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What are the most common symptoms of menopause? And which can hormone therapy treat?

<a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers. Adding to the uncertainty, a recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">series in the Lancet</a> medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate. So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says. <h2>Remind me, what exactly is menopause?</h2> Menopause, simply put, is complete loss of female fertility. Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause). Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months. Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder). <h2>What are the most common symptoms of menopause?</h2> <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">Our study</a> of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are: <ul> <li>hot flushes and night sweats (known as vasomotor symptoms)</li> <li>disturbed sleep</li> <li>musculoskeletal pain</li> <li>decreased sexual function or desire</li> <li>vaginal dryness and irritation</li> <li>mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.</li> </ul> However, none of these symptoms are menopause-specific, meaning they could have other causes. In <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">our study of Australian women</a>, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats. But the severity of these symptoms <a href="https://journals.lww.com/menopausejournal/abstract/2015/07000/moderate_to_severe_vasomotor_and_sexual_symptoms.6.aspx">varies greatly</a>. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55. So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are <a href="https://journals.lww.com/menopausejournal/fulltext/2022/05000/prevalence,_severity,_and_associated_factors_in.9.aspx">similarly affected</a>. Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span. The <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">most robust guidelines</a> do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of <a href="https://www.cell.com/cell/abstract/S0092-8674(23)00905-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867423009054%3Fshowall%3Dtrue">menopausal hormonal changes</a>. The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">Some studies</a> suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2022.2122792">have not been shown to change</a>. <h2>Who might benefit from hormone therapy?</h2> The Lancet papers <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00462-8/fulltext">suggest</a> menopause hormone therapy <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02799-X/fulltext">alleviates</a> hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats). In contrast, the highest quality <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">clinical guidelines</a> consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy. Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency). However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”. Despite musculoskeletal pain being the most common menopausal symptom in <a href="https://journals.lww.com/menopausejournal/abstract/2016/07000/prevalence_and_severity_of_vasomotor_symptoms_and.6.aspx">some populations</a>, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied. Some guidelines, such as an <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Australian endorsed guideline</a>, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease. <h2>What are the risks?</h2> The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot. Oestrogen-only menopause hormone therapy is <a href="https://www.nice.org.uk/guidance/ng23">consistently considered</a> to cause little or no change in breast cancer risk. Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, <a href="https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Women%20Health/CPG_Management_of_Menopause_2022_e-version-1.pdf">has been associated with a small increase</a> in the risk of breast cancer, although any <a href="https://www.bmj.com/content/bmj/371/bmj.m3873.full.pdf">risk appears to vary</a> according to the type of therapy used, the dose and duration of use. Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels <a href="https://www.bmj.com/content/bmj/364/bmj.k4810.full.pdf">prescribed at standard doses</a> <h2>What if I don’t want hormone therapy?</h2> If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats. In Australia, most of these options are “off-label”, although the new medication <a href="https://australianprescriber.tg.org.au/articles/management-of-menopause.html">fezolinetant</a> has just been <a href="https://www.tga.gov.au/resources/artg/401401">approved</a> in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat). Unfortunately, most over-the-counter treatments promoted for menopause are either <a href="https://srh.bmj.com/content/early/2024/02/21/bmjsrh-2023-202099.long">ineffective or unproven</a>. However, cognitive behaviour therapy and hypnosis <a href="https://journals.lww.com/menopausejournal/abstract/2023/06000/the_2023_nonhormone_therapy_position_statement_of.4.aspx">may provide symptom relief</a>. The Australasian Menopause Society has useful <a href="https://www.menopause.org.au/health-info/fact-sheets">menopause fact sheets</a> and a <a href="https://www.menopause.org.au/health-info/find-an-ams-doctor">find-a-doctor</a> page. The <a href="https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783">Practitioner Toolkit for Managing Menopause</a> is also freely available.<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/225174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">original article</a>.

Body

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months). There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles. We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>. But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again. <h2>People are often given the wrong advice</h2> People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis. But these findings are very common in people without low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain. Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain. In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress. It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves. <h2>So how should low back pain be treated?</h2> A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety. Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice. <a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language. They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities. An example of this type of care is cognitive functional therapy. <h2>What is cognitive functional therapy?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out. The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it. It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>. Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required. <h2>What’s the evidence for this type of therapy?</h2> Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments. We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”. We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care. The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>. People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group. The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work. <h2>What does this mean for you?</h2> This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success. <a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up. The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <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/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <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>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.

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Got no COVID-19 symptoms? A gene mutation might be the reason

<div class="copy"> A global study has unearthed a possible genetic reason why some people infected with the virus that causes COVID-19 show no symptoms. Human leukocyte antigens – or HLAs – are important genes that support immune function in the human body, particularly in identifying viral pathogens. And a particular variation in the HLA-B complex has been found to at least double the likelihood that a person infected with SARS-CoV-2 will be asymptomatic. For people who inherit a copy of the HLA-B15 variant from one parent, there was a 2.4 times greater chance of avoiding symptoms. Homozygous carriers — born with copies of the variant from each parent — were 8.5 times more likely to avoid symptoms. It’s a somewhat common variant among certain ethnicities – about 1 in 10 people with European ancestry are potential carriers – but having the gene is not a guaranteed protector against coronavirus symptoms. The findings, <a href="https://doi.org/10.1038/s41586-023-06331-x" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://doi.org/10.1038/s41586-023-06331-x">published</a> in Nature, have emerged from a joint study between researchers at the University of California San Fransisco and Australian institutions including Latrobe University, Monash University and the QIMR Berghofer Centre. The research came about almost by accident. <div class="in-content-area content-third content-right"> </div> Co-lead authors Professor Stephanie Gras from Latrobe and Jill Hollenbach from UCSF first met at a research conference in May 2022 and pooled their resources to track the association of possible gene variations with COVID-19 symptoms. Their teams narrowed a group of 30,000 people with high-quality HLA data to a cohort of about 1,500 unvaccinated people who tested positive for the virus. They then focussed on five locations of interest in the HLA genes while monitoring the emergence of symptoms to determine which variants, if any, might have a greater linkage to being COVID asymptomatic. “The [SARS-CoV-2] virus gets inside cells and ‘presents’ some small part of the virus on the surface via the HLA molecule,” Gras explains. “Those act as a red flag for T cells. The cell sends the signal to the T cell that it has been infected with the virus, and the T cells get activated and kill that [infected] cell. “HLA-B15 can actually present a small part of the spike protein that is very similar between SARS-CoV-2 and seasonal coronaviruses… [that] circulate every year in the population and give us the common cold during winter most of the time. They share some similarities.” The understanding provides a possible application for future treatments. Now an association between the variant and asymptomatic cases has been identified, the Gras and Hollenbach teams have begun to study the interaction between HLA-B15 and the SARS-CoV-2 spike protein at the atomic level. That research is already underway, including at the Australian Synchrotron at the Australian Nuclear Science and Technology Organisation. “We’re doing atomic-level models of proteins to understand the interaction,” Gras says. “We want to compare the T cells within people who are asymptomatic with HLA-B15 and people who are not asymptomatic with HLA-B15. Actually, HLA-B15 is not a magic bullet, you can have it and still have severe COVID.” Image credits: Getty Images </div> <div id="contributors"> <a href="https://cosmosmagazine.com/health/covid/got-no-covid-19-symptoms-a-gene-mutation-might-be-the-reason/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/matthew-agius">Matthew Ward Agius</a>. </div>

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“Irwin genes are strong”: Bindi shares adorable candid snap

Bindi Irwin has delighted fans after sharing a sweet snap of her two-year-old daughter, Grace Warrior cuddling a giant tortoise. The wildlife warrior took to Instagram to share the sweet snap with a comparison photo of herself hugging a giant tortoise when she was around Grace’s age. “Holding my newborn daughter wondering if she’ll love wildlife like I did” she captioned one of the photos in the Reel. The next two photos showed comparison photos of the mother-daughter duo which showed that the apple doesn’t fall far from the tree. “Our Grace Warrior, the Wildlife Warrior," she captioned the post. <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/Cs4wPGzBjZZ/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/Cs4wPGzBjZZ/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Bindi Irwin (@bindisueirwin)</a> </div> </blockquote> The adorable photo has been praised by fans who commented how proud Steve Irwin would be of his daughter and granddaughter. "It’s in the Irwin blood! You guys have the most beautiful connection with wildlife and each other! Steve Irwin genes are strong!” wrote one fan. "Your dad is probably so so proud looking down,” commented a second person. "This gives me happy goosebumps babe,” wrote a third. Images: Instagram

Family & Pets

Fun ways to boost memory in seniors

Memory issues can seriously deteriorate the quality of life for seniors. To reverse the typically progressive process of memory loss, many solutions have been put forward. These include creative leisure activities aimed to work on the senior’s brain while providing relaxation. To work on a senior’s memory, it’s optimal to have them work on a project, focusing and seeing the work being done. There are plenty of games and activities available to help memory. Paint by Numbers Paint by Numbers is a creative art form that involves painting a pre-drawn sketch on a linen canvas with reference numbers. It helps stimulate the intellect and senses. They’re available in colour books as well, you can find them at your local Kmart and select supermarkets. Diamond painting Diamond painting is a manual activity where the senior creates beautiful pictures using rhinestones to stick onto a self-adhesive canvas. It calls for concentration, reflection, memorisation, and patience from the practitioner, which is beneficial for working on memory. Scratch painting Scratch painting is a fun activity that involves scratching a picture with a coin or stylus, like a lottery scratch-off. It requires interest and concentration from the individual, who will enjoy the final picture and benefit their memory. Music therapy Music therapy is used to treat and alleviate disorders, such as relational, behavioural, and communication difficulties. It also has benefits for seniors with memory problems, as it allows them to mobilise concentration, emotions, and memory in a playful way. Image credit: Shutterstock

Mind

KISS concert halted as Gene Simmons falls ill on stage

KISS singer Gene Simmons gave fans - and bandmates - a fright when dehydration got the better of him live on stage, and the group were forced to bring their entire concert to a halt. In a video from the event, KISS’ Paul Stanley can be seen addressing the crowd, telling them that “we’re gonna have to stop to take care of him. Because we love him, right?” He goes on to call for a cheer for Simmons, with the 73-year-old catching his breath on a chair on stage - the same chair that he remained in for the rest of the show, after a five minute break to assure he was well enough to continue. <blockquote class="twitter-tweet"> Gene Simmons, baixista e vocalista do Kiss, passa mal e show é brevemente interrompido na Arena da Amazônia. <a href="https://t.co/nphJEj1PQo">pic.twitter.com/nphJEj1PQo</a> — A Crítica (@ACritica) <a href="https://twitter.com/ACritica/status/1646372105523478529?ref_src=twsrc%5Etfw">April 13, 2023</a></blockquote> And while fans were concerned for the singer, he later took to social media to assure them that he was “fine” and looking forward to the band’s next stadium performance. “I’m fine. Yesterday at Manaus Stadium in Brazil, [I] experienced weakness because of dehydration,” he explained. “We stopped for about five minutes, I drank some water, and then all was well. Nothing serious.” “Brazil is hotter than hell!!” one fan responded, “so glad you're okay and I can't wait to see you in São Paulo! Take care, god of thunder!!” “Even the God of Thunder needs hydration,” another agreed. “Good to hear you're doing well.” <blockquote class="twitter-tweet"> Hey everybody, thanks for the good wishes. I’m fine. Yesterday at Manaus Stadium in Brazil, experienced weakness because of dehydration. We stopped for about five minutes, I drank some water, and then all was well. Nothing serious. Tomorrow, Bogota Stadium. See you there! — Gene Simmons (@genesimmons) <a href="https://twitter.com/genesimmons/status/1646530305791266818?ref_src=twsrc%5Etfw">April 13, 2023</a></blockquote> And as news broke around the world of what had gone down in Brazil, Simmons returned with another round of assurances, writing that it was “not a big deal” while again thanking everyone for their well wishes. “Last night we played Amazon jungle Stadium/Brazil. Humidity and temperature were sky high. I was dehydrated and was forced to sit for a song,” he said. “We got back on stage in 5 minutes & finished the show.” It was enough for his fans, who were quick to share their delight that their star was okay, as well as voicing their excitement for upcoming shows - with a good portion of requests for the singer to take care of himself, and avoid a repeat performance. “Happy to hear you're doing better,” one wrote. “Even more happy it wasn’t anything serious.Ya'll take care.” “Frankly, I don’t know [how] you do it every night. You’re amazing!” another declared. Meanwhile, some could see the humour in it all now that their fears had been put to rest, with one joking “and who says playing music couldn't be dangerous”. Images: Twitter

Caring

Ed Sheeran shoots for the stars with daughter’s name reveal

When Ed Sheeran and his wife Cherry Seaborn announced the birth of their second child in May 2022, they kept things simple. In a post to social media, Sheeran shared a picture of socks on a crochet blanket, with a caption reading “Want to let you all know we’ve had another beautiful baby girl. We are both so in love with her, and over the moon to be a family of 4”. The couple shared no ‘face reveal’ - opting to keep their children far removed from the public eye - and did not share their youngest daughter’s name with Sheeran’s 42.8m followers. But in a March interview with Rolling Stone, the 32-year-old singer-songwriter took everyone by surprise, opening up about his family life, and revealing the out-of-this-world moniker bestowed upon their youngest, Jupiter. “Me and Cherry were talking earlier about how it’s so lovely,” he told the publication, opening up about the little things in life that he and his family cherish the most. “We had an entire day. We did nothing but this. It’s so nice and wholesome having family on tour. “On the last tour, I’d party till 7 am, sleep till 4 pm, get up, and do the gig. But I was like, 26. It’s very different.” Jupiter’s birth, and establishing their new “lovely” life, were no easy feats for the couple. In February 2022 - a month that was already proving determined to knock Sheeran down - when Cherry was six months along in her pregnancy, she was diagnosed with a tumour. Surgery was required, but couldn’t be performed until she had given birth. As Sheeran wrote in a post outlining plans for his album Subtract, “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. My best friend Jamal, a brother to me, died suddenly, and I found myself standing in court defending my integrity and career as a songwriter. “I was spiralling through fear, depression and anxiety. I felt like I was drowning, head below the surface, looking up but not being able to break through for air.” “There’s nothing you can do about it,” he confessed to Rolling Stone. “You feel so powerless.” Over the course of his interview, Sheeran toyed with a chain bracelet - one gifted to him by his wife, with their daughters’ name engraved. “It felt symbolic,” he said of the swap to the silver from the rubber bands that had previously adorned his wrist, “to take off those bracelets and put on one for my family.” After the slew of tragedies to hit Sheeran in such a short span of time, it was Cherry who realised that he was in need of professional help, leading to the singer seeking out a therapist. “No one really talks about their feelings where I come from,” he said. “People think it’s weird getting a therapist in England … I think it’s very helpful to be able to speak with someone and just vent and not feel guilty about venting. Obviously, like, I’ve lived a very privileged life. So my friends would always look at me like, ‘Oh, it’s not that bad.’ ” “The help isn’t a button that is pressed, where you’re automatically okay,” he added. “It is something that will always be there and just has to be managed.” And as Sheeran himself <a href="https://www.oversixty.com.au/health/caring/writing-songs-is-my-therapy-ed-sheeran-reveals-further-heartbreak">wrote in his Subtract post</a>, “Writing songs is my therapy. It helps me make sense of my feelings … in just over a week I replaced a decade’s worth of work with my deepest darkest thoughts.” Images: Getty

Family & Pets

Super rare pic of unrecognisable Gene Hackman

For the first time in a long time, legendary actor Gene Hackman has been spotted out and about at the age of 93. The icon had been reclusive in recent years, and these are the first photos of him snapped in a very long time. The Superman star still seemed fit and looked quite healthy in the snaps taken in Santa Fe, New Mexico. The retired actor was spotted enjoying a fast food lunch at a parking lot after going through the Wendy’s drive-thru. He is still sporting his signature moustache in the rare sighting. <blockquote class="twitter-tweet"> New photos of Hollywood Legend Gene Hackman have been released. He is currently 93-years-old. These are the first photos of him in years. <a href="https://t.co/5pn1wXN81w">pic.twitter.com/5pn1wXN81w</a> — Daily Loud (@DailyLoud) <a href="https://twitter.com/DailyLoud/status/1633270131324223489?ref_src=twsrc%5Etfw">March 8, 2023</a></blockquote> Hackman’s last movie role was with Ray Romano and Christine Baranski in the 2004 comedy Welcome To Mooseport. In July 2004, Hackman was interviewed by Larry King, where he announced there were no new film projects lined-up and believed his acting career was over. Years later, the star confirmed his retirement while promoting his third novel Escape From Andersonville, back in 2008. In an interview with CQ in 2011, he was asked if he would ever come out of retirement to do another film, and he responded, “If I could do it in my own house, maybe, without them disturbing anything and just one or two people.” CQ also asked him, “how do you want to be remembered?" “As someone who tried to portray what was given to them in an honest fashion. I don't know, beyond that. I don't think about that often, to be honest. I'm at an age where I should think about it.” He said with a laugh. Hackman has long been one of the most highly regarded film actors of all time, leading his Mississippi Burning director Alan Parker to state that “he is incapable of bad work. Every director has a shortlist of actors he’d die to work with, and I’ll bet Gene’s on every one.” The thespian really made waves when he was nominated for an Oscar for the Best Supporting Actor category for the 1970s film I Never Sang For My Father. A year later, he became a leading man in incredible fashion, winning the Academy Award for Best Actor in his New York City Detective Jimmy 'Popeye' Doyle in The French Connection (1971). Hackman’s career only went up from there, with countless awards under his belt, including two Oscars, two BAFTA awards and two Golden Globes. Image credit: Getty

Movies

"Writing songs is my therapy": Ed Sheeran reveals further heartbreak

In the wake of the tragic news of the <a href="https://www.oversixty.co.nz/news/news/tragedy-strikes-ed-sheeran-tour" target="_blank" rel="noopener">heartbreaking loss</a> suffered by his co-writer and touring partner, Ed Sheeran has taken to Instagram to share his struggle following a series of life-changing events – and how this has altered the course of his new album, Subtract. The singer shared how he “spiralled” into depression last year after his wife, Cherry, was diagnosed with a tumour during her second pregnancy, which couldn’t be treated until after she gave birth. The star explained that he was "trying to sculpt the perfect acoustic album" for almost a decade, when the series of events changed everything. “Writing songs is my therapy. It helps me make sense of my feelings. I wrote without thought of what the songs would be, I just wrote whatever tumbled out. “And in just over a week, I replaced a decade’s worth of work with my deepest darkest thoughts," he captioned. “Within the space of a month, my pregnant wife got told she had a tumour, with no route to treatment until after the birth. “My best friend Jamal [Edwards], a brother to me, died suddenly and I found myself standing in court defending my integrity and career as a songwriter. I was spiralling through fear, depression and anxiety. “I felt like I was drowning, head below the surface, looking up but not being able to break through for air". <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/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CpPY7qyI6XB/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ed Sheeran (@teddysphotos)</a> </div> </blockquote> The four-time Grammy award winner shared that this album was a "trapdoor" into his soul, and a way for him to make sense of everything he's been through. Sheeran announced the birth of his second daughter, Jupiter, in May of last year.Subtract will be released on the 5th of May 2023, through Asylum/Atlantic. Image: Getty

Caring

Hugh Jackman reveals why he is now in therapy

Hugh Jackman has revealed he is undergoing therapy to help him come to terms with the trauma he experienced as a child. The Aussie actor opened up about his healing process in a new interview with Who magazine, telling the publication he recently began treatment. "I just started it recently. It's helped me a lot," he said. "We all need a village." "You need a friend you can unload everything – having someone really smart, who's a little a bit removed from your world can be really helpful." In his sessions, Jackman discussed his longstanding pain from being abandoned by his mother, Grace, and sisters Zoe and Sonya, who left Australia for the UK when he was just eight. Jackman remained in Sydney with his father, Christopher, and brothers Ian and Ralph. It wasn't until he was about 12 years old that he realised she was not coming home. However, therapy has allowed Jackman to accept the past and make peace with loved ones. "Understanding my past and how it's informing my thinking unconsciously – getting to really understand some of the patterns that I was unconsciously just repeating," he said. However, Jackman has been fortunate enough to reconnect with his mother over the years, previously telling The Sun: "As I grew older I gained an understanding of why Mum did leave … and we have definitely made our peace, which is important. I was always quite connected with my mum. I have a good relationship with her." Sadly, Jackman's father passed away in September last year, on Father's Day in Australia. Images: Instagram

Mind

"An arts engagement that’s changed their life": the magic of arts and health

In 2007, a life-changing encounter at South Australia’s Flinders Medical Centre became the catalyst and symbol for a national arts and health movement. A young woman, Becky Corlett, was being transported through the hospital where an artist-in-residence, Rebecca Cambrell, was painting a mural. Becky had suffered a stroke and cardiac failure. She had stopped eating and was non-responsive even to family. When Becky passed the mural, however, she made a noise of interest. Cambrell instinctively drew Becky closer and gave her a paint brush. To everyone’s surprise, Becky started adding dabs of paint to the canvas, and then she smiled. The wonder of this moment only dawned on Cambrell when she turned around. “Her parents were convinced that the moment she touched that paintbrush, something was triggered inside Becky that made her want to live”, remembers Cambrell. Becky’s story is just one of many collected in our new report <a href="https://apo.org.au/node/321047">Telling the Story of Arts in Health in South Australia</a>. <h2>What is ‘arts and health’?</h2> Arts and health is broadly defined as using arts practice to deliver health outcomes, be they specifically targeted interventions or general wellbeing benefits. Arts and health work comes in many forms. It can be <a href="https://statetheatrecompany.com.au/shows/euphoria/">play</a> about mental health issues in rural areas. It can be a <a href="https://www.visualisingmentalhealth.com/">university competition</a> to design solutions to community wellbeing challenges. It can be the <a href="https://celsus.net.au/a-hospital-within-a-park/">integration</a> of art throughout an entire hospital to create a calming environment. In an interview with us, design researcher Jane Andrew said the breadth of arts and health work means participant involvement can range “from passively viewing to making to being in the environment”. The benefits are diverse. A <a href="https://www.who.int/europe/publications/i/item/9789289054553">2019 World Health Organisation study</a> looking at over 900 peer-reviewed publications found arts and health can do everything from encouraging health-promoting behaviours to supporting end-of-life care. The diversity of the arts and health field is represented by the perspectives of our report’s 47 interviewees. We spoke to arts therapists, managers of hospital-based arts and health programs, government arts agency staff, CEOs of local health networks and former ministers. We asked them about their past experiences with arts and health, the present challenges and opportunities for the field, and how best to advance this work in the future. <h2>Art and health in Australia</h2> Although benefits of the arts to health have been recognised <a href="https://academic.oup.com/book/9415/chapter/156246455">for millennia</a>, the formal field of arts and health work <a href="https://www.tandfonline.com/doi/abs/10.1080/17533010903421484">first emerged</a> across South Australia and the rest of the nation through the community arts movement of the 1970s and the rise of health promotion in the 1980s. The establishment of the Flinders Medical Centre’s Arts in Health program in the late 1990s provided a major step for the field into health settings, and the program remains an <a href="https://anmj.org.au/the-art-of-healing-inside-flinders-medical-centres-pioneering-arts-in-health-program/">innovative leader today</a>. The former director of the program, Sally Francis, recalled how, “on a regular basis” the program would have “three, four, five stories of someone who has been critically ill and had an arts engagement that’s changed their life.” But Becky Corlett’s story had, as Francis describes it, a “huge and far-reaching effect” on arts and health in Australia. Days after Becky’s first painting experience, former South Australian Minister of Health and Assistant Arts Minister, John Hill, visited the hospital "I was just walking along, and I saw the painting going on and there was this little girl busily doing art. […] Her parents came up to me and had tears in their eyes. […] She was reconnected with life." Inspired by this encounter, Hill and Francis led a push to have arts and health formally recognised by the state and then federal government. The <a href="https://www.arts.qld.gov.au/images/documents/artsqld/Research/National-Arts-and-Health-Framework-May-2014.pdf">National Arts and Health Framework</a> was officially endorsed in 2014. This historic statement declared the Australian federal, state and territory governments’ recognition of and support for the field. The framework aimed to raise awareness of arts and health, and to encourage government departments and agencies across the country to integrate arts and health work into their services. However, it did not make any funding or legislative requests, meaning no permanent arts and health policy followed its endorsement. <h2>What next for arts and health?</h2> Next year marks ten years since the framework’s endorsement. While there is continuing good work in this space across the country, our interviewees believe arts and health remains underutilised. Community artist Lisa Philip-Harbutt told us there is a lack of “connection between all the various things that people are doing” – different arts and health projects often aren’t speaking to each other. To regain momentum for the field, interviewees recommend developing educational pathways for prospective arts and health workers, conducting a review and update of the National Arts and Health Framework to embed it in policy, and establishing research partnerships between universities and arts and health programs. The hope is that the next generation of leaders will be inspired by witnessing arts and health’s life-changing power. According to Deborah Mills, a key driver of the National Arts and Health Framework, "If you want passionate advocates, they have to have a visceral understanding of what creative activity does." Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/an-arts-engagement-thats-changed-their-life-the-magic-of-arts-and-health-196212" target="_blank" rel="noopener">The Conversation</a>.

Art

Severe COVID-19 linked to signs of ageing in the brain

COVID-19 infection has been associated with the same molecular changes seen in ageing brains, including higher levels of activity from genes associated with the ageing process. As we age, our brains shrink - with a five percent decline in weight per decade after the age of 40 - while our memory and levels of neurotransmitters like serotonin and dopamine decline. With previous research finding that people who are infected with Covid can experience neurological conditions after they recover, as well as declines in cognitive performance that mimic accelerated ageing, a team of researchers from Harvard Medical School examined the brain tissue of 54 deceased people, including 21 who had severe Covid infections. They found that changes in how genes were expressed in the brains of Covid-infected people were similar to what is seen in older brains. Using a particular kind of analysis called whole-transcriptome sequencing, the team were able to investigate which genes were being switched on and off in a person at the time of their death, comparing brain samples from people infected with Covid and those who hadn’t been infected (from before the pandemic). In comparison to the uninfected group, the Covid group showed higher levels of activity for genes associated with immunity. Meanwhile, genes linked to cognition, memory and the activity of synapses, which are essential for helping impulses travel through the nervous system, had lower levels of expression. "We also observed significant associations of cellular response to DNA damage, mitochondrial function, regulation of response to stress and oxidative stress, vesicular transport, calcium homeostasis, and insulin signalling/secretion pathways previously associated with ageing processes and brain ageing," they wrote. "Altogether, our analyses suggest that many biological pathways that change with natural ageing in the brain also change in severe COVID-19." Also investigating the trigger of these changes, they found increased levels of activity in several inflammatory pathways associated with ageing in the brain, and that specific immune cells influence the expression of several of these genes. This supports the hypothesis that the neurological symptoms that can accompany Covid are caused by inflammation triggered by the virus. But they also explored the other hypothesis, that the neurological symptoms are caused by the virus infiltrating and infecting the brain - specifically the frontal cortex - by looking to see whether there was evidence of Covid RNA (which contains the virus’ genetic material it needs to replicate). “In agreement with previous studies, SARS-CoV-2 viral RNA was not detected in samples from individuals with COVID-19, suggesting that the observed gene expression changes are unlikely due to the effects of the viral RNA in the frontal cortex,” they wrote. With these findings, the researchers concluded that managing Covid-induced inflammation could protect against the development of the neurological symptoms associated with Covid. They also argue that following up with patients recovering from Covid could be beneficial in reducing the risk or delaying the neurological symptoms and cognitive decline. Speaking to Nature, neuropathologist Marianna Bugiani, who wasn’t involved in the study, said that it’s still difficult to know whether these changes to gene expression are permanent or whether they are also seen in people experiencing mild bouts of Covid. “It opens a plethora of questions that are important, not only for understanding the disease, but to prepare society for what the consequences of the pandemic might be,” she said. “And these consequences might not be clear for years.” The researchers published their findings in the journal <a href="https://doi.org/10.1038/s43587-022-00321-w" target="_blank" rel="noopener">Nature Aging</a>. Image: Getty Images

Mind

Chris Hemsworth’s Alzheimer’s gene doesn’t guarantee he’ll develop dementia

Chris Hemsworth, famous for his role as the god Thor in Marvel Cinematic Universe movies, has announced he will be <a href="https://www.theguardian.com/film/2022/nov/21/chris-hemsworth-to-take-time-off-from-acting-after-discovering-alzheimers-risk" target="_blank" rel="noopener">taking a break</a> from acting after being told he has two copies of the <a href="https://www.nia.nih.gov/news/study-reveals-how-apoe4-gene-may-increase-risk-dementia" target="_blank" rel="noopener">APOE4 gene</a>, increasing his risk of Alzheimer’s. Having one copy of the <a href="https://www.science.org/doi/abs/10.1126/science.8346443" target="_blank" rel="noopener">APOE4 gene</a> increases your risk for Alzheimer’s 2-3 times. Two copies increases your risk 10-15 times. But the key here is “risk”. Having one or more copies of the gene doesn’t guarantee Chris or anyone else in a similar situation will go on to develop Alzheimer’s, the most common form of dementia. Sharing the news Hemsworth’s willingness to share his concerns about developing Alzheimer’s with millions should be applauded. It’s a reminder to all of us to keep an eye on our health and reduce our risk of future illness. Alzheimer’s, and dementia more broadly, is <a href="https://www.dementiastatistics.org/statistics/global-prevalence/" target="_blank" rel="noopener">set to challenge</a> health-care systems worldwide. In Australia alone there are <a href="https://www.dementia.org.au/statistics" target="_blank" rel="noopener">up to</a> 500,000 people with dementia, supported by almost 1.6 million carers. By 2036, about <a href="https://www.dementia.org.au/sites/default/files/NATIONAL/documents/The-economic-cost-of-dementia-in-Australia-2016-to-2056.pdf" target="_blank" rel="noopener">450 people</a> are predicted to be diagnosed daily. So understanding how APOE4 alters the risk for the major cause of dementia may be pivotal in preventing cases. But not all people with the APOE4 gene go on to develop Alzheimer’s. This means that there may be a combination of environmental factors interplaying with the gene that lead some people to develop Alzheimer’s, while others do not. What’s APOE4 got to do with Alzheimer’s? Most Australians have APOE3 or APOE2 genes. In Caucasians it’s only <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531868/" target="_blank" rel="noopener">about 15%</a>, like Hemsworth, who have inherited an APOE4 gene. The APOE gene types are best known for their role in modulating the metabolism of lipids (fats), such as cholesterol and triglycerides. They code for synthesis of different versions of the protein APOE, with subtle differences in structure. The APOE proteins become an integral part of lipoproteins in the blood. These are the fat-carrying particles your GP measures to consider your risk of heart disease. APOE proteins have a similar function in the brain, to modulate lipid levels. But in the context of Alzheimer’s, researchers study it for its effect on the integrity of brain cells. Accumulating evidence <a href="https://www.sciencedirect.com/science/article/pii/S0197458022000550" target="_blank" rel="noopener">suggests</a> APOE4, is associated with brain inflammation and cellular damage. <blockquote class="twitter-tweet"> APOE4 is the strongest genetic risk factor for Alzheimer’s disease. A study in <a href="https://twitter.com/Nature?ref_src=twsrc%5Etfw">@Nature</a> establishes a functional link between APOE4, cholesterol, myelination and memory, offering therapeutic opportunities for Alzheimer’s disease. <a href="https://t.co/bNsmDVPfFW">https://t.co/bNsmDVPfFW</a> <a href="https://t.co/58odE1JASl">pic.twitter.com/58odE1JASl</a> — Nature Portfolio (@NaturePortfolio) <a href="https://twitter.com/NaturePortfolio/status/1594762841487249410?ref_src=twsrc%5Etfw">November 21, 2022</a></blockquote> Can we prevent Alzheimer’s? 1. Look after your capillaries Damaged and leaky blood vessels (capillaries) in the brain lead to inflammation, the death of brain cells and cognitive impairment. In fact, in Alzheimer’s, damaged capillaries are the earliest sign of the type of brain damage that causes disease. The protein encoded by the APOE4 gene may be less able to support healthy capillaries in the brain. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163782709000563" target="_blank" rel="noopener">We suggested</a> APOE4 increases the abundance of specific complexes of lipoproteins and proteins in blood that silently damage brain capillaries, causing them to leak. We also see more brain capillary leakage in mice fed Western-style diets richer in saturated fats. The relationship between how the APOE proteins mediate lipid metabolism and capillary health in humans is poorly understood. But we have 60 years of research knowledge to say with confidence that eating foods good for the heart should also be good for the brain. This is particularly relevant for people with the APOE4 gene. So if you have the APOE4 gene and want to minimise your risk of Alzheimer’s, a healthy diet is a good place to start. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=316&fit=crop&dpr=1 600w, https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=316&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=316&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=397&fit=crop&dpr=1 754w, https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=397&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/497142/original/file-20221124-24-rlqyk5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=397&fit=crop&dpr=3 2262w" alt="Capillaries" /></a><figcaption>Looking after your capillaries with a healthy diet is a good place to start. <a class="source" href="https://www.shutterstock.com/image-illustration/system-many-small-capillaries-branch-out-1745173364" target="_blank" rel="noopener">Shutterstock</a></figcaption></figure> 2. Give your brain a break Reducing unnecessary stimuli to “give your brain a rest” may have big impact over decades of your life. The latter may be a more important consideration if you have the APOE4 gene. That’s because the APOE gene is also linked to how the brain uses energy, which may lead to more <a href="https://www.frontiersin.org/articles/10.3389/fnmol.2018.00216/full" target="_blank" rel="noopener">oxidative stress and damage</a>. While we’ve yet to collect robust data in humans, take a digital detox now and again, plan some down time, and avoid unnecessary stress if you can. Should we test for the APOE4 gene? Some people might be tempted to get tested for the APOE4 gene, especially if there’s a family history of Alzheimer’s. But unless genetic testing is going to change your treatment (for instance, by taking certain medications to slow progression of brain damage), or your behaviour to minimise your risk Alzheimer’s, then testing is not justified. We can’t change the genes our parents gifted us, but we can change our environment. Poor diet, every drop of alcohol you drink, obesity and diabetes, high blood pressure and sedentary behaviour <a href="https://www.dementia.org.au/risk-reduction" target="_blank" rel="noopener">all contribute, over time</a>, to poorer vascular health and increase your risk of dementia. We’re still learning about how these risk factors for Alzheimer’s interact with the APOE4 gene. But there is no reason we shouldn’t all take greater responsibility for minimising our risk of dementia now, whether we have the APOE4 gene or not.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/195094/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by John Mamo. Republished with permission from <a href="https://theconversation.com/chris-hemsworths-alzheimers-gene-doesnt-guarantee-hell-develop-dementia-heres-what-we-can-all-do-to-reduce-our-risk-195094" target="_blank" rel="noopener">The Conversation</a>. Image: Instagram

Mind

This new tech could spell end for mouse plagues

Invasive mice populations could be a thing of the past, thanks to a new genetic tool developed by a team of Australian scientists. Researchers at the University of Adelaide have developed t-CRISPR, which uses gene editing technology to alter the fertility gene in laboratory mice to make females infertile. “This is the first time that a new genetic tool has been identified to suppress invasive mouse populations by inducing female infertility,” said lead researcher Professor Paul Thomas. “The t-CRISPR approach uses cutting-edge DNA editing technology to make alterations to a female fertility gene. Once the population is saturated with the genetic modification, all the females that are generated will be infertile. “We are also developing new versions of t-CRISPR technology that are designed to target specific pest populations to prevent unwanted spread of the gene drive.” The new tool is based on an existing technology, CRISPR-Cas9 gene editing, which has largely been applied to limiting the spread of malaria by making male mosquitoes infertile. CRISPR 101 Since it was unveiled in 2012, the CRISPR method has been used to edit pieces of DNA inside the cells of organisms, primarily insects. “Up until now, this technology has been aimed at insects to try and limit the spread of malaria, which causes up to 500,000 deaths worldwide per year,” Luke Gierus, a post-graduate student and the paper’s co-first author, said. The technology relies on the Cas9 protein found in bacteria, which scientists can program to find and bind to almost any 20-letter sequence of DNA in a gene with the help of a piece of RNA that matches the target DNA sequence. When it finds the target, standard CRISPR cuts the DNA, and the process of repairing the DNA introduces mutations that can disable the gene. Other variations of CRISPR can also replace faulty genes, turn genes on or off, or change one letter of the DNA code to another. In this study, the team simulated what would happen when an edited version of a fertility gene on chromosome 17, which affects the ability of sperm to swim, was introduced to populations of mice. Males who carry one copy of this gene are infertile, while females are still fertile but only have one functioning version of the gene and can pass on either the functioning or non-functioning version to their offspring. In females that had a second edited chromosome that affected their fertility, they found that male offspring would all be infertile, while only 50 percent of female offspring would be fertile. They found that 250 mice with modified genes could eradicate a population of 200,000 mice on an island in around 20 years. “The use of t-CRISPR technology provides a humane approach to controlling invasive mice without the release of toxins into the environment. We are also working on strategies to prevent failed eradication due to the emergence of gene drive resistance in the target population,” Gierus said. While t-CRISPR has been developed to specifically target mice, CSIRO Group Leader for Environmental Mitigation and Resilience Dr Owain Edwards said it could be developed to use on other invasive animals. The researchers, who collaborated with CSIRO, the Centre for Invasive Species Solutions, the Genetic Biocontrol for Invasive Rodents (GBIRd) consortium and the US Department of Agriculture, were supported by both the South Australian and NSW governments. “These promising findings demonstrate how gene drive technology may be a game changer in managing the impacts of mice on our environment, community, and agricultural sector,” South Australian Deputy Premier Dr Susan Close said. “This cutting-edge research also highlights the global leadership of the South Australian research sector, in finding solutions to social, environmental and economic challenges. “The South Australian Government is proud to have supported this proof-of-concept, having granted the University of Adelaide $1 million through the Research and Innovation Fund.” They published their findings in the journal <a href="https://doi.org/10.1073/pnas.2213308119" target="_blank" rel="noopener">Proceedings of the National Academy of Sciences</a>. Image: ABC News

Family & Pets

Sounds great: Scientists are manipulating dreams to prevent nightmares

It’s estimated that at any given time, around 4% of adults suffer <a href="https://cosmosmagazine.com/health/one-side-of-your-brain-might-be-giving-you-nightmares/" target="_blank" rel="noreferrer noopener">chronic nightmares</a> but researchers in Switzerland have a new approach which will be music to the ears of night-terror-sufferers. Basing their study on the relationship between the types of <a href="https://cosmosmagazine.com/science/biology/nightmares-and-night-terrors-in-kids-when-do-they-stop-being-normal/" target="_blank" rel="noreferrer noopener">emotions experienced in dreams</a> and our emotional well-being, researchers have investigated how to help people by manipulating emotions in their dreams. Traditional methods to help chronic nightmare patients involves ‘imagery rehearsal therapy’, during which they are coached to rehearse the dream scenario during the day and redirect it towards a more positive ending. A <a href="https://link.springer.com/article/10.1007/s11818-021-00320-w" target="_blank" rel="noreferrer noopener">2021 study</a> of 28 participants showed 3 in 5 patients benefitted from this approach, however, it doesn’t work for everyone. <div class="newsletter-box"> <div id="wpcf7-f6-p220659-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> </div> </div> In a <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01477-4" target="_blank" rel="noreferrer noopener">study from Geneva University</a>, over a two-week period, researchers asked a group of 18 patients to create an association between the positively redirected version of their dream and a sound during an imagination exercise. The patients then wore wireless headbands during night which would play the specific sound during the REM (Rapid Eye Movement) stage of sleep – when <a href="https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515" target="_blank" rel="noreferrer noopener">nightmares typically occur</a>. When compared to 18 patients who undertook only the image rehearsal therapy, those who received the combined rehearsal and sound therapy had fewer nightmares. This trend continued even after three months post-intervention, with those receiving combination therapy also reporting experiencing more positive emotions such as ‘joy’ in their dreams. “We were positively surprised by how well the participants respected and tolerated the study procedures, for example performing imagery rehearsal therapy every day and wearing the sleep headband during the night,” says Lampros Perogamvros, senior author of the study and a psychiatrist at the Sleep Laboratory of the Geneva University Hospitals and the University of Geneva. “We observed a fast decrease of nightmares, together with dreams becoming emotionally more positive. For us, researchers and clinicians, these findings are very promising both for the study of emotional processing during sleep and for the development of new therapies.” <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=220659&title=Sounds+great%3A+Scientists+are+manipulating+dreams+to+prevent+nightmares" width="1" height="1" /> <div id="contributors"> <a href="https://cosmosmagazine.com/health/sounds-great-preventing-nightmares/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Clare Kenyon. Image: Getty Images </div>

Mind

New study to “give hope” to childhood trauma survivors with depression

A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression. Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions. The study, published in <a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma. While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent. The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma. Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma). But, they found that both groups experienced an improvement in symptoms at a similar rate. Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope. “Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said. “Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.” Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients. “This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said. “However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.” According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood. But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective. If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380. Image: Getty Images

Mind

Excelling as a musician takes practice and requires opportunities – not just lucky genes

What makes talented musicians so good at what they do? There’s plenty of evidence that people can be born that way. Research findings suggest that about <a href="https://doi.org/10.1136/jmg.2007.056366">half of musical ability is inherited</a>. Even if that’s true, it doesn’t mean you must have musical talent in your genes to excel on the bass, oboe or drums. And even if you’re fortunate enough to belong to a family that includes musicians, you would still need to study, practice and get expert guidance to play well. As a <a href="https://scholar.google.com/citations?user=34DZlUIAAAAJ&hl=en&oi=ao">music professor and conductor</a>, I’ve seen the role that practice and experience play in propelling musicians toward mastery and success. There are some factors that help a musician get started – and heredity could be one of them. But musical skill is ultimately a complex interplay between <a href="https://doi.org/10.1177%2F0022429416680096">lots of practice and high-quality instruction</a>. <h2>The role genes can play</h2> Of course many great musicians, including some who are world famous, are related to other musical stars. Liza Minnelli, the famed actress, singer and dancer, is one of the late entertainer <a href="https://hollywoodlife.com/feature/judy-garland-kids-4728886/">Judy Garland’s three children</a>. <a href="https://people.com/music/jon-batiste-everything-to-know">Jon Batiste</a> – “The Late Show” bandleader, pianist and composer who has won Emmy, Oscar and Golden Globe awards – has at least 25 musicians in his family. Saxophonist Branford, trumpeter Wynton, trombonist Delfeayo and drummer Jason Marsalis are the <a href="https://www.npr.org/sections/coronavirus-live-updates/2020/04/02/825717204/ellis-marsalis-patriarch-of-new-orleans-most-famous-musical-family-has-died">sons of pianist Ellis Marsalis</a>. Singer and pianist <a href="https://www.notablebiographies.com/news/Ge-La/Jones-Norah.html">Norah Jones</a> is the daughter of Indian sitar player <a href="https://www.vogue.in/culture-and-living/content/norah-jones-on-her-relationship-with-pandit-ravi-shankar-september-2020-cover-interview-hope">Ravi Shankar</a>, though Jones had little contact with her renowned father while growing up. Absolute pitch, also known as perfect pitch, is the ability to recognize and name any note you hear anywhere. Researchers have found that it <a href="https://doi.org/10.1086/301704">may be hereditary</a>. But do you need it to be a great musician? Not really. <h2>Most people are born with some musical ability</h2> I define musical ability as the possession of talent or potential – the means to achieve something musical. Then there’s skill, which I define as what you attain by working at it. You need at least some basic musical ability to acquire musical skills. Unless you can hear and discern pitches and rhythms, you can’t reproduce them. But people may overestimate the role of genetics because, with very rare exceptions, <a href="https://www.apa.org/monitor/feb05/absolute">almost everyone can perceive pitches</a> and rhythms. My research regarding children’s musicality suggests measures of singing skills are <a href="https://doi.org/10.1177/0022429416666054">normally distributed</a> in the population. That is, pitch ability follows a <a href="https://www.investopedia.com/terms/b/bell-curve.asp">bell curve</a>: Most people are average singers. Not many are way below average or excellent. My team’s most recent research suggests that this distribution is <a href="https://doi.org/10.1177/00224294211032160">true for rhythm</a> in addition to pitch. Not surprisingly, some musical skills are correlated. The more training you have on specific musical skills, the <a href="https://doi.org/10.1177/00224294211011962">better you’ll test on certain others</a>. This is probably because musical experience enhances other musical abilities. To sum it up, an emerging body of research indicates that practice doesn’t make perfect. But for most people, it helps a lot. <h2>Lessons and practice are essential</h2> What about people who say they they can’t keep a beat? It turns out that they almost always can track a steady beat to music. They just haven’t done it enough. Indeed, the last time I gave a nonbeliever our lab’s test for rhythm perception, she performed excellently. For that and for singing, some people just need <a href="https://www.nytimes.com/2020/01/21/magazine/how-to-sing-in-tune.html">a little help</a> to move past assumptions they lack talent: You can’t say you’re incapable of something if you haven’t spent time trying. Some researchers and <a href="https://strategiesforinfluence.com/malcolm-gladwell-10000-hour-rule/">journalists have promoted</a> the idea it takes <a href="https://doi.org/10.1037/0033-295X.100.3.363">10,000 hours of practice or training to master</a> a new skill. Innate ability puts people at different starting lines toward musical mastery. But once you’ve started to study an instrument or singing style, skill development depends on many other factors. Getting lessons, practicing often and being in a musical family may make those more likely. For example, Lizzo, a hip-hop superstar and classically trained flute player, had the luck to <a href="https://www.thefamouspeople.com/profiles/lizzo-44986.php">grow up in family of music lovers</a>. They all had their own taste in music. Her success is a microcosm of why a well-rounded musical education for young people matters. The singers in the choir I lead at Penn State have a range of experience, from a little to a lot. Yet soon after they join it, they develop the ability to <a href="https://doi.org/10.1177/87551233211040726">pick a good key and starting pitch</a> as they get to know their own voices. Practicing more doesn’t change your baseline potential, it just changes what you can presently do. That is, if you practice a specific song over and over again, eventually you’re going to get better at it. Jonathon Heyward, the Baltimore Symphony’s new conductor, who has <a href="https://www.nytimes.com/2022/07/21/arts/music/jonathon-heyward-baltimore-symphony-orchestra.html">no musicians in his family</a>, has worked really hard to excel. He started taking cello lessons at age 10 and hasn’t stopped since, playing and practicing and studying. <h2>Privilege can play a role</h2> Socioeconomic factors can also enter the equation. While conducting research, I’ve seen high-income college students from high-income families, with more years of musical experience, perform better than their classmates who have lower-income backgrounds and had fewer opportunities. Genes can give someone a head start. At the same time, having a quiet space where you can practice on an acoustic instrument or a digital workstation might make a more decisive difference for the musical prospects of most children. The same goes for having money for private lessons or access to free classes. Even so, many of the best musicians, including jazz greats <a href="https://www.louisarmstronghouse.org/biography/">Louis Armstrong</a> and <a href="https://www.pbs.org/wnet/americanmasters/billie-holiday-about-the-singer/68/">Billie Holiday</a>, grew up facing many hardships. With the right conditions for practice and gaining experience, who knows where the next Liza or Lizzo will come from. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/excelling-as-a-musician-takes-practice-and-requires-opportunities-not-just-lucky-genes-186693" target="_blank" rel="noopener">The Conversation</a>.

Music

The truth behind the healing power of music

If you’ve suffered anything from a bad day to a devastating loss, you probably know that one of the first and best places to turn to is music. According to recent studies, there’s a reason for that: it’s scientifically proven to be healing and cathartic. According to a study performed by the University of Missouri, people are actually able to lift themselves out of a low emotional state by playing contrastingly cheerful music if they consciously attempt to feel happier while doing so. Significantly, study participants who were instructed to attempt to raise their moods while listening to upbeat music were able to achieve this in the immediate short term period and even increased their overall happiness over the course of two weeks. On the other end of the spectrum, another study, conducted by the University of California and Berkely, found that even sad songs can help to heal a “broken” heart. According to the researchers, "Under certain circumstances, consumers in negative moods might choose aesthetic experiences consistent with their mood even when more pleasant alternatives are also available." So basically, music can be a self-indulgent means of experiencing and working through our emotions. So whether your choice of music is The Rolling Stones’ melancholy Out of Tears, Zeppelin’s heart breaking, Baby Come on Home, The Beatles’ optimistic Getting Better, or Clapton’s rebellious Cocaine, your impulse to turn to music in hard times is actually backed up by science. Image credits: Getty Images

Music

How to be more articulate: 8 must-follow secrets to improve your speech

<h2>Listen to yourself speak</h2> We know it’s terrifying, but nothing will squash those verbal ticks quite like listening to yourself speak. Record yourself in a natural conversation; for example, replay a conference call or have a friend interview you on tape. Listen for technical issues, such as filler words, up talk, monotone, and run-on sentences, as well as any habits that sound awkward or uncomfortable. Identifying the problem is the first step toward tackling it. <h2>Monitor your speed</h2> Not sure if you’re speaking too fast or too slow? Try this: copy and paste a 160-word passage into a word processor. Read the passage aloud (at your standard conversational speed) while recording yourself on a tape recorder. How long did it take you? It should be near the minute mark, says communications coach, Dr Carol A. Fleming. “Aim for about 155 to 175 words per minute for normal conversation,” she writes. If you’re reciting background information or summarising something, pick up the pace. If you’re explaining something more technical, slow it down. <div> </div> <h2>Eliminate filler words</h2> If you’re wondering how to be more articulate, it’s probably because you’ve caught yourself over-utilising words such as ‘um,’ ‘like,’ and ‘ahh,’ which can make you sound unsure and inarticulate. Replace these fillers with more eloquent transitions, suggests Forbes contributor Selena Rezvani. “One of the functions of ‘Um’ is to tell your audience that you’re not done talking yet and need to gather your thoughts,” she writes. ‘Let’s move on to…’, ‘Another important consideration is…’, and ‘Let’s transition to talking about…’ are great replacements. <h2>Focus on the final sound</h2> Avoid trailing off or mumbling by making a conscious effort to fully pronounce each syllable. Pay special attention to the Ts in contractions and the final words of sentences. <h2>Study other speakers</h2> Articulate speakers learn from other articulate speakers. Need inspiration? Find a radio show or podcast you enjoy, and analyse the host’s speech. He or she has likely squashed any verbal ticks, and can help you identify effective patterns of speech. <h2>Speak with confidence</h2> How to be more articulate? Speak with confidence. Even if you’re talking on the phone, the way you hold yourself impacts the way people perceive your ideas. Extend your vocal cords by keeping your chin parallel to the floor and sitting up straight, and avoid moving your hands too much (studies show keeping them folded on the table projects trustworthiness). <h2>Think before you speak</h2> Perhaps the most important trick for more articulate speech? Know what you’re talking about. Having a clear idea of what you want to say will allow you to organise your thoughts into a coherent structure. It’s that simple. <h2>Address your weaknesses</h2> Once you’ve identified your weaknesses, create a plan for addressing them. One strategy is to tackle a specific issue each day. For example, focus on eliminating filler words on Monday, and on completing your sentences on Tuesday. Repeat the process each week until speaking clearly becomes second nature. This article originally appeared on <a href="https://www.readersdigest.com.au/culture/how-to-be-more-articulate-8-must-follow-secrets-to-improve-your-speech" target="_blank" rel="noopener">Reader’s Digest</a>. Image: Shutterstock

Caring

Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say?

Physiotherapists are increasingly offering needling therapies in addition to their standard care. Many Australian <a href="https://australian.physio/research/prf/translation/five-facts-about-acupuncture-and-dry-needling-musculoskeletal-pain" target="_blank" rel="noopener">physiotherapists</a> in private practice now offer dry needling or Western medical acupuncture as part of a treatment approach. Is it just a fad or does science support it? <h2>Needling, three ways</h2> Physiotherapists can be trained to use dry needling, Western acupuncture and/or traditional acupuncture. <a href="https://pubmed.ncbi.nlm.nih.gov/23801002/" target="_blank" rel="noopener">Dry needling</a> involves penetrating the skin with needles to altered or dysfunctional tissue in order to improve or restore function. This often involves needling muscle trigger points to activate a reflexive relaxation of the muscle. <a href="https://pubmed.ncbi.nlm.nih.gov/28739020/" target="_blank" rel="noopener">Western acupuncture</a> uses traditional needling <a href="https://www.sciencedirect.com/science/article/pii/S2005290110600143" target="_blank" rel="noopener">meridians</a> (the ancient idea of energy channels through the body) and trigger points. But these ideas are applied to Western understandings of anatomy. In Western acupuncture, points are stimulated to create local tissue changes, as well as spinal and brain effects. The goals is to trigger pain-relieving chemicals, muscle activation or relaxation. Even though traditional acupuncture points are used with this style of needling, Western acupuncture is not viewed as traditional Chinese medicine. <a href="https://healthtimes.com.au/hub/pain-management/44/research/kk1/acupuncture-for-pain-management/1581/" target="_blank" rel="noopener">Traditional acupuncture</a> uses meridian lines or other points based on traditional Chinese medicine assessment methods and approaches. All physiotherapists trained in either acupuncture or dry needling meet safety standards which are viewed as within scope by the <a href="https://www.ahpra.gov.au/" target="_blank" rel="noopener">Australian Health Practitioners Regulatory Agency</a> and the <a href="https://www.physiotherapyboard.gov.au/" target="_blank" rel="noopener">Physiotherapy Registration Board</a>. These standards cover the level of training required, registration to practice and safety standards that include needle safety and hygiene to protect the public. Minor reported <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015026/#:%7E:text=Examples%20of%20minor%20adverse%20reactions,pain%20during%20or%20after%20treatment." target="_blank" rel="noopener">side effects</a> related to acupuncture including pain and bleeding or bruising from needle insertion are fairly common. But major adverse events – pneumothorax (collapsed lung), excessive bleeding, prolonged aggravation – are rare. <h2>What’s needling good for?</h2> Research into the effectiveness of acupuncture and dry needling is variable. Some studies show comparable results between dry needling and acupuncture, while others show more favourable results for one or the other depending on the condition being treated. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedling" target="_blank" rel="noopener">review</a> that assessed the effects of acupuncture and dry needling for the treatment of low-back pain found they may be useful add-on therapies but could not make firm conclusions due to a lack of quality trials. Another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600071/#CIT0034" target="_blank" rel="noopener">review</a> reported the growing popularity of dry needling world wide and across disciplines and points out that many questions still remain regarding the use of needling. For <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001218.pub3/full?highlightAbstract=acupuncture%7Cmigraine%7Cmigrain%7Cacupunctur" target="_blank" rel="noopener">migraine</a> and <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007587.pub2/full?highlightAbstract=acupuncture%7Cheadach%7Ctension%7Cacupunctur%7Cheadache%7Ctype" target="_blank" rel="noopener">tension</a> headaches, experts say acupuncture seems to reduce the frequency and intensity of attacks – though more research is needed to compare it to other treatments. Acupuncture and dry needling may reduce pain and improve function for people with <a href="https://pubmed.ncbi.nlm.nih.gov/17224820/" target="_blank" rel="noopener">neck pain</a>. A systematic review found significant differences between acupuncture and “sham acupuncture” (which is performed away from acupuncture points) when used to treat <a href="https://pubmed.ncbi.nlm.nih.gov/22965186/" target="_blank" rel="noopener">certain types of chronic pain</a>. However, some research only shows <a href="https://pubmed.ncbi.nlm.nih.gov/33066556/" target="_blank" rel="noopener">small and temporary</a> relief for neck pain with dry needling. Results from randomised control trials support the use of needling for <a href="https://pubmed.ncbi.nlm.nih.gov/27062955" target="_blank" rel="noopener">shoulder pain</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/32301166/" target="_blank" rel="noopener">tennis elbow</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32186030/" target="_blank" rel="noopener">osteo arthritic knee pain</a>. But a recent systemic review of research reported only weak evidence to support needling to treat <a href="https://pubmed.ncbi.nlm.nih.gov/33760098/" target="_blank" rel="noopener">plantarfasciitis and chronic ankle instability</a>. <h2>Not just for sporting injuries</h2> Similarly, small randomised control trials have shown acupuncture and dry needling might reduce <a href="https://pubmed.ncbi.nlm.nih.gov/17095133/" target="_blank" rel="noopener">problematic jaw pain</a> (<a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/temporomandibular-disorder-tmd#:%7E:text=Temporomandibular%20disorders%20(TMD)%20are%20disorders,may%20result%20in%20temporomandibular%20disorder." target="_blank" rel="noopener">temporo mandibular disorder</a>) and improve mouth opening. Systematic reviews have reported needling and acupuncture were safe and effective recommendations for the treatment of broad conditions of <a href="https://www.healthline.com/health/tendinopathy" target="_blank" rel="noopener">tendinopathy</a> (the breakdown of collagen in tendons) and <a href="https://pubmed.ncbi.nlm.nih.gov/30787631/#:%7E:text=At%20follow%2Dup%20in%20the,for%20the%20management%20of%20FM." target="_blank" rel="noopener">fibromyalgia</a> (chronic pain in the muscles and bones). For women’s health, acupuncture has been shown to be effective for reducing pain with <a href="https://pubmed.ncbi.nlm.nih.gov/29879061/" target="_blank" rel="noopener">periods</a>, compared to no treatment or non-steroidal pain relief medications – but the research had design limitations. Though <a href="https://www.cochrane.org/CD002962/PREG_acupuncture-or-acupressure-induction-labour#:%7E:text=Acupuncture%20involves%20the%20insertion%20of,with%20onset%20of%20labour%20contractions." target="_blank" rel="noopener">widely used</a> in pregnancy, research into the use of acupuncture to <a href="https://pubmed.ncbi.nlm.nih.gov/32032444/" target="_blank" rel="noopener">induce labour</a> reports it may increase satisfaction with pain management and reduce pain intensity. But it may have little to no effect on the rates of caesarean or assisted vaginal birth. In summary, it appears needling techniques – whether dry needling or acupuncture – generally show positive effects over no treatment or “sham” treatments, but more research and high quality trials are needed. <h2>Just one part of a treatment program</h2> Needling <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedlin" target="_blank" rel="noopener">may be useful</a> as part of multimodal care – that is, when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780149/" target="_blank" rel="noopener">more than one treatment</a> is used in conjunction to treat a problem. Physiotherapists may combine needling therapies with exercise prescription, hands-on care including massage, mobilisations and manipulations, and taping techniques. They may also employ therapies that apply external energy such as ultrasound, laser, transcutaneous (under the skin) electrical nerve stimulation and biofeedback. Finally, while the various needling techniques all use a filiform needle (with a solid filament as opposed to a hollow bore needle), the styles with each can be quite different. Ask what style of needling is being employed to treat you, and if you have a history of finding one style works better for you, discuss this with your practitioner. This article originally appeared on <a href="https://theconversation.com/physio-dry-needling-and-acupuncture-whats-the-difference-and-what-does-the-evidence-say-181939" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

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What are the most common symptoms of menopause? And which can hormone therapy treat?

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

Got no COVID-19 symptoms? A gene mutation might be the reason

“Irwin genes are strong”: Bindi shares adorable candid snap

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Hugh Jackman reveals why he is now in therapy

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Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say?

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