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To tackle gendered violence, we also need to look at drugs, trauma and mental health

<p><em><a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged <a href="https://ministers.pmc.gov.au/gallagher/2024/helping-women-leave-violent-partner-payment">more than A$925 million</a> over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.</p> <p>However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.</p> <h2>Why is this crucial?</h2> <p>The World Health Organization estimates <a href="https://iris.who.int/bitstream/handle/10665/341604/WHO-SRH-21.6-eng.pdf?sequence=1">30% of women</a> globally have experienced intimate partner violence, gender-based violence or both. In Australia, <a href="https://www.abs.gov.au/statistics/people/crime-and-justice/partner-violence/latest-release#key-statistics">27% of women</a> have experienced intimate partner violence by a co-habiting partner; <a href="https://pubmed.ncbi.nlm.nih.gov/37004184/">almost 40%</a> of Australian children are exposed to domestic violence.</p> <p>By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.</p> <p>These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.</p> <h2>What’s the link with mental health, trauma and drugs?</h2> <p>The relationships between mental illness, drug use, traumatic experiences and violence are complex.</p> <p>When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there <a href="https://theconversation.com/bondi-attacker-had-mental-health-issues-but-most-people-with-mental-illness-arent-violent-227868">is evidence</a> people with serious mental illness can be more likely to become violent.</p> <p>The use of alcohol and other drugs also <a href="https://theconversation.com/alcohol-and-drug-use-exacerbate-family-violence-and-can-be-dealt-with-69986">increases the risk</a> of domestic violence, including intimate partner violence.</p> <p>About <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/understanding-fdsv/factors-associated-with-fdsv">one in three</a> intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/">using alcohol or other drugs</a>.</p> <p>It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00075-0/fulltext">high rates</a> of trauma among people who become violent.</p> <p>For example, experiences of childhood trauma (such as witnessing physical abuse) <a href="https://www.sciencedirect.com/science/article/pii/S1359178915000828?via%3Dihub">can increase the risk</a> of perpetrating domestic violence as an adult.</p> <p>Early traumatic experiences can affect the brain and body’s <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0895-4">stress response</a>, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.</p> <p>This response to stress increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675346/">alcohol and drug problems</a>, developing <a href="https://pubmed.ncbi.nlm.nih.gov/30798897/">PTSD</a> (post-traumatic stress disorder), and <a href="https://psycnet.apa.org/record/2015-17349-001">increases the risk</a> of perpetrating intimate partner violence.</p> <h2>How can we address these overlapping issues?</h2> <p>We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.</p> <p>The early intervention and treatment of <a href="https://doi.org/10.1186/s12905-019-0728-z">mental illness</a>, <a href="https://doi.org/10.1177/1541204020939645">trauma</a> (including PTSD), and <a href="https://doi.org/10.1016/j.avb.2015.06.001">alcohol and other drug use</a>, could help reduce violence. So extra investment for these are needed. We also need more investment to <a href="https://www.sciencedirect.com/science/article/pii/S2212657023000508">prevent mental health issues</a>, and preventing alcohol and drug use disorders from developing in the first place.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S074937972200023X?via%3Dihub">Preventing trauma</a> from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. <a href="https://journals.sagepub.com/doi/10.1177/070674371105600505">Safe and supportive</a> environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.</p> <p>We also need to acknowledge the widespread <a href="https://store.samhsa.gov/product/practical-guide-implementing-trauma-informed-approach/pep23-06-05-005">impact of trauma</a> and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.</p> <h2>How about programs for perpetrators?</h2> <p>Most existing standard intervention programs for perpetrators <a href="https://journals.sagepub.com/doi/10.1177/1524838018791268">do not consider</a> the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have <a href="https://psycnet.apa.org/doi/10.1037/a0012718">little</a> or <a href="https://doi.org/10.1016/j.cpr.2021.101974">mixed effects</a> on the behaviour of perpetrators.</p> <p>But we could improve these programs with a <a href="http://rcfv.archive.royalcommission.vic.gov.au/MediaLibraries/RCFamilyViolence/Reports/RCFV_Full_Report_Interactive.pdf">coordinated approach</a> including treating mental illness, drug use and trauma at the same time.</p> <p>Such “<a href="https://www.sciencedirect.com/science/article/pii/S014976341930449X?via%3Dihub">multicomponent</a>” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.</p> <h2>What needs to happen next?</h2> <p>Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.</p> <p>We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.</p> <p>We also need to look more widely at preventing intimate partner violence and gendered violence.</p> <p>We need developmentally appropriate <a href="https://theconversation.com/4-things-our-schools-should-do-now-to-help-prevent-gender-based-violence-228993">education and skills-based programs</a> for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.</p> <p>We also need to address the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278040/">social determinants of health</a> that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.</p> <p>All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.</p> <hr /> <p><em>The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.</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/229182/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <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/to-tackle-gendered-violence-we-also-need-to-look-at-drugs-trauma-and-mental-health-229182">original article</a>.</em></p>

Caring

How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a></em></p> <p>People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">good sleep is imperative</a>.</p> <p>However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health?</p> <p><a href="https://link.springer.com/article/10.1007/s00125-024-06145-0">Our research</a> attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each.</p> <p><iframe id="dw4bx" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/dw4bx/" width="100%" height="400px" frameborder="0"></iframe></p> <h2>Finding the right balance</h2> <p>Current health guidelines recommend you stick to a <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">sensible regime</a> of moderate-to vigorous-intensity physical activity 2.5–5 hours per week.</p> <p>However <a href="https://doi.org/10.1016/j.jacc.2019.02.031">mounting evidence</a> now <a href="https://doi.org/10.2337/dc14-2073">suggests</a> how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping.</p> <p>Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours.</p> <p>At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model.</p> <p>Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity.</p> <p>When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk.</p> <h2>You’re doing more physical activity than you think</h2> <p>We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise.</p> <p>Our experimental evidence shows that <a href="https://diabetesjournals.org/care/article/39/6/964/29532/Benefits-for-Type-2-Diabetes-of-Interrupting">interrupting our sitting</a> regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch.</p> <p>While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk.</p> <p>It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies.</p> <p>The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time.</p> <h2>Australia’s adult physical activity guidelines need updating</h2> <p>Australia’s <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">physical activity guidelines</a> currently only recommend exercise intensity and time. A <a href="https://www.uow.edu.au/media/2023/why-adults-need-to-move-more-stop-sitting-and-sleep-better-.php">new set of guidelines</a> are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements.</p> <p>While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night.</p> <p>Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening.</p> <p>It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.<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/228894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/christian-brakenridge-1295221"><em>Christian Brakenridge</em></a><em>, Postdoctoral research fellow at Swinburne University, Centre for Urban Transitions, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-time-should-you-spend-sitting-versus-standing-new-research-reveals-the-perfect-mix-for-optimal-health-228894">original article</a>.</em></p> </div>

Body

New birthday portrait of Princess Charlotte revealed

<p>The Prince and Princess of Wales have shared a new photo of their daughter, Princess Charlotte, to celebrate her ninth birthday. </p> <p>“Happy 9th birthday, Princess Charlotte! Thank you for all of the kind messages today,” they captioned the portrait of the young royal, which was posted on Instagram. </p> <p>Charlotte smiled confidently for the camera as she leaned against a fence surrounded by flowers in the garden of their home in Windsor.</p> <p>The young royal donned a dark red cardigan, a blue top and a denim skirt with stockings in the picture taken by her mother, Kate Middleton. </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/C6dejAktAsO/?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/C6dejAktAsO/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>Royal fans shared their birthday wishes and praised the Princess of Wales' photography skills. </p> <p>“Another gorgeous photo taken by Catherine,” wrote one fan. </p> <p>“Am enjoying seeing her grow up and flourish.”</p> <p>“She’s growing up so fast and isn’t she the image of her father,” another follower wrote.</p> <p>“Magical. Happy birthday young lady,” commented a third. </p> <p>One fan noted that Charlotte had her father’s eyes and her mother’s “beautiful smile”, while a few others commented on how quickly she was growing up. </p> <p>Just last week Charlotte’s younger brother Louis turned six, and as part of their tradition, a portrait <a href="https://www.oversixty.com.au/lifestyle/family-pets/kate-middleton-shares-new-birthday-photo-of-prince-louis" target="_blank" rel="noopener">photo</a> of him that was taken by his mother was also released. </p> <p><em>Image: Instagram/ Getty</em></p> <p> </p>

Family & Pets

What is childhood dementia? And how could new research help?

<p><em><a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>“Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around <a href="https://doi.org/10.1093/brain/awad242">1,400 Australian children and young people</a> live with currently untreatable childhood dementia.</p> <p>Broadly speaking, childhood dementia is caused by any one of <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">more than 100</a> rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same.</p> <p><a href="https://doi.org/10.1093/brain/awad242">Half</a> of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">before turning 18</a>.</p> <p>Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure.</p> <h2>More about the causes</h2> <p>Most types of childhood dementia are <a href="https://academic.oup.com/brain/article/146/11/4446/7226999">caused</a> by <a href="https://www.genome.gov/genetics-glossary/Mutation">mutations</a> (or mistakes) in our <a href="https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid">DNA</a>. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia.</p> <p><a href="https://doi.org/10.1093/brain/awad242">Two-thirds</a> of childhood dementia disorders are caused by “<a href="https://www.ncbi.nlm.nih.gov/books/NBK459183/">inborn errors of metabolism</a>”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail.</p> <p>As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs.</p> <h2>What happens to children with childhood dementia?</h2> <p>Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia <a href="https://doi.org/10.1016/j.pediatrneurol.2023.09.006">progressively lose</a> all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning.</p> <p>Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures.</p> <p>The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around <a href="https://doi.org/10.1093%2Fbrain%2Fawad242">two years old</a>. The symptoms are caused by significant, progressive brain damage.</p> <h2>Are there any treatments available?</h2> <p>Childhood dementia treatments currently <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">under evaluation</a> or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, <a href="https://doi.org/10.1002/jmd2.12378">gene-modified cell therapy</a> and protein or <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1712649">enzyme replacement therapy</a>. Enzyme replacement therapy is available in Australia for <a href="https://australianprescriber.tg.org.au/articles/cerliponase-alfa-for-neuronal-ceroid-lipofuscinosis-type-2-disease.html">one form of childhood dementia</a>. These therapies attempt to “fix” the problems causing the disease, and have shown promising results.</p> <p>Other experimental therapies include ones that <a href="https://doi.org/10.3390/life12050608">target</a> faulty protein production or <a href="https://doi.org/10.1056/nejmoa2310151">reduce inflammation</a> in the brain.</p> <h2>Research attention is lacking</h2> <p>Death rates for Australian children with cancer <a href="http://www.childhooddementia.org/getasset/2WX39O">nearly halved</a> between <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">1997 and 2017</a> thanks to research that has enabled the development of multiple treatments. But over recent decades, <a href="http://www.childhooddementia.org/getasset/2WX39O">nothing has changed</a> for children with dementia.</p> <p>In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for <a href="https://www.childhooddementia.org/getasset/2WX39O">childhood dementia</a>. This is despite childhood dementia causing a <a href="https://doi.org/10.1093/brain/awad242">similar number of deaths</a> each year as childhood cancer.</p> <p>The success <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">for childhood cancer sufferers</a> in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes.</p> <p>Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">analysis</a> published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia.</p> <p>Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves.</p> <p>That said, we’ve seen a slowing in the establishment of <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">clinical trials</a> for childhood dementia across the world in recent years.</p> <p>In addition, we know from <a href="https://www.childhooddementia.org/join-us/professionals/impacts">consultation with families</a> that current care and support systems <a href="https://www.childhooddementia.org/getasset/44MLP8">are not meeting the needs</a> of children with dementia and their families.</p> <h2>New research</h2> <p>Recently, we were awarded <a href="https://www.premier.sa.gov.au/media-releases/news-items/major-funding-boost-for-research-into-childhood-dementia">new funding</a> for <a href="https://www.flinders.edu.au/giving/our-donors/impact-of-giving/improving-the-lives-of-children-with-dementia">our research</a> on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments.</p> <p>More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions.</p> <p><em>Dr Kristina Elvidge, head of research at the <a href="https://www.childhooddementia.org/our-people">Childhood Dementia Initiative</a>, and Megan Maack, director and CEO, contributed 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/228508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, Head, Paediatric Neurodegenerative Diseases Research Group, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-childhood-dementia-and-how-could-new-research-help-228508">original article</a>.</em></p>

Mind

Kate Middleton shares new birthday photo of Prince Louis

<p>Prince Louis has turned six! </p> <p>Prince William and Princess Kate have released a new photo of the young royal to mark his special day. </p> <p>"Happy 6th Birthday, Prince Louis! Thank you for all the kind wishes today,” the couple wrote on social media. </p> <p>In the picture, taken by the Princess of Wales, the young royal donned a plaid shirt with blue pants and was smiling at the camera. </p> <p>Eagle-eyed royal watchers noticed one sweet detail in the photo: Prince Louis appears to have had a visit from the tooth fairy, as one of his bottom front-teeth was missing. </p> <p>“Thank you so much for sharing this delightful picture. I see the tooth fairy has been visiting - goodness time flies so fast,” one fan wrote on X. </p> <p>"Happy birthday Prince Louis!! Can’t believe how grown up he is looking, hope he has the best day!" wrote another on Instagram. </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/C6GhkvDNg0H/?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/C6GhkvDNg0H/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>"So glad to hear from Princess Catherine via this delightful photo. HBD, little Louis !" added a third. </p> <p>"Wishing this sweet little prince the happiest of the birthdays," commented a fourth. </p> <p>Kate is known for taking photos of her kids for their birthdays, and this milestone comes after a difficult period for the royal family, with both Kate and King Charles' cancer diagnosis. </p> <p>The family of five have taken time out of the spotlight in recent weeks and celebrated a more low-key and private Easter break in Norfolk. </p> <p><em>Image: Getty</em></p> <p> </p>

Family & Pets

Teen with Down Syndrome sets new world record

<p>A 19-year-old teen with Down Syndrome has conquered the London Marathon and became a Guinness World Record after just five months of training. </p> <p>Lloyd Martin from Cardiff completed the 42.1 km course across the capital with his mother cheering him on. </p> <p>Guinness World Record has awarded him the certificate for becoming the youngest person in his learning disability category to finish a marathon. </p> <p>"I'm so excited to run London. I love being fit and healthy and I want to make my family and friends proud," the teenager said. </p> <p>Mum Ceri Hooper also told the<em> BBC</em> how proud she was of her son's accomplishment. </p> <p>"In Lloyd's words, it's achieving his dream," she said. </p> <p>"Really anything is possible if you put your mind to it. With a bit of work, you can achieve it."</p> <p>Recalling the experience, the proud mum said: "He ran continuously for 14 miles which is the longest he's ever run before." </p> <p>Although Lloyd walked for a bit after his 14-mile-long streak, the crowd cheered him on every step of the way, and despite the challenge the mother-and-son duo had "a ball". </p> <p>The pair were at a loss for words when he finally crossed the finish line and they both "burst into tears." </p> <p>Lloyd is also now the third Welsh Special Olympics athlete to compete in the London Marathon. </p> <p>Prior to completing the world-famous marathon, Lloyed had completed an astonishing 30 Parkruns. </p> <p>Until last Christmas the teenager had never run further than three miles, but his mother was determined to get him marathon-ready. </p> <p>Ceri, who has taken on the London Marathon four times, created a specialised training regime for her son which included weekly runs. </p> <p>Lloyd managed to secure a spot in the marathon thanks to the help of the Special Olympics GB, where he is also a footballer and a gymnast. </p> <p><em>Images: Facebook/ Twitter</em></p>

Caring

Good news: midlife health is about more than a waist measurement. Here’s why

<p><em><a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>You’re not in your 20s or 30s anymore and you know regular health checks are important. So you go to your GP. During the appointment they measure your waist. They might also check your weight. Looking concerned, they recommend some lifestyle changes.</p> <p>GPs and health professionals commonly <a href="https://theconversation.com/the-body-mass-index-cant-tell-us-if-were-healthy-heres-what-we-should-use-instead-211190">measure waist circumference</a> as a vital sign for health. This is a better indicator than body mass index (BMI) of the amount of intra-abdominal fat. This is the really risky fat around and within the organs that can drive heart disease and metabolic disorders such as type 2 diabetes.</p> <p>Men are at greatly increased risk of health issues if their waist circumference is <a href="https://www.bmj.com/content/311/7017/1401">greater than 102 centimetres</a>. Women are considered to be at greater risk with a waist circumference of <a href="https://www.bmj.com/content/311/7017/1401">88 centimetres or more</a>. More than <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/waist-circumference-and-bmi/latest-release">two-thirds of Australian adults</a> have waist measurements that put them at an increased risk of disease. An even better indicator is waist circumference divided by height or <a href="https://www.baker.edu.au/news/in-the-media/waist-height-ratio#:%7E:text=According%20to%20research%2C%20a%20healthy,the%20highest%20risk%20of%20disease.">waist-to-height ratio</a>.</p> <p>But we know people (especially women) have a propensity to <a href="https://www.ajog.org/article/S0002-9378(19)30588-5/abstract">gain weight around their middle during midlife</a>, which can be very hard to control. Are they doomed to ill health? It turns out that, although such measurements are important, they are not the whole story when it comes to your risk of disease and death.</p> <h2>How much is too much?</h2> <p>Having a waist circumference to height ratio larger than 0.5 is associated with greater risk of chronic disease as well as premature death and this applies in adults of any age. A healthy waist-to-height ratio is between 0.4 to 0.49. A ratio of 0.6 or more <a href="https://www.baker.edu.au/news/in-the-media/waist-height-ratio#:%7E:text=According%20to%20research%2C%20a%20healthy,the%20highest%20risk%20of%20disease">places a person at the highest risk of disease</a>.</p> <p>Some experts recommend <a href="https://www.nature.com/articles/s41574-019-0310-7">waist circumference be routinely measured in patients during health appointments</a>. This can kick off a discussion about their risk of chronic diseases and how they might address this.</p> <p>Excessive body fat and the associated health problems manifest more strongly during midlife. A range of social, personal and physiological factors come together to make it more difficult to control waist circumference as we age. Metabolism tends to slow down mainly due to decreasing muscle mass because people do <a href="https://onlinelibrary.wiley.com/doi/10.1002/jcb.25077">less vigorous physical activity, in particular resistance exercise</a>.</p> <p>For women, hormone levels begin changing in mid-life and this also <a href="https://www.tandfonline.com/doi/full/10.3109/13697137.2012.707385">stimulates increased fat levels particularly around the abdomen</a>. At the same time, this life phase (often involving job responsibilities, parenting and caring for ageing parents) is when elevated stress can lead to <a href="https://journals.lww.com/psychosomaticmedicine/abstract/2000/09000/stress_and_body_shape__stress_induced_cortisol.5.aspx">increased cortisol which causes fat gain in the abdominal region</a>.</p> <p>Midlife can also bring poorer sleep patterns. These contribute to fat gain with <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0010062">disruption to the hormones that control appetite</a>.</p> <p>Finally, your family history and genetics can <a href="https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1002695">make you predisposed to gaining more abdominal fat</a>.</p> <h2>Why the waist?</h2> <p>This intra-abdominal or visceral fat is much more metabolically active (it has a greater impact on body organs and systems) than the fat under the skin (subcutaneous fat).</p> <p>Visceral fat surrounds and infiltrates major organs such as the liver, pancreas and intestines, releasing a variety of chemicals (hormones, inflammatory signals, and fatty acids). These affect inflammation, lipid metabolism, cholesterol levels and insulin resistance, <a href="https://academic.oup.com/eurheartjsupp/article/8/suppl_B/B4/461962">contributing to the development of chronic illnesses</a>.</p> <p>The issue is particularly evident <a href="https://www.ajog.org/article/S0002-9378(19)30588-5/abstract">during menopause</a>. In addition to the direct effects of hormone changes, <a href="https://www.sciencedirect.com/science/article/pii/S0960076013001118?via%3Dihub">declining levels of oestrogen change brain function, mood and motivation</a>. These psychological alterations can result in reduced physical activity and increased eating – often of comfort foods high in sugar and fat.</p> <p>But these outcomes are not inevitable. Diet, exercise and managing mental health can limit visceral fat gains in mid-life. And importantly, the waist circumference (and ratio to height) is just one measure of human health. There are so many other aspects of body composition, exercise and diet. These can have much larger influence on a person’s health.</p> <h2>Muscle matters</h2> <p>The quantity and quality of skeletal muscle (attached to bones to produce movement) a person has makes a <a href="https://www.nature.com/articles/nrendo.2012.49">big difference</a> to their heart, lung, metabolic, immune, neurological and mental health as well as their physical function.</p> <p>On current evidence, it is equally or more important for health and longevity to <a href="https://www.bmj.com/content/345/bmj.e7279">have</a> higher muscle mass and better cardiorespiratory (aerobic) fitness than waist circumference within the healthy range.</p> <p>So, if a person does have an excessive waist circumference, but they are also sedentary and have less muscle mass and aerobic fitness, then the recommendation would be to focus on an appropriate exercise program. The fitness deficits should be addressed as priority rather than worry about fat loss.</p> <p>Conversely, a person with low visceral fat levels is not necessarily fit and healthy and may have quite poor aerobic fitness, muscle mass, and strength. <a href="https://bjsm.bmj.com/content/45/6/504">The research evidence</a> is that these vital signs of health – how strong a person is, the quality of their diet and how well their heart, circulation and lungs are working – are more predictive of risk of disease and death than how thin or fat a person is.</p> <p>For example, a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510687/">2017 Dutch study</a> followed overweight and obese people for 15 years and found people who were very physically active had no increased heart disease risk than “normal weight” participants.</p> <h2>Getting moving is important advice</h2> <p>Physical activity has many benefits. Exercise can counter a lot of the negative behavioural and physiological changes that are occurring during midlife including for people going through menopause.</p> <p>And regular exercise reduces the tendency to use food and drink to help manage what can be a <a href="https://journals.lww.com/acsm-msse/fulltext/2008/05000/physical_activity,_sedentary_index,_and_mental.7.aspx">quite difficult time in life</a>.</p> <p>Measuring your waist circumference and monitoring your weight remains important. If the measures exceed the values listed above, then it is certainly a good idea to make some changes. Exercise is effective for fat loss and in particular <a href="https://bjsm.bmj.com/content/57/16/1035">decreasing visceral fat</a> with greater effectiveness when <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-019-0864-5">combined with dietary restriction of energy intake</a>. Importantly, any fat loss program – whether through drugs, diet or surgery – is also a muscle loss program unless resistance exercise is part of the program. Talking about your overall health with a doctor is a great place to start.</p> <p><a href="https://www.essa.org.au/Public/Public/Searches/find-aep-withdistance.aspx">Accredited exercise physiologists</a> and <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitians</a> are the most appropriate allied health professionals to assess your physical structure, fitness and diet and work with you to get a plan in place to improve your health, fitness and reduce your current and future health risks.<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/226019/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/rob-newton-12124"><em>Rob Newton</em></a><em>, Professor of Exercise Medicine, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/good-news-midlife-health-is-about-more-than-a-waist-measurement-heres-why-226019">original article</a>.</em></p>

Body

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

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

Body

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”.</p> <p>As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”.</p> <p>We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.</p> <p>Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.</p> <h2>How does it work?</h2> <p>Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better.</p> <p>GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars.</p> <p>GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.</p> <p><iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe></p> <p>GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.</p> <p>Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.</p> <p>GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection.</p> <h2>What can users expect? What does the research say?</h2> <p>Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).</p> <p>A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.</p> <p>Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.</p> <p>Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>.</p> <p>Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.</p> <h2>Who is eligible for semaglutide?</h2> <p>Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes.</p> <p>However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.</p> <p>The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia.</p> <p>When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.</p> <h2>What else do you need to do during Ozempic treatment?</h2> <p>Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.</p> <p>Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week.</p> <p>STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>.</p> <h2>But what are the side effects?</h2> <p>Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.</p> <p>In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.</p> <p>More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.</p> <p>To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term.</p> <p>Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.</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/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/clare-collins-7316"><em>Clare Collins</em></a><em>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>Image credits: </em><em>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/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.</em></p>

Body

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

<p><em><a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Many have <a href="https://www.economist.com/leaders/2023/03/02/new-drugs-could-spell-an-end-to-the-worlds-obesity-epidemic">declared</a> drugs like Ozempic could “end obesity” by reducing the appetite and waistlines of millions of people around the world.</p> <p>When we look past the hype, this isn’t just untrue – it can also be harmful. The focus on weight, as opposed to health, is a feature of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0277539521001217">diet culture</a>. This frames the pursuit of thinness as more important than other aspects of physical and cultural wellbeing.</p> <p>The Ozempic buzz isn’t just rooted in health and medicine but plays into ideas of <a href="https://butterfly.org.au/weight-bias-fatphobia-diet-culture/#:%7E:text=Weight%20bias%2C%20sometimes%20also%20called,or%20being%20around%20fat%20people.">fat stigma and fat phobia</a>. This can perpetuate fears of fatness and fat people, and the behaviours that <a href="https://link.springer.com/article/10.1186/S12916-018-1116-5">harm people who live in larger bodies</a>.</p> <h2>Not the first ‘miracle’ weight-loss drug</h2> <p>This isn’t the first time we have heard that weight-loss drugs will change the world. Ozempic and <a href="https://www.ncbi.nlm.nih.gov/books/NBK551568/">its family</a> of GLP-1-mimicking drugs are the <a href="https://theconversation.com/ozempic-is-in-the-spotlight-but-its-just-the-latest-in-a-long-and-strange-history-of-weight-loss-drugs-209324">latest in a long line of weight loss drugs</a>. Each looked promising at the time. But none have lived up to the hype in the long term. Some have even been withdrawn from sale due to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126837/">severe side effects</a>.</p> <p>Science does improve <a href="https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(20)30028-8/fulltext">incrementally</a>, but diet culture also keeps us on a cycle of hope for the next <a href="https://sahrc.org/2022/04/diet-culture-a-brief-history/">miracle cure</a>. So drugs like Ozempic might not deliver the results individuals expect, continuing the cycle of hope and shame.</p> <h2>Ozempic doesn’t work the same for everyone</h2> <p>When we talk about the results of studies using Ozempic, we often <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719041/">focus on the average</a> (also known as the mean) results or the maximum (or peak) results. So, studies might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">show</a> those using the drug lost an average of 10.9% of their body weight, but some lost more than 20% and others less than 5%</p> <p>What we don’t talk about as much is that responses are variable. Some people are “<a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769">non-responders</a>”. This means not everyone loses as much weight as the average, and some don’t lose weight at all. For some people, the side-effects will outweigh the benefits.</p> <p>When people are on drugs like Ozempic, their blood sugar is better controlled by enhancing the release of insulin and reducing the levels of another hormone called glucagon.</p> <p>But there is greater variability in the amount of <a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769#bib88">weight lost</a> than the variability in blood sugar control. It isn’t clear why, but is likely due to differences in genetics and lifestyles, and weight being more complex to regulate.</p> <h2>Treatment needs to be ongoing. What will this mean?</h2> <p>When weight-loss drugs do work, they are only effective while they’re being taken. This means that to keep the weight off people need to keep taking them long term. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542252/">One study found</a> an average weight loss of more than 17% after a year on Ozempic became an average net weight loss of 5.6% more than two years after stopping treatment.</p> <p>Short-term side effects of drugs like Ozempic include dizziness, nausea, vomiting and other gastrointestinal upsets. But because these are new drugs, we simply don’t have data to tell us if side effects will increase as people take them for longer periods.</p> <p>Nor do we know if <a href="https://www.medicalnewstoday.com/articles/why-weight-loss-drugs-stop-working-how-to-break-past-ozempic-plateau#:%7E:text=A%20lifetime%20commitment%20to%20Ozempic&text=By%20these%20standards%2C%20such%20drugs,long%2Dterm%20risk%20is%20unknown.">effectiveness will be reduced</a> in the long term. This is called <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/drug-tolerance#:%7E:text=A%20condition%20that%20occurs%20when,or%20different%20medicine%20is%20needed.">drug tolerance</a> and is documented for other long-term treatments such as antidepressants and chemotherapies.</p> <h2>Biology is only part of the story</h2> <p>For some people, using GLP-1-mimicking drugs like Ozempic will be validating and empowering. They will feel like their biology has been “normalised” in the same way that blood pressure or cholesterol medication can return people to the “normal” range of measures.</p> <p>But biologically, obesity <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202176/#:%7E:text=Obesity%20behaves%20as%20complex%20polygenic,about%2080%25%20(3).">isn’t solely about GLP-1 activity</a> with <a href="https://www.worldobesity.org/what-we-do/our-policy-priorities/the-roots-of-obesity">many other</a> hormones, physical activity, and even our gut microbes involved.</p> <p>Overall, <a href="https://www.ncbi.nlm.nih.gov/books/NBK278977/">obesity is complex and multifaceted</a>. Obesity isn’t just driven by personal biology and choice; it has social, cultural, political, environmental and economic determinants.</p> <h2>A weight-centred approach misses the rest of the story</h2> <p>The weight-centred approach <a href="https://butterfly.org.au/body-image/health-not-weight/#:%7E:text=Health%20and%20wellbeing%20are%20multi,on%20their%20size%20or%20appearance.">suggests that leading with thinness means health will follow</a>. But changing appetite is only part of the story when it comes to health.</p> <p>Obesity often <a href="https://www.sciencedirect.com/science/article/pii/S2667368123000335#:%7E:text=Obesity%20related%20malnutrition%20can%20also,%5D%2C%20%5B7%5D%5D.">co-exists with malnutrition</a>. We try to separate the effects in research using statistics, but focusing on the benefits of weight-loss drugs without addressing the underlying malnutrition means we aren’t likely to see the <a href="https://www.wsj.com/articles/ozempic-diet-exercise-healthy-43eee86c">improved health outcomes in everyone who loses weight</a>.</p> <h2>Obesity isn’t an issue detached from people</h2> <p>Even when it is well-intentioned, the rhetoric around the joy of “ending the obesity epidemic” can <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">harm people</a>. Obesity doesn’t occur in isolation. It is people who are obese. And the celebration and hype of these weight-loss drugs can reinforce harmful fat stigma.</p> <p>The framing of these drugs as a “cure” exacerbates the binary view of thin versus fat, and healthy versus unhealthy. These are not binary outcomes that are good or bad. Weight and health exist on a spectrum.</p> <p>Ironically, while fat people are told they need to lose weight for their health, they are also <a href="https://www.dailytelegraph.com.au/news/nsw/ozempic-shame-why-users-are-embarrassed-to-admit-using-weight-loss-wonder-drug/news-story/ee52a819c69459afe6576d25988f9bd6">shamed for “cheating” or taking shortcuts</a> by using medication.</p> <h2>Drugs are tools, not silver bullets</h2> <p>The creation of these drugs is a start, but they remain expensive, and the hype has been followed by <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#:%7E:text=Consumer%20Medicine%20Information%20.-,Why%20the%20Ozempic%20shortage%20happened,label%20prescribing%20for%20weight%20loss.">shortages</a>. Ultimately, complex challenges aren’t addressed with simple solutions. This is particularly true when people are involved, and even more so when there isn’t even an agreement on what the challenge is.</p> <p>Many organisations and individuals see obesity is a disease and believe this framing helps people to seek treatment.</p> <p>Others think it’s unnecessary to attach medical labels to body types and <a href="https://www.forbes.com/sites/geoffreykabat/2013/07/09/why-labeling-obesity-as-a-disease-is-a-big-mistake/?sh=5ca95cc2103b">argue</a> it confuses risk factors (things that are linked to increased risk of illness) with illness itself.</p> <p>Regardless, two things will always remain true. Drugs can only ever be tools, and those tools need to be applied in a context. To use these tools ethically, we need to remain mindful of who this application harms along the way.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></em></p> <p><em><a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation - School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/drugs-like-ozempic-wont-cure-obesity-but-they-might-make-us-more-fat-phobic-219309">original article</a>.</em></p>

Body

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

<p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people.</p> <p>Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020.</p> <p>It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year.</p> <p>Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>.</p> <h2>What goes into a flu vaccine?</h2> <p>Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus.</p> <p>Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains.</p> <p>All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future.</p> <h2>What’s different about new flu vaccines?</h2> <p>There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad).</p> <p>Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely.</p> <p>However, there have been several enhancements to influenza vaccines in recent years.</p> <p>Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people.</p> <p>An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people.</p> <p>Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future.</p> <h2>What should I do this year?</h2> <p>Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life.</p> <p>Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>.</p> <p>In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need.</p> <h2>Are there side effects?</h2> <p>All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines.</p> <p>As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines.</p> <p>Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.</em></p>

Body

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<p><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <em><a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs.</p> <p>As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns.</p> <p>But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug.</p> <h2>Potential benefits</h2> <p><strong>1) It’s likely to help you lose weight</strong></p> <p>The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity.</p> <p>The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight).</p> <p>In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg.</p> <p>Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication.</p> <p><strong>2) It may reduce your chronic disease risk factors</strong></p> <p>When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases.</p> <p>In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels.</p> <p>In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels.</p> <p><strong>3) It might improve your quality of life, emotional wellbeing or sense of achievement</strong></p> <p>The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health.</p> <p>Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image.</p> <h2>What about the risks?</h2> <p><strong>1) You may experience gastrointestinal symptoms</strong></p> <p>In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%).</p> <p>In the UK study, nausea and diarrhoea were also commonly reported.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living.</p> <p>Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study.</p> <p><strong>2) You might feel fatigued</strong></p> <p>Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants.</p> <p><strong>3) You might be among the minority who don’t tolerate the drug</strong></p> <p>Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia.</p> <p>In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing.</p> <p>More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period.</p> <p>A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period.</p> <p>Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions.</p> <p><strong>4) It might be difficult to access</strong></p> <p>Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024.</p> <p>To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication.</p> <p><strong>5) You might not always get clear information from vested interests</strong></p> <p>Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>.</p> <p>Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications.</p> <h2>Bottom line</h2> <p>Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.</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/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.</em></p>

Body

"Offer is on the table": New James Bond actor revealed

<p>In a world where the only constant is change, one thing remains certain: James Bond will always be suave, sophisticated, and British.</p> <p>The search for the next 007 has been a rollercoaster of speculation, rumours and hopes dashed faster than a villain's escape plan. But now the wait appears to be over. The man most likely in line to be the next James Bond has been revealed, and his name is Taylor-Johnson ... Aaron Taylor-Johnson. </p> <p>According to a report from <a href="https://www.thesun.co.uk/tv/26774029/aaron-taylor-johnson-offered-role-james-bond/" target="_blank" rel="noopener"><em>The Sun</em></a> on Tuesday, Eon Productions, the brilliant minds behind the iconic spy franchise, appear to have finally settled on their man. According to sources as reliable as Bond's impeccable taste in martinis, Taylor-Johnson is set to don the tuxedo and wield the Walther PPK in the next instalment of the series. Well, at least if he accepts the offer.</p> <p>“Bond is Aaron’s job, should he wish to accept it," <em>The Sun </em>reported. "The formal offer is on the table and they are waiting to hear back.</p> <p>“As far as Eon is concerned, Aaron is going to sign his contract in the coming days and they can start preparing for the big announcement.”</p> <p>Now, some of you might be scratching your heads, wondering, "Aaron who?"</p> <p>Aaron Taylor-Johnson is an English actor, which automatically makes him qualified for the role. Plus, he's been in action films like <em>Tenet</em>, <em>Bullet Train</em> and <em>Avengers: Age of Ultron</em>. So, he's no stranger to high-stakes thrills and spills. Also, did we mention he's British? Because that's kind of a prerequisite.</p> <p>At 33 years of age, Taylor-Johnson would be the youngest actor to step into Bond's impeccably polished shoes since George Lazenby back in 1969. Talk about big shoes to fill. But if anyone can handle the pressure, it's our man Aaron. </p> <p>Now, some purists might be clutching their martini glasses in horror, lamenting the departure of Daniel Craig, who graced our screens for five thrilling films. But fear not, for change is the spice of life, and if there's one thing Bond knows how to handle, it's change. Besides, who wouldn't want to see what Taylor-Johnson brings to the table? Maybe he'll introduce a new signature drink or a quirky catchphrase. The possibilities are as endless as Bond's list of conquests.</p> <p>The response to <em>The Sun</em>'s announcement has caused a few reactions across the globe, with 9News reporting that "A source with knowledge of the situation tells CNN that Johnson has not been cast as Bond. And, BBC News reports that a 'production insider' said there is no truth to the rumours about Taylor-Johnson's casting."</p> <p>So, as we eagerly await the official announcement from Eon Productions, let us raise our glasses to Aaron Taylor-Johnson, the next suave superspy set to save the world, one shaken, not stirred, adventure at a time. </p> <p><em>Images: Getty / Twitter (X)</em></p>

Movies

Bruce Willis' daughter reveals shock new health diagnosis

<p>Tallulah Willis, 30, has revealed that she was diagnosed with autism as an adult. </p> <p>The daughter of Hollywood stars Bruce Willis and Demi Moore took to Instagram to publicly share the news for the first time. </p> <p>"Tell me you're autistic without telling me you're autistic 😂," she wrote underneath a throwback video of her playing with her dad's ears during <em>The Whole Ten Yards</em> premiere in 2004. </p> <p>She continued opening up about her diagnosis in the comments. </p> <p>"Actually this is the first time I've ever publicly shared my diagnosis," she replied to a follower. </p> <p> "Found out this summer and it's changed my life," she added with a sun emoji. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C4jRY7Av5b8/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C4jRY7Av5b8/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by tallulah (@buuski)</a></p> </div> </blockquote> <p>According to <a href="https://www.healthdirect.gov.au/autism" target="_blank" rel="noopener"><em>Health Direct</em></a>, Autism spectrum disorder is a "lifelong developmental disorder" which affects how people behave and interact with the world around them and "is caused by differences in how the brain develops".</p> <p>Many fans were quick to comment on the sweet father-daughter bond that her and Bruce share. </p> <p>"The moment when you look at each other !!! So much was said with just one look ❤" one wrote. </p> <p>"I love this so much and I love how unfazed he is while you’re playing with his ear. So precious!" another added. </p> <p>"This is so powerful. The love you share with your papa. He calmed you here, his very body , and that is beautiful. You are beautiful. ❤" a third wrote. </p> <p>A few others thanked Tallulah for her transparency and sharing her autism diagnosis. </p> <p>"My son is autistic too. And I love the saying, “you know one autistic person, you know…. one autistic person.” Because everyone is so different. My son had stims that look nothing like this. But that certainly doesn’t discount what calms you! Most importantly tho: thank you for this post," wrote one fan. </p> <p>"This made me cry! I'm also autistic and felt this through my soul. Die Hard was a favourite movie of my dad's & knowing that you share the same diagnosis as me & so many others warms my heart," another commented.</p> <p>Tallulah has always been candid about her mental and physical health, as she recently opened up about her experience with anorexia nervosa and told her followers that recovery is not linear and can sometimes be "messy." </p> <p><em>Image: Getty</em></p> <p> </p>

Caring

Christchurch attack victims' families reflect on tragedy five years on

<p>It's been five years since 51 men, women and children, were murdered in a terror attack when a white supremacist opened fire at Al Noor and Linwood mosques in Christchurch, New Zealand.</p> <p>Now, the victims' families have reflected on the tragic day, and commemorated their loved ones on the five-year anniversary of the attacks.</p> <p>Dr Maysoon Salama, who lost her son Atta Elayyan, 33, relives the grief of losing her son every day.</p> <p>“The pain is still fresh,” she told <em>7NEWS</em>.</p> <p>Five years on, the good memories she shared with her son still play back in her mind.</p> <p>“Atta was an amazing son,” she said. “He’s touched the lives of so many people.”</p> <p>Despite the tragedy, Dr Salama remains strong and finds herself healing through her granddaughter Aya.</p> <p>“I feel like I see her father when I see her,” she said.</p> <p>“It’s a really hard journey ... but she has always been my focus.”</p> <p>Aya was two when she lost her father, and Dr Salama was faced with the heartbreaking task of helping her granddaughter adjust to a life without her father.</p> <p>“When I look her in the eyes and she will ask, ‘Where is my dad?’, what am I going to tell her?” she recalled thinking.</p> <p>“How are we going to tell her when she’s so attached to her daddy? She loved him so much.”</p> <p>Dr Salama's husband, Mohammad Alayan, was among the dozens of people hospitalised following the attack, with doctors at the time saying he was “lucky to survive”.</p> <p>“He had been shot twice. One in his head and it affected his vision and one in his shoulder and she said it was just a few millimetres away from his heart,” Maysoon said.</p> <p>The couple run a Muslim childcare centre An-Nur, and have worked together to help children navigate New Zealand's darkest days.</p> <p>She recalled the sinking feeling when she first heard of the attacks while at work, and how her husband's first instinct was to tell her to protect herself and everyone at the childcare centre.</p> <p>“I got a call from my husband and he told me he was in hospital and that I have a big responsibility to protect the children and the teachers and lock down, close the doors because he was afraid the shooter would also come to our place because we are a Muslim childcare centre,” she said.</p> <p>“More families who were distressed started coming to pick up their children, and some of them even had blood on their shirts, some of them witnessed the thing.</p> <p>“It was really an awful situation.”</p> <p>Not long after, she learned that her own son had also been injured, but at the time had no idea of the reality of it all.</p> <p>Aya Al-Umari lost her brother, Hussein, on the fateful day.</p> <p>“It happened so suddenly, I had no time to grieve,” she said.</p> <p>Hussein spent the last moments of his life protecting other people, and even though Aya misses his hugs more than anything, she takes comfort in knowing that her brother's legacy will live on.</p> <p>“He had the opportunity to escape, but he didn’t,” she said.</p> <p>“He was running towards the terrorist.</p> <p>“It really goes to show, especially in his last moments, he was always a giver.”</p> <p>Both Aya and Dr Salama both take comfort in the belief that their loved ones died as as a Shahid – a true martyr who died in the name of their faith in Islam.</p> <p>Dr Salama hopes that the findings from last year’s coronial inquest, expected to be handed down this year, will provide a sense of closure to the victims' families.</p> <p>She also hopes that people will use the fifth anniversary of the shootings to reflect on the work that is yet to be done and call for more action in fighting Islamophobia and extremism.</p> <p>“We can fight Islamophobia by challenging the biases and educating ourselves also and intervening against discrimination.</p> <p>“See something, say something.”</p> <p>Canterbury's Muslim community will also gather today to honour the victims with a commemoration service at Masjid Annur in the evening, according to<em> <a href="https://www.rnz.co.nz/news/national/511744/muslims-mark-5th-anniversary-of-christchurch-mosque-terror-attacks" target="_blank" rel="noopener">RNZ</a></em>.</p> <p>Brenton Tarrant, who was behind the terror attacks, was sentenced to life in jail without parole – the first person in New Zealand's history to receive the sentence because his actions were deemed "so wicked".</p> <p><em>Images: 7News</em></p>

Caring

"Unidentified life form" found off New Zealand coast

<p>Ah, the deep sea, where the mysteries of the ocean lurk in the shadows, waiting to be discovered by intrepid marine scientists armed with nets, trawls and a healthy dose of confusion...</p> <p>Recently, a team of brave souls embarked on a journey off the coast of New Zealand, armed with curiosity and a fervent desire to find Nemo's distant relatives. What they found, however, was not just Nemo's cousins – but a veritable treasure trove of potential new species. Or at least, they think so.</p> <p>In a saga that could rival any aquatic adventure film, the scientists stumbled upon approximately 100 potential new species, including one particularly enigmatic life form that has left them scratching their heads in bewilderment.</p> <p>Initially mistaking it for a sea star – or perhaps a particularly flamboyant sea cucumber – they now suspect it might be a deep-sea coral. Or a cosmic jellyfish. Or a lost prop from a sci-fi movie. The possibilities are as endless as the ocean itself.</p> <p>Dr Michela Mitchell, a taxonomist with a penchant for the dramatic, declared it could be "a whole new group outside of the octocoral." Because why settle for identifying just one species when you can potentially create an entire taxonomic order?</p> <p>Dr Daniel Moore, another member of the expedition and self-proclaimed captain of the confusion ship, confessed, "We can't even describe it to family." One can only imagine the perplexed expressions at family gatherings as they attempt to explain their latest discovery: "Well, it's sort of like a sponge, but not really. And it might have tentacles. Or wings. We're not entirely sure."</p> <p>Their research vessel, the <em>Tangaroa</em>, became a floating laboratory of befuddlement as they collected nearly 1,800 samples from the abyssal depths. Armed with modified sleds and a healthy dose of optimism, they trawled the ocean floor, hoping to snag the elusive creatures that lurked below.</p> <p>"It was true exploration, very exciting," Dr Moore boasted, his enthusiasm undiminished by the fact that they still couldn't <em>definitively</em> identify half of what they'd found.</p> <p>Among their discoveries was a new species of fish, dubbed the "eelpout", which was "instantly recognised as being different to the others." Because, apparently, it had a flair for the dramatic and refused to conform to traditional fish norms.</p> <p>In a surprising revelation, Dr Moore admitted, "Finding new vertebrates is rare." One can only assume that the eelpout, upon hearing this declaration, puffed out its chest (or whatever passes for a chest in fish anatomy) and proclaimed itself the king of the ocean.</p> <p>As the expedition came to a close, the scientists reflected on the vastness of the ocean and the infinitesimal fraction of its inhabitants they had encountered. With only 240,000 species identified out of an estimated 2.2 million, they realised they had barely scratched the surface. Or, in this case, the sea floor.</p> <p>And so, armed with their nets, their sleds, and their unshakeable sense of optimism, the intrepid scientists set sail once more, ready to delve deeper into the mysteries of the ocean and perhaps stumble upon another baffling creature that defies explanation. After all, what's science without a little bit of confusion?</p> <p><em>Image: Ocean-Census | NIWA</em></p>

Domestic Travel

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

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

Travel Trouble

Devastating new details emerge on Heath Ledger's death

<p>New details have emerged about the hours after Heath Ledger's death, as a Hollywood director has shared how he found out about Ledger's passing. </p> <p>Heath Ledger was found dead in his New York loft on January 22nd 2008, with his death being ruled as an accidental overdose and attributed to a mixture of prescription drugs, including OxyContin, Vicodin, Valium, Xanax, Unisom and Restoril.</p> <p>Now, 16 years on from the high profile death, Hollywood director Stephen Gaghan has shared how he found out about Heath's death. </p> <p>At the time of his passing, Ledger and Gaghan were working together on an adaptation of Malcolm Gladwell’s novel <em>Blink: The Power of Thinking Without Thinking</em>.</p> <p>Appearing on Malcolm Gladwell's <em>Revisionist History</em> podcast, in which the novelist discusses abandoned projects, Gaghan recalled getting a phone call from Ledger's father when his body was found. </p> <p>“They were there with the body and our script was in bed with him, and your book was on the bedside table,” he said on the podcast.</p> <p>“I think my number was on the script, like written. These guys, as you can imagine, they are in shock and they dialled that number and I don’t know why.”</p> <p>“I’m in an airport with my wife [Minnie Mortimer] just going from one place to another, and I literally just collapse, never happened to me before or since,” the director added. “My feet went out from under me. I just literally sat down because I was like, ‘What?’"</p> <p>"The emotion, what they were going through, I should not have been a party to in any way really, and yet as a human or as somebody who just cares, I just was there and I was listening and my wife was looking at me."</p> <p>"I remember her face and I was just like, I was speechless. I just listened and listened and listened. It was just really, really sad. And it’s still sad. For me, I just had to put a pin in it.”</p> <p>When discussing the adaptation of <em>Blink</em>, Gaghan shared how Leo DiCaprio was originally in on the film idea, and how the part of the lead seemed to be written especially for Ledger. </p> <p>“I’d gotten to be very, very close with him instantly,” Gaghan recalled. “I just had a real connection with him that was kind of unusual and really special to me. I got really excited and I started seeing him as the main character."</p> <p>"Once I started seeing that I couldn’t unsee it, and obviously it was very delicate in a way. Leo’s totally cool. I mean, obviously, he has a thousand choices, but in my mind it was a big deal.”</p> <p>Gaghan soon abandoned the revived project after Ledger’s untimely death.</p> <p><em>Image credits: Getty Images </em></p>

Caring

Why Mary Poppins has received a new rating 60 years on

<p dir="ltr">Almost 60 years after <em>Mary Poppins</em> was first released, the classic film has been given a new rating by the British Board of Film Classification (BBFC). </p> <p dir="ltr">The BBFC, which regulates films and video content in the country, changed the rating of the 1964 Disney musical last week from U (Universal) to PG (Parental Guidance) because it features a racial slur once used by white Europeans to refer to the native peoples of southern Africa.</p> <p dir="ltr">"<em>Mary Poppins</em> (1964) includes two uses of the discriminatory term 'hottentots'," a BBFC spokesperson said in a statement to CNN.</p> <p dir="ltr">"While <em>Mary Poppins</em> has a historical context, the use of discriminatory language is not condemned, and ultimately exceeds our guidelines for acceptable language at U."</p> <p dir="ltr">The approaching 60th anniversary of the film is what prompted the BBFC to reexamine the film, as it is set to return to UK cinemas in celebration of the milestone. </p> <p dir="ltr">Even as <em>Mary Poppins</em> remains a treasured part of UK culture, the film has long been criticised for the use of blackface. It's partly in this context that the discriminatory language referenced by BBFC appears in the film.</p> <p dir="ltr">In one scene, the eccentric Admiral Boom asks one of the Banks children if he is going on an adventure to "defeat hottentots." </p> <p dir="ltr">Later in the film, as Admiral Boom sees chimney sweeps with soot-blackened faces dancing in the distance, he shouts, "We're being attacked by hottentots!" and orders a cannon to be fired in their direction.</p> <p dir="ltr">"Hottentot" is a derogatory term used by European settlers to refer to Khoikhoi peoples of South Africa and Namibia, according to the Oxford Dictionary reference.</p> <p dir="ltr">Per the new film rating, children of any age can still watch without an adult present, but parents should consider whether the content might upset younger or more sensitive children, a BBFC spokesperson said.</p> <p dir="ltr"><em>Image credits: Disney</em></p>

Movies

Russell Crowe unveils new look not seen in over 20 years

<p>Russell Crowe, the man of many faces – literally, his beard has its own postcode – is making headlines again. Not for his stellar performances or his knack for embodying iconic characters, but for something far more groundbreaking: he shaved.</p> <p>Yes, you read that right. Russell Crowe has gone from grizzly lumberjack chic to smooth operator in what can only be described as a follicular metamorphosis of epic proportions.</p> <p>In a tweet that shook the internet harder than a magnitude 9 earthquake, Crowe proudly announced, "The actor prepares #20. First shave since 2019".</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">The actor prepares #20.<br />First shave since 2019. <a href="https://t.co/e48ctxh9GY">pic.twitter.com/e48ctxh9GY</a></p> <p>— Russell Crowe (@russellcrowe) <a href="https://twitter.com/russellcrowe/status/1759500781642780929?ref_src=twsrc%5Etfw">February 19, 2024</a></p></blockquote> <p>Now, to put this into perspective, in 2019 we were all living in a blissful ignorance of the chaos that awaited us in the years to come. So, the fact that Russell Crowe has finally decided to bid farewell to his facial foliage is nothing short of a miracle.</p> <p>In the accompanying photo, Crowe stares into the camera with the seriousness of a man who has just discovered a rare species of moth living in his beard. His face, now liberated from the tangled web of hair, appears decades younger, causing fans to collectively question if time travel is, in fact, possible.</p> <p>But let's not forget, this isn't Crowe's first rodeo with a clean-shaven face. Even though he cites "2019" in his caption, the last time he showcased such ephemeral smoothness was back in 2012 while promoting <em>Les Miserables –</em> a time when the world was still recovering from the shock of "Gangnam Style" and debating the colour of a certain pinstriped dress. So, it's safe to say, Crowe's clean-shaven look is rarer than a blue moon on a leap year.</p> <p>Of course, fans couldn't contain their excitement. One Twitter user exclaimed, "20 years younger instantly!" Another fan, probably needing a moment to catch their breath after witnessing the transformation, simply stated, "oh THERE you are". And let's not overlook the fan who eloquently remarked, "Looks good! It’s nice to change it up and shave. You have a nice face it was hiding behind all that hair." Ah, poetry in the age of social media.</p> <p>But what prompted this seismic shift in Crowe's appearance? Well, he didn't spill the beans on which movie role necessitated the razor, but we can only imagine the possibilities. Perhaps he's playing a time-travelling barber who inadvertently alters the course of history with each stroke of his razor. Or maybe he's set to star in a reboot of <em>The Santa Clause</em> as the titular character who decides to trade in his bushy beard for a more aerodynamic look. The possibilities are as endless as the hairs on Crowe's chin once were.</p> <p>Whatever the reason, one thing's for sure: Crowe's fresh shave has left an indelible mark on the internet. And as he gears up for roles in everything from historical dramas (he’s pegged to play Hermann Göring in the film <em>Nuremberg) </em>to MMA action flicks (such as <em>The Beast In Me</em>, which traces the life of a commercial fisherman who avenges his brother's death by fighting in a cage match)<span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">, we can only hope that his newfound smoothness becomes a permanent fixture.</span></p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">After all, in a world of chaos and uncertainty, sometimes all it takes is a clean shave to restore our faith in humanity.</span></p> <p><em>Images: Poker Face / Twitter (X) </em></p>

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To tackle gendered violence, we also need to look at drugs, trauma and mental health

How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

New birthday portrait of Princess Charlotte revealed

What is childhood dementia? And how could new research help?

Kate Middleton shares new birthday photo of Prince Louis

Teen with Down Syndrome sets new world record

Good news: midlife health is about more than a waist measurement. Here’s why

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

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

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

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

"Offer is on the table": New James Bond actor revealed

Bruce Willis' daughter reveals shock new health diagnosis

Christchurch attack victims' families reflect on tragedy five years on

"Unidentified life form" found off New Zealand coast

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

Devastating new details emerge on Heath Ledger's death

Why Mary Poppins has received a new rating 60 years on

Russell Crowe unveils new look not seen in over 20 years

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

To tackle gendered violence, we also need to look at drugs, trauma and mental health

How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

New birthday portrait of Princess Charlotte revealed

What is childhood dementia? And how could new research help?

Kate Middleton shares new birthday photo of Prince Louis

Teen with Down Syndrome sets new world record

Good news: midlife health is about more than a waist measurement. Here’s why

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

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

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

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

"Offer is on the table": New James Bond actor revealed

Bruce Willis' daughter reveals shock new health diagnosis

Christchurch attack victims' families reflect on tragedy five years on

"Unidentified life form" found off New Zealand coast

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

Devastating new details emerge on Heath Ledger's death

Why Mary Poppins has received a new rating 60 years on

Russell Crowe unveils new look not seen in over 20 years

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