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How risky is turbulence on a plane? How worried should I be?

<p><em><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>The Singapore Airlines <a href="https://www.abc.net.au/news/2024-05-21/singapore-london-flight-makes-emergency-landing/103876370">turbulence incident</a> that has sadly left one person dead and others hospitalised has made many of us think about the risks of air travel.</p> <p>We’ll hear more in coming days about how the aircraft came to drop so suddenly on its route from London to Singapore earlier this week, injuring passengers and crew, before making an emergency landing in Thailand.</p> <p>But thankfully, these types of incidents <a href="https://www.atsb.gov.au/publications/2014/in-flight-turbulence">are rare</a>, and much <a href="https://www.aihw.gov.au/reports/injury/transport-accidents">less-common</a> than injuries from other types of transport.</p> <p>So why do we sometimes think the risk of getting injured while travelling by plane is higher than it really is?</p> <h2>How common are turbulence injuries?</h2> <p><a href="https://theconversation.com/what-is-air-turbulence-196872">Turbulence</a> <a href="https://www.atsb.gov.au/publications/2014/in-flight-turbulence">is caused by</a> the irregular movement of air, leading to passengers and crew experiencing abrupt sideways and vertical jolts.</p> <p>In the case of the Singapore Airlines flight, this type of turbulence is thought to be a severe example of “<a href="https://www.theguardian.com/business/article/2024/may/21/what-causes-air-turbulence-and-how-worried-should-passengers-be">clear-air turbulence</a>”, which can occur without warning. There are several other types.</p> <p>About 25 in-flight turbulence injuries <a href="https://www.atsb.gov.au/publications/2014/in-flight-turbulence">are reported</a> to the Australian Transport Safety Bureau each year, although it is thought many more are un-reported. Some of these reported injuries are serious, including broken bones and head injuries. Passengers being thrown up and out of their seat during turbulence is one of the most common type of head injury on a plane.</p> <p>Other injuries from turbulence are caused by contact with flying laptops, or other unsecured items.</p> <p>In <a href="https://www.atsb.gov.au/sites/default/files/2023-04/AR-2008-034%20Turbulence%20FactSheet_v2.pdf">one example</a> of clear-air turbulence that came without warning, cabin crew, passengers and meal trolleys hit the ceiling, and landed heavily back on the floor. Serious injuries included bone fractures, lacerations, neck and back strains, a dislocated shoulder and shattered teeth. Almost all of those seriously injured did not have their seat belts fastened.</p> <p>But we need to put this into perspective. In the year to January 2024, there were <a href="https://www.bitre.gov.au/statistics/aviation/international">more than 36 million</a> passengers on international flights to Australia. In the year to February 2024, there were <a href="https://www.bitre.gov.au/statistics/aviation/domestic">more than 58 million</a> passengers on domestic flights.</p> <p>So while such incidents grab the headlines, they are exceedingly rare.</p> <h2>Why do we think flying is riskier than it is?</h2> <p>When we hear about this recent Singapore Airlines incident, it’s entirely natural to have a strong emotional reaction. We might have imagined the terror we might feel if we were on the aircraft at the time.</p> <p>But our emotional response <a href="https://psycnet.apa.org/record/2001-16969-005">alters our perception</a> of the risk and leads us to think these rare incidents are more common than they really are.</p> <p>There is a vast body of literature addressing the <a href="https://theconversation.com/explainer-how-our-understanding-of-risk-is-changing-79501">numerous factors</a> that influence how individuals perceive risk and the cognitive biases we are all subject to that mislead us.</p> <p>Nobel Prize-winning economist <a href="https://www.nobelprize.org/prizes/economic-sciences/2002/kahneman/facts/">Daniel Kahneman</a> covers them in his bestselling book <a href="https://www.penguin.com.au/books/thinking-fast-and-slow-9780141033570">Thinking, Fast and Slow</a>.</p> <p>He describes the way we respond to risks is not rational, but driven by emotion. Kahneman also highlights the fact that our brains are not wired to make sense of extremely small risks. So these types of risks – such as the chance of serious injury or death from in-flight turbulence – are hard for us to make sense of.</p> <p>The more unusual an event is, and this was a very unusual event, Kahneman says the more impact it makes on our psyche and the more likely we are to overestimate the risk.</p> <p>Of course, the more unusual the event, the <a href="https://psycnet.apa.org/record/1999-02435-000">more likely</a> it is for it to be in the media, amplifying this effect.</p> <p>Similarly, the easier it is to <a href="https://www.sciencedirect.com/science/article/abs/pii/0010028573900339">imagine an event</a>, the more it affects our perception and the more likely we are to respond to an event as if it were much more likely to occur.</p> <h2>How can we make sense of the risk?</h2> <p>One way to make sense of activities with small, hard-to-understand risks is by comparing their risks to the risks of more familiar activities.</p> <p>If we do this, the data shows very clearly that it is much <a href="https://www.aihw.gov.au/reports/injury/transport-accidents">more risky</a> to drive a car or ride a motorbike than to travel by plane.</p> <p>While events such as the Singapore Airlines incident are devastating and stir up lots of emotions, it’s important to recognise how our emotions can mislead us to over-estimate the risk of this happening again, or to us.</p> <p>Apart from the stress and anxiety this provokes, overestimating the risks of particular activities may lead us to make bad decisions that actually put us at greater risk of harm.<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/230665/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-risky-is-turbulence-on-a-plane-how-worried-should-i-be-230665">original article</a>.</em></p>

Travel Trouble

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If I’m diagnosed with one cancer, am I likely to get another?

<p><em><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.</p> <p>Fear of cancer returning is one of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321869/">top health concerns</a>. And <a href="https://www.cancercouncil.com.au/cancer-information/living-well/after-cancer-treatment/fear-of-the-cancer-returning/managing-fear-of-recurrence/">managing this fear</a> is an important part of cancer treatment.</p> <p>But how likely is it to get cancer for a second time?</p> <h2>Why can cancer return?</h2> <p>While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.</p> <p>This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">metastasis</a>.</p> <p>Actor Hugh Jackman has gone public about his <a href="https://www.skincancer.org/blog/is-basal-cell-carcinoma-serious/">multiple diagnoses</a> of basal cell carcinoma (a type of skin cancer) over the <a href="https://www.bbc.com/news/world-australia-65158945">past decade</a>.</p> <p>The exact reason why cancer returns differs depending on the cancer type and the treatment received. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486871/">Research</a> is <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.3408">ongoing</a> to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.</p> <h2>What are the chances of cancer returning?</h2> <p>The risk of cancer returning differs between cancers, and between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019423/">sub-types</a> of the same cancer.</p> <p>New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2812113">31-68%</a>. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.</p> <p>For most types of cancer, the highest risk of cancer returning is within the <a href="https://pubmed.ncbi.nlm.nih.gov/31231898/">first three years</a> after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.</p> <p>Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.</p> <h2>What about second, unrelated cancers?</h2> <p>Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) <a href="https://www.bbc.com/news/uk-68047608">shortly after</a> being treated for breast cancer.</p> <p>Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.</p> <p>Australian research from <a href="https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-83">Queensland</a> and <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.31247">Tasmania</a> shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.</p> <h2>Who’s at risk of another, unrelated cancer?</h2> <p>With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.</p> <p>Reasons for such cancers <a href="https://www.cancer.net/survivorship/what-second-cancer">include</a> different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.</p> <p>The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435077/">relatively small</a> when compared with the (sometimes lifesaving) benefits of these treatment and procedures.</p> <p>While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.</p> <p>Similarly, in a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.30164">large US study</a> only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).</p> <p>The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.</p> <p>People diagnosed with cancer as a <a href="https://www.mja.com.au/journal/2020/212/3/second-primary-cancers-people-who-had-cancer-children-australian-childhood">child</a>, <a href="https://www.liebertpub.com/doi/10.1089/jayao.2022.0074">adolescent or young adult</a> also have a greater risk of a second, unrelated cancer.</p> <h2>What can I do to lower my risk?</h2> <p>Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.</p> <p><a href="https://www.lymphoma.org.au/lymphoma/treatments/maintenance-therapy/">Maintenance therapy</a> may be used to reduce the risk of some types of cancer returning. However, despite ongoing <a href="https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.15626">research</a>, there are no <em>specific</em> treatments against cancer recurrence or developing a second, unrelated cancer.</p> <p>But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21719">cancer returning</a> and <a href="https://www.cancer.net/survivorship/what-second-cancer">getting a second cancer</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226386/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, Senior Lecturer in Cancer Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-im-diagnosed-with-one-cancer-am-i-likely-to-get-another-226386">original article</a>.</em></p>

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I can’t afford olive oil. What else can I use?

<p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>If you buy your olive oil in bulk, you’ve likely been in for a shock in recent weeks. Major supermarkets have been selling olive oil for up to A$65 for a four-litre tin, and up to $26 for a 750 millilitre bottle.</p> <p>We’ve been hearing about the health benefits of olive oil for years. And many of us are adding it to salads, or baking and frying with it.</p> <p>But during a cost-of-living crisis, these high prices can put olive oil out of reach.</p> <p>Let’s take a look at why olive oil is in demand, why it’s so expensive right now, and what to do until prices come down.</p> <h2>Remind me, why is olive oil so good for you?</h2> <p>Including olive oil in your diet can reduce your risk of developing type 2 diabetes and improve heart health through more favourable <a href="https://www.mdpi.com/2072-6643/12/6/1548">blood pressure</a>, <a href="https://www.mdpi.com/2072-6643/7/9/5356">inflammation</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0939475319302662">cholesterol levels</a>.</p> <p>This is largely because olive oil is high in <a href="https://www.mdpi.com/2072-6643/4/12/1989">monounsaturated fatty acids</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8300823/">polyphenols</a> (antioxidants).</p> <p>Some researchers have suggested you can get these benefits from consuming up to <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.1041203/full">20 grams a day</a>. That’s equivalent to about five teaspoons of olive oil.</p> <h2>Why is olive oil so expensive right now?</h2> <p>A European heatwave and drought have <a href="https://www.abc.net.au/news/rural/2024-04-27/olive-oil-alternatives-what-you-can-use-in-cooking/103761718">limited</a> Spanish and Italian producers’ ability to supply olive oil to international markets, including Australia.</p> <p>This has been coupled with an unusually cold and short growing season for Australian <a href="https://www.abc.net.au/news/rural/2023-08-02/record-olive-oil-price-set-to-increase-again/102675452">olive oil suppliers</a>.</p> <p>The lower-than-usual production and supply of olive oil, together with heightened demand from shoppers, means prices have gone up.</p> <h2>How can I make my olive oil go further?</h2> <p>Many households buy olive oil in large quantities because it is cheaper per litre. So, if you have some still in stock, you can make it go further by:</p> <ul> <li> <p><strong>storing it correctly</strong> – make sure the lid is on tightly and it’s kept in a cool, dark place, such as a pantry or cabinet. If stored this way, olive oil can typically last <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218649/">12–18 months</a></p> </li> <li> <p><strong>using a spray</strong> – sprays distribute oil more evenly than pourers, using less olive oil overall. You could buy a spray bottle to fill from a large tin, as needed</p> </li> <li> <p><strong>straining or freezing it</strong> – if you have leftover olive oil after frying, strain it and reuse it for other fried dishes. You could also freeze this used oil in an airtight container, then thaw and fry with it later, without affecting the oil’s <a href="https://link.springer.com/article/10.1007/s00217-022-04078-9">taste and other characteristics</a>. But for dressings, only use fresh oil.</p> </li> </ul> <h2>I’ve run out of olive oil. What else can I use?</h2> <p>Here are some healthy and cheaper alternatives to olive oil:</p> <ul> <li> <p><strong>canola oil</strong> is a good alternative for frying. It’s relatively <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/canola-oil">low</a> in saturated fat so is generally considered healthy. Like olive oil, it is high in <a href="https://pubmed.ncbi.nlm.nih.gov/23731447/">healthy monounsaturated fats</a>. Cost? Up to $6 for a 750mL bottle (home brand is about half the price)</p> </li> <li> <p><strong>sunflower oil</strong> is a great alternative to use on salads or for frying. It has a mild flavour that does not overwhelm other ingredients. Some <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/conjugated-linoleic-acid-versus-higholeic-acid-sunflower-oil-effects-on-energy-metabolism-glucose-tolerance-blood-lipids-appetite-and-body-composition-in-regularly-exercising-individuals/6C035B5C6E9FD7C9D6D7F806ADA56983">studies</a> suggest using sunflower oil may help reduce your risk of heart disease by lowering LDL (bad) cholesterol and raising HDL (good) cholesterol. Cost? Up to $6.50 for a 750mL bottle (again, home brand is about half the price)</p> </li> <li> <p><strong>sesame oil</strong> has a nutty flavour. It’s good for Asian dressings, and frying. Light sesame oil is typically used as a neutral cooking oil, while the toasted type is used to flavour sauces. Sesame oil is <a href="https://onlinelibrary.wiley.com/doi/10.1002/ptr.6428">high in</a> antioxidants and has some anti-inflammatory properties. Sesame oil is generally sold in smaller bottles than canola or sunflower oil. Cost? Up to $5 for a 150mL bottle.</p> </li> </ul> <h2>How can I use less oil, generally?</h2> <p>Using less oil in your cooking could keep your meals healthy. Here are some alternatives and cooking techniques:</p> <ul> <li> <p><strong>use alternatives for baking</strong> – unless you are making an olive oil cake, if your recipe calls for a large quantity of oil, try using an alternative such as apple sauce, Greek yoghurt or mashed banana</p> </li> <li> <p><strong>use non-stick cookware</strong> – using high-quality, non-stick pots and pans reduces the need for oil when cooking, or means you don’t need oil at all</p> </li> <li> <p><strong>steam instead</strong> – steam vegetables, fish and poultry to retain nutrients and moisture without adding oil</p> </li> <li> <p><strong>bake or roast</strong> – potatoes, vegetables or chicken can be baked or roasted rather than fried. You can still achieve crispy textures without needing excessive oil</p> </li> <li> <p><strong>grill</strong> – the natural fats in meat and vegetables can help keep ingredients moist, without using oil</p> </li> <li> <p><strong>use stock</strong> – instead of sautéing vegetables in oil, try using vegetable broth or stock to add flavour</p> </li> <li> <p><strong>try vinegar or citrus</strong> – use vinegar or citrus juice (such as lemon or lime) to add flavour to salads, marinades and sauces without relying on oil</p> </li> <li> <p><strong>use natural moisture</strong> – use the natural moisture in ingredients such as tomatoes, onions and mushrooms to cook dishes without adding extra oil. They release moisture as they cook, helping to prevent sticking.<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/228788/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-cant-afford-olive-oil-what-else-can-i-use-228788">original article</a>.</em></p>

Food & Wine

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"I love you all": Social media star announces her own death

<p>Social media star Kimberley Nix has passed away at the age of 31 after a gruelling battle with cancer, and has announced the news of her own death to her dedicated followers. </p> <p>The TikTok star, who has amassed a following of 143,000 people as she documented her cancer journey, spoke candidly in a pre-filmed video that was posted to her page, letting her followers know that her "journey here is over". </p> <p>Kimberley, who was also a doctor in training, told her fans that if they were seeing the heartbreaking clip, that she had "passed", before sharing that they had made her "so happy".</p> <p>She captioned the viral video, which has so far amassed more than 5.1 million views, "My journey here is over and I can't thank each and every one of you enough. You have all made me so happy and your comments and support are more than enough to have gotten anyone through anything!"</p> <p>"If you wish, please donate through my link in bio to sarcoma cancer research and follow my husband [Michael MacIsaac] in his updates."</p> <p>At the beginning of the clip, Kimberley said, "Hello followers, if you're seeing this clip, I have passed away peacefully. "</p> <p>Holding back tears, she said that she had a "very beautiful life" that she was "so proud" of. </p> <p>"Those who know me, know I love my pets, my husband, and makeup. And though being a doctor is a big part of my identity, those are the things that matter," she said during the heartbreaking clip.</p> <p>Kim went on to note that in 2021 she got the "opportunity to start making TikTok videos", admitting that she "never thought anything would come of it".</p> <p>"I shared about love, joy, and gratitude because in this journey, I was grateful for the people and the little moments."</p> <p>"Those little parts of your day, like that warm first sip of tea in the morning or how it feels when snow is fresh on your face, those are the most beautiful [moments]."</p> <p>At the end of the clip, she thanked her followers for helping her and said that they meant the world to her. </p> <p>"I can't thank you enough, I will miss you TikTok. I love you all. Thank you for this amazing opportunity, I am in happy tears because I have found so much purpose in the end of my life," she said.</p> <p>"Thank you from the bottom of my heart, goodbye."</p> <p>Kimberley was diagnosed with metastatic sarcoma, which is known as cell cancer, at just 28 years old, and she was finishing up her final year of her internal medicine core residency when she got the diagnosis. </p> <p>She is survived by her husband Michael, who she married in February. </p> <p><em>Image credits: TikTok</em></p>

Caring

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Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?

<p><em><a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/diny-thomson-1519736">Diny Thomson</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.</p> <p>Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.</p> <p>Since as early as the <a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">19th century</a>, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.</p> <p>It is estimated <a href="https://pubmed.ncbi.nlm.nih.gov/20010032/">43% of people</a> who experience this brief lucidity die within 24 hours, and 84% within a week.</p> <p>Why does this happen?</p> <h2>Terminal lucidity or paradoxical lucidity?</h2> <p>In 2009, researchers Michael Nahm and Bruce Greyson coined the term “<a href="https://pubmed.ncbi.nlm.nih.gov/21764150/">terminal lucidity</a>”, since these lucid episodes often occurred shortly before death.</p> <p>But not all lucid episodes indicate death is imminent. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13667">One study</a> found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.</p> <p>Lucidity has also been <a href="https://www.sciencedirect.com/science/article/pii/S0167494311001865?via%3Dihub">reported</a> in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.</p> <p>Moments of lucidity that do not necessarily indicate death are sometimes called <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12579">paradoxical lucidity</a>. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.</p> <p>But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.</p> <h2>Why does terminal lucidity happen?</h2> <p>Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that <a href="https://psywb.springeropen.com/articles/10.1186/s13612-014-0024-5">music can sometimes improve lucidity</a>. But many episodes of lucidity do not have a distinct trigger.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0300957223002162">A research team from New York University</a> speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.</p> <p>Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.</p> <p>And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.</p> <p>Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.</p> <h2>Why is it important to know about terminal lucidity?</h2> <p>People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.</p> <p>Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.</p> <p>For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.<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/202342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/yen-ying-lim-355185"><em>Yen Ying Lim</em></a><em>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/diny-thomson-1519736">Diny Thomson</a>, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/terminal-lucidity-why-do-loved-ones-with-dementia-sometimes-come-back-before-death-202342">original article</a>.</em></p>

Mind

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Love is in the air! Pilot proposes to flight attendant girlfriend before take off

<p>A pilot has proposed to his flight attendant girlfriend just minutes before take off in a heart-warming display of love. </p> <p>Polish pilot Konrad Hanc was captured emerging from the cockpit before embarking on a flight to Kraków to make a surprising announcement over the PA system. </p> <p>Hanc introduced himself to the passengers before explaining the real reason for his message. </p> <p>“On today’s flight there is a very special person," he began.</p> <p>“Ladies and gentlemen, about one and a half years ago in this job I met the most wonderful person that completely changed my life."</p> <p>“You are most precious to me. You are my greatest dream come true. This is why I have to ask you a favour, honey."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C6EHHyQskLc/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C6EHHyQskLc/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by LOT Polish Airlines (@flylot)</a></p> </div> </blockquote> <p>“Will you marry me?” he asked while getting down on one knee, as another flight attendant handed him a bouquet of flowers. </p> <p>His girlfriend, Paula, sprinted up the aisle of the plane before leaping into the arms of her future husband. </p> <p>Passengers watched on in anticipation for her answer with one yelling, “Did she say yes?” to which the beaming captain responded: “She said yes!”</p> <p>Hanc explained that he chose to pop the question on the flight to the Polish city as he met Paula on the same flight just 18 months ago. </p> <p>As the pair embraced in a hug and kiss, passengers erupted in applause, with many taking to the now viral Facebook post to send them well wishes. </p> <p>“I love this! Sweet couple!” one person wrote.</p> <p>”TOTALLYYYYY LOVE IN THE AIR,” another enthusiastic person commented, to which the airline responded: “YES, love IS in the air!”</p> <p><em>Image credits: LOT Polish Airlines</em></p>

Relationships

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What happens when I stop taking a drug like Ozempic or Mounjaro?

<p><em><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Drugs like Ozempic are very <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.12932">effective</a> at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.</p> <p>But does weight come back when you stop using it?</p> <p>The short answer is yes. Stopping <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">tirzepatide</a> and <a href="https://doi.org/10.1111/dom.14725">semaglutide</a> will result in weight regain in most people.</p> <p>So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.</p> <h2>It’s a long-term treatment, not a short course</h2> <p>If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.</p> <p>For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.</p> <p>Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)</p> <p>Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.</p> <h2>Why do people stop?</h2> <p>Research trials show anywhere from <a href="https://asean-endocrinejournal.org/index.php/JAFES/article/view/1771">6%</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/35015037/">13.5%</a> of participants stop taking these drugs, primarily because of <a href="https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more">side effects</a>.</p> <p>But these studies don’t account for those forced to stop because of cost or <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">widespread supply issues</a>. We don’t know how many people have needed to stop this medication over the past few years for these reasons.</p> <p>Understanding what stopping does to the body is therefore important.</p> <h2>So what happens when you stop?</h2> <p>When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to <a href="https://pubmed.ncbi.nlm.nih.gov/30565096/">move out of your system</a>. As it does, a number of things happen:</p> <ul> <li>you start feeling hungry again, because both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/">your brain and your gut</a> no longer have the medication working to make you feel full</li> </ul> <ul> <li> <p>blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index">low glycemic index</a> to stabilise your blood sugars</p> </li> <li> <p>over the longer term, most people experience a return to their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/">previous blood pressure and cholesterol levels</a>, as the weight comes back</p> </li> <li> <p>weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.</p> </li> </ul> <p>While you were on the medication, you will have lost <a href="https://academic.oup.com/jes/article/5/Supplement_1/A16/6240360">proportionally less skeletal muscle than fat</a>, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.</p> <h2>Is stopping and starting the medications a problem?</h2> <p>People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">yo-yo dieting</a>.</p> <p>When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to <a href="https://www.jomes.org/journal/view.html?doi=10.7570/jomes.2017.26.4.237">deal with</a> spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-022-01735-x">stress</a> your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.</p> <p>Interestingly, the risk to the body from weight fluctuations is greater for people who are <a href="https://jech.bmj.com/content/74/8/662">not obese</a>. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.</p> <h2>How can you avoid gaining weight when you stop?</h2> <p>Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:</p> <ul> <li> <p>getting quality <a href="https://www.hindawi.com/journals/ije/2010/270832/">sleep</a></p> </li> <li> <p>exercising in a way that builds and maintains muscle. While on the medication, you will <a href="https://pubmed.ncbi.nlm.nih.gov/32628589/">likely have lost muscle</a> as well as fat, although this is not inevitable, especially if you <a href="https://www.europeanreview.org/article/34169">exercise regularly</a> while taking it</p> </li> </ul> <ul> <li> <p>addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2009.159491">fat-phobic and discriminates</a> against people in larger bodies</p> </li> <li> <p>eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.</p> </li> </ul> <p>Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224972/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></em></p> <p><em><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-when-i-stop-taking-a-drug-like-ozempic-or-mounjaro-224972">original article</a>.</em></p>

Body

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"I miss her hugs": British acting legend shares heartbreaking loss

<p>Actor Warwick Davis has shared the heartbreaking news of his wife's death. </p> <p>The actor, known for his roles in <em>Harry Potter</em> and <em>Star Wars</em>, took to social media to share the news of his wife Samantha's death, who passed away at the age of 53. </p> <p>“Her passing has left a huge hole in our lives as a family. I miss her hugs”, Warwick, 54, said.</p> <p>He added, “She was a unique character, always seeing the sunny side of life she had a wicked sense of humour and always laughed at my bad jokes.</p> <p>“Without Sammy, there would have been no Tenable quiz show, no Willow series. No Idiot Abroad Series 3.”</p> <p>Warwick said Samantha was his “most trusted confidant and an ardent supporter of everything I did in my career”.</p> <p>The couple’s children, Harrison and Annabelle, added, “Mum is our best friend and we’re honoured to have received a love like hers</p> <p>“Her love and happiness carried us through our whole lives”.</p> <p>Warwick and Samantha met on the set of the movie Willow in 1988 and got married three years later. </p> <p>Samantha had achondroplasia, a bone growth disorder that causes disproportionate dwarfism.</p> <p>Warwick has previously opened up about his wife’s health after she was rushed to hospital with sepsis in 2018, and had to undergo several different surgeries to stabilise her condition. </p> <p>Warwick, co-founder of charity Little People UK, has often spoken out about the health battles related to his condition, as well his wife’s.</p> <p>He was born with Spondyloepiphyseal dysplasia congenita (SED), an extremely rare genetic form of dwarfism, which has been inherited by both their daughter Annabelle and son Harrison.</p> <p><em>Image credits: Getty Images </em></p>

Caring

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“Love is so sweet": Man's sweet mid-air proposal goes viral

<p>Love is in the air! </p> <p>A smitten passenger took his love to the skies and proposed to his girlfriend while on board an Air Peace flight, with the romantic moment captured on camera. </p> <p>A social media user took to TikTok to share the sweet proposal, with the caption: “POV: My friend was proposed to in a plane.”</p> <p>The minute-long video showed a man getting out of his seat on board the packed plane to use the aircraft’s PA system so that he could ask for his girlfriend’s hand in marriage.</p> <p>“She’s so precious and her name is Precious,” the man said before popping the question. </p> <p> “Please, my Precious, I want to ask, will you marry me?”</p> <p>“If you will, just come out and say ‘yes’ to me, my precious,” he added before walking down the aisle of the aircraft. </p> <p>Other passengers cheered for the couple, and in a second video, the man is seen greeting Precious, then getting down on one knee to offer her the ring.</p> <p>Precious was overjoyed at the proposal and said yes, hugging her new fiance. </p> <p>While it is unclear where the plane was travelling, Air Peace is a Nigerian carrier that operates flights to destinations in West Africa and the Middle East, according to the NY Post. </p> <p>TikTok users were also touched by the romantic act, with many of them congratulating the couple. </p> <p>“This is beautiful,” one wrote. </p> <p>“Love is so sweet for real,” another swooned. </p> <p><em>Images: TikTok</em></p>

Relationships

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There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people.</p> <p>Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020.</p> <p>It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year.</p> <p>Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>.</p> <h2>What goes into a flu vaccine?</h2> <p>Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus.</p> <p>Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains.</p> <p>All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future.</p> <h2>What’s different about new flu vaccines?</h2> <p>There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad).</p> <p>Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely.</p> <p>However, there have been several enhancements to influenza vaccines in recent years.</p> <p>Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people.</p> <p>An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people.</p> <p>Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future.</p> <h2>What should I do this year?</h2> <p>Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life.</p> <p>Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>.</p> <p>In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need.</p> <h2>Are there side effects?</h2> <p>All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines.</p> <p>As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines.</p> <p>Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<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/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.</em></p>

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Summer’s over, so how much sun can (and should) I get?

<p><em><a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a></em></p> <p>As we slide of out summer, you might be wondering how careful you need to be about sun exposure. Excessive exposure causes <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/skin-cancer-statistics-and-issues/uv-radiation">skin cancer</a>, but sun exposure also has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">benefits</a>. How do you balance the two?</p> <p>A new <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">position statement</a> from cancer, bone health and other experts <a href="https://www.assc.org.au/wp-content/uploads/2023/01/Sun-Exposure-Summit-PositionStatement_V1.9.pdf">aims to help</a> Australians balance the good and bad effects of sun exposure by taking into account their skin colour, risk of skin cancer, and where they live.</p> <h2>What are the benefits of sunlight?</h2> <p>Ultraviolet (UV) radiation (the wavelengths in sunlight that cause skin cancer) also leads to vitamin D production. <a href="https://dermnetnz.org/topics/vitamin-d">Vitamin D</a> is very important for maintaining strong bones, and is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">multiple other health benefits</a>.</p> <p>But vitamin D probably isn’t the whole story. Sunshine, including UV radiation, is thought to affect health in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">other ways</a> such as improving our mood and reducing the risk of autoimmune diseases and infections. So for many people, avoiding the sun and taking a vitamin D supplement may not be the best approach.</p> <h2>How much time does it take to make vitamin D?</h2> <p>It’s complicated, but for most people and most of the year across most of Australia, it’s a lot less than you think.</p> <p>The <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">amount of time needed</a> depends on the amount of skin covered by clothing and the intensity of UV radiation (indicated by the UV index). More skin exposed and higher UV index equate to less time needed.</p> <p>Both the UV index and the amount of the year that UV radiation is high increase as you get closer to the equator. In summer, all of Australia is bathed in sunshine. But in winter, opposite ends of the country have <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">very different exposures</a>.</p> <p>In summer, everybody except those with deeply pigmented skin can make enough vitamin D in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">just five minutes</a> between 9am and 3pm, anywhere in Australia, provided they are wearing shorts and a T-shirt.</p> <p>In winter it’s a different story. In <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Darwin and Brisbane</a>, 5–10 minutes between 10am and 3pm will do the trick, but in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Hobart</a>, factoring in winter clothing, it will take nearly an hour in the middle of the day.</p> <p>Hover your mouse over the lines below to see the length of exposure needed at specific times of day.</p> <p><iframe id="X5szQ" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/X5szQ/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Staying out for longer than needed doesn’t necessarily make more vitamin D, but it <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib25">does cause skin damage</a>.</p> <h2>Hang on, what about those with darker skin?</h2> <p>People with deeply pigmented, brown to black skin accumulate both vitamin D and DNA damage at a much slower rate than people with lighter skin tones.</p> <p>When UV radiation hits a DNA strand, it causes the DNA to become distorted. If the distortion isn’t fixed, it will cause a mistake when the DNA is copied for a new cell, causing a permanent mutation that sometimes leads to cancer.</p> <p>Melanin, the brown pigment in the skin, absorbs UV photons before that can happen, and the high melanin content in the darkest skin tones provides <a href="https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.201701472R">60 times</a> as much UV protection as the small amount in very fair skin.</p> <p>The flip side is the risk of vitamin D deficiency is much higher than the risk of skin cancer.</p> <p>The new statement accounts for this by putting people into <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">three groups</a> based on their risk of skin cancer, with specialised advice for each group.</p> <h2>Highest skin cancer risk</h2> <p>This includes people with very pale skin that burns easily and tans minimally, but also people with darker white or olive skin who can tan easily but have extra skin cancer risk factors because they:</p> <ul> <li>have had <strong>skin cancer</strong> before</li> <li>have a <strong>family history</strong> of melanomas</li> <li>have many <strong>moles</strong></li> <li>are taking <strong>immunosuppressant</strong> medications.</li> </ul> <p>For these people, the harms of sun exposure almost certainly <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">outweigh the benefits</a>.</p> <p>These people should wear sunscreen every day the <a href="https://www.arpansa.gov.au/our-services/monitoring/ultraviolet-radiation-monitoring/ultraviolet-radiation-index">UV index</a> is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, and use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">five sunsmart steps</a> whenever the UV index is above three:</p> <ul> <li><strong>slip</strong> on clothing covering as much of the body as possible</li> <li><strong>slop</strong> on SPF30+ sunscreen on areas that can’t be covered up</li> <li><strong>slap</strong> on a hat</li> <li><strong>seek</strong> shade</li> <li><strong>slide</strong> on sunglasses.</li> </ul> <p>They shouldn’t spend time outdoors deliberately to make vitamin D, but should discuss vitamin D supplements with their doctor.</p> <h2>Intermediate skin cancer risk</h2> <p>This means people with dark white/olive skin that sometimes burns but tans easily, and who don’t have other skin cancer risk factors.</p> <p>These people should still apply sunscreen as part of their usual routine on all days when the UV index is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, but they can spend enough time outdoors to get a “dose” of vitamin D on most days of the week.</p> <p>Once the time needed for their vitamin D dose is up, they should also use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> steps to avoid accumulating DNA damage.</p> <p>If they’re unable to do this because of health or lifestyle factors, like being housebound, working night shifts, or always covering up with clothing, they should see their doctor about whether they need vitamin D supplements.</p> <h2>Lowest skin cancer risk</h2> <p>This covers people with deeply pigmented brown to black skin that rarely or never burns.</p> <p>These people can <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib14">safely spend enough time outdoors</a> to make vitamin D and get the other benefits of sunshine. But because more time is needed, it can be difficult, particularly when the weather is cold. Vitamin D supplements might be needed.</p> <p>They don’t need to routinely protect their skin, but might need to <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> if they are outdoors for more than two hours.</p> <h2>How do I get the feel-good effects of sunshine?</h2> <p>Spending time outdoors in the early morning is the best way to get the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">feel-good effects</a> of sunshine. An early morning walk is a great idea for all of us, but it won’t make vitamin D.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224144/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, PhD Candidate, Dermatology Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, Principal research fellow, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/summers-over-so-how-much-sun-can-and-should-i-get-224144">original article</a>.</em></p>

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“I lost all ability to fly the plane”: Pilot's shock claim after plane drops mid-flight

<p>At least 50 passengers have been injured with a dozen hospitalised after a Boeing 787 Dreamliner suddenly plunged about two hours into the flight from Sydney to Auckland on Monday. </p> <p>LATAM Airlines said that the plane experienced an unspecified "technical event during the flight which caused a strong movement." </p> <p>Passengers on board the flight have recalled the terrifying moment the plane took a nose-dive mid-flight. </p> <p>"The plane dipped so dramatically into a nose dive for a couple of seconds and around 30 people hit the ceiling hard," Daniel, who was travelling from London, told the <em>NZ Herald</em>. </p> <p>“None of us knew what had happened until after the flight, I was just trying to keep everyone calm. We never heard any announcement from the captain." </p> <p>He added that passengers were screaming and it was hard to tell whether blood or red wine was splattered through the cabin. </p> <p>Another passenger, Brian Jokat, told broadcaster <em>RNZ t</em>hat the incident took place in "split seconds". </p> <p>"There was no pre-turbulence, we were just sailing smoothly the whole way,” he said. </p> <p>“I had just dozed off and I luckily had my seatbelt on, and all of a sudden the plane just dropped. It wasn’t one of those things where you hit turbulence and you drop a few times … we just dropped.”</p> <p>He added that a passenger two seats away from him, who was not wearing his seatbelt, flew up into the ceiling and was suspended mid-air before he fell and broke his ribs. </p> <p>“I thought I was dreaming,” he said. “I opened my eyes and he was on the roof of the plane on his back, looking down on me. It was like <em>The Exorcist</em>.”</p> <p>Paramedics and more than 10 emergency vehicles were waiting for passengers when the plane landed in Auckland. </p> <p>Around 50 patients were treated, with 12 of them hospitalised and one in serious condition. </p> <p>At least three of those treated were cabin crew. </p> <p>Jokat told <em>RNZ </em>that after the plane landed, the pilot came to the back and explained what had happened. </p> <p>"He said to me, ‘I lost my instrumentation briefly and then it just came back all of a sudden,’” Jokat said.</p> <p>In another interview with <em>Stuff.co.nz</em>, Jokat recalled the pilot also saying: “My gauges just blanked out, I lost all of my ability to fly the plane.” </p> <p>The airline's final destination was Santiago, Chile, but it was landing at Auckland Airport in accordance with its normal flight path, according to <em>Reuters</em>. </p> <p>"LATAM regrets the inconvenience and injury this situation may have caused its passengers, and reiterates its commitment to safety as a priority within the framework of its operational standards," the airline said.  </p> <p><em>Images: Brian Jokat/ News.com.au</em></p>

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Why do I need to get up during the night to wee? Is this normal?

<p><em><a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>It can be normal to wake up once or even twice during the night to wee, especially as we get older.</p> <p>One in three adults over 30 makes <a href="https://pubmed.ncbi.nlm.nih.gov/30085529">at least two</a> trips to the bathroom every night.</p> <p>Waking up from sleep to urinate on a regular basis is called <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">nocturia</a>. It’s one of the most commonly reported <a href="https://pubmed.ncbi.nlm.nih.gov/32249998/">bothersome urinary symptoms</a> (others include urgency and poor stream).</p> <p>So what causes nocturia, and how can it affect wellbeing?</p> <h2>A range of causes</h2> <p>Nocturia can be caused by a variety of <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">medical conditions</a>, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an <a href="https://www.nature.com/articles/s41598-023-44916-8">overactive bladder</a>, or gastrointestinal issues. Other causes include pregnancy, <a href="https://onlinelibrary.wiley.com/doi/10.1002/nau.24839">medications</a> and consumption of alcohol or caffeine before bed.</p> <p>While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055528/">insomnia</a>, can also cause nocturia.</p> <p>When we sleep, an antidiuretic hormone is released that slows down the rate at which our <a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">kidneys produce urine</a>. If we lie awake at night, less of this hormone <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00025.2023">is released</a>, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.</p> <p>Stress, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153377/">anxiety</a> and watching television <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987">late into the night</a> are common causes of insomnia.</p> <h2>Effects of nocturia on daily functioning</h2> <p>The recommended amount of sleep for adults is between <a href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep">seven and nine hours</a> per night. The more times you have to get up in the night to go to the bathroom, the more this impacts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602727/#:%7E:text=Nocturia%20is%2C%20however%2C%20an%20important,(QoL)%20and%20general%20health.">sleep quantity and quality</a>.</p> <p>Decreased sleep can result in increased <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1251-5">tiredness</a> during the day, poor concentration, forgetfulness, changes in mood and impaired <a href="https://pubmed.ncbi.nlm.nih.gov/28425062/">work performance</a>.</p> <p>If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.</p> <p>In more severe cases, nocturia has been compared to having a similar impact on <a href="https://www.racgp.org.au/getattachment/b43c05ba-e29e-47c3-b816-ec47ceeafe97/Nocturia-a-guide-to-assessment-and-management.aspx">quality of life</a> as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.</p> <p>Nocturia not only upsets sleep, but also increases the risk of <a href="https://www.auajournals.org/doi/10.1097/JU.0000000000000459">falls</a> from moving around in the dark to go to the bathroom.</p> <p>Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.</p> <h2>Can you have a ‘small bladder’?</h2> <p>It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is <a href="https://youtu.be/blVmyrBPves">smaller</a> relative to your other organs.</p> <p>If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.</p> <figure><iframe src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Can you have a small bladder?</span></figcaption></figure> <p>If you find you are going to the bathroom quite a lot during the day and evening (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903463/">more than eight times</a> in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.</p> <p>If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.</p> <p>There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.</p> <h2>A happy and healthy bladder</h2> <p>Here are some tips to maintain a happy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/">healthy</a> bladder, and reduce the risk you’ll be up at night:</p> <ul> <li> <p>make your <a href="https://theconversation.com/what-position-should-i-sleep-in-and-is-there-a-right-way-to-sleep-189873">sleep environment comfortable</a>, with a suitable mattress and sheets to suit the temperature</p> </li> <li> <p>get to bed early, and limit <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">screens</a>, or activites before bed</p> </li> <li> <p>limit foods and drinks that irritate the bladder, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811496/">coffee or alcohol</a>, especially before bedtime</p> </li> <li> <p>sit in a <a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">relaxed position</a> when urinating, and allow time for the bladder to completely empty</p> </li> <li> <p>practice <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor muscle exercises</a></p> </li> <li> <p>drink an adequate amount of fluids during the day, and avoid becoming <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">dehydrated</a></p> </li> <li> <p>maintain a healthy lifestyle, eat <a href="https://journals.physiology.org/doi/full/10.1152/advan.00052.2023">nutritious foods</a> and do not do anything harmful to the body such as smoking or using illicit drugs</p> </li> <li> <p>review your medications, as the time you take some <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">pharmaceuticals</a> may affect urine production or sleep</p> </li> <li> <p>if you have <a href="https://pubmed.ncbi.nlm.nih.gov/28675633/">swollen legs</a>, raise them a few hours before bedtime to let the <a href="https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management">fluid drain</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224160/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, Associate Professor of Science &amp; Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, Senior Teaching Fellow, Medical Program, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-get-up-during-the-night-to-wee-is-this-normal-224160">original article</a>.</em></p>

Body

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How can I stop overthinking everything? A clinical psychologist offers solutions

<p><em><a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a></em></p> <p>As a clinical psychologist, I often have clients say they are having trouble with thoughts “on a loop” in their head, which they find difficult to manage.</p> <p>While rumination and overthinking are often considered the same thing, they are slightly different (though linked). <a href="https://www.apa.org/monitor/nov05/cycle">Rumination</a> is having thoughts on repeat in our minds. This can lead to overthinking – analysing those thoughts without finding solutions or solving the problem.</p> <p>It’s like a vinyl record playing the same part of the song over and over. With a record, this is usually because of a scratch. Why we overthink is a little more complicated.</p> <h2>We’re on the lookout for threats</h2> <p>Our brains are hardwired to look for threats, to make a plan to address those threats and keep us safe. Those perceived threats may be based on past experiences, or may be the “what ifs” we imagine could happen in the future.</p> <p>Our “what ifs” are usually negative outcomes. These are what we call “<a href="https://ccbhc.org/hot-thoughts-what-are-they-and-how-can-you-handle-them/">hot thoughts</a>” – they bring up a lot of emotion (particularly sadness, worry or anger), which means we can easily get stuck on those thoughts and keep going over them.</p> <p>However, because they are about things that have either already happened or might happen in the future (but are not happening now), we cannot fix the problem, so we keep going over the same thoughts.</p> <h2>Who overthinks?</h2> <p>Most people find themselves in situations at one time or another when they overthink.</p> <p>Some people are <a href="https://www.apa.org/monitor/nov05/cycle">more likely</a> to ruminate. People who have had prior challenges or experienced trauma may have come to expect threats and look for them more than people who have not had adversities.</p> <p>Deep thinkers, people who are prone to anxiety or low mood, and those who are sensitive or feel emotions deeply are also more likely to ruminate and overthink.</p> <p>Also, when we are stressed, our emotions tend to be stronger and last longer, and our thoughts can be less accurate, which means we can get stuck on thoughts more than we would usually.</p> <p>Being run down or physically unwell can also mean our thoughts are <a href="https://healthify.nz/hauora-wellbeing/m/mental-health-and-your-body/">harder to tackle</a> and manage.</p> <h2>Acknowledge your feelings</h2> <p>When thoughts go on repeat, it is helpful to use both emotion-focused and problem-focused <a href="https://link.springer.com/referencework/10.1007/978-1-4419-1005-9">strategies</a>.</p> <p>Being emotion-focused means figuring out how we feel about something and addressing those feelings. For example, we might feel regret, anger or sadness about something that has happened, or worry about something that might happen.</p> <p>Acknowledging those emotions, using self-care techniques and accessing social support to talk about and manage your feelings will be helpful.</p> <p>The second part is being problem-focused. Looking at what you would do differently (if the thoughts are about something from your past) and making a plan for dealing with future possibilities your thoughts are raising.</p> <p>But it is difficult to plan for all eventualities, so this strategy has limited usefulness.</p> <p>What is more helpful is to make a plan for one or two of the more likely possibilities and accept there may be things that happen you haven’t thought of.</p> <h2>Think about why these thoughts are showing up</h2> <p>Our feelings and experiences are information; it is important to ask what this information is telling you and why these thoughts are showing up now.</p> <p>For example, university has just started again. Parents of high school leavers might be lying awake at night (which is when rumination and overthinking is common) worrying about their young person.</p> <p>Knowing how you would respond to some more likely possibilities (such as they will need money, they might be lonely or homesick) might be helpful.</p> <p>But overthinking is also a sign of a new stage in both your lives, and needing to accept less control over your child’s choices and lives, while wanting the best for them. Recognising this means you can also talk about those feelings with others.</p> <h2>Let the thoughts go</h2> <p>A useful way to manage rumination or overthinking is “<a href="https://www.getselfhelp.co.uk/docs/Options.pdf">change, accept, and let go</a>”.</p> <p>Challenge and change aspects of your thoughts where you can. For example, the chance that your young person will run out of money and have no food and starve (overthinking tends to lead to your brain coming up with catastrophic outcomes!) is not likely.</p> <p>You could plan to check in with your child regularly about how they are coping financially and encourage them to access budgeting support from university services.</p> <p>Your thoughts are just ideas. They are not necessarily true or accurate, but when we overthink and have them on repeat, they can start to feel true because they become familiar. Coming up with a more realistic thought can help stop the loop of the unhelpful thought.</p> <p>Accepting your emotions and finding ways to manage those (good self-care, social support, communication with those close to you) will also be helpful. As will accepting that life inevitably involves a lack of complete control over outcomes and possibilities life may throw at us. What we do have control over is our reactions and behaviours.</p> <p>Remember, you have a 100% success rate of getting through challenges up until this point. You might have wanted to do things differently (and can plan to do that) but nevertheless, you coped and got through.</p> <p>So, the last part is letting go of the need to know exactly how things will turn out, and believing in your ability (and sometimes others’) to cope.</p> <h2>What else can you do?</h2> <p>A stressed out and tired brain will be <a href="https://mentalhealth.org.nz/resources/resource/stress-and-how-to-manage-it">more likely</a> to overthink, leading to more stress and creating a cycle that can affect your wellbeing.</p> <p>So it’s important to manage your stress levels by eating and sleeping well, moving your body, doing things you enjoy, seeing people you care about, and doing things that fuel your soul and spirit.</p> <p>Distraction – with pleasurable activities and people who bring you joy – can also get your thoughts off repeat.</p> <p>If you do find overthinking is affecting your life, and your levels of anxiety are rising or your mood is dropping (your sleep, appetite and enjoyment of life and people is being negatively affected), it might be time to talk to someone and get some strategies to manage.</p> <p>When things become too difficult to manage yourself (or with the help of those close to you), a therapist can provide tools that have been proven to be helpful. Some helpful tools to manage worry and your thoughts can also be found <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Anxiety">here</a>.</p> <p>When you find yourself overthinking, think about why you are having “hot thoughts”, acknowledge your feelings and do some future-focused problem solving. But also accept life can be unpredictable and focus on having faith in your ability to cope. <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/223973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/kirsty-ross-1513078"><em>Kirsty Ross</em></a><em>, Associate Professor and Senior Clinical Psychologist, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-stop-overthinking-everything-a-clinical-psychologist-offers-solutions-223973">original article</a>.</em></p>

Mind

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Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one

<p><em><a href="https://theconversation.com/profiles/lisa-graham-wisener-1247893">Lisa Graham-Wisener</a>, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> and <a href="https://theconversation.com/profiles/audrey-roulston-1512057">Audrey Roulston</a>, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a></em></p> <p>For many people, grief starts not at the point of death, but from the moment a loved one is diagnosed with a life-limiting illness.</p> <p>Whether it’s the diagnosis of an advanced cancer or a non-malignant condition such as dementia, heart failure or Parkinson’s disease, the psychological and emotional process of grief can begin many months or even years before the person dies. This experience of mourning a future loss is known as <a href="https://link.springer.com/referenceworkentry/10.1007/978-3-319-69892-2_1006-1">anticipatory grief</a>.</p> <p>While not experienced by everyone, anticipatory grief is a <a href="https://spcare.bmj.com/content/bmjspcare/early/2022/02/10/bmjspcare-2021-003338.full.pdf?casa_token=IWNMDFN5SoIAAAAA:2EybwyPcKu73VdrACTNk7jITor-mMIXK8rv76arXgdjV9cA2Y0MV0LyZLLwcYe1rZUAQymOzFYo">common</a> part of the grieving process and can include a range of conflicting, often difficult thoughts and emotions. For example, as well as feelings of loss, some people can experience guilt from wanting their loved one to be free of pain, or imagining what life will be like after they die.</p> <h2>Difficult to define, distressing to experience</h2> <p>Anticipatory grief has proved <a href="https://journals.sagepub.com/doi/full/10.1177/02692163221074540#bibr13-02692163221074540">challenging to define</a>. A <a href="https://journals.sagepub.com/doi/full/10.1177/02692163221074540#bibr13-02692163221074540">systematic review</a> of research studies on anticipatory grief identified over 30 different descriptions of pre-death grief. This lack of consensus has limited research progress, because there’s no shared understanding of how to identify anticipatory grief.</p> <p>Therese Rando, a <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781315800806-9/grief-mourning-accommodating-loss-therese-rando">prominent theorist</a>, has proposed that anticipatory grief can help prepare for death, contributing to a more positive grieving experience post-bereavement. Rando also suggests that pre-death mourning can aid with adjustment to the loss of a loved one and reduce the risk of <a href="https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/">“complicated grief”</a>, a term that describes persistent and debilitating emotional distress.</p> <figure><iframe src="https://www.youtube.com/embed/AapGn60DZSA?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But pre-death mourning doesn’t necessarily mean grief will be easier to work through once a loved one has died. Other <a href="https://www.sciencedirect.com/science/article/pii/S0277953621005724?casa_token=I9mbdSv3d3gAAAAA:MqxN5X_iWbcqa6BYj7IXmImUviheOQWAVA4UBy6795UDuS1uOHG9b245qMkyOiLcvjv_SU6yVA">research evidence</a> shows that it’s possible to experience severe anticipatory grief yet remain unprepared for death.</p> <h2>Carers should seek support</h2> <p>Carers of people with life-limiting illnesses may notice distressing changes in the health of their loved ones. Witnessing close-up someone’s deterioration and decline in independence, memory or ability to perform routine daily tasks, such as personal care, is a painful experience.</p> <p>It is essential, then, for carers to acknowledge difficult emotions and seek support from those around them – especially because caring for a loved one at the end of their life <a href="https://www.mind.org.uk/information-support/helping-someone-else/carers-friends-family-coping-support/your-mental-health/">can be an isolating time</a>.</p> <p>Where possible, it can also be beneficial for carers to offer their loved one <a href="https://compassionatecommunitiesni.com/our-programs/dying-to-talk/">opportunities to reflect</a> on significant life events, attend to unfinished business, and to discuss preferences for funeral arrangements. For some, this may involve supporting loved ones to reconnect with friends and family, helping them to put legal or financial affairs in order, talking about how the illness is affecting them, or making an <a href="https://www.england.nhs.uk/publication/universal-principles-for-advance-care-planning/">advance care plan</a>.</p> <figure><iframe src="https://www.youtube.com/embed/wrJaTXW1Xvk?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Talking is key</h2> <p>Living with altered family dynamics, multiple losses, transition and uncertainty can be <a href="https://www.tandfonline.com/doi/full/10.1080/07481187.2021.1998935">distressing for all family members</a>. It may be difficult to manage the emotional strain of knowing death is unavoidable, to make sense of the situation, and to <a href="https://hospicefoundation.ie/i-need-help/i-am-seriously-ill/how-to-talk-to-those-you-care-about/">talk about dying</a>.</p> <p>However, talking is key in <a href="https://www.cruse.org.uk/about/blog/important-conversations-death/">preparing for an impending death</a>. Organisations who offer specialist palliative care have information and trained professionals to help with difficult conversations, including <a href="https://www.mariecurie.org.uk/help/support/diagnosed/talking-children/children">talking to children</a> about death and dying.</p> <p>Navigating anticipatory grief can involve self-compassion for both the patient and carer. This includes acknowledging difficult emotions and treating oneself with kindness. Open communication with the person nearing the end of their life can foster emotional connection and help address their concerns, alongside support from the wider circle of family and friends.</p> <p>Extending empathy and understanding to those nearing death – and those grieving their impending loss – will help contribute to a compassionate community that supports those experiencing death, dying and bereavement.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221629/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lisa-graham-wisener-1247893">Lisa Graham-Wisener</a>, Lecturer of Health Psychology, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> and <a href="https://theconversation.com/profiles/audrey-roulston-1512057">Audrey Roulston</a>, Professor of Social Work in Palliative Care, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-mourning-happens-after-bereavement-for-some-grief-can-start-years-before-the-death-of-a-loved-one-221629">original article</a>.</em></p>

Caring

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Why and how often do I need to wash makeup brushes and sponges?

<p><em><a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rosalie-hocking-1428271">Rosalie Hocking</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>From the bristles of brushes to the porous surfaces of sponges, your makeup kit can harbour a host of bacteria and fungi.</p> <p>These potentially hazardous contaminants can originate not only from the cosmetics themselves, but also from the very surface of our skin.</p> <p>So, how can we keep things hygienic and avoid microbial growth on makeup brushes and sponges? Here’s what you need to know.</p> <h2>How do germs and fungi get in my brushes and sponges?</h2> <p>Germs and fungi can make their way into your makeup kit in lots of ways.</p> <p>Ever flushed a toilet with the lid open with your makeup brushes nearby? There’s a good chance <a href="https://theconversation.com/mobile-phones-are-covered-in-germs-disinfecting-them-daily-could-help-stop-diseases-spreading-135318">faecal particles</a> have landed on them.</p> <p>Perhaps a family member or housemate has used your eyeshadow brush when you weren’t looking, and transferred some microbes across in the process.</p> <p>Bacteria that trigger a pimple outbreak can be easily transferred from the surface of your skin to a makeup brush or sponge.</p> <p>And tiny little mites called Demodex mites, which have been linked to certain rashes and acne, live on your skin, as well, and so may end up in your sponge or brushes.</p> <p>Bacterial contamination of <a href="https://pubmed.ncbi.nlm.nih.gov/38020232/">lip cosmetics</a>, in particular, can pose a risk of skin and eye infections (so keep that in mind if you use lip brushes). Lipsticks are frequently contaminated with bacteria such as <em>Staphylococcus aureus</em>, <em>E. coli</em>, and <em>Streptococcus pneumoniae</em>.</p> <p>Low-quality cosmetics are more likely to have higher and more diverse microbial growth compared to <a href="https://www.sciencedirect.com/science/article/pii/S1319562X23002978?pes=vor">high-quality cosmetics</a>.</p> <p>Brushes exposed to sensitive areas like the eyes, mouth and nose are particularly susceptible to being potential sources of infection.</p> <p>The range of conditions caused by these microorganisms includes:</p> <ul> <li> <p>abscesses</p> </li> <li> <p>skin and soft tissue infections</p> </li> <li> <p>skin lesions</p> </li> <li> <p>rashes</p> </li> <li> <p>and dermatitis.</p> </li> </ul> <p>In severe cases, infections can lead to invasion of the bloodstream or deep tissues.</p> <p>Commercially available cosmetics contain varying amounts and types of preservatives aimed at inhibiting the growth of fungi and bacteria.</p> <p>But when you apply makeup, different cosmetics with unique formulations of preservatives can become mixed. When a preservative meant for one product mixes with others, it might not work as well because they have different water amounts or pH levels.</p> <p>So preservatives are not foolproof. We also need to observe good hygiene practices when it comes to brushes and other cosmetics applicators.</p> <h2>Keeping brushes clean</h2> <p>Start with the basics: never <a href="https://www.semanticscholar.org/paper/Isolation-of-Pathogenic-Microbes-from-Beauty-Salons-Hassan-Hamad/0199635290628fe326fcd04a2b8a2422884a8240">share makeup brushes or sponges</a>. Everyone carries different microbes on their skin, so sharing brushes and sponges means you are also sharing germs and fungi.</p> <p>If you need to share makeup, use something disposable to apply it, or make sure any shared brushes are washed and sterilised before the next person uses it.</p> <p>Clean makeup brushes by washing with hot soapy water and rinsing thoroughly.</p> <p>How often? Stick to a cleaning routine you can repeat with consistency (as opposed to a deep clean that is done annually). <a href="https://www.aad.org/public/everyday-care/skin-care-secrets/routine/clean-your-makeup-brushes#:%7E:text=To%20protect%20your%20skin%20and,every%207%20to%2010%20days.">Once a week</a> might be a good goal for some, while others may need to wash more regularly if they are heavy users of makeup.</p> <p>Definitely wash straight away if someone else has used your brushes or sponges. And if you’ve had an eye infection such as conjunctivitis, ensure you clean applicators thoroughly after the infection has resolved.</p> <p>You can use bactericidal soap, 70% ethanol or chlorhexidine solutions to wash. Just make sure you wash very thoroughly with hot water after, as some of these things can irritate your skin. (While some people online say alcohol can degrade brushes and sponges, opinion seems to be mixed; in general, most disinfectants are unlikely to cause significant corrosion.)</p> <p>For some brushes, heating or steaming them and letting them dry may also be an effective sterilisation method once they are washed with detergent. Microwaving sponges isn’t a good idea because while the heat generated by a domestic microwave would kill microbes, it would need temperatures approaching 100°C for a decent period of time (at least several minutes). The heat could melt some parts of the sponge and hot materials could be a scalding hazard.</p> <p>Once clean, ensure brushes and sponges are stored in a dry place away from water sources (and not near an open toilet).</p> <p>If you’re having makeup applied professionally, brushes and applicators should be sterilised or changed from person to person.</p> <h2>Should I wash them with micellar water?</h2> <p>No.</p> <p>Not only is this expensive, it’s unnecessary. The same benefits can be achieved with cheaper detergents or alcohol (just rinse brushes carefully afterwards).</p> <p>Disinfection methods such as using bactericidal soap, 70% ethanol, or chlorhexidine are all very good at reducing the amount of microbes on your brushes and sponges.<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/220280/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/enzo-palombo-249510"><em>Enzo Palombo</em></a><em>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rosalie-hocking-1428271">Rosalie Hocking</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-and-how-often-do-i-need-to-wash-makeup-brushes-and-sponges-220280">original article</a>.</em></p>

Beauty & Style

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I want to eat healthily. So why do I crave sugar, salt and carbs?

<p><em><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>We all want to eat healthily, especially as we reset our health goals at the start of a new year. But sometimes these plans are sabotaged by powerful cravings for sweet, salty or carb-heavy foods.</p> <p>So why do you crave these foods when you’re trying to improve your diet or lose weight? And what can you do about it?</p> <p>There are many reasons for craving specific foods, but let’s focus on four common ones:</p> <h2>1. Blood sugar crashes</h2> <p>Sugar is a key energy source for all animals, and its taste is one of the most basic sensory experiences. Even without specific sweet taste receptors on the tongue, a strong preference for sugar can develop, indicating a mechanism beyond taste alone.</p> <p>Neurons <a href="https://www.nature.com/articles/s41593-021-00982-7">responding to sugar</a> are activated when sugar is delivered to the gut. This can increase appetite and make you want to consume more. Giving into cravings also drives an appetite for more sugar.</p> <p>In the long term, research suggests a high-sugar diet can affect <a href="https://www.bmj.com/content/369/bmj.m2382">mood</a>, digestion and <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a> in the <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">gut</a>.</p> <p>While there’s a lot of <a href="https://www.sciencedirect.com/science/article/pii/S0149763402000040?via%3Dihub#aep-section-id23">variation between individuals</a>, regularly eating sugary and high-carb foods can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">rapid spikes and crashes</a> in blood sugar levels. When your blood sugar drops, your body can respond by craving quick sources of energy, often in the form of sugar and carbs because these deliver the fastest, most easily accessible form of energy.</p> <h2>2. Drops in dopamine and serotonin</h2> <p>Certain neurotransmitters, such as <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a>, are involved in the reward and pleasure centres of the brain. Eating sugary and carb-rich foods can trigger the release of dopamine, creating a pleasurable experience and reinforcing the craving.</p> <p>Serotonin, the feel-good hormone, suppresses <a href="https://www.sciencedirect.com/science/article/pii/S1569733910700886">appetite</a>. Natural changes in serotonin can influence daily fluctuations in mood, energy levels and attention. It’s also associated with eating more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829131/">carb-rich snacks in the afternoon</a>.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21985780/">Low carb diets</a> may reduce serotonin and lower mood. However, a recent systematic review suggests little association between these diets and risk for <a href="https://www.sciencedirect.com/science/article/pii/S0165032722013933?via%3Dihub">anxiety and depression</a>.</p> <p>Compared to men, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189179/">women tend to crave more carb rich foods</a>. Feeling irritable, tired, depressed or experiencing carb cravings are part of premenstrual <a href="https://pubmed.ncbi.nlm.nih.gov/29218451/">symptoms</a> and could be <a href="https://www.ncbi.nlm.nih.gov/books/NBK560698/">linked to</a> reduced <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9928757/">serotonin levels</a>.</p> <h2>3. Loss of fluids and drops in blood sugar and salt</h2> <p>Sometimes our bodies crave the things they’re missing, such as hydration or even salt. A low-carb diet, for example, <a href="https://www.ncbi.nlm.nih.gov/books/NBK537084/">depletes</a> insulin levels, decreasing sodium and water retention.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S1933287419302673">Very low-carb diets</a>, like ketogenic diets, induce “ketosis”, a metabolic state where the body switches to using fat as its primary energy source, moving away from the usual dependence on carbohydrates.</p> <p>Ketosis is often associated with increased urine production, further contributing to potential fluid loss, electrolyte imbalances and salt cravings.</p> <h2>4. High levels of stress or emotional turmoil</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214609/">Stress</a>, boredom and emotional turmoil can lead to cravings for comfort foods. This is because stress-related hormones can impact our appetite, satiety (feeling full) and food preferences.</p> <p>The stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425607/">cortisol</a>, in particular, can drive cravings for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">sweet comfort foods</a>.</p> <p>A <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">2001 study</a> of 59 premenopausal women subjected to stress revealed that the stress led to higher calorie consumption.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/37295418/">A more recent study</a> found chronic stress, when paired with high-calorie diet, increases food intake and a preference for sweet foods. This shows the importance of a healthy diet during stress to prevent weight gain.</p> <h2>What can you do about cravings?</h2> <p>Here are four tips to curb cravings:</p> <p><strong>1) don’t cut out whole food groups.</strong> Aim for a well-balanced diet and make sure you include:</p> <ul> <li> <p><em>sufficient protein</em> in your meals to help you feel full and reduce the urge to snack on sugary and carb-rich foods. Older adults should aim for 20–40g protein per meal with a particular focus on <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.12838">breakfast and lunch</a> and an overall daily protein intake of at least <a href="https://apps.who.int/iris/handle/10665/43411">0.8g</a> per kg of body weight for <a href="https://pubmed.ncbi.nlm.nih.gov/35187864/">muscle health</a></p> </li> <li> <p><em>fibre-rich foods</em>, such as vegetables and whole grains. These make you feel full and <a href="https://pubmed.ncbi.nlm.nih.gov/32142510/">stabilise your blood sugar</a> levels. Examples include broccoli, quinoa, brown rice, oats, beans, lentils and bran cereals. Substitute refined carbs high in sugar like processed snack bars, soft drink or baked goods for more complex ones like whole grain bread or wholewheat muffins, or nut and seed bars or energy bites made with chia seeds and oats</p> </li> </ul> <p><strong>2) manage your stress levels.</strong> Practise stress-reduction techniques like meditation, deep breathing, or yoga to manage emotional triggers for cravings. Practising <a href="https://pubmed.ncbi.nlm.nih.gov/30570305/">mindful eating</a>, by eating slowly and tuning into bodily sensations, can also reduce daily calorie intake and curb cravings and stress-driven eating</p> <p><strong>3) get enough sleep.</strong> Aim for <a href="https://pubmed.ncbi.nlm.nih.gov/33054337/">seven to eight</a> hours of quality sleep per night, with a minimum of seven hours. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031614/">Lack of sleep</a> can disrupt hormones that regulate hunger and cravings</p> <p><strong>4) control your portions.</strong> If you decide to indulge in a treat, control your portion size to avoid overindulging.</p> <p>Overcoming cravings for sugar, salt and carbs when trying to eat healthily or lose weight is undoubtedly a formidable challenge. Remember, it’s a journey, and setbacks may occur. Be patient with yourself – your success is not defined by occasional cravings but by your ability to manage and overcome them.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-want-to-eat-healthily-so-why-do-i-crave-sugar-salt-and-carbs-212114">original article</a>.</em></p>

Food & Wine

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"I almost cried": Mum shocked by stranger's random act of kindness

<p>A mother-of-two has almost been reduced to tears by a stranger's random act of kindness in a busy cafe. </p> <p>The mum, a woman named Tyne, was at a cafe in the Sunshine Coast suburb of Mooloolaba with her husband and two young sons, when she struck up a conversation with a woman reading a book nearby. </p> <p>She said she felt a wave of guilt that her rowdy children were disrupting the woman's peaceful morning, and leaned over to apologise. </p> <p>The woman assured the mother there was nothing to apologise for, with the woman's next act leaving the mum speechless. </p> <p>“A beautiful (and full on) weekend away with Mr 3.5y &amp; Mr 1.5y my husband and I sat with coffees at a beautiful cafe waiting for breakfast for us,” Tyne wrote in a Facebook group called The Kindness Pandemic, where people share stories of their heartwarming interactions with strangers. </p> <p>“I immediately apologised to the lovely lady sitting near us as she had a book and I was afraid the boys wouldn’t be too peaceful." </p> <p>“We were chatting for a little and then she left after her breakfast.”</p> <p>When the mum went to pay for her family’s bill, the cashier informed her that the stranger had “taken care of it” and handed her a heartwarming note.</p> <p>“It was such a pleasure sharing my brekkie space with you,” the note read.</p> <p>“Please keep doing what you’re doing. You’ve got a beautiful family.”</p> <p>Tyne said she “almost cried” when she realised that the stranger had paid for her family’s entire breakfast.</p> <p>The cafe was situated close to one of the Sunshine Coast’s most popular attractions, Sea Life Aquarium, where the family had planned to spend their day.</p> <p>“Hopefully you can splurge a little more at Sea Life today,” the stranger added in the note, before signing off, “Love Em.”</p> <p>The mum said she was overwhelmed by the stranger’s incredible act of kindness, saying she "almost cried".</p> <p>“She paid for us … And her kind words were what I needed to hear.”</p> <p>Tyne said the stranger was an “amazing soul” and vowed to pay it forward”.</p> <p>“If you are Em staying in Mooloolaba for work and went to a quirky local that’s your favourite … YOU ARE AN AMAZING SOUL!” she said.</p> <p>People in the comments also shared their reactions to the heartfelt gesture.</p> <p>“Lovely lady. Your children would be being just that, children. Don’t apologise about them,” one wrote.</p> <p>“What a beautiful person Em clearly is. This was so gorgeous to read.”</p> <p><em>Image credits: Facebook</em></p>

Family & Pets

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

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

Body