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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”. As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”. We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out. Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise. <h2>How does it work?</h2> Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better. GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars. GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating. <iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe> GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action. Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more. GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection. <h2>What can users expect? What does the research say?</h2> Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly). A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs. Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up. Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>. Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up. <h2>Who is eligible for semaglutide?</h2> Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes. However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use. The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia. When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications. <h2>What else do you need to do during Ozempic treatment?</h2> Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials. Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week. STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling. A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>. <h2>But what are the side effects?</h2> Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain. In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos. More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions. To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term. Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.

Body

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

It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast. Give meditation a try 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. 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. Stop wanting to fall asleep 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. 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. Start a journal 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. 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. Find yourself a "3am friend" 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. 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. Take a warm shower 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. (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. Stretch yourself to sleep 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. 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. Read (or listen!) to something new 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. 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. Image credits: Getty Images This article by Deepak Kashyap 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>.

Body

Announcing Kate Middleton’s cancer diagnosis should have been simple. But the palace let it get out of hand

<a href="https://theconversation.com/profiles/victoria-fielding-236389">Victoria Fielding</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/saira-ali-1522239">Saira Ali</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> The British royal family is famous for its carefully curated media image. That’s why it was a surprise to see them lose control of the narrative in the wake of what we now know is a serious health crisis befalling Catherine, Princess of Wales (or Kate Middleton as she’s popularly known). It is clear the nearly 1,000-year-old institution of the monarchy and its tradition of “<a href="https://news.northeastern.edu/2024/03/14/kate-middleton-photo-pr-crisis/">never complain, never explain</a>” is being tested by social media and its power to spread rumours and misinformation. The palace’s public relations team has underestimated how difficult it is to manage relationships with social media audiences. Their reactive attempts to rein in speculation has turned Catherine’s health challenge into a PR disaster. Social media, with its lax regulations and freer environment, offers a more open forum for users to say whatever they like about the royals. It’s served as a hotbed for Catherine conspiracies, particularly on TikTok. These theories are as wild as they are ridiculous, from Catherine being a prisoner in the palace to her hiding in <a href="https://www.prdaily.com/kate-middleton-stanley-alabama-retail/">Taylor Swift’s London home</a>. What should have been a simple announcement to a sympathetic public about a popular royal having cancer turned into a spider’s web of competing conspiracy theories across social media. How did it all go so terribly wrong? <h2>I’ve lost track, what happened?</h2> All was well with the Prince and Princess of Wales when they were filmed attending church on Christmas Day. As usual when royals are out in public, the scene was picture perfect with everyone dutifully smiling for the cameras in “<a href="https://www.harpersbazaar.com/celebrity/latest/a46227698/kate-middleton-royal-blue-christmas-day-church-service-prince-william-kids/">co-ordinated</a>” outfits. Two weeks later, Kensington Palace announced Catherine had undergone planned abdominal surgery, with <a href="https://abcnews.go.com/GMA/Culture/princess-kate-hospitalized-after-planned-abdominal-surgery-palace/story?id=106441561">palace sources</a> telling media the surgery had been “successful” and she would need two weeks to recover. On January 29, the palace announced Catherine had returned home to recuperate. <a href="https://www.townandcountrymag.com/society/tradition/a46569739/king-charles-discharged-from-hospital/">Unlike King Charles</a> when he released news of his cancer diagnosis on February 5, Catherine was not photographed leaving hospital. This was the first PR misstep. She had appeared outside hospital soon after giving birth to her three children, but this time she remained uncharacteristically out of the public eye. Almost a month later, when Prince William <a href="https://au.lifestyle.yahoo.com/prince-william-pulls-memorial-godfather-211406977.html?amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAG6tOzuXsqZXP6G2nLLd-lnWzZhYKHVJ5TJ-w5XCCfgMjerRrR8v1R8unjtcoQTbvPDsVt3mtTcZ_g0os6zwOuEFfMKCh0kfEExvz-dB2FG0uqcy6-GoryjvG99TEhMli66hNZLjLENmMhq1mwoV7GmM0AYezMDsZtZVtONH9C1b&guccounter=2">unexpectedly withdrew</a> from his godfather’s memorial citing “personal reasons”, social media users started asking “Where is Princess Kate?”. Used to a steady stream of content about the royal family, the public were unsurprisingly questioning if there was more to Catherine’s abdominal surgery than they were being told. In a rare reactive move, the palace tried to quell questions about Catherine’s whereabouts by releasing a <a href="https://people.com/palace-responds-kate-middleton-conspiracy-theories-online-surgery-recovery-rare-statement-8602191">statement</a> reiterating that she would not be returning to public duties until Easter. On March 4, US outlet <a href="https://www.tmz.com/2024/03/04/kate-middleton-seen-spotted-public-first-time-mystery-hospitalization/">TMZ published</a> a paparazzi photo of Catherine driving with her mother. Social media audiences asked if it really was Catherine. Over the next week, conspiracy theories about Catherine’s absence reached frenzied levels. To show everything was fine, Kensington Palace released a <a href="https://twitter.com/KensingtonRoyal/status/1766750995445387393?s=20">Mother’s Day photo</a> of Catherine and her children on their social media accounts. Social media users spotted apparently edited flaws and global news agencies announced “<a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">kill orders</a>”, saying the image had been manipulated. The next day, Catherine <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised</a> on social media for editing the photo. Although royals have been <a href="https://www.townandcountrymag.com/society/tradition/a60191061/royal-photoshop-history/">editing their pictures</a> for centuries, it seems particularly digitally naive of the palace’s PR team to release such an obviously edited image into an already cynical social media environment, creating fodder for more conspiracy theories. Mainstream news outlets then joined social media users in asking questions about Catherine’s absence. Although this media attention did not legitimise wild conspiracies, in some ways it fuelled them. Days later, TMZ <a href="https://www.youtube.com/watch?v=erWJNmbrECs">published footage</a> of Catherine and William shopping. At this point in the media chaos, many social media users claimed it was fake. This intense public speculation finally ended on March 23, when Catherine <a href="https://twitter.com/KensingtonRoyal/status/1771235267837321694?s=20">released a video</a> explaining her extended absence after abdominal surgery was caused by the surgeons discovering cancer. During a crisis, the public crave transparency, authenticity, honesty and reassurance. These elements were missing in the royal PR team’s carefully worded statements made directly to mainstream media along with reactive, overly curated social media posts. By providing scant details, the palace seemed to believe they could control public perception. But public image is increasingly difficult to control. <h2>The double-edged sword of social media</h2> After Princess Diana’s death in a paparazzi-chase car accident, privacy laws and <a href="https://time.com/4914324/princess-diana-anniversary-paparazzi-tabloid-media/">media regulations</a> forbade the most invasive breaches of the royal family’s privacy, particularly for her children, princes William and Harry. However, tabloid appetite for uncontrolled access soon returned once the princes became adults. Recently, Harry and his wife Meghan have been involved in <a href="https://www.reuters.com/world/uk/prince-harry-his-many-lawsuits-against-press-2023-12-15/">several lawsuits</a> against media companies over breaches of privacy, including phone hacking. The rise of social media has typically been viewed as a tool that gives royals more control over their image through the curation of their own personal content. Previously, the fact Catherine was the one <a href="https://www.businessinsider.com/kate-middleton-cutest-family-photos-2018-5">taking photos</a> of her children was seen as a sign of authenticity and being down to earth (as much as a princess could be). Yet, social media is both a blessing and a curse for the management of public reputations. The perpetuation of contested facts and theories on social media in the wake of Princess Catherine’s unexplained absence shows how difficult it is to curate a controlled image using social media. Lack of verified information in mainstream media helps fuel speculative flames. While <a href="https://www.thedrum.com/news/2024/03/22/where-the-palace-lost-the-plot-and-what-we-can-learn-about-pr-and-empathy-kategate">PR experts</a> believe it is understandable and appropriate for Catherine and her family to have privacy during this time, more timely, direct and honest communication would have gone a long way to prevent relentless gossip. Once rumours and conspiracies gained momentum, the palace perhaps thought the less information provided, the better. However, silence during a crisis just fuels more speculation because the lack of information makes it look like there is something to hide. Catherine’s personal video announcing her cancer diagnosis helped end the social media frenzy. This shows a simple, clear statement posted by Kensington Palace to social media weeks ago would likely have avoided the PR disaster and provided Catherine the privacy she so clearly needs. The palace is now <a href="https://www.sheknows.com/entertainment/articles/2986509/kate-middleton-cancer-pr-disaster/">being criticised</a> for complicating a situation that was relatively simple in retrospect. Many social media users are also upset Catherine took public blame for the photoshopping incident. Any organisation that deals with the media to maintain positive reputations, including the British monarchy, has no choice but to adapt to all kinds of media, including social media. The long-time practice of keeping calm and carrying on amid controversy and the 24-hour gossip cycle doesn’t work in the era of TikTok, X and YouTube. In the absence of trusted information, social media will do what it does best: take mostly innocuous online chatter and amplify it until it goes viral.<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/226490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/victoria-fielding-236389">Victoria Fielding</a>, Lecturer, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/saira-ali-1522239">Saira Ali</a>, Senior Lecturer in Media, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/announcing-kate-middletons-cancer-diagnosis-should-have-been-simple-but-the-palace-let-it-get-out-of-hand-226490">original article</a>.

Caring

Only walking for exercise? Here’s how to get the most out of it

<a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> We’re living longer than in previous generations, with <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile">one in eight</a> elderly Australians now aged over 85. But the current <a href="https://pubmed.ncbi.nlm.nih.gov/26561272/">gap</a> between life expectancy (“lifespan”) and health-adjusted life expectancy (“healthspan”) is about ten years. This means many of us live with significant health problems in our later years. To increase our healthspan, we need planned, structured and regular physical activity (or exercise). The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization recommends</a> 150–300 minutes of moderate-intensity exercise – such as brisk walking, cycling and swimming – per week and muscle strengthening twice a week. Yet few of us meet these recommendations. <a href="https://doi.org/10.1186/s12966-019-0797-2">Only 10%</a> meet the strength-training recommendations. <a href="https://pubmed.ncbi.nlm.nih.gov/32488898/">Lack of time</a> is one of the most common reasons. Walking is cost-effective, doesn’t require any special equipment or training, and can be done with small pockets of time. <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">Our preliminary research</a>, published this week, shows there are ways to incorporate strength-training components into walking to improve your muscle strength and balance. <h2>Why walking isn’t usually enough</h2> Regular walking <a href="http://theconversation.com/health-check-in-terms-of-exercise-is-walking-enough-78604">does not appear</a> to work as muscle-strengthening exercise. In contrast, exercises consisting of “eccentric” or muscle-lengthening contractions <a href="http://theconversation.com/its-ok-to-aim%20lower-with-your-new-years-exercise-resolutions-a-few-minutes-a-day-can-improve-your-muscle-strength-193713">improve</a> muscle strength, <a href="https://pubmed.ncbi.nlm.nih.gov/31130877/">prevent muscle wasting</a> and improve other functions such as balance and flexibility. Typical eccentric contractions are seen, for example, when we sit on a chair slowly. The front thigh muscles lengthen with force generation. <h2>Our research</h2> Our <a href="https://pubmed.ncbi.nlm.nih.gov/31055678/">previous research</a> found body-weight-based eccentric exercise training, such as sitting down on a chair slowly, improved lower limb muscle strength and balance in healthy older adults. We also <a href="https://pubmed.ncbi.nlm.nih.gov/28291022/">showed</a> walking down stairs, with the front thigh muscles undergoing eccentric contractions, increased leg muscle strength and balance in older women more than walking up stairs. When climbing stairs, the front thigh muscles undergo “concentric” contractions, with the muscles shortening. It can be difficult to find stairs or slopes suitable for eccentric exercises. But if they could be incorporated into daily walking, lower limb muscle strength and balance function could be improved. This is where the idea of “eccentric walking” comes into play. This means inserting lunges in conventional walking, in addition to downstairs and downhill walking. <figure><iframe src="https://www.youtube.com/embed/wAI7z3XdY9o?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Eccentric walking means incorporating deep lunges into your movement.</figcaption></figure> In our <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">new research</a>, published in the European Journal of Applied Physiology, we investigated the effects of eccentric walking on lower limb muscle strength and balance in 11 regular walkers aged 54 to 88 years. The intervention period was 12 weeks. It consisted of four weeks of normal walking followed by eight weeks of eccentric walking. The number of eccentric steps in the eccentric walking period gradually increased over eight weeks from 100 to 1,000 steps (including lunges, downhill and downstairs steps). Participants took a total of 3,900 eccentric steps over the eight-week eccentric walking period while the total number of steps was the same as the previous four weeks. We measured the thickness of the participants’ front thigh muscles, muscle strength in their knee, their balance and endurance, including how many times they could go from a sitting position to standing in 30 seconds without using their arms. We took these measurements before the study started, at four weeks, after the conventional walking period, and at four and eight weeks into the eccentric walking period. We also tested their cognitive function using a digit symbol-substitution test at the same time points of other tests. And we asked participants to complete a questionnaire relating to their activities of daily living, such as dressing and moving around at home. Finally, we tested participants’ blood sugar, cholesterol levels and complement component 1q (C1q) concentrations, a potential <a href="https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fj.14-262154">marker of sarcopenia</a> (muscle wasting with ageing). <h2>What did we find?</h2> We found no significant changes in any of the outcomes in the first four weeks when participants walked conventionally. From week four to 12, we found significant improvements in muscle strength (19%), chair-stand ability (24%), balance (45%) and a cognitive function test (21%). Serum C1q concentration decreased by 10% after the eccentric walking intervention, indicating participants’ muscles were effectively stimulated. The sample size of the study was small, so we need larger and more comprehensive studies to verify our findings and investigate whether eccentric walking is effective for sedentary people, older people, how the different types of eccentric exercise compare and the potential cognitive and mental health benefits. But, in the meantime, “eccentric walking” appears to be a beneficial exercise that will extend your healthspan. It may look a bit eccentric if we insert lunges while walking on the street, but the more people do it and benefit from it, the less eccentric it will become. <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/224159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, Professor of Exercise and Sports Science, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/only-walking-for-exercise-heres-how-to-get-the-most-out-of-it-224159">original article</a>.

Body

Princess Kate sensationally speaks out over photo fiasco

Kensington Palace's attempt to quell speculation about Kate Middleton's health has ignited a storm of controversy, raising concerns about the future Queen's well-being to feverish levels. The Princess of Wales, at 42, issued an unprecedented statement on Monday morning, UK time, taking responsibility for what was described as <a href="https://www.oversixty.co.nz/health/caring/princess-kate-s-post-surgery-pic-ignites-even-wilder-conspiracy-theories" target="_blank" rel="noopener">"editing" an official portrait </a> released on Sunday for Mother’s Day. This portrait, featuring Kate alongside her three children – Prince George, Princess Charlotte, and Prince Louis – was eagerly anticipated as it marked the first sighting of the Princess since her mysterious abdominal surgery in January and subsequent disappearance from the public eye. However, far from dispelling concerns, the photograph seemed to amplify existing suspicions about her health, with many pointing out apparent discrepancies and suggesting it had been manipulated. The situation escalated when four major photo agencies issued "kill notice" orders for the image, alleging it had been "manipulated at the source [palace]." In a rare move, Kate Middleton took to X (Twitter) to address the controversy directly, admitting to the editing mishap and expressing regret for any confusion caused by the altered image. "Like many amateur photographers, I do occasionally experiment with editing," she wrote. "I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother's Day. C" Despite her efforts to diffuse the situation, the fallout continued to unravel. Royal watchers and fans reacted strongly to the events, with some accusing the palace of using Kate as a scapegoat and questioning the integrity of the institution itself. Omid Scobie, a UK author known for his association with Prince Harry and Meghan Markle, highlighted the palace's history of misinformation and suggested that regaining public trust would be an uphill battle. “It’s fair to say that most photos released by the offices of public figures have been retouched in some way, so *if* this was an isolated incident then it would just be an unfortunate error," Scobie wrote. "But with the Palace’s long history of lying, covering up, and even issuing statements on behalf of family members without their permission (cc: Prince Harry), it’s becoming increasingly difficult for the public to believe a word (and now photo) they share. Gaining that back at this point is an almost impossible task.” Piers Morgan strongly urged the palace to release the unedited version of the photo to quell speculation. Failure to do so, he warned, would only fuel further conspiracy theories. As the debate raged on social media, with Kate Middleton's name trending worldwide, users dissected the image, pointing out inconsistencies and suggesting alternative theories. The withdrawal of the photo by major news agencies, citing editorial issues, have only added fuel to the fire, further intensifying speculation. Amidst the controversy, Princess Kate's prolonged absence from the public eye following her hospitalisation in January has only heightened concerns. <a href="https://www.oversixty.co.nz/finance/legal/kate-middleton-spotted-for-the-first-time-since-surgery" target="_blank" rel="noopener">Her recent appearance</a>, photographed near Windsor Castle, marked her first public sighting in over two months, adding to the intrigue surrounding her health. As the debate continues, the fallout from this incident may have lasting implications for both Kate Middleton and the institution she represents. Image: Instagram

Family & Pets

How people get sucked into misinformation rabbit holes – and how to get them out

<a href="https://theconversation.com/profiles/emily-booth-715018">Emily Booth</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/marian-andrei-rizoiu-850922">Marian-Andrei Rizoiu</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> As misinformation and radicalisation rise, it’s tempting to look for something to blame: the internet, social media personalities, sensationalised political campaigns, religion, or conspiracy theories. And once we’ve settled on a cause, solutions usually follow: do more fact-checking, regulate advertising, ban YouTubers deemed to have “gone too far”. However, if these strategies were the whole answer, we should already be seeing a decrease in people being drawn into fringe communities and beliefs, and less misinformation in the online environment. We’re not. In new research <a href="https://doi.org/10.1177/14407833241231756">published in the Journal of Sociology</a>, we and our colleagues found radicalisation is a process of increasingly intense stages, and only a small number of people progress to the point where they commit violent acts. Our work shows the misinformation radicalisation process is a pathway driven by human emotions rather than the information itself – and this understanding may be a first step in finding solutions. <h2>A feeling of control</h2> We analysed dozens of public statements from newspapers and online in which former radicalised people described their experiences. We identified different levels of intensity in misinformation and its online communities, associated with common recurring behaviours. In the early stages, we found people either encountered misinformation about an anxiety-inducing topic through algorithms or friends, or they went looking for an explanation for something that gave them a “bad feeling”. Regardless, they often reported finding the same things: a new sense of certainty, a new community they could talk to, and feeling they had regained some control of their lives. Once people reached the middle stages of our proposed radicalisation pathway, we considered them to be invested in the new community, its goals, and its values. <h2>Growing intensity</h2> It was during these more intense stages that people began to report more negative impacts on their own lives. This could include the loss of friends and family, health issues caused by too much time spent on screens and too little sleep, and feelings of stress and paranoia. To soothe these pains, they turned again to their fringe communities for support. Most people in our dataset didn’t progress past these middle stages. However, their continued activity in these spaces kept the misinformation ecosystem alive. When people did move further and reach the extreme final stages in our model, they were doing active harm. In their recounting of their experiences at these high levels of intensity, individuals spoke of choosing to break ties with loved ones, participating in public acts of disruption and, in some cases, engaging in violence against other people in the name of their cause. Once people reached this stage, it took pretty strong interventions to get them out of it. The challenge, then, is how to intervene safely and effectively when people are in the earlier stages of being drawn into a fringe community. <h2>Respond with empathy, not shame</h2> We have a few suggestions. For people who are still in the earlier stages, friends and trusted advisers, like a doctor or a nurse, can have a big impact by simply responding with empathy. If a loved one starts voicing possible fringe views, like a fear of vaccines, or animosity against women or other marginalised groups, a calm response that seeks to understand the person’s underlying concern can go a long way. The worst response is one that might leave them feeling ashamed or upset. It may drive them back to their fringe community and accelerate their radicalisation. Even if the person’s views intensify, maintaining your connection with them can turn you into a lifeline that will see them get out sooner rather than later. Once people reached the middle stages, we found third-party online content – not produced by government, but regular users – could reach people without backfiring. Considering that many people in our research sample had their radicalisation instigated by social media, we also suggest the private companies behind such platforms should be held responsible for the effects of their automated tools on society. By the middle stages, arguments on the basis of logic or fact are ineffective. It doesn’t matter whether they are delivered by a friend, a news anchor, or a platform-affiliated fact-checking tool. At the most extreme final stages, we found that only heavy-handed interventions worked, such as family members forcibly hospitalising their radicalised relative, or individuals undergoing government-supported deradicalisation programs. <h2>How not to be radicalised</h2> After all this, you might be wondering: how do you protect yourself from being radicalised? As much of society becomes more dependent on digital technologies, we’re going to get exposed to even more misinformation, and our world is likely going to get smaller through online echo chambers. One strategy is to foster your critical thinking skills by <a href="https://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(23)00198-5">reading long-form texts from paper books</a>. Another is to protect yourself from the emotional manipulation of platform algorithms by <a href="https://guilfordjournals.com/doi/10.1521/jscp.2018.37.10.751">limiting your social media use</a> to small, infrequent, purposefully-directed pockets of time. And a third is to sustain connections with other humans, and lead a more analogue life – which has other benefits as well. So in short: log off, read a book, and spend time with people you care about. <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/223717/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-booth-715018">Emily Booth</a>, Research assistant, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/marian-andrei-rizoiu-850922">Marian-Andrei Rizoiu</a>, Associate Professor in Behavioral Data Science, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-people-get-sucked-into-misinformation-rabbit-holes-and-how-to-get-them-out-223717">original article</a>.

Mind

Out of the rabbit hole: new research shows people can change their minds about conspiracy theories

<a href="https://theconversation.com/profiles/matt-williams-666794">Matt Williams</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a>; <a href="https://theconversation.com/profiles/john-kerr-1073102">John Kerr</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>, and <a href="https://theconversation.com/profiles/mathew-marques-14884">Mathew Marques</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> Many people <a href="https://theconversation.com/was-phar-lap-killed-by-gangsters-new-research-shows-which-conspiracies-people-believe-in-and-why-158610">believe at least one</a> conspiracy theory. And that isn’t necessarily a bad thing – conspiracies do happen. To take just one example, the CIA really did engage in <a href="https://www.politico.com/story/2019/04/13/cia-mind-control-1266649">illegal experiments</a> in the 1950s to identify drugs and procedures that might produce confessions from captured spies. However, many conspiracy theories are not supported by evidence, yet still attract believers. For example, in a <a href="https://doi.org/10.1111/pops.12746">previous study</a>, we found about 7% of New Zealanders and Australians agreed with the theory that <a href="https://www.earthdata.nasa.gov/learn/sensing-our-planet/on-the-trail-of-contrails">visible trails behind aircraft</a> are “chemtrails” of chemical agents sprayed as part of a secret government program. That’s despite the theory being <a href="https://iopscience.iop.org/article/10.1088/1748-9326/11/8/084011">roundly rejected</a> by the scientific community. The fact that conspiracy theories attract believers despite a lack of credible evidence remains a puzzle for researchers in psychology and other academic disciplines. Indeed, there has been a great deal of research on conspiracy theories published in the past few years. We now know more about how many people believe them, as well as the psychological and political factors that <a href="https://www.nature.com/articles/s41598-022-25617-0">correlate with that belief</a>. But we know much less about how often people change their minds. Do they do so frequently, or do they to stick tenaciously to their beliefs, regardless of what evidence they come across? <h2>From 9/11 to COVID</h2> We set out to answer this question using a <a href="https://doi.org/10.1038/s41598-024-51653-z">longitudinal survey</a>. We recruited 498 Australians and New Zealanders (using the <a href="http://prolific.com">Prolific</a> website, which recruits people to take part in paid research). Each month from March to September 2021, we presented our sample group with a survey, including ten conspiracy theories, and asked them how much they agreed with each one. All of these theories related to claims about events that are either ongoing, or occurred this millennium: the September 11 attacks, the rollout of 5G telecommunications technology, and COVID-19, among others. While there were definitely some believers in our sample, most participants disagreed with each of the theories. The most popular theory was that “pharmaceutical companies (‘Big Pharma’) have suppressed a cure for cancer to protect their profits”. Some 18% of the sample group agreed when first asked. The least popular was the theory that “COVID-19 ‘vaccines’ contain microchips to monitor and control people”. Only 2% agreed. <h2>Conspiracy beliefs probably aren’t increasing</h2> Despite contemporary concerns about a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320252/">pandemic of misinformation</a>” or “<a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30461-X/fulltext">infodemic</a>”, we found no evidence that individual beliefs in conspiracy theories increased on average over time. This was despite our data collection happening during the tumultuous second year of the COVID-19 pandemic. Lockdowns were still happening occasionally in both <a href="https://www.timeout.com/melbourne/things-to-do/a-timeline-of-covid-19-in-australia-two-years-on">Australia</a> and <a href="https://covid19.govt.nz/about-our-covid-19-response/history-of-the-covid-19-alert-system/">New Zealand</a>, and anti-government sentiment was building. While we only tracked participants for six months, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0270429">other studies</a> over much longer time frames have also found little evidence that beliefs in conspiracy theories are increasing over time. <hr /> <iframe class="flourish-embed-iframe" style="width: 100%; height: 600px;" title="Interactive or visual content" src="https://flo.uri.sh/visualisation/16665395/embed" width="100%" height="400" frameborder="0" scrolling="no" sandbox="allow-same-origin allow-forms allow-scripts allow-downloads allow-popups allow-popups-to-escape-sandbox allow-top-navigation-by-user-activation"></iframe> <div style="width: 100%!; margin-top: 4px!important; text-align: right!important;"><a class="flourish-credit" href="https://public.flourish.studio/visualisation/16665395/?utm_source=embed&utm_campaign=visualisation/16665395" target="_top"><img src="https://public.flourish.studio/resources/made_with_flourish.svg" alt="Made with Flourish" /></a></div> <hr /> Finally, we found that beliefs (or non-beliefs) in conspiracy theories were stable – but not completely fixed. For any given theory, the vast majority of participants were “consistent sceptics” – not agreeing with the theory at any point. There were also some “consistent believers” who agreed at every point in the survey they responded to. For most theories, this was the second-largest group. Yet for every conspiracy theory, there was also a small proportion of converts. They disagreed with the theory at the start of the study, but agreed with it by the end. There was also a small proportion of “apostates” who agreed with the theory at the start, but disagreed by the end. Nevertheless, the percentages of converts and apostates tended to balance each other pretty closely, leaving the percentage of believers fairly stable over time. <h2>Inside the ‘rabbit hole’</h2> This relative stability is interesting, because <a href="https://www.jstor.org/stable/2564659">one criticism</a> of conspiracy theories is that they may not be “<a href="https://www.britannica.com/topic/criterion-of-falsifiability">falsifiable</a>”: what seems like evidence against a conspiracy theory can just be written off by believers as part of the cover up. Yet people clearly do sometimes decide to reject conspiracy theories they previously believed. Our findings bring into question the popular notion of the “rabbit hole” – that people rapidly develop beliefs in a succession of conspiracy theories, much as Alice tumbles down into Wonderland in Lewis Carroll’s <a href="https://www.gutenberg.org/ebooks/11">famous story</a>. While it’s possible this does happen for a small number of people, our results suggest it isn’t a typical experience. For most, the <a href="https://www.latrobe.edu.au/news/articles/2023/opinion/how-to-talk-to-someone-about-conspiracy-theories">journey into</a> conspiracy theory belief might involve a more gradual slope – a bit like a <a href="https://zslpublications.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1469-7998.1985.tb05649.x">real rabbit burrow</a>, from which one can also emerge. <hr /> Mathew Ling (<a href="https://www.neaminational.org.au/">Neami National</a>), Stephen Hill (Massey University) and Edward Clarke (Philipps-Universität Marburg) contributed to the research referred to in this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222507/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <hr /> <a href="https://theconversation.com/profiles/matt-williams-666794">Matt Williams</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a>; <a href="https://theconversation.com/profiles/john-kerr-1073102">John Kerr</a>, Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>, and <a href="https://theconversation.com/profiles/mathew-marques-14884">Mathew Marques</a>, Senior Lecturer in Social Psychology, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/out-of-the-rabbit-hole-new-research-shows-people-can-change-their-minds-about-conspiracy-theories-222507">original article</a>.

Mind

Run out of butter or eggs? Here’s the science behind substitute ingredients

<a href="https://theconversation.com/profiles/paulomi-polly-burey-404695">Paulomi (Polly) Burey</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a> It’s an all too common situation – you’re busy cooking or baking to a recipe when you open the cupboard and suddenly realise you are missing an ingredient. Unless you can immediately run to the shops, this can leave you scrambling for a substitute that can perform a similar function. Thankfully, such substitutes can be more successful than you’d expect. There are a few reasons why certain ingredient substitutions work so well. This is usually to do with the chemistry and the physical features having enough similarity to the original ingredient to still do the job appropriately. Let’s delve into some common ingredient substitutions and why they work – or need to be tweaked. <iframe id="IitfH" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/IitfH/1/" width="100%" height="400px" frameborder="0"></iframe> <h2>Oils versus butter</h2> Both butter and oils belong to a chemical class called <a href="https://chem.libretexts.org/Bookshelves/Introductory_Chemistry/Map%3A_Fundamentals_of_General_Organic_and_Biological_Chemistry_(McMurry_et_al.)/23%3A_Lipids/23.01%3A_Structure_and_Classification_of_Lipids">lipids</a>. It encompasses solid, semi-solid and liquid fats. In a baked product the “job” of these ingredients is to provide flavour and influence the structure and texture of the finished item. In cake batters, lipids contribute to creating an emulsion structure – this means combining two liquids that wouldn’t usually mix. In the baking process, this helps to create a light, fluffy crumb. One of the primary differences between butter and oil is that butter is only about 80% lipid (the rest being water), while <a href="https://www.nutritionadvance.com/types-of-cooking-fats-and-oils/">oil is almost 100% lipid</a>. Oil creates a softer crumb but is still a great fat to bake with. You can use a wide range of oils from different sources, such as olive oil, rice bran, avocado, peanut, coconut, macadamia and many more. Each of these may impart different flavours. Other “butters”, such as peanut and cashew butter, aren’t strictly butters but pastes. They impart different characteristics and can’t easily replace dairy butter, unless you also add extra oil. <h2>Aquafaba or flaxseed versus eggs</h2> Aquafaba is the liquid you drain from a can of legumes – such as chickpeas or lentils. It contains proteins, kind of how egg white also contains proteins. The proteins in egg white include albumins, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912395/">aquafaba also contains albumins</a>. This is why it is possible to make meringue from egg whites, or from aquafaba if you’re after a vegan version. The proteins act as a foam stabiliser – they hold the light, airy texture in the product. The concentration of protein in egg white is a bit higher, so it doesn’t take long to create a stable foam. Aquafaba requires more whipping to create a meringue-like foam, but it will bake in a similar way. Another albumin-containing alternative for eggs is <a href="https://foodstruct.com/compare/seeds-flaxseed-vs-egg">flaxseed</a>. These seeds form a thick gel texture when mixed with a little water. The texture is similar to raw egg and can provide structure and emulsification in baked recipes that call for a small amount of egg white. <h2>Lemon plus dairy versus buttermilk</h2> Buttermilk is the liquid left over after churning butter – it can be made from sweet cream, cultured/sour cream or whey-based cream. Buttermilk mostly <a href="https://www.journalofdairyscience.org/article/S0022-0302(06)72115-4/fulltext">contains proteins and fats</a>. Cultured buttermilk has a somewhat tangy flavour. Slightly soured milk can be a good substitute as it contains similar components and isn’t too different from “real” buttermilk, chemically speaking. One way to achieve slightly soured milk is by adding some lemon juice or cream of tartar to milk. Buttermilk is used in pancakes and baked goods to give extra height or volume. This is because the acidic (sour) components of buttermilk interact with baking soda, producing a light and airy texture. Buttermilk can also influence flavour, imparting a slightly tangy taste to pancakes and baked goods. It can also be used in sauces and dressings if you’re looking for a lightly acidic touch. <h2>Honey versus sugar</h2> Honey is a <a href="https://resources.perkinelmer.com/lab-solutions/resources/docs/APP_Analysis-of-Sugars-in-Honey-012101_01.pdf">complex sugar-based syrup</a> that includes floral or botanical flavours and aromas. Honey can be used in cooking and baking, adding both flavour and texture (viscosity, softness) to a wide range of products. If you add honey instead of regular sugar in baked goods, keep in mind that honey imparts a softer, moister texture. This is because it contains more moisture and is a humectant (that is, it likes to hold on to water). It is also less crystalline than sugar, unless you leave it to crystallise. The intensity of sweetness can also be different – some people find honey is sweeter than its granular counterpart, so you will want to adjust your recipes accordingly. <h2>Gluten-free versus regular flour</h2> Sometimes you need to make substitutions to avoid allergens, such as gluten – the protein found in cereal grains such as wheat, rye, barley and others. Unfortunately, gluten is also the component that gives a nice, stretchy, squishy quality to bread. To build this characteristic in a gluten-free product, it’s necessary to have a mixture of ingredients that work together to mimic this texture. Common ingredients used are corn or rice flour, xanthan gum, which acts as a binder and moisture holder, and tapioca starch, which is a good water absorbent and can aid with binding the dough. <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/202036/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paulomi-polly-burey-404695">Paulomi (Polly) Burey</a>, Associate Professor (Food Science), <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/run-out-of-butter-or-eggs-heres-the-science-behind-substitute-ingredients-202036">original article</a>.

Food & Wine

Rod Stewart's bizarre Ed Sheeran call out

Rod Stewart has called out Ed Sheeran in a bizarre rant, saying he doesn't think the pop singer's music will stand the test of time. In a recent interview, the 79-year-old rocker was discussing what musicians would continue to be popular with the younger generations, although the interview quickly went awry when he couldn't remember the name of who he was thinking about. “You mean like ‘Maggie May’? Songs that will be played in 50 years?” Stewart said in response to the question. “I like whatshisname. Oh f**king great, Rod. Well done,” said the rocker, unable to remember the name of the star he was thinking of. “He’s British, really talented and his songs will be around,” he continued. When the interviewer suggested that Sheeran was the person whose name he forgot, Stewart was quick to hit back by proclaiming himself to not being a fan of the singer-songwriter. “No, not Ed, I don’t know any of his songs, old ginger bollocks. Jesus,” moaned Stewart. Ultimately, Stewart was thinking of another British singer: George Ezra. “Yes! I think he writes really tremendous songs,” he said of Ezra. “He’ll be around for quite a while.” Stewart's comments come after he admitted he wanted to move in a different direction with his music from now on. During an interview on BBC Breakfast, Stewart responded to a statement that host Charlie Stayt made, saying that “rock stars are performing into incredible ages now.” Stewart reacted and said, “I am actually stopping.” “I’m not retiring but I want to move on,” Stewart noted. “I had great success with The Great American Songbook … and I’ve just done a swing album with Jools Holland, which is going to come out next year, so I want to go in that direction.” “I just want to leave all the rock ‘n’ roll stuff behind, for a while, maybe.” “Everything has to come to an end sooner or later,” Stewart declared. Image credits: Getty Images

Music

Boss slammed for demanding an employee complete work during annual leave

A boss has been dubbed an “abysmal manager” for demanding his employee join a video call for work, despite being on annual leave. 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. 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.” The employee responded, reminding his boss that he was off on pre-approved annual leave, and was enjoying a holiday abroad in Spain. 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.” <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&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&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ben Askins (@benaskins.official)</a> </div> </blockquote> 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”. “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.” 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.” 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.” “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. “Because the manager is shocking, it's now impacting the employee's holiday. I just hate it when that happens.” 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”. “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. 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. Image credits: Instagram

Legal

What is micellar water and how does it work?

<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> 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. So, what is micellar water and why is it so good at getting makeup and sunscreen off? Here’s the science. <h2>What are micelles?</h2> 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. But micellar water products contain something called micelles – clusters of molecules that are very effective at removing oily substances. To understand why, you need to first know two chemistry terms: hydrophilic and hydrophobic. A hydrophilic substance “loves” water and mixes easily with it. Salt and sugar are examples. A hydrophobic substance “hates” water and generally refuses to mix with it. Examples include oil and wax. 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. <h2>How are micelles formed? It’s all about surfactants</h2> The micelles in micellar water are formed by special molecules known as surfactants. 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. 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. 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. All the hydrophilic heads will be pointing outwards, while the hydrophobic tails remain “hidden” at the centre. These clusters are micelles. 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. 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. <figure><iframe src="https://www.youtube.com/embed/fnRBCn8fm2o?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Micellar water in action</h2> 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. 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. 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. As you sweep the cotton pad across your skin, these contaminants bind to the hydrophobic tails and are removed from the skin. Some contaminants will also find themselves encapsulated in the hydrophobic centres of the micelle. Either way, a cleaner surface is left behind. Look at how a cotton wipe soaked in micellar water cleans up a small oil spill, in comparison to water alone. <figure><iframe src="https://www.youtube.com/embed/5Nge5FEiuYE?wmode=transparent&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> Technically, that would work as detergent does indeed contain lots of micelle-forming surfactants. But these particular surfactants would probably cause a lot of skin and eye irritation, while also damaging and drying out your skin. Not nice. 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. 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). Some products say there is “zero residue”, although the fine print clearly states this refers to visible residue. 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. 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.<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" /> <a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-micellar-water-and-how-does-it-work-219492">original article</a>.

Beauty & Style

Christmas can be hazardous for pets – here’s what to look out for

<a href="https://theconversation.com/profiles/jacqueline-boyd-178858">Jacqueline Boyd</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> Christmas is a wonderful time to relax with family and friends, both two and four legged. But it can be a scary and dangerous time for pets. Food, presents, decorations and even visitors to our homes can all become hazards. Vets typically report the festive season as being one of their <a href="https://bvajournals.onlinelibrary.wiley.com/doi/epdf/10.1136/vr.j5760">busiest times of year</a>. <a href="https://doi.org/10.1136/vr.j5890">Knowing the dangers</a> is key. It is also important to let everyone in the house know what is safe and what is not for family pets. Prevention is always better than cure. Visitors can be advised on pet etiquette, too. Some pets can get distressed by changes to their routine and anxious in the presence of unfamiliar people. Unfortunately, this has been <a href="https://www.sciencedirect.com/science/article/pii/S0168159121001829?via%3Dihub">exacerbated by the pandemic</a>. Be especially aware of leaving dogs unsupervised around <a href="https://injuryprevention.bmj.com/content/25/4/290">excited or unknown children</a> as bites are a real risk. Providing your pet with a safe, quiet space might be important to protect both your visitors and your pet. Festive foods are a particular problem. A tasty treat for us can be fatal for some pets, so beware of sharing your festive meals with your pets. Some animals will be sensitive even to slight dietary changes, perhaps showing signs of digestive upset and discomfort. Dogs tend to be less discriminating in their food choices than cats. This means that our dogs might be more likely to eat things they shouldn’t, but care should be taken with cats, too. Pancreatitis is a painful and distressing condition often seen in dogs who have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808289/">consumed fatty foods</a>. Avoid giving leftovers to your pets to reduce this risk. Cooked bones can also cause significant injury, so make sure they can’t get into the bins to steal scraps. Mince pies, Christmas cake and puddings are full of <a href="https://onlinelibrary.wiley.com/doi/10.1111/jvim.15884">raisins</a> – which are toxic to dogs. Grapes, currants and sultanas are also dangerous for dogs and are hidden in many festive recipes. And macadamia nuts are a <a href="https://pubmed.ncbi.nlm.nih.gov/10670081/">health hazard</a>, causing a range of symptoms including weakness, vomiting, stiffness and depression. Other nuts and seeds can pose a choking risk. Alcohol needs to be strictly limited to human-only consumption. <a href="https://europepmc.org/article/med/11757994">Rotting apples</a> have even caused alcohol poisoning in dogs, so keep food waste and leftovers out of harm’s way, too. Access to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1435-6935.2003.00068.x">raw bread dough</a>, blue cheese and salt-dough ornaments should also be avoided as they contain compounds that can cause significant illness. Similarly, <a href="https://www.frontiersin.org/articles/10.3389/fvets.2016.00026/full">onions, garlic and chives</a> contain chemicals that are toxic to cats and dogs – and cooking doesn’t make them safer. As little as a single spoonful of sage and onion stuffing can cause harm. Sweet treats are no safer. Chocolate is a significant concern, and holidays are associated with an increased risk of <a href="https://bvajournals.onlinelibrary.wiley.com/doi/full/10.1136/vr.104762">chocolate toxicity</a>. Even artificial sweeteners, such as <a href="https://www.vetsmall.theclinics.com/article/S0195-5616(11)00219-1/fulltext">xylitol</a> – which is commonly used in chewing gum – should be avoided. <h2>Not just food</h2> Wrappers from sweets and chocolates can pose a risk if consumed. Indeed, digestive <a href="https://doi.org/10.1111/j.1748-5827.2009.00783.x">foreign bodies</a> are a common problem for dogs and cats, often requiring emergency surgery. If consumed, toys, gifts and decorations can cause intestinal blockage and damage. Be aware of plant hazards, too. Needles from Christmas trees can penetrate paws, causing pain and infection. Other festive plants such as poinsettia, mistletoe and holly berries are toxic if consumed. The leaves, petals and pollen of lilies are especially <a href="https://doi.org/10.1053/j.tcam.2010.09.006">dangerous for cats</a>. Antifreeze is another <a href="https://bvajournals.onlinelibrary.wiley.com/doi/full/10.1136/vr.h6831">hazard for cats</a> with the ingestion of small amounts potentially fatal. Colder temperatures mean antifreeze is commonly used on our vehicles and spillages can occur. Occasionally it is also found in some decorations, such as snow globes, so care should be taken to prevent inadvertent access by our pets. In any case, where you think your pet has eaten or otherwise been exposed to something potentially nasty, it is best to seek veterinary advice as soon as possible. By taking a bit of care over the festive season, we can all make sure it is a safe and restful time for us, our pets and our pets’ vets.<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/173345/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacqueline-boyd-178858">Jacqueline Boyd</a>, Senior Lecturer in Animal Science, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/christmas-can-be-hazardous-for-pets-heres-what-to-look-out-for-173345">original article</a>.

Family & Pets

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

<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> 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. 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. 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. Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe? <h2>Who’s eligible for the new boosters?</h2> 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. 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. People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>For people without risk factors. <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></figcaption></figure> Adults aged 18 to 64 with 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. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=311&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=311&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=311&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=391&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=391&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=391&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Advice for people with risk factors. <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></figcaption></figure> For adults aged 18 to 64 without 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. Additional doses aren’t recommended for children without underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years without additional risk factors. <h2>Monovalent, bivalent? What’s the difference?</h2> From monovalent The initial COVID vaccines were “monovalent”. They had one target – the original viral strain. 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. To bivalent 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>. Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission. 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. Back to monovalent Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement. 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>). This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed. 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. 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. 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>. <h2>Do these newer vaccines work?</h2> 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=&id=CP-2023-PI-02409-1&d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA. 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. 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. 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>. 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. <h2>Are they safe?</h2> The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&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. 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. <h2>What happens next?</h2> 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. 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.<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" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.

Body

How do stimulants actually work to reduce ADHD symptoms?

<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> 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? <h2>First, let’s look at the brain</h2> ADHD is a neurodevelopmental condition, which means it affects how the brain functions. 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. These brain differences are associated with the symptoms of ADHD, including inattention, impulse control and problems with memory. <h2>What stimulants are prescribed in Australia?</h2> 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). 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. 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”. <h2>So how do they work for ADHD?</h2> 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. 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. 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. 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. <h2>What effect do they have on ADHD symptoms?</h2> We still don’t fully understand the underlying brain mechanisms that change behaviour in people with ADHD. 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: <ul> <li>attention</li> <li>memory</li> <li>decision-making</li> <li>task completion</li> <li>hyperactivity.</li> </ul> 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. 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. Some people will notice their symptoms improve right away. Other times, these improvements will be more noticeable to parents, carers, teachers, colleagues and partners. <h2>Not everyone gets the same dose</h2> The optimal stimulant dose varies between individuals, with multiple dosage options available. This enables a “start low, go slow” approach, where the stimulant can be gradually increased to the most effective dose for the individual. There are also different delivery options. 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. Methylphenidate is also <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03175-3&d=20231023172310101">available</a> in long-acting tablets (Concerta) and capsules (Ritalin LA). They are released into the body over the day. Lisdexamfetamine is a long-acting drug and is not available in a short-acting formulation. 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). <h2>What are the side effects?</h2> 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. Headache and abdominal pain are also relatively common. <h2>Can someone without ADHD take a stimulant to improve productivity?</h2> 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. 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>. 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. 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. 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. 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" /> <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> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-stimulants-actually-work-to-reduce-adhd-symptoms-215801">original article</a>.

Mind

“May her memory be a blessing”: Father of Hamas victim speaks out

The grieving father of a 23-year-old German-Israeli woman, Shani Louk, who was kidnapped from the Nova music festival by Hamas militants on October 7, has shared his devastation after it was confirmed that his daughter had been found dead. The Israeli Ministry of Foreign Affairs confirmed the discovery and identification of Shani Louk's body on Monday. Louk was attending the festival in southern Israel when Hamas breached the border between Gaza and Israel, leading to a series of tragic events. However, her father, Nissim Louk, remembers his daughter as someone who was enjoying herself "until the last moment". "Until about 6.45pm, Shani was still dancing, cheering, and going wild at the party and was surrounded by all her best friends — and they had fun all night," he told the Israeli news outlet, N12. He emphasised that she was killed instantly and didn't suffer. Just ten minutes earlier, she was still immersed in the festival's joy. “She was killed on the spot and not only did she not suffer, 10 minutes earlier she was still enjoying herself.” Mr Louk also criticised the government's response, calling it a failure. He claimed that the government ministries underestimated the situation, were unresponsive, and failed to take adequate measures. He pointed out the responsibility of then-Prime Minister Benjamin Netanyahu in the events and expressed his discontent with the government's handling of the situation. Shani Louk was kidnapped at the festival and subjected to torture and captivity by Hamas terrorists. The Israeli Ministry of Foreign Affairs stated that she "experienced unfathomable horrors", and expressed their condolences, saying, "May her memory be a blessing." The attack by Hamas militants on the festival was a horrifying event. They blocked off access to the festival site from both the north and the south before storming the area on foot. Videos from the site showed them encircling the crowds on three sides, leading to casualties and chaos. Shani's mother, Ricarda Louk, revealed that she last spoke to her daughter after hearing rockets and alarms sounding in southern Israel. She called to ensure her daughter's safety, and Shani informed her that she was at the festival with few places to hide. Her abduction occurred as she was trying to reach her car, with military personnel preventing people from leaving the scene. The tragedy at the Nova festival was immense, with more than 260 bodies found at the site by Israeli rescue service Zaka. However, based on CNN's analysis, the total death toll could be even higher. Additionally, a number of hostages were taken to Gaza during the attack, with the latest figures indicating that up to 239 hostages are believed to be held by Hamas in the enclave. In a glimmer of hope amidst the tragedy, a female Israeli soldier who had been kidnapped by Hamas on October 7 was released during ground operations in Gaza, as confirmed by the Israel Defence Forces. The soldier received medical attention, is in good health, and has been reunited with her family. Images: CNN / N12

Caring

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

<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> 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? 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. 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? <h2>What not to do</h2> These probably won’t help: <ul> <li> spending more time in bed often results in more time spent awake 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> </li> <li> drinking coffee and taking naps 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 </li> <li> drinking alcohol 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. </li> </ul> <h2>What to do next?</h2> 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. 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. It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia. 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>. 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. <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>. <h2>What if that doesn’t work?</h2> 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. 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. Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor. <h2>What about sleeping pills?</h2> 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. Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep. 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. 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. <h2>Are there new treatments? How about medicinal cannabis?</h2> Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant). 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. However, we don’t know if they work or are safe over the long term. <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>. 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>. 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. 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. <h2>What now?</h2> 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. 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. <hr /> 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>.<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" /> <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> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.

Body

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

<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> 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. 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. 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. <h2>What causes hot flushes</h2> 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). 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>. 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. 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. <h2>A long history</h2> 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. 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. Black cohosh (plant name Cimicifuga racemosa) 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. 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>. 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. 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. 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. 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. 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. More good quality studies are needed to decide whether black cohosh works for hot flushes and other menopausal symptoms. <h2>Is it safe to try?</h2> 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. 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. 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. 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. 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" /> <a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, Research fellow, Chronic Disease & 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> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/lots-of-women-try-herbs-like-black-cohosh-for-menopausal-symptoms-like-hot-flushes-but-does-it-work-211272">original article</a>.

Body

Hugh Jackman's first outing with his famous friends after bombshell split

Hugh Jackman has been spotted rubbing shoulders with his famous friends in his first public outing since announcing his divorce. The actor was joined by Hollywood A-listers Ryan Reynolds, Blake Lively, Sophie Turner, Taylor Swift and many more famous mates at an NFL game in New York. The celebrity group showed up at the game in support of their friend Taylor Swift, who was barracking on for her rumoured new boyfriend, NFL player Travis Kelce. Jackman snapped a series of selfies with his pals, sporting a beaming smile. <blockquote class="twitter-tweet"> Shawn Levy shares new photo with Taylor Swift, Hugh Jackman, Ryan Reynolds and Blake Lively. <a href="https://t.co/8XkYlm1Uqj">pic.twitter.com/8XkYlm1Uqj</a> — Pop Base (@PopBase) <a href="https://twitter.com/PopBase/status/1708928938448232854?ref_src=twsrc%5Etfw">October 2, 2023</a></blockquote> <blockquote class="twitter-tweet"> Hugh Jackman, Ryan Reynolds and Shawn Levy tonight at New York Jets football game 📸 <a href="https://t.co/d5T55C4BpH">pic.twitter.com/d5T55C4BpH</a> — Deadpool Updates (@DeadpoolUpdate) <a href="https://twitter.com/DeadpoolUpdate/status/1708636773629182395?ref_src=twsrc%5Etfw">October 2, 2023</a></blockquote> <blockquote class="twitter-tweet"> 📷| <a href="https://twitter.com/taylorswift13?ref_src=twsrc%5Etfw">@TaylorSwift13</a> with Blake Lively, Ryan Reynolds and Hugh Jackman <a href="https://t.co/7X6DND2VQV">pic.twitter.com/7X6DND2VQV</a> — The Swift Society (@TheSwiftSociety) <a href="https://twitter.com/TheSwiftSociety/status/1708816628471812467?ref_src=twsrc%5Etfw">October 2, 2023</a></blockquote> Despite Hugh's happy smile when posing for cameras, while being snapped in candid moments, fans were quick to point out that he seemed downcast while watching the game. “Poor Hugh looks miserable,” one person wrote on X, formerly known as Twitter. “Hugh doesn’t seem himself,” said another. “I’m glad Hugh Jackman is out and supported by friends, poor thing,” a third wrote. One person wrote light-heartedly, “Hugh Jackman in his single era let’s gooooooo.” Jackman's public outing comes just weeks after announcing he and his wife Deborra-Lee Furness are getting a divorce. The Hollywood couple <a href="https://oversixty.com.au/lifestyle/relationships/hugh-jackman-devastated-after-marriage-split" target="_blank" rel="noopener">shocked the world</a> on September 15th when they released a statement confirming their separation after being married for 27 years. “We have been blessed to share almost three decades together as husband and wife in a wonderful, loving marriage,” Jackman and Furness told <a href="https://people.com/hugh-jackman-and-deborra-lee-jackman-separate-exclusive-7970286" target="_blank" rel="noopener" data-link-type="article-inline">People</a>. “Our journey now is shifting and we have decided to separate to pursue our individual growth." Image credits: Getty Images / Instagram

Beauty & Style

Take the pain out of toothache with these 11 home remedies

Toothache remedy: clove oil Cloves are a traditional remedy for numbing nerves; the primary chemical compound of this spice is eugenol, a natural anaesthetic. Research has shown that, used topically, clove oil can be as effective against tooth pain as benzocaine. Put two drops of clove oil on a cotton ball and place it against the tooth itself until the pain recedes. In a pinch, use a bit of powdered clove or place a whole clove on the tooth. Chew the whole clove a little to release its oil and keep it in place up to half an hour or until the pain subsides. Toothache remedy: cayenne paste The main chemical component of cayenne – capsaicin – has been found to alter some of the mechanisms involved in pain. Mix powdered cayenne with enough water to make a paste. Roll a small ball of cotton into enough paste to saturate it, then place it on your tooth while avoiding your gums and tongue. Leave it until the pain fades – or as long as you can stand it (the concoction is likely to burn). Toothache remedy: swish some salt water A teaspoon of salt dissolved in a cup of boiling water makes an effective mouthwash, which will clean away irritating debris and help reduce swelling. Swish it around for about 30 seconds before spitting it out. Saltwater cleanses the area around the tooth and draws out some of the fluid that causes swelling, according to Professor Thomas Salinas. Repeat this treatment as often as needed. “A hot rinse can also help consolidate the infection until you get to your dentist,” says Dr Salinas. Toothache remedy: soothe with tea Peppermint tea has a nice flavour and some medicinal powers as well. Put 1 teaspoon dried peppermint leaves in 1 cup boiling water and steep for 20 minutes. After the tea cools, swish it around in your mouth, then spit it out or swallow. Also, the astringent tannins in strong black tea may help quell pain by reducing swelling. For this folk remedy place a warm, wet tea bag against the affected tooth for temporary relief. “The fluoride in tea can help kill bacteria, which is especially helpful after a tooth extraction,” says Salinas. Toothache remedy: rinse with hydrogen peroxide To help kill bacteria and relieve some discomfort, swish with a mouthful of 3 per cent hydrogen peroxide solution diluted with water. This can provide temporary relief if a toothache is accompanied by fever and a foul taste in the mouth (both are signs of infection), but like other toothache remedies, it’s only a stopgap measure until you see your dentist and get the source of infection cleared up. A hydrogen peroxide solution is only for rinsing. Spit it out, then rinse several times with plain water. Toothache remedy: ice it Place a small ice cube in a plastic bag, wrap a thin cloth around the bag, and apply it to the aching tooth for about 15 minutes to numb the nerves. Alternatively, that ice pack can go on your cheek, over the painful tooth. Also, according to folklore, if you massage your hand with an ice cube, you can help relieve a toothache. When nerves in your fingers send ‘cold’ signals to your brain, they may distract from the pain in your tooth. Just wrap up an ice cube in a thin cloth and massage it in the fleshy area between your thumb and forefinger. Toothache remedy: wash it with myrrh You can also rinse with a tincture of myrrh. “Myrrh definitely has an effect on infected tissue and can sometimes also interfere with the pain generated by tooth infection,” says Salinas. Simmer 1 teaspoon of powdered myrrh in 2 cups water for 30 minutes. Strain and let cool. Rinse with 1 teaspoon of the solution in a half-cup water several times a day. Toothache remedy: distract with vinegar and brown paper Another country cure calls for soaking a small piece of brown paper (from a grocery or lunch bag) in vinegar, sprinkling one side with black pepper, and holding this to the cheek. The warm sensation on your cheek may distract you from your tooth pain. This technique is an example of the Gate Control theory of pain. By using a distracting stimulus, the ‘gates’ to the pain receptors in your brain close and you don’t feel the original pain as powerfully. Toothache remedy: brush with the right tools “Sensitive toothpaste is very helpful for people with significant gum recession,” says Salinas. When gums shrink, the dentin beneath your teeth’s enamel surface is exposed, and this material is particularly sensitive. Look for pastes that contain sodium fluoride, potassium nitrate or strontium nitrate – ingredients which have been shown to reduce sensitivity, according to Salinas. Switch to the softest-bristled brush you can find to help preserve gum tissue and prevent further shrinking. Toothache remedy: cover a crack with gum If you’ve broken a tooth or have lost a filling, you can relieve some pain by covering the exposed area with softened chewing gum. This might work with a loose filling, too, to hold it in place until you can get to the dentist. To avoid further discomfort, avoid chewing anything with that tooth until you can have it repaired. Just make sure you use sugarless gum, since sugar may actually exacerbate the pain (not to mention that it can cause cavities). Toothache remedy: apply pressure Try an acupressure technique to stop tooth pain fast. With your thumb, press the point on the back of your other hand where the base of your thumb and your index finger meet. Apply pressure for about two minutes. “This works in several ways,” says Salinas. “The pressure can help prevent pain signals from being sent as well as help express some of the fluid that causes swelling.” Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/11-home-remedies-for-a-toothache?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

Body

How did Taylor Swift get so popular? She never goes out of style

<a href="https://theconversation.com/profiles/kate-pattison-1407185">Kate Pattison</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Last week, USA Today/Gannett <a href="https://us231.dayforcehcm.com/CandidatePortal/en-US/gannett/Posting/View/63544">posted a job ad</a> for a Taylor Swift reporter, seeking an experienced journalist and content creator to “capture the music and cultural impact of Taylor Swift”. It’s not the first time Swift has been the focus of professional and academic work. In 2022, New York University’s Clive Davis Institute <a href="https://variety.com/2022/music/news/taylor-swift-course-nyu-clive-davis-institute-1235170200/">announced a course focused on Swift</a>, taught by Rolling Stone’s Brittany Spanos. They also gave Swift <a href="https://www.nyu.edu/about/news-publications/news/2022/march/Commencement_HDs_2020_2021_2022.html">an honorary doctorate in fine arts</a>, as “one of the most prolific and celebrated artists of her generation”. Other universities around the world followed with their own dedicated courses, including “<a href="https://www.nme.com/en_au/news/music/taylor-swift-is-the-subject-of-a-new-university-course-3483713">The Psychology of Taylor Swift</a>”, “<a href="https://www.billboard.com/music/music-news/taylor-swift-songbook-class-offered-university-of-texas-1235130293/">The Taylor Swift Songbook</a>” and “<a href="https://amp.cnn.com/cnn/style/taylor-swift-lyrics-course-belgian-university/index.html">Literature: Taylor’s Version</a>”. While musicians and celebrities have been the subject of our fascinations for decades, it’s not often they receive such individualised attention. Swift’s impressive career can be studied from multiple perspectives, including marketing, fandom, business and songwriting, to name a few. <figure><iframe src="https://www.youtube.com/embed/KudedLV0tP0?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>So why Taylor Swift?</h2> From a music perspective, Swift has broken a lot of records. Last month, she became the <a href="https://variety.com/2023/music/news/taylor-swift-spotify-record-monthly-listeners-1235707101/">first female artist in Spotify history</a> to reach 100 million monthly listeners. Swift has achieved 12 number one albums on Billboard, <a href="https://www.nytimes.com/2023/07/17/arts/music/taylor-swift-speak-now-billboard-chart-record.html">the most by a woman artist</a>, overtaking Barbra Streisand earlier this year. She’s the first and only woman solo artist to win the <a href="https://www.grammy.com/artists/taylor-swift/15450">Album Of The Year Grammy</a> three times, for Fearless (2009), 1989 (2015) and Folklore (2020) – each in a different musical genre. It’s a credit to Swift’s masterful songwriting, and demonstrates her ability to adapt her craft for different audiences. There is an expectation for female artists to constantly re-invent themselves, something <a href="https://www.theguardian.com/commentisfree/2020/feb/10/interesting-reinvention-taylor-swift-celebrities">Swift reflected on</a> in her Netflix documentary Miss Americana: <blockquote> The female artists I know of have to remake themselves like 20 times more than the male artists, or you’re out of a job. </blockquote> Over the course of her career, Swift has evolved from an award-winning country music singer to one of the biggest pop stars in the world. Each of her ten original studio albums <a href="https://www.thelist.com/463869/every-taylor-swift-era-explained/">has a distinct theme and aesthetic</a>, which have been celebrated on Swift’s juggernaut Eras Tour. The tour, which has just wrapped up its first US leg, is set to be the highest-grossing of all time, boosting local travel and tourism revenue along the way. A <a href="https://www.cbsnews.com/news/taylor-swift-eras-tour-boosted-economy-tourism-federal-reserve-how-much-money-made/">recent report estimates</a> the tour could help add a monumental US$5 billion (A$7.8 billion) to the worldwide economy. <figure><iframe src="https://www.youtube.com/embed/b1kbLwvqugk?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>‘All I do is try, try, try’</h2> But to measure Swift’s impact by her music alone would be limiting. Swift has been instrumental in changing the business game for musicians. She’s taken on record labels and streaming services, advocating for better deals for artists. In 2015, <a href="https://www.bbc.com/news/entertainment-arts-33220189">Apple Music changed its payment policies</a> after Swift wrote an <a href="https://www.stereogum.com/1810310/read-taylor-swifts-open-letter-to-apple-music/news/">open letter</a> campaigning for better compensation. Most notably, she took a stand <a href="https://taylorswift.tumblr.com/post/185958366550/for-years-i-asked-pleaded-for-a-chance-to-own-my">against her former record label</a>, Big Machine Records, after it wouldn’t give her an opportunity to buy back her original master recordings. Her back catalogue was eventually sold to music executive Scooter Braun, kicking off a <a href="https://pitchfork.com/news/taylor-swifts-music-ownership-controversy-with-scooter-braun-what-it-means-and-why-it-matters/">very public feud</a>. While she’s not the first artist to go after her masters, she’s generated an enormous amount of attention to an issue that’s often overlooked. Of course, Swift is in a position of privilege – she can take risks many other artists can’t afford to. But with this power she’s driving conversations around contracts and the value of music, paving the way for emerging artists. In an effort to regain control of her earlier work, <a href="https://www.cbsnews.com/news/taylor-swift-on-lover-and-haters/">Swift announced</a> she would be re-recording her first six albums. Each re-recorded album has included additional <a href="https://www.insider.com/taylor-swift-fearless-rerecord-release-date-unreleased-songs-2021-2">vault tracks</a>, previously unreleased songs left off the original recordings. These releases have each been accompanied by a robust promotional campaign, including new merchandise and multiple, limited-edition versions of each record for fans to collect. The release of Speak Now (Taylor’s Version) marked the halfway point of this process, which has paid off big time. Fearless (Taylor’s Version), Red (Taylor’s Version) and Speak Now (Taylor’s Version) <a href="https://www.billboard.com/lists/taylor-swift-taylors-version-stats-chart-numbers/the-equivalent-album-units-gap/">have all performed better</a> than the originals. This is largely due to the unwavering support from her fans, known as “Swifties”. They’ve embraced the new recordings, shaming anyone who plays the original “stolen” versions. <h2>The power of Swifties</h2> Swift’s loyal fandom are known for their high levels of participation and creativity. Fans have spent an extensive amount of time hand-making outfits for concerts, and discussing elaborate theories online. Swift has a reputation for leaving clues, known as <a href="https://junkee.com/taylor-swift-easter-eggs/219709">Easter eggs</a>, in her lyrics, music videos, social media posts and interviews. There are fan accounts dedicated to analysing these Easter eggs, studying specific number patterns and phrases to uncover hints for what Swift might do next. Swift and Taylor Nation, a branch of her management team, encourage these behaviours by rewarding fans for their participation. For the upcoming release of 1989 (Taylor’s Version), Swift has unveiled a series of puzzles on Google, which fans must solve together in order to reveal the names of the upcoming vault tracks. Swifties collectively <a href="https://www.washingtonpost.com/style/2023/09/20/taylor-swift-vault-puzzle-1989-tracks/">solved the 33 million</a> (yes, that’s million) puzzles in less than 24 hours. The games played a dual role - not only did <a href="https://www.instagram.com/p/CxbFSR1RAOv/?img_index=1">Swift announce the vault track titles</a>, but she’s <a href="https://vt.tiktok.com/ZSN1uHN9R/">reclaimed her Google searches</a> in the process. Swift’s fandom crosses generations. She’s a quintessential millennial, and many fans have grown up with Swift over the past two decades. Some have even started to bring their children along to the concerts, <a href="https://www.tiktok.com/@folkloreswift_/video/7255857466213158149?is_from_webapp=1&sender_device=pc&web_id=6972316934294291973">posting videos</a> of them set to the bridge to Long Live. She’s also found a younger audience on TikTok, a platform <a href="https://sproutsocial.com/insights/tiktok-stats/">predominantly used by Gen Z</a>. Affectionately dubbed “<a href="https://newsroom.tiktok.com/en-us/year-on-tiktok-music-report-2021">SwiftTok</a>” by fans (and now <a href="https://vt.tiktok.com/ZSLokp2rQ/">Swift herself</a>), users post videos to engage with other Swifties and participate in the community. Swift’s songs are often used in popular trends. The release of Midnights last year had many dancing to <a href="https://www.cosmopolitan.com/entertainment/celebs/a43488940/taylor-swift-surprised-fan-viral-tiktok-dance-bejeweled-eras-tour/">Bejeweled</a> and <a href="https://www.tiktok.com/@tatycake/video/7216131364469427499?is_from_webapp=1&sender_device=pc&web_id=6972316934294291973">Karma</a>, but Swift’s older catalogue has also gotten a good run. A remix of Love Story <a href="https://www.rollingstone.com/music/music-features/taylor-swift-tiktok-love-story-remix-disco-lines-1035691/">went viral in 2020</a>, which helped a new generation discover her older music. Most recently, her song August has been used for running on the beach and <a href="https://vt.tiktok.com/ZSLok2jRb/">spinning around</a> with your pets. <iframe id="tc-infographic-925" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/925/cad71d8026910236be1d5880a20a247cdee29c82/site/index.html" width="100%" height="400px" frameborder="0"></iframe> She’s also closely aligned with young adult shows like The Summer I Turned Pretty, which has <a href="https://www.vulture.com/2023/08/taylor-swift-summer-i-turned-pretty.html">featured 13 of her songs</a> throughout the show’s first two seasons. Swift’s music is so central to the story that <a href="https://www.latimes.com/entertainment-arts/tv/story/2023-08-19/summer-i-turned-pretty-music-jenny-han-taylor-swift">author Jenny Han nearly dedicated</a> the second book to her. Swift continues to dominate the cultural conversation through her music, business decisions and legions of devoted fans. Right now, Swift’s popularity is at an all time high, and it could be easy to dismiss this hype as a passing trend. But if these first 17 years are anything to go by, Swift’s proven she’s in it for the long haul, and worthy of our time.<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/213871/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kate-pattison-1407185">Kate Pattison</a>, PhD Candidate, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-did-taylor-swift-get-so-popular-she-never-goes-out-of-style-213871">original article</a>.

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