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How long does back pain last? And how can learning about pain increase the chance of recovery?

<p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<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/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p>

Body

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He's back! Charles and Camilla's secret "son" drops DNA bombshell

<p>The Australian man who has long claimed to be the secret child of King Charles and Queen Camilla has shared the details of a wild plot to extract his DNA. </p> <p>The 57-year-old man from Queensland revealed he was tracked down by an American woman, who claimed she was the illegitimate child of the late Prince Philip, and attempted to get a DNA sample from the man. </p> <p>Simon Dorante-Day has made headline around the world with his claims that he is the son of Charles and Camilla, which he says are the results of decades worth of research. </p> <p>“My grandmother, who had worked for the Queen, told me outright that I was Camilla and Charles’ son many times,” he said.</p> <p>Now, in an interview with <a href="https://7news.com.au/lifestyle/aussie-man-who-claims-to-be-charles-and-camillas-son-drops-biggest-ever-dna-bombshell-c-12788618" target="_blank" rel="noopener"><em>7News</em></a>, Dorante-Day shared the story of how he was tracked down by the American woman, who knocked on his door in the early hours of the morning on December 2nd. </p> <p>The 57-year-old and his wife Elvianna were immediately skeptical of the woman, who said she used a private investigator to track him down. </p> <p>“This woman claimed that she was the secret illegitimate daughter of Prince Philip who lived in San Francisco,” Dorante-Day said.</p> <p>“She explained that she had travelled from the US after hiring an investigator to track me down in Queensland. The whole purpose of her visit was to ask me for a sample of my DNA."</p> <p>“She wanted to compare it to hers, to basically prove that we were both related to the royal family.”</p> <p>After humouring the woman and letting her share her evidence along with her elaborate story, Simon concluded that the whole thing was a scam, along with an illegal attempt to extract his DNA.</p> <p>“This woman had a lot of so-called proof to back up her claims, but the whole thing just seemed really fishy,” he said.</p> <p>He recalled how the woman shared her own adoption story, which resulted in her turning to the FBI for help, who allegedly handed her her original birth certificate, which listed Prince Philip as her father. </p> <p>“Of course my bulls*** meter is flying off the handle at this point. I know how hard it is to get any government authority to address these sorts of issues — I hardly think the Federal Bereau of Investigation would just offer up the fact that she was the daughter of the Queen’s late husband," Simon said. </p> <p>“It was all just wild.”</p> <p>The Queensland father and grandfather said it wasn’t long until the woman gave away her real reason for wanting his DNA: money.</p> <p>“She said that she’s already been given a large payout from the royal family after she proved she was the daughter of Prince Philip,” he said.</p> <p>“And she felt that if she was able to compare my DNA to her DNA, and prove we were both descendants of the royal family, then we could ask them for even more money."</p> <p>“Elvianna and I told her what we’ve said to everyone from day one — this isn’t about money for us, at all. This is about us finding out who my birth parents are and protecting my family. We have never wanted money.”</p> <p>After saying goodbye to the pair, Dorante-Day said he and his wife were left reeling.</p> <div> <p>“At the end of the day, this was an illegal attempt to procure my DNA,” he said. </p> <p>Despite the whole experience leaving Dorante-Day and his wife rattled, he said his stance on proving that he is Charles and Camilla's son has not changed. </p> <p>“It takes a lot of work, money and time to build a case like this, but I am confident I will get there,” he said.</p> <p>“I know Charles and Camilla are my parents and I’m ready to prove it.”</p> <p><em>Image credits: Supplied</em></p> </div>

Family & Pets

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Couple misses their own wedding after cruise ship forced to turn back

<p>A couple has missed their own dream destination wedding after their cruise ship was denied entry into New Zealand. </p> <p>Janine Sherriff and Kyle Risk dreamed of exchanging rings at the popular Lord of the Rings filming location, Hobbiton, located on the north island of New Zealand. </p> <p>The couple were meant to meet up with some close friends and family in New Zealand, as they travelled across from Australia on a P&amp;O cruise ship, but were turned back from docking over an unclean hull. </p> <p>The “Kiwi Adventure” cruise, which was meant to be a 13-day journey, turned into more of a Tasmanian adventure after the ship was told to head to Australia’s southernmost state instead.</p> <p>New Zealand’s biosecurity laws were triggered over just three juvenile mussels and one single hydroid (AKA: lace coral), which needed to be removed from the ship's hull. </p> <p>“We took the time off from work, we had our nearest and dearest friends and family all co-ordinate to be in New Zealand at this exact time,” Janine told the <em><a href="https://www.abc.net.au/news/2023-11-25/cruise-ship-turned-away-from-nz/103151078">ABC</a></em>.</p> <p>“The plan was to get off the boat, go straight to Hobbiton, have our wedding, then head straight back to the boat for the rest of the honeymoon.”</p> <p>“Now we have to figure out what to do about our wedding, we have all this money down the drain. I am heartbroken this day has been taken away from me."</p> <p>Kyle added, “First off, I was furious.” </p> <p>“I saw Janine’s face when we got the news. I was ready to explode.</p> <p>“I got a selfie from our family and friends at the site in Hobbiton we should have been on about 20 minutes before we had to turn around.”</p> <p>“It would have meant a lot as it was a beautiful setting. As long as we have each other,” he added.</p> <p>The cruise operator in charge of the vessel, P&amp;O, has offered customers $300 in on-board credit and a 50 per cent credit on a future cruise.</p> <p>“We apologise for the change in itinerary and thank our guests for their patience and understanding,” a spokesperson for the company’s Australian division said per the <em><a href="https://www.dailymail.co.uk/news/article-12791331/Engaged-couple-P-O-cruise-forced-turn-New-Zealand-fume-dream-Lord-Rings-wedding-ruined.html">Daily Mail</a></em>.</p> <p><em>Image credits: Facebook / Shutterstock</em></p>

Travel Trouble

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How to get rid of sciatica pain: solutions from back experts

<p><strong>The scoop on sciatica pain</strong></p> <p>Fun fact: The sciatic nerve is the largest nerve in the human body. It runs from the lower back down each side of your body, along the back of the hips, butt cheeks, and knees, down the back of the calf, and into the foot. It provides both sensory and motor nerve function to the legs and feet.</p> <p>Not-so-fun fact: Sometimes this nerve can get compressed in the spine at one of the roots – where it branches off the spinal cord – and cause pain that radiates down the length of the nerve. This is a dreaded condition known as sciatica. It is estimated that between 10 and 40 percent of people will experience sciatica in their lifetime.</p> <p>“Sciatica is the body telling you the sciatic nerve is unhappy,” says E. Quinn Regan, MD, an orthopaedic surgeon. “When the nerve is compressed at the root, it becomes inflamed, causing symptoms,” Dr Regan says. These symptoms can range from mild to debilitating.</p> <p>While sciatica can often resolve on its own, easing symptoms and feeling better usually requires some attention and careful behaviour modifications. Rarely, you may need more medical intervention to recover fully.</p> <p>Here’s everything you need to know about sciatica, including symptoms, how it’s diagnosed, how it’s treated, and what you can do to prevent it from recurring.</p> <p><strong>Symptoms of sciatica</strong></p> <p>Sciatica is quite literally a pain in the butt. The telltale symptom of sciatica is pain that radiates along the nerve, usually on the outside of the butt cheek and down the back of the leg. It usually only happens on one side of the body at a time. Sciatica doesn’t necessarily cause lower back pain, though it can.</p> <p>Dr Regan says that people with sciatica describe the pain as electric, burning, or stabbing, and in more severe cases, it can also be associated with numbness or weakness in the leg. If sciatica causes significant muscle weakness, to the point of losing function, and/or the pain is so bad you can’t function, it’s time to get immediate help, Dr Regan says.</p> <p>Another symptom that warrants a trip to the ER and immediate medical intervention: bowel or bladder incontinence. “That means there’s a massive compression, and the pressure is so severe it’s harming the nerves that go to the bowel and bladder,” says orthopaedic surgeon Dr Brian A. Cole. This is rare, but when it happens, it’s imperative to decompress the nerve immediately, he says.</p> <p><strong>The main causes of sciatica</strong></p> <p>The most common cause of sciatica is a herniated or slipped disc. A herniated or slipped disc happens when pressure forces one of the discs that cushion each vertebra in the spine to move out of place or rupture. Usually it’s caused when you lift something heavy and hurt your back, or after repetitive bending or twisting of the lower back from a sport or a physically demanding job.</p> <p>Sciatica also can be caused by:</p> <ul> <li>a bone spur (osteophyte), which can form as a result of osteoarthritis</li> <li>narrowing of the spinal canal (spinal stenosis), which happens with normal wear-and-tear of the spine and is more common in people over 60</li> <li>spondylolisthesis, a condition where one of your vertebrae slips out of place</li> <li>a lower back or pelvic muscle spasm or any sort of inflammation that presses on the nerve root</li> </ul> <p>Some people are born with back problems that lead to spinal stenosis at an earlier age. Other potential, yet rare, causes of sciatic nerve compression include tumours and abscesses.</p> <p><strong>Could it be piriformis syndrome?</strong></p> <p>Something known as piriformis syndrome can also cause sciatica-like symptoms, though it is not considered true sciatica. The piriformis is a muscle that runs along the outside of the hip and butt and plays an important role in hip extension and leg rotation.</p> <p>Piriformis syndrome is an overuse injury that’s common in runners, who repetitively strain this muscle, leading to inflammation and irritation. Because the muscle is so close to the sciatic nerve, piriformis syndrome can compress the nerve and cause a similar tingling, radiating pain as sciatica. The difference is that this pain is not caused by compression at the nerve root, but rather, irritation or pressure at some point along the length of the nerve.</p> <p><strong>Sciatica risk factors </strong></p> <p>Anyone can end up with a herniated disc and ultimately sciatica, but some people are more at risk than others. The biggest risk factor is age. “The discs begin to age at about age 30, and when this happens they can develop defects,” Dr Regan says. These defects slowly increase the risk of a disc slipping or rupturing.</p> <p>Men are three times more likely than women to have a herniated disc, Dr Regan says. Being overweight or obese also increases your chance of injuring a disc. A physically demanding job, regular strenuous exercise, osteoarthritis in the spine, and a history of back injury can also increase your risk. Sitting all day doesn’t help either, Dr Cole says. “You put more stress on your back biomechanically sitting than anything else you do.”</p> <p>Certain muscle weaknesses and imbalances can also make you more prone to disc injury and, consequently, sciatica. “People with weak core muscles and instability around the spine might be more prone to this since the muscles need to stabilise the joints of the vertebrae in which the nerves exit,” says Theresa Marko, an orthopaedic physical therapist.</p> <p><strong>How sciatica is diagnosed</strong></p> <p>If your symptoms suggest sciatica, your doctor will do a physical exam to check your strength, reflexes and sensation. A test called a straight leg raise can also test for sciatica, Dr Regan says. How it’s done: Patients lie face up on the floor, legs extended, and the clinician slowly lifts one leg up. At a certain point, it may trigger sciatica symptoms. (The test can also be done sitting down.)</p> <p>Depending on how severe the pain is and how long you’ve had symptoms, doctors may also do some scans (MRI or CT) on your spine to figure out what’s causing the sciatica and how many nerve roots are impacted.</p> <p>Scans can also confirm there isn’t something else mimicking the symptoms of sciatica. Muscle spasms, abscesses, hematomas (a collection of blood outside a blood vessel), tumours and Potts disease (spinal tuberculosis) can all cause similar symptoms.</p> <p><strong>Managing mild to moderate sciatica </strong></p> <p>Resting, avoiding anything that strains your back, icing the area that hurts, and taking nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, are the first-line treatment options for sciatica, Dr Regan says. If you have a physically demanding job that requires you to lift heavy things, taking some time off, if at all possible, will help.</p> <p>While it’s important to avoid activities that might make things worse, you do want to keep moving, says Marko. “Research now advises against bed rest. You want to move without overdoing it.”</p> <p>A physical therapist can help you figure out what movements are safe and beneficial to do. For example, certain motions – squatting, performing a deadlift, or doing anything that involves bending forward at the waist – can be really aggravating. Light spine and hamstring stretching, low-impact activities like biking and swimming, and core work can help. “In general, we need the nerve to calm down a bit and to strengthen the muscles of your spine, pelvis and hips,” Marko says.</p> <p>“Within a week to 10 days, about 80 percent of patients with mild to moderate sciatica are going to be doing much better,” Dr Regan says. Within four to six weeks, you should be able to return to your regular activities – with the caveat that you’ll need to be careful about straining your back to avoid triggering sciatica again.</p> <p><strong>Treating severe sciatica</strong></p> <p>If you’re trying the treatment options for mild to moderate sciatica and your symptoms worsen or just don’t get better, you may need a higher level of treatment.</p> <p>If OTC pain relievers aren’t cutting it, your doctor may prescribe a muscle relaxant like cyclobenzaprine (Flexeril).</p> <p>An epidural steroid injection near the nerve root can reduce inflammation and provide a huge relief for some people with sciatica. The results are varied, and some people may need more than one injection to really feel relief.</p> <p>Surgery is usually a last resort, only considered once all of the conservative and minimally invasive options have been exhausted. Dr Regan notes that a small percentage of people with sciatica end up needing surgery – these are usually patients who have severe enough sciatica that their primary care doctors have referred them to spinal specialists. And only about a third of patients who see spinal specialists may end up having surgery, he says.</p> <p>Surgeries to relieve disc compression are typically quick and done on an outpatient basis, according to Dr Cole.</p> <p><strong>Preventing sciatica in the future</strong></p> <p>“Once you have a back issue, you have a higher chance of having a back issue in the future,” Dr Regan says. Which means that your first bout of sciatica isn’t likely to be your last. It’s important to adopt a healthy lifestyle to reduce the risk of sciatica striking again.</p> <p>Building core strength is key. “Think of your midsection as a box, and you need to target all sides,” Marko says. “By this, I mean abdominals, obliques, diaphragm, pelvic floor, glutes and lateral hip muscles.” These muscles all support the spine, so the stronger they are, the better the spine can handle whatever is thrown its way.</p> <p>If there’s an activity you enjoy that aggravates your back, ditch it for an alternative. For example, running can trigger back pain and sciatica in some people, Dr Regan says. If you’re prone to it, try a new form of cardio that’s gentler on your back, like swimming, biking, or using the elliptical. Even just logging fewer kilometres per week can help reduce your risk.</p> <p>Dr Regan also recommends making sure you learn how to weight train properly. Lifting with the best form possible, learning your limits, and reducing weight when you need to will help keep your back safe from disc injuries.</p> <p>Making small changes to your daily life and workouts can help keep your back healthy and minimise the time you have to waste dealing with sciatica in the future.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/backtips-advice/how-to-get-rid-of-sciatica-pain-solutions-from-back-experts" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Body

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Cruise ship forced to turn back after 100 passengers injured in storm

<p>The Spirit of Discovery cruise ship was forced to turn back after around 100 passengers were injured during a massive storm. </p> <p>Cruise company Saga have said that most of the injuries were minor, but five people had to be taken to hospital when the ship returned to England on Tuesday local time. </p> <p>One passenger told<em> BBC News</em> that a few passengers  "feared for their lives", when the storm hit the ship in the Bay of Biscay, off the French coast. </p> <p>"People were writing texts to their loved ones in case we capsized," they added. </p> <p>"The tone of voice in our captain... he was physically scared. We had crew crying. We had many passengers in awful states of fear." </p> <p>The passenger also claimed that that injuries included broken bones and cuts, with reports of furniture flying around and  people  being knocked off their feet, as the ship stopped moving and veered dramatically to one side as part of its safety manoeuvre. </p> <p>Another passenger, 75-year-old Jan Bendall, told the BBC that she and her husband were "holding on for dear life", and that it was overall a frightening experience. </p> <p>"It was quite frightening, I'm not somebody who frightens easily," Bendall said.</p> <p>"We were lucky - we're quite able-bodied, but I think some of the older people and people in their own cabins were quite worried," she added.</p> <p>The ship itself holds almost 1000 passengers and holds cruises for people over 50. </p> <p>Saga told the <em>BBC </em>that there had been "very limited" damage and the ship had "remained safe at all times." </p> <p>"While the weather is clearly beyond our control, we want to offer our sincere apologies to all those affected who are now safely on their way home in calmer seas," the spokesperson said.</p> <p><em>Images: Nine News/ Facebook</em></p>

Travel Trouble

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Meg Ryan is back after a "giant break"

<p>Meg Ryan is back and she has spilled it all, ahead of her first rom-com release in nearly 15 years. </p> <p>In an interview with <em>People Magazine,</em> the <em>When Harry Met Sally </em>star revealed the reason why she took a step back from her career. </p> <p>"I took a giant break because I felt like there's just so many other parts of my experience as a human being I wanted to develop," she told the outlet. </p> <p>"It's nice to think of it as a job and not a lifestyle. And that is a great way of navigating it for me."</p> <p>The 61-year-old also shared the inspiration behind her first rom-com <em>What Happens Later, </em>which she directed, wrote and starred in. </p> <p>"It came to me during lockdown," she gushed. </p> <p>"The essence of it is these two people who are stuck together. I just love that idea that we're held in a space, even if it feels conflicted, maybe for reasons that heal them."</p> <p>This is the first rom-com that she has acted in for over a decade, with her last film in that genre being <em>Serious Moonlight</em> back in 2009.</p> <p>In another another conversation with <em>Interview</em> <em>magazine's</em> Carol Burnett, she opened up about the process of making her film. </p> <p>"Truly, the easiest part was acting in it," she told the publication. </p> <p>"I want to direct again just so I can sit in the chair, because I’m sure there’s a lot of things I missed."</p> <p>"I hadn’t done a role in a really long time, but it was fun with David," she added, referring to co-star David Duchovny, known for his role as Fox Mulder in <em>The X Files</em>.</p> <p>"A lot of it was done in two shots. I’m proud of that. I set up everything beforehand so that once we were there, it was just David and I trying to tell the truth."</p> <p>She revealed that the film was assembled together with a very "deliberate" process and a budget of only $3 million. </p> <p>"We had to do it really quickly. A lot of those extras weren’t even ours, they were real people," she said. </p> <p>"We went back in post and made everybody the same palette. There’s a lot of stuff you can do digitally now, thank god." </p> <p>The actress first shot to fame in 1980 for her girl-next-door image, after playing the love interest in iconic films like the original <em>Top Gun </em>and <em>When Harry Met Sally. </em></p> <p><em>Images: Getty Images/ Edward Berthelot/WireImage</em></p>

Movies

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"Devastating blow": Back to the Future star's tragic family news

<p><em>Back to the Future </em>star Lea Thompson, renowned for her role as Lorraine, the endearing mother of Michael J. Fox's iconic character, Marty McFly, has recently shared some deeply saddening family news.</p> <p>The 62-year-old actress opened up about her personal struggle, revealing that both of her older brothers have been diagnosed with Parkinson's disease within a few months of each other.</p> <p>This announcement resonated profoundly with her fans and followers, especially given Michael J. Fox's well-known battle with the condition since his diagnosis in 1991 at the tender age of 29.</p> <p>In an emotionally charged Instagram post, Thompson shared her family's ordeal, writing, "Both of my beloved exceptional big brothers have been diagnosed with Parkinson’s within a few months of each other. It was such a devastating blow."</p> <p>She went on to describe how the disease had stealthily crept into their lives, noting that her brothers had been displaying signs of slowing down, but the true nature of their condition hadn't been immediately apparent.</p> <p>Fortunately, their early diagnosis, made possible by the diligent efforts of researchers supported by the Michael J. Fox Foundation, has offered them access to medications and tools that have significantly improved their quality of life.</p> <p>Accompanying her heartfelt message, Thompson posted pictures of herself with her two brothers during a day of golf, capturing a precious family moment. Another poignant photo showed her brothers with their arms wrapped around each other.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/Cyz8bCxO9GF/?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/Cyz8bCxO9GF/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Lea Thompson (@lea_thompson)</a></p> </div> </blockquote> <p>Thompson's dedication to raising awareness and support for Parkinson's research was evident when she expressed feeling "honoured" to be part of a "public service announcement" for the Michael J. Fox Foundation's gala, sharing a behind-the-scenes photo from the campaign. She also expressed gratitude for the support of scientists, philanthropists, and her "movie son", Michael J. Fox, who has been an unwavering advocate for Parkinson's research.</p> <p>The response from Thompson's fans and followers was heartwarming, as they flocked to the comments section to express their solidarity. Messages of love, hope and empathy poured in from all corners, with many sharing personal connections to Parkinson's disease and the advances in treatment and therapies they have witnessed.</p> <p>Parkinson's disease is a debilitating neurodegenerative condition, and it is the second most common neurological disorder in Australia, with over 100,000 Australians grappling with its impact. Common symptoms include tremors, slowness of movement, and rigidity.</p> <p>Michael J. Fox's diagnosis at the astonishingly young age of 29 stands as a stark reminder of the disease's unpredictable reach, as the average age of diagnosis hovers around 65.</p> <p>Parkinson's disease results from the brain's inability to produce sufficient dopamine, a neurotransmitter vital for controlling movement. Diagnosing Parkinson's is not straightforward; it often relies on clinical evaluation by specialists such as neurologists, who meticulously assess clinical signs and symptoms, as there are no definitive laboratory tests like blood work or brain scans available for diagnosis.</p> <p>Lea Thompson's open acknowledgment of her family's struggle with Parkinson's disease not only shines a light on the challenges faced by those living with the condition but also underscores the importance of continued research and support for those affected. </p> <p><em>Images: Instagram</em></p>

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Dawn French hits back at "shameful" weight loss comments

<p>Dawn French has hit back at hurtful comments about her drastic weight loss almost a decade ago, admitting she "never rejected" the size she was. </p> <p>In 2014, the British comedian and actress dropped over 45kg after undergoing a hysterectomy following a terrifying cancer scare. </p> <p>The dramatic weight loss came after French's surgeon said she would heal better from the procedure if she lost weight. </p> <p>At the time, dozens of articles were written about French's transformation, praising her weight loss. </p> <p>Now, the 65-year-old has taken umbrage with the comments, telling <a href="https://www.thetimes.co.uk/article/id-never-felt-so-ugly-how-dawn-french-learnt-to-love-her-flaws-3z95kc823" target="_blank" rel="noopener"><em>The Times</em></a> how unfair it is that women are in the public eye are often “reduced” to descriptions of their appearance.</p> <p>“I have never rejected the bigger woman I have been. Lots of people do it and say, ‘Oh, you look so much better – now you look well.’ And I think, ‘F*** off! Don’t judge that other person who I loved,’” she said.</p> <p>“[British singer] Alison Moyet is a very good friend and so often she has been reduced to descriptions of her physicality.”</p> <p>“She’s this giant talent, why reduce her to that? I’m not taking any s*** from anyone about any of it,” she said.</p> <p>French went on to reflect on the early days of her career, which began in the late 1980s alongside Jennifer Saunders. </p> <p>Despite the success of their BBC show <em>French and Saunders</em>, they were often described by how they looked, something she says “never” happened to their male colleagues.</p> <p>“For many years Jennifer [Saunders] and I were always described by how we looked, especially me, because I was the bigger one.”</p> <p>“It was always about ‘running to fat’ or ‘plump’, and they never said that about any of the male comedians.”</p> <p>“I absolutely own whatever my size is and I will call myself whatever I want. But if I feel like the intent is to shame me, I will not have it,” French said.</p> <p><em>Image credits: Getty Images</em></p>

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

<p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p>If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months).</p> <p>There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles.</p> <p>We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>.</p> <p>But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again.</p> <h2>People are often given the wrong advice</h2> <p>People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis.</p> <p>But these findings are very common in people <em>without</em> low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain.</p> <p>Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain.</p> <p>In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress.</p> <p>It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves.</p> <h2>So how should low back pain be treated?</h2> <p>A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety.</p> <p>Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language.</p> <p>They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities.</p> <p>An example of this type of care is cognitive functional therapy.</p> <h2>What is cognitive functional therapy?</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out.</p> <p>The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it.</p> <p>It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>.</p> <p>Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required.</p> <h2>What’s the evidence for this type of therapy?</h2> <p>Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments.</p> <p>We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”.</p> <p>We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care.</p> <p>The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>.</p> <p>People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group.</p> <p>The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work.</p> <h2>What does this mean for you?</h2> <p>This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success.</p> <p><a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up.</p> <p>The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.</em></p>

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Loch Ness monster back in headlines after "most exciting" photo in decades

<p>A recent potential Loch Ness monster sighting has generated immense excitement among monster enthusiasts, who claim these photographs are the most captivating seen in decades.</p> <p>The incident unfolded when Chie Kelly, 51, inadvertently captured images of an unidentified, sizeable creature gliding across the surface of Loch Ness five years ago in August.</p> <p>At the time, she hesitated to release the images, fearing public ridicule. However, her decision changed after the largest 'Nessie' search in over half a century took place last month – called The Quest Weekend.</p> <p>Kelly, accompanied by her family, was enjoying a meal at an inn nestled on the shores of the Scottish loch when she began snapping photos.</p> <p>According to the <a href="https://lochness.com/findings-revealed-from-the-quest-weekend/" target="_blank" rel="noopener">Lochness.com website</a>, Chie Kelly "had lunch in the Dores Inn and then started walking around. I was just taking pictures with my Canon camera of Scott and our daughter Alisa, who was then five, when about 200 metres from the shore, moving right to left at a steady speed was this creature.</p> <p>"It was spinning and rolling at times. We never saw a head or neck. After a couple of minutes, it just disappeared and we never saw it again.</p> <p>"At first I wondered if it was an otter or a pair of otters or a seal, but we never saw a head and it never came up again for air.</p> <p>"It was making this strange movement on the surface. We did not hear any sound. There were these strange shapes below the surface. I could not make out any colours – the water was dark. I could not accurately assess its length, but the two parts that were visible were less than two metres long together.</p> <p>"I don’t know what it was, but it was definitely a creature – an animal. At the time I did not want to face public ridicule by making the photographs public. But I met Steve Feltham at the weekend and showed him the images, and he said immediately that they were ‘very interesting’.”</p> <p>Feltham has dedicated more than 30 years to the search for Nessie since abandoning his job and selling his house in 1991. After looking at the images, he said, “These are the most exciting surface pictures I have seen. They are exactly the type of pictures I have been wanting to take for three decades.</p> <p>"It is rare to see something so clear on the surface. They are vindication for all the people who believe there is something unexplained in Loch Ness. They are remarkable. I have studied them and still do not know what it is. I persuaded them that these pictures were so important they should make them public. They warrant further investigation. It is not driftwood – it is a moving creature and totally unexplained.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CrRewR8txip/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CrRewR8txip/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Chie Tchié Kelly-Kano (@kelly.chie)</a></p> </div> </blockquote> <p>Reports of the Loch Ness monster have spanned ancient history, with stories dating back to an Irish missionary allegedly rescuing a swimmer from a creature in the loch during the 7th century.</p> <p>The completion of a road adjacent to the loch in 1933 led to a surge in monster sightings. Despite numerous searches over the years, a DNA survey conducted in 2018 failed to provide any evidence of a plesiosaur or other large animals residing in the lake.</p> <p><em>Images: Instagram / Chie Kelly</em></p> <p> </p>

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Ballet flats are back. Here’s what the research says about how they affect your feet

<p><a href="https://theconversation.com/profiles/kristin-graham-1427672">Kristin Graham</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em>; <a href="https://theconversation.com/profiles/helen-banwell-305575">Helen Banwell</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em>, and <a href="https://theconversation.com/profiles/saravana-kumar-181105">Saravana Kumar</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Ballet flat shoes – those thin-heeled lightweight slip-on shoes – are making a fashion <a href="https://www.vogue.com/slideshow/ballet-flats">comeback</a>. And it’s not hard to see why: they’re versatile, easy to wear, soft, flexible and often worn by celebrities.</p> <p>We have often been warned of the dangers of high-heeled shoes, so you might think ballet flats are problem-free.</p> <p>When you look at the research, however, a complicated picture emerges. There’s no definitive evidence to show ballet flats are generally harmful to foot health in the long-term. But ill-fitting ballet flats can be a problem.</p> <h2>Make sure it fits, especially in the toe box</h2> <p>An estimated <a href="https://pubmed.ncbi.nlm.nih.gov/30065787/">70%</a> of the population are wearing ill-fitting shoes. This mismatch between foot and shoe shape can increase foot pain, <a href="https://pubmed.ncbi.nlm.nih.gov/17507530/">reduce stability</a>, and can mean more blisters, corns and calluses. And habitual wearing of tight shoes has been <a href="https://www.sciencedirect.com/science/article/pii/S0958259207000533">associated</a> with bone changes in the toes and feet over time.</p> <p>Many flats feature a shallow and narrow toe box (the part of the shoe where the toes go). A too-small toe box often doesn’t align with the shape of a foot and ends up squishing the toes. It can also <a href="https://www.sciencedirect.com/science/article/pii/S0958259206000770">increase</a> pressure on top of and under the foot, and <a href="https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-6-28">restrict</a> the movement of the forefoot during walking.</p> <p>But a too-big toe box is also a problem. Too much foot movement within the shoe can cause pressure and friction on the skin, which can also lead to calluses, corns, blisters, and wounds.</p> <p>A poorly fitting toe box can also cause micro trauma to toenails which, ultimately, can change <a href="https://www.researchgate.net/profile/Anuva-Bansal/publication/347522694_Traumatic_Nail_Disorders/links/60d6135592851ca94487df7e/Traumatic-Nail-Disorders.pdf">their look and thickness</a>.</p> <p>So if you’re wearing flats, make sure you choose a shoe with the right sized toe box.</p> <h2>What about the heel?</h2> <p>Health professionals often recommend a small heel over a completely flat shoe. Very flat shoes can <a href="https://pubmed.ncbi.nlm.nih.gov/27498844/">place</a> <a href="https://www.sciencedirect.com/science/article/pii/S0268003307002082">more</a> strain on the soft tissues that support the foot arch – specifically, the plantar fascia.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/27498844/">Research</a> has shown moving from a completely flat shoe to a small, raised heel reduces the tension force on the plantar fascia during standing activities.</p> <p>On the other hand, other <a href="https://journals.lww.com/jpojournal/Fulltext/2009/01000/Effects_of_Shoe_Heel_Height_on_the_Roll_Over.7.aspx#:%7E:text=The%20roll%2Dover%20shapes%20seem,without%20a%20change%20in%20alignment.&amp;text=Photographs%20of%20the%20prosthetic%20feet,shapes%20of%20these%20feet%20superimposed">research</a> has shown most people will adapt their ankle and knee motion to accommodate shoes of different heel heights.</p> <h2>What about support?</h2> <p>Ballet flats tend to have very flexible, thin soles and heel counters (the part, coloured red in this picture, that hugs the heel and the back part of the foot).</p> <p>These thin and flexible structures mean flats are often accused of lacking support. But debate rages among foot and shoe experts about how important support is in the first place.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/27729290/">Research</a> on barefoot-style shoes has shown walking in these types of shoes significantly reduces some loads on the knee compared to more stable supportive shoes.</p> <p>Minimalist shoes have also been found to <a href="https://pubmed.ncbi.nlm.nih.gov/30102872/">increase strength</a> in certain foot muscles used when we push off during walking, running or jumping.</p> <p>However, other research found stable supportive shoes can <a href="https://pubmed.ncbi.nlm.nih.gov/33428439/">improve knee pain</a> when walking more than flat flexible shoes.</p> <p>The thin soles in flats mean there is little cushioning under the foot. While more cushioning can improve comfort, and reduce stress and strain on your foot sole <a href="https://www.sciencedirect.com/science/article/abs/pii/S0021929011001758?casa_token=gecXFCMi0LcAAAAA:TazyTd8TRaAl_bG0jprifYIUIlWRDwEH6bVeymBYTWups2iDGMuUjLs2gaNqsiNGHVJhHC3J9AdB">skin</a>, there is no evidence it reduces loads across the lower leg.</p> <p>In fact, walking in cushioned shoes has been shown to <a href="https://pubmed.ncbi.nlm.nih.gov/20191571/">increase</a> the load on the knee compared to flat, flexible shoes.</p> <h2>So, what’s the verdict?</h2> <p>The verdict is mixed. Yes, there’s evidence poorly fitting shoes and a flat heel can be detrimental, with consequences seen in the <a href="https://www.sciencedirect.com/science/article/pii/S0966636221000199">rearfoot</a> (around the ankle) and <a href="https://www.sciencedirect.com/science/article/pii/S0966636218300687">knee</a>.</p> <p>But there’s also no hard evidence ballet flats cause long-term foot health problems.</p> <p>What matters is choosing a well-fitted shoe to suit your foot shape and needs.</p> <p>If you’re shopping for ballet flats, try to:</p> <ul> <li> <p>choose a pair with a toe box that does not cramp your toes and has a sole at least as wide as your foot</p> </li> <li> <p>choose flats that offer at least some structure and support</p> </li> <li> <p>choose a pair with a small heel rather being than completely flat.<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/207806/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/kristin-graham-1427672">Kristin Graham</a>, Lecturer in Podiatry, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/helen-banwell-305575">Helen Banwell</a>, Lecturer in Podiatry, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/saravana-kumar-181105">Saravana Kumar</a>, Professor in Allied Health and Health Services Research, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ballet-flats-are-back-heres-what-the-research-says-about-how-they-affect-your-feet-207806">original article</a>.</em></p>

Beauty & Style

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What is dandruff? How do I get rid of it? Why does it keep coming back?

<p><em><a href="https://theconversation.com/profiles/lorraine-mackenzie-1420658">Lorraine Mackenzie</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/sean-mangion-1420661">Sean Mangion</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180"><em>University of South Australia</em></a></em></p> <p>Dandruff can be dry, like snowflakes, or greasy, with yellow clumps. <a href="https://www.ncbi.nlm.nih.gov/books/NBK551707/">Up to half</a> of all adults have had this scalp condition at one point, so you’ll no doubt know about these skin flakes and the itchiness.</p> <p>Dandruff can be <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1439-0507.2008.01624.x">embarrassing</a>. It can affect many aspects of people’s lives, such as how they socialise, how they style their hair, and what clothes they wear.</p> <p>Dandruff is not a modern problem. In fact, it has been around for millennia and was <a href="https://pubmed.ncbi.nlm.nih.gov/2181905/">described</a> by Greek physicians. We don’t know for sure whether our ancestors were as bothered by it as much as we are today. But they were interested in what causes it.</p> <h2>What causes dandruff?</h2> <p>Dandruff is mainly caused by the yeast <em><a href="https://www.cell.com/cell-host-microbe/pdf/S1931-3128(19)30106-4.pdf">Malassezia</a></em>. The yeast lives on most people’s skin, either on the surface or in the opening of the hair follicle, the structure that surrounds a hair’s root and strand.</p> <p>The yeast feeds on sebum, the natural moisturiser secreted by your sebaceous glands to stop your skin drying out. These glands are attached to every hair follicle and the hair provides a dark, sheltered micro-environment ideal for the yeast to flourish.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=520&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=520&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=520&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=653&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=653&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536003/original/file-20230706-22-6t0yr8.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=653&amp;fit=crop&amp;dpr=3 2262w" alt="Diagram of skin cross-section showing hair follicle and other skin structures" /></a><figcaption><span class="caption">The yeast that causes dandruff lives on the skin surface and in the opening of the hair follicle.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/medical-education-chart-biology-hair-diagram-645657787">Shutterstock</a></span></figcaption></figure> <p>As the yeast grows, it releases molecules that irritate the skin and disrupts how the skin normally renews itself. This causes the cells to cluster together, appearing as white flakes. When there is excess sebum, this can mix with the cells and cause the dandruff to appear <a href="https://www.headandshoulders.co.in/en-in/healthy-hair-and-scalp/dandruff/yellow-dandruff">yellow</a>.</p> <p>The link between dandruff and yeast was made nearly 150 years ago. The person who first identified and described this yeast <a href="https://www.cell.com/cell-host-microbe/pdf/S1931-3128(19)30106-4.pdf">in 1874</a> was Louis-Charles Malassez (the yeast’s namesake).</p> <h2>Why do I have dandruff?</h2> <p>As <em>Malassezia</em> is found on most people, why do some people get dandruff and others don’t? This depends on a range of factors.</p> <p>These include the quality of your skin barrier. This may mean yeast can penetrate deeper if the skin is damaged in some way, for example, if it’s sunburnt. Other factors include your immunity, and external factors, such as which hair-care products you use.</p> <p>How <em>Malassezia</em> grows also depends on the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864613/">balance</a> of other microorganisms that live on your skin, such as bacteria.</p> <h2>How do I get rid of dandruff?</h2> <p>Dandruff is mostly treated with <a href="https://www.sciencedirect.com/science/article/abs/pii/S0939641123000292?via%3Dihub">anti-fungal</a> shampoos and scalp treatments to dampen down growth of <em>Malassezia</em>. The shampoos most commonly contain the anti-fungal agent <a href="https://pubmed.ncbi.nlm.nih.gov/34575891/">zinc pyrithione</a> (ZnPT for short). Other common anti-fungals in shampoos include selenium sulfide, ketoconazole and coal tar.</p> <p>You can also treat dandruff with scalp masks and scrubs that help restore the scalp barrier, by reducing inflammation and irritation. But as these may not have any anti-fungal action, your dandruff is likely to return.</p> <p>Home remedies <a href="https://www.healthline.com/nutrition/ways-to-treat-dandruff#7.-Omega-3s">include</a> tea tree oil, coconut or other oils, and honey. There is some evidence to support their use, mostly from <a href="https://pubmed.ncbi.nlm.nih.gov/35642120/">studies</a> that show extracts from botanical ingredients can reduce growth of the yeast in the lab. But there is great variation in the quality and composition of these ingredients.</p> <p>There is also the risk of making the problem worse by providing more oils that the yeast will enjoy, causing more imbalance to the scalp micro-organisms and leading to more irritation.</p> <p>So it’s best to stick with commercial products.</p> <h2>Why does my dandruff come back?</h2> <p>Your dandruff is likely to return unless the active ingredients in your shampoo can reach the right spot, at the right concentration, for the right amount of time needed to kill the yeast.</p> <p>Our <a href="https://pubmed.ncbi.nlm.nih.gov/36842718/">research</a> focussing on zinc pyrithione-based products showed these shampoos reached the skin surface. But they less-reliably ended up in the harder-to-reach hair follicles.</p> <p>We found the zinc pythione seemed <a href="https://pubmed.ncbi.nlm.nih.gov/35631659/">to target</a> the top of the follicles rather than deep into the follicles.</p> <p>So this may explain why dandruff keeps on coming back. Your shampoo’s active ingredient may not reach the yeast that causes your dandruff.</p> <p>We don’t yet know how we can encourage existing formulations to penetrate deeper into the follicles.</p> <h2>What about future treatments?</h2> <p>We’ll likely see new formulations of dandruff shampoos and scalp treatments that better deliver the active ingredient to where it’s needed – deeper into the hair follicles.</p> <p>We can also expect new active ingredients, such as <a href="https://pubmed.ncbi.nlm.nih.gov/28766952/">carbonic anhydrase</a> enzymes. These might target how the yeast grows in a different way to current active ingredients.</p> <p>We are also beginning to see the development of creams and lotions that aim to boost the health balance of flora of the skin, much like we see with similar products for the gut. These include pre-biotics (supplements or food for skin flora) or pro-biotics (products that contain skin flora). However we have <a href="https://www.mdpi.com/2079-9284/8/3/90/htm">much to learn</a> about these types of formulations.</p> <h2>In a nutshell</h2> <p>Dandruff is annoying, treatment helps, but you may need to repeat it. Hopefully, we can develop improved shampoos that better deliver the active ingredient to where it’s needed.</p> <p>But we need to strike a balance. We don’t want to eliminate all micro-organisms from our skin.</p> <p>These are important for our immunity, including preventing more disease-causing microbes (pathogens) from moving in. They also help the skin produce antimicrobial peptides (short proteins) that protect us from pathogens.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/201082/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lorraine-mackenzie-1420658">Lorraine Mackenzie</a>, Associate Professor, Clinical and Health Sciences, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/sean-mangion-1420661">Sean Mangion</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-dandruff-how-do-i-get-rid-of-it-why-does-it-keep-coming-back-201082">original article</a>.</em></p>

Body

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"Finally a celebrity fighting back": Cardi B hurls mic at concert goer

<p>The latest celebrity to be hit with something on stage has fought back, as Cardi B took revenge on the concert goer who threw a drink over her during a performance. </p> <p>The rapper, 30, was performing in Las Vegas on Saturday, as she sang her 2018 song, <em>Bodak Yellow</em>, that propelled her to global fame. </p> <p>During the song, a member of the audience threw their drink on stage, splashing the singer in the liquid. </p> <p>Cardi B immediately retaliated by lobbing her microphone into the crowd, targeting the audience member. </p> <p>The fan was led out of the crowd by security, while the performer took the time to casually fix up her hair before continuing her performance. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Cardi B throws microphone at audience member who threw a drink at her. <a href="https://t.co/alLgHMFshb">pic.twitter.com/alLgHMFshb</a></p> <p>— Pop Base (@PopBase) <a href="https://twitter.com/PopBase/status/1685461526646525952?ref_src=twsrc%5Etfw">July 30, 2023</a></p></blockquote> <p>The confrontation, which was filmed by many fellow concert goers, has since gone viral, with many commending the artist for fighting back. </p> <p>"Finally a celebrity fighting back," said one.</p> <p>"Exactly, it's about time a performer retaliated to this 'trend'," another agreed.</p> <p>"She did what needed to be done! People need to stop throwing stuff at performers," added another fan.</p> <p>The incident in Vegas was the second time in just 24 hours that the singer was captured on video hurling a microphone at inconsiderate fans. </p> <p>The singer was performing at another club in Las Vegas the night before, when the DJ in control of her music kept cutting out the track as she was trying to sing. </p> <p>After the song stopping and starting abruptly several times, Cardi B yelled out her own name before spinning around and aiming the microphone at the DJ before storming off the stage.</p> <p><em>Image credits: Twitter</em></p>

Music

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Why can’t we just tow stranded whales and dolphins back out to sea?

<p><em><a href="https://theconversation.com/profiles/vanessa-pirotta-873986">Vanessa Pirotta</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>On Tuesday night, a pod of almost 100 long-finned pilot whales stranded itself on a beach on Western Australia’s south coast. Over the course of Wednesday, more than 100 parks and wildlife staff and 250 registered volunteers worked tirelessly to try to keep alive the 45 animals surviving the night.</p> <p>They used small boats and surf skis to try to get the pilot whales into deeper water. Volunteers helped keep the animals’ blowholes above water to prevent them drowning, and poured water on them to cool them down.</p> <p>Our rescue efforts were, sadly, unsuccessful. The animals (actually large ocean-going dolphins) able to be towed or helped out to deeper water turned around and stranded themselves again, <a href="https://www.facebook.com/watch/?v=228337910167574&amp;ref=sharing">further down the beach</a>. Sadly, they had to be euthanised.</p> <p>Unfortunately, towing whales and dolphins is not simple. It can work and work well, as we saw in Tasmania last year, when dozens of pilot whales were rescued. But rescuers have to have good conditions and a fair dash of luck for it to succeed.</p> <h2>Rescuing beached whales is hard</h2> <p>When we try to rescue stranded whales and dolphins, the goal is to get them off the sandbars or beach, and back into deep water.</p> <p>Why is it so difficult? Consider the problem. First, you have to know that a pod has beached itself. Then, you have to be able to get there in time, with people skilled in wildlife rescue.</p> <p>These animals are generally too big and heavy to rely on muscle power alone. To get them out far enough, you need boats and sometimes tractors. That means the sea conditions and the slope of the beach have to be suitable.</p> <p>Often, one of the first things rescuers might do is look for those individuals who might be good candidates to be refloated. Generally, these are individuals still alive, and not completely exhausted.</p> <p>If rescuers have boats and good conditions, they may use slings. The boats need to be able to tow the animals well out to sea.</p> <p>Trained people must always be there to oversee the operation. That’s because these large, stressed animals could seriously injure humans just by moving their bodies on the beach.</p> <p>There are extra challenges. Dolphins and whales are slippery and extremely heavy. Long-finned pilot whales can weigh up to 2.3 tonnes. They may have never seen humans before and won’t necessarily know humans are there to help.</p> <p>They’re out of their element, under the sun and extremely stressed. Out of the water, their sheer weight begins to crush their organs. They can also become sunburnt. Because they are so efficient at keeping a comfortable temperature in the sea, they can overheat and die on land. Often, as we saw yesterday, they can’t always keep themselves upright in the shallow water.</p> <p>And to add to the problem, pilot whales are highly social. They want to be with each other. If you tow a single animal back out to sea, it may try to get back to its family and friends or remain disorientated and strand once again.</p> <p>Because of these reasons – and probably others – it wasn’t possible to save the pilot whales yesterday. Those that didn’t die naturally were euthanised to minimise their suffering.</p> <h2>Successful rescues do happen</h2> <p>Despite the remarkable effort from authorities and local communities, we couldn’t save this pod. Every single person working around the clock to help these animals did an amazing job, from experts to volunteers in the cold water to those making cups of tea.</p> <p>But sometimes, we get luckier. Last year, 230 pilot whales beached themselves at Macquarie Harbour, on Tasmania’s west coast. By the time rescuers could get there, <a href="https://www.theguardian.com/australia-news/2022/sep/27/44-pilot-whales-rescued-and-returned-to-sea-after-mass-stranding-at-tasmanian-beach">most were dead</a>. But dozens were still alive. This time, conditions were different and towing worked.</p> <p>Rescuers were able to bring boats close to shore. Surviving pilot whales were helped into a sling, and then the boat took them far out to sea. Taking them to the same location prevented them from beaching again.</p> <h2>Every stranding lets us learn more</h2> <p>Unfortunately, we don’t really know why whales and dolphins strand at all. Has something gone wrong with how toothed whales and dolphins navigate? Are they following a sick leader? Are human-made undersea sounds making it too loud? Are they avoiding predators such as killer whales? We don’t know.</p> <p>We do know there are stranding hotspots. Macquarie Harbour is one. In 2020, it was the site of one of the worst-ever strandings, with up to 470 pilot whales stranded. Authorities were able to save 94, drawing on trained <a href="https://www.theguardian.com/environment/2020/sep/25/death-at-hells-gates-rescuers-witness-tragic-end-for-hundreds-of-pilot-whales-on-australian-coast">rescue experts</a>.</p> <p>We will need more research to find out why they do this. What we do know suggests navigational problems play a role.</p> <p>That’s because we can divide whales and dolphins into two types: toothed and toothless. Whales and dolphins with teeth – such as pilot whales – appear to beach a lot more. These animals use echolocation (biological sonar) to find prey with high-pitched clicks bouncing off objects. But toothless baleen whales like humpbacks (there are no dolphins with baleen) don’t use this technique. They use low-frequency sounds, but to communicate, not hunt.</p> <p>So – it is possible to save beached whales and dolphins. But it’s not as easy as towing them straight back to sea, alas.</p> <p><em>The Conversation thanks 10-year-old reader Grace Thornton from Canberra for suggesting the question that gave rise to this article.</em><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/210544/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/vanessa-pirotta-873986">Vanessa Pirotta</a>, Postdoctoral Researcher and Wildlife Scientist, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Getty </em><em>Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-cant-we-just-tow-stranded-whales-and-dolphins-back-out-to-sea-210544">original article</a>.</em></p>

Travel Trouble

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Harrison Ford is back as an 80-year-old Indiana Jones – and a 40-something Indy. The highs (and lows) of returning to iconic roles

<p><a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Saddle up, don the fedora and crack that whip: Harrison Ford is back as the intrepid archaeologist in <em>Indiana Jones and the Dial of Destiny</em>. The film premiered at Cannes, where Ford was <a href="https://www.hollywoodreporter.com/movies/movie-news/harrison-ford-honorary-palme-dor-cannes-1235495463/">awarded</a> an Honorary Palme d’Or in recognition of his life’s work.</p> <p>Reviews for the fifth film in the franchise <a href="https://www.hollywoodreporter.com/movies/movie-news/indiana-jones-5-review-roundup-1235495961/">have been mixed</a>, and it is the first Indy film not to be directed by Steven Spielberg (this time, it’s James Mangold, best known for his motor-racing drama Ford v Ferrari).</p> <p>But this is “event” cinema that combines nostalgia, old-school special effects and John Williams’ <a href="https://theconversation.com/from-jaws-to-star-wars-to-harry-potter-john-williams-90-today-is-our-greatest-living-composer-176245">iconic score</a>.</p> <p>So, Ford is back, aged 80. What draws actors back after all this time?</p> <figure><iframe src="https://www.youtube.com/embed/eQfMbSe7F2g?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Role returns</h2> <p>Ford first played Indy in 1981 and last played him in 2008. That is a full 15 years since the most recent film in the series, and 42 years since his first outing in <em>Raiders of the Lost Ark</em>.</p> <p>Ford has form in returning to celebrated characters. One of the great pleasures of watching <em>The Force Awakens</em> back in 2015 was seeing Ford play Han Solo again for the <a href="https://www.dailymotion.com/video/x3j2j09">first time in over 30 years</a>.</p> <figure><iframe src="https://www.youtube.com/embed/0xQSIdSRlAk?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Actors return to roles for numerous reasons:</p> <ul> <li>financial (Ford was reportedly paid <a href="https://okmagazine.com/exclusives/harrison-ford-paid-indiana-jones-5-plagued-with-problems/">US$25 million</a> for <em>Dial of Destiny</em>)</li> <li>protection of their brand, image and star persona (Michael Keaton <a href="https://www.fortressofsolitude.co.za/the-flash-movies-biggest-hero-how-michael-keaton-saved-the-film/">returning to play Batman</a> after three decades and three other actors who have embodied the role)</li> <li>professional (Tom Cruise admitted over the 36 years between <em>Top Gun</em> films he wanted to make sure the sequel <a href="https://screenrant.com/top-gun-maverick-tom-cruise-return-how-explained/">could live up to the original</a>)</li> <li>personal (once-huge stars are working less and less, and only feel the need to return to a built-in fan base every few years – Bill Murray in the 2021 <em>Ghostbusters</em> sequel springs to mind).</li> </ul> <p>It’s not always a successful endeavour.</p> <p>Arnold Schwarzenegger and Sylvester Stallone – two of the biggest action stars of the 1980s off the back of iconic roles as <em>The Terminator</em>, Rocky Balboa and John Rambo – have repeatedly returned to those roles, and critics have been <a href="https://screenrant.com/terminator-dark-fate-undermined-john-connor-storyline-franchise-bad/">particularly harsh</a>.</p> <p>It did not work for Sigourney Weaver in <em><a href="https://www.rogerebert.com/reviews/alien-resurrection-1997">Alien: Resurrection</a></em> in 1997, 18 years after her first time as Ripley; nor for Keanu Reeves in <em><a href="https://www.theguardian.com/film/2021/dec/21/the-matrix-resurrections-review-keanu-reeves">The Matrix Resurrections</a></em> in 2021, 23 years after the original.</p> <p>And still, I’m intrigued to see what Michael Mann could do with his long-rumoured sequel to <em>Heat</em>, his definitive 1995 crime film. Ever since Mann published his novel Heat 2 last year – a kind of origin story for <em>Heat’s</em> key protagonists – fans have been hoping a de-aged Al Pacino (now aged 83) <a href="https://deadline.com/2023/04/michael-mann-heat-2-warner-bros-adam-driver-young-neil-mccauley-1235316777/">might return</a> as LA cop Vincent Hanna.</p> <h2>Undoing time</h2> <p>“Digital de-ageing” first entered the Hollywood mainstream in 2019 with <em>The Irishman</em> and <em>Captain Marvel</em>.</p> <p><a href="https://www.indiewire.com/features/craft/de-aging-actors-history-benjamin-button-dial-of-destiny-harrison-ford-1234863938/">Via this process</a>, older actors (Robert De Niro, Al Pacino and Samuel L. Jackson have all been subject to the technology) move back and forwards in time without younger actors having to play them.</p> <figure><iframe src="https://www.youtube.com/embed/OF-lElIlZM0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Films still tend to cast two actors to play older and younger versions of the same character, a choice that dates back at least to 1974’s <em>The Godfather Part II</em>, in which a young Robert de Niro plays Vito Corleone, portrayed by the much older Marlon Brando in the first film.</p> <p>In 1989, <em>Indiana Jones and the Last Crusade</em> features a delightful opening scene where River Phoenix plays the young version of Indiana Jones, before Ford takes over for the rest of the film.</p> <figure><iframe src="https://www.youtube.com/embed/AwH6-Yh7_SM?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Actors used to just play characters of their own age when reprising earlier roles. Paul Newman finally won a Best Actor Oscar for his role as “Fast Eddie” Felson in <em>The Color of Money</em> (1986), a quarter of a century after first playing him in The Hustler.</p> <p>The sequel plays on Newman’s age, and his role as a mentor to an upcoming Tom Cruise, and bathes viewers in nostalgia and memories of <a href="https://faroutmagazine.co.uk/paul-newman-schooled-tom-cruise-the-color-of-money/">a younger Newman</a>.</p> <figure><iframe src="https://www.youtube.com/embed/k7gmrKAFshE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But actors no longer have to exclusively play their age.</p> <p>The first part of <em>Dial of Destiny</em> is an extended flashback, set in 1944, in which Ford has been digitally de-aged to appear in his 40s. This process used an AI system that scanned used and unused reels of footage of Ford from <a href="https://www.cbr.com/harrison-ford-de-aging-indiana-jones-dial-of-destiny/">the first three Indy films</a> to match his present-day performance.</p> <p>Here, it is as if we are getting two Fords for the price of one: the “younger”, fitter Indy and the older, more world-weary version. It makes for a powerfully emotional connection on screen.</p> <p>Yet there are some <a href="https://variety.com/2023/film/awards/indiana-jones-5-harrison-ford-de-aging-not-working-1235618698/">pitfalls to de-ageing</a>. Some viewers complain that the whole process is distracting and that the hyper-real visual look of de-aged scenes resembles a video game.</p> <p>Even so, de-ageing in Hollywood cinema is here to stay. Tom Hanks’s <a href="https://variety.com/2023/film/news/tom-hanks-robin-wright-digitally-deaged-robert-zemeckis-movie-1235507766/">next film</a> is using AI-based generative technology to digitally de-age him.</p> <p>Given its reduced cost, speed and reduced human input, AI-driven innovation might have <a href="https://filmstories.co.uk/news/new-ai-driven-de-ageing-tools-to-be-used-in-tom-hanks-project/">industry-changing ramifications</a>.</p> <h2>The star of Ford</h2> <p>Harrison Ford remains a bona fide “movie star” in an industry profoundly buffeted by COVID, the rise of streaming platforms, the demise of the monoculture, and the changing nature of who constitutes a star.</p> <p>In the midst of all this industry uncertainty, it seems there is no longer a statute of limitations on actors returning to much-loved characters.</p> <p>The next big ethical issue for the film industry as it further embraces AI is whether to <a href="https://collider.com/james-dean-digital-cgi-performance-in-new-movie/">resurrect deceased actors</a> and cast them in new movies.</p> <p>Still, I’m looking forward to seeing more actors de-aged as the technology improves and audiences acclimatise to watching older actors “playing” younger versions of themselves. We are only at the start of Hollywood’s next big adventure.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/202357/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, Associate Professor of French Studies, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/harrison-ford-is-back-as-an-80-year-old-indiana-jones-and-a-40-something-indy-the-highs-and-lows-of-returning-to-iconic-roles-202357">original article</a>.</em></p>

Movies

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Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <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></em></p> <p>Opioids are the one of the most prescribed pain-relief for people with low back and neck pain. In Australia, around <a href="https://link.springer.com/article/10.1007/s00586-017-5178-4">40% of people</a> with low back and neck pain who present to their GP and <a href="https://qualitysafety.bmj.com/content/28/10/826">70% of people</a> with low back pain who visit a hospital emergency department are prescribed opioids such as oxycodone.</p> <p>But our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext">new study</a>, published today in the Lancet medical journal, found opioids do not relieve “acute” low back or neck pain (lasting up to 12 weeks) and can result in worse pain.</p> <p>Prescribing opioids for low back and neck pain can also cause <a href="https://www.healthdirect.gov.au/taking-opioid-medicines-safely">harms</a> ranging from common side effects – such as nausea, constipation and dizziness – to <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/opioid-harm-in-australia/summary">misuse, dependency, poisoning and death</a>.</p> <p>Our findings show opioids should <em>not</em> be recommended for acute low back pain or neck pain. A change in prescribing for low back pain and neck pain is urgently needed in <a href="https://www.tga.gov.au/resources/publication/publications/addressing-prescription-opioid-use-and-misuse-australia">Australia</a> and <a href="https://www.thelancet.com/commissions/opioid-crisis">globally</a> to reduce opioid-related harms.</p> <h2>Comparing opioids to a placebo</h2> <p>In our trial, we randomly allocated 347 people with acute low back pain and neck pain to take either an opioid (oxycodone plus naloxone) or <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo</a> (a tablet that looked the same but had no active ingredients).</p> <p>Oxycodone is an opioid pain medicine which can be given orally. <a href="https://www.nps.org.au/radar/articles/oxycodone-with-naloxone-controlled-release-tablets-targin-for-chronic-severe-pain">Naloxone</a>, an opioid-reversal drug, reduces the severity of constipation while not disrupting the pain relieving effects of oxycodone.</p> <p>Participants took the opioid or placebo for a maximum of six weeks.</p> <p>People in the both groups also received <a href="https://www.sciencedirect.com/science/article/pii/S1836955321000941">education and advice</a> from their treating doctor. This could be, for example, advice on returning to their normal activities and avoiding bed rest.</p> <p>We assessed their outcomes over a one-year period.</p> <h2>What did we find?</h2> <p>After six weeks of treatment, taking opioids did not result in better pain relief compared to the placebo.</p> <p>Nor were there benefits to other outcomes such as physical function, quality of life, recovery time or work absenteeism.</p> <p>More people in the group treated with opioids experienced nausea, constipation and dizziness than in the placebo group.</p> <p>Results at one year highlight the potential long-term harm of opioids even with short-term use. Compared to the placebo group, people in the opioid group experienced slightly worse pain, and reported a higher risk of <a href="https://academic.oup.com/painmedicine/article/20/1/113/4728236#129780622">opioid misuse</a> (problems with their thinking, mood or behaviour, or using opioids differently from how the medicines were prescribed).</p> <p>More people in the opioid group reported pain at one year: 66 people compared to 50 in the placebo group.</p> <h2>What will this mean for opioid prescribing?</h2> <p>In recent years, international low back pain guidelines have shifted the focus of treatment from drug to non-drug treatment due to <a href="https://www.thelancet.com/article/S0140-6736(18)30489-6/fulltext">evidence</a> of limited treatment benefits and concern of medication-related harm.</p> <p>For acute low back pain, <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">guidelines</a> recommend patient education and advice, and if required, anti-inflammatory pain medicines such as ibuprofen. Opioids are <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">recommended only</a> when other treatments haven’t worked or aren’t appropriate.</p> <p>Guidelines for <a href="https://pubmed.ncbi.nlm.nih.gov/33064878/">neck</a> pain similarly discourage the use of opioids.</p> <p>Our latest research clearly demonstrates the benefits of opioids do not outweigh possible harms in people with acute low back pain and neck pain.</p> <p>Instead of advising opioid use for these conditions in selected circumstances, opioids should be discouraged without qualification.</p> <h2>Change is possible</h2> <p>Complex problems such as opioid use need smart solutions, and another study we recently conducted provides convincing data opioid prescribing can be successfully reduced.</p> <p>The <a href="https://qualitysafety.bmj.com/content/30/10/825">study</a> involved four hospital emergency departments, 269 clinicians and 4,625 patients with low back pain. The intervention comprised of:</p> <ul> <li>clinician education about <a href="https://aci.health.nsw.gov.au/networks/musculoskeletal/resources/low-back-pain">evidence-based management</a> of low back pain</li> <li>patient education using posters and handouts to highlight the benefits and harms of opioids</li> <li>providing heat packs and anti-inflammatory pain medicines as alternative pain-management treatments</li> <li>fast-tracking referrals to outpatient clinics to avoid long waiting lists</li> <li>audits and feedback to clinicians on information about opioid prescribing rates.</li> </ul> <p>This intervention reduced opioid prescribing from <a href="https://qualitysafety.bmj.com/content/30/10/825">63% to 51% of low back pain presentations</a>. The <a href="https://emj.bmj.com/content/early/2023/04/02/emermed-2022-212874">reduction was sustained for 30 months</a>.</p> <p>Key to this successful approach is that we worked with clinicians to develop suitable pain-management treatments without opioids that were feasible in their setting.</p> <p>More work is needed to evaluate this and other interventions aimed at reducing opioid prescribing in other settings including GP clinics.</p> <p>A nuanced approach is often necessary to avoid causing <a href="https://theconversation.com/opioid-script-changes-mean-well-but-have-left-some-people-in-chronic-pain-156753">unintended consequences</a> in reducing opioid use.</p> <p>If people with low back pain or neck pain are using opioids, especially at higher doses over an extended period of time, it’s important they seek advice from their doctor or pharmacist before stopping these medicines to avoid <a href="https://www.healthdirect.gov.au/opioid-withdrawal-symptoms">unwanted effects when the medicines are abruptly stopped</a>.</p> <p>Our research provides compelling evidence opioids have a limited role in the management of acute low back and neck pain. The challenge is getting this new information to clinicians and the general public, and to implement this evidence into practice.<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/203244/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><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/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, Postdoctoral Research Associate in Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <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></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/opioids-dont-relieve-acute-low-back-or-neck-pain-and-can-result-in-worse-pain-new-study-finds-203244">original article</a>.</em></p>

Body

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Why does my back get so sore when I’m sick? The connection between immunity and pain

<p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID?</p> <p>This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”.</p> <p>A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats.</p> <h2>Immunology basics</h2> <p>Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing.</p> <p>When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology.</p> <p>This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual.</p> <h2>Invisibly small changes</h2> <p>Part of this self-protective response is a change in how we perceive threats, including sensory stimuli.</p> <p>When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain.</p> <p>Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>.</p> <h2>Immune memories</h2> <p>This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>.</p> <p>Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are.</p> <p>After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>.</p> <p>Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>.</p> <h2>When to worry and what to do</h2> <p>If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves.</p> <p>While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain.</p> <p>Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>.</p> <p>Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse.</p> <p>Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness.</p> <p>Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications.</p> <h2>All in the mind?</h2> <p>Is this all mind over matter? A little of yes and a lot of no.</p> <p>The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level.</p> <p>But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<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/207222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.</em></p>

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Tina Turner: an immense talent with a voice and back catalogue that unites disparate music lovers

<p><em><a href="https://theconversation.com/profiles/freya-jarman-535397">Freya Jarman</a>, <a href="https://theconversation.com/institutions/university-of-liverpool-1198">University of Liverpool</a></em></p> <p>On a few rare occasions (often at the end of a night), I’ve confided to my friends that Tina Turner was one of my biggest celebrity crushes. The revelation has usually been met with some surprise, and not unreasonably. Born in 1939, Tina was older than my mother and nearly 40 years older than me.</p> <p>But to me, she was a complete goddess from the moment I first encountered her. I vividly recall a white button-down shirt and figure-hugging blue jeans (probably the Foreign Affair tour of 1990) and an awakening of teenage desire.</p> <p>Turner has died aged 83. Reflecting now on her 50-year-long career, I can see the threads that made her the perfect icon for the young queer feminist I was in the early 90s. She was a strong and resilient woman who escaped the control of abusive men and went on to forge a stronger solo career afterwards.</p> <p>But her music also pushed boundaries of genre in ways that start to defy categories of gender, race and age, thereby changing the way female performers could be thought of.</p> <p>In 1967, Turner was both the first Black artist and woman to appear on the cover of <a href="https://www.rollingstone.com/music/music-pictures/tina-turner-rolling-stone-covers-916255/">Rolling Stone</a>. She remains the only Black woman to have been inducted twice into the Rock and Roll Hall of Fame. In 2013, she became the oldest person (at 73) to appear on the <a href="https://www.thecut.com/2013/03/tina-turner-oldest-vogue-cover-model.html">cover of Vogue</a>.</p> <p>Vocally, Turner was raised in the church, Spring Hill Baptist Church in Nutbush, specifically. However, her voice was different from the others she came up alongside.</p> <p>Unlike Dionne Warwick, Aretha Franklin or Diana Ross, Turner’s voice had a grit and a rasp, qualities that always added an unexpected edge to her early work. It was also a sound that enabled her to move beyond soul and blues in her solo career.</p> <h2>A genre-fluid singer</h2> <p>Turner’s first solo album (in 1974) was country, replete with steel guitars and talk of the bayou. The very next year, she performed the role of the <a href="https://www.youtube.com/watch?v=2rJGX8uqoL8&amp;ab_channel=StevenPrestidge">Acid Queen</a> in film of The Who’s psychedelic operetta fantasy, Tommy. The role gave its name to an album featuring several notable rock covers by Turner, such as Led Zeppelin’s Whole Lotta Love.</p> <p>Famously, she escaped from an abusive relationship with her singing partner Ike Turner, securing the rights to her stage name to her comparative financial detriment in their divorce settlement in 1978. Ike exerted his dominance in plain sight, slipping verbal threats of violence into <a href="https://youtu.be/FqdhfwUd2lk?t=88">a live performance of I’ve Been Loving You Too Long</a> at a concert in Ghana (1971).</p> <p>From the early 1980s, Turner made what has repeatedly been described as one of the most remarkable career comebacks of the century. The chart success of her cover of Al Green’s <a href="https://www.youtube.com/watch?v=4rFB4nj_GRc&amp;ab_channel=TinaTurner">Let’s Stay Together</a> (1983) came from left of field and the ensuing album, Private Dancer (1984) went platinum five times.</p> <figure><iframe src="https://www.youtube.com/embed/d4QnalIHlVc?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Private Dancer represented another musical turn, this time towards the electro-synth pop world inhabited by Heaven 17, whose Rupert Hine and Martyn Ware produced several of the songs.</p> <p>The title song of the album exemplifies the narrative of Tina as a feminist powerhouse. Even 40 years on, the idea of a woman in her mid-40s singing a pop song about sex work is somewhat surprising.</p> <p>It’s not just an allusion to sex work (like, for instance, Blondie’s Call Me). And it’s far from the many songs about female sex workers written and performed by men (take Roxanne by The Police or Killer Queen by Queen for instance).</p> <p>Private Dancer is an explicit and unambiguous declaration of female desire and power in the first person. If anyone were in any doubt that Beyoncé owes a great deal to Turner’s trailblazing, her video for <a href="https://www.youtube.com/watch?v=pZ12_E5R3qc&amp;ab_channel=Beyonc%C3%A9VEVO">Partition</a> is surely evidence, being a direct descendant of Private Dancer with its cage-dancing sex show.</p> <p>Over her 14 solo albums, Turner developed a remarkable capacity to push through boundaries and exist between categories. Along the way, she also changed how a woman in popular music was positioned for consumption. This magic made her fans in all sorts of music listeners.</p> <h2>A musical uniter</h2> <p>Turner’s musical agility allowed her to inhabit contradictory musical spaces simultaneously. For instance, there is the Tina Turner who makes regular appearances on the setlists of DJs at retro club nights, inspiring inebriated patrons to shake their tail feathers in unison.</p> <p>There is an exuberance here that crosses times and identities to bring a crowd together in the ritual of “rolling on the river”. It’s a song that also invites all shades of <a href="https://www.youtube.com/watch?v=GLUJz5xrdds&amp;ab_channel=ThatRPDRChannel">drag performance to honour it</a>.</p> <figure><iframe src="https://www.youtube.com/embed/GC5E8ie2pdM?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Then there is the Tina Turner who appears – frequently as the only woman, and perhaps uniquely as a Black woman – on compilations targeted at a predominantly male audience.</p> <p>The world of “dad rock” and “driving anthems” is a stronghold of largely white, male baby boomers. Think Robert Palmer, ZZ Top, The Jam and Whitesnake. There alongside them is Turner with songs like The Best, We Don’t Need Another Hero and Nutbush City Limits.</p> <p>Tina Turner’s capacity to transcend these borders of genre, and with them, borders of race, age, and gender, is what made her the absolute legend that she was. To me, it will also always represent a hybridity that calls to my identity as a queer feminist.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/206526/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/freya-jarman-535397">Freya Jarman</a>, Reader in the Department of Music, <a href="https://theconversation.com/institutions/university-of-liverpool-1198">University of Liverpool</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/tina-turner-an-immense-talent-with-a-voice-and-back-catalogue-that-unites-disparate-music-lovers-206526">original article</a>.</em></p>

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"Get my voice back": Kathy Griffin's intense pre-op drama

<p>Kathy Griffin has shared footage of her pre-operation appointment before she undergoes vocal cord surgery in an effort to save her voice.</p> <p>The American comedian took to TikTok to show fans the process of her surgeon sticking a camera scope up her nose and through to her vocal cord to get a clearer view of the damage.</p> <p>"First step is the numbing spray. Then the scope goes up the nose, down into the vocal cords!" she explained with captions.</p> <p>"As you can see, the left chord is paralyzed.”</p> <p>After she was instructed to make noises to test the cords, Griffin is seen following the doctor’s orders and watching her vocal cord movement on the screen.</p> <p>Griffin reflected post-operation in the same clip, with the 62-year-old lying in a recovery bed following the surgery.</p> <div><iframe title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7242029180651687214&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40kathygriffin%2Fvideo%2F7242029180651687214&image=https%3A%2F%2Fp19-sign.tiktokcdn-us.com%2Fobj%2Ftos-useast5-p-0068-tx%2F202ea4a9813e435c92a1c6996f018c11_1686166329%3Fx-expires%3D1686236400%26x-signature%3D%252Bk5fTTtG0O6jMWR7Pnky9ekvIlw%253D&key=5b465a7e134d4f09b4e6901220de11f0&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> <p>"I just had my latest surgery on my left vocal cord, because I want to be in good shape for my big Vegas show," she said.</p> <p>"This is just part of my recovery post-lung cancer surgery," she added. "I'm cancer-free, so anyway a little scratchy today, but I'll be in good shape.”</p> <p>"I so appreciate you guys following along on my journey to get my voice back after lung cancer,” Griffin captioned the video, also sharing it to her Instagram.</p> <p>Griffin had part of her lung removed in 2021 after being diagnosed with lung cancer and was in remission four months later.</p> <p>Her latest hospital visit comes after she revealed her diagnosis of “complex PTSD” in early 2023.</p> <p>Griffin shared her diagnosis in a TikTok in April, asking her followers for recommendations on how to cope with anxiety and depression.</p> <p>"Let's talk about PTSD. Never talked about it publicly," she said. "You can laugh or whatever, but I've been diagnosed with complex PTSD, and it's called an extreme case."</p> <p><em>Image credit: TikTok</em></p>

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Is it true the faster you lose weight the quicker it comes back? Here’s what we know about slow and fast weight loss

<p><em><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></em></p> <p>When people decide it’s time to lose weight, they’re usually keen to see quick results. Maybe they have an event coming up or want relief from health problems and discomfort.</p> <p>But expert guidelines typically recommend slower weight loss for the treatment of obesity. This tallies with a a widely held opinion that fast weight loss is more quickly regained. Slow weight loss is generally perceived as better for your health and more sustainable. Many programs offering “the fastest way to lose weight” are considered fad diets that severely restrict calories or eliminate some foods.</p> <p>But does slow and steady really win the weight-loss race? Or is fast weight loss just as effective and safe?</p> <h2>What’s the difference between slow and fast weight loss?</h2> <p>Governing bodies typically <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/weight-loss-a-healthy-approach">recommend</a> a weight loss of 0.5 to 1 kilogram each week, which would be defined as slow weight loss.</p> <p>So <a href="https://medlineplus.gov/ency/patientinstructions/000885.htm#:%7E:text=Rapid%20weight%20loss%20diet%20is,a%20week%20over%20several%20weeks.">fast weight loss</a> – also termed “rapid weight loss” – is losing more than 1 kilo a week over several weeks.</p> <h2>What does the research say about fast weight loss?</h2> <p>There are several well-conducted studies examining differing approaches.</p> <p>One <a href="https://pubmed.ncbi.nlm.nih.gov/25459211/">study</a> of 200 people randomly assigned them to fast or slow weight loss – 12 weeks versus 36 weeks – aimed at a 15% reduction in weight.</p> <p>The fast weight loss group was put on a very low energy diet using meal replacements, including shakes, bars and soups, three times per day. The slow weight loss group was advised on the <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Australian Guide to Healthy Eating</a> with the goal to eat 500 calories less than they used for energy (creating a calorie deficit) each day. They also used one to two meal replacements daily.</p> <p>Some 50% of the slow weight loss group and 81% of the fast weight loss group achieved 12.5% or more weight loss during this time.</p> <p>After this initial phase, those who had lost 12.5% or more were then placed on a weight maintenance diet for approximately 2.75 years.</p> <p>By the three-year mark, 76% of those in the slow weight loss and the same percentage of those in the fast weight loss group had regained their lost weight.</p> <p>So, it didn’t matter if they had lost it slow or fast, they still regained the weight.</p> <p>However, another <a href="https://www.sciencedirect.com/science/article/pii/S2405844020308513#bib17">study</a> on 101 postmenopausal women found fast weight loss resulted in better outcomes than a slow weight loss group at the three-year mark.</p> <p>But there are other factors to consider, aside from weight loss, when it comes to the differing ways of losing weight – such as changes in body composition and bone mineral density.</p> <p>This is best highlighted by a large <a href="https://pubmed.ncbi.nlm.nih.gov/32576318/">meta-analysis</a>. These type of studies combine the results of all previous well-conducted studies on the topic.</p> <p>While this <a href="https://pubmed.ncbi.nlm.nih.gov/32576318/">analysis</a> found the magnitude of weight loss was similar for both approaches, slow weight loss resulted in better outcomes than fast weight loss with respect to metabolism or how many calories we burn at rest.</p> <p>There were no differences in the amount of fat-free mass or muscle mass lost between the slow and fast weight loss groups. But slow weight loss resulted in greater reductions in fat mass and therefore a better fat-to-muscle ratio.</p> <p>Slow weight loss also seems better for bone density, because rapid weight loss results in a <a href="https://www.sciencedirect.com/science/article/pii/S2405844020308513#bib17">twice as much bone loss</a> and puts a person at increased risk of brittle bones or osteoporosis.</p> <h2>What about other diet approaches?</h2> <p>Research shows it doesn’t matter what type of macronutrient diet you follow – moderate or high-protein diet, low or high-carbodyrate diet, low or high-fat diet. All diet approaches achieve similar <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa0804748">weight loss outcomes</a>.</p> <p>The same can be said for fashionable ways of cutting calories from the diet, such as intermittent fasting. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">Research</a> has shown such diets don’t result in any better weight loss results than any of its predecessors. This is because our body is extremely good at <a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">protecting against weight loss</a>.</p> <h2>When you want to lose weight consider …</h2> <p><strong>Your metabolism</strong> When you lose large amounts of weight, you resting metabolic rate – the energy you burn at rest – will lower. Keeping your resting metabolic rate high is essential for keeping the weight off. Unfortunately, once it slows down, your resting metabolic rate doesn’t recover to the level it was pre-dieting <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21538">even after you regain weight</a>.</p> <p>However, research has confirmed <a href="https://pubmed.ncbi.nlm.nih.gov/32576318/">slow weight loss</a> preserves your resting metabolic rate compared with rapid weight loss. As does a weight loss program <a href="https://www.sciencedirect.com/science/article/pii/S2161831323002867?via%3Dihub">that includes exercise</a> rather than one that focuses on diet alone.</p> <p><strong>Side effects</strong> While restrictive diets can achieve rapid results, studies suggest they can come with adverse effects. This includes a <a href="https://pubmed.ncbi.nlm.nih.gov/16350561/">higher risk of gallstones</a> and deficiencies that can result in poor immune function, fatigue and a <a href="https://pubmed.ncbi.nlm.nih.gov/32613096/">decrease in bone density</a>. Such restrictive diets can make it challenging to meet your nutritional needs.</p> <p><strong>Sustainability</strong> Many fast weight loss diets restrict or exclude foods required for long-term health. Carbohydrates are often banned, yet wholegrain carbohydrates are an essential source of nutrition, helping with weight loss and <a href="https://www.sciencedirect.com/science/article/pii/S0002822301001948">prevention of disease</a>. Including meal replacements as part of a restrictive diet is also not sustainable for long.</p> <h2>The bottom line?</h2> <p>Regardless of how you lose the weight, it’s very difficult to maintain losses. Our bodies work to keep our weight around a <a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">set point</a> by adjusting our biological systems and imposing a series of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">physiological changes</a> within the body to ensure we regain weight we lose. This stems from our hunter-gatherer ancestors, whose bodies developed this survival response to adapt to periods of deprivation when food was scarce.</p> <p>Successful long-term weight loss comes down to:</p> <p><strong>1.</strong> following evidence-based programs based on what we know about the science of obesity</p> <p><strong>2.</strong> losing weight under the supervision of qualified health-care professionals</p> <p><strong>3.</strong> making gradual changes to your lifestyle – diet, exercise and sleep – to ensure you form health habits that last a lifetime.</p> <p>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register for free <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">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/198301/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><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></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-true-the-faster-you-lose-weight-the-quicker-it-comes-back-heres-what-we-know-about-slow-and-fast-weight-loss-198301">original article</a>.</em></p>

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