Placeholder Content Image

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

<p>It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast.</p> <p><strong>Give meditation a try </strong></p> <p>As a mindfulness coach, I’m very aware of the day-to-day anxieties and worries that can interfere with a good night’s sleep. One of the most effective natural sleep aids is a quick meditation session to ease yourself out of those stresses. If you’ve never meditated before, you’ll likely find the meditation interrupted by thoughts flashing through your mind.</p> <p>It’s important for you to know that this isn’t a failure on your part, and that you aren’t doing anything wrong. Thinking is just what the brain does, as naturally as lungs take in air. The point is to be non-judgmental yet aware of your thoughts, bodily experiences and breath, moment by moment.</p> <p><strong>Stop wanting to fall asleep</strong></p> <p>It’s counterintuitive, isn’t it? Sometimes trying too hard to do something is the very thing that prevents us from achieving it – and that’s never more true than when it comes to falling asleep. Desperately wanting to sleep will only stoke anxieties that will further stress your brain, essentially feeding it the message that it’s not safe to sleep.</p> <p>Throw in those worries about your to-do list at work the following day, and the whole thing can snowball into a panic attack. Try letting go of that feeling that you absolutely must sleep now, and observe your own anxieties for what they are without judgment. When you stop looking at sleep as a goal, you’ll find it easier to fall asleep.</p> <p><strong>Start a journal </strong></p> <p>If you find yourself struggling to fall asleep, pick up a pen and paper (not your phone!), and start writing: simply scribble down an account of what’s going on inside your head. Although there’s no “right” way to journal, you might start by listing the events of your day, and from there, how those events and encounters made you feel.</p> <p>Building this structured picture of your thoughts may help you see that the problem that’s keeping you up at night, and is likely less overwhelming than you thought. Why my insistence on a pen and paper? First off, studies show the simple motor action that’s involved in the act of handwriting has a calming effect. Secondly, the light emitted by laptops and phones isn’t conducive to falling asleep.</p> <p><strong>Find yourself a "3am friend"</strong></p> <p>Some of us are lucky to have a ‘3am friend’, that close confidant you can call up in the wee hours knowing that they won’t hold it against you in the morning. Although it’s great to have someone to talk to when you want to fall asleep, it’s important that the conversation doesn’t just rehash the anxieties that are preventing you from catching shut-eye in the first place.</p> <p>Rather than using the call to seek solutions for those issues, talk about things that calm your nerves, or even have them assist you in deep breathing. It may sound silly, but doing a series of deep, relaxing breaths can help you let go of the troubles that are keeping you wide awake.</p> <p><strong>Take a warm shower</strong></p> <p>Taking a warm shower not only relaxes your muscles and soothes minor aches and pains, but it also raises your core body temperature. As soon as you step out of the shower, your body starts working at lowering that temperature, which is something that normally happens when you’re falling asleep naturally.</p> <p>(That’s why we always feel the need for a blanket when we sleep, no matter how warm it is!) By kick-starting that temperature-lowering process, you’re tricking your body into falling asleep fast.</p> <p><strong>Stretch yourself to sleep </strong></p> <p>Anxiety keeping you up? Research suggests mild stretching can help take the edge off and relax muscles that have become stiff and sore after a long day. We’re not talking intricate yoga poses or acrobatics here, either: Simple stretches like an overhead arm stretch and bending over to touch your toes should do the trick. Ramp up the relaxation potential with a soundtrack of ambient noise at a volume that’s just barely audible.</p> <p>There are plenty of white noise apps that are free to download, but soft music can work as well (so long as there are no lyrics). Just remember, if you’re using an electronic device to play these sleep-promoting sounds, make sure it’s placed screen-down so you’re not distracted by the light it emits.</p> <p><strong>Read (or listen!) to something new</strong></p> <p>When you’re struggling with insomnia, it might be tempting to pull an old favourite off the bookshelf. In reality, it’s better to read or listen to an audio book that covers a topic on which you know absolutely nothing. New information, while taking attention away from the stressors that are keeping you up at night, gives your brain enough of a workout to make it tire more quickly than when it’s engaged with familiar subjects and concepts.</p> <p>Again, if it’s an audio book or podcast you’re listening to, make sure the light-emitting side of the device is face down to keep the room as dark as possible. Darkness and warmth play an essential part in the production and maintenance of melatonin, the hormone that plays the central role falling asleep.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article by Deepak Kashyap </em><em>originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/conditions/sleep/how-to-fall-asleep-without-sleeping-pills-7-natural-sleep-aids-that-actually-work" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Body

Placeholder Content Image

Boss slammed for demanding an employee complete work during annual leave

<p dir="ltr">A boss has been dubbed an “abysmal manager” for demanding his employee join a video call for work, despite being on annual leave. </p> <p dir="ltr">Businessman Ben Askins, who has dedicated his TikTok account to calling out unacceptable workplace behaviour, read out the text exchange between the man and his boss, who quickly became unreasonable in his demands. </p> <p dir="ltr">The first message came from the man’s boss, who asked “Where are you? Haven’t seen you at your desk today? I need to run something by you.”</p> <p dir="ltr">The employee responded, reminding his boss that he was off on pre-approved annual leave, and was enjoying a holiday abroad in Spain. </p> <p dir="ltr">Despite his holiday, the employee still offered to help, saying he could “probably jump on a quick call when I am on the bus from the airport if it is really urgent.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C2QFCsgtSoS/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C2QFCsgtSoS/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ben Askins (@benaskins.official)</a></p> </div> </blockquote> <p dir="ltr">Unhappy with the compromise, the demanding boss then asked if the employee would “jump on a Zoom call when you get to the hotel” as he would “prefer to do this in person”. </p> <p dir="ltr">“Sorry, not really possible, we have a really packed schedule,” the worker replied to his boss, to which the manager hit back with, “Damn, wish you had told me that you were on annual leave.”</p> <p dir="ltr">The man reminded his boss he had signed off his leave two months prior and it was “in the system” but he came back saying, “Lol as if I would remember that. It is poor form for you to not remind me.”</p> <p dir="ltr">As Ben continued to read the text exchange, he added his own commentary on the situation, saying, “It's your job to remember that, it's not his fault you're just being unbelievably shocking at yours.”</p> <p dir="ltr">“This is so bad, this poor employee has done everything right; he's got it signed off two months in advance, he's done all the handover, he's done everything he could have done,' Ben ranted. </p> <p dir="ltr">“Because the manager is shocking, it's now impacting the employee's holiday. I just hate it when that happens.”</p> <p dir="ltr">Ben, a self-described “champion of younger gens in the workplace” said the heated chat showed the boss's “really poor” form and “abysmal management”. </p> <p dir="ltr">“What are you doing being so unorganised? Because the problem when an unorganised manager happens it hits down to the team below him - what the hell he's playing at? I have no idea,” he said. </p> <p dir="ltr">Ben's clip was viewed more than 2.3million and had users fired up, with thousands of comments flooding in in support of the burnt out employee trying to enjoy his holiday. </p> <p dir="ltr"><em>Image credits: Instagram </em></p> <p> </p>

Legal

Placeholder Content Image

What is micellar water and how does it work?

<p><em><a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>Micellar water, a product found in supermarkets, chemists and bathroom cabinets around the world, is commonly used to remove make-up. It’s a very effective cleanser and many people swear by it as part of their skincare routine.</p> <p>So, what is micellar water and why is it so good at getting makeup and sunscreen off? Here’s the science.</p> <h2>What are micelles?</h2> <p>Oil and water generally don’t mix, which is why you’ll struggle to remove makeup and sunscreen (which both contain oils) with just plain water.</p> <p>But micellar water products contain something called micelles – clusters of molecules that are <em>very</em> effective at removing oily substances. To understand why, you need to first know two chemistry terms: hydrophilic and hydrophobic.</p> <p>A hydrophilic substance “loves” water and mixes easily with it. Salt and sugar are examples.</p> <p>A hydrophobic substance “hates” water and generally refuses to mix with it. Examples include oil and wax.</p> <p>Hydrophilic materials will happily mix with other hydrophilic materials. The same goes for hydrophobic substances. But if you try to combine hydrophilic and hydrophobic materials, they won’t mix.</p> <h2>How are micelles formed? It’s all about surfactants</h2> <p>The micelles in micellar water are formed by special molecules known as surfactants.</p> <p>Surfactant stands for surface active agent. These molecules looked at their hydrophilic and hydrophobic brethren and said, why not both? They are typically comprised of two ends: a head group that is hydrophilic and a tail that is hydrophobic.</p> <p>When a small amount of surfactant is added to water, the two ends of the molecule have competing interests. The hydrophilic head wants to be in the water, but the hydrophobic tail can’t stand water.</p> <p>Add enough surfactant and, eventually, we will pass a critical micelle concentration and the surfactants will self-assemble into clusters of approximately 20 to 100 surfactant molecules.</p> <p>All the hydrophilic heads will be pointing outwards, while the hydrophobic tails remain “hidden” at the centre. These clusters are micelles.</p> <p>These micelles have a hydrophilic exterior, meaning that they are very happy to remain mixed throughout water. However, in the centre remains a hydrophobic pocket that’s very good at attracting oils.</p> <p>This is very handy, and helps explain why adding some detergent (a surfactant) to water will allow you to wash an oily saucepan. The surfactant first helps lift of the oil, and then the oil can remained mixed into the water, finding a new home in the hydrophobic centre of the micelle.</p> <figure><iframe src="https://www.youtube.com/embed/fnRBCn8fm2o?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Micellar water in action</h2> <p>Surfactants are in your dishwashing detergent, your body wash, your shampoo, your toothpaste and even many foods. In all of these cases, they are there to help the water interact with the dirt and oils, and micellar water is no different.</p> <p>When you apply some micellar water to a cotton pad, another convenient interaction occurs. The wet cotton is hydrophilic (loves water). Consequently, some of the micelles will unravel, with the hydrophilic heads being attracted to the wet cotton pad.</p> <p>Now, sticking out from the surface will be a layer of hydrophobic tail groups. These hydrophobic tails cannot wait to attract themselves to makeup, sunscreen, oils, dirt, grease and other contaminants on your face.</p> <p>As you sweep the cotton pad across your skin, these contaminants bind to the hydrophobic tails and are removed from the skin.</p> <p>Some contaminants will also find themselves encapsulated in the hydrophobic centres of the micelle.</p> <p>Either way, a cleaner surface is left behind.</p> <p>Look at how a cotton wipe soaked in micellar water cleans up a small oil spill, in comparison to water alone.</p> <figure><iframe src="https://www.youtube.com/embed/5Nge5FEiuYE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>So why shouldn’t I just use dishwashing detergent to wash my face?</h2> <p>Technically, that would work as detergent does indeed contain lots of micelle-forming surfactants.</p> <p>But these particular surfactants would probably cause a lot of skin and eye irritation, while also damaging and drying out your skin. Not nice.</p> <p>The surfactants in micellar water are chosen to be mild and well tolerated by most people’s skin. But micellar water isn’t the only skincare product to contain micelles. There are many other face-cleaning products that also make great use of surfactant molecules and work very well too.</p> <p>Now, it’s not perfect. While it is effective at removing a wide range of contaminants, thick or heavy makeup might not come off easily with micellar water (you might need to do a more vigorous clean).</p> <p>Some products say there is “zero residue”, although the fine print clearly states this refers to visible residue.</p> <p>Many products also state there is no rinse off required. Surfactants will remain on your skin after product use, but for many people they don’t cause irritation. If your skin is feeling irritated after using a micellar water product, you can try rinsing afterwards or discontinuing use.</p> <p>And as is the case with many cosmetic products, you should test it first on a small patch of skin before using it all over your face.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219492/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/daniel-eldridge-1494633"><em>Daniel Eldridge</em></a><em>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-micellar-water-and-how-does-it-work-219492">original article</a>.</em></p>

Beauty & Style

Placeholder Content Image

What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection.</p> <p>These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID.</p> <p>Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older.</p> <p>Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe?</p> <h2>Who’s eligible for the new boosters?</h2> <p>The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September.</p> <p>ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose.</p> <p>People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">For people without risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>Adults aged 18 to 64 <em>with</em> underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Advice for people with risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>For adults aged 18 to 64 <em>without</em> underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose.</p> <p>Additional doses aren’t recommended for children <em>without</em> underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years <em>without</em> additional risk factors.</p> <h2>Monovalent, bivalent? What’s the difference?</h2> <p><strong>From monovalent</strong></p> <p>The initial COVID vaccines were “monovalent”. They had one target – the original viral strain.</p> <p>But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity.</p> <p><strong>To bivalent</strong></p> <p>So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>.</p> <p>Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission.</p> <p>The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5.</p> <p><strong>Back to monovalent</strong></p> <p>Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement.</p> <p>This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>).</p> <p>This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed.</p> <p>According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is.</p> <p>The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore.</p> <p>In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>.</p> <h2>Do these newer vaccines work?</h2> <p>Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA.</p> <p>Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control.</p> <p>Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster.</p> <p>The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>.</p> <p>It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored.</p> <h2>Are they safe?</h2> <p>The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported.</p> <p>Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines.</p> <h2>What happens next?</h2> <p>The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated.</p> <p>We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217804/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/paul-griffin-1129798"><em>Paul Griffin</em></a><em>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.</em></p>

Body

Placeholder Content Image

How do stimulants actually work to reduce ADHD symptoms?

<p><em><a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>Stimulants are <a href="https://adhdguideline.aadpa.com.au/">first-line drugs</a> for children and adults diagnosed with attention-deficit hyperactivity disorder (ADHD). But how do they actually work?</p> <h2>First, let’s look at the brain</h2> <p>ADHD is a neurodevelopmental condition, which means it affects how the brain functions.</p> <p>Medical imaging indicates people with ADHD may have slight differences in their brain’s <a href="https://jamanetwork.com/journals/jama/article-abstract/195386">structure</a>, the way their brain regions work together to perform tasks, and how their brain’s chemical messengers, called neurotransmitters, pass on information.</p> <p>These brain differences are associated with the symptoms of ADHD, including inattention, impulse control and problems with memory.</p> <h2>What stimulants are prescribed in Australia?</h2> <p>The three main stimulants prescribed for ADHD in Australia are dexamfetamine, methylphenidate (sold under the brand names Ritalin and Concerta) and lisdexamfetamine (sold as Vyvanse).</p> <p>Dexamfetamine and methylphenidate have been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/">since</a> the 1930s and 1940s respectively. Lisdexamfetamine is a newer stimulant that has been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">since</a> the late 2000s.</p> <p>Dexamfetamine and lisdexamfetamine are amphetamines. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">Lisdexamfetamine</a> is inactive when it’s taken and actually changes into active dexamfetamine in the red blood cells. This is what’s known as a “prodrug”.</p> <h2>So how do they work for ADHD?</h2> <p>Stimulant drugs are thought to alter the activity of key neuotransmitters, dopamine and noradrenaline, in the brain. These neurotransmitters help with attention and focus, among other things.</p> <p>Stimulants increase the amount of dopamine and noradrenaline in the tiny gaps between neurons, known as synapses. They do this by predominantly blocking a transporter that then prevents their re-uptake back into the neuron that released them.</p> <p>This means more dopamine and noradrenaline can bind to their respective receptors. This <a href="https://www.tga.gov.au/sites/default/files/auspar-lisdexamfetamine-dimesilate-180515-pi.pdf">helps</a> connected neurons in the brain talk to one another.</p> <p>Amphetamines also increase the amount of dopamine the neuron releases into the synapse (the tiny gaps between neurons). And it stops the enzymes that break down dopamine. This results in an increase of dopamine in the synapse.</p> <h2>What effect do they have on ADHD symptoms?</h2> <p>We still don’t fully understand the underlying brain mechanisms that change behaviour in people with ADHD.</p> <p>But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109107/">research shows</a> stimulants that modulate noradrenaline and dopamine can improve brain processes such as:</p> <ul> <li>attention</li> <li>memory</li> <li>decision-making</li> <li>task completion</li> <li>hyperactivity.</li> </ul> <p>They can also improve general behaviour, such as self-control, not talking over the top of others, and concentration. These behaviours are important for social interactions.</p> <p>Stimulants <a href="https://pubmed.ncbi.nlm.nih.gov/15737659/">reduce ADHD symptoms</a> in about 70% to 80% of children and adults who take them.</p> <p>Some people will notice their symptoms improve right away. Other times, these improvements will be more noticeable to parents, carers, teachers, colleagues and partners.</p> <h2>Not everyone gets the same dose</h2> <p>The optimal stimulant dose varies between individuals, with multiple dosage options available.</p> <p>This enables a “start low, go slow” approach, where the stimulant can be gradually increased to the most effective dose for the individual.</p> <p>There are also different delivery options.</p> <p>Dexamfetamine and methylphenidate are available in immediate-release preparations. As these have short half-lives (meaning they act quickly and wear off rapidly), they are often taken multiple times a day – usually in the morning, lunch and afternoon.</p> <p>Methylphenidate is also <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2010-PI-03175-3&amp;d=20231023172310101">available</a> in long-acting tablets (Concerta) and capsules (Ritalin LA). They are released into the body over the day.</p> <p>Lisdexamfetamine is a long-acting drug and is not available in a short-acting formulation.</p> <p>The long-acting stimulants are generally taken once in the morning. This avoids the need to take tablets during school or work hours (and the need to store a “controlled drug”, which has the potential for abuse, outside the home).</p> <h2>What are the side effects?</h2> <p>The most common side effects are sleep problems and decreased appetite. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012069.pub2/full">recent study</a> showed children and young people taking methylphenidate for ADHD were around 2.6 times more likely to have sleep problems and 15 times more likely to have a decreased appetite than those not taking methylphenidate.</p> <p>Headache and abdominal pain are also relatively common.</p> <h2>Can someone without ADHD take a stimulant to improve productivity?</h2> <p>Stimulants are tightly controlled because of their potential for abuse. In Australia, only paediatricians, psychiatrists or neurologists (and GPs in special circumstances) can prescribe them. This follows a long assessment process.</p> <p>As stimulants increase dopamine, they can cause euphoria and a heightened sense of wellbeing. They can also cause <a href="https://www.ncbi.nlm.nih.gov/books/NBK576548/#:%7E:text=The%20immediate%20psychological%20effects%20of,and%20may%20result%20in%20insomnia.">weight loss</a>.</p> <p>A common myth about stimulant medicines is they can improve the concentration and productivity of people without ADHD. A <a href="https://www.science.org/doi/full/10.1126/sciadv.add4165">recent study shows</a> the opposite is true.</p> <p>This study gave a group of 40 people online arithmetic tasks to complete across four sessions. At each of the sessions, participants were given either a placebo or a stimulant before completing the task.</p> <p>The results showed that while stimulants did not impact getting the correct answer, it increased the number of moves and time to solve the problems compared to a placebo. This indicates a reduction in productivity.</p> <p>However, the myth that stimulants improve study prevails. It’s likely that users feel different – after all, they are taking a medicine that speeds up messages between the brain and body. It may make them “feel” more alert and productive, even if they’re not.<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/215801/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/mary-bushell-919262"><em>Mary Bushell</em></a><em>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-stimulants-actually-work-to-reduce-adhd-symptoms-215801">original article</a>.</em></p>

Mind

Placeholder Content Image

How can I get some sleep? Which treatments actually work?

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months?</p> <p>If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia.</p> <p>You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next?</p> <h2>What not to do</h2> <p>These probably won’t help:</p> <ul> <li> <p><strong>spending more time in bed</strong> often results in more time spent <em>awake</em> in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a></p> </li> <li> <p><strong>drinking coffee and taking naps</strong> might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening</p> </li> <li> <p><strong>drinking alcohol</strong> might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid.</p> </li> </ul> <h2>What to do next?</h2> <p>If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours.</p> <p>So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills.</p> <p>It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia.</p> <p>You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>.</p> <p>Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some.</p> <p><a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>.</p> <h2>What if that doesn’t work?</h2> <p>If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia.</p> <p>It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep.</p> <p>Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor.</p> <h2>What about sleeping pills?</h2> <p>Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful.</p> <p>Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep.</p> <p>However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence.</p> <p>Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits.</p> <h2>Are there new treatments? How about medicinal cannabis?</h2> <p>Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant).</p> <p>These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines.</p> <p>However, we don’t know if they work or are safe over the long term.</p> <p><a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>.</p> <p>In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>.</p> <p>But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment.</p> <p>So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term.</p> <h2>What now?</h2> <p>If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these.</p> <p>Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors.</p> <hr /> <p><em>For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.</em><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/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.</em></p>

Body

Placeholder Content Image

Princess Beatrice reveals the “most terrifying moment” in her life

<p dir="ltr">Princess Beatrice has shared the “most terrifying moment” that she encountered at work. </p> <p dir="ltr">The 35-year-old royal has been open about her struggles with dyslexia, and has opened up on a podcast about a major challenge she faced at work. </p> <p>"I was anecdotally talking about how difficult it was at work," Beatrice, who works for US-based technology firm Afiniti, told podcast host Kate Griggs. </p> <p>"Sometimes you get handed a whiteboard pen and you've got to do the group think again and collaborate and off you go to the whiteboard."</p> <p dir="ltr">"And I was thinking that's the most terrifying moment for me in my life, and please don't ever make me do it. I'll do a speech tomorrow but don't give me a pen and a whiteboard."</p> <p dir="ltr">Beatrice also shared the difficulties she faced as a child, and having to go through school before being formally diagnosed with dyslexia. </p> <p dir="ltr">"The early days of school really, really stand out as to those moments where you just don't fit in and you can't figure out what it is about you," the royal said candidly.</p> <p dir="ltr">"I remember trying to do extra lessons with teachers and just sort of blankly staring up at her face, and she was like, 'why are you looking at me? The words are not on my face' [and] I said 'well, they're not on the page either'."</p> <p dir="ltr">"So the early days, in and around that understanding that my brain worked slightly differently, I remember them being a real challenge."</p> <p dir="ltr">Princess Beatrice became emotional when talking about the teachers who helped her during her schooling career, saying she "probably wouldn't be the person I am today if they hadn't been there in my life".</p> <p dir="ltr">The princess also paid tribute to her mum, Sarah Ferguson, for championing her to find a new way to do things.</p> <p dir="ltr">"My family and I are incredibly close, so I would say that all throughout our lives, we've been able to go through everything with humour and with joy and my mum really instilled that," Beatrice said.</p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

Mind

Placeholder Content Image

Lots of women try herbs like black cohosh for menopausal symptoms like hot flushes – but does it work?

<p><em><a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Menopause is the stage of life where the ovaries stop releasing eggs and menstrual periods cease. Most Australian women go through menopause between <a href="https://www.nature.com/articles/nrdp20154">45 and 55</a> years of age, with the average age being 51 years, although some women may be younger.</p> <p>Hot flushes and night sweats are <a href="https://www.nature.com/articles/nrendo.2017.180">typical symptoms</a> of menopause, with vaginal dryness, muscle and joint pains, mood changes and sleep disturbance also commonly reported. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">75% of women</a> experience menopausal symptoms, with nearly 30% severely affected.</p> <p>These symptoms can negatively impact day-to-day life and wellbeing. The main therapies available include menopausal hormone therapy (MHT) and non-hormonal prescription therapy. Some women will elect to try complementary and alternative medicines, such as herbal medicines and nutritional supplements. Black cohosh is one of them.</p> <h2>What causes hot flushes</h2> <p>The cause of hormonal hot flushes (also called hot flashes) still isn’t completely understood, but the decline in oestrogen at menopause appears to play a role in a process that involves the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833827/">area of the brain that regulates temperature</a> (the hypothalamus).</p> <p>Factors linked to a greater likelihood of hot flushes include <a href="https://pubmed.ncbi.nlm.nih.gov/19675142/">being overweight or having obesity</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">smoking</a>.</p> <p>MHT, previously known as hormone replacement therapy (HRT), usually includes oestrogen and is the <a href="https://pubmed.ncbi.nlm.nih.gov/26444994/">most effective treatment</a> for menopausal symptoms, such as hot flushes. But women may choose complementary and alternative medicines instead – either because they shouldn’t take hormone therapy, for example because they have breast cancer, or because of personal preference.</p> <p>Close <a href="https://pubmed.ncbi.nlm.nih.gov/26224187/">to 40%</a> of Australian women report using complementary and alternative medicines for menopausal symptoms, and up to 20% using them specifically to treat hot flushes and sweats.</p> <h2>A long history</h2> <p>Complementary and alternative medicines have a long history of use in many cultures. Today, their potential benefits for menopausal symptoms are promoted by the companies that make and sell them.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/">complementary and alternative medicines</a> women often try for menopausal symptoms include phytoestrogens, wild yam, dong quai, ginseng and black cohosh.</p> <p>Black cohosh (plant name <em>Cimicifuga racemosa</em>) was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">traditionally</a> used by Native Americans to treat a variety of health concerns such as sore throat, kidney trouble, musculoskeletal pain and menstrual problems. It is now a popular herbal choice for hot flushes and night sweats, as well as vaginal dryness and mood changes.</p> <p>There are <a href="https://pubmed.ncbi.nlm.nih.gov/37252752/">many theories</a> for how the active ingredients in black cohosh might work in the body, such as acting like oestrogen, or affecting chemical pathways in the brain. But despite extensive research, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">evidence to support these theories remains inconclusive</a>.</p> <p>It is also not clear whether black cohosh is effective for hot flushes. Results from individual studies are mixed, with <a href="https://pubmed.ncbi.nlm.nih.gov/17565936/">some</a> finding black cohosh improves hot flushes, while <a href="https://pubmed.ncbi.nlm.nih.gov/18257142/">others</a> have found it doesn’t.</p> <p>A 2012 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">review</a> combined all the results from studies of menopausal women using black cohosh to that date and found overall there was no proof black cohosh reduces hot flushes more effectively than an inactive treatment (placebo). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">This review</a> also revealed that many studies did not use rigorous research methods, so the findings are hard to interpret.</p> <p>A more recent <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review</a> of clinical trials claimed black cohosh may ease menopausal symptoms, but the included studies were mostly small, less than six months long, and included women with mild symptoms.</p> <p>There is also no meaningful evidence black cohosh helps other symptoms of menopause, such as vaginal symptoms, sexual problems, or poor general wellbeing, or that it protects against bone loss.</p> <p>Evidence for how black cohosh is absorbed and metabolised by the body is also lacking, and it is not known what dose or formulation is best to use.</p> <p>More good quality studies are needed to decide whether black cohosh works for hot flushes and other menopausal symptoms.</p> <h2>Is it safe to try?</h2> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review of studies</a> suggests black cohosh is safe to use, although many of the studies have not reported possible adverse reactions in detail. Side effects such as gastrointestinal upset and rashes may occur.</p> <p>While there have been <a href="https://www.mja.com.au/journal/2008/188/7/liver-failure-associated-use-black-cohosh-menopausal-symptoms#0_i1091948">rare reports of liver damage</a>, there is <a href="https://pubmed.ncbi.nlm.nih.gov/21228727/">no clear evidence</a> black cohosh was the cause. Even so, in Australia, black cohosh manufacturers and suppliers are required to put a warning label for the potential of harm to the liver on their products.</p> <p>It is recommended black cohosh is not used by women with menopausal symptoms <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/impacted-by-breast-cancer/physical-changes/menopause/treatments-menopausal-symptoms">after breast cancer</a>, as its safety after breast cancer is uncertain. All women should consult with their doctor before using black cohosh if they are taking other medications in case of possible drug interactions.</p> <p>Many women like to try herbal therapies for hot flushes and other menopausal symptoms. While black cohosh is generally considered safe and some women may find it helps them, at the moment there is not enough scientific evidence to show its effects are any better than placebo.</p> <p>Women experiencing troublesome menopausal symptoms, such as hot flushes, should talk to their doctor about the best treatment options for them.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/sasha-taylor-1461085"><em>Sasha Taylor</em></a><em>, Research fellow, Chronic Disease &amp; Ageing, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <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></em></p> <p><em>Image credits: Getty </em><em>Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/lots-of-women-try-herbs-like-black-cohosh-for-menopausal-symptoms-like-hot-flushes-but-does-it-work-211272">original article</a>.</em></p>

Body

Placeholder Content Image

Do blue-light glasses really work? Can they reduce eye strain or help me sleep?

<p><em><a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Blue-light glasses are said to <a href="https://www.baxterblue.com.au/collections/blue-light-glasses">reduce eye strain</a> when using <a href="https://www.blockbluelight.com.au/collections/computer-glasses">computers</a>, improve your <a href="https://www.ocushield.com/products/anti-blue-light-glasses">sleep</a> and protect your eye health. You can buy them yourself or your optometrist can prescribe them.</p> <p>But <a href="https://mivision.com.au/2019/03/debate-continues-over-blue-blocking-lenses/">do they work</a>? Or could they do you harm?</p> <p>We <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">reviewed</a> the evidence. Here’s what we found.</p> <h2>What are they?</h2> <p>Blue-light glasses, blue light-filtering lenses or blue-blocking lenses are different terms used to describe lenses that reduce the amount of short-wavelength visible (blue) light reaching the eyes.</p> <p>Most of these lenses prescribed by an optometrist decrease blue light transmission by <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">10-25%</a>. Standard (clear) lenses do not filter blue light.</p> <p>A wide variety of lens products are available. A filter can be added to prescription or non-prescription lenses. They are widely marketed and are becoming <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">increasingly popular</a>.</p> <p>There’s often an added cost, which depends on the specific product. So, is the extra expense worth it?</p> <h2>Blue light is all around us</h2> <p>Outdoors, sunlight is the main source of blue light. Indoors, light sources – such as light-emitting diodes (LEDs) and the screens of digital devices – emit varying degrees of blue light.</p> <p>The amount of blue light emitted from artificial light sources is much lower than from the Sun. Nevertheless, artificial light sources are all around us, at home and at work, and we can spend a lot of our time inside.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=566&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=566&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=566&amp;fit=crop&amp;dpr=3 2262w" alt="Blue light-filtering lenses block some blue light from screens from reaching the eye" /></a><figcaption><span class="caption">Screens emit blue light. The lenses are designed to reduce the amount of blue light that reaches the eye.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/blue-light-blocking-ray-filter-lens-2286229107">Shutterstock</a></span></figcaption></figure> <p>Our research team at the University of Melbourne, along with collaborators from Monash University and City, University London, sought to see if the best available evidence supports using blue light-filtering glasses, or if they could do you any harm. So we conducted a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">systematic review</a> to bring together and evaluate all the relevant studies.</p> <p>We included all randomised controlled trials (clinical studies designed to test the effects of interventions) that evaluated blue light-filtering lenses in adults. We identified 17 eligible trials from six countries, involving a total of 619 adults.</p> <h2>Do they reduce eye strain?</h2> <p>We found no benefit of using blue light-filtering lenses, over standard (clear) lenses, to reduce eye strain with computer use.</p> <p>This conclusion was based on consistent findings from three studies that evaluated effects on eye strain over time periods ranging from two hours to five days.</p> <h2>Do they help you sleep?</h2> <p>Possible effects on sleep were uncertain. Six studies evaluated whether wearing blue-light filtering lenses before bedtime could improve sleep quality, and the findings were mixed.</p> <p>These studies involved people with a diverse range of medical conditions, including insomnia and bipolar disorder. Healthy adults were not included in the studies. So we do not yet know whether these lenses affect sleep quality in the general population.</p> <h2>Do they boost your eye health?</h2> <p>We did not find any clinical evidence to support using blue-light filtering lenses to protect the macula (the region of the retina that controls high-detailed, central vision).</p> <p>None of the studies evaluated this.</p> <h2>Could they do harm? How about causing headaches?</h2> <p>We could not draw clear conclusions on whether there might be harms from wearing blue light-filtering lenses, compared with standard (non blue-light filtering) lenses.</p> <p>Some studies described how study participants had headaches, lowered mood and discomfort from wearing the glasses. However, people using glasses with standard lenses reported similar effects.</p> <h2>What about other benefits or harms?</h2> <p>There are some important general considerations when interpreting our findings.</p> <p>First, most of the studies were for a relatively short period of time, which limited our ability to consider longer-term effects on vision, sleep quality and eye health.</p> <p>Second, the review evaluated effects in adults. We don’t yet know if the effects are different for children.</p> <p>Finally, we could not draw conclusions about the possible effects of blue light-filtering lenses on many vision and eye health measures, including colour vision, as the studies did not evaluate these.</p> <h2>In a nutshell</h2> <p>Overall, based on relatively limited published clinical data, our review does not support using blue-light filtering lenses to reduce eye strain with digital device use. It is unclear whether these lenses affect vision quality or sleep, and no conclusions can be drawn about any potential effects on the health of the retina.</p> <p>High-quality research is needed to answer these questions, as well as whether the effectiveness and safety of these lenses varies in people of different ages and health status.</p> <p>If you have eye strain, or other eye or vision concerns, discuss this with your optometrist. They can perform a thorough examination of your eye health and vision, and discuss any relevant treatment options.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213145/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/laura-downie-1469379"><em>Laura Downie</em></a><em>, Associate Professor in Optometry and Vision Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-blue-light-glasses-really-work-can-they-reduce-eye-strain-or-help-me-sleep-213145">original article</a>.</em></p>

Body

Placeholder Content Image

How do hay fever treatments actually work? And what’s best for my symptoms?

<p><em><a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing.</p> <p>Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine.</p> <p>Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging.</p> <p>So what medicines can prevent or reduce hay fever symptoms, and how do they work?</p> <h2>Antihistamines</h2> <p>Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that <em>anti</em>-histamines are one of the most frequently recommended medicines to treat hay fever.</p> <p>Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms.</p> <p>In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines.</p> <p>Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation.</p> <p>The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever.</p> <p>The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones.</p> <p>Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines.</p> <p>The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you.</p> <p>Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients).</p> <h2>Steroid nasal sprays</h2> <p>If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended.</p> <p>Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation.</p> <p>Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever.</p> <p>There are also nasal sprays that contain both an antihistamine and corticosteroid.</p> <p>While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days.</p> <h2>Sodium cromoglycate</h2> <p>Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies.</p> <p>This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation.</p> <p>This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies).</p> <h2>Decongestants</h2> <p>Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running.</p> <p>However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose.</p> <h2>Saline</h2> <p>Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects.</p> <p>If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines.</p> <p>Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<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/213071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.</em></p>

Body

Placeholder Content Image

How can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?

<p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options.</p> <p>Could taking supplements over this time help?</p> <p>You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference.</p> <h2>Why are we so worried about cholesterol?</h2> <p>There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins.</p> <p><strong>Low-density lipoprotein or LDL cholesterol</strong></p> <p>This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011433">build-up of plaque</a> in arteries, which leads to an <em>increased</em> risk of heart disease and stroke.</p> <p><strong>High-density lipoprotein or HDL cholesterol</strong></p> <p>This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.312617">linked to</a> a <em>reduced</em> risk of heart disease and stroke.</p> <p>Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are <a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">well recognised</a>. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado), and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases).</p> <h2>Fibre is your friend</h2> <p>An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">soluble fibre</a>.</p> <p>This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces.</p> <p>You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils.</p> <h2>Fibre supplements, such as psyllium</h2> <p>There are also many fibre supplements and food-based products on the market that may help lower cholesterol. These include:</p> <ul> <li> <p><strong>natural soluble fibres</strong>, such as inulin (for example, Benefiber) or psyllium (for example, Metamucil) or beta-glucan (for example, in ground oats)</p> </li> <li> <p><strong>synthetic soluble fibres</strong>, such as polydextrose (for example, STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel)</p> </li> <li> <p><strong>natural insoluble fibres</strong>, which bulk out your faeces, such as flax seeds.</p> </li> </ul> <p>Most of these supplements come as fibres you add to food or dissolve in water or drinks.</p> <p>Psyllium is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/">studied</a> in at least 24 high-quality randomised controlled trials.</p> <p>These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, <a href="https://www.sciencedirect.com/science/article/pii/S0002916523070107#:%7E:text=Conclusions%3A,mild%2Dto%2Dmoderate%20hypercholesterolemia.">can significantly lower</a> total cholesterol levels by 4% and LDL cholesterol levels by 7%.</p> <h2>Probiotics</h2> <p>Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352670/">number of mechanisms</a>. These include helping to incorporate cholesterol into cells, and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces.</p> <p>Using probiotics to reduce cholesterol is an upcoming area of interest and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S089990071500461X">research</a> is promising.</p> <p>In a <a href="https://pubmed.ncbi.nlm.nih.gov/29384846/">2018 study</a>, researchers pooled results from 32 studies and analysed them altogether in a type of study known as a meta-analysis. The people who took probiotics reduced their total cholesterol level by 13%.</p> <p><a href="https://www.tandfonline.com/doi/full/10.3109/07853890.2015.1071872">Other</a> <a href="https://link.springer.com/article/10.1007/s11906-020-01080-y">systematic reviews</a> support these findings.</p> <p>Most of these studies use probiotics containing <em>Lactobacillus acidophilus</em> and <em>Bifidobacterium lactis</em>, which come in capsules or powders and are consumed daily.</p> <p>Ultimately, probiotics could be worth a try. However, the effects will likely vary according to the probiotic strains used, whether you take the probiotic each day as indicated, as well as your health status and your diet.</p> <h2>Red yeast rice</h2> <p><a href="https://www.nccih.nih.gov/health/red-yeast-rice">Red yeast rice</a> is another non-fibre supplement that has gained attention for lowering cholesterol. It is often used in Asia and some European countries as a complementary therapy. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins.</p> <p>A <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.819482/full">2022 systematic review</a> analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4,800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins.</p> <p>However, these trials don’t tell us if red yeast rice works and is safe in the long term. The authors also said only one study in the review was registered in a major <a href="https://www.clinicaltrials.gov">database</a> of clinical trials. So we don’t know if the evidence base was complete or biased to only publish studies with positive results.</p> <h2>Diet and supplements may not be enough</h2> <p>Always speak to your GP and dietitian about your plan to take supplements to lower your cholesterol.</p> <p>But remember, dietary changes alone – with or without supplements – might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role.</p> <p>Even then, depending on your cholesterol levels and other risk factors, you may still be recommended cholesterol-lowering medications, such as <a href="https://jamanetwork.com/journals/jama/fullarticle/2795522">statins</a>. Your GP will discuss your options at your six-month review.<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/211748/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher &amp; Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-lower-my-cholesterol-do-supplements-work-how-about-psyllium-or-probiotics-211748">original article</a>.</em></p>

Body

Placeholder Content Image

Do psychedelics really work to treat depression and PTSD? Here’s what the evidence says

<p><em><a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>As of July 1, authorised psychiatrists have been allowed to prescribe MDMA (the chemical found in “ecstasy”) to treat post-traumatic stress disorder (PTSD), and psilocybin (found in “magic mushrooms”) to treat depression that hasn’t responded to other treatment.</p> <p>Psychedelic therapies have researchers excited because evidence suggests they might have lasting beneficial effects on factors that cause psychological distress beyond the treatment period. These include <a href="https://link.springer.com/article/10.1007/s00213-017-4701-y">feeling disconnected from other people</a>, <a href="https://link.springer.com/article/10.1007/s00213-019-05391-0">fear of death</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S2212144719301140?casa_token=OP6tKGxjPHAAAAAA:NTQ4khgsOY5wmsQ5HzCMcZ4eZ43wQV-sdhUbf5LXFiIeKWNwdonhfCxo77k7QbNk4G69EfX-">rigid ways of thinking</a>.</p> <p>This stands in contrast to most medications for psychological issues, which only directly help while people keep taking them regularly.</p> <p>But how strong is the evidence for psychedelic therapy?</p> <h2>Early promise</h2> <p>Early results from studies around the world have found psychedelic therapy <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">might be effective</a> for treating a range of psychological issues.</p> <p>For instance, most studies (<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">but not all</a>) have found patients tend to report <a href="https://pubmed.ncbi.nlm.nih.gov/37357767/">fewer depression symptoms</a> for periods ranging from several weeks to several months after psilocybin therapy.</p> <p>Similarly, studies have found <a href="https://journals.sagepub.com/doi/10.1177/0269881120965915">reductions in PTSD symptoms</a> three weeks after MDMA therapy.</p> <h2>Not so fast</h2> <p>However, as psychedelic research has grown, <a href="https://pubmed.ncbi.nlm.nih.gov/35243919/">limitations</a> of the research have been identified by researchers both <a href="https://psyarxiv.com/ak6gx/">within</a> and <a href="https://www.sciencefictions.org/p/psychedelics">outside</a> the psychedelic field.</p> <p>One issue is that we aren’t sure whether findings might be due to a <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo effect</a>, which occurs when a treatment works because people expect it to work.</p> <p>In clinical trials, participants are often given either a medication or a placebo (inactive) drug – and it’s important they don’t know which they have been given. However, due to the strong effects, it is difficult to prevent participants from knowing whether they have been given a psychedelic drug.</p> <p>Researchers have tried to use a range of different drugs (such as Ritalin) as a placebo in order to “trick” those participants not given a psychedelic into thinking they have received one. But this can be difficult to achieve.</p> <p>In 2021, researchers <a href="https://www.tandfonline.com/doi/full/10.1080/17512433.2021.1933434?casa_token=Dovn7x_rkdUAAAAA%3AsPzBTYNTPnNwqj9NvwN0m9ptrP4x4-c83gp3tGcshs30dWHNnmB_Vx-X5H5Y3pZJdG02IWW6X2E">reviewed</a> clinical trials involving psychedelics such as LSD, psilocybin, and dimethyltryptamine (found in animals and plants) for mood and anxiety disorders. They found trials either had not assessed whether participants guessed correctly which drug they had been given, or that this had been tested and participants tended to guess correctly.</p> <p>More recent trials <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">either don’t measure this</a> or find participants have a <a href="https://journals.sagepub.com/doi/full/10.1177/02698811231154852?casa_token=VsPt344fVGwAAAAA%3AA-i1VPBE1EWyFITWNncZEt876lWMiC7rtTOLJBQnb2pHI2775imUJhrzeSZW6r9doaBeDaj61D0">pretty good idea</a> of whether they’ve had a placebo or a psychedelic drug.</p> <p>Given the publicity and excitement around psychedelic research in recent years, it is likely most participants have <a href="https://culanth.org/fieldsights/the-pollan-effect-psychedelic-research-between-world-and-word">strong beliefs</a> such therapies work. This could lead to a significant placebo effect for participants given a psychedelic dose. Additionally, participants who realise they have received a placebo could experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184717/">disappointment and frustration</a>, resulting in worse symptoms. The benefits of a psychedelic may seem even greater when they are compared to the experiences of disappointed participants.</p> <h2>Translating trials to practice</h2> <p>Anecdotally, patients might be motivated to report they have gotten better, even when they haven’t.</p> <p>On a 2021 podcast, one clinical trial participant <a href="https://www.psymposia.com/powertrip/">described</a> how, in hindsight, the information they provided to the trial did not accurately capture the worsening of their symptoms. Trial participants are likely aware their results might affect whether treatments are legalised. They may not want to “ruin” the research by admitting the treatment didn’t work for them.</p> <p>There is also uncertainty about whether the findings from clinical trials mean treatments will work in private practice. There may be a lack of clarity around <a href="https://psyarxiv.com/ak6gx/">how trial participants</a> are recruited and selected. Therefore participants may not represent the typical person with PTSD or treatment-resistant depression.</p> <p>And while <a href="https://journals.sagepub.com/doi/full/10.1177/02698811211069100">the safety of psychedelics</a> within controlled contexts is often emphasised by advocates, less is known about safety of psychedelic therapy <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2021.737738/full">outside</a> clinical trials.</p> <h2>Resolving issues</h2> <p>These issues do not mean the promising psychedelic research conducted over the past several decades is worthless. Nevertheless, a <a href="https://pubmed.ncbi.nlm.nih.gov/35285280/#full-view-affiliation-1">recent review</a> of the effects of MDMA and psilocybin on mental, behavioural or developmental disorders by Australian researchers concluded the “overall certainty of evidence was low or very low”.</p> <p>Dutch researchers recently drafted a <a href="https://psyarxiv.com/ak6gx/">roadmap for psychedelic science</a> with a checklist for future research to help avoid these pitfalls. When more research is done, it might turn out psychedelic treatments help patients and don’t come with unacceptable harms – we simply don’t know that yet.<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/208857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/sam-moreton-194043">Sa<em>m Moreton</em></a><em>, Associate Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-psychedelics-really-work-to-treat-depression-and-ptsd-heres-what-the-evidence-says-208857">original article</a>.</em></p>

Mind

Placeholder Content Image

Paracetamol versus ibuprofen – which works best and when?

<p><em><a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>In most cases, pain and fever relief is as simple as a trip to your local supermarket for some paracetamol or ibuprofen.</p> <p>While both are effective at reducing pain, they work in different ways. So deciding which one you should choose is dependent on the type of pain you are experiencing. Sometimes it might be appropriate to take a medication that contains both drugs.</p> <p>In Australia, <a href="https://www.tga.gov.au/paracetamol-practitioner-fact-sheet#:%7E:text=It%20is%20available%20in%20many,Panamax%2C%20Chemist%20Own%20and%20Dymadon.">paracetamol</a> is branded as Panadol, Herron Paracetamol, Panamax, Chemist Own or Dymadon, plus there are generic chemist brands. Nurofen is the common brand name for <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI?OpenForm&amp;t=&amp;q=ibuprofen">ibuprofen</a>, which is also sold under generic brand names.</p> <p>So how do you know which one to choose and when?</p> <h2>Different blocking actions</h2> <p>While ibuprofen and paracetamol can be taken for similar reasons (pain relief) each works in a slightly different way.</p> <p>Ibuprofen is a <a href="https://www.healthdirect.gov.au/anti-inflammatory-medicines">non-steroidal anti-inflammatory drug</a>, which means it acts by blocking the enzymes that produce a group of chemicals called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081099/">prostaglandins</a>. These chemicals are important for normal body functions such as relaxing blood vessels, preventing blood clotting, secreting protective mucus in the gut and helping the uterus contract. They are also involved in inflammation, pain and fever.</p> <p>It is still not completely understood how paracetamol works. Like ibuprofen, it is thought to act by blocking the enzymes that produce prostaglandins, although through a different mechanism to ibuprofen. There is also good evidence paracetamol <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590544/">interacts</a> with the brain’s <a href="https://www.healthline.com/health/endocannabinoid-system">endocannabinoid system</a> and the “<a href="https://www.physio-pedia.com/Pain_Descending_Pathways">descending pain pathway</a>”, which inhibits the perception of pain.</p> <h2>Is one drug better than the other?</h2> <p>Because they each provide pain relief in different ways, paracetamol can be better at treating some types of pain, while ibuprofen is better at treating other types. But be wary of packaging that claims a medication is useful for targeting pain associated with a specific condition as these claims are <a href="https://www.abc.net.au/news/2017-08-03/nurofen-offers-3.5-million-compensation-to-customers/8770910">not true</a>.</p> <p>Because it reduces inflammation, the <a href="https://www.tg.org.au/">Australian Therapeutic Guidelines</a> state ibuprofen is the better choice for pain associated with osteo- and rheumatoid arthritis, period pain, some types of headache, and for pain that comes from having an operation. Paracetamol does not reduce inflammation but it is a better choice when fever is associated with the pain, like when you have a cold or flu.</p> <p>The Australian government recommends either paracetamol or ibuprofen if you have <a href="https://www.healthdirect.gov.au/covid-19/treating-symptoms-at-home">pain associated with COVID</a>.</p> <h2>What about taking both or ‘piggybacking’ them at intervals?</h2> <p>We can sometimes get better relief when we take both types of medicine at the same time, since each targets a different cause or pathway of the pain. If one pathway does not completely control the pain then it can be useful to target the other one. The effects of each drug <a href="https://www.frontiersin.org/articles/10.3389/fphar.2017.00158/full">can add</a> together for a bigger effect.</p> <p>Combination products that contain both paracetamol and ibuprofen in a single tablet include <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2022-CMI-02442-1&amp;d=20230620172310101">Nuromol</a> and <a href="https://maxigesic.com.au/wp-content/uploads/2021/05/cmi-approved.pdf">Maxigesic</a>.</p> <p>Using a combination product means you can take fewer tablets. However, the doses in these combined products are sometimes less than the maximum recommended dose, meaning they might not work as well when compared with taking the tablets individually.</p> <p>Other times, you can get the best effect by alternating doses of ibuprofen and paracetamol. This keeps the levels of the medication in the body more constant and helps to provide more steady pain relief. This may be particularly useful when treating <a href="https://www.rch.org.au/kidsinfo/fact_sheets/Pain_relief_for_children_-_Paracetamol_and_Ibuprofen/#:%7E:text=So%20that%20your%20child%27s%20pain,too%20much%20of%20either%20medicine.">pain</a> and <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009572.pub2/full?highlightAbstract=therapy%7Cfor%7Cibuprofen%7Calternating%7Cchildren%7Creview%7Cfour%7Ctherapi%7Caltern%7Ccombin%7Cfebril%7Ccombined%7Cparacetamol%7Cfebrile%7Cchild">fever</a> in children. To do this, one drug is given, then a dose of the other drug is given a few hours later, with you continuing to alternate between the two throughout the day.</p> <p>If you are alternating between different pain medicines, make sure you leave <a href="https://www.nhs.uk/medicines/paracetamol-for-children/taking-paracetamol-for-children-with-other-medicines-and-herbal-supplements/#:%7E:text=If%20you%27ve%20given%20your%20child%20paracetamol%20and%20they%27re,1%20medicine%20at%20a%20time">time (at least one hour)</a> between the dosing of each product to get more effective and consistent relief. Only give the recommended dose of each medicine as outlined on the pack. And do not administer more than the maximum recommended number of doses for each medicine per day.</p> <h2>How do the side effects compare?</h2> <p>Side effects from either drug are rare and generally mild.</p> <p><a href="https://www.tga.gov.au/sites/default/files/otc-template-pi-ibuprofen.rtf">Ibuprofen</a> does have a <a href="https://www.webmd.com/rheumatoid-arthritis/features/anti-inflammatory-drugs-rheumatoid-arthritis">reputation</a> for causing stomach problems. These can manifest as nausea, indigestion, bleeding in the stomach, and diarrhoea. For this reason, people with a history of bleeding or ulcers in the gut should not take ibuprofen. Ibuprofen is also known to sometimes cause headaches, dizziness, and higher blood pressure.</p> <p>Because ibuprofen thins the blood, it should also not be taken by people who are taking other medicines to thin the blood; like aspirin, warfarin, and clopidogrel. Ibuprofen should also be <a href="https://www.tga.gov.au/sites/default/files/otc-template-pi-ibuprofen.rtf">avoided</a> by pregnant women and people with asthma. In these cases, paracetamol is the better choice.</p> <p>However, you need to be careful when using these medicines to make sure you don’t use more than is recommended. This is particularly important for <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50296">paracetamol</a>.</p> <p>Paracetamol at the recommended doses is not toxic but too much can lead to liver failure.</p> <p>Because paracetamol is found in lots of different products, it can be hard to keep track of exactly how much paracetamol you have taken and this increases the risk of taking too much.</p> <h2>Both work, both need to be used safely</h2> <p>Paracetamol and ibuprofen are effective medications for the relief of both pain and fever; however, care must be taken to use them safely.</p> <p>Always read the label so you know exactly what products you are using and how much. Only take the recommended dose, and if you need to, write down the time you take each dose. Your pharmacist or doctor can also advise on the best medicine for your pain and fever and how to use the selected medicine safely.<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/207921/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/paracetamol-versus-ibuprofen-which-works-best-and-when-207921">original article</a>.</em></p>

Body

Placeholder Content Image

Film stars’ surprising jobs before they were famous

<p>Today, they’re Oscar-winners and household names, but before they were famous, these actors were just like us. From restaurant servers to professional jugglers, we take a look at the surprising jobs Hollywood’s most well-known names had before they hit the big time.</p> <ol> <li><strong>Whoopi Goldberg</strong> – Goldberg has had a couple of unexpected professions (including as a bricklayer), but perhaps her most bizarre was her stint as a morgue beautician – yep, she used to doll-up corpses for funerals!</li> <li><strong>Hugh Jackman</strong> – Before he was Wolverine, the beloved Aussie actor was known as “Mr. Jackman” – he was a P.E. teacher at Uppingham School while living in the UK during his post-high school gap year. Jackman also worked as a clown for hire at birthday parties!</li> <li><strong>Johnny Depp</strong> – Prior to becoming a screen star, Depp was a salesman of sorts! The actor sold personalised pens over the phone to “people who don't want you to call them.”</li> <li><strong>Rachel McAdams</strong> – <em>The Notebook</em> star, like many young people, got her start at Maccas. In fact, she worked at the fast food joint for three years, but told <a href="http://www.glamour.com/story/rachel-mcadams-glamour-magazine-cover-interview-ok-we-love-this-girl" target="_blank" rel="noopener"><em><strong>Glamour</strong></em></a> she “was not a great employee” but that it was “a great place to work”.</li> <li><strong>Helen Mirren</strong> – She may have played the Queen, but Mirren’s first job wasn’t exactly the most royal role in the world. As a child, she worked as a promoter for the Kursaal amusement park in the UK.</li> <li><strong>Harrison Ford</strong> – Before saving the world as Indiana Jones, Ford was just a regular tradie. Before hitting the big time, the actor was a carpenter. In fact, he was renowned as one of Los Angeles’ best cabinetmakers.</li> <li><strong>Jim Carrey</strong> – The Hollywood funnyman worked as a cleaner in a factory before finding fame as a comedic actor. He took up the janitorial job after quitting school at 15 to help provide for his financially struggling family.</li> <li><strong>George Clooney</strong> – Heartthrob Clooney had many jobs before becoming a successful actor, including as a door-to-door insurance salesman, tobacco cutter and ladies shoe store sales assistant.</li> <li><strong>Nicole Kidman</strong> – She’s one of Australia’s most well-known exports, but prior to breaking into the film industry, Kidman worked as a masseuse! She took up the job at 17 to support her mother, who had been diagnoses with breast cancer.</li> <li><strong>Christopher Walken</strong> – The acclaimed actor’s career almost went in a very different direction, after he took up the position of lion tamer in a travelling circus. “I used to go in and have this lion do tricks,” he told <em><a href="http://www.vanityfair.com/hollywood/2012/09/christopher-walken-seven-psychopaths-interview" target="_blank" rel="noopener"><strong>Vanity Fair</strong></a></em>. “It was a female named Sheba, and she was very sweet.”</li> </ol> <p><em>Images: Getty</em></p>

Movies

Placeholder Content Image

13 homemade weed killers that work

<p>Don’t want to use chemicals on your garden? You don't have to! Mix up these handy helpers in the kitchen.</p> <p><strong>1. Boiling water</strong></p> <p>Homemade treatments don’t come much cheaper than this. Put the kettle on, boil a pot of water and then pour it straight over the weeds – just make sure to avoid any surrounding plants. This works especially for small weed coming up through the cracks in pavement or in brickwork.</p> <p><strong>2. White vinegar</strong></p> <p>Is there anything white vinegar can’t do? You can use regular old kitchen vinegar or get the heavy duty stuff from gardening stores. Spray directly onto the leaves of the weeds and watch them fade away.</p> <p><strong>3. Salt</strong></p> <p>Another kitchen staple that can do double duty in the garden. You can either sprinkle rock salt or basic table salt directly around garden beds where weeds usually appear or create a 3:1 solution of water and salt to spray onto the leaves.</p> <p><strong>4. Salt &amp; vinegar</strong></p> <p>Combine the two and you’ll get even better results! Mix a cup of table salt with a litre of vinegar, then brush directly onto the leaves of the weeds. It’ll kill anything it touches, so avoid other plants.</p> <p><strong>5. Vegetable oil</strong></p> <p>For bulbous weeds, like onion weed and oxalis, you can inject vegetable oil into the ground surrounding the bulbs. The oil will coat the bulbs so they suffocate and will then rot into the soil.</p> <p><strong>6. Cornmeal</strong></p> <p>This won't kill existing weeds but is great for preventing them from sprouting in the first place. Cornmeal is a pre-emergent, meaning it stops seeds from growing, so it’s best for using around established plants.</p> <p><strong>7. Clove or citrus oil</strong></p> <p>Mix 15 to 20 drops of clove or citrus oil with a litre of water and spray or brush directly onto the leaves. This works best on small, actively growing seedlings rather than more established weeds.</p> <p><strong>8. Rubbing alcohol</strong></p> <p>Grab that bottle of rubbing alcohol out of the bathroom cabinet and mix two tablespoons with a litre of water. Pour it into a spray bottle and spray directly onto the weeds. The alcohol removes moisture so the weeds will quickly dry out and die.</p> <p><strong>9. Baking soda</strong></p> <p>Baking soda is sodium bicarbonate (essentially a salt), so increases the salinity of the ground to a point where the weeds cannot survive. Use around a teaspoon per weed to cover the entire plant, especially the stem. It’s also great for weeds in cracks.</p> <p><strong>10. Bleach</strong></p> <p>This one couldn’t be simpler. Pour undiluted bleach straight over the top of mature weeds at the hottest part of the day, then let the sun do its work. You should be able to pull the dead weeds out the next day. Plus the bleach stays in the soil and prevents new growth.</p> <p><strong>11. Newspaper</strong></p> <p>Rather than killing the weeds, you can smother them with leftover newspaper. Lay down at least four sheets (though the thicker the better) and the lack of sun means the weeds won’t be able to sprout.</p> <p><strong>12. Mulch</strong></p> <p>Another one from the smothering camp, a good layer of mulch will keep your soil moist, healthy and weed-free. It also blocks out the sunshine weeds need to grow while leaving the surrounding plants untouched.</p> <p><strong>Elbow grease</strong></p> <p>Ok, so this isn’t actually something you put on the weeds, but it’s all you really need to get rid of most of them. Roll up your sleeves, put on some gloves and get pulling. Make sure you get the roots so they don’t grow straight back.</p> <p><em>Image: Unsplash / Josue Michel</em></p>

Home & Garden

Placeholder Content Image

‘We lose ourselves’: carers talk about the lonely, stressful work of looking after loved ones

<p><em><a href="https://theconversation.com/profiles/fleur-sharafizad-1138251">Fleur Sharafizad</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>; <a href="https://theconversation.com/profiles/esme-franken-947855">Esme Franken</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>, and <a href="https://theconversation.com/profiles/uma-jogulu-1278812">Uma Jogulu</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>An informal personal carer is someone who looks after a family member, neighbour or friend in need of care due to disability, illness or age.</p> <p>In Australia, there are approximately 2.8 million informal personal carers, including 906,000 who are primary carers. Projections suggest the national demand for carers will <a href="https://www.carersaustralia.com.au/wp-content/uploads/2020/07/FINAL-Value-of-Informal-Care-22-May-2020_No-CIC.pdf">rise 23% by 2030</a>.</p> <p>Around one in ten Australians are informal carers: <a href="https://www.aihw.gov.au/reports/australias-welfare/informal-carers">most of these unpaid</a>. This group of people support one of society’s most foundational needs and our economy would struggle without them.</p> <p>Yet, little is understood about their experiences. <a href="https://bristoluniversitypressdigital.com/view/journals/ijcc/aop/article-10.1332-239788223X16789866214981/article-10.1332-239788223X16789866214981.xml">Our recent research</a> reveals how this group of carers lack necessary support for their own wellbeing.</p> <h2>Our research</h2> <p>We interviewed 36 informal personal primary carers living across Western Australia and Queensland. Respondents were aged between 34 and 69 years, and had all been the primary carer for a child, parent, partner, or in-law, for between two and 21 years. Data was collected in two waves: one in 2020 and the other in 2021. Respondents were recruited with the help of an Australian carers’ organisation.</p> <h2>‘I’d rather it be someone else’s problem’</h2> <p>Many of the carers we spoke to said they were not caring by choice, but by necessity. They said they feel both unseen and undervalued. A husband who had been caring for his wife who suffers from Alzheimer’s said: "I would rather work. I really don’t like being a carer. I’d rather it be someone else’s problem. Being a carer, you just get forgotten."</p> <p>Carers generally provide care around-the-clock, yet their compensations (such as <a href="https://www.servicesaustralia.gov.au/carer-payment">carer payments</a>) are far from equivalent to full-time pay. The carer payment, for example, equates to only <a href="https://www.carersaustralia.com.au/programs-projects/caring-costs-us/">28% of weekly ordinary time earnings</a> in Australia, and carers can expect to lose <a href="https://www.carersaustralia.com.au/carers-are-17700-worse-off-every-year-in-superannuation-payments/#:%7E:text=Caring%20Costs%20Us%3A%20The%20economic%20impact%20on%20lifetime,every%20year%20they%20are%20in%20that%20caring%20role.">approximately $17,700 in superannuation</a> every year they provide care.</p> <p>Few of <a href="https://www.carersaustralia.com.au/wp-content/uploads/2023/02/FINAL-Carers-Australia-2023-24-Jan-2023-Budget-Submission.pdf">Carers Australia’s pre-budget submission items</a> to benefit carers were adopted in the most recent federal budget. Instead, the budget contained items which may indirectly benefit carers through <a href="https://www.carersaustralia.com.au/wp-content/uploads/2023/05/2023-24-Budget-What-it-means-for-carers.pdf">increased support for the cared-for</a>. But these measures do not explicitly recognise and support carers’ wellbeing.</p> <p>Similarly, the recent draft of the <a href="https://www.pmc.gov.au/resources/draft-national-strategy-care-and-support-economy">National Strategy for the Care and Support Economy</a> recognises the contribution informal carers make to Australia’s economy but focuses on paid care and support.</p> <p>Our interviewees spoke about the personal costs of their work, and the stress and loneliness they experience. They shared feelings of being taken for granted as if their role was not work, let alone difficult work. </p> <p>One mum caring for her disabled son shared: "I just want people to see that, [a] carer doesn’t have any leave, paid leave, or recognition. People just think that’s your loved one, that’s your job. But I do want people to understand that I did not choose to be a carer as my career, but I will do it because it is important."</p> <p>This played into a feeling of people losing their sense of self, because caring work was so demanding and time consuming. A mother who had been caring for her daughter for 17 years after she had been involved in an accident said, "People don’t realise how much we put our life on hold to support the people that need that emotional and mental and physical and spiritual support. We put ourselves in the back shed while we’re supporting them, so we lose ourselves."</p> <h2>A mental toll</h2> <p>Many spoke of how they once had individual goals and ambitions, which they now considered unachievable. All of our interviewees had quit jobs and halted careers to take on personal care full-time. One mother caring for her ill child said: "I think if I had a crystal ball, I don’t know that I would perhaps have become a parent, I think I would have just stuck to my corporate life and had a cat and be done with it."</p> <p>The mental health toll experienced by carers in our study was clear throughout all interviews. A mother looking after her child with mental health challenges expressed: "Every carer has mental health impacts from being a carer. They won’t say it’s depression or anxiety, but it’s mental health because when the hierarchy of needs is not being met for you, you can’t provide them for somebody else."</p> <p>As one interviewee explained, the demanding nature of the work had left them exhausted and as though they “can’t do it”. Our interviewees spoke of “falling apart” under the strain of constantly caring for high-needs people in their households. </p> <p>One mother who cared for her children who were both on the autism spectrum recalled: "How many times, if I don’t go to the bathroom and have a shower to cool down myself, I could kill the kids and myself easily. That’s how bad. We are not ever in the category to get help."</p> <h2>Feeling abandoned</h2> <p>Because so much of their work happens in pre-existing relationships and behind closed doors, carers talked about not just feeling unseen but abandoned. A common theme across all interviews was how carers felt abandoned by institutions, health professionals and, in many cases, friends and family members. </p> <p>One husband who had cared for his wife for close to 20 years said: "The government doesn’t even care about the carers […] we’re not really getting anything and then they’re trying to take the crumbs off us."</p> <p>Carers do not have psychological, institutional or social support for themselves as individuals, separate from their role. But these support pillars are necessary so the entire responsibility of care does not fall solely on informal carers.</p> <p><a href="https://www.carersaustralia.com.au/wp-content/uploads/2023/02/FINAL-Carers-Australia-2023-24-Jan-2023-Budget-Submission.pdf">Carer-inclusive activities</a> could be a good start. But policy should also be responsive to the unique and unmet needs of carers. These relate to the lack of personal and professional development, feelings of abandonment and social isolation.</p> <p>With an ageing population, a pandemic, and an emerging crisis over the quality of care for older Australians and people with disabilities, the role of informal carers has become increasingly important.</p> <p>The truth is that most of us will likely, at some point, undertake care work or be the person being cared for. Better formalised support for carers will ultimately improve the care for the most vulnerable among us and society as a whole.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="http://lifeline.org.au/">Lifeline</a> on 13 11 14. </em></p> <p><em><a href="https://theconversation.com/profiles/fleur-sharafizad-1138251">Fleur Sharafizad</a>, Lecturer in Management, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>; <a href="https://theconversation.com/profiles/esme-franken-947855">Esme Franken</a>, Lecturer in Management, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>, and <a href="https://theconversation.com/profiles/uma-jogulu-1278812">Uma Jogulu</a>, Senior Lecturer, School of Business and Law, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-lose-ourselves-carers-talk-about-the-lonely-stressful-work-of-looking-after-loved-ones-206409">original article</a>.</em></p>

Caring

Placeholder Content Image

Everything you’ve always wanted to know about the inner workings of your cruise ship

<p dir="ltr">When it comes to life on board a cruise ship, travellers will usually look for features like great food options, fun shows, activities to keep busy, and a comfortable bed.</p> <p dir="ltr">What many don’t think about, however, is the thought and precision that goes into building and designing a cruise ship. </p> <p dir="ltr">Charlie, a cruise ship designer from Florida, has worked in the industry for over a decade and had a hand in helping put together the design for two huge cruise ships.</p> <p dir="ltr">Charlie said that the main mission is to make guests feel comfortable and safe by any means necessary. </p> <p dir="ltr">Speaking to <a href="https://travel.nine.com.au/cruising/cruise-ship-designer-what-travellers-should-know-exclusive/b1c6f650-cb17-408d-9b91-9c67282c54b5" target="_blank" rel="noopener">9Honey Travel</a>, Charlie said, "If you notice things, we're not doing our job correctly."</p> <p dir="ltr">"Our job is to make you feel at ease with the space."</p> <p dir="ltr">A cruise ship takes several years to design, with a lot of planning, care and thought going into the most intricate details. </p> <p dir="ltr">"Cruise ships are so large scale and that even though a lot of the designs are replicated from each room or ship, you have to ensure that the design fits each area and it's not just copy paste."</p> <p dir="ltr">There are four main things Charlie says to keep an eye out for on your next cruising adventure, which make all the difference to your journey.</p> <p dir="ltr"><strong>Safety first</strong></p> <p dir="ltr">Above all else on a cruise ship, the safety of the passengers and the crew must come first. </p> <p dir="ltr">Aside from the practical elements such as bullet-proof glass and lounges that have the potential to turn into flotation devices, there are psychological considerations as well.</p> <p dir="ltr">"Everything when it comes to cruise ship design comes from a safety standpoint, and how you make sure guests feel safe at all times," Charlie says.</p> <p dir="ltr">"Like the fact there's handrails almost everywhere you look. Down to whether the height of a table will be at a height where if you need to lean down, it's probably a little bit taller than the average table, just so that you have something to grab onto."</p> <p dir="ltr"><strong>Nothing moves unless it’s supposed to</strong></p> <p dir="ltr">Due to the constant movement on a cruise ship, everything onboard the vessel must be secured, which can make design aspects difficult. </p> <p dir="ltr">"You have to keep in mind how things function within a space. So if you go to a restaurant, you can't join tables, or move tables because they're literally secured to the floor.</p> <p dir="ltr">"And it's one of those things where it actually becomes very difficult in planning. The lighting plan, for example, also has to incorporate that because the lights overhead can't move. So your interior designers and your lighting designers have to be working together probably at least three to four years before you would actually install any of those."</p> <p dir="ltr">So you're less likely to see things like pendant lights, unless they are on a rod fixed to the ceiling.</p> <p dir="ltr">"You don't want to have that ability to see something in motion, because then that gives you the idea that you aren't safe," Charlie adds.</p> <p dir="ltr"><strong>Quick repairs are a rarity </strong></p> <p dir="ltr">Charlie shared that longevity needs to be considered when designing a cruise ship, as repairs can often take a long time to complete. </p> <p dir="ltr">"What's the lifespan and what's the duration of time it would take for someone to repair it. And are you able to store that stuff on a ship?</p> <p dir="ltr">"Nothing is off the shelf. Nothing is just 'oh, I can go to the store and get that'. A manufacturer would produce that specifically for them. So if something does break, getting it replaced is going to be a lot more difficult.”</p> <p dir="ltr"><strong>Long hallways are a big no</strong></p> <p dir="ltr">"Guest flow and how people move through a space is very key," Charlie points out.</p> <p dir="ltr">"In most modern day ships, you wouldn't directly have a linear path except down your guest room hallway. Nowadays, you'd have little jogs (or alcoves) so that you can't just see all the way to the end of a floor.”</p> <p dir="ltr">And the reasoning for this design choice is two-fold.</p> <p dir="ltr">"Being able to have an end point or something to focus on helps to establish equilibrium. You have something to focus on if the ship starts to move a little bit," he explains.</p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

Cruising

Placeholder Content Image

Expert reveals why working parents are really parting ways

<p dir="ltr">Dennis R Vetrano Jr, a divorce lawyer who regularly provides insight into the secrets of his industry on social media, has revealed the major theme he has identified when it comes to working parents ending their relationships. </p> <p dir="ltr">In one of his TikTok videos, which has been viewed over 4.7 million times since its release, the US-based lawyer opens by asking, “do you want to know the major theme that I’m seeing in the divorce industry, as a divorce lawyer, as I do consults these days?"</p> <p dir="ltr">The answer, it turns out, is quite simple: “women are tired”. </p> <p dir="ltr">“I am seeing working mums do it all, and I am seeing the husbands step back and say ‘huh, I don’t gotta do a thing!’,” Dennis explained. </p> <p dir="ltr">“She’s got the kids, she’s got the groceries, she’s got the laundry, she’s got the meals, she’s got the work. And by the way, she’s making all the money and she’s paying for the house, and doing everything else. </p> <p dir="ltr">“‘I’m going to go to the firehouse, I’m going to go play this, I’m going to go hang out with my friends.’ That’s the theme. </p> <p dir="ltr">“And women are tired.”</p> <p dir="ltr">Dennis’ video drew in over 10,000 comments, many from women who couldn’t agree more with what he’d said, sharing their own stories and experiences with each other. </p> <p dir="ltr">“And the younger generation of women are choosing not to marry, they have grown up watching their mums struggle and refuse to let that happen to them,” one wrote. </p> <p dir="ltr">“This is why I got divorced,” another shared, to over 15.3 likes. “He then accused me of cheating! When would I have time? I don’t even sit on the couch”.</p> <p dir="ltr">“WAY less stressed since divorce. And I get nights to myself!!!” one woman said. </p> <p dir="ltr">“We aren’t just tired. We are sick and tired,” one corrected.</p> <p dir="ltr">“We get sick of the mental load,” another viewer agreed. “Having to give instructions on everything. It's exhausting.” </p> <p dir="ltr">“I'm a stay at home mom to 5 and my husband legit told me today ‘I don't go to his job and help him’. It changed something in me tonight,” one revealed. </p> <p dir="ltr">Another had something else to add to the discussion, noting that while she agreed “100%”, Dennis had forgotten “to say that the husband’s ‘super power’ was his ability to critique meals, housework, fashion, body image etc!”</p> <p dir="ltr"><em>Images: TikTok</em></p>

Relationships

Placeholder Content Image

I’ve worked at an all-inclusive resort for 10 years – these are 19 mistakes every traveller should avoid

<p><strong>All-inclusive resort tips for the best trip ever</strong></p> <p>Heading to an inclusive resort is the best of both worlds: you get to go on an amazing holiday while someone else takes care of all the little details. But how do all those little details work, exactly? And how can you, as the guest, have an epic experience? As an entertainment director for more than a decade, I’ve gotten an insider look into nearly every aspect of these types of hotels, which means I know a few things that you’ll definitely want to know. My job may sound like a 24/7 party, but it’s a lot of work too. I joke that my ‘nightlife’ fills my entire day. But my lack of work-life balance is your gain, since my experience translates into all-inclusive resort tips that will help you have a blast and give you the most bang for your buck. Because let’s be honest, if you’re going to an all-inclusive resort, you’re spending a lot of money – and you deserve to get what you’re paying for.</p> <p>Over the years, I’ve seen thousands of guests, and there are some common mistakes people make – from the type of package they book to what they do (and don’t do) when staying at an all-inclusive. So memorise this advice because it can help you have the best holiday of your life.</p> <p><strong>Thinking that 'all-inclusive' means everything is included</strong></p> <p>Despite the title of ‘all-inclusive,’ most all-inclusive resorts don’t include everything. While the specifics will vary depending on the resort, your membership status and the package you booked, common exclusions include transportation to and from the airport, spa treatments, premium alcohol and Wi-Fi in your room (although it’s generally provided for free in common areas). Other amenities may be partially included. For instance, water sports may be included in your rate, but you might have to pay extra to rent motorised equipment like jet skis. While you’ll be told about extra charges when booking a service or activity, if you’re not really paying attention, you could end up with quite the surprise when you see the final bill at the end of your stay. This is also true of all-inclusive cruises.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: read the fine print of your package before you arrive (and ideally before you book), and be sure to ask staff if you’re unsure whether something’s included. You could easily add an extra 10 per cent or more to your bill if you don’t. You should also always ask whether resort fees – which can range from $25 to $100 a day, depending on the company – are included.</p> <p><strong>Not researching the resort before you go</strong></p> <p>Even within the same chain, every all-inclusive resort is different – from the culture and dining to the amenities and excursions – and the time to discover those differences is not the day you get there. Knowing what to expect can help you have a better experience, since you’ll know what you want to do and can jump on reservations quickly, as well as know what to pack for the weather and available activities. It’s also an important part of managing your expectations. Sometimes we have guests show up expecting everything under the sun and then are disappointed when all their expectations aren’t met – things they would have realised if they’d researched the resort first.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: Take an hour or so to check out the resources on the resort’s website, and go to online forums for that resort so you know what the can’t-miss things are. Come prepared with a list of activities, foods, cultural experiences and shows that you’re most excited about. Upon checking in, you can also talk to the concierge, entertainment director or other employees for their personal recommendations and for help making reservations.</p> <p><strong>Overtipping or undertipping</strong></p> <p>Tipping etiquette can be confusing no matter where you are, and the rules are different at all-inclusive resorts. One of the selling points of an all-inclusive resort is that gratuities are usually included in the package. But while this means guests aren’t expected to tip for regular services like housekeeping or dining, guests may still choose to tip for exceptional service or for special requests, such as having an item ordered online and delivered to them. Plus, certain ‘extra’ services – like spa treatments, deluxe excursions or butler service – may not be included in the all-inclusive package, which means that a tip wouldn’t be included either.</p> <p>In addition, tipping culture at resorts has changed since the pandemic, and even though tips for normal services aren’t required, in some countries and some resorts (for instance, in Mexico), they are now expected – even if it isn’t explicitly stated. That isn’t true everywhere, of course. In certain countries, tipping isn’t the norm. For example, in Japan, you shouldn’t tip at all at an all-inclusive resort.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: read the details of your package to understand which services are included and which require an additional tip. Bring $100 to $200 in cash for tipping, and ask the concierge upon arriving what is generally expected and appropriate. Some resort employees, especially those in poorer countries, depend on these tips to make a living wage, so while you may not have to tip them, it’s still the kind thing to do.</p> <p><strong>Overindulging in food and drinks</strong></p> <p>Just because you can eat a kilo of crab legs and a litre of ice cream, it doesn’t mean you should. (And yes, I saw someone do that!) Since most, if not all, food and drinks are included, some guests feel that the way to get their money’s worth is to overeat or drink to the point of inebriation. Unfortunately, I’ve seen guests stuck in bed for an entire day or two after a binge, making them miss out on all the other fun things.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: feel free to indulge, but be moderate in how much you eat and drink at once. Remember, it’s about enjoying the overall experience, and that’s about having fun while doing things you couldn’t do at home.</p> <p><strong>Staying at the resort the whole time</strong></p> <p>While you certainly can stay in your room and enjoy the peace and quiet, the draw of an all-inclusive resort is that it offers far more than just a place to relax. Yet you’d be surprised at how many guests don’t take advantage of all the resort and the surrounding area have to offer. Most resorts are in locations known for their beauty, culture, weather and opportunities for adventure, and it would be a mistake to not even check it all out.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: this is the perfect opportunity to get out of your comfort zone and try something new, whether that’s eating a local delicacy or going on a guided tour through ancient ruins. You might even make some new friends along the way. It’s exactly these types of things that will make your holiday fun and memorable.</p> <p><strong>Sticking to the standard buffet</strong></p> <p>We work hard to provide delicious, one-of-a-kind dining experiences that reflect the culture and flavours of the locale. This isn’t just about offering local delicacies; it may also include a special cooking method, watching the chef prepare your food, seeing where the food comes from or allowing you to participate in the dining experience in a unique way. Filling up on hamburgers and fries is fine, but the food is a big part of what you are paying for.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: look up the resort’s dining options in advance, and pick out a few adventures to try. Most resorts offer a chef’s tasting menu that encompasses the local cuisine – for example, in Bali, you can watch your fish caught fresh and then cooked on a traditional grill.</p> <p>Ask the chef or entertainment director for their suggestions for what’s best at the moment. And book your reservations as early as possible.</p> <p><strong>Not making a connection with the staff</strong></p> <p>Many guests are repeat visitors at specific resorts, and staff develop relationships with their favourites and will go out of their way to make sure you have everything you want and need. They might even provide little extras for free, like treats, drinks or early-access passes to shows. The employees are also an incredible resource for what to try in the surrounding areas, what you need to know about local cultural norms, how to prepare for certain excursions and other site-specific tips. But they can only do that if you’ve already built a good relationship with them.</p> <p>Even if you’ll only ever be at the resort once, a little kindness goes a long way with all the staff, ensuring that your stay is pleasant and that you feel taken care of. Honestly, a kind guest will find themselves being treated like a king or queen, so this is one of the all-inclusive resort tips that you really don’t want to skip!</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: start by acknowledging staff with a smile, remembering their names and asking how they are. Do not be rude to staff, even if you’re upset; you’re much more likely to get help when you’re kind and calm. Ask questions about the area or the resort – they are a wealth of insider information – but steer clear of overly personal questions that could come off as creepy. For instance, do not hit on the staff, ask where they live or for their private phone numbers. If you want to keep in touch, they can give you their company email address.</p> <p><strong>Being glued to your phone</strong></p> <p>I’ve seen too many people miss out on the joy of the moment because their eyes are constantly on their phone. You’re on holidays for a reason – to get a break from daily life – so let this be a magical experience. Take in the beauty of the surrounding nature, watch your children play, have a cocktail with your spouse, check out a performance, go dancing at the nightclub.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: use your phone to snap a few pictures or videos for memories, but otherwise try to keep your tech use to a minimum so you can be fully present. (Plus, you’ll avoid a lot of frustration, since internet service may be spotty and limited to certain areas.)</p> <p><strong>Not getting traveller's insurance</strong></p> <p>When it comes to holidays, you have to plan for the unexpected, and that includes making sure you have adequate insurance coverage and knowing how to access it. Insurance coverage depends on where you are and what you’re doing, but expect the resort’s insurance to cover only things under their direct control, such as mechanical malfunctions, equipment failures, schedule changes and cancellations. It generally won’t cover weather-related disasters, personal medical emergencies, accidents, injuries, flight cancellations and other things that could seriously mess up your trip (and your budget) if you’re not prepared.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: consider buying separate travel insurance for the trip, and read through it carefully so you know what’s covered. You will most likely be offered travel insurance as an extra when booking, either through a travel agent or directly through the resort. You can also purchase travel insurance as a rider to other insurance policies, like a homeowner’s policy, and many credit cards offer travel insurance as a perk when you pay for the trip with that card. Also make sure to check with your personal medical insurance about what they cover while you are away, especially if you are out of the country.</p> <p><strong>Dressing too casually</strong></p> <p>You’re on holidays at an all-inclusive resort in Hawaii, so it’s swimsuits and flip-flops 24/7, right? While that is true for some areas of the resort, many all-inclusive resorts have upscale dining and shows that require, at the very least, trousers or a sundress and real shoes. You will be turned away if you don’t meet that dress code.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: read up on the dress code before you start packing, and make sure to bring at least one outfit that goes beyond beachwear on your packing list. A pair of khakis or trousers and a collared shirt will likely suffice for men, while women should bring a dress (beyond the all-cotton beach cover-up) or nice pants and a blouse. Some resorts have formal nights where suits and formal dresses are required. And don’t forget to pack a pair of dress shoes!</p> <p><strong>Ignoring safety guidelines </strong></p> <p>Some guests think weather advisories, public-health mandates (like masks), staying out of roped-off areas, only swimming in designated spots, wearing life jackets and other safety rules are for everyone else but not them. But our safety guidelines aren’t there to mess up your fun – they are to keep you safe so you can have more fun. Ignoring these guidelines can put you in danger and ruin your holiday.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: follow the rules, and avoid endangering yourself or others. This is true even if you ‘already know how’ to do an activity (like snorkelling or skiing). Guests ignoring the rules have been caught in dangerous riptides, attacked by wildlife, taken jaw-dropping falls or been stranded on land that suddenly turns into an island when the tide comes in.</p> <p><strong>Getting dehydrated </strong></p> <p>Too many tropical holidays have been ruined by heat stroke! You have delicious beverages (both alcoholic and regular treats) at your fingertips, so it’s understandable that you might forget to drink enough water – something that can be compounded by being outdoors more than usual, forgetting sun protection like hats or umbrellas, and loading up on salty snacks. But getting dehydrated can make you feel tired and irritable at best, or gravely ill at worst. This is especially important if you are travelling to a climate that is significantly hotter or drier than you’re used to.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: balance out each alcoholic or sugary drink with a glass of water. Take a reusable water bottle and a sun hat with you on excursions, and be on the lookout for signs of dehydration like exhaustion, being overly sweaty or unable to sweat, becoming very red in the face or very pale, disorientation, muscle cramps and weakness.</p> <p><strong>Not consulting the schedule </strong></p> <p>Not only does the resorts daily tell you when things are happening – it’s also a great way to see what is happening. Even if you did some research ahead of time, it’s not uncommon for a resort to add even more shows, excursions or dining experiences. Some are first-come, first-serve, while others require an advance reservation. Certain activities, like a riverboat tour through the city, will always be popular and can be fully booked by the time breakfast is over. Be sure to note events that happen only once during your stay – like a special show performance – and prioritise booking those first.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: download the resort app, and check it daily, first thing in the morning. It’s a goldmine of information. It usually has schedules, tips, previews and menus, and many resorts offer special events or deals through it too. You can also check the flyer that lists the day’s schedules, posted in common areas, or the informational binder in your room. In general, travel apps can make your trip better in so many ways.</p> <p><strong>Forgetting medications or vaccinations</strong></p> <p>Resorts usually have doctors or medical staff onsite, but they’re there to handle normal vacation maladies or emergencies. You can’t expect them to have a supply of your prescription medication on hand, nor can they manage any chronic illnesses. Also be aware that some resorts have vaccine mandates, and for the vaccine to fully take effect, you need to get it some time before you arrive. For instance, a series of two typhoid vaccines are required for most countries in South Asia, and the vaccinations need to be completed at least one week before your arrival.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: check out the medical section of the resort’s website or app, and make sure to pack anything you need for your health – and pack it in your carry-on. As a precaution, in case you lose your medication, have your doctor email you an electronic copy of your prescription. If you have a chronic health condition, talk with your doctor before leaving about how to manage it on holidays.</p> <p><strong>Booking the first resort package you find </strong></p> <p>All-inclusive resorts are more expensive than regular resorts because they take the headache out of planning every detail of your vacation. However, that means you need to be extra careful in how you select the resort, the package and your membership level (if applicable). If you’re on a budget and you don’t comparison shop, you might end up paying more than you’d like because what you want isn’t included.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: book through a travel agent, they often have access to exclusive deals and know the ins and outs of different resort packages. Also try to book as early as possible. While there are good deals to be had at the last minute, you’re more likely to get what you want for a good price by booking early; many places offer discounts or promotions for early bookings.</p> <p><strong>Forgetting sunscreen</strong></p> <p>You know what will really ruin a romantic holiday or a girls’ weekend getaway? A blistering sunburn. One common issue: women (or men in Speedos) who neglect to put waterproof sunscreen on their bottoms where their suit doesn’t cover when snorkelling. Sunburns gotten over a day of swimming in the ocean – the sun not only beats down from above but is also reflected up from the surface – can be incredibly painful and may make sitting and sleeping miserable.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: bring sunscreen, and check to make sure it’s reef-safe if you’re going to be swimming in an ocean. Also bring insect repellents (and use them regularly). If you forget yours, definitely ask the staff, as the resort will likely have some on hand, or you can make a quick trip to town to pick up what you need.</p> <p><strong>Not using your points or miles</strong></p> <p>Perks at all-inclusive resorts are a common benefit of many credit card, airline, hotel, corporate or other rewards programs. You can get free upgrades, extra nights, bonus excursions, transportation and other fun freebies. But they only work if you remember to use them. If you’re not prompted to enter the info when booking, be sure to ask customer service to make sure they’ve got your membership details on file.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: know what your perks are and how to use them, especially since many must be activated before arrival. If you’re using a credit card to book the trip, the perks should be activated automatically at the time of booking (but check your account to make sure). If you’re using a corporate reward or hotel loyalty program, look up the details before booking. You will likely need to book through their site or provide a membership number during the booking process.</p> <p>If you arrive and notice that you didn’t receive the extras you signed up for, talk to the concierge to see if they are on file with your reservation. If not, you’ll need to contact customer service for the rewards company. Combining points is one of the top tips for how to travel for free.</p> <p><strong>Expecting the staff to babysit your kids</strong></p> <p>All-inclusive family resorts exist so that families with kids of all ages can holiday together … and also have some time apart. Many resorts offer childcare and/or classes for kids, but make sure you know the rules (like age restrictions) and the times they’re offered. Please know that just because something is labelled as a ‘family’ and ‘all-inclusive’ resort, it doesn’t mean that any staff member will watch your kids or that babysitting is available at all hours.</p> <p><span style="text-decoration: underline;"><em>Do this instead</em></span>: read all the details about what services and activities are offered for babies, young children, older kids and teens. Do not leave kids unattended, even in children’s areas, unless it is specified that they are being supervised by staff there. Bring your own baby monitor, as they generally aren’t provided, but do not leave young children alone in hotel rooms.</p> <p><strong>Not taking advantage of room service</strong></p> <p>You might skip room service at a normal hotel because of the price, but room service is one of the areas where all-inclusive resorts really shine. At most resorts, you can order anything off the menu 24/7 and have it delivered to your room for no extra charge. (Some items or services may incur an extra fee, like special meals, off-hours delivery or alcohol.) This is a huge bonus for families with young kids or people who like to have breakfast in bed.</p> <p><span style="text-decoration: underline;"><em>What to do instead</em></span>: check with the resort before arrival, since what’s included in room service varies. One etiquette-based resort tip, though: while tipping isn’t necessary, if you do order room service in the middle of the night, consider tipping the staff a few dollars when they bring it.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/travel/ive-worked-at-an-all-inclusive-resort-for-10-years-these-are-19-mistakes-every-traveller-should-avoid?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.</em> </p>

Travel Tips

Placeholder Content Image

3 sales tactics rife in the real estate industry, and why they work

<p>Buying a home is likely to be the biggest financial transaction you will ever make, and you’re at a distinct disadvantage. You’re an amateur up against professionals – real estate agents – versed in psychological tricks to get you excited about owning a property and paying more than you planned.</p> <p>These tricks start with comparatively simple things such as making rooms look bigger in adverts by using a wide-angle photography. They extend all the way to the point of sale. </p> <p>None of these tactics necessarily involve outright lying – there are laws against false and misleading conduct. But they are manipulative, exploiting the fact that humans are emotional beings with many “cognitive biases” – a perception of reality that is more emotional ratther than rational.</p> <p>The three most common tactics come down to manipulating your confidence in your own decisions. Close to <a href="https://www.worldscientific.com/doi/abs/10.1142/S0217590816500156">80 studies</a> suggest overconfidence is one of the most significant cognitive biases influencing behaviour in the real estate market.</p> <h2>1. Underquote, entice the bargain hunters</h2> <p>You see a property in your price range that’s everything you want. You call the agent, inspect the property, then prepare for the auction. It sells for $200,000 more. </p> <p>Underquoting involves deliberately advertising a property significantly lower than its likely sales price. While the prevalence of the practice is disputed, with industry representatives saying most agents do the right thing, <a href="https://www.theage.com.au/property/news/new-3-8-million-crackdown-on-underquoting-by-victorian-real-estate-agents-20220914-p5bhzq.html">anecdotal evidence</a>points to underquoting being very common. </p> <p>Underquoting is effective because it attracts more interested buyers and increases the number and intensity of bidding. It exploits two of the most ubiquitous cognitive biases – herd behaviour and irrational exuberance. </p> <p>More interest doesn’t just increase competition. A real estate agent will communicate that interest to us, confirming our desire in the property is justified. </p> <p>This tendency to “follow the herd” and imitate others, as US economist Robert Shiller noted in an influential <a href="https://www.jstor.org/stable/2117915">1995 paper</a>, is built on the assumption others have information that justifies their actions. </p> <p>This helps explain pretty much every stockmarket bubble since <a href="https://theconversation.com/tulip-mania-the-classic-story-of-a-dutch-financial-bubble-is-mostly-wrong-91413">tulipmania in the 17th century</a>, including the <a href="https://lsecentralbanking.medium.com/how-did-herd-behaviour-contribute-to-the-global-financial-crisis-3b0024a4755e">Global Financial Crisis of 2007-8</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S1544612318303647">speculation on cryptocurrency</a>. We are emotionally swayed by the decisions of others, assuming their decisions are rational, even when they are not. This is fertile ground for our own decisions to be manipulated.</p> <h2>2. Hide reality, inflate expectations</h2> <p>Real estate agents will generally favour auctions to extract the <a href="https://www.domain.com.au/news/selling-at-auction-in-melbourne-earns-vendors-tens-of-thousands-in-extra-cash-1072565/">maximum sales price</a>, for the reasons outlined above and the prospect of <a href="https://www.researchgate.net/publication/220505543_Understanding_auction_fever_A_framework_for_emotional_bidding">auction fever</a> – when carefully decided limits are forgotten in the thrill of the moment. </p> <p>But that’s not always the case. In a soft market with few buyers, agents may instead opt for a private sale, sometimes called a “<a href="https://attwoodmarshall.com.au/the-silent-auction/">silent auction</a>”. The goal here is to cause you to overestimate the degree of competition and thus make a bigger offer.</p> <p>An agent might assist this perception by instead supplying you with information from previous public auctions of similar properties more favourable to their preferred narrative.</p> <p>The value of hiding information also explains why you may come across so many sold listings with <a href="https://www.smh.com.au/property/news/should-you-be-able-to-know-how-much-your-neighbours-sold-their-house-for-20220223-p59z2t.html">labels</a> such as “price not disclosed” or “price withheld.” The reason for this may well be that the property sold for less than hoped.</p> <p>Hiding information the agent doesn’t want you to think about depends principally on exploiting our cognitive bias towards <a href="https://www.sciencedirect.com/topics/psychology/overconfidence">overconfidence</a> – assuming we are smarter, more knowledgeable or better skilled than we actually are.</p> <p>In lieu of that negative information, you are more likely to focus on the available information – particularly if it suits what you want to believe.</p> <h2>3. Talk up nominal gains</h2> <p>You may have heard the <a href="https://www.smh.com.au/property/news/do-house-prices-really-double-every-10-years-20211203-p59eif.html">old saying</a> that property values double every 10 years. Stressing what a property is likely to be worth in a decade <a href="https://www.realestate.com.au/news/suburbs-you-shouldve-bought-a-home-in-10-years-ago-and-how-much-your-area-has-grown/">based on what it was worth a decade ago</a> can be a powerful motivator to bid more.</p> <p>As Robert Shiller noted in his 2013 book <a href="https://press.princeton.edu/books/paperback/9780691156323/the-subprime-solution">The Subprime Solution</a> (about the property-buying mania that led to the Global Financial Crisis), homes are such significant investments that we tend to recall their prices from the distant past (unlike, say, like a loaf of bread or bottle of milk).</p> <p>This tendency results in an unconscious focus on nominal values rather than <a href="https://www.fool.com/investing/general/2012/04/12/the-illusion-of-housing-as-a-great-investment.aspx">real (inflation-adjusted) values</a>. This cognitive bias is known as the <a href="https://www.emerald.com/insight/content/doi/10.1108/14635789810212931/full/html">money illusion</a>, a mental miscalculation that may increase your willingness to pay more for the property. </p> <h2>In conclusion…</h2> <p>There’s a case for laws to <a href="https://www.realestate.com.au/news/push-to-end-home-sale-price-confusion-in-victorian-property-industry-review/">increase transparency</a> and the accuracy of information available in the real estate market. </p> <p>But in the meantime, if you’re buying a home, it’s wise to acknowledge your limitations. Do your homework, seek out independent advice and even consider hiring a professional advocate with the knowledge and experience to balance emotional and rational thoughts.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/3-sales-tactics-rife-in-the-real-estate-industry-and-why-they-work-202960" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Real Estate