country back then vote to leave! Independence Day,” wrote Farage, to which Soames replied simply, “Oh bollocks.”</p> <p>Let us know in the comments, what do you think about the UK referendum? Should they stay or should they go?</p> <p><strong>Related links:</strong></p> <p><a href="/travel/international-travel/2016/06/photographs-of-britain-preparing-for-referendum/"><strong><em><span style="text-decoration: underline;">13 photographs of Britain preparing for historic EU referendum</span></em></strong></a></p> <p><a href="/health/caring/2016/06/grandpa-leaves-gold-to-family-in-treasure-hunt/"><strong><em><span style="text-decoration: underline;">Grandpa buries $1.65 million worth of gold in his backyard</span></em></strong></a></p> <p><a href="/news/news/2016/06/duchess-of-cambridge-bad-cook/"><span style="text-decoration: underline;"><em><strong>Duchess of Cambridge admits she can’t cook</strong></em></span></a></p>

News

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Different vision test results – how can this happen?

<p>If you have regular eye examinations (which everyone should) you may have found that the results differed – even when the tests were taken by the same optician and in a very short time frame. If this has happened to you, don’t panic! It’s actually a very common occurrence due to a couple of different reasons.</p> <ol> <li><strong>Your eyes –</strong> The visual performance of our eyes varies throughout the day due to fluctuations in our hormones and blood sugar amongst other things. A test taken before the workday and after an hour on the computer will often yield a different result due to the stress that has occurred to the eye in a short period. To achieve the best result, try and schedule your test for a time when you’re relaxed, hydrated and not hungry. First thing in the morning is ideal.</li> <li><strong>The conditions during your test –</strong> The conditions in which a sight test is performed can have a distinct impact on the result. You should see an experienced optician for a thorough and comprehensive test in a dark examination room without any daylight present. To ensure the best result, make an appointment with your optician and discuss any issues or questions you may have.</li> <li><strong>Exterior influencers –</strong> Wearing contact lenses, taking medication and conditions like diabetes can all lead to an incorrect eye test result. To ensure the most accurate reading, let your optician know what medication you’re taking and if you suffer any medical issues. Try wearing your glasses instead of your contacts for 24 hours before your test as well if you can.</li> </ol>

Eye Care