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

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>This week’s ABC Four Corners episode <a href="https://www.abc.net.au/news/2024-04-08/pain-factory/103683180">Pain Factory</a> highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.</p> <p>The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.</p> <p><a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">One in five</a> Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">A$139 billion a year</a>, including $12 billion in direct health-care costs.</p> <p>The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?</p> <h2>Opioids and invasive procedures</h2> <p>Treatments offered to people with chronic pain include strong pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/30561481/">opioids</a> and invasive procedures such as <a href="https://pubmed.ncbi.nlm.nih.gov/36878313/">spinal cord stimulators</a> or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120">spinal fusion surgery</a>. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.</p> <p><a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8">Spinal fusion surgery</a> and <a href="https://privatehealthcareaustralia.org.au/consumers-urged-to-be-cautious-about-spinal-cord-stimulators-for-pain/#:%7E:text=Australian%20health%20insurance%20data%20shows,of%20the%20procedure%20is%20%2458%2C377.">spinal cord stimulators</a> are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.</p> <h2>Addressing the contributors to pain</h2> <p>Recommendations from the latest <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard">Australian</a> and <a href="https://www.who.int/publications/i/item/9789240081789">World Health Organization</a> clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:</p> <ul> <li>education</li> <li>advice</li> <li>structured exercise programs</li> <li>physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.</li> </ul> <p>Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.</p> <p>The interventions have minimal side effects and are cost-effective.</p> <p>In the <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">RESOLVE</a> trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.</p> <p>In the <a href="https://pubmed.ncbi.nlm.nih.gov/37146623/">RESTORE</a> trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.</p> <h2>Why isn’t everyone with chronic pain getting this care?</h2> <p>While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session <a href="https://www.sira.nsw.gov.au/__data/assets/pdf_file/0005/1122674/Physiotherapy-chiropractic-and-osteopathy-fees-practice-requirements-effective-1-February-2023.pdf">can cost</a> $90–$150.</p> <p>In contrast, <a href="https://www.servicesaustralia.gov.au/chronic-disease-individual-allied-health-services-medicare-items">Medicare</a> provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.</p> <p>Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.</p> <p>Access to trained clinicians is another barrier. This problem is particularly evident in <a href="https://www.ruralhealth.org.au/15nrhc/sites/default/files/B2-1_Bennett.pdf">regional and rural Australia</a>, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.</p> <p>Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/data-file-57-opioid-medicines-dispensing-2016-17-third-atlas-healthcare-variation-2018">rate of opioid use</a>, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.</p> <h2>So what can we do about it?</h2> <p>We need to reform Australia’s health system, private and <a href="https://www.health.gov.au/sites/default/files/documents/2020/12/taskforce-final-report-pain-management-mbs-items-final-report-on-the-review-of-pain-management-mbs-items.docx">public</a>, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.</p> <p>Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian <a href="https://pubmed.ncbi.nlm.nih.gov/38461844/">trial</a>, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.</p> <p>Advocacy and <a href="https://pubmed.ncbi.nlm.nih.gov/37918470/">improving the public’s understanding</a> of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/christine-lin-346821"><em>Christine Lin</em></a><em>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/surgery-wont-fix-my-chronic-back-pain-so-what-will-227450">original article</a>.</em></p>

Body

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Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<p><em><a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial.</p> <p>UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom.</p> <p>Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year.</p> <p>They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area.</p> <p>Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments.</p> <h2>Why are chronic UTIs so hard to treat?</h2> <p>Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach.</p> <p>The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments.</p> <p>This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective.</p> <p>Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted.</p> <p>But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead.</p> <p>Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria.</p> <p>Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions.</p> <p>The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence.</p> <p>For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur.</p> <p>Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role.</p> <p>Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>.</p> <h2>What treatments might we see in the future?</h2> <p>Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu.</p> <p>Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus.</p> <p>Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves.</p> <p>Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response.</p> <p>Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/iris-lim-1204657">I<em>ris Lim</em></a><em>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.</em></p>

Body

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90-year-old-with chronic leukaemia skydives for charity

<p>A thrill-seeking 90-year-old has celebrated her birthday - in what some would call an unconventional manner for her age - by skydiving, and raising £5,000 for a homeless charity in the process.</p> <p>Shirley Robinson, from Long Clawson in Leicestershire, jumped out of a plane at 14,000ft for the fundraiser at Skydive Langar in Nottinghamshire.</p> <p>Shirley, who was diagnosed with chronic leukaemia in 2022, raised funds for Crisis, a charity that provides help and support for homeless people.</p> <p>She told <em>BBC News</em>, “It's just wonderful how generous people have been. It's lovely.”</p> <p>Footage of her dive saw Shirley styled in a bright blue jumpsuit as she was cheered on by family and friends before getting on the plane.</p> <p>She smiled and waved at the camera as she was strapped to her skydiving instructor.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/CsZGxykN0PN/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/CsZGxykN0PN/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Skydive Langar (@skydivelangar)</a></p> </div> </blockquote> <p>After Shirley’s adrenaline packed skydive, she landed safely in a field and can be heard in the video exclaiming, “That was wonderful.”</p> <p>When asked about her favourite part of the experience, she responded, “That was lovely, going through the clouds.”</p> <p>She confessed afterwards that the free fall was a “bit breathtaking” but she “loved it” before thanking her instructor for looking after her.</p> <p>Shirley returned to a hero’s welcome with her beaming friends and family congratulating her.</p> <p>A spokesperson for the charity said, “We want to say an enormous thank you to Shirley for the incredible amount of money she has raised.</p> <p>“Shirley's donation will provide vital support for people experiencing or at risk of homelessness. We're so grateful.”</p> <p><em>Image credit: Instagram</em></p>

Retirement Life

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Tiredness of life: the growing phenomenon in western society

<p>Molly was 88 years old and in good health. She had outlived two husbands, her siblings, most of her friends and her only son. </p> <p>“I don’t have any meaningful relationships left, dear,” she told me. “They’ve all died. And you know what? Underneath it all, I want to leave this world too.” </p> <p>Leaning a little closer, as though she was telling me a secret, she continued: "Shall I tell you what I am? I’m strong. I can admit to myself and to you that there’s nothing left for me here. I’m more than ready to leave when it’s my time. In fact, it can’t come quickly enough."</p> <p>I’ve <a href="https://theconversation.com/loneliness-loss-and-regret-what-getting-old-really-feels-like-new-study-157731">interviewed</a> many older people for research. Every so often, I’m struck by the sincerity with which some people feel that their life is completed. They seem tired of being alive. </p> <p>I’m a member of of the European <a href="https://research.ugent.be/web/result/project/6d511516-39ad-4c2e-ad46-44d5ce25ca29/details/en">Understanding Tiredness of Life in Older People Research Network</a>, a group of geriatricians, psychiatrists, social scientists, psychologists and death scholars. We want to better understand the phenomenon and unpick what is unique about it. The network is also working on advice for politicians and healthcare practices, as well as caregiver and patient support.</p> <p>Professor of care ethics Els van Wijngaarden and colleagues in the Netherlands <a href="https://www.sciencedirect.com/science/article/pii/S0277953615002889">listened to a group of older people</a> who were not seriously ill, yet felt a yearning to end their lives. The key issues they identified in such people were: aching loneliness, pain associated with not mattering, struggles with self-expression, existential tiredness, and fear of being reduced to a completely dependent state.</p> <p>This need not be the consequence of a lifetime of suffering, or a response to intolerable physical pain. Tiredness of life also seems to arise in people who consider themselves to have lived fulfilling lives.</p> <p>One man of 92 told the network’s researchers: "You have no effect on anything. The ship sets sail and everyone has a job, but you just sail along. I am cargo to them. That’s not easy. That’s not me. Humiliation is too strong a word, but it is bordering on it. I simply feel ignored, completely marginalised."</p> <p>Another man said: "Look at the condition of those old ladies in the building opposite. Gaunt and half-dead, pointlessly driven around in a wheelchair … It has nothing to do with being human anymore. It is a stage of life I simply don’t want to go through."</p> <h2>A unique suffering</h2> <p>The American novelist <a href="https://www.nytimes.com/2006/05/07/books/review/07gord.html">Philip Roth wrote</a> that “old age is not a battle, old age is a massacre”. If we live long enough, we can lose our identity, physical capabilities, partner, friends and careers. </p> <p>For some people, <a href="https://www.cambridge.org/core/journals/ageing-and-society/article/abs/gradual-separation-from-the-world-a-qualitative-exploration-of-existential-loneliness-in-old-age/5567288AD35DFB878F3F756FF233FB1C">this elicits</a> a deep-rooted sense that life has been stripped of meaning – and that the tools we need to rebuild a sense of purpose are irretrievable.</p> <p>Care professor Helena Larsson and colleagues in Sweden have <a href="https://bmcgeriatr.biomedcentral.com/counter/pdf/10.1186/s12877-017-0533-1.pdf#:%7E:text=This%20study%20is%20part%20of%20a%20larger%20research,was%20analysed%20using%20Hsiehand%20Shannon%E2%80%99s%20conventional%20content%20analysis.">written about</a> a gradual “turning out of the lights” in old age. They argue that people steadily let go of life, until they reach a point where they are ready to turn off the outside world. Larsson’s team raises the question of whether this might be inevitable for us all. </p> <p>Of course, this sort of suffering shares characteristics (it’s depressing and painful) with anguish we encounter at other points in life. But it’s not the same. Consider the existential suffering that might arise from a terminal illness or recent divorce. In these examples, part of the suffering is connected to the fact that there is more of life’s voyage to make – but that the rest of the journey feels uncertain and no longer looks the way we fantasised it would. </p> <p>This sort of suffering is often tied to mourning a future we feel we should have had, or fearing a future we are uncertain about. One of the distinctions in tiredness of life is that there is no desire for, or mourning of, a future; only a profound sense that the journey is over, yet drags on painfully and indefinitely.</p> <h2>The global view</h2> <p>In countries where euthanasia and assisted suicide are <a href="https://www.bmj.com/content/372/bmj.n147">legal</a>, doctors and <a href="https://www.tandfonline.com/doi/full/10.1080/15265161.2021.2013981?casa_token=XEzfqjWH8uUAAAAA:GD6c6mZEv7q9eq2fqfSNcrbGWYD1-0ehOU3tTTJ2Zbnyraf3VvdvQcIRXF847Dp6T9k_yWctt3E">researchers are debating</a> whether tiredness of life meets the threshold for the sort of <a href="http://www.bioethics.org.au/Resources/Online%20Articles/Opinion%20Pieces/2201%20Tired%20of%20Life.pdf">unceasing emotional suffering</a> that grants people the right to euthanasia. </p> <p>The fact that this problem is common enough for researchers to debate it may suggest that modern life has shut older people out of western society. Perhaps elders are <a href="https://arro.anglia.ac.uk/id/eprint/703688/">no longer revered</a> for their wisdom and experience. But it’s not inevitable. In Japan, age is seen as a spring or rebirth after a busy period of working and raising children. One study found older adults in Japan showed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183740/#R34">higher scores on personal growth</a> compared with midlife adults, whereas the opposite age pattern was found in the US.</p> <p>Surgeon and medical professor <a href="https://mh.bmj.com/content/41/2/145">Atul Gawande</a> argues that in western societies, medicine has created the ideal conditions for transforming ageing into a “long, slow fade”. He believes quality of life has been overlooked as we channel our resources towards biological survival. This is unprecedented in history. Tiredness of life may be evidence of the cost.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/tiredness-of-life-the-growing-phenomenon-in-western-society-203934" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Caring

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5 signs you need to get more sleep

<p>They don’t call it beauty sleep for no good reason – a good night’s slumber results in increased energy and productivity, improved heart and immune system health, a better mood, even a longer life.</p> <p>As your body naturally regenerates itself at night, if you’re not getting enough sleep – or enough adequate quality sleep – you will likely see (and feel) the clues.</p> <p>If you experience more of the following indicators of a lack of sleep than you’d like to admit, chances are you’re not getting enough shuteye.  </p> <p><strong>Dullness</strong></p> <p>Lack of sleep reduces your skin’s natural moisture barrier, leaving your skin dry and flaky.</p> <p><strong>Fine lines</strong></p> <p>When you sleep, your body releases melatonin, a natural antioxidant. Get too little shuteye and there aren’t enough antioxidants to help fight off wrinkle-causing free radicals.</p> <p><strong>Breakouts</strong></p> <p>Stress hormones, like cortisol, skyrocket when you’re tired. They increase inflammation, provoking pimples to appear.</p> <p><strong>Puffy eyes</strong></p> <p>Cortisol is a pesky little bugger – as cortisol levels increase, not only are your hormones affected but your body also retains water. Since your eyelid skin is the thinnest on your body, it’s most obvious there.</p> <p><strong>Weight gain</strong></p> <p>Sleep deprivation causes your body to release too much ghrelin, a hormone that makes you hungry and simultaneously causes it not to create enough leptin, a hormone that tells us we're full.</p> <p><em>Image credits: Getty Images</em></p>

Body

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Could mobile phones revolutionise chronic wound treatment?

<p>Australian researchers are developing a contactless, thermal imaging system that uses artificial intelligence to help nurses determine the best way to treat leg ulcers without waiting to see if the wound is going to heal properly.</p> <p>It’s estimated that 450,000 thousand Australians currently live with a chronic wound.</p> <p>Being able to predict early on which wounds will become chronic could improve outcomes by enabling nurses to start specialised therapy as soon as possible. But current techniques rely on physically monitoring the wound area over several weeks.</p> <p>New research from RMIT in Melbourne paired thermal imaging with AI.</p> <p>The software was able to accurately identify unhealing ulcers 78% of the time, and healing ulcers 60% of the time, according to the new study <a href="https://www.nature.com/articles/s41598-022-20835-y" target="_blank" rel="noreferrer noopener">published</a> in <em>Scientific Reports</em>.</p> <p>“Our new work that identifies chronic leg wounds during the first visit is a world-first achievement,” says lead researcher Professor Dinesh Kumar, from RMIT’s School of Engineering.</p> <p>“This means specialised treatment for slow-healing leg ulcers can begin up to four weeks earlier than the current gold standard.”</p> <p><strong>How do you normally assess wound healing?</strong></p> <p>The work builds on <a href="https://www.nature.com/articles/s41598-021-92828-2.epdf?sharing_token=7SIEmbOksKOou2TGQ5qPWdRgN0jAjWel9jnR3ZoTv0NntGTf8gfSMhoDjLAz58SefUeGL0aP2A-0mDVnZaiZTcBjNNpA4cvP9FgK6-aoPzyk4oQ0OSbPh83HNS_AwGDQVMg43K4WmG60QDoQohtsdkaRv70YSxfPg4Dn0qa_CUs%3D" target="_blank" rel="noreferrer noopener">previous research</a> by the same team, which found that this method could be used to predict wound healing by week 3 after initial assessment. But they wanted to know whether healing could be predicted from the first wound assessment only, reducing any delay in treatment.</p> <p>If a wound is healing normally it’s area would reduce by 50% within four weeks, but more than 20% of ulcers don’t heal in this expected trajectory and may need specialist interventions.</p> <p>Venous leg ulcers (VLUs) are the <a href="https://treasury.gov.au/sites/default/files/2022-03/258735_wounds_australia.pdf" target="_blank" rel="noreferrer noopener">most common</a> chronic wound seen in Australia and currently, the gold standard for predicting their healing– conventional digital planimetry – requires physical contact. Regular wound photography is also less accurate because there can be variations between images due to lighting, image quality, and differences in camera angle.</p> <p>But a non-contact method like thermal imaging could overcome this.</p> <p>The thermal profile of wounds changes over the healing trajectory, with higher temperatures signalling potential inflammation or infection and lower temperatures indicating a slower healing rate due to decreased oxygen in the region. So, taking thermal images of wounds can provide important information for predicting how they will heal.</p> <p><strong>What did they do?</strong></p> <p>The study collected VLU data from 56 older participants collected over 12 weeks, including thermal images of their wounds at initial assessment and information on their status at the 12<sup>th</sup> week follow-up.</p> <p>“Our innovation is not sensitive to changes in ambient temperature and light, so it is effective for nurses to use during their regular visits to people’s homes,” says co-author Dr Quoc Cuong Ngo, from RMIT’s School of Engineering.</p> <p>“It is also effective in tropical environments, not just here in Melbourne.”</p> <p>“Clinical care is provided in many different locations, including specialist clinics, general practices and in people’s homes,” says co-author Dr Rajna Ogrin, a Senior Research Fellow at Bolton Clarke Research Institute.</p> <p>“This method provides a quick, objective, non-invasive way to determine the wound-healing potential of chronic leg wounds that can be used by healthcare providers, irrespective of the setting.”</p> <p><strong>So, what’s next?</strong></p> <p>There are a few limitations to this study. First, the number of healed wounds in the dataset was relatively small compared to unhealed wounds, and the study only investigated older people.</p> <p>The authors recommend that “future research should focus on improving the predictive accuracy and customising this method to incorporate this assessment into clinical practice on a wider pool of participants and in a variety of settings.”</p> <p>Kumar says that they are hoping to adapt the method for use with mobile phones.</p> <p>“With the funding we have received from the Medical Research Future Fund, we are now working towards that,” he says. “We are keen to work with prospective partners with different expertise to help us achieve this goal within the next few years.”</p> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=222978&amp;title=Could+mobile+phones+revolutionise+chronic+wound+treatment%3F" width="1" height="1" /></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/revolutionise-chronic-wounds-treatment/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Imma Perfetto.</em></p> <p><em>Image: RMIT University</em></p> </div>

Technology

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“It’s not easy”: Michael Klim shares health update

<p dir="ltr">Aussie swimmer Michael Klim has opened up about how his life has changed following his diagnosis with a rare autoimmune disease, including the strategy he uses to cope.</p> <p dir="ltr">In 2020, the world champion was diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) - a rare neurological disorder where the fatty myelin sheath protecting nerves is damaged and feeling is lost in the arms and legs.</p> <p dir="ltr">The condition has affected Klim’s physical and mental wellbeing, with the father-of-three struggling to perform everyday tasks such as walking and playing with his kids.</p> <p dir="ltr">But, Klim has adopted a new strategy to help him acknowledge the toll the disease has while not letting it get him down.</p> <p dir="ltr">“My counsellor and I have come up with a strategy where I give myself an hour a day to feel sorry for myself,” he told the <em><a href="https://www.smh.com.au/sport/swimming/i-am-trying-to-not-let-it-consume-me-the-rare-disease-that-turned-michael-klim-s-world-upside-down-20221027-p5bte5.html" target="_blank" rel="noopener">Sydney Morning Herald</a></em>.</p> <p dir="ltr">“I can whinge as much as I want and feel down, but after that, then there are still a lot of things I can do and be functional and still have responsibilities as a parent and a coach and as a partner, and I can still do them effectively.</p> <p><span id="docs-internal-guid-8d660eff-7fff-aa27-2fa7-881fe83fec3d"></span></p> <p dir="ltr">“I am trying to not let it consume me completely. But it's hard.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Ci1vISQBbPk/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Ci1vISQBbPk/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by MICHAEL KLIM (@michaelklim1)</a></p> </div> </blockquote> <p dir="ltr">Klim said the effect on his body has meant he had to go through a “grieving process”, where he came to grips with the condition and the possibility he may need a wheelchair.</p> <p dir="ltr">“And to a degree the fear is still there. I think I am a bit better, in the sense I have accepted – to a degree – that these are the cards I have been dealt,” he said.</p> <p dir="ltr">“But I am still working through it. When we experience grief, you don't just go one day, 'I am fine, I am better now'. It affects you for much longer, and particularly because it is in my face daily.</p> <p dir="ltr">“There was a fear because I got bad really quickly. I am now in a remission, stable phase. But there is a fear I may go again at the same rate and if I degrade that quickly again, I probably will need assistance with walking and things like that.”</p> <p dir="ltr">Earlier this month, Klim said his mobility has been affected to the point where can no longer leave Bali and make trips to Australia, which he had done several times a year for work and treatment in the past.</p> <p dir="ltr">“I have pulled my focus to the swim academy here in Bali and... we run a bunch of camps and clinics,” he said.</p> <p dir="ltr">“I have sort of simplified my lifestyle just from that point of view.</p> <p dir="ltr">“I mean I did use to do 20 return trips to Australia a year for work and whatever.”</p> <p dir="ltr">“But for now it's just physically... physically actually impossible because (for) myself getting around is not simple.”</p> <p dir="ltr">The 45-year-old revealed he is now facing financial stresses too, after he left his role in sales and marketing at Milk &amp; Co, the skincare company he founded in 2008, due to his inability to travel.</p> <p dir="ltr">“Look it has definitely put a stress on our finances and security because there is a level of investment for me,” Klim told Brett Hawke, the host of the <em>Inside with Brett Hawke </em>podcast, this week.</p> <p dir="ltr">“I stepped back from my role with Milk and Co. because of the demand it had on me physically, flying back and forth and the stress as well.</p> <p dir="ltr">“I was very hands-on doing sales and marketing. (But) unless I could give myself one hundred percent I didn't want to do it.”</p> <p dir="ltr">To make matters worse, Klim’s battle with CIDP has been self-funded because his original health insurance policy doesn’t cover the condition.</p> <p dir="ltr">“Unfortunately unless you have a very good insurance policy, which mine unfortunately didn't cover this disorder, everything is self-funded so it has put a fair bit of stress on everybody I think,” he said.</p> <p dir="ltr"><span id="docs-internal-guid-d26f087e-7fff-e019-16f1-8e5d2fb6f4c8"></span></p> <p dir="ltr">“I have had great support from the family but it's, yeah, it's not easy.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Cf3hl1fhzH6/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Cf3hl1fhzH6/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by MICHAEL KLIM (@michaelklim1)</a></p> </div> </blockquote> <p dir="ltr">After first speaking about his condition on <em>The Project</em> in July, including noticing numbness and other symptoms in his legs and feet in 2019, Klim told Hawke that the disorder had worsened in recent months, with the numbness in his feet now in his calf muscles and knees.</p> <p dir="ltr">“I had a big foot drop...my foot is just really floppy and can't control my foot so I'm having to wear special braces called AFO's (ankle-foot orthoses) which keeps my toes up so I don't trip up over myself when I'm using a walking stick or crutches,” he explained.</p> <p dir="ltr">He admitted that he fears losing all of his physical mobility, but still remains determined to fight CIDP and seek treatment from neurological experts in Australia and the US.</p> <p dir="ltr">“I think there is definitely an element of fear in this because it's the fear of the unknown, which we're always scared of, you know,” an emotional Klim said.</p> <p dir="ltr">“So there is 30 percent of patients (that) end up in a wheelchair and it's just to get around. So that's in the back of my mind.”</p> <p dir="ltr">Despite his worsening condition, Klim said he is still able to regularly swim with the assistance of a pool buoy between his legs.</p> <p dir="ltr">“The thing that gives me so much joy at the moment is I can actually still jump in the pool and have a bit of float around,” Klim said.</p> <p dir="ltr">“I like to put the buoy in and punch out a couple of times and, and yeah, it's kind of my happy place at the moment.”</p> <p dir="ltr"><span id="docs-internal-guid-363c0b61-7fff-f7ad-3931-6e11dda35332"></span></p> <p dir="ltr"><em>Image: @michaelklim1 (Instagram)</em></p>

Caring

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5 tips to combat fatigue

<p>A good night’s sleep consisting of 7-8 hours’ sleep should prepare us for the day ahead but, as we know, this isn’t always the case! One of the most common causes of fatigue and waking unrefreshed is sleep apnoea. If your fatigue is really affecting the quality of your life, it is vital you have an assessment for this condition. If sleep apnoea or some other medical condition, such as anaemia or a thyroid disorder has been excluded, cardiologist <span style="text-decoration: underline;"><strong><a href="http://www.drrosswalker.com/">Dr Ross Walker</a></strong></span> recommends these five tips for easing fatigue.</p> <p><strong>1. Cut the caffeine</strong><br />Your day should begin when you get out of bed – not when you’ve had your coffee. While coffee can be the pick-me-up you need to start your morning, you shouldn’t need it. If you’re feeling fatigued you might need to cut out the caffeine. Rather than going cold turkey, and experiencing those awful headaches, try to gradually cut back on your caffeine intake.</p> <p><strong>2. Supplementation</strong> <br />If you’re getting enough sleep, exercising, eating well, and cutting out the caffeine but still feeling fatigued you might need to bring in a little help. Ubiquinol is a powerful antioxidant, that is vital to providing energy and relieving the body from oxidative stress. Ubiquinol is also found naturally in our bodies, but unfortunately depletes in levels after the age of 30, so it’s worth discussing supplementation with your healthcare practitioner.</p> <p><strong>3. Move it</strong><br />While you might feel tired and worn out after a brisk walk or a swim, you’ll feel more energised in the long run. Many people think exercise can cause fatigue, but there are numerous studies that indicate exercise actually boosts energy and increases the efficiency of your muscles, lungs and heart.</p> <p><strong>4. Eat well</strong><br />When refuelling your car, you fill it to the top – not with the bare minimum to get you down the road – so why would you do that to your body? While sugary foods can give you an immediate boost, your energy will soon run out and you’ll be left feeling tired and hungry. Food is fuel to your body which is why it’s important to nourish yourself with natural and healthy foods to ensure you have a full tank, and run like a well-oiled engine. </p> <p><strong>5. De-stress</strong><br />Finally, fatigue may actually be a result of ongoing stress. Meditation, yoga, spending time with friends and family, and listening to music are calming activities that help minimise stress and, in the long term, fight off fatigue.</p> <p><em>Consult your healthcare practitioner to find out which supplement is right for you. Always read the label. Use only as directed.</em></p> <p><em>Image: Getty</em></p>

Body

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Why am I so tired?

<p>Carol Heffernan, a 43-year-old marketing writer, regularly felt worn out from her busy life of working, shuttling her two young kids to school and play dates, and taking care of housework. But when COVID-19 hit and the kids were suddenly at home all day, learning remotely, she noticed that her run-of-the-mill weariness quickly turned into full-on exhaustion.</p> <div title="Page 1"> <p>“All the extra responsibility and the mental load – it just added up,” she says. “I felt grumpy and tired – and it wasn’t due to lack of sleep.”</p> <p>Heffernan didn’t have any time in the day to exercise off her stress. She was short on energy, and she started becoming short with her kids. “After I put them to bed at 8pm, I would just crash on the couch,” she says.</p> <p>If there’s one thing many of us have in common, it’s that we’re tired. In fact, lethargy is so pervasive that it’s one of the issues people ask their doctors about the most. Doctors even have a name for it: ‘tired all the time’, or TATT for short. The solution isn’t always as simple as getting more sleep; nearly a quarter of people who get seven or more hours of rest a night report they still wake up feeling tired most days of the week.</p> <p>Here are eight reasons why your energy might be low – and what you can do to bring it back.</p> <p><strong>1. YOU SPEND TOO MUCH TIME ON THE COUCH</strong></p> <p>When you’re feeling sluggish, it can be tempting to plop down and binge-watch TV. But doing something active will actually give you more energy, not consume the little that you have. In fact, researchers at the University of Georgia found that just ten minutes of low- or moderate-intensity exercise gave study participants a noticeable energy boost.</p> <p>Exercise also works its magic at the cellular level: the mitochondria (the parts of your cells that provide energy to your muscles) actually grow more powerful and numerous after aerobic exercise, providing a continuous source of increased energy.</p> <p><strong>2. YOU’RE PUSHING YOURSELF TOO HARD</strong></p> <p>People who feel overcommitted – whether from volunteering for one too many causes or shouldering too much at work or at home – often try to squeeze in more tasks. But it might be wiser to take a break. “When it comes to optimising energy over the long haul, it’s about getting into a rhythm of periods of exertion and rest,” says Dane Jensen, CEO of Third Factor, an organisation that helps companies’ employees perform better under pressure. “In fact, to stay energised over the course of the day, you need a 15- to 20-minute break every 90 minutes.”</p> <div title="Page 1"> <p>Not all downtime is equal: a 2016 study looked at office workers in South Korea and found that those who looked at their phones during breaks were significantly less recharged than those who went for a walk or chatted with friends. Jensen suggests choosing breaks from work that balance out what’s taxing you. If you’ve been working at a computer take a walk outside. If you’ve been doing spring cleaning, sit down and call a friend.</p> <div title="Page 1"> <p>Jensen also suggests considering four categories of breaks, based on how they can benefit you: physical (walking or stretching); cognitive (crossword puzzles or Sudoku); emotional (phoning a loved one); and spiritual (walking in the woods or practising a religion).</p> <p><strong>3. YOU’RE ANXIOUS</strong></p> <p>Anxiety is draining. When you’re distressed, your body is on high alert and produces adrenaline. Your muscles might tighten up, and your brain shifts into overdrive to try to work through all possible scenarios. That all takes energy – and will leave you feeling tired.</p> <div title="Page 1"> <p>And, the pile-up of global crises – natural disasters, the pandemic and the war in Ukraine being the most notable – is having a measurable effect on many people’s mental health. One study published in the British Journal Of Psychology found that participants who watched a negative news bulletin were more likely to feel anxious or sad than those who watched a neutral or positive one – and then they felt worse about their personal problems.</p> <div title="Page 1"> <p>One antidote to all the bad news is cultivating your friendships. Scientists have long known that socialising decreases the risk of developing mental-health issues like depression, and avoiding loneliness also lowers stress-hormone levels in your body.</p> <div title="Page 1"> <p>Dr Vincent Agyapong, a professor of psychiatry and global mental health, says that his research has demonstrated that nurturing relationships is a mood booster. “Maintaining social contacts is one of the ways to maintain your mental health,” he says. “It doesn’t necessarily have to be face to face – it can be via social media, telephone call or video conference.”</p> <p>All that said, if you think you might have clinical levels of anxiety – for example, if you’re having panic attacks or completely avoiding doing everyday tasks – speak to your doctor about therapy or medication.</p> <p><strong>4. YOU’RE LOW ON VITAMINS</strong></p> <p>Fatigue is often connected to not having enough of two key nutrients, says Dr Lin: iron and B vitamins. When you don’t get enough iron in your diet, it can lead to iron-deficiency anaemia, which means your body doesn’t produce enough healthy red blood cells.</p> <p>“When there are not enough red blood cells around, less oxygen gets carried to the cells to allow them to generate energy, which causes fatigue,” says Dr Lin.</p> <p>Having a B-vitamin deficiency, especially B12, also affects energy levels, since vitamin B12 is another key to creating enough red blood cells. Since iron and vitamin B are commonly absorbed from red meat and shellfish, people who follow a vegetarian or vegan diet are at more risk.</p> <p>But anaemia can also occur during pregnancy or stem from gastro-intestinal problems, such as ulcers or Crohn’s disease. These and other less common vitamin and mineral deficiencies can all be identified with a blood test and treated with supplements and a change in diet. Dr Lin warns, however, that supplements and drinks that are advertised as energy enhancers can be dangerous.</p> <div title="Page 1"> <p>“A lot of those ‘energy’ supplements are laced with caffeine, ginseng or other stimulants at a high dose,” she says. She also cautions that they can cause serious side effects, like heart palpitations, insomnia and anxiety.</p> <p><strong>5. YOU’RE DEPRESSED</strong></p> <p>If you’re feeling excessively fatigued – dragging yourself through the normal tasks of daily living, or are unable to complete them – it could be a sign that you’ve slipped into depression.</p> <div title="Page 1"> <p>Some people are genetically predisposed to the condition, and others develop it as a result of difficult circumstances; the proportion of people experiencing psychological distress in Australia, for example, rose to 12.5 per cent in October 2021, the highest level recorded since the start of the COVID-19 pandemic.</p> <p>“It’s expected that so much fear and uncertainty will increase people’s levels of stress, anxiety and depression,” says Dr Agyapong.</p> <p>“With how long the pandemic is going on, it’s becoming pathological for a lot of people.”</p> <div title="Page 1"> <p>Other symptoms of depression include loss of appetite and irritability. If you’re feeling tired all the time and suspect depression might be to blame, ask your doctor for a mental-health screening. Talk therapy can help, as can antidepressants.</p> <p><strong>6. YOU’RE EATING AN UNBALANCED DIET</strong></p> <p>We often think about how our diet affects our weight, but what you eat has a large effect on your energy levels, too. When your body digests food, it turns it into glucose, which is then sent by way of your blood to all of your muscles and organs, including your brain. Our blood sugar naturally fluctuates during this process, and when it’s low, we can feel sluggish.</p> <div title="Page 1"> <p>A simple way to keep your blood sugar consistent is to eat regularly. “If you go more than several hours without a meal or snack, that’s probably too long of a stretch,” says dietitian Cara Harbstreet.</p> <p>Another common error, Harbstreet says, is eating too many simple carbohydrates – juice, chocolate bars or white bread. Those can lead to an increase in blood sugar, prompting your body to produce insulin, which then makes your blood sugar drop.</p> <div title="Page 1"> <p>“You get an energy spike and then you come crashing down and eat more of the same kinds of foods,” she explains. “And that cycle can repeat indefinitely.”</p> <p>Instead, reach for complex carbs – like whole grains and non-starchy vegetables – which are more slowly digested than simple carbs, giving you a steady stream of energy. To make sure you’re getting enough nutrients to fuel your body, Harbstreet recommends trying to eat three food groups at every meal and at least two at snack time.</p> <p><strong>7. YOU’RE NOT BREATHING WELL AT NIGHT</strong></p> <p>If you’ve been unusually tired for more than a month, ask your doctor if an underlying problem could be behind it. One common culprit is sleep apnoea, a condition that causes breathing to start and stop throughout the night.<br />According to an Australian Institute Of Health And Welfare report, Sleep-related Breathing Disorders With A Focus On Obstructive Sleep Apnoea, sleep apnoea affects 6.7 per 1000 Australian adults – and those numbers are on the rise, likely because of growing rates of obesity.</p> <div title="Page 1"> <p>Since sleep apnoea causes sufferers to rouse multiple times a night to keep breathing – often without knowing it – they don’t get enough deep sleep. The condition, which often comes with daytime exhaustion and nighttime snoring, can also lead to other issues, including cardiovascular disease and diabetes. If diagnosed, sleep apnoea can be treated with a machine that pushes pressurised air into your nose or mouth during the night to make sure your airways stay open.</p> <p><strong>8. YOUR THYROID IS STRAINED</strong></p> <div title="Page 1"> <p>Another underlying problem to watch out for is hypothyroidism, which affects about five per cent of the population and almost always includes tiredness as a symptom. The condition is caused when your thyroid, a butterfly-shaped gland inside your neck, produces too few hormones.</p> <div title="Page 1"> <p>“Thyroid hormones control your metabolism, which is like the engine in your car,” says Dr Lin. “When your engine runs too low, the car drives too slowly.” Along with fatigue, hypothyroidism may also result in weight gain, slow movement and speech, and sensitivity to cold. The condition is most common in women over 60 and can be treated by taking a medication that contains either natural or synthetic thyroid chemicals.</p> <p>—</p> <p>A few weeks after her fatigue set in, Heffernan knew she needed to do something to feel better. Finally, one day she decided to drop everything and go for a walk – something she hadn’t done since the pandemic began.</p> <div title="Page 1"> <div> <p>“I just wanted to be by myself,” she says. “I needed a break.” When she returned, she felt recharged and decided to make a habit of it.</p> <p>“Going for a 45-minute walk really feeds me, spiritually, emotionally and physically,” she says. I have something to look forward to every afternoon. I’m in a better mood. And after putting the kids to bed, I have the energy to stay up, talk to my husband and have some more time for myself.”</p> </div> <p><strong>60-Second Fixes: How to boost your energy in a minute or less</strong></p> <p><strong>1. Drink peppermint tea</strong><br />According to researchers, people who drink peppermint tea are more alert and complete mental tasks faster.</p> <p><strong>2. Open the blinds</strong><br />Exposing yourself to natural sunlight, especially when you wake up, can help suppress melatonin, the chemical in your body that makes you sleepy.</p> <p><strong>3. Take deep breaths</strong><br />When you’re stressed, it’s natural to breathe shallowly, which can decrease the amount of oxygen that reaches your cells. To counteract that, try breathing in through your nose for four seconds, holding your breath for four seconds, then slowly exhaling for four seconds.</p> <p><strong>4. Chew gum</strong><br />Though it’s not exactly clear why, numerous studies have shown that chewing (sugar-free) gum increases alertness. Even before science confirmed it, during WWI, American soldiers were issued gum to help them focus.</p> <p><strong>5. Sing a song</strong><br />Listening to music can increase levels of happy chemicals like serotonin and oxytocin – and belting out lyrics makes you breathe deeper and take in more oxygen, boosting your energy.</p> <p><strong>This article originally appeared in <a href="https://www.readersdigest.com.au/healthsmart/conditions/sleep/why-am-i-so-tired" target="_blank" rel="noopener">Reader's Digest</a>.</strong></p> <p><em>Image: Shutterstock</em></p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>

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Paul Green’s brain donated to science

<p dir="ltr">Paul Green’s brain has been donated to the Australian Sports Brain Bank to help with science. </p> <p dir="ltr">The legendary coach and former player Paul Green was just 49 when he <a href="https://oversixty.com.au/news/news/rugby-league-icon-dead-at-49" target="_blank" rel="noopener">was found dead</a> at his home in Brisbane on August 11. </p> <p dir="ltr">It is confirmed that the father-of-two died from suicide. </p> <p dir="ltr">His family has now confirmed that his brain will be donated to the <a href="https://www.mycause.com.au/page/290298/in-memory-of-paul-green" target="_blank" rel="noopener">Australian Sports Brain Bank</a> to help aid research into concussion-related condition chronic traumatic encephalopathy (CTE) - a common injury amongst NRL players due to the nature of the game. </p> <p dir="ltr">"In memory of our beloved Paul, we ask that you support the pioneering work of the Australian Sports Brain Bank,” their post read.</p> <p dir="ltr">"Paul was known for always looking out for others. We are proud that part of his legacy will be looking out for the brain health of all others involved in the game that he loved.</p> <p dir="ltr">"Amanda, Emerson and Jed."</p> <p dir="ltr">They are hoping to raise $150,000 to help with the research. </p> <p dir="ltr">Michael Buckland, the director of the Australian Sports Brain Bank, thanked Green’s family for their donation.</p> <p dir="ltr">"This is an incredibly generous donation and will be an invaluable part of our research into the long-term effects of repetitive head impacts in sport and elsewhere," he said.</p> <p dir="ltr">"We at the Australian Sports Brain Bank are blown away by the fact that in their time of grief, Amanda and the rest of the family thought of how they could help others."</p> <p dir="ltr">Green had an incredible NRL career, playing 162 first grade matches between 1994-2004 and winning the prestigious Rothmans Medal in 1995 as the game's best and fairest.</p> <p dir="ltr">He played for several different clubs including Cronulla-Sutherland Sharks, North Queensland Cowboys, Sydney Roosters, Parramatta Eels and the Brisbane Broncos.</p> <p dir="ltr">Green eventually swapped his playing boots to coaching ones as he took on the North Queensland Cowboys from 2014-2020.</p> <p dir="ltr">If you would like to donate to the research, click <a href="https://www.mycause.com.au/page/290298/in-memory-of-paul-green" target="_blank" rel="noopener">here</a>. </p> <p dir="ltr"><strong>If you are experiencing a personal crisis or thinking about suicide, you can call Lifeline 131 114 or beyondblue 1300 224 636 or visit <a href="https://www.lifeline.org.au/">lifeline.org.au</a> or <a href="https://www.beyondblue.org.au/">beyondblue.org.au</a>.</strong></p> <p dir="ltr"><em>Image: Australian Sports Brain Bank</em></p>

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Feeling tired after a long day of thinking? Here’s why

<p dir="ltr"> A long day of thinking can feel just as tiring as a day of hard labour, and now we know why.</p> <p dir="ltr">According to a recently-published study in the journal <em><a href="https://doi.org/10.1016/j.cub.2022.07.010" target="_blank" rel="noopener">Current Biology</a></em>, the all-too-common feeling of being mentally worn out is due to build-up of glutamate, a chemical in the brain’s prefrontal cortex that is useful but dangerous in high doses.</p> <p dir="ltr"><strong>An important messenger in our brains</strong></p> <p dir="ltr">Normally, <a href="https://my.clevelandclinic.org/health/articles/22839-glutamate#:~:text=Glutamate%20is%20the%20most%20abundant,places%20at%20the%20right%20time." target="_blank" rel="noopener">glutamate acts as a neurotransmitter</a>, or “chemical messenger”, that stimulates the nerve cells in our brains to send messages between them. This helps us learn and process information, with glutamate also allowing for nerve cells to build the foundations of our memories.</p> <p dir="ltr">But, when we have too much glutamate in our brains the nerve cells can become overexcited, which can lead to the cells becoming damaged or dying. Glutamate levels that are too high are also associated with several conditions that affect the brain, including Alzheimer’s, Parkinson’s, chronic fatigue syndrome, strokes, and multiple sclerosis.</p> <p dir="ltr">In this new study, the team of researchers say a build-up of glutamate in the prefrontal cortex alters our control over decisions and makes the continued use of our prefrontal cortex more energy-consuming. As a result, we’re more likely to make decisions that are low effort and have high rewards.</p> <p dir="ltr">Wanting to understand what mental fatigue actually is, Mathias Pessiglione and his colleagues at the Pitié-Salpêtrière University in Paris monitored the brain chemistry of two groups of people over the course of a workday.</p> <p dir="ltr">One group, who were performing mentally difficult work, showed signs of fatigue such as reduced pupil dilation where the group performing relatively easier tasks didn’t.</p> <p dir="ltr">The team also noticed that members of this group began to shift their choices towards tasks that were little effort but came with high rewards they didn’t have to wait long for.</p> <p dir="ltr">Importantly, the team found that the group doing hard work had higher levels of glutamate in the synapses of the prefrontal cortex.</p> <p dir="ltr">Their findings also go against popular theories that mental fatigue is all in our head.</p> <p dir="ltr">“Influential theories suggested that fatigue is a sort of illusion cooked up by the brain to make us stop whatever we are doing and turn to a more gratifying activity,” Pessiglione said.</p> <p dir="ltr">“But our findings show that cognitive work results in a true functional alteration – accumulation of noxious substances – so fatigue would indeed be a signal that makes us stop working but for a different purpose: to preserve the integrity of brain functioning.”</p> <p dir="ltr"><strong>Can we deal with glutamate build-up?</strong></p> <p dir="ltr">Though we can now explain why we’re feeling so tired, Pessiglione said there are only two ways to deal with the build-up of glutamate in our brains and our fatigue.</p> <p dir="ltr"> “I would employ good old recipes: rest and sleep!” he said.</p> <p dir="ltr">“There is good evidence that glutamate is eliminated from synapses during sleep.”</p> <p dir="ltr">Even so, the findings from Pessiglione and his team could have practical implications.</p> <p dir="ltr">For example, the researchers say that monitoring prefrontal metabolites - such as glutamate - could help detect severe mental fatigue, which could be beneficial for managing work agendas to avoid burnout.</p> <p dir="ltr">Pessiglione also advised people to avoid making important decisions when they’re tired.</p> <p dir="ltr">In the future, the team hopes to discover why the prefrontal cortex is so susceptible to fatigue and the accumulation of glutamate, and whether these markers for fatigue could be used to predict how people recover from conditions such as cancer or depression.</p> <p><span id="docs-internal-guid-383bbd64-7fff-2ec5-3606-8d318b130987"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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Online dating fatigue – why some people are turning to face-to-face apps first

<p>For the last two-plus years, people hoping to meet their soulmate in person have had a rough time. Lockdowns and uncertainty about social gatherings have led many people to turn to dating apps. People who feel they have lost months or years of their dating life may be eager to avoid the perils of dating apps – <a href="https://theconversation.com/from-ghosting-to-backburner-relationships-the-reasons-people-behave-so-badly-on-dating-apps-179600" target="_blank" rel="noopener">ghosting, backburner relationships</a>, or just wasting time chatting with the wrong people.</p> <p>People are eager to meet in person, and the menu of dating apps is expanding to accommodate this. In addition to the likes of Tinder, Hinge and Bumble, there are apps that focus on bringing people together in person.</p> <p>One of these is an <a href="https://www.telegraph.co.uk/news/2022/01/07/thursday-dating-hit-millennials-suffering-app-fatigue/" target="_blank" rel="noopener">increasingly popular</a> app called Thursday. It is live just once a week (on Thursdays) and gives users just 24 hours to arrange a date. This cuts down on the onerous swiping and messaging throughout the week and possibly prevents people using the app simply for validation or amusement. Thursday also hosts in-person events where attendees might meet someone without swiping at all.</p> <p>There are a few reasons in-person dating may be more appealing to some people than dating apps. The information we glean from online profiles gives us little to go on. Meeting in person results in a far richer and more detailed impression of a date than meeting online, where all we see is a photo and, usually, a brief bio. Also, 45% of current or previous users of dating apps or sites reported that the experience left them <a href="https://www.pewresearch.org/ft_2020-02-06_datingtakeaways_02" target="_blank" rel="noopener">feeling frustrated</a>.</p> <p>Online dating matches us to people we don’t know, making it easy for <a href="https://theconversation.com/first-the-love-bomb-then-the-financial-emergency-5-tactics-of-tinder-swindlers-176807" target="_blank" rel="noopener">scammers to take advantage of them</a>. Apart from this, users often misrepresent themselves, resulting in disappointment when daters meet face to face.</p> <p>While online dating appears to offer an abundance of choice, <a href="https://www.tandfonline.com/doi/abs/10.1080/15213269.2015.1121827?cookieSet=1" target="_blank" rel="noopener">research suggests</a> that we make poorer decisions online about dating choice. We use simpler methods when choosing from a large array of potential suitors than when we choose on a one-to-one basis in person. This is often referred to as the paradox of choice.</p> <h2>Are dating apps dead?</h2> <p>Dating apps have undisputedly had a huge impact on how couples meet. In the US, <a href="https://news.stanford.edu/2019/08/21/online-dating-popular-way-u-s-couples-meet/" target="_blank" rel="noopener">meeting online is the most popular</a> way that couples meet, and the number has increased in recent years.</p> <p>Part of the appeal of apps is their simplicity: you can create a profile and start matching with people in a matter of minutes. Despite this, using dating apps does take time and effort. A large survey by <a href="https://www.bustle.com/p/millennials-spend-average-of-10-hours-a-week-on-dating-apps-survey-finds-but-heres-what-experts-actually-recommend-8066805" target="_blank" rel="noopener">dating app Badoo found</a> that millennials spend on average 90 minutes a day looking for a date, by swiping, liking, matching and chatting.</p> <p>Often, messages by one party go unanswered by the other, and even if there is a response, the chatting may never result in meeting in person. In 2016, Hinge’s data found that only <a href="https://www.washingtonpost.com/news/soloish/wp/2016/10/03/why-is-the-dating-app-hinge-bashing-swipe-apps/" target="_blank" rel="noopener">one in 500 swipes</a> resulted in phone numbers being exchanged.</p> <p>This onerous process may lead to online dating fatigue for some. If we get no positive matches from our seemingly endless swiping, or we receive no response to our messages, our online dating efforts will eventually fizzle out.</p> <p>Traditional dating apps are still incredibly popular, especially among young people. As of 2021, Tinder has been <a href="https://www.tinderpressroom.com/news?item=122515" target="_blank" rel="noopener">downloaded</a> over 450 million times – with Generation Z making up 50% of the app’s users.</p> <p>Research by <a href="https://lendedu.com/blog/tinder-match-millennials/" target="_blank" rel="noopener">Lendedu</a> asked 3,852 millennials whether they had ever met up with their Tinder matches. The research found that only 29% said “yes” – much lower than the 66% who reported meeting for at least one date via more traditional dating sites such as Match or OKCupid.</p> <p>But not everyone on Tinder is hoping to find a date. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0736585316301216" target="_blank" rel="noopener">Research among Dutch Tinder users found</a> that many use the app for validation (using matches merely as an assessment of one’s own level of attractiveness), or for the thrill of receiving a match but having no intention of pursuing a date.</p> <p>For this reason, dating apps may eventually lose users who are pursuing genuine relationships, particularly if they are instead turning to face-to-face opportunities first. But as long as they adapt to the changing demands of daters, apps are here to stay.</p> <p><em><strong>This article originally appeared on <a href="https://theconversation.com/online-dating-fatigue-why-some-people-are-turning-to-face-to-face-apps-first-184910" target="_blank" rel="noopener">The Conversation</a>.</strong></em></p> <p><em>Image: Shutterstock</em></p>

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Stroke, cancer and other chronic diseases more likely for those with poor mental health

<p><a href="https://www.aihw.gov.au/reports-statistics/health-welfare-services/mental-health-services/overview">Four million Australians</a>, including our friends, family members, co-workers and neighbours, are living with mental health conditions, including anxiety and depression.</p> <p>A <a href="https://www.vu.edu.au/australian-health-policy-collaboration/publications#chronic-diseases">new report out today</a> from the <a href="https://www.vu.edu.au/australian-health-policy-collaboration">Australian Health Policy Collaboration</a> has found these four million Australians are at much greater risk of chronic physical disease and much greater risk of early death.</p> <p>Having a mental health condition increases the risk of every major chronic disease. Heart disease, high blood pressure, arthritis, back pain, diabetes, asthma, bronchitis, emphysema and cancer are all much more likely to occur among people with anxiety and depression. </p> <p>More than 2.4 million people have both a mental and at least one physical health condition.</p> <p>For the first time in Australia, this report quantifies the extent of this problem. For example, people with mental health conditions are more likely to have a circulatory system disease (that is, heart disease, high blood pressure and stroke). The likelihood increases by 52% for men, and 41% for women.</p> <p>More than a million people are affected by both a circulatory system disease and a mental health condition. These diseases are Australia’s biggest killers.</p> <p>For painful, debilitating conditions such as arthritis and back pain, the numbers are even higher. Arthritis is 66% more likely for men with mental health conditions, and 46% more likely for women, with 959,000 people affected.</p> <p>Back pain is 74% more likely for men with mental health conditions, and 68% more likely for women, with more than a million affected.</p> <p>The gender differences are significant. Women with mental health conditions are much more likely to have asthma than women across Australia as a whole (70% more likely), while men are 49% more likely to have asthma with a mental health condition.</p> <p>The biggest gender difference is cancer. Men with mental health conditions are 84% more likely to have cancer than the general population, and for women the figure is 20%.</p> <p>As more women live with mental health conditions than men, overall, women are 23% more likely to be living with both a mental and physical health condition than men.</p> <p>The report shows having a co-existing mental health condition and chronic physical disease generally results in worse quality of life, greater functional decline, needing to use more health care and higher healthcare costs. </p> <p>These people require more treatment, use more medications, and have to spend more time, energy and money managing their health. People with a mental health condition are also <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60240-2/abstract">more likely to be poorer</a>, less likely to work, less likely to receive health screening and, sadly, <a href="https://www.rethink.org/media/810988/Rethink%20Mental%20Illness%20-%20Lethal%20Discrimination.pdf">more likely to receive substandard care</a> for their physical diseases.</p> <p>On average, people with mental health conditions die younger than the general population, and mostly from preventable conditions. We know from <a href="https://www.bmj.com/content/346/bmj.f2539">earlier research</a>that people with severe mental illnesses die much earlier than the rest of the population. Our report shows even common mental health conditions such as anxiety and depression contribute to more chronic disease, leading to higher rates of early death.</p> <h2>Why?</h2> <p>We don’t know exactly why people with mental health conditions have poorer physical health. The <a href="https://acmedsci.ac.uk/policy/policy-projects/multimorbidity">Academy of Medical Sciences</a> has identified that poor mental health and psychosocial risk factors such as feeling dissatisfied with life, not feeling calm, having sleep problems that affect work, and financial concerns can predict physical disease.</p> <p>Other factors, such as <a href="https://theconversation.com/low-income-earners-are-more-likely-to-die-early-from-preventable-diseases-87676">low socioeconomic status</a>, poor social networks, living in rural areas and smoking are associated with both poor mental health and poor physical health.</p> <p>We do know people with mental health conditions often don’t receive advice about healthy lifestyles, don’t get common tests for disease, and are less likely to receive treatment for disease. Some of this is due to <a href="https://www.ncbi.nlm.nih.gov/pubmed/21379357">stigma and discrimination</a>, and sometimes it’s neglect. People with mental health conditions can <a href="https://www.ranzcp.org/Files/Publications/RANZCP-Serious-Mental-Illness.aspx">fall through the gaps between disjointed physical and mental health systems</a>. </p> <h2>What can we do about it?</h2> <p>There is <a href="https://www.ranzcp.org/Files/Publications/RANZCP-Keeping-body-and-mind-together.aspx">momentum for change</a> among the mental health sector, with dozens of organisations signing up to the <a href="https://equallywell.org.au/">Equally Well</a> consensus statement. This aims to improve the quality of life of people living with mental illness by providing equal access to quality health care. </p> <p>There’s some great work being done around the country, including in the <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12459">Hunter region</a>, where people with mental health conditions can access tailored help with physical health risk factors such as smoking and diet.</p> <p>People using mental health services should have their physical health regularly assessed, and any problems addressed as early as possible. Better coordination of care would preserve healthcare resources and improve quality of life.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/stroke-cancer-and-other-chronic-diseases-more-likely-for-those-with-poor-mental-health-100955" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Midlife chronic conditions associated with higher dementia risk as we age

<p dir="ltr">Middle-aged people with multiple chronic conditions may have a higher risk of developing dementia later in life according to a new study.</p> <p dir="ltr">French researchers <a href="https://www.scimex.org/newsfeed/midlife-chronic-conditions-linked-to-increased-dementia-risk-later-in-life" target="_blank" rel="noopener">found</a> that middle aged people with at least two chronic conditions - including diabetes, high blood pressure, coronary heart disease and chronic lung disease (COPD) - have a higher risk of dementia than those who develop these conditions when they are older.</p> <p dir="ltr">While studies have shown that having two or more chronic conditions - known as multimorbidity - is common, especially among older people and those with dementia, little is known about how multimorbidity affects one’s risk of dementia.</p> <p dir="ltr">The new study, published in the <em><a href="https://doi.org/10.1136/bmj-2021-068005" target="_blank" rel="noopener">BMJ</a></em>, saw the team use data collected from over 10,000 British men and women involved in the Whitehall II Study, which looks at the association between social, behavioural and biological factors and long-term health.</p> <p dir="ltr">Of the 10,095 participants in the study, about 600 people (6.6 percent) had multimorbidity at 55, while 3200 people (32 percent) did by 70.</p> <p dir="ltr">When participants first joined the study between the ages of 35 and 55, they were free of dementia.</p> <p dir="ltr">Over a median follow-up period of 32 years, the team identified 639 people with dementia.</p> <p dir="ltr">The researchers then found that, considering factors such as age, sex, diet and lifestyle, people with multimorbidity at 55 had a 2.4-times higher risk of dementia compared to those without any of the 13 chronic conditions they looked at.</p> <p dir="ltr">They also found that this association weakened as the age that people were diagnosed with multiple chronic conditions increased.</p> <p dir="ltr">Though the team did find an association between age, multimorbidity and dementia risk, they stressed it was an observational study that can’t establish cause and effect.</p> <p dir="ltr">They also noted some limitations to their study, such as the misclassification of some dementia cases, and that the study participants were likely to be healthier than the general population.</p> <p dir="ltr">Despite these limitations, the researchers said their findings could be promising for finding ways of preventing dementia.</p> <p dir="ltr">“Given the lack of effective treatment and its personal and societal implications, finding targets for prevention of dementia is imperative,” they write.</p> <p dir="ltr">“These findings highlight the role of prevention and management of chronic diseases over the course of adulthood to mitigate adverse outcomes in old age.”</p> <p><span id="docs-internal-guid-626c7940-7fff-39aa-b438-7752a9c6a76c"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

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Coffee may prevent chronic liver disease

<div class="copy"> <p>Drinking coffee – whichever way you take it – may reduce the risk of liver disease, according to a new <a rel="noreferrer noopener" href="https://doi.org/10.1186/s12889-021-10991-7" target="_blank">study</a> published in the journal <em>BMC Public Health.</em></p> <p>A team of researchers, from the universities of Southampton and Edinburgh in the UK, analysed <a rel="noreferrer noopener" href="https://www.ukbiobank.ac.uk/" target="_blank">UK Biobank</a> data on 495,585 participants, followed over roughly 11 years, to monitor the development of chronic liver disease and its relationship to coffee consumption.</p> <p>Coffee drinkers had a 21% reduced risk of chronic liver disease and a 49% reduced risk of death from liver disease, according to the study. The maximum benefit was found among those who drank ground coffee, which contains high levels of the ingredients kahweol and cafestol – which have been <a rel="noreferrer noopener" href="https://pubmed.ncbi.nlm.nih.gov/17590492/" target="_blank">shown</a> to be beneficial against liver disease in animal trials.</p> <p>But even instant coffee, which has low levels of these two key ingredients, had a marked benefit in reducing risk of liver disease, suggesting other ingredients or combinations are also beneficial.</p> <p>The find is important because chronic liver disease is a <a rel="noreferrer noopener" href="https://www.ncbi.nlm.nih.gov/books/NBK554597/" target="_blank">growing cause</a> of morbidity and mortality worldwide.</p> <p>“Coffee is widely accessible and the benefits we see from our study may mean it could offer a potential preventative treatment for chronic liver disease,” says lead author Oliver Kennedy, of the University of Southampton. “This would be especially valuable in countries with lower income and worse access to healthcare and where the burden of chronic liver disease is highest.”</p> <p>Coffee has <a rel="noreferrer noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/coffee-and-health/faq-20058339" target="_blank">often had a bad rap</a>, with early studies suggesting negative health impacts and a <a rel="noreferrer noopener" href="https://hellogiggles.com/lifestyle/health-fitness/health-benefits-caffeine-free/" target="_blank">bevy</a> of health gurus and online blogs espousing the benefits of abandoning the drink. But in recent years, a number of studies have demonstrated the potential benefits of coffee against a range of illnesses, including <a rel="noreferrer noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125458/" target="_blank">Parkinson’s disease</a>, <a rel="noreferrer noopener" href="https://care.diabetesjournals.org/content/29/2/398" target="_blank">type 2 diabetes</a>, and <a rel="noreferrer noopener" href="https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.119.006799" target="_blank">heart failure</a>.</p> <p>The authors conducted their research based on the “biological plausibility” of coffee as a preventive factor in liver disease. Caffeine is a non-selective antagonist of the A2aA receptor. When activated, the A2aA receptor stimulates collagen production by hepatic stellate cells, which mitigate against liver fibrosis. Other active ingredients including kahweol, cafestol and chlorogenic acid have also been shown to protect against fibrosis in animal studies.</p> <p>The authors note that coffee consumption was only reported at initial enrolment into the study, so long-term changes in consumption are not accounted for. The participants in the study were also predominantly white and from higher socio-economic backgrounds, skewing the results towards particular physiologies and lifestyle factors, highlighting the need for further research.</p> <p><em>Image credits: Getty Images</em></p> </div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/coffee-may-prevent-chronic-liver-disease/">cosmosmagazine.com</a> and was written by Amalyah Hart. </em></p> </div>

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Physical symptoms linked to genetic risk of depression

<p><span style="font-weight: 400;">People who experience physical symptoms such as chronic pain, fatigue and migraines are also more likely to have a higher genetic risk of clinical depression, according to a new study.</span></p> <p><span style="font-weight: 400;">Researchers from the University of Queensland collaborated with the QIMR Berghofer Medical Research Institute at the Royal Brisbane and Women’s Hospital to conduct a new study published in </span><em><a rel="noopener" href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2783096" target="_blank"><span style="font-weight: 400;">JAMA Psychiatry</span></a></em><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">They analysed data from over 15,000 volunteers, who provided information about their mental health history, depression symptoms, and a DNA sample.</span></p> <p><span style="font-weight: 400;">The team found that participants who had a higher genetic risk of developing clinical depression were more likely to experience additional physical symptoms.</span></p> <p><span style="font-weight: 400;">Dr Enda Byrne, a senior research fellow in psychiatric genetics and one of the researchers involved, said the study aimed to improve understanding of the genetic risks of depression and how other symptoms can be used to aid diagnosis.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7845012/depression1.jpg" alt="" data-udi="umb://media/e08ca3fc9f134a3c8fb3556dde363b83" /></p> <p><em><span style="font-weight: 400;">Dr Enda Byrnes, the senior author of the latest study on depression and genetic risk. Image: The University of Queensland</span></em></p> <p><span style="font-weight: 400;">“A large proportion of people with clinically-diagnosed depression present initially to doctors with physical symptoms that cause distress and can severely impact on people’s quality of life,” </span><a rel="noopener" href="https://www.scimex.org/newsfeed/genetic-risk-for-clinical-depression-linked-to-physical-symptoms" target="_blank"><span style="font-weight: 400;">he said</span></a><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">“Our research aimed to better understand the biological basis of depression and found that assessing a broad range of symptoms was important.</span></p> <p><span style="font-weight: 400;">“We wanted to see how genetic risk factors based on clinical definitions of depression differed - from those based on a single question to those based on a doctor’s consultation about mental health problems.”</span></p> <p><strong>Genetic risks of depression, explained</strong></p> <p><span style="font-weight: 400;">Many different factors can contribute to the onset of depression, and there is strong evidence to suggest that genetics can affect the likelihood of developing the mental illness.</span></p> <p><span style="font-weight: 400;">Individuals can be predisposed to developing depression if someone in their family has been diagnosed. If a person’s biological parent has been diagnosed with clinical depression, their genetic risk of developing the illness sits at </span><a rel="noopener" href="https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/1-causesofdepression.pdf" target="_blank"><span style="font-weight: 400;">about 40 percent</span></a><span style="font-weight: 400;">, with the other 60 percent coming from factors in their environment such as stress and age.</span></p> <p><span style="font-weight: 400;">Previous studies have also examined the role genetics plays in depression, but Dr Byrne said it can be difficult to find genetic risk factors that are specific to clinical depression.</span></p> <p><span style="font-weight: 400;">“Previous genetic studies have included participants who report having seen a doctor for worries or tension - but who may not meet the ‘official’ criteria for a diagnosis of depression,” he said.</span></p> <p><span style="font-weight: 400;">The researchers also stressed the importance of using a large number of samples in order to identify the risk factors for clinical depression but not for other definitions of depression.</span></p> <p><span style="font-weight: 400;">“It is also linked to higher rates of somatic symptoms - that is, physical symptoms that cause distress and can severely impact on people’s quality of life,” Dr Byrne said.</span></p> <p><span style="font-weight: 400;">“Our results highlight the need for larger studies investigating the broad range of symptoms experienced by people with depression.”</span></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p>

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Pain and the brain: Closing the gap between modern pain science and clinical practice

<div> <div class="copy"> <p>Statistics show that chronic pain affects 3.4 million Australians – that’s almost 14% of the population.</p> <p>But while pain science discoveries have enormous consequences on chronic pain treatment, the medical community knows little about them.</p> <p>Pain scientists have been urging clinicians for decades to ditch the traditional biomedical approach and adopt a multidisciplinary and multimodal methodology to chronic pain treatment.</p> <p>This latter approach considers the biological, psychological and social factors that affect the patient’s perception of danger.</p> <p>Evidence-based treatment includes a <a rel="noreferrer noopener" href="https://www.sciencedirect.com/science/article/pii/S0004951414601690?via%3Dihub" target="_blank">combination</a> of pharmacological and non-pharmacological techniques, including pain education, physiotherapy management and mental health support.</p> <p>“We have developed a four-steps process that brings together all these ideas (drawn from modern pain science),” says Professor Benedict Wand, a pain scientist at the University of Notre Dame.</p> <p>The first, fundamental step of this process, he says, is modern pain neurobiology education, which helps people gain a less threatening understanding of pain.</p> <p>The second step is helping the person feel safe to move, while the third step includes an active progressive rehabilitation that gradually loads the body so that movement continues to feel safe.</p> <p>Lastly, the focus shifts towards making the body stronger.</p> <p class="has-text-align-center"><strong><em>Read more: <a rel="noreferrer noopener" href="https://cosmosmagazine.com/health/medicine/chronic-pain-in-women-could-be-genetic/" target="_blank">Chronic pain in women could be genetic</a></em></strong></p> <p>The biomedical model in which most health professionals in Australia have been trained describes pain as a direct consequence of tissue damage – the more severe an injury, the stronger the pain.</p> <p>In this model, pain provides an accurate measure of the state of the tissues, and it can be ‘fixed’ by providing pain relief.</p> <p>“We originally thought that pain was a simple readout of noxious information from the body,” says Wand. “But that is certainly not the process that underpins complex and long-standing pain experiences.”</p> <p>Decades of <a rel="noreferrer noopener" href="http://www.cor-kinetic.com/wp-content/uploads/2014/04/reconceptualizing-pain.pdf" target="_blank">research</a> in pain science have led scientists to believe that the level of pain is not an indication of the level of tissue damage.</p> <p>Instead, scientists have discovered that pain is a vital mechanism that happens in the brain (and not in the tissues) to protect us from more severe injuries.</p> <p>When we get hurt, pain receptors send a ‘possible threat’ signal to the brain, which then evaluates the danger of the threat by drawing information from current and past experiences and the state of the mind.</p> <p>If the brain does not perceive the circumstance as dangerous, it will not cause pain.</p> <p>If we are anxious or frightened, our brain might perceive the situation as dangerous and produce pain to protect us.</p> <p>“An interaction between incoming information from the world around you and held information – things that you already think and feel and believe – gives rise to an experience of pain when you judge your body to be under threat or needing protection,” says Wand.</p> <p>In one <a rel="noreferrer noopener" href="https://journals.lww.com/pain/Fulltext/2007/12150/The_context_of_a_noxious_stimulus_affects_the_pain.9.aspx" target="_blank">study</a>, scientists placed an ice-cold rod on the back of volunteers’ hands while showing them either a red or blue light.</p> <p>The rod was at the same temperature each time, but those who were shown the red light, which in our imagery represents danger, reported more intense pain than those who saw the blue light.</p> <p>In another <a rel="noreferrer noopener" href="https://journals.lww.com/pain/Fulltext/1998/01000/The_role_of_prior_pain_experience_and_expectancy.24.aspx" target="_blank">experiment</a>, volunteers put their heads inside what they thought was a ‘head stimulator’.</p> <p>In front of them, researchers manoeuvred an ‘intensity knob’.</p> <p>The volunteers reported levels of pain that correlated with the intensity on the knob, although the stimulator was doing nothing at all.</p> <p>These studies suggest that pain is not a response to real danger or physical damage but to perceived danger, says Professor Lorimer Moseley, a pain scientist at the University of South Australia.</p> <p>Consequently, psychosocial factors that alter our perception of threat play a crucial role in the level of pain we experience.</p> <p>When pain becomes chronic, it is less about physical damage and more about a pain system that has become excessively protective.</p> <p>A physical cause of the pain might never be found in scans, yet the pain people feel is real, says Moseley.</p> <h2><strong>Go the distance for pain science</strong></h2> <p>While lack of access to multidisciplinary pain services is a countrywide issue, rural and regional areas are severely underserved.</p> <p>Pain Revolution is <a rel="noreferrer noopener" href="https://www.painrevolution.org/" target="_blank">an organisation</a> set up to close the gap between modern pain science and clinical practice in rural and regional communities.</p> <p>The organisation has established a Local Pain Educator Program that trains rural and regional GPs and health professionals in modern pain science and management.</p> <p>In turn, they support their communities by providing pain education to the public.</p> <p>With another project called the Local Pain Collectives, Pain Revolution helps rural and regional health professionals establish community-based, interdisciplinary networks to build their skills in contemporary pain education and management.</p> <p>“Two essential ingredients for recovery from persistent pain are learning and movement,” says Moseley, who is also CEO of Pain Revolution.</p> <p>“There is very strong evidence that movement is medicine. Our muscles, bones, ligaments, skin, tendons – you name it – <em>love</em> movement.”</p> <p>To support its work, Pain Revolution has launched a virtual challenge to raise funds called Go the Distance.</p> <p>“Go the Distance is challenging everyone to learn a bit more about pain and get moving, and walking, running and cycling are three easy ways to do it,” says Moseley.</p> <p>The initiative has replaced the annual Rural Outreach Tour, which had previously been the major Pain Revolution fundraiser.</p> <p>“Like many events in 2021, COVID has meant that we had to find an alternative to the tour,” says Moseley.</p> <p>The initiative will be held in October, and it challenges participants to walk, run or ride as far as possible to support people who suffer from chronic pain and often don’t receive medical care that is based on the latest scientific evidence.</p> <p>If you want to help, support our science writer Manuela Callari, who has taken the challenge, by donating <a rel="noreferrer noopener" href="https://painrevolution.raisely.com/manuela-callari" target="_blank">here</a>. If you want to sign up as an individual, or join a team, go to <a rel="noreferrer noopener" href="http://painrevolution.raisely.com/" target="_blank">painrevolution.raisely.com</a>.</p> <p><em>Image credit: Shutterstock</em></p> <p><em>This article was originally published by <a rel="noopener" href="https://cosmosmagazine.com/health/pain-and-the-brain-closing-the-gap-between-modern-pain-science-and-clinical-practice/" target="_blank">cosmosmagazine.com</a> and was written by Dr Manuela Callari.</em></p> </div> </div>

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Chronic pain could be changing your brain

<p><span style="font-weight: 400;">The way we feel - whether it’s happiness, irritation or any other emotion - has been found to be a balancing act between two chemical messengers in our brains.</span></p> <p><span style="font-weight: 400;">But, for the more than 3 million Australians who experience chronic pain, new research has found the likelihood of experiencing negative emotions more often than positive ones is higher.</span></p> <p><span style="font-weight: 400;">The new study, which used advanced imaging techniques to scan the brains of volunteers with and without a history of chronic pain, saw that those affected by chronic pain tend to be more anxious and depressed due to disruptions in the communication between cells.</span></p> <p><span style="font-weight: 400;">“Chronic pain is more than an awful sensation,” </span><a rel="noopener" href="https://newsroom.unsw.edu.au/news/science-tech/chronic-pain-might-impact-how-brain-processes-emotions" target="_blank"><span style="font-weight: 400;">says</span></a><span style="font-weight: 400;"> Associate Professor Sylvia Gustin, the senior author of the new study and a neuroscientist and psychologist at the University of New South Wales and NeuRA.</span></p> <p><span style="font-weight: 400;">“It can affect our feelings, beliefs and the way we are.”</span></p> <p><strong>What happens in the brain</strong></p> <p><span style="font-weight: 400;">Emotions are processed by many different areas in the brain, which work together as a network. These regions include the amygdala (responsible for handling positive and negative information), and the prefrontal cortex (which helps us regulate our emotions).</span></p> <p><span style="font-weight: 400;">For example, when something frightening is happening, the amygdala sends that information to the prefrontal cortex, which decides whether to communicate with other areas of the brain so you can run away or react in other ways.</span></p> <p><span style="font-weight: 400;">This communication requires the help of chemical ‘messengers’ called neurotransmitters, which both help in sending messages between cells and regulating everything from mood to appetite..</span></p> <p><span style="font-weight: 400;">One neurotransmitter called gamma-aminobutyric acid (GABA) can stop neurons from becoming over excited to limit communication between the amygdala and the prefrontal cortex.</span></p> <p><span style="font-weight: 400;">A second, called glutamate, can excite them.</span></p> <p><span style="font-weight: 400;">These neurotransmitters work together to regulate mood, so that our feelings help motivate us to take action when we need to, without feeling overwhelmed or overly anxious.</span></p> <p><img style="width: 500px; height: 499.99999999999994px;" src="https://oversixtydev.blob.core.windows.net/media/7842887/gettyimages-1030518600.jpg" alt="" data-udi="umb://media/47371b7ecc6f445b94f92f194fa15a0c" /></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p> <p><span style="font-weight: 400;">In previous studies on animal models, scientists found that subjects in pain experience varying levels of glutamate. Similarly, a </span><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/31849800/" target="_blank"><span style="font-weight: 400;">decrease in glutamate</span></a><span style="font-weight: 400;"> has also been seen in humans experiencing chronic pain, matching a decline in their emotional regulation.</span></p> <p><span style="font-weight: 400;">However, changes in the amount of GABA in subjects experiencing pain has only been seen in mice, which is where this new study comes in.</span></p> <p><strong>The study</strong></p> <p><span style="font-weight: 400;">By scanning the brains of 48 participants with and without chronic pain, the scientists were able to determine whether the levels of GABA differed when someone was in pain and not in pain.</span></p> <p><span style="font-weight: 400;">Though the sample size isn’t large, the study does show enough evidence to support the view that being in pain for a long period of time changes how the brain processes emotions.</span></p> <p><span style="font-weight: 400;">“We have discovered, for the first time, that ongoing pain is associated with a decrease in GABA, an inhibitive neurotransmitter in the medial prefrontal cortex. In other words, there’s an actual pathological change going on,” Gustin says.</span></p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CR3BpqlK9kg/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="13"> <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/CR3BpqlK9kg/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by NeuRA (@neuraustralia)</a></p> </div> </blockquote> <p><span style="font-weight: 400;">With lower levels of GABA, it can become harder to dampen the thought processes which deal with our emotional responses and reasoned-out thoughts and actions.</span></p> <p><strong>Why it matters</strong></p> <p><span style="font-weight: 400;">Understanding how pain affects our emotions in the long term can help researchers develop ways to manage its effects, including poorer sleep, additional stress, and feelings of guilt.</span></p> <p><span style="font-weight: 400;">“It’s important to remember it’s not you - there’s actually something physically happening to your brain,” says Gustin.</span></p> <p><span style="font-weight: 400;">“The brain can’t dampen down these feelings on its own, but it is plastic - and we can learn to change it.”</span></p> <p><span style="font-weight: 400;">This research was published in the </span><em><a rel="noopener" href="https://onlinelibrary.wiley.com/doi/10.1002/ejp.1838" target="_blank"><span style="font-weight: 400;">European Journal of Pain</span></a></em><span style="font-weight: 400;">.</span></p>

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How coronavirus self-isolation fatigue may lead to more beach drownings this summer

<p>The easing of physical distancing restrictions can’t come soon enough for those tired of self-isolation, and for many the beach represents a welcome therapy after an extended time indoors and alone.</p> <p>In Australia, <a href="https://www.abc.net.au/news/2020-04-26/coronavirus-crowds-sydney-beaches-again-despite-covid-19-risks/12185926">popular beaches in Sydney</a>, including the iconic Bondi Beach, were completely closed to public access during the government-imposed lockdown period. When they reopened under restricted conditions in late April (fall in the southern hemisphere), the unexpectedly large crowds led authorities to close them again.</p> <p>More recently, crowded beaches in the <a href="https://toronto.ctvnews.ca/ontario-premier-shocked-by-packed-toronto-beaches-warns-covid-19-fight-is-not-over-1.4995033">Great Lakes</a>, <a href="https://www.nbcnews.com/news/us-news/coronavirus-comes-spring-break-locals-close-florida-beaches-after-governor-n1163741">Florida</a>, <a href="https://www.khou.com/article/news/health/coronavirus/galveston-beaches-see-uptick-in-crowds-as-city-takes-additional-measures-to-protect-visitors-from-covid-19/285-6bc76e6b-a076-40ac-8a22-a714e8ba0dfc">Texas</a>, <a href="https://www.latimes.com/california/story/2020-05-26/crowds-masks-venice-beach-memorial-day-weekend">California</a> and the <a href="https://www.smh.com.au/world/europe/brits-flock-to-the-beach-amid-medics-warning-of-second-wave-20200625-p555y7.html">United Kingdom</a> show that people are eager to find their spot on the sand.</p> <p>While going to the beach to bathe or swim is seen as an enjoyable recreational experience, aside from social distancing concerns, beaches can be dangerous environments and it is <a href="http://doi.org/10.5194/nhess-19-389-2019">not uncommon for drownings</a> to occur. Unfortunately, there are several COVID-19-related factors that have the potential to significantly increase the number of beach drownings and rescues.</p> <p><strong>Beach hazards in a time of COVID-19</strong></p> <p>First, many of those people seeking out beaches may be infrequent beachgoers, <a href="https://doi.org/10.1016/j.apgeog.2014.10.011">unfamiliar with beach hazards, such as rip currents, and safety practices</a>, including strategies on how to react when caught in a rip current as recommended by the <a href="http://doi.org/10.5194/nhess-17-1003-2017">Break the Grip of the Rip campaign</a> in the United States.</p> <p>Second, summer travel plans have been altered for many, meaning local and non-holiday beaches — many of which are not patrolled by lifeguards — may see larger crowds and could put <a href="https://doi.org/10.1371/journal.pone.0212349">bystanders who attempt rescues</a> at greater risk.</p> <p>Third, and most important, in normal years, lifeguard services would intervene to ensure that people don’t put themselves into dangerous situations. This year is different.</p> <p>Several jurisdictions from the <a href="https://www.bbc.com/news/uk-england-52038489">U.K.</a> and the <a href="https://www.hollandsentinel.com/news/20200608/covid-furloughs-meant-no-warning-flags-on-holland-beach-as-two-boys-drowned">Great Lakes</a> have cancelled their lifesaving programs due to COVID-19-related budget and health concern restraints.</p> <p>Coronavirus-related staff cuts and furloughs prevented Holland State Park in Michigan from setting up the flags to warn swimmers of the daily hazard along that section of Lake Michigan. The <a href="https://www.mlive.com/news/muskegon/2020/06/double-drowning-tragedy-underscores-danger-of-great-lakes.html">lack of warning flags and lifeguards has already been blamed for the drownings</a> of a six-year-old and a 17-year-old on June 6. This is just but one example of how cutting funding to beach safety programs could cost lives.</p> <p><strong>Masking the truth about the surf hazard</strong></p> <p>There are interesting parallels between drowning prevention and efforts to flatten the COVID-19 curve.</p> <p>Many people do not wear a mask in public despite evidence that masks reduce the <a href="https://today.tamu.edu/2020/06/12/texas-am-study-face-masks-critical-in-preventing-spread-of-covid-19/">potential for COVID-19 transmission</a>. For example, if you have gone grocery shopping and avoided infection, you may become complacent and feel that masks and hand-washing are unnecessary. Or you may bend to peer pressure if you meet up with friends who are not wearing masks or social distancing.</p> <p>These same behaviours come into play with drownings. <a href="https://doi.org/10.1007/s11069-018-3424-7">Evidence suggests</a> that if you didn’t drown on your last visit to the beach, you’ll be confident that you won’t drown on your next visit — despite changing waves, tides and other conditions.</p> <p>Or if you are with a group of friends who are better swimmers, there is a greater chance that you will venture into deeper water to avoid the social cost of staying close to shore. You may also mirror the risky behaviours of other beachgoers.</p> <p><strong>Ignoring the warning signs</strong></p> <p>The time and financial investment made in travelling to the beach after being limited by stay-at-home orders for weeks and months means that more people may enter the water, even if the conditions aren’t ideal.</p> <p>Beach users escaping self-isolation at home may be tired of warnings and further restrictions on the beach and may ignore them, particularly if they believe that lifeguards are being <a href="https://doi.org/10.5194/nhess-19-2541-2019">overly cautious</a>. This was the greatest concern expressed at a recent (virtual) conference to celebrate the creation of a legislated lifesaving program in <a href="https://doi.org/10.1007/s11069-015-1626-9">Costa Rica</a>.</p> <p>In the Great Lakes, the problem is made worse by the high-water levels that have <a href="https://www.chicagotribune.com/news/environment/ct-lake-michigan-record-water-levels-20200619-ntztvazvynf7bgbro3cgkp2diy-story.html">limited the amount of beach available</a>. Even where lifeguard services are still provided, the limited beach width means that people will either crowd together on the beach or move away from others, increasing the lifeguard’s patrol area — and the risk that someone will need rescue or will drown.</p> <p><a href="https://www.sbs.com.au/news/famous-sydney-beaches-closed-after-crowds-flout-coronavirus-restrictions">Restricting access to beaches</a> to limit crowds and the <a href="https://www.cnn.com/2020/06/15/us/covid-19-second-shutdown/index.html">potential for a second wave of COVID-19 cases</a>, will in turn limit the number of drownings as long as people <a href="https://abc7chicago.com/lake-michigan-chicago-beach-beaches-open/6265505">heed those closures</a>.</p> <p>COVID-19 has created a perfect storm that could make beaches more popular than ever before and raise the risk of drowning. So far, most of the concern has focused on the lack of social distancing and the looming threat of a second COVID-19 wave, but that focus may soon shift to drowning. Are we going to love our beaches to death?<!-- 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/141491/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/chris-houser-688101">Chris Houser</a>, Professor of Earth and Environmental Science, and Dean of Science, <a href="https://theconversation.com/institutions/university-of-windsor-3044">University of Windsor</a> and <a href="https://theconversation.com/profiles/rob-brander-111027">Rob Brander</a>, Professor, <a href="https://theconversation.com/institutions/unsw-1414">UNSW</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-coronavirus-self-isolation-fatigue-may-lead-to-more-beach-drownings-this-summer-141491">original article</a>.</em></p>

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11 things to never say to someone with chronic pain

<p>When someone you care about is living with pain, the most important thing you can do is to support them with understanding. But that’s not always easy. Sydney pain medicine specialist Dr Charlotte Johnstone says, “People tend to talk down to others in chronic pain and try to ‘manage them’ or tell them what they should do – and that closes the conversation.” Instead aim to keep the conversation going, she advises. Allow the person in pain to say what’s wrong and respond in a way that shows you’ve listened. Here’s what not to say - and what they might like to hear instead.</p> <p><strong>1. “Snap out of it.” </strong></p> <p>In an ideal world we would all have the ability to shake off a black mood or “focus on the positive”. However, pain can feel very isolating. Do you really want to make someone you care about feel even worse because they can’t “brighten up” or “forget about it”, just to make you feel better?</p> <p>Johnstone suggests you avoid asking questions with yes or no answers as they don’t encourage conversation. Instead you could say, “It sounds to me like you’ve had a difficult day and you managed it (this way). How do you think you’re going to handle the rest of the day?”</p> <p><strong>2. “Well, you don’t look sick.”</strong></p> <p>It’s too easy for someone to misread your incredulity. Are you insinuating they’re putting it on? Or are you being a little patronising because it isn’t true? Instead try asking, “How are you today?” This gives someone who’s already feeling misunderstood, an opportunity to share their feelings.</p> <p><strong>3. “There’s always someone worse off.”</strong></p> <p>Or just as bad is: “We all have bad days” or, “At least it isn’t cancer.” While you may be trying to give a bit of perspective, you’ll only undercut the emotional and physical pain of the other person. It’s better to concentrate on the positives of your friendship.</p> <p>“Highlight the things you appreciate or you can see they’re doing really well,” suggests Johnstone. Try: “It sounds like you’ve had a tough day today but it’s really nice we can spend some time together now.”</p> <p><strong>4. “Have you tried …”</strong></p> <p>The reality is they probably are already investigating every possible option. It’s possible nothing will ever erase or even manage their pain and they know it. If you really have to go there, then instead try something like, “You must be driven mad by all these hare-brained cures that people come up with, but every now and then they do seem to work for some people.”</p> <p><strong>5. “Just don’t think about it and you’ll feel better.”</strong></p> <p>So snapping the elastic band on your wrist distracted you when you were trying to cut back on sugar. That’s great. However, when your loved one’s best day is the equivalent of your worst day, you‘re not exactly on a level playing field. If you really do want to say something, try, “A lot of people say that relaxation or meditation works for them. Have you ever thought of trying it?”</p> <p>Clinical psychologist and pain specialist Toby Newton-John adds, “Be careful not to suggest their pain is psychological, or suggest they see a psychologist without being given ‘permission’ to talk about the emotional affect of their pain. People with chronic pain are often sensitive about either being not seen as genuine - or being ‘weak minded’. A good strategy is to mention your own positive experiences with a psychologist or ask if they’re feeling ‘stressed’, as this is a more neutral word.”</p> <p><strong>6. “Let me know if I can do anything to help.”</strong></p> <p>The thought is a good one, however try offering something specific such as, “I’d honestly love to help. How about I do your laundry and take your dog for a walk once a week?” Or get into the habit of calling or texting when you’re going to the shops to see if they need anything.</p> <p><strong>7. “At least you don’t have to go to work/school.”</strong></p> <p>Telling someone with chronic pain that they’re lucky they don’t have to go to work is as insensitive as saying to someone with no legs, “You’re lucky you don’t have to walk up the stairs.” They’re probably dreaming of the time they’re well enough to have something else to fill their day.</p> <p><strong>8. “Things will get better soon.”</strong></p> <p>Even if things do eventually turn around, your loved one isn’t in the head space to think about some magical time in the future. Your hopes are likely to be taken as annoying.</p> <p>“Do give positive feedback,” advises Newton-John, “but make it about them. Say something like, ‘I really admire the way you do X. Or ‘I think you’re remarkable for coping how you do.”</p> <p><strong>9. “Wow! You’ve lost so much weight.”</strong></p> <p>Remember the reason behind the weight loss is likely to be associated with their pain so it isn’t necessarily a cause for celebration. Instead try saying, “You look really fit” (but only if it’s true).</p> <p><strong>10. “Are you in pain because you…”</strong></p> <p>Even if your loved one’s back may hurt them a little more because they’re carrying a few extra kilos, do you really think pointing this out is being supportive? Newton-John adds, “As much as you might be genuinely concerned, enquiring about the cause of someone’s pain is not always helpful or respectful. If they want to tell you about it they will. A lot of people don’t want their pain to define them.”</p> <p><strong>11. “I feel so sorry for you.”</strong></p> <p>There’s a massive difference between pity and empathy. Instead saying, “I’m here for you,” is always a good option. Newton-John adds, “If you want to convey your empathy then say ‘I admire how well you cope.’” When in doubt? Smile, hug your friend or family member, say “I love you” or “I’m here for you”, hold their hand, sit and truly listen.</p> <p><em>Written by [AUTHOR]. This article first appeared in </em><a href="http://www.readersdigest.com.au/healthsmart/tips/11-Things-to-Never-Say-to-Someone-With-Chronic-Pain"><em>Reader’s Digest</em>.</a><em> For more of what you love from the world’s best-loved magazine, </em><a href="http://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRN87V"><em>here’s our subscription offer.</em></a></p> <p> </p> <p><img style="width: 100px !important; height: 100px !important;" src="https://oversixtydev.blob.core.windows.net/media/7820640/1.png" alt="" data-udi="umb://media/f30947086c8e47b89cb076eb5bb9b3e2" /></p>

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