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Man infects at least 32 people with coronavirus in 2.5 hours

<p>A man unknowingly infected at least 32 people with coronavirus at a choir practice, a <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm?s_cid=mm6919e6_e&amp;deliveryName=USCDC_921-DM28169">new report by the US Centres for Disease Control and Prevention (CDC)</a> found.</p> <p>The choir practice was held in Skagit Valley, Washington, on March 10 – three days before President Donald Trump declared national emergency over the COVID-19 outbreak.</p> <p>Out of the 122 members of the Skagit Valley Chorale, 61 attended the evening practice at the Mount Vernon Presbyterian Church.</p> <p>One of those singers had cold-like symptoms starting on March 7 but only realised it was COVID-19 after a test later confirmed the diagnosis, according to the CDC study.</p> <p>The members avoided direct physical contact such as hugs and handshakes. “It seemed like a normal rehearsal, except that choirs are huggy places,” conductor Adam Burdick told the <em><a href="https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak">Los Angeles Times</a></em>. “We were making music and trying to keep a certain distance between each other.”</p> <p>The practice lasted 2.5 hours. Most members sat in their usual rehearsal seats. Once seated, they practiced singing for 40 minutes before splitting into two smaller groups for a 50-minute block. After a 15-minute break, during which some members shared cookies and oranges, they all reconvened for a final 45-minute practice session.</p> <p>“During the entire rehearsal, no one sneezed, no one coughed, no one there appeared to be sick in any way,” member Carolynn Comstock told <em><a href="https://edition.cnn.com/2020/04/01/us/washington-choir-practice-coronavirus-deaths/index.html">KIRO</a></em>.</p> <p>Within days, people began showing COVID-19 symptoms. In less than two weeks, 32 people tested positive for COVID-19 and another 20 were considered to have probable infections. Three were hospitalised, and two of them died.</p> <p>The CDC said people with symptoms should isolate or self-quarantine to prevent further spread of the disease.</p> <p>“The potential for superspreader events underscores the importance of physical distancing, including avoiding gathering in large groups, to control spread of COVID-19,” the agency said in the report.</p>

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Check your feet! 'COVID toes' are a new and more rampant sign of coronavirus

<p>Skin doctors are currently looking at a lot of toes, as concern grows that for some people, a symptom COVID-19 might be in an unusual spot.</p> <p>Boston dermatologist Esther Freeman expected to see skin complaints as COVID-19 hit the US but wasn’t expecting them to be toes.</p> <p>"But I was not anticipating those would be toes," Massachusetts General Hospital employee Dr Freeman said to <em><a rel="noopener" href="https://www.9news.com.au/world/covid-toe-rash-possible-coronavirus-infection-sign/5bf041bd-a472-44e9-9e95-f8eb10695447" target="_blank">9news</a>.</em></p> <p>Cases were initially recorded in children but has appeared to have spread to adults as well.</p> <p>Dr Freeman has viewed via telemedicine more toes in the last several weeks than in her entire week.</p> <p>They’re being called ‘COVID toes’, which are red, sore and sometimes itchy swellings on toes.</p> <p>"I think it's much more rampant than we even realize. The good news is it resolves spontaneously," Dr Amy Paller of Northwestern University said.</p> <p>There are many theories as to why ‘COVID toes’ are appearing, including that it could be inflammation triggered by the infection instead of the cold as well as the virus potentially irritating the lining of blood vessels in the skin.</p> <p>"The public health message is not to panic," Dr Freeman said, noting that most toe patients she's seen haven't become severely ill. Are they contagious?</p> <p>"We can't tell if you've got COVID-19 just by looking at your toes," she said.</p>

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How to cope without touch during coronavirus

<p>Don’t shake hands, don’t high-five, and definitely don’t hug.</p> <p>We’ve been bombarded with these messages during the pandemic as a way to slow the spread of COVID-19, meaning we may not have hugged our friends and family in months.</p> <p>This might be really hard for a lot of us, particularly if we live alone. This is because positive physical touch can make us feel good. It boosts levels of hormones and neurotransmitters that promote mental well-being, is involved in bonding, and can help reduce stress.</p> <p>So how can we cope with a lack of touch?</p> <p style="text-align: center;"><img style="display: block; margin-left: auto; margin-right: auto;" src="https://images.theconversation.com/files/334569/original/file-20200513-82383-15hqj0h.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /> <span class="caption"></span> <span class="attribution"><span class="source">Wes Mountain/The Conversation</span>, <a href="http://creativecommons.org/licenses/by-nd/4.0/" class="license">CC BY-ND</a></span></p> <p><strong>Touch helps us bond</strong></p> <p>In humans, the hormone oxytocin is released during <a href="https://journals.lww.com/psychosomaticmedicine/Abstract/2008/11000/Influence_of_a__Warm_Touch__Support_Enhancement.4.aspx">hugging</a>, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.2008.02324.x">touching</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/8135652/">and</a> <a href="https://pubmed.ncbi.nlm.nih.gov/3782434/">orgasm</a>. Oxytocin also acts as a neuropeptide, which are small molecules used in brain communication.</p> <p>It is involved in social recognition and bonding, such as between <a href="https://www.biologicalpsychiatryjournal.com/article/S0006-3223(10)00120-4/fulltext">parents</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582747/">children</a>. It may also be involved in <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0001128">generosity</a> and the formation of <a href="https://www.nature.com/articles/nature03701">trust between people</a>.</p> <p>Touch also helps reduce <a href="https://www.sciencedirect.com/science/article/pii/S0149763413001085?via%3Dihub">anxiety</a>. When premature babies are <a href="https://journals.sagepub.com/doi/abs/10.1177/1099800408327789?casa_token=UyxpZV84Ga4AAAAA:0qKl1M2evatEr299KZQMXn24rRu8xplYFuWgajWb1C-J73h1svAeJgb2IbOrRMx_ksqRBkw63GW8">held by their mothers</a>, both infants and mothers show a decrease in cortisol, a hormone involved in the stress response.</p> <p><strong>Touch promotes mental well-being</strong></p> <p>In adults with advanced cancer, massages or simple touch can reduce pain and <a href="https://annals.org/aim/article-abstract/742783/massage-therapy-versus-simple-touch-improve-pain-mood-patients-advanced">improve mood</a>. Massage therapy has been shown to increase <a href="https://journals.sagepub.com/doi/full/10.1177/1088868316650307?casa_token=dZb778AAnTAAAAAA%3Ai512eiP2Qyah4oj9VFPLJu9UvqES_Lv1T0TXIs-8SsAodnVfwfwBvnlhWIg5di-ZiDvS7-YMFCNB">levels of dopamine</a>, a neurotransmitter (one of the body’s chemical messengers) involved in satisfaction, motivation, and <a href="https://www.sciencedirect.com/science/article/pii/S0960982209018442">pleasure</a>. Dopamine is even released when we <a href="https://pubmed.ncbi.nlm.nih.gov/9858756/">anticipate</a> pleasurable activities such as eating and sex.</p> <p>Disruptions to normal dopamine levels are linked to a range of mental illnesses, including <a href="https://pubmed.ncbi.nlm.nih.gov/28289283/">schizophrenia, depression</a> and <a href="https://motamem.org/wp-content/uploads/2019/10/dopamine-functions-pathways.pdf">addiction</a>.</p> <p>Serotonin is another neurotransmitter that promotes feelings of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0028393206002910?via%3Dihub">well-being and happiness</a>. Positive touch boosts the release of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0022399903005002">serotonin</a>, which corresponds with reductions in <a href="https://pubmed.ncbi.nlm.nih.gov/16162447/">cortisol</a>.</p> <p>Serotonin is also important for <a href="https://pubmed.ncbi.nlm.nih.gov/10080856/">immune system function</a>, and touch has been found to <a href="https://journals.sagepub.com/doi/abs/10.1177/1043454208323295?casa_token=kN8OStP1vNEAAAAA:FAuh0bnUQRNoJiGe1KyvUcpTQXTivmRnX7_UXyQjwAG-v9Lp44ZSlgaweJnY7Og7YMI9RC9YxbD9">improve our</a> <a href="https://pubmed.ncbi.nlm.nih.gov/15740822/">immune system response</a>.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/23440471/">Symptoms of depression and suicidal behaviour</a> are associated with disruptions in normal serotonin levels.</p> <p><strong>But what about a lack of touch?</strong></p> <p>Due to social distancing measures during the COVID-19 pandemic, we should be vigilant about the possible effects of a lack of physical touch, on mental health.</p> <p>It is not ethical to experimentally deprive people of touch. Several studies have explored the impacts of naturally occurring reduced physical touch.</p> <p>For example, living in institutional care and receiving reduced positive touch from caregivers is associated with <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/impact-of-institutionalization-on-child-development/5DF14A15441D8235B9A946E0EAA33D45">cognitive</a> <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053811901909176">and</a> <a href="https://srcd.onlinelibrary.wiley.com/doi/full/10.1111/j.1750-8606.2007.00004.x?casa_token=rVR0WRhyjk8AAAAA%3Ax0NsVLjChNFMf5myt1TBjSGm7bvdvKws-7jjgUr5r2Lmyvw-szX_rBFKkT12ItsnlsrzuQSD8CapzA">developmental</a> delays in children. These delays can persist for many years after <a href="https://srcd.onlinelibrary.wiley.com/doi/full/10.1111/j.1467-8624.2006.00898.x?casa_token=ZnNURAdsKrAAAAAA%3AFS72bcP6Ig6lCN8FI46GN9vloIqP9rROUg9uGtPx_JemFofu3vMwNOfH6oT8q3z7vVbuLD46Y2PRDw">adoption</a>.</p> <p>Less physical touch has also been linked with a higher likelihood of aggressive behaviour. <a href="https://www.tandfonline.com/doi/abs/10.1080/0300443991510102?casa_token=bZf5x9lhwNkAAAAA:yUsRa2LZ6nWfn_JA5MVMNFd32Kog7VPcSyuAhhTdn4-PCD65Ac5ZnE8eW_Uv8ekUZHuL4IE4yhgr">One study</a> observed preschool children in playgrounds with their parents and peers, in both the US and France, and found that parents from the US touched their children less than French parents. It also found the children from the US displayed more aggressive behaviour towards their parents and peers, compared to preschoolers in France.</p> <p>Another study observed adolescents from the US and France interacting with their peers. The American kids showed more aggressive verbal and physical behaviour than French adolescents, <a href="https://go.gale.com/ps/anonymous?id=GALE%7CA59810232&amp;sid=googleScholar&amp;v=2.1&amp;it=r&amp;linkaccess=abs&amp;issn=00018449&amp;p=AONE&amp;sw=w">who engaged in more physical touch</a>, although there may also be other factors that contribute to different levels of aggression in young people from different cultures.</p> <p><strong>Maintain touch where we can</strong></p> <p>We can maintain touch with the people we live with even if we are not getting our usual level of physical contact elsewhere. Making time for a hug with family members can even help with promoting positive mood during conflict. Hugging is associated with smaller decreases in positive emotions and can lessen the impact of negative emotions in times of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169869/">conflict</a>.</p> <p>In children, positive touch is correlated with more self-control, happiness, and pro-social skills, which are behaviours intended to benefit others. People who received more affection in childhood behave more pro-socially in <a href="https://link.springer.com/epdf/10.1186/s41155-019-0129-0?author_access_token=CbUzFXMVtXQL2lmf5BV1wm_BpE1tBhCbnbw3BuzI2RM8OT5TtfvmMHxgMooOJlL5qpk4nvXH8JFe5eXPtcMFc9eaCU5804N8DmnqjYuywulsb9KjAyYKHOa7brBihmOftIV-4CscBuXEInDWdZw4uA%3D%3D">adulthood</a> and also have more secure attachments, meaning they display more positive views of themselves, others, and relationships.</p> <p><strong>Pets can help</strong></p> <p>Petting animals can increase levels of oxytocin and <a href="https://www.tandfonline.com/doi/abs/10.2752/175303711X13045914865385">decrease cortisol</a>, so you can still get your fill of touch by interacting with your pets. Pets can reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408111/">stress, anxiety</a>, <a href="https://www.tandfonline.com/doi/abs/10.2752/175303707X207954">depression</a> and improve <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408111/">overall health</a>.</p> <p>In paediatric hospital settings, pet therapy results in improvements in <a href="https://www.tandfonline.com/doi/abs/10.1207/s15326888chc3104_5?casa_token=G8-y9KR7dAAAAAAA:O4DN6KFbXxhX0ePX51-3yMotiehGdWHTD3j2f72FBLy3VGpsQ1NSB2T3RNPKCOkUZs-4h1b_pW2M">mood</a>. In adults, companion animals can decrease mental distress in people experiencing <a href="https://www.sciencedirect.com/science/article/pii/S0022103111002411?casa_token=AVYxxYaVqi8AAAAA:tEpkuxiITfvS5evk60XO6nOAEHmihxWv_WrQq6GIWb9lcNvQLj4JnEpmOWDKbeOcwgbqicsb-dg">social exclusion</a>.</p> <p><strong>What if I live alone?</strong></p> <p>If you live alone, and you don’t have any pets, don’t despair. There are many ways to promote mental health and well-being even in the absence of a good hug.</p> <p><a href="https://www.lifestylemedicine.org/">The American College of Lifestyle Medicine</a> highlights six areas for us to invest in to promote or <a href="https://theconversation.com/is-your-mental-health-deteriorating-during-the-coronavirus-pandemic-heres-what-to-look-out-for-134827">improve our mental health</a>: sleep, nutrition, social connectedness, exercise, stress management, and avoiding risky substance use. <a href="https://www.hsj.gr/medicine/stress-management-techniques-evidencebased-procedures-that-reduce-stress-and-promote-health.php?aid=3429">Stress management techniques</a> that use breathing or relaxation may be a way to nurture your body when touch and hugs aren’t available.</p> <p>Staying in touch with friends and loved ones can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921311/">increase oxytocin and reduce stress</a> by providing the social support we all need during physical distancing.</p> <hr /> <p><em>This article is supported by the <a href="https://theconversation.com/au/partners/judith-neilson-institute">Judith Neilson Institute for Journalism and Ideas</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/137612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/michaela-pascoe-429568">Michaela Pascoe</a>, Postdoctoral Research Fellow in Mental Health, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a>; <a href="https://theconversation.com/profiles/alexandra-parker-572547">Alexandra Parker</a>, Professor of Physical Activity and Mental Health, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a>; <a href="https://theconversation.com/profiles/glen-hosking-1056173">Glen Hosking</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a>, and <a href="https://theconversation.com/profiles/sarah-dash-137408">Sarah Dash</a>, Postdoctoral research fellow, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/miss-hugs-touch-forms-bonds-and-boosts-immune-systems-heres-how-to-cope-without-it-during-coronavirus-137612">original article</a>.</em></p>

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Hey Hey It’s Saturday star John Blackman undergoes more facial surgery

<p><em>Hey Hey It’s Saturday</em> star John Blackman has undergone more surgery on Monday after doctors were forced to remove his jaw to save him from skin cancer.</p> <p>He shared a photo of himself recovering in Melbourne’s Linacre Private Hospital, showing his face bruised and stitched together.</p> <p>“My journey towards becoming George Clooney's stunt double for all his love scenes (or the part of Scarecrow in the Wizard of Oz) continued today,” John joked on Monday.</p> <p>“Huge thanks to all the wonderful staff and my plastic surgeon Doctor Frank!”</p> <blockquote class="twitter-tweet"> <p dir="ltr">My journey towards becoming George Clooney's stunt double for all his love scenes (or the part of Scarecrow in the Wizard of Oz) continued today at Linacre Private Hospital. Huge thanks to all the wonderful staff and my plastic surgeon Doctor Frank! <a href="https://t.co/9Xta5eDB3E">pic.twitter.com/9Xta5eDB3E</a></p> — JohnBlackman (@johnblackmanhey) <a href="https://twitter.com/johnblackmanhey/status/1259757239964844045?ref_src=twsrc%5Etfw">May 11, 2020</a></blockquote> <p>He last went under the knife in February to have a ‘gutter’ placed in his mouth to stop him from dribbling. This is after his jaw was completely removed and was replaced with a reshaped section of his fibula.</p> <p>John was diagnosed with basal cell carcinoma, which is a type of skin cancer that accounts for around 70% of non-melanoma skin cancers. He was first diagnosed in 2018 when he found a lump on his chin which he initially thought was a pimple.</p> <p>Speaking to 3AW's Neil Mitchell in March 2019, John said: “It's like I've had an accident. It's like I've ploughed into a tree and my life has changed forever.</p> <p>“There are people out there far worse off, and I'm reminded of that everyday,' he said, adding that he had to communicate through eye movements while in recovery.”</p> <p>The beloved former voice of Dickie Knee on the show said he has a newfound appreciation for people with disabilities and their resilience.</p> <p>“Sometime's it's like Groundhog Day, every morning I wake up and look in the mirror and think "maybe today it'll change" but it's still there,” he said.</p>

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Why some twins aren't identical

<p>When a mother gives birth to twins, the offspring are not always identical or even the same gender. Known as fraternal twins, they represent a longstanding evolutionary puzzle.</p> <p>Identical twins arise from a single fertilised egg that accidentally splits in two, but fraternal twins arise when two eggs are released and fertilised. Why this would happen was the puzzle.</p> <p>In research <a href="https://www.nature.com/articles/s41559-020-1173-y" title="An age-dependent ovulatory strategy explains the evolution of dizygotic twinning in humans">published in <em>Nature Ecology &amp; Evolution</em></a> we used computer simulations and modelling to try to explain why natural selection favours releasing two eggs, despite the low survival of twins and the risks of twin births for mothers.</p> <p><strong>Why twins?</strong></p> <p>Since Michael Bulmer’s landmark 1970 <a href="https://books.google.com.au/books/about/The_Biology_of_Twinning_in_Man.html?id=awo-AAAAYAAJ">book on the biology of twinning in humans</a>, biologists have questioned whether double ovulation was favoured by natural selection or, like identical twins, was the result of an accident.</p> <p>At first glance, this seems unlikely. The embryo splitting that produces identical twins is not heritable and the incidence of identical twinning does not vary with other aspects of human biology. It seems accidental in every sense of the word.</p> <p>In contrast, the incidence of fraternal twinning changes with <a href="https://doi.org/10.1017/S0021932000007896" title="Ethnic differences in twinning rates in Nigeria">maternal age</a> and is <a href="https://doi.org/10.1016/S0140-6736(03)14237-7" title="Twinning">heritable</a>.</p> <p>Those do not sound like the characteristics of something accidental.</p> <p><strong>The twin disadvantage</strong></p> <p>In human populations without access to medical care there seems little benefit to having twins. <a href="https://doi.org/10.1046/j.1420-9101.2001.00287.x" title="The fitness of twin mothers: evidence from rural Gambia">Twins</a> are more likely to die in childhood than single births. Mothers of twins also have an increased risk of dying in childbirth.</p> <p>In common with other great apes, women seem to be built to give birth to <a href="https://doi.org/10.1111/j.1558-5646.1990.tb05211.x" title="ON THE EVOLUTION OF HUMAN BROOD SIZE">one child at a time</a>. So if twinning is costly, why has evolution not removed it?</p> <p>Paradoxically, in high-fertility populations, the mothers of twins often have <a href="https://doi.org/10.1046/j.1420-9101.2001.00287.x" title="The fitness of twin mothers: evidence from rural Gambia">more offspring</a> by the end of their lives than other mothers. This suggests having twins might have an evolutionary benefit, at least for mothers.</p> <p>But, if this is the case, why are twins so rare?</p> <p><strong>Modelling mothers</strong></p> <p>To resolve these questions, together with colleagues Bob Black and Rick Smock, we <a href="https://doi.org/10.1038/s41559-020-1173-y" title="An age-dependent ovulatory strategy explains the evolution of dizygotic twinning in humans">constructed simulations and mathematical models</a> fed with data on maternal, child and fetal survival from real populations.</p> <p>This allowed us to do something otherwise impossible: control in the simulations and modelling whether women ovulated one or two eggs during their cycles. We also modelled different <a href="https://doi.org/10.1016/j.tree.2007.09.002" title="The status of the conditional evolutionarily stable strategy">strategies</a>, where we switched women from ovulating one egg to ovulating two at different ages.</p> <p>We could then compare the number of surviving children for women with different patterns of ovulation.</p> <p>Women who switched from single to double ovulation in their mid-20s had the most children survive in our models – more than those who always released a single egg, or always released two eggs.</p> <p><a href="https://images.theconversation.com/files/333966/original/file-20200511-49558-4l8o82.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/333966/original/file-20200511-49558-4l8o82.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption"></span> <span class="attribution"><span class="license">Author provided</span></span></p> <p>This suggests natural selection favours an unconscious switch from single to double ovulation with increasing age.</p> <p><strong>A strategy for prolonging fertility</strong></p> <p>The reason a switch is beneficial is fetal survival – the chance that a fertilised egg will result in a liveborn child – <a href="https://doi.org/10.1126/science.aaa3337" title="Common variants spanning PLK4 are associated with mitotic-origin aneuploidy in human embryos">decreases rapidly as women age</a></p> <p>So switching to releasing two eggs increases the chance at least one will result in a successful birth.</p> <p>But what about twinning? Is it a side effect of selection favouring fertility in older women? To answer this question, we ran the simulations again, except now when women double ovulated the simulation removed one offspring before birth.</p> <p>In these simulations, women who double ovulated throughout their lives, but never gave birth to twins, had more children survive than those who did have twins and switched from single to double ovulating.</p> <p><a href="https://images.theconversation.com/files/333982/original/file-20200511-49558-d6tomg.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/333982/original/file-20200511-49558-d6tomg.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption"></span> <span class="attribution"><span class="license">Author provided</span></span></p> <p>This suggests the ideal strategy would be to always double ovulate but never produce twins, so fraternal twins are an accidental side effect of a beneficial strategy of double ovulating.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/138209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/joseph-l-tomkins-311105">Joseph L Tomkins</a>, Associate Professor in Evolutionary Biology, <a href="https://theconversation.com/institutions/university-of-western-australia-1067">University of Western Australia</a>; <a href="https://theconversation.com/profiles/rebecca-sear-1067265">Rebecca Sear</a>, Head of the Department of Population Health, <a href="https://theconversation.com/institutions/london-school-of-hygiene-and-tropical-medicine-859">London School of Hygiene &amp; Tropical Medicine</a>, and <a href="https://theconversation.com/profiles/wade-hazel-1067264">Wade Hazel</a>, Professor of Biology, <a href="https://theconversation.com/institutions/depauw-university-1274">DePauw University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-twins-are-identical-and-thats-been-an-evolutionary-puzzle-until-now-138209">original article</a>.</em></p>

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Adele shows off dramatic weight loss in new snaps

<div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>Grammy winner Adele has just sent fans into meltdown by showing off her svelte figure in her latest snap. The singer rarely posts on social media, but thanked her fans for the “birthday love” as she celebrated her 32nd birthday in lockdown.</p> <p>"Thank you for the birthday love. I hope you're all staying safe and sane during this crazy time," she captioned her post.</p> <p>"I'd like to thank all of our first responders and essential workers who are keeping us safe while risking their lives! You are truly our angels ♥️ 2020 okay bye thanks x"</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B_1VGc5AsoZ/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="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;" rel="noopener" href="https://www.instagram.com/p/B_1VGc5AsoZ/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Adele (@adele)</a> on May 5, 2020 at 9:38pm PDT</p> </div> </blockquote> <p>Adele’s fans and famous friends were lost for words.</p> <p>"So long waiting for this photo, it is incredible, how beautiful and unique Adele is," one fan wrote.</p> <p>Model Chrissy Teigen was left shocked, commenting: "I mean are you kidding me."</p> <p>The latest snap is more evidence that Adele has been working hard behind the scenes, as her PT Camila Goodis can confirm.</p> <p>"The first week is pretty intense ... it's a lot of green juice and 1000 calories a day," she revealed on British breakfast television show<span> </span>Lorraine.</p> <p>"Giving up processed food, sugar, soda and get into an exercise routine, like cardio and strength training, will change people's bodies."</p> <p>"I believe now she's into working out, she's working out more and more but, it's 90 per cent what she did was diet. There's no secret, I didn't help with any diet. She started doing this certain diet and now she's maintaining just eating healthy. It's a good diet to shed the weight," Camila said.</p> </div> </div> </div>

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How to beat weight gain at menopause

<p>For many women, the journey through menopause is a roller coaster of <a href="https://www.jeanhailes.org.au/health-a-z/menopause/menopause-symptoms">symptoms including hot flushes</a>, night sweats, sleep disturbance, dry and itchy skin, mood changes, anxiety, depression and weight gain. For some, it can be relatively uneventful.</p> <p>Menopause <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause">is medically defined</a> as not having any menstrual bleeding for 12 months. Most women reach this milestone <a href="https://www.jeanhailes.org.au/health-a-z/menopause/about-menopause">between the ages of 45 to 55</a>.</p> <p>Even though weight gain is common, you can beat it by using menopause as an opportunity to reset your eating and exercise habits.</p> <p><strong>Do women gain weight at menopause?</strong></p> <p>During menopause, women also experience a shift in <a href="https://www.ncbi.nlm.nih.gov/pubmed/28982486">how fat stores are distributed</a> around the body. Fat tends to move from the thigh region up to the waist and abdomen.</p> <p>A review of studies that quantified changes in body fat stores before and after menopause found <a href="https://www.ncbi.nlm.nih.gov/pubmed/31034807">total body fat mass also increased significantly</a>.</p> <p>While the average weight increase was only about one kilogram, the increase in percentage total body fat was almost 3%, with fat on the trunk increasing by 5.5% and total leg fat decreasing around 3%.</p> <p>Average waist circumference increased by about 4.6 centimetres and hips by 2.0 centimetres.</p> <p>Other bad news is that once postmenopausal, <a href="https://www.ncbi.nlm.nih.gov/pubmed/25191611">women have lower total daily energy needs</a>. This is partly because body fat requires less energy to maintain it compared to muscle. So even if your weight doesn’t change, the increase in body fat means your body needs fewer kilojoules each day.</p> <p>In addition to this, <a href="https://www.ncbi.nlm.nih.gov/pubmed/1522233">the menstrual cycle had a small energy cost</a> to maintain ovarian function. This amounted to about 200 kilojoules a day, which is now “saved”.</p> <p>The bottom line is that unless your transition to menopause is accompanied by a reduction in your total energy intake or an increase in your physical activity, you’re at high risk of weight gain.</p> <p><strong>But there is some good news</strong></p> <p>Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/16491110">60% of women manage to avoid weight gain</a> at menopause.</p> <p>They <a href="https://www.ncbi.nlm.nih.gov/pubmed/17264847">manage this by</a> either decreasing the total amount of food they eat, cutting down on fat and sugar, using commercial weight loss programs, doing more exercise, or a combination of all these.</p> <p>They key thing is that they change some aspects of their lifestyle.</p> <p><strong>So what works best?</strong></p> <p>Until recently, only <a href="https://www.ncbi.nlm.nih.gov/pubmed/24971172">three major studies</a> had tested interventions.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pubmed/14644697">Women’s Healthy Lifestyle Project</a> compared the impact of receiving support to improve diet and exercise habits over four years covering menopause, to making no changes at all.</p> <p>Women who changed their lifestyle had lower body weights, less abdominal fat and better blood sugar levels compared to those in the control group.</p> <p>The second study, of 168 women, enrolled <a href="https://www.ncbi.nlm.nih.gov/pubmed/19339904">them into a 90 minute Nordic walking program</a>, three times a week.</p> <p>This was associated with a reduction in weight, body fat and waist circumference, as well as blood levels of <a href="https://en.wikipedia.org/wiki/Low-density_lipoprotein">bad cholesterol</a> and fats, highlighting the benefits of endurance walking.</p> <p>The third study divided 175 Nigerian women into two groups: one group undertook a <a href="https://www.ncbi.nlm.nih.gov/pubmed/22547191">12-week circuit training exercise program</a>, the other was a control group.</p> <p>Women in the exercise group reduced their waist circumference relative to their hips, indicating a reduction in abdominal fat, even though their total body weight did not change.</p> <p><strong>The 40-something trial</strong></p> <p>More recently, we studied 54 women aged 45-50 years in the <a href="https://www.ncbi.nlm.nih.gov/pubmed/24156558">“40-Something” trial</a>.</p> <p>We randomly assigned half the participants to receive healthy eating and physical activity support from health professionals, using motivational interviewing to encourage behaviour change. The other half received information only and were asked to self-direct their lifestyle changes.</p> <p>Our aim was to prevent weight gain in women who were in either the overweight or healthy weight range as they entered early menopause.</p> <p>We encouraged women who were overweight to reduce their body weight to achieve a body mass index (<a href="https://www.heartfoundation.org.au/your-heart/know-your-risks/healthy-weight/bmi-calculator">BMI</a>) in the healthy weight range (BMI 18 to 25). We encouraged women already in the healthy weight range to maintain their weight within one kilogram.</p> <p>We gave all women the same healthy lifestyle advice, including to eat:</p> <ul> <li>2 serves of fruit and at least 5 serves of vegetables every day</li> <li>1-1.5 serves of meat or meat alternatives</li> <li>2-3 serves of dairy</li> <li>wholegrain breads and cereals.</li> </ul> <p>And to:</p> <ul> <li>limit foods high in fat and sugar</li> <li>cut down on meals eaten outside the home</li> <li>engage in moderate to vigorous physical activity for 150-250 minutes per week</li> <li>sit for less than three hours per day</li> <li>take at least 10,000 steps per day.</li> </ul> <p>Women in the intervention group had five consultations with a dietitian and exercise physiologist over one year to provide support and motivation to change their eating habits and physical activity.</p> <p>After two years, women in the intervention group had <a href="https://www.ncbi.nlm.nih.gov/pubmed/31108930">lower body weights, less body fat and smaller waist circumferences</a> compared to the control group who received information pamphlets only.</p> <p>When we evaluated changes based on their starting BMI, the intervention was more effective for preventing weight gain in women initially of a healthy weight.</p> <p>Of all the health advice, <a href="https://www.ncbi.nlm.nih.gov/pubmed/25062965">eating five serves of vegetables and taking 10,000 steps per day</a> were the most effective strategies for long-term weight control during menopause.</p> <p>Although weight gain, and especially body fat gain, is usual during the menopausal transition, you can beat it.</p> <p>Rather than menopause being a time to put your feet up, it’s a time to step up your physical activity and boost your efforts to eat a healthy, balanced diet, especially when it comes to the frequency and variety of vegetables you eat.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/123368/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jenna-hollis-171991">Jenna Hollis</a>, Conjoint Lecturer, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/lauren-williams-14548">Lauren Williams</a>, Professor of Nutrition and Dietetics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-beat-weight-gain-at-menopause-123368">original article</a>.</em></p>

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Can you get the COVID-19 coronavirus twice?

<p>Governments are starting to lift restrictions and some are considering “<a href="https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19">immunity passports</a>”, where all restrictions are lifted for those previously infected.</p> <p>But are you immune from COVID-19 if you’ve already been infected?</p> <p>Some infections never recur once you’ve had them, such as measles and smallpox. But you can get plenty of others again, such as influenza and tetanus.</p> <p>So far, research suggests at least a proportion of people who have had COVID-19 will be protected from another infection – <a href="https://www.science.org.au/covid19/re-infection-sars-cov-2">at least initially</a>. But the science is far from certain. Here’s what we know so far.</p> <p><strong>First, a quick recap about antibodies</strong></p> <p>When we encounter an infection for the first time, our body needs to respond quickly to the threat. So within hours, it activates our innate immune system. This system is quick-acting but isn’t targeted to the specific threat.</p> <p>The innate immune system’s attack distracts the infection while the body produces a more targeted but slower response against the infection, via the adaptive immune system.</p> <p>The adaptive immune system produces antibodies to fight the infection. These are what we measure in the blood when trying to determine who has been exposed to SARS-CoV-2, the virus that causes COVID-19.</p> <p>The body produces different types of antibodies to respond to different parts of the virus. But only some have the ability to stop the virus entering cells. These are called “neutralising antibodies”.</p> <p>According to the <a href="https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19">World Health Organisation</a>, people who recover from COVID-19 develop antibodies in their blood. But some people appear to have low levels of neutralising antibodies.</p> <p>To see if an antibody is a neutralising antibody, you need to do special laboratory tests to see the effect of the antibody in cells exposed to the virus.</p> <p>But even if an antibody blood test could confirm neutralising antibodies, it doesn’t automatically mean the person is immune from further infection. Even though the antibody is present, for example, the quantities may be insufficient to work.</p> <p>So a positive antibody blood test to COVID-19 doesn’t confirm if someone is immune to COVID-19 or not. It only tells us if a person has ever been exposed to COVID-19 – and even that depends on how sensitive and specific the antibody test is.</p> <p><strong>Why do some people test positive again?</strong></p> <p>There are <a href="https://www.livescience.com/coronavirus-reinfections-were-false-positives.html">reports from different countries</a> of people hospitalised with COVID-19 who tested negative when they were discharged, before testing positive again.</p> <p>However, a <a href="https://www.medrxiv.org/content/10.1101/2020.03.26.20044222v1.full.pdf">study from China</a> found those who retested positive didn’t get any sicker. This suggests these people were intermittently shedding the virus and were at the tail end of their original illness, rather than getting a new COVID-19 infection.</p> <p>The nasal and throat swab test being used to detect the virus also can’t say whether the virus is alive or not; therefore, they could have just been shedding dead virus. This could explain why their close contacts didn’t become sick or test positive.</p> <p><strong>Do other coronaviruses generate immunity?</strong></p> <p>Four other types of human coronaviruses (HCoVs) – 229E, NL63, OC43 and HKU1 – <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416289/pdf/zjv7577.pdf">cause about 15-30% of the common colds</a> worldwide. Two of these – OC43 and HKU1 – are a subgroup of coronaviruses known as betacoronaviruses, as are SARS-CoV, MERS and SARS-CoV-2.</p> <p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/2170159">study from 1990</a> found infection with human coronavirus 229E generated protective immunity from that particular virus. But one year later, as antibody levels declined, these people could be reinfected. The researchers hypothesised a cyclic pattern of infection, with people getting coronavirus infections every two to three years.</p> <p>More recently, when <a href="https://www.jimmunol.org/content/181/8/5490.long">researchers examined</a> 128 samples from people who had recovered from SARS (severe acute respiratory syndrome, or SARS-CoV), they found 90% had strong neutralising antibodies, while 50% had positive T cell responses, meaning they were likely to be immune.</p> <p>Given this information about other coronaviruses, it’s likely that infection with SARS-CoV-2 provides some immunity from a second infection. But whether everyone becomes immune, and the duration of that immunity, are unknown.</p> <p><strong>Do other coronaviruses provide cross-immunity against COVID-19?</strong></p> <p>Cross-immunity is where immunity against one infection provides protection from another infection.</p> <p>In <a href="https://www.ncbi.nlm.nih.gov/pubmed/22188723">one study</a>, researchers tracked newborns up to 20 months of age. They found that infection with human coronavirus OC43 generated neutralising antibodies that may have protected against HKU1. In other words, it led to cross-immunity.<a href="https://theconversation.com/what-does-it-mean-to-be-immunocompromised-and-why-does-this-increase-your-risk-of-coronavirus-135200"></a></p> <p>If there is cross-immunity between HCoV-OC43 and HCoV-HKU1, which are both betacoronaviruses, it’s possible they could generate cross-immunity with the new betacoronavirus, SARS-CoV-2.</p> <p>But unfortunately, the current tests for COVID-19 (nasal and throat swabs, and blood tests) can’t give us information about cross-immunity.</p> <p><strong>Why could cross-immunity be important?</strong></p> <p>Cross-immunity with the other two betacoronaviruses could partly explain some of the inconsistencies we see with COVID-19.</p> <p>For example, why do some <a href="https://www.abc.net.au/news/2020-04-04/more-younger-people-dying-and-in-icu-from-coronavirus-covid-19/12121772">people under 50 years of age</a> experience severe and even fatal illness with COVID-19, while <a href="https://www.dailymail.co.uk/news/article-8216871/Turkish-woman-second-107-year-old-beat-coronavirus.html">others over 100 years old</a> fully recover?</p> <p>Given that immunity to these two other betacoronaviruses is widespread and probably fluctuates over time, people with COVID-19 may have had different antibody levels against HCoV-OC43 and HCoV-HKU1 when they were infected with SARS-CoV-2. This could have contributed to differing levels of severity of COVID-19 infection.</p> <p>It’s even possible that the presence of cross-immunity could have been harmful rather than protective, because it might lead to an over-exuberant immune response. This phenomenon can be seen in dengue, another viral infection.</p> <p>Over time, the issue of immunity to COVID-19 will be resolved. But for now, scientists are still piecing the information together.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/137309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/sanjaya-senanayake-134837"><em>Sanjaya Senanayake</em></a><em>, Associate Professor of Medicine, Infectious Diseases Physician, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a></em></span></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-you-get-the-covid-19-coronavirus-twice-137309">original article</a>.</em></p>

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Do I need to floss my teeth?

<p>As a dentist, my patients often ask whether they still need to floss even though they brush their teeth. The answer is – that depends.</p> <p>A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008829.pub2/abstract">review of the research</a> on this topic found flossing, combined with regular brushing, reduced the chance of bleeding gums. But the review could not provide evidence flossing prevented holes (tooth cavities) from forming.</p> <p>This is likely <a href="https://www.sciencedirect.com/science/article/abs/pii/S1532338216301877">because</a> all of the included studies were conducted within one to three month periods. A few months is long enough to detect bleeding gums, but not for cavities to grow substantially.</p> <p>So studies in the review looked at the effectiveness of flossing on preventing gum disease rather than cavities.</p> <p> </p> <p>But at the very least, we know regular flossing protects our gum health, which in turn protects our teeth. So it’s definitely worth doing.</p> <p>The advice may be different if you have certain dental conditions – but we’ll get to that later.</p> <p><strong>Why should I floss?</strong></p> <p>Cavities and gum disease are mainly caused by plaque that accumulates on our teeth and gums. Dental plaque is part of a complex ecosystem that includes <a href="http://www.homd.org">800 different types</a> of bacteria found in our mouth.</p> <p>Our plaque’s unique <a href="https://www.pnas.org/content/108/10/4152.short">ecosystem</a> is a like a major city, and brushing is like Godzilla destroying the infrastructure. But plaque bacteria can rebuild infrastructure fairly quickly, which is why we brush frequently.</p> <p>Brushing, however, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-051X.1991.tb00109.x">isn’t very effective</a> at cleaning in between your teeth. And it’s the plaque that remains in these areas that leads to most <a href="http://www.parodontologie-utrecht.nl/media/boeken/boekintraoralhygieneevidence.pdf">cavities</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-051X.1992.tb02174.x">gum disease</a>. So that’s where flossing comes in – to clean between the teeth.</p> <p> </p> <p>If plaque on our teeth and gums are left long enough, the mineral in our saliva hardens it to form a white chalky substance called calculus. The calculus acts as a home to many different types of bacteria that can advance gum disease.</p> <p>Once formed, calculus is impossible to remove by brushing or flossing alone. It needs to be removed using special tools at the dentist.</p> <p><strong>What’s the big deal about bleeding gums?</strong></p> <p>Similar to the way doctors measure health by checking your blood pressure, dentists and hygienists gently <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-051X.1990.tb01059.x">poke</a> your gums to see if they bleed.</p> <p>Bleeding gums often signal the presence of uncleaned plaque and/or calculus in the area. You may even notice bleeding after you brush your teeth or eat certain foods.</p> <p>To a dental practitioner, bleeding gums indicate you’re at risk of developing advanced gum issues, called <a href="https://www.nidcr.nih.gov/health-info/gum-disease/more-info">periodontal disease</a>. This condition sees the foundations that hold your teeth in your jaw bone deteriorate, eventually causing your teeth to loosen and fall out.</p> <p>Socially embarrassing by-products of advanced gum disease include:</p> <ul> <li>loose teeth</li> <li>a yellow/brown smile</li> <li>large black gaps appearing between your teeth where the gums have shrunk away</li> <li>bad breath.</li> </ul> <p>So the act of flossing can serve to safeguard your smile.</p> <p>Current evidence also suggests periodontal disease is associated with an <a href="https://www.tandfonline.com/doi/abs/10.1185/03007990802131215">increased risk</a> of heart disease and diabetes, among other health issues.</p> <p><strong>OK, so I should definitely floss then?</strong></p> <p>This depends on your current situation. Just like you wouldn’t mop your rug or vacuum the shower recess, we have specific <a href="http://168.176.239.58/cursos/odontologia/2016549/pdf/Claydon2008Cepilladoylimpiezainterdental.pdf">tools</a> to suit every cleaning situation. Flossing (effectively) is great if:</p> <ul> <li>you still have most of your teeth</li> <li>your teeth are tightly jammed together</li> <li>your gums haven’t receded to leave triangular gaps between your teeth.</li> </ul> <p>While for a lot of us this may be the case, for some of us, simply flossing our teeth and gums will be ineffective. Particularly if you have:</p> <ul> <li>gaps between your teeth that are too large for floss to clean</li> <li>complex dental work such as <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/prd.12189">crowns, bridges</a> and <a href="http://www.quintpub.com/userhome/qi/qi_47_5_clark_p417.pdf">implants</a></li> <li>partial dentures (dentures that replace some missing teeth)</li> <li>orthodontic appliances such as <a href="https://orthodonticsaustralia.org.au/caring-for-braces/">braces</a>.</li> </ul> <p>In these instances, we have to start thinking about interdental cleaning, or using other tools to clean between your teeth such as special Christmas tree-shaped brushes or sticks.</p> <p> </p> <p>If you don’t think flossing is right for you, ask about interdental (between teeth) cleaning during your next visit to the dentist. Your dentist or hygienist will be able to recommend products and a cleaning routine to suit your needs.</p> <p><strong>Tips for good flossing</strong></p> <p>To floss effectively, keep in mind:</p> <ul> <li>floss at least once a day</li> <li>floss before brushing so it becomes part of your routine</li> <li>cut 30-40cm of regular floss for each use</li> <li>wrap most of it around the finger of one hand and 2-3cm around the finger of another</li> <li>slowly move the floss towards the gums to ensure you clean both teeth.</li> </ul> <p>Flossing can cause some bleeding, but this will resolve over time.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/KypRbdD68QQ?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p>Flossing can take some time to master. But the more often you floss, the faster and better you’ll become. And what better time to practise than when you’re stuck at home during a pandemic?</p> <p><em><a href="https://theconversation.com/profiles/arosha-weerakoon-792707">Arosha Weerakoon</a>, Lecturer, General Dentist &amp; PhD Candidate, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-i-need-to-floss-my-teeth-133245">original article</a>.</em></p>

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5 life lessons from your immune system

<p>Scientists love analogies. We use them continually to communicate our scientific approaches and discoveries.</p> <p>As an immunologist, it strikes me that many of our recurring analogies for a healthy, functioning immune system promote excellent behaviour traits. In this regard, we should all aim to be a little more like the cells of our immune system and emulate these characteristics in our lives and workplaces.</p> <p>Here are five life lessons from your immune system.</p> <p><strong>1. Build diverse and collaborative teams</strong></p> <p>Our adaptive immune system works in a very specific way to detect and eradicate infections and cancer. To function, it relies on effective team work.</p> <p>At the centre of this immune system team sits dendritic cells. These are the sentinels and leaders of the immune system – akin to coaches, CEOs and directors.</p> <p>They have usually travelled widely and have a lot of “life experience”. For a dendritic cell, this means they have detected a pathogen in the organs of the body. Perhaps they’ve come into contact with influenza virus in the lung, or encountered dengue fever virus in the skin following a mosquito bite.</p> <p>After such an experience, dendritic cells make their way to their local lymph nodes – organs structured to facilitate immune cell collaboration and teamwork.</p> <p>Here, like the best leaders, dendritic cells share their life experiences and provide vision and direction for their team (multiple other cell types). This gets the immune cell team activated and working together towards a shared goal – the eradication of the pathogen in question.</p> <p>The most important aspect of the dendritic cell strategy is knowing <a href="https://www.pnas.org/content/101/46/16385">the strength of combined diverse expertise</a>. It is essential that immune team members come from diverse backgrounds to get the best results.</p> <p>To do this, dendritic cells secrete small molecules known as chemokines. Chemokines facilitate good conversations between different types of immune cells, helping dendritic cells discuss their plans with the team. In immunology, we call this “recruitment”.</p> <p>Much <a href="https://www.nature.com/articles/s41467-018-07634-8">like our workplaces</a>, diversity is key here. It’s fair to say, if dendritic cells only recruited more dendritic cells, our immune system would completely fail its job. Dendritic cells instead hire T cells (among others) and share the critical knowledge and strategy to steer effective action of immune cells.</p> <p>T cells can then pass these plans down the line – either preparing themselves to act directly on the pathogen, or working alongside other cell types, such as B cells that make protective antibodies.</p> <p>In this way, dendritic cells establish a rich and diverse team that works together to clear infections or cancer.</p> <p><strong>2. Learn through positive and negative feedback</strong></p> <p>Immune cells are excellent students.</p> <p>During development, T cells mature in a way that depends on both positive and negative feedback. This occurs in the thymus, an organ found in the front of your chest and whose function was first discovered by Australian scientist <a href="https://www.wehi.edu.au/about-history/notable-scientists/professor-jacques-miller">Jacques Miller</a> (awarded the <a href="http://www.japanprize.jp/en/prize_prof_2018_miller.html">2018 Japan Prize</a> for his discoveries).</p> <p>As they mature, T cells are exposed to a process of trial and error, and take on board criticism and advice in equal measure, to ensure they are “trained” to respond appropriately to what they “see” (for example, molecules from your own body, or from a foreign pathogen) when they leave the thymus.</p> <p>Importantly, this process is balanced, and T cells must receive both positive and negative feedback to mature appropriately – too much of either on its own is not enough.</p> <p>In the diverse team of the immune system, cells can be both the student and the teacher. This occurs during immune responses with intense cross-talk between dendritic cells, T cells and B cells.</p> <p>In this supportive environment, multiple rounds of feedback allow B cells to gain a tighter grip on infections, tailoring antibodies specifically towards each pathogen.</p> <p>The result of this feedback is so powerful, it can divert cells away from acting against your own body, instead converting them into <a href="https://www.ncbi.nlm.nih.gov/pubmed/29650674">active participants of the immune system team</a>.</p> <p>Developing avenues that promote constructive feedback offers potential to correct autoimmune disorders.</p> <p><strong>3. A unique response for each situation</strong></p> <p>Our immune system knows that context is important – it doesn’t rely on a “one-size–fits-all” approach to resolve all infections.</p> <p>This allows the cells of our immune system to perfectly respond to different types of pathogens: such as viruses, fungi, bacteria and helminths (worms).</p> <p>In these different scenarios, even though the team members contributing to the response are the same (or similar), our immune system displays emotional intelligence and utilises different tools and strategies depending on the different situations, or pathogens, it encounters.</p> <p>Importantly, our immune system needs to carefully control attack responses to get rid of danger. Being too heavy handed leaves us with collateral tissue damage, such as is seen allergy and asthma. Conversely, weak responses lead to immunodeficiencies, chronic infection or cancer.</p> <p>A major research aim for people working in immunology is to learn how to harness balanced and tailored immune responses for therapeutic benefit.</p> <p><strong>4. Focus on work/life balance</strong></p> <p>When we are overworked and poorly rested, we don’t function at our peak. The same is true for our immune cells.</p> <p>An overworked immune cell is commonly referred to as being “chronically exhausted”. In this state, T cells are no longer effective at attacking tumour or virus-infected cells. They are lethargic and inefficient, much like us when we overdo it.</p> <p>For T cells, this switch to exhaustion helps ensure a balanced response and avoids collateral damage. However, viruses and cancers exploit this weakness in immune responses by deliberately promoting exhaustion.</p> <p>The rapidly advancing field of immunotherapy has tackled this limitation in our immune system head-on to create new cancer therapeutics. These therapies release cells of their exhaustion, refresh them, so they become effective once more.</p> <p>This therapeutic avenue (called “<a href="https://theconversation.com/2018-nobel-prize-in-physiology-or-medicine-a-turning-point-in-the-war-on-cancer-104191">immune checkpoint inhibition</a>”) is like a self-care day spa for your T cells. It revives them, renewing their determination and efficiency.</p> <p>This has revolutionised the way cancer is treated, leading to the award of the <a href="https://www.nobelprize.org/prizes/medicine/2018/press-release/">2018 Nobel prize in Medicine</a> to two of its pioneers, James P. Allison and Tasuku Honjo.</p> <p><strong>5. Learn from life experiences</strong></p> <p>The cornerstone of our adaptive immune system is the ability to remember our past infections. In doing so, it can respond faster and in a more targeted manner when we encounter the same pathogen multiple times.</p> <p>Quite literally, if it doesn’t kill you, it makes your immune system stronger.</p> <p>Vaccines exploit this <em>modus operandi</em>, providing immune cells with the memories without the risk of infection.</p> <p>Work still remains to identify the pathways that optimise formation of memory cells that drive this response. Researchers aim to discover which memories are the most efficient, and how to make them target particularly recalcitrant infections, such as malaria, HIV-AIDS and seasonal influenza.</p> <p>While life might not have the shortcuts provided by vaccines, certainly taking time to reflect and learn after challenges can allow us to find better, faster solutions to future problems.</p> <p><span><a href="https://theconversation.com/profiles/joanna-groom-550055"><em>Joanna Groom</em></a><em>, Laboratory Head, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a></em></span></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/five-life-lessons-from-your-immune-system-103425">original article</a>.</em></p>

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Surprising new coronavirus symptom has people itching for information

<p>As the world continues to battle coronavirus, new symptoms are emerging that have people looking at their feet.</p> <p>With headaches, muscle aches, a dry cough, fever, chills and losing your sense of taste and smell are established, doctors in Italy have noticed a rash appearing on people diagnosed with coronavirus’ toes.</p> <p>Viral rashes can occur when anyone has a virus, but dermatologists in Italy investigated the rate of skin-related symptoms in COVID-19 patients, they discovered one in five coronavirus patients had developed a rash.</p> <blockquote class="twitter-tweet"> <p dir="ltr">COVID TOES! As more patients throughout the country are getting tested for COVID-19 and more research is being conducted, more symptoms are starting to emerge, including signs and skin changes to your feet...Sudden onset increase redness, pain, blistering, itchiness. <a href="https://twitter.com/hashtag/COVIDTOES?src=hash&amp;ref_src=twsrc%5Etfw">#COVIDTOES</a> <a href="https://t.co/ldm7zA5BqQ">pic.twitter.com/ldm7zA5BqQ</a></p> — Jason Mendivil, DPM (@Dr_JMendivil) <a href="https://twitter.com/Dr_JMendivil/status/1253038875657846786?ref_src=twsrc%5Etfw">April 22, 2020</a></blockquote> <p>Texan dermatologist Dr Sanober Amin sparked interest when she suggested that “some skin findings are more consistent with superficial clotting in blood vessels close to the skin”.</p> <p>“It looks like the blood vessels are getting clotted, so patients are presenting with painful bumps on their toes. A lot of these patients are younger population and most of them didn’t have any COVID symptoms or had mild symptoms to begin with,” she said.</p> <p><iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Fphoto%2F%3Ffbid%3D714584779277938%26set%3Da.363761154360304&amp;show_text=true&amp;width=552&amp;height=702&amp;appId" width="552" height="702" style="border: none; overflow: hidden;" scrolling="no" frameborder="0" allowtransparency="true" allow="encrypted-media"></iframe></p> <p>For scientists, the rash is just more evidence that COVID is one of the “great imitators” as it can present with symptoms that sound like a cold or flu.</p> <p>“There’s clearly a respiratory syndrome, and that’s why people end up in the hospital. Some people get a gastrointestinal illness with diarrhoea, maybe some abdominal pain, which may or may not be associated with a respiratory illness,” Dr Joseph Vinetz, an infectious disease specialist at Yale School of Medicine said.</p> <p>However, Australian infectious diseases expert and ANU Professor Peter Collignon remains cautious.</p> <p>“The one thing that you have to be a bit careful of is people with COVID can have other infections too,’’ he said.</p> <p>“And some of those pictures looked like foot and mouth disease, which is a virus children get. So, you’ve got to be careful that what’s being attributed to COVID is not just another virus they have at the same time.</p> <p>“You can’t assume that just because someone has COVID that COVID is the cause of a rash.”</p> <p>The phenomena of COVID toes has not yet been recognised as a symptom by the World Health Organisation and more work needs to be done to investigate whether or not it is a legitimate symptom.</p> <p>“This is a manifestation that occurs early on in the disease, meaning you have this first, then you progress,” says the University of Pennsylvania’s chief of infectious disease Dr Ebbing Lautenbach.</p> <p> “Sometimes this might be your first clue that they have COVID when they don’t have any other symptoms.”</p> <p>“The short answer is, nobody knows.”</p>

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Shop’s blunt sign causes stir online after banning gloves in store

<p>A sign from an unknown store has caused furious debate online as it said all those wearing gloves would either have to remove them or be denied entry.</p> <p>The store, assumed to be located in the U.S, claims those wearing gloves are not stopping the spread of viruses, but in fact possibly creating cross contamination.</p> <p>“Absolutely no gloves allowed inside store - management,” the note says.</p> <p>“Gloves are meant to avoid cross-contamination. For instance, in a hospital, workers glove up to touch a patient and then DISCARD the gloves before moving on to the next task. If you are wearing the same set of gloves all over town, you are carrying germs everywhere! Every door you touch, the cart, the supplies, your phone, your face.</p> <p>“It would be far better to not wear gloves and WASH YOUR HANDS after every store or every task.”</p> <p>The photograph of the sign was shared over 60,000 times within the span of a week and gravitated many people who agreed with the note writer.</p> <p>“If you wear a clean pair of gloves into the store, pick up an item put it in your cart then pick up another item your gloves are contaminated, you have no idea who touched that item before you,” one person said. </p> <p>“Not everyone has common sense or knows anything about cross-contamination,” another wrote.</p> <p>“People are in fact wearing them store to store. Not even taking them off when they re-enter their vehicle after walking out of Walmart.</p> <p>“If there’s a medical condition, and you need gloves, wear them. But too many don’t understand their proper use, which isn’t helping and is preventing those that need them, from getting them.”</p> <p>Some people said they wash their gloves or change them between visiting each store.</p> <p>“So, I typically wash my gloves or wipe them with a Clorox wipe if going to a new store, usually I just use a new pair for each store. They absolutely are helpful,” said one woman in the comment section.</p> <p>Dr Catherine Bennett, chair in epidemiology at Deakin University explained to<span> </span><a rel="noopener noreferrer" href="https://au.news.yahoo.com/shop-sign-why-wearing-gloves-isnt-protecting-you-201747209.html" target="_blank">Yahoo News,</a><span> </span>that there is a risk of gloves transferring virus’ from one surface to another.</p> <p>“If the wearer is not practicing the usual hygiene and awareness of the surfaces being touched that we should all be practising, this risk of cross contamination of surfaces may be higher with gloves on,” she said.</p> <p>“If people are less mindful of what they are touching, including their own face, or tissues etc, then this may increase the risk of spreading the virus from surface to surface further.</p> <p>“It may also undo any protection to the wearer if they are more likely to touch their face with the gloves on with a false sense of security.”</p> <p>Virologist Professor Ian Mackay, from the University of Queensland urges people to stop assuming a pair of gloves will protect them at all costs. He says they can actually increase the chances of someone becoming sick.</p> <p>“They will drag their hands all over the place thinking they’re safe, but they’re actually spreading potential viruses to other people,” he said.</p> <p>“They then leave those gloves, in some cases, in the shopping trolley or in the car park for other people that clean up the shopping trolley to come in to contact with, and risk their health because of laziness.”</p>

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Why do some people with coronavirus get symptoms while others don't?

<p>SARS-CoV-2, the coronavirus which causes COVID-19, has <a href="https://coronavirus.jhu.edu/map.html">infected almost 2.5 million people</a> around the world and claimed 170,000 lives.</p> <p>But some people don’t even get symptoms. Recent studies suggest <a href="https://www.bmj.com/content/369/bmj.m1375">as many as 80%</a> <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2009316">or more</a> of those infected are “silent carriers”, showing no or very mild symptoms.</p> <p>It seems children and young, healthy people are <a href="https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/">more likely to be asymptomatic</a>.</p> <p>But to calculate the true proportions of people who have no symptoms right through to severe illness, testing would need to be expanded across whole populations, and this hasn’t been feasible yet.</p> <p>We don’t know exactly why some people with coronavirus are asymptomatic while others develop life-threatening illness. But here’s what we know so far.</p> <p><strong>What happens when coronavirus enters your body?</strong></p> <p>Like all viruses, SARS-CoV-2 needs to get inside human cells to multiply and survive.</p> <p>To do this, a particle on the outer shell of the virus latches onto a matching protein receptor, called ACE2, like a lock and key. ACE2 receptors are normally found in the lungs, kidneys, heart and the gut.</p> <p>Once a person has been infected with the virus, it can take <a href="https://www.who.int/news-room/q-a-detail/q-a-coronaviruses">up to 14 days</a> for symptoms to appear (if they do at all) – known as the incubation period.</p> <p>The path from the point of infection can vary enormously. The body’s immune system is critical for determining this.</p> <p>Having a strong immune response during the incubation period can prevent the infection taking hold, reduce the actual quantity of virus in the body and prevent it from getting to the lungs.</p> <p><strong>Some immune response basics</strong></p> <p>Our immune system offers us two lines of defence against viruses.</p> <p>The first is the <strong>innate system</strong> and includes physical barriers such as skin and mucous membranes (the lining of the throat and nose), various proteins and molecules found in tissues, as well as some of the white blood cells that attack invading organisms. This immune response is general, non-specific and kicks in quickly.</p> <p>Children have immature immune systems, but one hypothesis to explain why they don’t seem to get as sick with COVID-19 is that their innate immune response to coronavirus is greater than in adults.</p> <p>This may lead to a reduced viral load – the quantity of virus particles that survive in the body – because they’re able to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113798/">clear the virus more quickly</a>.</p> <p>The second line of defence is the <strong>adaptive immune response</strong>. This takes longer to initiate but once established, is much more efficient at eradicating a specific infection when encountering it again.</p> <p>It’s thought that <a href="https://www.medrxiv.org/content/10.1101/2020.03.22.20040600v2">very specific genetic variations</a> in some people might play a part in how sick they get. By generating an early adaptive immune response, the body seems to recognise the virus during the incubation period and fight it off.</p> <p>A person also needs to be generally healthy to <a href="https://www.nature.com/articles/s41418-020-0530-3">be able to mount an appropriate immune response</a> to the infection.</p> <p><strong>After the incubation period, what determines how sick you get?</strong></p> <p>If the SARS-CoV-2 virus survives beyond the point of entry to the body (nose, eyes, throat) it might then make its way down the respiratory tract into the lungs.</p> <p>In the lungs, it latches onto ACE2 receptors and continues replicating itself, triggering further immune responses to clean out infected cells. The amount of virus that gets deep into the lungs may be another important factor determining how sick you get.</p> <p>As the battle between virus and immune responses proceeds, infected airway linings produce large amounts of fluid that fill the air sacs, leaving less room for transferring oxygen into the bloodstream and removing carbon dioxide.</p> <p>Symptoms of pneumonia appear, such as fever, cough with sputum (phlegm) and shortness of breath.</p> <p>For some people, the immune response is <a href="https://theconversation.com/what-the-coronavirus-does-to-your-body-that-makes-it-so-deadly-133856">excessive or prolonged</a> and causes what’s known as a “cytokine storm”. Cytokines are a group of proteins that send signals to cells in the immune system, helping direct the response.</p> <p>A cytokine storm is a catastrophic overreaction that causes so much inflammation and organ damage, it can be fatal.</p> <p>In people with <a href="https://www.sciencedirect.com/science/article/pii/S2095177920302045">COVID-19, as well as the previous SARS and MERS coronaviruses</a>, this causes acute respiratory distress syndrome (ARDS), when fluid builds up in the lungs. This is the most common cause of death from SARS-CoV-2.</p> <p>Elderly people and those with chronic lung disorders are more likely to develop ARDS and therefore to die. This is currently thought to be due to these groups of people having fewer ACE2 receptors in their lungs.</p> <p>This seems counter-intuitive, because the virus attaches itself to these receptors. However, ACE2 receptors have an important role in regulating the immune response, particularly in managing the degree of inflammation.</p> <p>So the reduced levels of ACE2 receptors in the elderly may actually make them more at risk of a cytokine storm and severe lung disease.</p> <p>Conversely, children have more ACE2 receptors in their lungs which <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113798/">might explain</a> why they do not get as sick.</p> <p>In some cases, medications that work to suppress the immune system have <a href="https://www.ncbi.nlm.nih.gov/pubmed/32192578">successfully treated</a> this excessive immune response in people with COVID-19.</p> <p><strong>Can people without symptoms pass it on?</strong></p> <p><a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30196-1/fulltext">Some studies</a> have indicated people with COVID-19 tend to have a high viral load just before and shortly after they start getting symptoms.</p> <p>This suggests they can transmit it when they first get sick and <a href="https://www.nature.com/articles/s41591-020-0869-5">up to 48 hours before</a>, while they’re <em>pre-symptomatic</em>.</p> <p>However, there is no good evidence that <em>asymptomatic</em> people who never develop symptoms are able to pass it on.</p> <p>Researchers and clinicians are working around the clock to understand the complex relationship between humans’ immune systems and SARS-CoV-2 but it remains very much a work in progress.</p> <p><span><a href="https://theconversation.com/profiles/abela-mahimbo-1015703"><em>Abela Mahimbo</em></a><em>, Lecturer in Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a>; <a href="https://theconversation.com/profiles/david-isaacs-7752">David Isaacs</a>, Professor of Pediatric Infectious Diseases, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/melanie-wong-1033743">Melanie Wong</a>, Head of Diagnostic Immunology Laboratory, <a href="https://theconversation.com/institutions/kids-research-4414">Kids Research</a>, and <a href="https://theconversation.com/profiles/melissa-kang-2152">Melissa Kang</a>, Associate professor, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></span></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-some-people-with-coronavirus-get-symptoms-while-others-dont-135546">original article</a>.</em></p>

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How to clean the house while fitting in a workout

<blockquote> <p>The washing, drying, ironing, airing, pushing baby in his pram – these can all take on a different aspect if done with figure consciousness … Stretch to the ceiling Relax to the floor Swing to the window Swing to the door Bend by the table Foot on the chair Head to your knees Stretch in the air.</p> <p>– Eileen Fowler, “Housework for the Figure” in Home Management (1954)</p> </blockquote> <p>Before the aerobics revolution, <a href="https://www.theguardian.com/news/2000/mar/11/guardianobituaries">Eileen Fowler</a> was a health guru on the BBC’s first keep-fit radio program broadcast in 1954 with her catchwords: “Down with a bounce; with a bounce, come up.”</p> <p>She moved on to television and then records for people to exercise at home.</p> <p>“I don’t set aside certain hours for my exercises – they are with me all the time,” she wrote in Home Management.</p> <p>“Domestic duties involve a great deal of movement and, by merging them with easy exercises, you can help your figure.”</p> <p>Fowler’s objective was to make fitness fun. Prior to industrialisation, the working classes got exercise on the job – paid or unpaid. Manual labour was the primary way people got work done before machines, and even crafts like weaving were labour-intensive.</p> <p>Before irons became lightweight in the early 20th century, they could have substituted for dumbbells. <a href="https://collections.museumvictoria.com.au/items/260857">Hand-pumped vacuum cleaners</a> would have made for a great arm pump challenge.</p> <p>Stuck at home, I now seem to spend more time in the kitchen than in my bed at night. Deprived of pasta from the supermarket, I am making my own and heartened by the possibility that home cooking might <a href="https://theconversation.com/making-and-breaking-bread-during-the-coronavirus-pandemic-home-cooking-could-make-a-comeback-134504">make a comeback</a>.</p> <p>In the absence of an appliance, all this dough kneading for pasta and pizza and bread may be building my muscle strength as well as girth. It might be time to put away the food processor.</p> <p>Powered by home electricity, mass production and technology, home appliances gradually reduced the labour – but not expectations – of unpaid work at home. As Wilhelmina Rawson assured her readers in <a href="http://collectionsearch.nma.gov.au/object/72773">The Antipodean Cookery Book and Kitchen Companion</a> in 1907, a lady with ten specific appliances, including a mincer and eggbeater, “can do the whole of her housework with very little exertion or fatigue”.</p> <p>But gyms and sporting venues are now closed and fitness supplies are <a href="https://www.channelnews.com.au/home-gym-equipment-new-target-of-covid-19-panic-buying/">short on the shelves</a>. Maybe it is time to flip the narrative again and get clean and fed and fit and decluttered at the same time.</p> <p>And since attempts have failed to tackle the housework gap, would knowing vacuuming, window washing and mowing might be as good as a circuit class at the gym get men exer-cleaning?</p> <p>Even today where women are <a href="https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0011/3127664/HILDA-Statistical-Report-2019.pdf">the breadwinner</a> with dependent children, they still spend five hours more per week then men on housework. After losing his job, a man is likely to do <a href="https://www.smh.com.au/business/the-economy/one-way-to-get-out-of-housework-20180223-p4z1ix.html">less housework</a>, not more, and the time his partner spends on housework is likely to increase.</p> <p>“Few tasks are more like the torture of Sisyphus than housework, with its endless repetition,” wrote Simone de Beauvoir in <a href="https://www.goodreads.com/book/show/457264.The_Second_Sex">The Second Sex</a>. But the torture for some of us are the sets and reps that don’t result in a clean house.</p> <p>If you are looking at housework as a workout, you can <a href="https://www.latimes.com/archives/la-xpm-1993-04-13-vw-22382-story.html">cardio-vac</a> or do squats while you are emptying the dishwasher. And YouTuber <a href="https://www.youtube.com/watch?v=5KLgUzk6WdY">Lizzy Williamson</a> promises we won’t look at housework the same way once we incorporate her heart-pumping, whole-body-toning exercises into our clean-up.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/5KLgUzk6WdY?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p><strong>Tips for house workouts</strong></p> <p><strong>Play music</strong></p> <p>Eileen Fowler did not have the benefit of Bluetooth ear phones, but you do not have to subject the whole family to your soundtrack while you dust and distract. Spotify has an album of <a href="https://open.spotify.com/album/4GS7tCDCWFFzaeMJen069V">Housework Hits</a> for all varieties of chores or <a href="https://open.spotify.com/album/2GK2GCdvpeVuyLbA3R7drl">Housework Songs</a> by artists you might be more familiar with if you’re struggling to put together your own playlist.</p> <p><strong>Cook from scratch</strong></p> <p>If you are one of those people lucky enough to score flour and yeast you can join the <a href="https://www.wired.com/story/bread-boom-science-stephen-jones/">stay-at-home bread boom</a>. If you missed out on yeast, you can <a href="http://allrecipes.com.au/recipe/1388/basic-beer-bread.aspx">make it with beer</a>, but you will not get the knead-ercise.</p> <p>Old cookbooks like the Country Women’s Association’s <a href="https://ehive.com/collections/3977/objects/1029880/the-coronation-cookery-book">Coronation Cookery Book</a> may be better than new ones if you want to make your mashed potato go further, or you need a substitute for eggs, or milk is scarce. These old books also often include cleaning tips and other useful advice, like how to tan sheepskins or make your own soap.</p> <p><strong>Democratise domesticity</strong></p> <p>Domestic equality between men and women has not been achieved despite the idea that revolutionary transformations are taking place. While someone might need to delegate, there is no point imagining the drudgery and boredom of housework should not be shared equally as well as its physical benefits.</p> <p>Housework might not be sufficient to provide <a href="https://www.livescience.com/40523-housework-exercise-physical-activity.html">all the benefits</a> associated with physical activity, and unless you live with very dirty people in a huge mansion you might not find enough <a href="https://www.wikihow.fitness/Exercise-While-Doing-your-Housework">windows to work your arms</a>.</p> <p>I have had no success convincing my children either that housework might substitute for the sport they are missing. But, inspired by Eileen Fowler, I have dusted and polished and tightened my stomach muscles cleaning high ledges while waiting for the pizza dough to rise.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/135816/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/adele-wessell-489">Adele Wessell</a>, Associate Professor in History, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/great-time-to-try-cleaning-the-house-while-fitting-in-a-workout-135816">original article</a>.</em></p>

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Should everyone be wearing face masks?

<p>Should members of the public be wearing face masks during the COVID-19 pandemic? It’s a controversial question, with different countries and authorities giving different advice.</p> <p>We have reviewed the results of more than a dozen randomised trials of facemasks and transmission of respiratory illnesses. We <a href="https://www.medrxiv.org/content/10.1101/2020.03.30.20047217v1">found the current best evidence</a> suggests wearing a mask to avoid viral respiratory infections such as COVID-19 offers minimal protection, if any.</p> <p style="text-align: center;"><iframe src="https://player.vimeo.com/video/403558946" width="500" height="281" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe></p> <p style="text-align: center;"><span class="caption">Australian Academy of Science.</span></p> <p style="text-align: left;"><strong>Conflicting recommendations</strong></p> <p>Two of the world’s major health organisations disagree on mask wearing. The World Health Organisation (WHO) currently <a href="https://www.who.int/publications-detail/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak">discourages</a> mask use:</p> <blockquote> <p>There is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.</p> </blockquote> <p>WHO does recommend special masks (<a href="https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-and-surgical-masks-face-masks">N95 masks</a> or equivalent) plus other protection for health-care workers working with people who have, or are suspected to have, COVID-19.</p> <p>By contrast, the Centres for Disease Control and Prevention (CDC) in the United States has recently <a href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html">recommended</a> everyone wear a (cloth) mask. However, this is to prevent infected people passing on the infection, not to prevent the wearer getting infected.</p> <p>Who is right? Does wearing a mask protect the wearer? Does it protect others?</p> <p><strong>Understanding the spread</strong></p> <p>To examine this, we need to first look at how coronavirus spreads and how masks might stop it.</p> <p style="text-align: center;"><a href="https://images.theconversation.com/files/325971/original/file-20200407-36391-1rup8u7.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img style="display: block; margin-left: auto; margin-right: auto;" src="https://images.theconversation.com/files/325971/original/file-20200407-36391-1rup8u7.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" alt="" /></a> <span class="caption">Coronavirus can be transmitted directly from one person to another through the air or via hands or an object.</span> <span class="attribution"><span class="source">Author supplied.</span>, <span class="license">Author provided</span></span></p> <p>There are several possible routes to infection. An infected person can cough, sneeze or <a href="https://www.nap.edu/read/25769/chapter/1">breathe</a> while within about two metres of another person, and the virus lands in the other person’s eyes, nose or mouth(1).</p> <p>Another route is when an infected person coughs or sneezes onto their hand or onto a surface. The uninfected person then shakes the hand (2a) or touches the surface (2b), and transfers the virus to their own eye, nose or mouth.</p> <p>It is possible that an infected person can also cough or sneeze to create an airborne spread (3) <a href="https://www.medrxiv.org/content/10.1101/2020.03.23.20039446v2">beyond the close contact range</a> – but it is controversial whether this last route is a major means of transmission.</p> <p>We don’t know how much transmission occurs by each of these routes for COVID-19. It’s also unclear how much protection a mask would offer in each case.</p> <p><strong>Current best evidence</strong></p> <p>To resolve this question, we analysed 14 randomised trials of mask wearing and infection for influenza-like illnesses. (There are no randomised trials involving COVID-19 itself, so the best we can do is look at similar diseases.)</p> <p>When we <a href="https://www.medrxiv.org/content/10.1101/2020.03.30.20047217v1">combined the results</a> of these trials that studied the effect of masks versus no masks in health-care workers and the general population, they did not show that wearing masks leads to any substantial reduction of influenza-like illness. However, the studies were too small to rule out a minor effect for masks.</p> <p><strong>Why don’t masks protect the wearer?</strong></p> <p>There are several possible reasons why masks don’t offer significant protection. First, masks may not do much without eye protection. We know from animal and laboratory experiments that influenza or other coronaviruses can enter the eyes and travel to the nose and into the respiratory system.</p> <p>While standard and special masks provide incomplete protection, special masks combined with goggles <a href="https://academic.oup.com/jid/article/204/2/193/833588">appear</a> to provide complete protection in laboratory experiments. However, there are no studies in real-world situations measuring the results of combined mask and eyewear.</p> <p>The apparent minimal impact of wearing masks might also be because people didn’t use them properly. For example, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662657/">one study</a> found less than half of the participants wore them “most of the time”. People may also wear masks inappropriately, or touch a contaminated part of the mask when removing it and transfer the virus to their hand, then their eyes and thus to the nose.</p> <p>Masks may also provide a false sense of security, meaning wearers might do riskier things such as going into crowded spaces and places.</p> <p><strong>Do masks protect others?</strong></p> <p>Could masks protect others from the virus that might have been spread by the mask wearer? A recent <a href="https://www.nature.com/articles/s41591-020-0843-2">Hong Kong laboratory study</a> found some evidence masks may prevent the spread of viruses from the wearer.</p> <p>They took people with influenza-like symptoms, gave half of them masks and half no masks, and for 30 minutes collected viruses from the air they breathed out, including coughs.</p> <p>Masks did reduce the amounts of droplets and aerosols containing detectable amounts of virus. But only 17 of the 111 subjects had a coronavirus, and these were not the SARS-CoV-2 coronavirus. While the study is promising, it needs to be repeated urgently.</p> <p>We also don’t know how this reduction of aerosols and droplets translates to reduction of infections in the real world. If there is an effect, it may be diluted by several factors such as ill people who don’t wear a mask and “well” people who have no symptoms but are still carrying and spreading the virus.</p> <p><iframe id="ByzEg" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/ByzEg/2/" height="400px" width="100%" style="border: none;" frameborder="0"></iframe><strong>Masks for some?</strong></p> <p>If wearing masks does substantially reduce the spread of the infection to others, what should we do? We could ask everyone with any respiratory symptoms to wear masks in public. That could supplement other strategies such as social distancing, testing, tracking and tracing to reduce transmission.</p> <p>To also capture infected people without symptoms, we could ask everyone to wear masks in indoor public spaces. Outdoors is more difficult, since most people pose little or no risk. Perhaps, as we reduce restrictions, masks could also be required at some outdoor crowd events, such as sporting events or concerts.</p> <p>Another possibility is a “2 x 2” rule: if you are outdoors and within 2 metres of other people for more than 2 minutes you need to wear a mask.</p> <p>Mask wearing for the possibly infected, to prevent spreading the infection, warrants rigorous and rapid investigation. It could be an alternative or a supplement to social distancing, hand hygiene, testing, and lockdowns.</p> <p><em>The authors would like to thank John Conly, Liz Dooley, Lubna Al-Ansary, Susan Michie and Amanda McCullough for comments.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/135548/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/chris-del-mar-2636">Chris Del Mar</a>, Professor of Public Health, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-everyone-be-wearing-face-masks-its-complicated-135548">original article</a>.</em></p>

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Hugh Jackman reveals how he’s staying fit in quarantine

<p>Beloved Aussie actor Hugh Jackman has shown how he’s still keeping active while being bunkered down in his apartment in New York.</p> <p>The city of New York is under lockdown, but after being called out by tennis legend Roger Federer asking how he’s keeping active, Jackman had a witty response ready for him.</p> <p>The 51-year-old shared a video that showed him running up the stairs in his 15-storey apartment building to get a cardio workout.</p> <p>“Roger, love those trick shots, unfortunately, we don't have tennis courts at our place in New York City,” explained Hugh as he panted up the stairs in his video.</p> <p>“But we have something you guys don't have which is a lot of this,” he added while panning out to show the deserted stairwell.</p> <p>“15 floors, baby!”</p> <blockquote class="twitter-tweet"> <p dir="ltr">We don’t have a tennis court. But, we do have a lot of these! <a href="https://twitter.com/rogerfederer?ref_src=twsrc%5Etfw">@rogerfederer</a> <a href="https://twitter.com/hashtag/Trainingfromhome?src=hash&amp;ref_src=twsrc%5Etfw">#Trainingfromhome</a> <a href="https://t.co/SJ8RE6tFDC">https://t.co/SJ8RE6tFDC</a> <a href="https://t.co/OLbZoZ9fkF">pic.twitter.com/OLbZoZ9fkF</a></p> — Hugh Jackman (@RealHughJackman) <a href="https://twitter.com/RealHughJackman/status/1247547043326971904?ref_src=twsrc%5Etfw">April 7, 2020</a></blockquote> <p>It is not known whether or not the X-Men star is still staying in his New York apartment as he was recently seen in the Hamptons with his wife Deborra-Lee Furness, 64, and daughter Ava, 14.</p> <p>Later, Jackman was spotted with his family and their two dogs Dali and Allegra along the beach. After the walk, he put up a sweet snap of their two dogs, saying that Allegra was “social distancing” from Dali.</p> <p>The image of Dali urged everyone to “stay safe” as the coronavirus pandemic continues to be fought around the world.</p>

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Why exercise addiction is a real mental health condition

<p>We might assume a person that goes to the gym every day is “addicted” to exercise. But in reality, exercise addiction is a complicated condition that researchers still don’t fully understand.</p> <p>Exercise addiction is different from going to the gym or for a run everyday. Rather, the <a href="https://www.bmj.com/content/357/bmj.j1745">condition</a> is characterised by an obsessive or compulsive need to exercise, to the detriment of quality of life. For example, a person with the condition might skip a friend’s wedding because they “need” to train.</p> <p>Exercise addicts also experience strong withdrawal symptoms and train through injury, rather than following medical advice. One example of this is the case of <a href="https://www.bbc.co.uk/news/uk-51294715?fbclid=IwAR0p0i8l0u18IUFlHndTIRqtoXY5Y-BPIdpmfsFu6kNfDlN54C8ij73X0ZI">Hope Virgo</a>, who exercised so much and ate so little that she had a calcium deficiency, causing her to break bones while exercising.</p> <p>Key symptoms of exercise addiction generally include:</p> <ul> <li>Feeling a compulsion to do more and more exercise, or feeling that you’re not doing enough</li> <li>Training through injury</li> <li>Feeling strong withdrawal symptoms if exercise is stopped</li> <li>Missing important social events because you “have to” exercise.</li> </ul> <p>Exercise addiction is not currently recognised by either the World Health Organization or the American Psychiatric Association due to a lack of research on the condition. However there’s a <a href="https://www.sciencedirect.com/science/article/pii/S0306460318308633">growing body of research</a> exploring exercise addiction.</p> <p>How common the issue is seems to vary significantly between different types of exercise. It’s estimated that between <a href="https://www.sciencedirect.com/science/article/pii/S1469029212000829">0.3-0.5%</a> of the total population (including people who don’t exercise) are at risk of exercise addiction. In people who exercise regularly, between <a href="https://link.springer.com/article/10.1007/s40279-018-1011-4">3-7% of people</a> are at risk of developing exercise addiction. However, we can’t be sure how accurate these numbers are as there’s currently no universally accepted diagnostic criteria for exercise addiction.</p> <p><strong>Complicated diagnosis</strong></p> <p>As such, current tools to diagnose exercise addiction assess a person’s risk by using an educated guess of what to measure. Some tools are based on medical <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/">diagnostic criteria for substance</a> abuse, while others compare symptoms against the experiences of self-defined “exercise addicts”. This means that different methods of measuring exercise addiction are reporting on different things, which makes it pretty hard to say how common it really is.</p> <p>Complicating matters further is the athlete paradox. Professional athletes train a lot – typically more than the average gym enthusiast. They definitely have to make sacrifices, often impacting their quality of life because of it – for example, they probably miss social events for training at times.</p> <p>But if you ask them to analyse their own behaviour, they will often tell you they are just following their training schedule, that they have no choice. Athletes would therefore score highly on standard exercise addiction questionnaires.</p> <p>Exercise addiction has also been shown to be linked to eating disorders, with a <a href="https://link.springer.com/article/10.1007/s40519-019-00842-1">recent study</a> showing that people with eating disorders are 3.7 times more likely to have exercise addiction. In fact, “excessive exercise” is part of the diagnostic criteria for both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221424/pdf/Dtsch_Arztebl_Int-108-0678.pdf">bulimia and anorexia</a>. This is because people with eating disorders look to find ways to lose weight, and exercise is one way to burn calories.</p> <p>Links have also been found between body <a href="https://www.nhs.uk/conditions/body-dysmorphia/">dysmorphic disorder</a> (also known as body dysmorphia) and exercise addiction. Body dysmorphic disorder is an anxiety disorder in which a person might obsess over one or more perceived flaws in their appearance. This link suggests that negative body image might be intrinsically linked to exercise addiction.</p> <p>There are also links between exercise addiction, eating disorders and <a href="https://www.nhs.uk/conditions/obsessive-compulsive-disorder-ocd/">obsessive-compulsive disorder</a> (OCD). People with OCD demonstrate many of the same traits that are present in both exercise addiction and eating disorders such as a lack of control over a compulsion, such as exercise. This shows that exercise addiction could simply be another form of OCD.</p> <p>Some researchers have argued that exercise addiction does not exist if <a href="https://bjsm.bmj.com/content/bjsports/34/6/423.full.pdf">another disorder</a> isn’t present. Yet the <a href="https://www.apa.org/pubs/books/4311538">majority of research</a> on exercise addiction doesn’t screen for primary conditions like eating disorders or body dysmorphic disorder – instead they only looks for signs of exercise addiction.</p> <p>This means that we just don’t know whether or not exercise addiction is an independent condition or simply a symptom of something else. Future research should try focusing on screening for other disorders when looking at exercise addiction to see whether or not this condition exists if other conditions – like eating disorders – aren’t present.</p> <p>Current treatments for potential exercise addiction can include <a href="https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/">cognitive behavioural therapy</a>, although its <a href="https://www.tandfonline.com/doi/abs/10.1080/1606635021000032366">efficacy is questionable</a> as limited studies have been conducted. When it comes to treatment, it’s important to determine if exercise addiction is the primary condition, or whether it is a symptom of something else. If it’s a symptom of another condition, treating the primary condition should be the priority.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/133577/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><em><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/mike-trott-534834">Mike Trott</a>, PhD candidate, Centre for Sport and Exercise Sciences, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/lee-smith-509285">Lee Smith</a>, Reader in Physical Activity and Public Health, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/exercise-addiction-is-a-real-mental-health-condition-yet-still-poorly-understood-133577">original article</a>.</em></p>

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Why sleep is important in the fight against coronavirus

<p>Getting a good night’s sleep can be difficult at the best of times. But it can be even harder when you’re anxious or have something on your mind – a global pandemic, for example.</p> <p>Right now though, getting a good night’s sleep could be more important than ever.</p> <p>Sleep is essential for maintaining our <a href="https://www.ncbi.nlm.nih.gov/books/NBK19960/">health and mood</a>. Sleep can also boost our <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">immune function</a> and help us deal with <a href="https://www.sciencedirect.com/science/article/pii/S1984006315000607">stress</a>.</p> <p><strong>How much do we need?</strong></p> <p>Social distancing has many of us spending more time at home. This may mean <em>more</em> sleep for some people – suddenly you’ve got time to sleep in and even have a nap in the afternoon.</p> <p>For others, falling out of your usual routine may mean <em>less</em> sleep. Instead of going to bed when you normally would, you might be staying up late watching Netflix, scrolling social media or glued to coronavirus news.</p> <p>For adults, achieving between seven and nine hours of sleep per night is <a href="https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need">the goal</a>. If you know you’re a person who needs more or less, finding that perfect amount of sleep for you and aiming to achieve that consistently is key.</p> <p>Sleep and our <a href="https://www.youtube.com/watch?v=2BoLqqNuqwA">circadian system</a> (or internal body clock) are essential for regulating our mood, hunger, recovery from illness or injury, and our cognitive and physical functioning.</p> <p>Shifting our bed or wake times from day-to-day may affect all of these <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/ejn.14255">functions</a>. For example, higher variability in night-to-night sleep duration has been linked to increased <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0071292">depression and anxiety</a> symptoms.</p> <p>Long-term <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/">consequences</a> of sleep problems can include obesity, diabetes, heart disease, and high blood pressure.</p> <p><strong>Sleep and immune function</strong></p> <p>Declines in the quality and/or quantity of sleep can affect our immunity, leaving us more susceptible to illnesses including viruses.</p> <p>During sleep, the immune system releases proteins called cytokines. Certain cytokines are important for fighting infections and inflammation, and help us respond to stress. But when we don’t get enough sleep or our sleep is disrupted, our bodies <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">produce fewer</a> of these important cytokines.</p> <p>In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629403/">one study</a>, participants were exposed to the common cold (rhinovirus). Those who slept less than seven hours per night were almost three times more likely to develop a cold than those who slept eight hours per night or more.</p> <p>Another <a href="https://bmcimmunol.biomedcentral.com/articles/10.1186/1471-2172-13-1">study</a> indicated that a single night of no sleep may delay our immune response, slowing our body’s ability to recover.</p> <p>While we don’t have any research yet on the relationship between sleep and the coronavirus, we could expect to see a similar pattern.</p> <p><strong>Sleep and stress: a vicious cycle</strong></p> <p>You’ve probably heard the phrase “to lose sleep over” something. We have this saying because stress can negatively affect sleep <a href="https://www.tandfonline.com/doi/full/10.1080/15402002.2019.1629443">quality and quantity</a>.</p> <p>Lack of sleep also causes a biological stress response, boosting levels of stress hormones such as <a href="http://dx.doi.org/10.1016/j.jsmc.2014.11.007">cortisol</a> in our bodies the next day.</p> <p>Cortisol levels typically peak in the <a href="http://www.sciencedirect.com/science/article/pii/S0149763419301496">morning and evenings</a>. Following a poor night’s sleep, you might feel more stressed, have trouble focusing, be more emotional, and potentially have trouble falling asleep the next night.</p> <p>Prolonged sleep loss can make us more vulnerable to experiencing stress and less resilient at managing daily stressors.</p> <p>Think of sleep as your “shield” against stress. A lack of sleep can damage the shield. When you don’t get enough sleep the shield cracks and you are more susceptible to stress. But when you get enough sleep the shield is restored.</p> <p>It’s important to stop this cycle by learning to manage stress and prioritising sleep.</p> <p><strong>Tips for healthy sleep</strong></p> <p>To allow yourself the opportunity to get enough sleep, plan to go to bed about eight to nine hours before your usual wake-up time.</p> <p>This may not be possible every night. But trying to stick to a consistent wake-up time, no matter how long you slept the night before, will help improve your sleep quality and quantity on subsequent nights.</p> <p>Think about your environment. If you’re spending a lot of time at home, keep your bed as a space for sex and sleep only. You can also enhance your sleep environment by:</p> <ul> <li>keeping your lights dim in the evening, especially in the hour before sleep time</li> <li>minimising noise (you might try using earplugs or white noise if your bedroom gets a lot of noise from outside)</li> <li>optimising the <a href="https://www.sleepadvisor.org/best-temperature-for-sleep/">temperature</a> in your room by using a fan, or setting a timer on your air conditioning to ensure you’re comfortable.</li> </ul> <p>Create a routine before bedtime to mentally relax and prepare for sleep. This could include:</p> <ul> <li>setting an alarm one hour before bed to signal it’s time to start getting ready</li> <li>taking a warm shower or bath</li> <li>turning off screens or putting phones on airplane mode an hour before bed</li> <li>winding down with a book, stretching exercises, or gentle music.</li> </ul> <p>Some other good ways to reduce stress and improve sleep include:</p> <ul> <li>exercising daily. To maximise the benefits for sleep, exercise in the morning in <a href="https://sciencenordic.com/denmark-fitness-sleep/exercise-in-the-morning-and-sleep-better-at-night/1436958">natural light</a></li> <li>incorporating relaxation into your daily life</li> <li>limiting caffeine, alcohol and cigarettes, particularly in the hours before bed.</li> </ul> <p>Some nights will be better than others. But to boost your immunity and maintain your sanity <a href="https://www.sleephealthfoundation.org.au/fact-sheets/covid19-resources.html">during this unprecedented time</a>, make sleep a priority.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/134674/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/cassandra-pattinson-1007254">Cassandra Pattinson</a>, Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/kalina-rossa-1018253">Kalina Rossa</a>, Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/simon-smith-413286">Simon Smith</a>, Professor, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">original article</a>.</em></p>

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Do joint and muscle aches get worse in the cold?

<p>The winter chill is often associated with an increase in aches and pains for many older people, particularly in the joints, but also in the muscles. Some <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Strusberg+I+Mendelberg">recent studies</a> have shown an increase in general aches and pain in older men and women, and in particular a correlation between joint pain and weather conditions in patients with <a href="https://www.ncbi.nlm.nih.gov/pubmed/27633622">rheumatoid arthritis</a> or <a href="https://www.ncbi.nlm.nih.gov/pubmed/26329341">osteoarthritis</a>.</p> <p>For those without these conditions, any experience of pain with cold or wet weather may be related to changes in physical activity and diet.</p> <p><strong>How does the cold affect our muscles and joints?</strong></p> <p>In investigating a link between weather and joint pain, <a href="https://www.ncbi.nlm.nih.gov/pubmed/11838853">studies have examined</a> temperature, barometric pressure, precipitation, humidity and sunshine for their links to pain. The results are somewhat inconclusive because they vary greatly. This is largely because pain is subjective and it’s difficult to isolate a particular cause.</p> <p>Other factors like exercise, mood and diet also have an influence on pain perception. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19714599">Some research focused on the idea</a> that atmospheric pressure may have the greatest effect. This is because there are gasses and fluids within joints, and if atmospheric pressure reduces, these gasses and fluids might expand, putting pressure on surrounding nerves causing pain. But this has not been shown clearly.</p> <p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Savage+rheumatoid+arthritis+pain+2015">recent study found</a> the combination of temperature, sunlight exposure and humidity correlates with joint pain in patients with rheumatoid arthritis. But the authors were quick to point out the variability in pain perception and other factors, like exercise and diet, means a clear link still can’t be drawn with confidence.</p> <p><strong>How we can prevent aches in winter</strong></p> <p>There are some things that can help reduce pain during the colder months.</p> <p><strong>Exercise</strong>: joint pain is <a href="https://www.ncbi.nlm.nih.gov/pubmed/28355375">often associated with excess weight</a>, so a weight-loss exercise program will help to take the pressure off the joints. Exercise also helps to improve metabolism and blood flow through muscles and joints, which can reduce inflammation, stiffness and pain.</p> <p>Many people tend to be more active in the warmer months when the weather is pleasant and it’s comfortable to be outside. It’s important to continue exercise into winter as a reduction in physical activity in winter for more than two weeks <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Colliander+detraining">results in loss of muscle strength</a> and mass as well as reduced bone density. Being inactive for long periods can lead to a gain in fat mass and overall body weight which puts <a href="https://www.ncbi.nlm.nih.gov/pubmed/28142365">excess pressure on joints that can lead to injury</a>.</p> <p>Movements that include large muscles of the legs, arms and torso such as squats, sit-ups and push-ups can be done in a fairly small space, and so are ideal inside during winter. Resistance exercise of this type is important for muscle and bone strength. Like muscles, bones adapt to the stimulus of repeated load bearing making them stronger and less prone to injury. This is <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Beavers+Martin+CHnge+bone+mineral+density+2017">particularly important</a> for older individuals.</p> <p>This doesn’t mean you need to go to a gym and lift heavy weights, although you may consider joining a gym for individual or group exercise sessions. You can get enough stimulation for maintenance of muscle and bone strength through daily tasks and home workouts.</p> <p><strong>Vitamin D</strong>: exercising regularly can help to reduce symptoms in the long term, and getting outdoors for longer periods more often provides <a href="https://www.ncbi.nlm.nih.gov/pubmed/27258303">vitamin D for healthier bones and joints</a>.</p> <p>When daylight hours are limited, vitamin D supplements are a good way to continue to get the benefits of this vitamin, which has an important role in bone mineralisation, muscle function and nerve growth. Studies have found daily supplementation with vitamin D <a href="https://www.ncbi.nlm.nih.gov/pubmed/22592290">reduces the risk of bone fracture</a> and improves muscle strength for older people.</p> <p>It’s recommended adults get at least 200 to 600 international units (IU) of Vitamin D daily if they’re getting some exposure to sunlight most days. </p> <p>The best foods for vitamin D include fatty fish like sardines, mackerel and herring, milk, margarine and vitamin D-fortified soy drinks. But it’s important to remember dietary sources alone are not sufficient to provide enough vitamin D. Sunlight is an important source and supplementation should be considered for those who have limited exposure to the sun in winter.</p> <p><strong>Glucosamine and chondroitin</strong>: glucosamine and chondroitin sulphate help to provide nourishment to cartilage to improve joint function. They make movement of the joint smoother by <a href="https://www.ncbi.nlm.nih.gov/pubmed/26881338">reducing the friction produced</a> between the articulating surfaces of the bones. Crustaceans provide a good source of glucosamine, while chondroitin sulphate can be obtained from cartilage of animal bones. Supplementation of these is <a href="https://www.ncbi.nlm.nih.gov/pubmed/26881338">prescribed for patients</a> with osteoarthritis to help restore cartilage.</p> <p><strong>Heat therapy</strong>: heat therapy can help greatly when you do have pain. Warm baths or showers, particularly in the morning <a href="https://www.ncbi.nlm.nih.gov/pubmed/27403866">can make a big difference</a> to the level of pain and stiffness. Warming the body increases elasticity of the tissue and improves blood flow making movement easier. It also activates neural pathways that <a href="http://www.tandfonline.com/doi/full/10.1080/00325481.2015.992719">reduce the brain’s perception of pain</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/81260/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/andrew-lavender-219133">Andrew Lavender</a>, Lecturer, School of Physiotherapy and Exercise Science, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/health-check-do-joint-and-muscle-aches-get-worse-in-the-cold-81260">original article</a>.</em></p>

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