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Property tycoon sentenced to death over $27 billion fraud

A Vietnamese billionaire was sentenced to death on Thursday in one of the biggest corruption cases in history, an estimated $27 billion in damages - a figure equivalent to six percent of the country’s 2023 GDP. Truong My Lan, chair of major developer Van Thinh Phat, was found guilty of embezzlement, after looting from one of the country's biggest banks, Saigon Commercial Bank (SCB) for over a decade. “The defendant’s actions... eroded people’s trust in the leadership of the (Communist) Party and state,” the verdict read at the trial in Ho Chi Minh City. After a five-week trial, 85 others were also charged for their involvement in the fraud, with charges ranging from from bribery and abuse of power to appropriation and violations of banking law. Four were given life imprisonment, while others received jail terms ranging between 20 years and three years suspended. Lan's husband was Hong Kong billionaire Eric Chu Nap Kee, was sentenced to nine years in prison. Lan and the others were arrested as part of a national corruption crackdown. Lan was initially believed to have embezzled $12.5 billion, but on Thursday prosecutors have said that the total damages caused by the fraud now amounted to $27 billion. The property tycoon was convicted of taking out $44bn in loans from the bank, according to the BBC, with prosecutors saying that $27 billion of this may never be recovered. The court ordered Lan to to pay almost the entire damages sum in compensation. It is also <a href="https://www.bbc.com/news/world-asia-68778636" target="_blank" rel="noopener">reported</a> that she is one of very few women in Vietnam to be sentenced to death for a white collar crime. “In my desperation, I thought of death,” Lan said in her final remarks to the court, according to state media. “I am so angry that I was stupid enough to get involved in this very fierce business environment -- the banking sector -- which I have little knowledge of.” Police have identified around 42,000 victims of the scam, and many of them were unhappy with the verdict. One 67-year-old Hanoi resident told the AFP that she had hoped Lan would receive a life sentence so she could fully witness the devastating impact of her actions. “Many people worked hard to deposit money into the bank, but now she’s received the death sentence and that’s it for her,” they said. “She can’t see the suffering of the people.” The resident has so far been unable to retrieve the $120,000 she invested with SCB. Police have said that many of the victims are SCB bondholders, who cannot withdraw their money and have not received interest or principal payments since Lan’s arrest. Authorities have also reportedly seized over 1000 properties belonging to Lan. Image: Twitter

Legal

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

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

Body

Could my glasses be making my eyesight worse?

<a href="https://theconversation.com/profiles/james-armitage-399647">James Armitage</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/nick-hockley-1517162">Nick Hockley</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> So, you got your eyesight tested and found out you need your first pair of glasses. Or you found out you need a stronger pair than the ones you have. You put them on and everything looks crystal clear. But after a few weeks things look blurrier without them than they did before your eye test. What’s going on? Some people start to wear spectacles for the first time and perceive their vision is “bad” when they take their glasses off. They incorrectly interpret this as the glasses making their vision worse. Fear of this might make them <a href="https://www.bbc.com/future/article/20140513-do-glasses-weaken-your-eyesight#:%7E:text=A%20study%20from,they%20are%20right%3F">less likely to wear their glasses</a>. But what they are noticing is how much better the world appears through the glasses. They become <a href="https://www.tandfonline.com/doi/full/10.1080/2576117X.2022.2033588">less tolerant</a> of a blurry world when they remove them. Here are some other things you might notice about eyesight and wearing glasses. <h2>Lazy eyes?</h2> Some people sense an increasing reliance on glasses and wonder if their eyes have become “lazy”. Our eyes work in much the same way as an auto-focus camera. A flexible lens inside each eye is controlled by muscles that let us <a href="https://www.aao.org/museum-eye-openers/how-does-eye-focus">focus on objects</a> in the distance (such as a footy scoreboard) by relaxing the muscle to flatten the lens. When the muscle contracts it makes the lens steeper and more powerful to see things that are much closer to us (such as a text message). From the age of about 40, the lens in our eye <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">progressively hardens</a> and loses its ability to change shape. Gradually, we lose our capacity to focus on near objects. This is called “<a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/presbyopia">presbyopia</a>” and at the moment there are no treatments for this lens hardening. Optometrists correct this with prescription glasses that take the load of your natural lens. The lenses allow you to see those up-close images clearly by providing extra refractive power. Once we are used to seeing clearly, our tolerance for blurry vision will be lower and we will reach for the glasses to see well again. <h2>The wrong glasses?</h2> Wearing old glasses, the wrong prescription (or even someone else’s glasses) won’t allow you to see as well as possible for day-to-day tasks. It could also cause <a href="https://headaches.org/readers-mail-glasses-causing-headache/">eyestrain and headaches</a>. Incorrectly prescribed or dispensed prescription glasses can lead to vision impairment in children <a href="https://iovs.arvojournals.org/article.aspx?articleid=2126392">as their visual system is still in development</a>. But it is more common for kids to develop long-term vision problems as a result of <a href="https://www.cera.org.au/wp-content/uploads/2021/08/Healthy-Young-Eyes-Guide-ACC.pdf">not wearing glasses when they need them</a>. By the time children are about 10–12 years of age, wearing incorrect spectacles is less likely to cause their eyes to become lazy or damage vision in the long term, but it is likely to result in <a href="https://www.cera.org.au/wp-content/uploads/2021/08/Healthy-Young-Eyes-Guide-ACC.pdf">blurry or uncomfortable vision</a> during daily wear. <a href="https://goodvisionforlife.com.au/">Registered optometrists in Australia</a> are trained to assess refractive error (whether the eye focuses light into the retina) as well as the different aspects of ocular function (including how the eyes work together, change focus, move around to see objects). All of these help us see clearly and comfortably. <h2>What about dirty glasses?</h2> Dirty or scratched glasses can give you the impression your vision is worse than it actually is. Just like a window, the dirtier your glasses are, the more difficult it is to see clearly through them. <a href="https://www.optometry.org.au/wp-content/uploads/GVFL/Brochure_PDFs/Care-for-Glasses-2018-A4-single-page-final.pdf">Cleaning glasses regularly</a> with a microfibre lens cloth will help. While dirty glasses are not commonly associated with eye infections, some research suggests dirty glasses can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207238">harbour bacteria</a> with the remote but theoretical <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628431/#:%7E:text=59%2C60%5D.-,S.,39%2C40%2C41%5D.">potential to cause eye infection</a>. To ensure best possible vision, people who wear prescription glasses every day should clean their lenses at least every morning and twice a day where required. Cleaning frames with alcohol wipes can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207238">reduce bacterial contamination by 96%</a> – but care should be taken as alcohol can damage some frames, depending on what they are made of. <h2>When should I get my eyes checked?</h2> <a href="https://goodvisionforlife.com.au/faqs/">Regular eye exams</a>, starting just before school age, are important for ocular health. Most prescriptions for corrective glasses <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD16%2F20156&dbid=AP&chksum=676U2aH1QM4XJ6ICVAVaKg%3D%3D">expire within two years</a> and contact lens prescriptions often expire after a year. So you’ll need an eye check for a new pair every year or so. Kids with ocular conditions such as progressive myopia (short-sightedness), strabismus (poor eye alignment), or amblyopia (reduced vision in one eye) will need checks at least every year, but likely more often. Likewise, people over 65 or who have known eye conditions, such as <a href="https://goodvisionforlife.com.au/vision-problems/glaucoma/">glaucoma</a>, will be recommended more frequent checks. An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706420/">online prescription estimator</a> is no substitute for a full eye examination. If you have a valid prescription then you can order glasses online, but you miss out on the ability to check the fit of the frame or to have them adjusted properly. This is particularly important for multifocal lenses where even a millimetre or two of misalignment can cause uncomfortable or blurry vision. Conditions such as <a href="https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html#:%7E:text=Diabetic%20retinopathy%20is%20caused%20when,vision%20or%20stopping%20blood%20flow.">diabetes</a> or <a href="https://www.ncbi.nlm.nih.gov/books/NBK525980/">high blood pressure</a>, can affect the eyes so regular eye checks can also help flag broader health issues. The vast majority of eye conditions can be treated if caught early, highlighting the importance of regular preventative care.<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/225169/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/james-armitage-399647">James Armitage</a>, Associate Professor in Vision Science, Optometry Course Director, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/nick-hockley-1517162">Nick Hockley</a>, Lecturer in Optometric Clinical Skills, Director Deakin Collaborative Eye Care Clinic, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-my-glasses-be-making-my-eyesight-worse-225169">original article</a>.

Body

“My sister-in-law announced she was pregnant at my child’s funeral”

A woman has asked for advice on how to navigate her relationship with her sister-in-law, after the woman overheard an inappropriate conversation at her child’s funeral. The grieving mother, a 28-year-old named Melissa, took to Reddit to share the heartbreaking story of how her toddler passed away after a battle with cancer. Melissa described the time as the “hardest in my life”, explaining how she felt she lost “a part of herself” after the funeral. While Melissa expected her toddlers’ memorial service to be difficult, she never predicted a family member would make it even harder. The mother said that when she heard her sister-in-law telling people about her pregnancy, she thought the move was just cruel. “She didn't make a big announcement but more than ten people at the service 'heard' and it's what everyone was talking about. To understate it, I was livid,” Melissa wrote on Reddit. Melissa’s post then asked social media users for advice, as she was unsure how much of a relationship she wanted to have with her sister-in-law after the stunt. The 28-year-old shared that she had fallen pregnant herself, and was facing pressure to have a party in celebration, but she didn’t want her whole family in attendance. “I've been working on who I want to invite, and I really don't want my SIL there,” she said. “Besides what she did, she's a vindictive and mean person and I cannot stand her.” “I mentioned it to my husband and he says he couldn't care less whether she's there or not. But for the sake of saving face, I want opinions before I do this.” She asked the online forum if she would be “an a**hole” for not inviting her, addin that she would still be inviting her husband's other sister and husband's brother's wife. “The original SIL will be the only one not invited,” she clarified. The post was flooded with comments as many backed up Melissa, slamming the sister-in-law for her selfish behaviour. “I wouldn't want someone like that around me. Announcing a pregnancy at a child's funeral is insane,” one said. “Cut her off and ignore everyone close to her. You are right to have nothing to do with her. She's totally classless.” However, others encouraged her to have an adult conversation with her sister-in-law in an attempt to mend their relationship. “Please let it go,” one person began. “This happened on a terrible day during a bad time for you. It's possible that could be clouding how you're looking at this, she may not have been malicious at all.” Image credits: Shutterstock

Family & Pets

How do I handle it if my parent is refusing aged care? 4 things to consider

<a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s a shock when we realise our parents aren’t managing well at home. Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed. You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what? Here are four things to consider. <h2>1. Start with more help at home</h2> Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move. Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both. Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety. Call <a href="https://www.myagedcare.gov.au/">My Aged Care</a> to discuss your options. <h2>2. Be prepared for multiple conversations</h2> Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made. Ideally, the older person feels supported rather than attacked during these conversations. Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice. Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”. <h2>3. Understand the options when help at home isn’t enough</h2> If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be <a href="https://academic.oup.com/gerontologist/article/60/8/1504/5863160">considering a nursing home</a> (also known as residential aged care in Australia). Every person has a legal right to <a href="https://humanrights.gov.au/our-work/9-your-right-choose-where-you-live">choose where we live</a> (unless they have lost capacity to make that decision). This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”. It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational). Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else? Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space. Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826495/">Research</a> suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control. Mum and Dad should be involved in the decision-making process about where they live, and when they might move. Some families start looking “just in case” as it often takes some time to <a href="https://www.abc.net.au/everyday/questions-to-ask-when-choosing-an-aged-care-home-for-a-loved-one/10302590">find the right nursing home</a> and there can be a wait. After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule. We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions. For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”. Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead. <h2>4. Understand the options if a parent has lost capacity to make decisions</h2> If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests. If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity. Mum or Dad may have appointed an <a href="https://www.tag.nsw.gov.au/wills/appoint-enduring-guardian/what-enduring-guardian">enduring guardian</a> to make decisions about their health and lifestyle decisions when they are not able to. An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves. If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can <a href="https://www.tag.nsw.gov.au/guardianship/information-about-guardianship">appoint</a> that person a private guardian (usually a family member, close friend or unpaid carer). If no such person is available to act as private guardian, a public official may be appointed as public guardian. <h2>Deal with your own feelings</h2> Families often feel <a href="https://link.springer.com/article/10.1007/s12144-023-04538-9">guilt and grief</a> during the decision-making and transition process. Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.<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/221210/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-i-handle-it-if-my-parent-is-refusing-aged-care-4-things-to-consider-221210">original article</a>.

All My Children star dies at age 50

Soap opera actor and fitness model Alec Musser has died at the age of 50. The All My Children star tragically died at his home in California on Friday evening, with his fiancé Paige Press confirming the news to <a href="https://www.tmz.com/2024/01/13/alec-musser-model-actor-all-my-children-dead-dies/" target="_blank" rel="noopener">TMZ</a>. “RIP to the love of my life,” Press wrote on Instagram. “I will never stop loving you. My heart is broken.” “Today is the worst day of my life. We were so happy … You were the best fiancé I could of ever asked for.” In another heartbreaking post to her Instagram stories, Press shared a photo of herself wearing her engagement ring and vowed: “I am never taking off my ring.” Other family members further confirmed the news of Musser's passing to TMZ, with his cause of death not yet revealed. Alec Musser starred in All My Children from 2005 to 2007, appearing in a total of 43 episodes. He landed the role on the long-running soap after he won the second season of the SOAPnet original series I Wanna Be a Soap Star. After his stint on the show, he went on to feature in other TV series including Grown Ups, Rita Rocks, Desperate Housewives and Road to the Altar. The New York native was also a fitness model and bodybuilder who appeared on the cover of several magazines like Men’s Health, Men’s Workout, Exercise Health and more. After hearing the news of his death, many of Musser’s fans took to the comment section of his last post and shared their condolences. “I’m in shock brother. You were a dear friend and will always be remembered," one fan wrote. Celebrity friend Adam Sandler also shared a tribute to Musser, writing on Instagram, "I loved this guy. Cannot believe he is gone. Such a wonderful, funny good man. Thinking of Alec Musser and his family and sending all my love. A true great sweetheart of a person." Image credits: Getty Images

Caring

Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid

<a href="https://theconversation.com/profiles/robert-andrew-robergs-435390">Robert Andrew Robergs</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/samuel-l-torrens-1476404">Samuel L. Torrens</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness. This is especially true if it has been a while between workouts. A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles. Research, however, shows lactic acid has <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">nothing to do with it</a>. The truth is far more interesting, but also a bit more complex. <h2>It’s not lactic acid</h2> We’ve known for decades that lactic acid has <a href="https://pubmed.ncbi.nlm.nih.gov/27409551/">nothing to do with</a> muscle soreness after exercise. In fact, as one of us (Robert Andrew Robergs) has long <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004">argued</a>, cells produce lactate, not lactic acid. This process actually <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">opposes</a> not causes the build-up of acid in the muscles and bloodstream. Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise. Lactate <a href="https://www.science.org/doi/10.1126/science.1101141">doesn’t cause major problems</a> for the muscles you use when you exercise. You’d probably be <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&">worse off</a> without it due to other benefits to your working muscles. Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break. So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness? <h2>Muscle pain during and after exercise</h2> When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells. That causes the pressure inside and between muscle cells to increase. This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause <a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">discomfort</a> during exercise. The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes. If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons. Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings. This is sometimes known as “<a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">delayed onset muscle soreness</a>” or DOMS. While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement. <h2>The upshot</h2> Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with <a href="https://scholar.google.com/citations?user=UVjRNSUAAAAJ&view_op=view_citation&citation_for_view=UVjRNSUAAAAJ:J_g5lzvAfSwC">lactate</a> or <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">lactic acid</a>. The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness. So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort. If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months. Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit. Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.<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/214638/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/robert-andrew-robergs-435390">Robert Andrew Robergs</a>, Associate Professor - Exercise Physiology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/samuel-l-torrens-1476404">Samuel L. Torrens</a>, PhD Candidate, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-my-muscles-sore-after-exercise-hint-its-nothing-to-do-with-lactic-acid-214638">original article</a>.

Body

"You've restored my faith": Community shows up for lonely birthday boy

One dad's desperate plea has "restored" his faith after his local community showed up for his son's third birthday party. Pre-schooler William Buck and his dad Steven sat patiently on a beach in Wellington, waiting for his friends to arrive and begin the celebrations for his third birthday party. As time passed, William and his dad grew more hopeless, and they worried about the fate of the celebrations. "He kept asking where everyone was, and we were like 'they’re coming soon'," Steven Buck told <a href="https://www.stuff.co.nz/life-style/wellbeing/parenting/133203054/familys-plea-after-nobody-shows-at-3yearolds-birthday-brings-community-to-beach" target="_blank" rel="nofollow noopener" data-i13n="cpos:2;pos:1" data-ylk="slk:Stuff;cpos:2;pos:1;elm:context_link;itc:0" data-rapid_p="9" data-v9y="1">Stuff</a>. Steven felt "guilty" that none of his son's mates had come to the party, especially given how excited his son had been for this birthday, as he had been talking about the celebration for weeks. In a last ditch effort to make William's day special, Steven turned to social media for help. Steven posted an image of the pair online and invited any locals wanting "some sun and sand" to join them. "William would love some friends to play with. He has Hot Wheels, sand toys, dinos, and we have some snacks and drinks. Any and all welcome," he wrote. Amazingly, locals responded in their thousands, wishing William a 'Happy Birthday' while many others joined the three-year-old and his parents. "Going there. See you soon," one local wrote, before arriving with her family. The partygoers arrived with bubbles and inflatables, parking themselves down on beach chairs ready to celebrate the sunny day with William. "Thank you so much everyone for the birthday wishes and support," Steven wrote online after the day. "Wellington you always restore my faith in humanity!" Image credits: Facebook

Family & Pets

Can I actually target areas to lose fat, like my belly?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Spend some time scrolling social media and you’re all-but-guaranteed to see an ad promising to help you with targeted fat loss. These ads promote a concept known as “spot reduction”, claiming you can burn fat in a specific body area, usually the belly, with specially designed exercises or workouts. It’s also common to see ads touting special diets, pills and supplements that will blast fat in targeted areas. These ads – which often feature impressive before and after photos taken weeks apart – can seem believable. Unfortunately, spot reduction is another weight-loss myth. It’s simply not possible to target the location of fat loss. Here’s why. <h2>1. Our bodies are hardwired to access and burn all our fat stores for energy</h2> To understand why spot reduction is a myth, it’s important to understand how body fat is stored and used. The fat stored in our bodies takes the form of triglycerides, which are a type of lipid or fat molecule we can use for energy. Around 95% of the dietary fats <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">we consume are triglycerides</a>, and when we eat, our bodies also convert any unused energy consumed into triglycerides. Triglycerides are stored in special fat cells called adipocytes, and they’re released into our bloodstream and transported to adipose tissue – tissue we more commonly refer to as body fat. This body fat is found all over our bodies, but it’s primarily stored as subcutaneous fat under our skin and as visceral fat around our internal organs. These fat stores serve as a vital energy reserve, with our bodies mobilising to access stored triglycerides to provide energy during periods of prolonged exercise. We also draw on these reserves when we’re dieting and fasting. However, contrary to what many spot-reduction ads would have us think, our muscles can’t directly access and burn specific fat stores when we exercise. Instead, they use a process called lipolysis to convert triglycerides into free fatty acids and a compound called glycerol, which then travels to our muscles via our bloodstream. As a result, the fat stores we’re using for energy when we exercise come from everywhere in our bodies – not just the areas we’re targeting for fat loss. Research reinforces how our bodies burn fat when we exercise, confirming spot reduction is a weight-loss myth. This includes a randomised <a href="https://pubmed.ncbi.nlm.nih.gov/25766455/">12-week clinical trial</a> which found no greater improvement in reducing belly fat between people who undertook an abdominal resistance program in addition to changes in diet compared to those in the diet-only group. Further, <a href="https://www.termedia.pl/A-proposed-model-to-test-the-hypothesis-of-exerciseinduced-localized-fat-reduction-spot-reduction-including-a-systematic-review-with-meta-analysis,129,45538,0,1.html">a 2021 meta-analysis</a> of 13 studies involving more than 1,100 participants found that localised muscle training had no effect on localised fat deposits. That is, exercising a specific part of the body did not reduce fat in that part of the body. <a href="https://www.mdpi.com/1660-4601/18/7/3845">Studies</a> purporting to show spot-reduction benefits have small numbers of participants with results that aren’t clinically meaningful. <h2>2. Our bodies decide where we store fat and where we lose it from first</h2> Factors outside of our control influence the areas and order in which our bodies store and lose fat, namely: <ul> <li> our genes. Just as DNA prescribes whether we’re short or tall, genetics plays a significant role in how our fat stores are managed. Research shows our genes can account for <a href="https://pubmed.ncbi.nlm.nih.gov/24632736/">60% of where fat is distributed</a>. So, if your mum tends to store and lose weight from her face first, there’s a good chance you will, too </li> <li> our gender. Our bodies, by nature, have distinct fat storage characteristics <a href="https://pubmed.ncbi.nlm.nih.gov/11706283/">driven by our gender</a>, including females having more fat mass than males. This is primarily because the female body is designed to hold fat reserves to support pregnancy and nursing, with women tending to lose weight from their face, calves and arms first because they impact childbearing the least, while holding onto fat stored around the hips, thighs and buttocks </li> <li> our age. The ageing process triggers changes in muscle mass, metabolism, and hormone levels, which can impact where and how quickly fat is lost. Post-menopausal <a href="https://theconversation.com/is-menopause-making-me-put-on-weight-no-but-its-complicated-198308">women</a> and middle-aged <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/sex-differences-in-fat-storage-fat-metabolism-and-the-health-risks-from-obesity-possible-evolutionary-origins/00950AD6710FB3D0414B13EAA67D4327">men</a> tend to store visceral fat around the midsection and find it a stubborn place to shift fat from. </li> </ul> <h2>3. Over-the-counter pills and supplements cannot effectively target fat loss</h2> Most advertising for these pills and dietary supplements – including products claiming to be “the best way to lose belly fat” – will also proudly claim their product’s results are backed by “clinical trials” and “scientific evidence”. But the reality is a host of independent studies don’t support these claims. This includes two recent studies by the University of Sydney that examined data from more than 120 placebo-controlled trials of <a href="https://pubmed.ncbi.nlm.nih.gov/31984610/">herbal</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33976376/">dietary</a> supplements. None of the supplements examined provided a clinically meaningful reduction in body weight among overweight or obese people. <h2>The bottom line</h2> Spot reduction is a myth – we can’t control where our bodies lose fat. But we can achieve the results we’re seeking in specific areas by targeting overall fat loss. While you may not lose the weight in a specific spot when exercising, all physical activity helps to burn body fat and preserve muscle mass. This will lead to a change in your body shape over time and it will also help you with long-term weight management. This is because your metabolic rate – how much energy you burn at rest – is determined by how much muscle and fat you carry. As muscle is more metabolically active than fat (meaning it burns more energy than fat), a person with a higher muscle mass will have a faster metabolic rate than someone of the same body weight with a higher fat mass. Successfully losing fat long term comes down to losing weight in small, manageable chunks you can sustain – periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight. It also requires gradual changes to your lifestyle (diet, exercise and sleep) to ensure you form habits that last a lifetime. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<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/205203/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-i-actually-target-areas-to-lose-fat-like-my-belly-205203">original article</a>.

Body

How should I add sunscreen to my skincare routine now it’s getting hotter?

<a href="https://theconversation.com/profiles/monika-janda-167949">Monika Janda</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/caitlin-horsham-1405367">Caitlin Horsham</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <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> Sun exposure is the number one cause of skin cancer – including the most deadly form, melanoma. High levels of sun exposure cause <a href="https://europepmc.org/article/MED/26437734#id580549">an estimated 7,200 melanomas in Australia each year</a>. Too much sun exposure can also lead to premature ageing, resulting in wrinkles, fine lines and age spots. Can a tweak to your skincare routine help prevent this? <h2>When should I start wearing sunscreen?</h2> In Australia, we are advised to <a href="https://pubmed.ncbi.nlm.nih.gov/30681231/">wear sunscreen</a> on days when the ultraviolet (UV) index reaches three or higher. That’s year-round for much of Australia. The weather forecast or the Cancer Council’s free <a href="https://www.sunsmart.com.au/resources/sunsmart-app">SunSmart app</a> are easy ways to check the UV Index. Besides “primary sunscreens”, which are dedicated sun-protection products, a sun protection factor (SPF) is also found in many beauty products, such as foundations, powders and moisturisers. These are called “secondary sunscreens” because they have a primary purpose other than sun protection. Primary sunscreens are regulated by the <a href="https://www.tga.gov.au/news/news/about-sunscreens#_Sun_protection_factor">Therapeutic Goods Administration</a> and the SPF must be determined by testing on human skin. SPF measures how quickly skin burns with and without the sunscreen under intense UV light. If the skin takes ten seconds to burn with no sunscreen, and 300 seconds to burn with the sunscreen, the SPF is 30 (300 divided by 10). <h2>Is the SPF in makeup or moisturisers enough to protect me the whole day?</h2> Simple answer? No. SPF 30 mixed into foundation is not going to be as effective as a primary SPF 30 sunscreen. Also, when people use a moisturiser or makeup that includes SPF, they generally don’t do the three key steps that make sunscreens effective: <ol> <li>putting a thick enough amount on</li> <li>covering all sun exposed areas</li> <li>reapplying regularly when outdoors for a sustained amount of time.</li> </ol> One <a href="https://pubmed.ncbi.nlm.nih.gov/37632801/">study</a> had 39 participants apply their usual SPF makeup/moisturisers and photographed them with UV photography in the morning, then again in the afternoon, without reapplying during the day. The UV photography allowed the researchers to visualise how much protection these products were still providing. They found participants missed some facial areas with the initial application and the SPF products provided less coverage by the afternoon. Another consideration is the product type. Liquid foundation may be applied more thickly than powder makeup, which is generally lightly applied. The <a href="https://www.tga.gov.au/products/medicines/sunscreens">Therapeutic Goods Administration</a> tests primary sunscreens so they’re effective when applied at 2mg per 2 square centimetres of skin. For the face, ears and neck, this is about one teaspoon (5mL) – are you applying that much powder? It’s unlikely people will cake on their moisturiser thickly and reapply during the day, so these products aren’t effective sun protection if outdoors for a sustained amount of time when used alone. <h2>If skin products with SPF aren’t giving me better protection, should I stop using them?</h2> These products can still serve a protective purpose, as <a href="https://onlinelibrary.wiley.com/doi/10.1111/srt.13010">some research</a> suggests layering sunscreen and makeup products may help to cover areas that were missed during a single application. When layering, SPF factors are not additive. If wearing an SPF 30 sunscreen and makeup with SPF 15, that doesn’t equal SPF 45. You will be getting the protection from the highest product (in this scenario, it’s the SPF 30). A good metaphor is SPF in makeup is like “icing on the cake”. Use it as an add-on and if areas were missed with the initial sunscreen application, then there is another chance to cover all areas with the SPF makeup. <h2>Should I apply sunscreen before or after makeup?</h2> It depends on whether you’re using a chemical or physical sunscreen. Chemical sunscreens need to absorb into the skin to block and absorb the sun’s rays, whereas physical sunscreens sit on the surface of the skin and act as a shield. When the main ingredient is zinc oxide or titanium dioxide, it’s a physical sunscreen – think the classic zinc sticks you used to apply to your nose and lips at the beach. Physical sunscreens are recommended for people with sensitive skin and although they used to be pretty thick and sticky, newer versions feel more like chemical sunscreens. For maximum sun protection when using chemical sunscreens, apply sunscreen first, followed by moisturiser, then makeup. Give the sunscreen a few minutes to dry and sink into the skin before starting to put on other products. Chemical sunscreen should be applied 20 minutes before going outdoors. When using a physical sunscreen, first apply moisturisers, followed by sunscreen, and then makeup. When reapplying sunscreen, it’s recommended to wash off makeup and start fresh, but this isn’t going to be practical for many people, so gently patting sunscreen over makeup is another option. Physical sunscreens will be most effective for reapplication over makeup. <h2>What type of sunscreen should I use?</h2> The best sunscreen is the one you actually like to apply. Protecting your skin on a daily basis (and not just for trips to the beach!) is a must in Australia’s high UV climate, and should be done with a primary sunscreen. Look for sunscreens that have the label “broad spectrum”, which means it covers for UVA and UVB, and has at least SPF30. Then experiment with features like matte finish, milk texture or fragrance-free to find a sunscreen you like. No sunscreen provides 100% protection so you should also use other sun protection such as protective clothing, hats, sunglasses, using shade and avoiding the sun during peak UV hours. Skin care and makeup products with SPF is better than nothing, but don’t rely solely on your morning makeup for sun protection the entire day.<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/213453/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/monika-janda-167949">Monika Janda</a>, Professor in Behavioural Science, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/caitlin-horsham-1405367">Caitlin Horsham</a>, Research Manager, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, PhD Candidate, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-should-i-add-sunscreen-to-my-skincare-routine-now-its-getting-hotter-213453">original article</a>.

Beauty & Style

Should I be getting my vitamin D levels checked?

<a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Australia has seen a <a href="https://insightplus.mja.com.au/2023/29/gps-urged-not-to-routinely-test-children-for-vitamin-d/">surge in vitamin D testing</a> of children, with similar trends reported for adults around the <a href="https://pubmed.ncbi.nlm.nih.gov/29659534/">world</a>. GPs are now <a href="https://insightplus.mja.com.au/2023/29/gps-urged-not-to-routinely-test-children-for-vitamin-d/">being urged</a> not to test for vitamin D unnecessarily. So when is low vitamin D a potential concern? And when might you need to get your levels tested? <h2>How much vitamin D do we need?</h2> Vitamin D is not only a nutrient – when metabolised in the body it acts as a <a href="https://pubmed.ncbi.nlm.nih.gov/29080638/">hormone</a>. We have receptors for this hormone all around our body and it helps regulate the metabolism of calcium and phosphorus. Vitamin D also has many other roles, including helping our immune defences and contributing to <a href="https://pubmed.ncbi.nlm.nih.gov/11295155/">DNA repair</a> and cell differentiation. We can thank the sun for most of our vitamin D. A chemical in our skin called 7-dehydrocholesterol is converted to vitamin D after contact with UVB radiation from the sun. While we get some vitamin D also <a href="https://pubmed.ncbi.nlm.nih.gov/35253289/">through our diet</a>, this makes a relatively small contribution. It’s difficult to get much more than one-third of our daily vitamin D requirement from diet without supplementation. Nutritional vitamin D status is <a href="https://en.wikipedia.org/wiki/Calcifediol">typically measured</a> via a blood test. This checks the calcidiol (calcifediol, 25-hydroxyvitamin D) concentrations, which reflect the average intakes from the sun and diet over the past three to four weeks. The <a href="https://pubmed.ncbi.nlm.nih.gov/22708765/">current recommendation</a> is that we should all aim to have at least 50nmol/L (20ng/mL) at the end of winter. However, one problem with vitamin D tests is that there is <a href="https://pubmed.ncbi.nlm.nih.gov/37182753/">variation</a> in measured concentrations between the laboratories and between the assays, and whether you’re deemed to have a deficiency can depend on the testing method used. Doctors do not always agree with what is deficiency. While very low concentrations are likely to prompt doctors to recommend a supplement (and, potentially, follow-up testing), some may consider even relatively high concentrations as inadequate. This is all understandable as research in this space is still evolving, and we know low concentrations do not always cause any symptoms. <h2>Why avoid vitamin D deficiency?</h2> Prolonged, severe vitamin D deficiency will lead to softening of bone tissue and cause diseases such as rickets (children) and osteomalacia (adults). However, avoiding low concentrations is likely to be good for <a href="https://pubmed.ncbi.nlm.nih.gov/37483080/">many aspects of health</a>, with consistent evidence suggesting benefits for <a href="https://www.bmj.com/content/356/bmj.i6583">infectious diseases</a> and autoimmune conditions such as multiple sclerosis. Randomised trials have also provided evidence for lower <a href="https://pubmed.ncbi.nlm.nih.gov/35676320/">cancer</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/24414552/">all cause mortality</a> by daily supplementation, although any benefit is likely to be restricted to those who otherwise have insufficient intakes. <h2>Who is at risk of deficiency?</h2> Most of us do not need tests to have a relatively good idea whether we might be at risk of a clinically important deficiency. If it’s not late winter, we spend regularly at least some time outside with skin exposed to the sun, and we do not belong to a specific high-risk group, it is unlikely that our <a href="https://pubmed.ncbi.nlm.nih.gov/22168576/">levels would be very low</a>. The two main reasons for vitamin D deficiency typically relate to: 1. not getting (enough) vitamin D through sun exposure. Deficiency risk <a href="https://www.healthdirect.gov.au/vitamin-d-deficiency">can be high</a> for anyone who is housebound, such as older or disabled people in residential care. The risk of deficiency increases if we always cover our skin carefully by <a href="https://pubmed.ncbi.nlm.nih.gov/19211395/">modest cultural dress,</a> and also <a href="https://pubmed.ncbi.nlm.nih.gov/6119494/">dark skin pigmentation</a> is known to reduce vitamin D synthesis. 2. having a chronic disease that alters your requirement. Medications such as anticonvulsants used to treat epilepsy, and conditions such as <a href="https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency">liver and kidney diseases</a> can interfere with vitamin D metabolism. Some <a href="https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency">digestive diseases</a> can reduce vitamin D absorption from your diet, while <a href="https://pubmed.ncbi.nlm.nih.gov/30020507">obesity</a> will increase your vitamin D requirement and make it more difficult to raise your blood levels. <h2>Am I getting enough sun exposure?</h2> In Australia, it is possible to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. This isn’t so for many people living in the northern hemisphere. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun a few minutes on most days. The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer. During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D. If you are concerned, you have very dark skin, or are otherwise in a high-risk group, you may want to talk to your GP. In any case, taking a modest daily dose of vitamin D (1,000-2,000 IU) during the darker winter months is unlikely to cause harm and it <a href="https://pubmed.ncbi.nlm.nih.gov/37483080/">may be beneficial</a>. <h2>Why does excess vitamin D testing matter?</h2> When not indicated, testing can cause unnecessary worry and promote a cascade of <a href="https://pubmed.ncbi.nlm.nih.gov/32675268/">laboratory, prescription and imaging services</a> that are of low value. Excessive testing is also a waste of health-care resources, with one <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50619">single test</a> costing about the same as a years’ worth of vitamin D supplementation. Very often, we can make relatively small changes to our lifestyles to reduce the risks of vitamin D deficiency. <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/211268/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-i-be-getting-my-vitamin-d-levels-checked-211268">original article</a>.

Body

Why does my hair turn green from the swimming pool?

<a href="https://theconversation.com/profiles/magdalena-wajrak-1432339">Magdalena Wajrak</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> If you are a blonde like me and enjoy laps in a swimming pool, you may have noticed your hair acquires a green tint after frequent swims in chlorinated water. This happens to both bleached and natural blondes. In fact, the green tinge happens to everyone, but it’s less visible on dark hair and those whose hair isn’t damaged by chemical treatments such as bleaching. But what exactly causes this green discoloration, and what can we do about it? Most of us blame the chlorine in the pool water. However, although chlorine does play a part, it is not the main culprit. <h2>Which chemicals in the pool turn the hair green?</h2> The element to blame for the green staining of hair is copper. The main source of copper is copper sulfate (CuSO₄), a compound added to swimming pools to prevent the growth of algae. <a href="https://www.sciencedirect.com/science/article/pii/S1568988320301803?via%3Dihub">Contact with algae</a> can cause skin irritation and respiratory issues, and ingesting water with algae can lead to serious gastrointestinal problems. Only a small amount (around 0.5mg per litre or 0.5 parts per million) of copper sulfate is needed to prevent algal growth. However, copper can also enter swimming pools through the corrosion of water pipes, so concentrations may be higher in some pools. Copper sulfate crystals are greenish-blue in colour. So, when hair comes into contact with copper ions – a positively charged variant of a copper atom with extra electrons – those ions get absorbed by the hair and cause the greenish hue. Scientists were fascinated by the green “pool hair” phenomenon as far back as the 1970s, so we actually have research data on copper being the cause. One very <a href="https://jamanetwork.com/journals/jamadermatology/article-abstract/538197">interesting study in 1978</a> performed experiments by immersing hair samples into water containing different concentrations of copper ions, chlorine and various pH values (neutral and basic). Their results showed hair exposed to free copper ions does turn green. Furthermore, when hair is oxidised (meaning electrons are removed from the hair proteins) by chlorine, it actually damages the hair, enhancing the absorption of copper ions. Hair submerged in water with chlorine but without copper ions did not turn green. Meanwhile, hair exposed to water with only copper ions and no chlorine still formed a green colour. Hence, chlorine by itself does not play a role in causing the green hue we see in “pool hair”, but it does exacerbate it. <h2>So, how does copper get into the hair?</h2> <a href="https://doi.org/10.1007/978-1-4684-0943-7_24">Other research teams</a> have conducted <a href="https://doi.org/10.1071/ch9682437">more extensive studies</a>, using sophisticated instruments, such as scanning electron microscopy, to examine how exactly copper ions attach to the hair. Our hair is predominantly composed of protein called keratin. Keratin is classified as a “structural fibrous protein”, meaning it has an elongated, sheet-like structure. The keratin structure is composed of various <a href="https://chem.libretexts.org/Courses/University_of_Kentucky/UK%3A_CHE_103_-_Chemistry_for_Allied_Health_(Soult)/Chapters/Chapter_4%3A_Structure_and_Function/4.4%3A_Functional_Groups">chemical groups</a> (types of atom groupings with similar properties), such as carboxyl groups, amino groups and disulfide groups. Copper ions have the ability to form bonds with these groups, forming a copper-keratin complex. This complex remains in the hair, causing it to appear green. Interestingly, the most recent study <a href="https://doi.org/10.32657/10356/142466">conducted in 2020</a>, showed copper ions mainly bind to the disulfide groups. This study also found other metal ions such as zinc, lead, chromium and mercury also bind to hair in the same way. This is very useful in <a href="https://theconversation.com/forensic-breakthrough-study-suggests-humans-can-be-identified-by-the-proteins-in-their-hair-65051">forensic analysis</a>, for example, because forensic scientists can analyse hair samples to determine if a person has been exposed to a particular metal. Light-coloured hair already has the most visible green discoloration, but research has shown that damaged hair, caused by bleaching, straightening, or exposure to sun, is the <a href="https://pubmed.ncbi.nlm.nih.gov/19586601/">most susceptible</a> to the binding of copper ions. This is because in damaged hair the disulfide groups have “broken bonds” (the link that holds the elements within these groups together is broken), making it easier for the copper ions to bind to the hair. <h2>Can I prevent the green colour or get rid of it?</h2> To prevent your hair from turning green in a swimming pool, you have two basic options. The first is a physical barrier – just wear a swim cap. The second option is chemical – you can pre-treat your hair with an alkaline shampoo. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0891584918310050">Studies have shown</a> under alkaline pH conditions, the copper ions won’t attach to the hair. To treat your hair before going to the pool, you can either use a shampoo with a pH higher than 7, or you can even try mixing some baking soda into your regular shampoo. But what can you do if your hair has already turned greenish? Well, you can try washing your hair with a shampoo designed to achieve this, typically marketed as a “chlorine removal” shampoo. These products contain a chemical called EDTA – it can bind to metal ions (such as copper) and thus will remove copper from the hair. You may have heard tomato sauce or ketchup is a good way to get the green out of your pool hair – potentially because the red pigments are supposed to “cancel out” the green ones. However, I’m not aware of any scientific evidence this would work. Correction: This article has been amended to clarify that alkaline shampoos have a pH higher than 7, not lower.<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/211736/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/magdalena-wajrak-1432339">Magdalena Wajrak</a>, Senior lecturer, Chemistry, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-hair-turn-green-from-the-swimming-pool-211736">original article</a>.

Beauty & Style

How do hay fever treatments actually work? And what’s best for my symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing. Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine. Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging. So what medicines can prevent or reduce hay fever symptoms, and how do they work? <h2>Antihistamines</h2> Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that anti-histamines are one of the most frequently recommended medicines to treat hay fever. Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms. In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines. Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation. The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever. The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones. Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines. The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you. Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients). <h2>Steroid nasal sprays</h2> If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended. Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation. Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever. There are also nasal sprays that contain both an antihistamine and corticosteroid. While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days. <h2>Sodium cromoglycate</h2> Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies. This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation. This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies). <h2>Decongestants</h2> Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running. However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose. <h2>Saline</h2> Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects. If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines. Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<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/213071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.

Body

Why do I get so much spam and unwanted email in my inbox? And how can I get rid of it?

<a href="https://theconversation.com/profiles/kayleen-manwaring-8735">Kayleen Manwaring</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Spam might not have brought an end to the internet or email, as some dire predictions <a href="https://www.zdnet.com/article/why-spam-could-destroy-the-internet/">in the early 2000s</a> claimed it could – but it’s still a massive pain. Despite all the spam being removed by spam-filtering technologies, most people still receive spam every day. How do these messages end up flooding our inboxes? And are there any legal consequences for the senders? <h2>What is spam?</h2> The Organisation for Economic Co-operation and Development (OECD) noted in 2004 “there does not appear to be a widely agreed and workable definition for spam” across jurisdictions – and this remains true today. That said, “spam” generally <a href="https://www.oecd-ilibrary.org/docserver/232784860063.pdf?expires=1693541947&id=id&accname=ocid177499&checksum=D0C5BDAC49951DF353618B8E38483253">refers to</a> unsolicited electronic messages. These are often sent in bulk and frequently advertise goods or services. It also includes scamming and phishing messages, according to the OECD. Most people think of spam in the form of emails or SMS messages. However, what we now call spam actually predates the internet. In 1854, a spam telegram was sent to British politicians advertising the opening hours of dentists who <a href="https://www.theguardian.com/technology/2013/aug/09/why-spammers-are-winning-junk-mail">sold tooth-whitening powder</a>. The first spam email came more than 100 years later. It was reportedly sent to 600 people on May 3 1978 <a href="https://web.archive.org/web/20080628205216/http://www.latimes.com/technology/la-fi-spam11may11001420,1,5168218,full.story">through ARPAnet</a> – a precursor to the modern internet. As for how much spam is out there, the figures vary, possibly due to the various <a href="https://www.spamhaus.org/consumer/definition/">definitions of “spam”</a>. One source reports the average number of spam emails sent daily in 2022 was about <a href="https://dataprot.net/statistics/spam-statistics/">122.33 billion</a> (which would mean more than half of all emails were spam). As for text messages, another source reports a daily average of 1.6 billion <a href="https://thesmallbusinessblog.net/spam-text-statistics/">spam texts</a>. <h2>Where do spammers get my details?</h2> Each time you enter your email address or phone number into an e-commerce website, you may be handing it to spammers. But sometimes you may even receive spam from entities you don’t recognise. That’s because businesses will often transfer customers’ contact information to related companies, or sell their data to third parties such as data brokers. Australia’s Privacy Act 1988 somewhat limits the transfer of personal information to third parties. However, these laws <a href="https://theconversation.com/accc-says-consumers-need-more-choices-about-what-online-marketplaces-are-doing-with-their-data-182134">are weak</a> – and <a href="http://handle.unsw.edu.au/1959.4/unsworks_75600">weakly enforced</a>. Some entities also use “address-harvesting” software to search the internet for electronic addresses that are captured in a database. The collector then uses these addresses directly, or sells them to others looking to send spam. Many jurisdictions (including <a href="http://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/s19.html">Australia</a>) prohibit these harvesting activities, but they are still <a href="https://www.projecthoneypot.org/statistics.php">common</a>. <h2>Is spamming against the law?</h2> Australia has had legislation regulating spam messaging since 2003. But the <a href="https://www.legislation.gov.au/Details/C2016C00614">Spam Act</a> surprisingly does not define the word “spam”. It tackles spam by prohibiting the sending of <a href="http://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/s15.html">unsolicited commercial electronic messages</a> containing offers, ads or other promotions of goods, services or land. However, if the receiver <a href="http://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/sch2.html">consented</a> to these types of messages, the prohibition does not apply. When you buy goods or services from a company, you will often see a request to click on a “yes” button to receive marketing promotions. Doing so means you have consented. On the other hand, if your phone or inbox are hit by commercial messages you haven’t agreed to receive, that is a breach of the <a href="https://austlii.edu.au/cgi-bin/viewdb/au/legis/cth/consol_act/sa200366/">Spam Act</a> by the sender. If you originally signed up to receive the messages, but then unsubscribed and the messages kept coming after <a href="https://austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/sch2.html">five business days</a>, that is also illegal. Senders must also include a <a href="https://austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/s18.html">functioning unsubscribe facility</a> in every commercial message they send. Spammers can be penalised for breaches of the Spam Act. In the past few months alone, <a href="https://www.acma.gov.au/articles/2023-06/commonwealth-bank-penalised-355-million-spam-breaches">Commonwealth Bank</a>, <a href="https://www.acma.gov.au/articles/2023-08/doordash-penalised-2-million-spam-breaches">DoorDash</a> and <a href="https://www.acma.gov.au/articles/2023-06/mycar-tyre-auto-penalised-1m-spam-breaches">mycar Tyre & Auto</a> were fined more than A$6 million in total for breaches. However, most spam comes from outside Australia where the laws aren’t the same. In the United States spam is legal under the <a href="https://www.ftc.gov/business-guidance/resources/can-spam-act-compliance-guide-business">CAN-SPAM Act</a> until you opt out. Unsurprisingly, the US <a href="https://talosintelligence.com/reputation_center/email_rep#spam-country-senders">tops the list</a> of countries where the most spam originates. Although spam sent to Australia from overseas <a href="https://austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/s16.html">can still breach</a> the Spam Act – and the Australian Communications and Media Authority (ACMA) co-operates with overseas regulators – overseas enforcement actions are difficult and expensive, especially if the spammer has disguised their true identity and location. It’s worth noting that messages from political parties, registered charities and government bodies aren’t prohibited – nor are messages from educational institutions to students and former students. So while you might consider these messages as “spam”, they can legally be <a href="http://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/sa200366/sch1.html">sent freely without consent</a>. Factual messages (without marketing content) from businesses are also legal as long as they include accurate sender details and contact information. Moreover, the Spam Act generally only covers spam sent via email, SMS/MMS or instant messaging services, such as WhatsApp. Voice calls and faxes aren’t covered (although you can use the <a href="https://www.donotcall.gov.au/">Do Not Call Register</a> to block some commercial calls). <h2>Staying safe from spam (and cyberattacks)</h2> Spam isn’t only annoying, it can also be dangerous. Spam messages can contain indecent images, scams and <a href="https://www.cyber.gov.au/learn-basics/explore-basics/watch-out-threats/phishing-emails-and-texts">phishing attempts</a>. Some have <a href="https://www.cyber.gov.au/threats/types-threats/malware">malware</a> (malicious software) designed to break into computer networks and cause harm, such as by stealing data or money, or shutting down systems. The <a href="https://www.cyber.gov.au/protect-yourself/securing-your-email/email-security/protect-yourself-malicious-email">Australian Cyber Security Centre</a> and <a href="https://www.acma.gov.au/dealing-with-spam">ACMA</a> provide useful tips for reducing the spam you get and your risk of being hit by cyberattacks. They suggest to: <ol> <li> use a spam filter and block spammers – email and telecommunications providers often supply useful tools as part of their services </li> <li> unsubscribe from any emails you no longer want to receive – even if you originally agreed to receive them </li> <li> remove as much of your contact details from websites as you can and always restrict the sharing of your personal information (such as name, birth date, email address and mobile number) when you can – beware of pre-ticked boxes asking for your consent to receive marketing emails </li> <li> install cybersecurity updates for your devices and software as you get them </li> <li> always think twice about opening emails or clicking on links, especially for messages promising rewards or asking for personal information – if it looks too good to be true, it probably is </li> <li> use <a href="https://theconversation.com/what-is-multi-factor-authentication-and-how-should-i-be-using-it-191591">multi-factor authentication</a> to access online services so even if a scam compromises your login details, it will still be difficult for hackers to break into your accounts </li> <li> report spam to your email and telecommunications providers, and to <a href="https://www.acma.gov.au/dealing-with-spam#complain-or-forward-spam-to-the-acma">ACMA</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/208665/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ol> <a href="https://theconversation.com/profiles/kayleen-manwaring-8735">Kayleen Manwaring</a>, Senior Research Fellow, UNSW Allens Hub for Technology, Law & Innovation and Senior Lecturer, School of Private & Commercial Law, UNSW Law & Justice, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-get-so-much-spam-and-unwanted-email-in-my-inbox-and-how-can-i-get-rid-of-it-208665">original article</a>.

Technology

How can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?

<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> Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options. Could taking supplements over this time help? You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference. <h2>Why are we so worried about cholesterol?</h2> There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins. Low-density lipoprotein or LDL cholesterol This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011433">build-up of plaque</a> in arteries, which leads to an increased risk of heart disease and stroke. High-density lipoprotein or HDL cholesterol This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.312617">linked to</a> a reduced risk of heart disease and stroke. Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are <a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">well recognised</a>. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado), and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases). <h2>Fibre is your friend</h2> An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">soluble fibre</a>. This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces. You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils. <h2>Fibre supplements, such as psyllium</h2> There are also many fibre supplements and food-based products on the market that may help lower cholesterol. These include: <ul> <li> natural soluble fibres, such as inulin (for example, Benefiber) or psyllium (for example, Metamucil) or beta-glucan (for example, in ground oats) </li> <li> synthetic soluble fibres, such as polydextrose (for example, STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel) </li> <li> natural insoluble fibres, which bulk out your faeces, such as flax seeds. </li> </ul> Most of these supplements come as fibres you add to food or dissolve in water or drinks. Psyllium is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/">studied</a> in at least 24 high-quality randomised controlled trials. These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, <a href="https://www.sciencedirect.com/science/article/pii/S0002916523070107#:%7E:text=Conclusions%3A,mild%2Dto%2Dmoderate%20hypercholesterolemia.">can significantly lower</a> total cholesterol levels by 4% and LDL cholesterol levels by 7%. <h2>Probiotics</h2> Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352670/">number of mechanisms</a>. These include helping to incorporate cholesterol into cells, and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces. Using probiotics to reduce cholesterol is an upcoming area of interest and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S089990071500461X">research</a> is promising. In a <a href="https://pubmed.ncbi.nlm.nih.gov/29384846/">2018 study</a>, researchers pooled results from 32 studies and analysed them altogether in a type of study known as a meta-analysis. The people who took probiotics reduced their total cholesterol level by 13%. <a href="https://www.tandfonline.com/doi/full/10.3109/07853890.2015.1071872">Other</a> <a href="https://link.springer.com/article/10.1007/s11906-020-01080-y">systematic reviews</a> support these findings. Most of these studies use probiotics containing Lactobacillus acidophilus and Bifidobacterium lactis, which come in capsules or powders and are consumed daily. Ultimately, probiotics could be worth a try. However, the effects will likely vary according to the probiotic strains used, whether you take the probiotic each day as indicated, as well as your health status and your diet. <h2>Red yeast rice</h2> <a href="https://www.nccih.nih.gov/health/red-yeast-rice">Red yeast rice</a> is another non-fibre supplement that has gained attention for lowering cholesterol. It is often used in Asia and some European countries as a complementary therapy. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins. A <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.819482/full">2022 systematic review</a> analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4,800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins. However, these trials don’t tell us if red yeast rice works and is safe in the long term. The authors also said only one study in the review was registered in a major <a href="https://www.clinicaltrials.gov">database</a> of clinical trials. So we don’t know if the evidence base was complete or biased to only publish studies with positive results. <h2>Diet and supplements may not be enough</h2> Always speak to your GP and dietitian about your plan to take supplements to lower your cholesterol. But remember, dietary changes alone – with or without supplements – might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role. Even then, depending on your cholesterol levels and other risk factors, you may still be recommended cholesterol-lowering medications, such as <a href="https://jamanetwork.com/journals/jama/fullarticle/2795522">statins</a>. Your GP will discuss your options at your six-month review.<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/211748/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <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>, Dietitian, Researcher & Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-lower-my-cholesterol-do-supplements-work-how-about-psyllium-or-probiotics-211748">original article</a>.

Body

If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear

<a href="https://theconversation.com/profiles/arash-javanbakht-416594">Arash Javanbakht</a>, <a href="https://theconversation.com/institutions/wayne-state-university-989">Wayne State University</a> Heart in your throat. Butterflies in your stomach. Bad gut feeling. These are all phrases many people use to describe fear and anxiety. You have likely felt anxiety inside your chest or stomach, and your brain usually doesn’t hurt when you’re scared. Many cultures tie cowardice and bravery more <a href="https://afosa.org/the-meaning-of-heart-qalb-in-quran/">to the heart</a> <a href="https://byustudies.byu.edu/article/bowels-of-mercy/">or the guts</a> than to the brain. But science has traditionally seen the brain as the birthplace and processing site of fear and anxiety. Then why and how do you feel these emotions in other parts of your body? I am a <a href="https://scholar.google.com/citations?user=UDytFmIAAAAJ&hl=en">psychiatrist and neuroscientist</a> who researches and treats fear and anxiety. In my book “<a href="https://rowman.com/ISBN/9781538170380/Afraid-Understanding-the-Purpose-of-Fear-and-Harnessing-the-Power-of-Anxiety">Afraid,</a>” I explain how fear works in the brain and the body and what too much anxiety does to the body. Research confirms that while emotions do originate in your brain, it’s your body that carries out the orders. <h2>Fear and the brain</h2> While your brain evolved to save you from a falling rock or speeding predator, the anxieties of modern life are often a lot more abstract. Fifty-thousand years ago, being rejected by your tribe could mean death, but not doing a great job on a public speech at school or at work doesn’t have the same consequences. Your brain, however, <a href="https://doi.org/10.1006/nimg.2002.1179">might not know the difference</a>. There are a few key areas of the brain that are heavily involved in processing fear. When you perceive something as dangerous, whether it’s a gun pointed at you or a group of people looking unhappily at you, these sensory inputs are first relayed to <a href="https://doi.org/10.1038%2Fnpp.2009.121">the amygdala</a>. This small, almond-shaped area of the brain located near your ears detects salience, or the emotional relevance of a situation and how to react to it. When you see something, it determines whether you should eat it, attack it, run away from it or have sex with it. <a href="https://theconversation.com/the-science-of-fright-why-we-love-to-be-scared-85885">Threat detection</a> is a vital part of this process, and it has to be fast. Early humans did not have much time to think when a lion was lunging toward them. They had to act quickly. For this reason, the amygdala evolved to bypass brain areas involved in logical thinking and can directly engage physical responses. For example, seeing an angry face on a computer screen can immediately trigger a <a href="https://doi.org/10.1006/nimg.2002.1179">detectable response from the amygdala</a> without the viewer even being aware of this reaction. <figure><iframe src="https://www.youtube.com/embed/xoU9tw6Jgyw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In response to a looming threat, mammals often fight, flee or freeze.</figcaption></figure> <a href="https://doi.org/10.1038/npp.2009.83">The hippocampus</a> is near and tightly connected to the amygdala. It’s involved in memorizing what is safe and what is dangerous, especially in relation to the environment – it puts fear in context. For example, seeing an angry lion in the zoo and in the Sahara both trigger a fear response in the amygdala. But the hippocampus steps in and blocks this response when you’re at the zoo because you aren’t in danger. The <a href="https://doi.org/10.1176/appi.ajp.2016.16030353">prefrontal cortex</a>, located above your eyes, is mostly involved in the cognitive and social aspects of fear processing. For example, you might be scared of a snake until you read a sign that the snake is nonpoisonous or the owner tells you it’s their friendly pet. Although the prefrontal cortex is usually seen as the part of the brain that regulates emotions, it can also teach you fear based on your social environment. For example, you might feel neutral about a meeting with your boss but immediately feel nervous when a colleague tells you about rumors of layoffs. Many <a href="https://theconversation.com/trump-the-politics-of-fear-and-racism-how-our-brains-can-be-manipulated-to-tribalism-139811">prejudices like racism</a> are rooted in learning fear through tribalism. <h2>Fear and the rest of the body</h2> If your brain decides that a fear response is justified in a particular situation, it activates a <a href="https://doi.org/10.1093/med/9780190259440.003.0019">cascade of neuronal and hormonal pathways</a> to prepare you for immediate action. Some of the fight-or-flight response – like heightened attention and threat detection – takes place in the brain. But the body is where most of the action happens. Several pathways prepare different body systems for intense physical action. The <a href="https://doi.org/10.3389/fnins.2014.00043">motor cortex</a> of the brain sends rapid signals to your muscles to prepare them for quick and forceful movements. These include muscles in the chest and stomach that help protect vital organs in those areas. That might contribute to a feeling of tightness in your chest and stomach in stressful conditions. <figure><iframe src="https://www.youtube.com/embed/0IDgBlCHVsA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Your sympathetic nervous system is involved in regulating stress.</figcaption></figure> The <a href="https://www.ncbi.nlm.nih.gov/books/NBK542195/">sympathetic nervous system</a> is the gas pedal that speeds up the systems involved in fight or flight. Sympathetic neurons are spread throughout the body and are especially dense in places like the heart, lungs and intestines. These neurons trigger the adrenal gland to release hormones like adrenaline that travel through the blood to reach those organs and increase the rate at which they undergo the fear response. To assure sufficient blood supply to your muscles when they’re in high demand, signals from the sympathetic nervous system increase the rate your heart beats and the force with which it contracts. You feel both increased heart rate and contraction force in your chest, which is why you may connect the feeling of intense emotions to your heart. In your lungs, signals from the sympathetic nervous system dilate airways and often increase your breathing rate and depth. Sometimes this results in a feeling of <a href="https://theconversation.com/pain-and-anxiety-are-linked-to-breathing-in-mouse-brains-suggesting-a-potential-target-to-prevent-opioid-overdose-deaths-174187">shortness of breath</a>. As digestion is the last priority during a fight-or-flight situation, sympathetic activation slows down your gut and reduces blood flow to your stomach to save oxygen and nutrients for more vital organs like the heart and the brain. These changes to your gastrointestinal system can be perceived as the discomfort linked to fear and anxiety. <h2>It all goes back to the brain</h2> All bodily sensations, including those visceral feelings from your chest and stomach, are relayed back to the brain through the pathways <a href="https://www.ncbi.nlm.nih.gov/books/NBK555915/">via the spinal cord</a>. Your already anxious and highly alert brain then processes these signals at both conscious and unconscious levels. <a href="https://doi.org/10.1176/appi.ajp.2016.16030353">The insula</a> is a part of the brain specifically involved in conscious awareness of your emotions, pain and bodily sensations. The <a href="https://doi.org/10.1038%2Fs41598-019-52776-4">prefrontal cortex</a> also engages in self-awareness, especially by labeling and naming these physical sensations, like feeling tightness or pain in your stomach, and attributing cognitive value to them, like “this is fine and will go away” or “this is terrible and I am dying.” These physical sensations can sometimes create a loop of increasing anxiety as they make the brain feel more scared of the situation because of the turmoil it senses in the body. Although the feelings of fear and anxiety start in your brain, you also feel them in your body because your brain alters your bodily functions. Emotions take place in both your body and your brain, but you become aware of their existence with your brain. As the rapper Eminem recounted in his song “Lose Yourself,” the reason his palms were sweaty, his knees weak and his arms heavy was because his brain was nervous.<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/210871/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/arash-javanbakht-416594">Arash Javanbakht</a>, Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/wayne-state-university-989">Wayne State University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-anxiety-is-in-my-brain-why-is-my-heart-pounding-a-psychiatrist-explains-the-neuroscience-and-physiology-of-fear-210871">original article</a>.

Body

"My little girl!": Cindy Crawford gushes over lookalike daughter

Cindy Crawford is every bit the doting mum as she posted an adorable video montage to celebrate her daughter's 22nd birthday. The former model took to Instagram to share clips of her daughter Kaia Gerber throughout her childhood. "Such a joy watching you bloom into an inspiring young woman," she captioned the video. "Love spending time with you at this new stage in our lives — woman to woman — but you'll also always be my little girl!" The young model replied: "This made me cry! I feel so lucky to have been raised by my best friend. I love you mama ♥️" <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/CwvF7iIuwEB/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/CwvF7iIuwEB/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Cindy Crawford (@cindycrawford)</a> </div> </blockquote> Gerber was born in 2001 and is the daughter of Crawford and her businessman husband Rande Gerber. She first started her modelling career at only 10-years-old, in a campaign for Versace, and has since followed in her mum's footsteps. Her most recent photoshoot for Italian fashion magazine, D, showcases just how identical she looks to mum as she posed in a few glamorous dresses made by luxury fashion brand, Celine. Gerber looked stunning in the black-and-white photos and mum Crawford couldn't hide her pride. "Love these! And you!" she commented with a kissing face emoji. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CwyaeYPRqye/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CwyaeYPRqye/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Kaia (@kaiagerber)</a> </div> </blockquote> Fellow celebrity friends and fans took to the comments to praise the young model's gorgeous looks. "Wow!" wrote fellow model Hailey Bieber. "Omg," commented model and Daisy Jones & The Six actress Camila Morrone. "So so beautiful," wrote one fan. "This is my favourite shoot of you. ❤️" commented another. Images: Instagram

Family & Pets

“Dig a hole in my chest”: Supermodel reveals double cancer fight

Supermodel icon Linda Evangelista has shared the devastating details of her cancer battle, after being diagnosed twice in five years. In a candid interview with <a href="https://www.wsj.com/style/fashion/linda-evangelista-steven-meisel-32909b7b?mod=style_lead_story" target="_blank" rel="noopener">WSJ magazine</a>, the 58-year-old revealed why she chose to "keep it quiet" and only tell a handful of people close to her about her health battle. Evangelista was first diagnosed with breast cancer in 2018 after a routine mammogram, and decided to undergo a bilateral mastectomy: a surgical procedure to remove both breasts. "The margins were not good. [I chose this treatment] due to other health factors, without hesitation, because I wanted to put everything behind me and not to have to deal with this. "Thinking I was good and set for life. Breast cancer was not going to kill me." Four years later in 2022, Evangelista felt a lump on her chest and an MRI revealed cancer was present in her pectoral muscle. "I just went into this mode that I know how to do – just do what you've got to do and get through it," she said. "And that's what I did." "Dig a hole in my chest," she recalled telling her doctors. "I don't want it to look pretty. I want you to excavate. I want to see a hole in my chest when you're done. Do you understand me? I'm not dying from this." After another round of surgery, she was told the outlook was good for the future, but there is always a possibility the cancer could return. "Well, once it's come back, there's a chance," she recalled the oncologist's words. "I know I have one foot in the grave, but I'm totally in celebration mode." Image credits: Instagram / Getty Images

Caring

I think I have the flu. Should I ask my GP for antivirals?

<a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/yong-qian-koo-1457640">Yong Qian Koo</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> If you test positive for COVID and you’re eligible for antivirals, you’ll likely ask your GP for a script to protect you from severe disease. <a href="https://healthdispatch.com.au/news/immunisation-coalition-urging-people-with-flu-like-symptoms-to-g">Antivirals</a> are also available to fight influenza viruses, via a doctor’s prescription. But they have a mixed history, with their benefits at times <a href="https://theconversation.com/controversies-in-medicine-the-rise-and-fall-of-the-challenge-to-tamiflu-38287">overstated</a>. It can be difficult to get an appointment to see your GP. So when should you make the effort to see a GP for a prescription for influenza antivirals? And how effective are they? <h2>What exactly is influenza?</h2> The flu is primarily a viral infection of the respiratory system that can spread through sneezing, coughing, or touching contaminated objects then touching your nose or mouth. Common symptoms include headache, sore throat, fever, runny or blocked nose and body aches that last a week or more. Influenza is actually a group of viruses, divided into several <a href="https://www.cdc.gov/flu/about/viruses/types.htm#:%7E:text=There%20are%20four%20types%20of,global%20epidemics%20of%20flu%20disease,%20https://www.cdc.gov/flu/professionals/acip/background-epidemiology.htm">sub-groups</a>. Flu A and B are the <a href="https://www.health.gov.au/resources/collections/aisr?language=en,%20https://www.health.gov.au/resources/collections/australian-influenza-surveillance-reports-2023?language=en">most common groups</a> that circulate in humans. <h2>What are flu antivirals?</h2> Influenza antivirals, target specific parts of the viral life cycle, which prevents the virus replicating and spreading. Most flu antivirals <a href="https://www.nejm.org/doi/full/10.1056/NEJMra050740">target</a> neuraminidase, an important enzyme the virus uses to release itself from cells. On the other hand, COVID antivirals work by inhibiting other parts of the viral life cycle involved in the <a href="https://www.tga.gov.au/news/media-releases/tga-provisionally-approves-two-oral-covid-19-treatments-molnupiravir-lagevrio-and-nirmatrelvir-ritonavir-paxlovid">virus replicating itself</a>. Three influenza antivirals are <a href="https://australianprescriber.tg.org.au/articles/influenza-overview-on-prevention-and-therapy.html#r20">used in Australia</a>. Relenza (zanamivir) is an inhaled powder and Tamiflu (oseltamivir) is a capsule; both are five-day treatments. Rapivab (peramivir) is a single injection. These antivirals may also come with <a href="https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm">side effects</a>, such as a headache, vomiting, cough, or <a href="https://www.immunisationcoalition.org.au/resources/antiviral-treatments-for-influenza/">fever</a>. Tamiflu and Relenza generally cost A$40-50 in Australia, plus the cost of the consultation fee with your doctor, if applicable. <h2>How effective are antivirals for the flu?</h2> Antivirals have the greatest effect if started 24-72 hours after symptoms. This is to prevent the virus from reaching <a href="https://www.mdpi.com/1660-4601/19/5/3018">high levels in the body</a>. Among healthy adults, if Relenza or Tamiflu are started within 48 hours from your first symptoms, they can <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008965.pub4/full">reduce the duration</a> of symptoms such as cough, blocked nose, sore throat, fatigue, headache, muscle pain and fever by just under a day. For people who have developed severe flu symptoms or who have existing health conditions such as heart disease or chronic obstructive pulmonary disease (COPD), antivirals that start later (but still before day five of symptoms) can still reduce the <a href="https://academic.oup.com/cid/article/52/4/457/378776?login=true">severity of infection</a> and reduce the <a href="https://thorax.bmj.com/content/thoraxjnl/65/6/510.full.pdf?frbrVersion=3">chance of</a> <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/215903">hospitalisation</a> and <a href="https://academic.oup.com/jac/article/72/11/2990/4091484?login=false">death</a>. In a study from the 2009 swine flu (H1N1) pandemic in the United States, treatment with antivirals (Tamiflu and Relenza) <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358088/">reduced</a> the chance of needing to be hospitalised. Around 60% of hospitalisations prevented were among 18-64 years olds, around 20% in children 0-17 years, and 20% in adults aged over 65. The research is less clear about whether antivirals prevent the development of flu complications such as secondary bacterial pneumonia. They might, but so far the data aren’t clear. <h2>Are flu antivirals becoming less effective?</h2> Antiviral resistance to Tamiflu has been <a href="https://link.springer.com/article/10.1007/s10096-020-03840-9">reported</a> around the world, mostly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223162/">immunocompromised people</a>, as they <a href="https://link.springer.com/article/10.1007/s10096-020-03840-9">have</a> a weakened immune system that allows higher viral loads and prolonged viral shedding. The impact of the antiviral resistance is unclear but there is evidence indicating resistant strains can uphold their ability to replicate effectively and spread. So far it’s not clear if these stains cause more severe disease. However, government agencies and surveillance programs are constantly monitoring the spread of antiviral resistance. Currently there is <a href="https://www.cdc.gov/flu/treatment/antiviralresistance.htm">minimal concern</a> for strains that are resistant to Tamiflu or Relenza. <h2>Antivirals can also prevent the flu if you’ve been exposed</h2> Tamiflu and Relenza can also be used to <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12046">prevent flu infections</a>, if we’re exposed to the virus or come into contact with infected people. Some studies suggest Tamiflu and Relenza can <a href="https://www.bmj.com/content/326/7401/1235.long">reduce the chance of developing symptomatic influenza</a> by 70-90%. Many health agencies around the world <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165743/">recommend</a> “prophylactic” treatment for high-risk patients in hospitals or age care setting when people have been in contact with others infected with influenza. <h2>So who should talk to their GP about a prescription?</h2> <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/racf-antiviral-treatments-and-prophylaxis.aspx#:%7E:text=The%20Australian%20Therapeutic%20Guidelines*%20recommends,of%20severe%20disease%20from%20influenza.&text=people%20with%20chronic%20conditions%20including,heart%20disease">Australian guidelines recommend</a> doctors offer antivirals to people with influenza who have severe disease or complications. Doctors can also consider treatment for people at higher risk of developing severe disease from influenza. This includes: <ul> <li>adults aged 65 years or older</li> <li>pregnant women</li> <li>people with certain chronic conditions (heart disease, Down syndrome, obesity, chronic respiratory conditions, severe neurological conditions)</li> <li>people with compromised immunity</li> <li>Aboriginal and Torres Strait Islander people</li> <li>children aged five years or younger</li> <li>residents of long-term residential facilities</li> <li>homeless people.</li> </ul> Doctors can prescribe antivirals for the prevention of influenza <a href="https://australianprescriber.tg.org.au/articles/influenza-overview-on-prevention-and-therapy.html#r20">in</a> vulnerable people who have been exposed to the virus. Antiviral treatment also can be <a href="https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm#:%7E:text=Antiviral%20treatment%20also%20can%20be,48%20hours%20of%20illness%20onset">considered</a> for otherwise healthy symptomatic patients who have confirmed or suspected influenza, if they can start treatment within 48 hours of developing symptoms. In some instances a doctors can make a clinical diagnosis of influenza based on the symptoms and known close flu positive contacts of the patient. However, it is preferred to have flu diagnosed by one of the approved diagnostic tests, such as a <a href="https://24-7medcare.com.au/influenza/australian-gp-influenza-2023-guide/">rapid antigen test</a> (RAT) or the more accurate <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/influenza_factsheet.aspx">PCR test</a>, similar to what is perfomed for COVID. There are also now combo tests that can <a href="https://www.tga.gov.au/news/media-releases/first-combination-covid-19-and-influenza-self-tests-approved-australia">distinguish between SARS-CoV-2 and influenza virus</a>. Remember, the flu can cause <a href="https://www.abc.net.au/news/2023-07-23/flu-season-hitting-children-hard-antivirals-may-help/102633722">severe illness or death</a>, particularly among people from the high-risk groups. So if you think you might have the flu, wear a mask and stay away to avoid spreading the virus to others. <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/210457/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/yong-qian-koo-1457640">Yong Qian Koo</a>, , <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-think-i-have-the-flu-should-i-ask-my-gp-for-antivirals-210457">original article</a>.

Body

"My brother and I are safe and alive": Lil Tay speaks out

Rising to online stardom at the tender age of nine, rapper Lil Tay, the child prodigy, has defied widespread reports of her demise, as confirmed by her recent statement following a <a href="https://www.oversixty.co.nz/news/news/death-announced-of-child-star-and-her-brother-at-just-14" target="_blank" rel="noopener">death announcement that appeared on her official Instagram page</a>. Speaking to TMZ, the 14-year-old social media sensation expressed her relief, saying: "I want to make it clear that my brother and I are safe and alive, but I'm completely heartbroken, and struggling to even find the right words to say. "It's been a very traumatising 24 hours. All day yesterday I was bombarded with endless heartbreaking and tearful phone calls from loved ones – all while trying to sort out this mess." Those past 24 hours have certainly been harrowing for Lil Tay, having to deal with a barrage of anguished and tearful phone calls from concerned relatives. Lil Tay has come forward to explain that her Instagram account, which initially held 3.3 million followers and now exceeds 3.5 million, was subjected to a hack before the now-deleted misleading announcement was posted. "My Instagram account was compromised by a 3rd party and used to spread jarring misinformation and rumours regarding me, to the point that even my name was wrong. My legal name is Tay Tian, not 'Claire Hope'." Early on the morning of Thursday August 10, a message surfaced on the official Instagram account, proclaiming the "sudden and tragic" passing of the artist – the first post to surface since 2018. In the heartfelt message, it was conveyed, "Words fail to capture the insurmountable void and inexpressible anguish. This outcome took us by complete surprise, leaving us all in a state of disbelief." "We have no words to express the unbearable loss and indescribably pain. This outcome was entirely unexpected, and has left us all in shock." It was also claimed in the statement that Jason Tian, Lil Tay's 21-year-old brother, had also died. "Her bother's passing adds an even more unimaginable depth to our grief," the statement continued. "During this time of immense sorrow, we kindly ask for privacy as we grieve this overwhelming loss, as the circumstances surrounding [Lil Tay] and her brother's passing are still under investigation." "[Lil Tay] will forever remain in our hearts, her absence leaving an irreplaceable void that will be felt by all who knew and loved her." Following the announcement, Variety initially reported Lil Tay's management as confirming her demise. Nonetheless, Insider revealed that Lil Tay's father, Christopher Hope, refrained from commenting on the Instagram post and declined to address queries regarding her current state. During her brief yet impactful three-month presence in the social media landscape, Lil Tay found herself entangled in various controversies, most notably offering an apology after employing a racial slur in one of her videos. Yet, as swiftly as her rise to virtual stardom unfolded, Lil Tay faded from view. Lil Tay's ultimate Instagram post before the now-deleted death notice emerged on June 19, 2018. This post was a tribute to the late rapper XXXTentacion, who tragically lost his life at 20 years old the preceding day. Image: Instagram

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Property tycoon sentenced to death over $27 billion fraud

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

Could my glasses be making my eyesight worse?

“My sister-in-law announced she was pregnant at my child’s funeral”

How do I handle it if my parent is refusing aged care? 4 things to consider

All My Children star dies at age 50

Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid

"You've restored my faith": Community shows up for lonely birthday boy

Can I actually target areas to lose fat, like my belly?

How should I add sunscreen to my skincare routine now it’s getting hotter?

Should I be getting my vitamin D levels checked?

Why does my hair turn green from the swimming pool?

How do hay fever treatments actually work? And what’s best for my symptoms?

Why do I get so much spam and unwanted email in my inbox? And how can I get rid of it?

How can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?

If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear

"My little girl!": Cindy Crawford gushes over lookalike daughter

“Dig a hole in my chest”: Supermodel reveals double cancer fight

I think I have the flu. Should I ask my GP for antivirals?

"My brother and I are safe and alive": Lil Tay speaks out

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

Property tycoon sentenced to death over $27 billion fraud

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

Could my glasses be making my eyesight worse?

“My sister-in-law announced she was pregnant at my child’s funeral”

How do I handle it if my parent is refusing aged care? 4 things to consider

All My Children star dies at age 50

Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid

"You've restored my faith": Community shows up for lonely birthday boy

Can I actually target areas to lose fat, like my belly?

How should I add sunscreen to my skincare routine now it’s getting hotter?

Should I be getting my vitamin D levels checked?

Why does my hair turn green from the swimming pool?

How do hay fever treatments actually work? And what’s best for my symptoms?

Why do I get so much spam and unwanted email in my inbox? And how can I get rid of it?

How can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?

If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear

"My little girl!": Cindy Crawford gushes over lookalike daughter

“Dig a hole in my chest”: Supermodel reveals double cancer fight

I think I have the flu. Should I ask my GP for antivirals?

"My brother and I are safe and alive": Lil Tay speaks out

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