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"There's no way": Man receives $52 billion tax bill

<p>An American man has been left confused after receiving a letter from the government claiming he owed $52 billion in unpaid taxes. </p> <p>Barry Tangert got two letters in the mail from the state of Pennsylvania, opening the first to find a refund check from the federal government for over $900.</p> <p>His joy was short-lived though as he opened the second letter to find the income billing notice from the Pennsylvania Department of Revenue claiming that he owed a jaw-dropping $52,950,744,735.28 ($34,576,826,561.47 AUD).</p> <p>“I knew it was an obvious blunder. I don’t even make over $100,000 a year, so there’s no way I could owe anywhere near that,” Barry Tangert told local outlet <em>News 8</em>.</p> <p>The total sum was so large it didn’t even fit on a single line on the document.</p> <p>Tangert immediately knew it was a mistake, with the astonishing number being more than triple the $11 billion America’s richest man Elon Musk says he owed the government in 2022.</p> <p>How the error made it all the way to his doorstep is still a mystery to Tangert.</p> <p>“I don’t know if it was a computer glitch in the transmission or if it was an input error from my tax preparer,” Tangert said, noting that his tax preparer filed an amendment after noticing an error on his 2022 return.</p> <p>He reached out to the Pennsylvania Department of Revenue’s customer service line, which also provided little help to the baffled man.</p> <p>“The first thing he said was, ‘You had a good year.’ And I said, ‘I wish,’” Tangert said.</p> <p>Fortunately, the state department has since resolved the issue, which it chalked up to wrong numbers simply being put into the system.</p> <p><em>Image credits: WGAL News 8</em></p> <p><em> </em></p>

Money & Banking

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World's oldest woman turns 117

<p>One of the world's oldest living person has turned 117. </p> <p>Maria Branyas Morera born on March 4, 1907 in San Francisco, lived through the 1918 pandemic, the two World Wars, Spain’s civil war and fully recovered after contracting Covid just days before her 113th birthday. </p> <p>She was one of the world's oldest Covid survivor's in 2020 and is now the 12th oldest verified person in history. </p> <p>Maria, who moved to Catalonia, Spain when she was eight, proudly announced her age on X, formerly known as Twitter in a post that read:  “Good morning, world. Today I turn 117 years old. I’ve come this far.”</p> <p>Maria, who has lived in a nursing home for the past 23 years, is healthier than ever aside from hearing difficulties and mobility issues, and scientists are studying her to find out the secrets to a long life. </p> <p>“She remembers with impressive clarity events from when she was only four years old, and she does not present any cardiovascular disease, common in elderly people," Scientist Manel Esteller told Spanish outlet <em>ABC</em>.</p> <p>“It is clear that there is a genetic component because there are several members of her family who are over 90 years old.”</p> <p>Scientists and Maria are working together to gain further insights into living longer, and researchers hope that studying Maria’s genes will help with the development of drugs which could combat diseases associated with ageing.</p> <p>Maria had three children with her husband  a Catalan doctor named Joan Moret.</p> <p>Her husband passed away 1976, and Maria also outlived her only son, August who tragically passed away in a tractor accident when he was 86. </p> <p>Maria now has two daughters, 11 grandchildren and 11 great-grandchildren.</p> <p>The oldest person ever established was a Frenchwoman named Jeanne Calment, who lived to the age of 122 years and 164 days.</p> <p><em>Image: news.com.au/ Guiness Book of Records</em></p>

Family & Pets

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Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<p><em><a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a></em></p> <p>Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above.</p> <p>Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>.</p> <p>While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey.</p> <p>As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way.</p> <h2>The science behind altitude sickness</h2> <p>Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research.</p> <p>The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent.</p> <p>When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>.</p> <p>Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations.</p> <p>As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level.</p> <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Tips for preventing or reducing the risk of altitude sickness.</span></figcaption></figure> <h2>The importance of gradual ascent</h2> <p>High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness.</p> <p>This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>.</p> <p>People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed.</p> <p>Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>.</p> <h2>Effective medications</h2> <p>For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye.</p> <p>If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent.</p> <p>Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken.</p> <p>Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize.</p> <h2>Unproven therapies and remedies are common</h2> <p>As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend.</p> <p>Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective.</p> <p><a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>.</p> <p><a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness.</p> <p>Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective.</p> <p>Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness.</p> <p>The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/brian-strickland-1506270"><em>Brian Strickland</em></a><em>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</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/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.</em></p>

Travel Trouble

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How to turn your handy skills into material wealth

<p>If you’re looking for an opportunity to be your own boss, minus all of the uncertainties that come with starting a business from scratch, a <a href="https://www.hireahubby.co.nz/franchise/" target="_blank" rel="noopener">Hire A Hubby franchise</a> offers the perfect chance for you to take charge of your time, your future, and do what you love while building a successful business.</p> <p>This is no flash-in-the-pan start-up venture either; with more than 25 years of experience, the recognition and solid reputation already cemented by Hire A Hubby provide a valuable head start, making it far easier for you to connect with clients and build lasting relationships in your local community and beyond.</p> <p>Combining a proven business model refined and perfected over the years with all of the experience and insights of a solid Franchise Support Team, the risks commonly associated with entrepreneurship are virtually eliminated. Not only will you be stepping into a well-established brand that has earned the trust of customers nationwide, you’ll also be saying goodbye to the daily grind and hello to work-life harmony.</p> <p>One of the standout features of a Hire A Hubby franchise is the diverse range of services it offers. From general maintenance to renovations and repairs, franchisees have the opportunity to cater to a wide spectrum of customer needs. This versatility means you will not only attract a broader clientele, but also ensures a steady stream of business throughout the year, contributing to your long-term success.</p> <p>With New Zealand's property market experiencing a strong, continuous upward trend, there’s an equally strong demand for home maintenance and improvement services. What better way to position yourself to capitalise on this expanding market than with a Hire A Hubby franchise? As homeowners and businesses continue to place property upkeep front and centre, you’ll find yourself in a lucrative position to meet those needs – while contributing to the overall well-being of your community.</p> <p>And there’s no need to go it alone. Since success in any venture is most often the result of proper guidance and support, you’ll also benefit from Hire A Hubby’s comprehensive training programs, designed to equip you with all the necessary skills and knowledge to run a successful business. Backed by ongoing help from the Franchise Support Team, you’ll be able to stay well ahead of any industry trends and challenges standing in the way of success.</p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/uNvVOK5UgPk?si=rbZkgdrP5fzmZ1m4" width="560" height="315" frameborder="0" data-mce-fragment="1"></iframe></p> <p>But how best to get your name out there? Hire A Hubby understands all too well that visibility is key in any competitive marketplace. That’s why you’ll be able to tap into the collective strength of a national advertising and marketing campaign to not only boosts local visibility, but do wonders for your credibility at the same time, leading to new customers, new experiences and even greater success.</p> <p>The flexibility that comes with owning a Hire A Hubby franchise can’t help but add a serious dose of satisfaction to your lifestyle. You're not just running a business; you're crafting a life that allows you to balance work and play. That freedom to set your schedule means more time for the things you love.</p> <p>Speaking of which – as the proud owner of a Hire A Hubby franchise, you're not just fixing homes; you're also spreading joy one repair at a time. Whether it's a leaky roof or a wonky shelf, your expertise becomes a beacon of happiness for your clients. Imagine the pleasure of seeing a problem solved and the smiles on your customers' faces? These are priceless rewards that we all know come with the handyman territory.</p> <p>In the world of Hire A Hubby, happy customers aren’t just a metric; they are the real currency of success. That’s because satisfied clients are not just repeat clients; they are ambassadors for your brand, sharing their positive experiences and spreading the joy of your services.</p> <p><img class="alignnone size-full wp-image-13682" src="https://oversixtydev.blob.core.windows.net/media/2024/01/HireAHubby01_060.jpg" alt="" width="1280" height="720" /></p> <p>Owning and running a Hire A Hubby franchise means building a community of satisfied customers who appreciate not just your skills but the positive energy you bring to their homes.</p> <p>In the end, Hire A Hubby isn't just a brand; it's a positive force in the world of home maintenance and improvement. Becoming a part of that means contributing to a brand that is known for its reliability, professionalism and, most importantly, its ability to bring smiles to the faces of homeowners across New Zealand.</p> <p>So put on that tool belt, square your shoulders and get ready to join The Everything Experts!</p> <p>For more information on how to transform your handy skills into easy material wealth, head to <a href="https://www.hireahubby.co.nz/franchise/" target="_blank" rel="noopener">www.hireahubby.co.nz/franchise</a></p> <p><em>Images: Supplied.</em></p> <p><em>This is a sponsored article produced in partnership with Hire A Hubby.</em></p>

Home & Garden

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Senior changes will to leave fortune to pets instead of family

<p>An elderly woman in China has decided to leave her $A4.3 million fortune to her pets instead of her three children, after she claims they never visited or took care of her when she was sick. </p> <p>The Shanghai woman, known by her last name Liu, drafted the will a few years ago according to the <a href="https://www.scmp.com/news/people-culture/trending-china/article/3248592/elderly-china-woman-leaves-us28-million-assets-beloved-pets-instead-children-who-never-visited-even" target="_blank" rel="noopener"><em>South China Morning Post</em></a>. </p> <p>However, as her three children rarely contacted her, and left her on her own while she was sick, Liu decided her cats and dogs were more deserving of her multi-million dollar fortune, and changed her will. </p> <p>Chen Kai, an official from the China’s Will Registration Centre headquarters, told her that leaving her entire inheritance to animals is illegal in China, but there is a way for her to ensure her pets get taken care of. </p> <p>“Liu’s current will is one way, and we would have advised her to appoint a person she trusts to supervise the vet clinic to ensure the pets are properly cared for,” he told the <em>South China Morning Post</em>. </p> <p>Another official added that Liu could always change her mind, if her children changed their attitude. </p> <p>“We told Auntie Liu that if her children change their attitude towards her, she could always alter her will again,” the official said. </p> <p><em>Image: Getty</em></p> <p> </p>

Family & Pets

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

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

Travel Trouble

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5 reasons why climate change may see more of us turn to alcohol and other drugs

<p><em><a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a></em></p> <p>Climate change will affect every aspect of our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01859-7/fulltext">health and wellbeing</a>. But its potential harms go beyond the body’s ability to handle extreme heat, important as this is.</p> <p>Extreme weather events, such as floods, droughts, storms and wildfires, are becoming more frequent and severe. These affect our <a href="https://pubmed.ncbi.nlm.nih.gov/36165756/">mental health</a> in a multitude of <a href="https://www.nature.com/articles/s41558-018-0102-4">ways</a>.</p> <p>Coping with climate change can be overwhelming. Sometimes, the best someone can do is to seek refuge in alcohol, tobacco, over-the-counter and prescription drugs, or other psychoactive substances. This is understandable, but dangerous, and can have serious consequences.</p> <p>We outline <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221132739">five ways</a> climate change could increase the risk of harmful substance use.</p> <h2>1. Mental health is harmed</h2> <p>Perhaps the most obvious way climate change can be linked to harmful substance use is by damaging mental health. This <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12448">increases the risk</a> of new or worsened substance use.</p> <p>People with a mental disorder are <a href="https://www.hindawi.com/journals/psychiatry/2018/5697103/">at high risk</a> of also having a <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-25#:%7E:text=Prevalence%20of%20comorbidity%20in%20epidemiological%20studies&amp;text=Among%20subjects%20with%20an%20alcohol,a%20comorbid%20SUD%20%5B39%5D.">substance-use disorder</a>. This often precedes their mental health problems. Climate change-related increases in the number and nature of extreme events, in turn, are escalating risks to mental health.</p> <p>For example, extreme heat is linked to increased <a href="https://pubmed.ncbi.nlm.nih.gov/27727320/">distress</a> across the whole population. In extreme heat, more people go to the <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2789481">emergency department</a> for psychiatric problems, including for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969720338249">alcohol</a> and <a href="https://www.nature.com/articles/s43856-023-00346-1">substance use</a> generally. This is even true for <a href="https://www.sciencedirect.com/science/article/pii/S0048969720325572">a single very hot day</a>.</p> <p>Post-traumatic stress disorder, depression, anxiety and <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja13.10307">other mental health</a> problems are <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00367/full">common</a> at the time of extreme weather events and can persist for months, even years afterwards, especially if people are exposed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116266/">multiple events</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101235/">increase</a> the likelihood of using substances as a way to cope.</p> <h2>2. Worry increases</h2> <p>With <a href="https://climatecommunication.yale.edu/publications/climate-change-in-the-american-mind-beliefs-attitudes-december-2022/">increasing public awareness</a> of how climate change is endangering wellbeing, people are <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/worriesaboutclimatechangegreatbritain/septembertooctober2022#:%7E:text=The%20level%20of%20worry%20about,lives%20right%20now%20(29%25).">increasingly worried</a> about what will happen if it remains unchecked.</p> <p>Worrying isn’t the same as meeting the criteria for a mental disorder. But <a href="https://www.undp.org/publications/peoples-climate-vote">surveys</a> show climate change generates complex emotional responses, <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00278-3/fulltext">especially in children</a>. As well as feelings of worry, there is anxiety, fear, guilt, anger, grief and helplessness.</p> <p>Some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/">emotional states</a>, such as <a href="https://www.pnas.org/doi/full/10.1073/pnas.1909888116">sadness</a>, are linked with long-term tobacco use and also make substance use <a href="https://pubmed.ncbi.nlm.nih.gov/16011392/">relapse</a> more likely.</p> <h2>3. Physical injuries hurt us in many ways</h2> <p>Physical injuries caused by extreme weather events – such as smoke inhalation, burns and flood-related cuts and infections – increase the risk of harmful substance use. That’s partly because they <a href="https://pubmed.ncbi.nlm.nih.gov/20033251/">increase</a> the risk of psychological distress. If injuries cause long-term illness or disability, consequent feelings of hopelessness and depression can dispose some people to self-medicate with alcohol or other drugs.</p> <p>Substance use itself can also generate long-term physiological harm, disabilities or other chronic health problems. These are <a href="https://www.tandfonline.com/doi/abs/10.3109/00952999609001655">linked with</a> higher rates of harmful substance use.</p> <h2>4. Our day-to-day lives change</h2> <p>A single catastrophic event, such as a storm or flood, can devastate lives overnight and change the way we live. So, too, can the more subtle changes in climate and day-to-day weather. Both can disrupt behaviour and routines in ways that risk new or worsened substance use, for example, using stimulants to cope with fatigue.</p> <p>Take, for example, hotter temperatures, which disrupt <a href="https://www.cell.com/one-earth/fulltext/S2590-3322(22)00209-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2590332222002093%3Fshowall%3Dtrue">sleep</a>, undermine <a href="https://jhr.uwpress.org/content/57/2/400">academic performance</a>, <a href="https://www.nature.com/articles/s41562-017-0097">reduce physical activity</a>, and promote <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00173-5/fulltext">hostile language</a> and <a href="https://www.cambridge.org/core/elements/abs/climate-change-and-human-behavior/F64471FA47B8A6F5524E7DDDDE571D57">violent behaviour</a>.</p> <h2>5. It destabilises communities</h2> <p>Finally, climate change is destabilising the socioeconomic, natural, built and geopolitical <a href="https://www.nature.com/articles/s41558-018-0102-4">systems</a> on which human wellbeing – <a href="https://theconversation.com/climate-change-and-health-ipcc-reports-emerging-risks-emerging-consensus-24213">indeed survival</a> – depends.</p> <p>Damaged infrastructure, agricultural losses, school closures, homelessness and displacement are significant <a href="https://www.nature.com/articles/s41558-018-0102-4">sources of psychosocial distress</a> that prompt acute (short-term) and chronic (long-term) stress responses.</p> <p><a href="https://doi.org/10.1196/annals.1441.030">Stress</a>, in turn, can <a href="https://doi.org/10.1007/s002130100917">increase</a> the risk of <a href="https://link.springer.com/article/10.1007/s002130100917">harmful substance use</a> and make people more likely to relapse.</p> <h2>Why are we so concerned?</h2> <p>Substance-use disorders are economically and socially <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30337-7/fulltext">very costly</a>. Risky substance use that doesn’t meet the criteria for a formal diagnosis <a href="https://digitalcommons.fiu.edu/srhreports/health/health/32/">can also harm</a>.</p> <p>Aside from its direct physical harm, harmful substance use disrupts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843305/">education</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234116/">employment</a>. It increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676144/">accidents</a> and <a href="https://www.tandfonline.com/doi/abs/10.1080/09595230600944479">crime</a>, and it undermines social relationships, intimate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795906/#:%7E:text=Results%20indicated%20that%20alcohol%20use,drinkers%20with%20low%20relationship%20satisfaction.">partnerships</a> and <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/abs/longitudinal-relations-between-parental-drinking-problems-family-functioning-and-child-adjustment/CE508589A9E799FD6DC9E23DF364FB8F">family functioning</a>.</p> <h2>Politicians take note</h2> <p>As we head towards the <a href="https://www.cop28.com">COP28 global climate talks</a> in Dubai, climate change is set to hit the headlines once more. Politicians know climate change is undermining human health and wellbeing. It’s well past time to insist they act.</p> <p>As we have seen for populations as a whole, there are multiple possible ways for climate change to cause a rise in harmful substance use. This means multidimensional <a href="https://www.nature.com/articles/s41558-018-0102-4">prevention strategies</a> are needed. As well as addressing climate change more broadly, we need strategies including:</p> <ul> <li> <p>supporting vulnerable individuals, especially <a href="https://journals.sagepub.com/doi/full/10.1177/21677026211040787">young people</a>, and marginalised commmunities, who are <a href="https://www.nature.com/articles/s41558-018-0102-4">hit hardest</a> by extreme weather-related events</p> </li> <li> <p>focusing health-related policies more on broadscale health promotion, for example, healthier eating, active transport and community-led mental health support</p> </li> <li> <p>investing in climate-resilient infrastructure, such as heat-proofing buildings and greening cities, to prevent more of the destabilising effects and stress we know contributes to mental health problems and harmful substance use.</p> </li> </ul> <p>There is now <a href="https://news.un.org/en/story/2022/10/1129912">no credible pathway</a> to avoiding dangerous climate change. However, if <a href="https://carnegieendowment.org/2023/01/12/climate-protests-tracking-growing-unrest-pub-88778#:%7E:text=These%20are%20just%20a%20few,even%20more%20numerous%20and%20influential.">increasing rates</a> of climate protests are anything to go by, the world may finally be ready for radical change – and perhaps for reduced harmful substance use.<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/217894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, Honorary Professor, Centre for Health Systems and Safety Research, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, Associate Professor, Psychosocial Difficulties, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</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/5-reasons-why-climate-change-may-see-more-of-us-turn-to-alcohol-and-other-drugs-217894">original article</a>.</em></p>

Mind

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

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

Travel Trouble

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Why does my hair turn green from the swimming pool?

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

Beauty & Style

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"His worst moment as a person": Sean Penn unleashes on Will Smith's Oscar's slap

<p>Sean Penn has become visibly angry as he recalled the infamous moment at the 2022 Oscars ceremony when Will Smith stormed the stage to slap Chris Rock. </p> <p>Penn recalled the award ceremony moment as he reflected on the Academy's decision to not let Ukraine’s president, Volodymyr Zelenskyy, speak at the ceremony. </p> <p>The actor has been a strong advocate for the people of Ukraine in their ongoing war against Russia, and even traveling to the war-torn region to help in their fight. </p> <p>Speaking to <a href="https://variety.com/2023/film/features/sean-penn-slams-will-smith-slap-ai-oscars-1235720417/" target="_blank" rel="noopener"><em>Variety</em></a>, Penn shared how frustrated he was that Zelenskyy was silenced, while Smith's actions were the real problem. </p> <p>“The Oscars producer thought, ‘Oh, he’s [Zelenskyy] not lighthearted enough.’ Well, guess what you got instead? Will Smith.”</p> <p><em>Variety</em> noted that the actor was visibly infuriated speaking on the subject, even turning red during the interview.</p> <p>“I don’t know Will Smith. I met him once,” Penn said. “He seemed very nice when I met him. He was so f***ing good in <em>King Richard</em>.”</p> <p>“So why the f**k did you just spit on yourself and everybody else with this stupid f***ing thing? Why did I go to f***ing jail for what you just did? And you’re still sitting there? Why are you guys standing and applauding his worst moment as a person?” the 63-year-old said, referencing his 1987 arrest and jail stint for punching a film extra in the face.</p> <p>“This f***ing bulls**t wouldn’t have happened with Zelenskyy,” Penn added. “Will Smith would never have left that chair to be part of stupid violence. It never would have happened.”</p> <p>Penn was so shocked and infuriated by the moment that he chose to destroy his two Oscars. </p> <p>"I thought, ‘Well, f**k, you know? I’ll give them to Ukraine. They can be melted down to bullets they can shoot at the Russians,’” he said.</p> <p>When visiting Zelenskyy in Ukraine last fall, Penn showed his support by giving the leader one of his Oscars.</p> <p>At the 2022 Oscar's ceremony, Will Smith stormed the stage and slapped comedian Chris Rock after he made a joke about his wife, Jada Pinkett-Smith. </p> <p>After returning to his seat, Smith shouted out, “Keep my wife’s name out your f***ing mouth!”</p> <p><em>Image credits: Getty Images</em></p>

Movies

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7 tips to help turn your cat into a friendly member of the family

<p><strong>How to make your cat love you</strong></p> <p>Getting a cat to be more affectionate is the yearning of many a pet owner. Some cats are antisocial when it comes to being picked up, cuddled or petted (much less sitting in a person’s lap). Other kitties are born loving this sort of attention.</p> <p>If you’re not lucky enough to have a cat who automatically seeks out your affection, trying to entice that reclusive furball to become your snuggle buddy may take some motivation and determination on your part. Your pet may never convert to a drooly lap cat, even after weeks of effort on your part, but at the very least you’ll probably strengthen your relationship with your cat.</p> <p><strong>Get the basics down</strong></p> <p>The initial stage of coaxing a cat into being more lovable is to let her recognise your positive intentions by dependably offering her good food, clean water, fun toys to play with and a litterbox that is cleaned regularly. When she’s happier, you’ll be happier, and these mutual good feelings will carry over into your relationship together.</p> <p>Spend extra time with your cat, letting her see you not as her owner but as her friend, meal provider and guardian. If she’s not coming up to you to say hi, be proactive: Walk over to her (as long as she’s not super-shy) and lavish affection on her. Once she gets used to all this attention, she might very well start seeking it out from you.</p> <p><strong>Be affectionate while feeding </strong></p> <p>While preparing her food (or making a production of opening that can of food), talk to your kitty. When she begins eating, gently stroke her a few times. This will help her associate being petted with a positive experience.</p> <p><strong>Be playful </strong></p> <p>Instead of trying to force a hug from your reluctant cat, play with her a little, maybe getting her to paw at a piece of string or chase after a laser pointer.</p> <p><strong>Try a little catnip</strong></p> <p>Bringing out a tin of catnip often brings timid felines out of their shells, and aloof cats sometimes become far friendlier under the influence of catnip.</p> <p><strong>Use the "slow blink"</strong></p> <p>Remember that using the “slow blink” as a non-verbal statement saying “I love you” will go a much longer way with your cat, versus a direct stare, which she may take as a threat.</p> <p><strong>Don't chase</strong></p> <p>Don’t try to push affection on your cat – for example, running after her. This might work with a dog, but chasing usually causes a scaredy cat to jolt off in another direction feeling victimised. And I should hope it goes without saying, but don’t punish or yell at your shy cat.</p> <p><strong>Give them a treat</strong></p> <p>Each time you share a session of tenderness with your cat, give her a treat. Let her see that this affectionate behaviour has its rewards.</p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/food-home-garden/pets/7-tips-to-make-your-cat-more-friendly" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Family & Pets

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Five things to do before you die – because planning your eventual demise takes preparation

<p><em><a href="https://theconversation.com/profiles/hui-yun-chan-715995">Hui Yun Chan</a>, <a href="https://theconversation.com/institutions/university-of-huddersfield-1226">University of Huddersfield</a></em></p> <p>Many people who are struck with sudden, progressive or terminal illness are <a href="https://theconversation.com/why-are-patients-in-permanent-comas-routinely-kept-alive-43365">kept alive mechanically</a>, while families and doctors make decisions about treatment. As a researcher in medical law, particularly end-of-life decision-making, I have seen how this can become a minefield of legal and ethical problems.</p> <p>UK law allows people to plan in advance of any debilitating illness, and thus have some control over future treatment. This is known as “<a href="https://www.nhs.uk/conditions/end-of-life-care/advance-decision-to-refuse-treatment/">advance decisions</a>”. While these laws are in place, research shows the <a href="https://rm.coe.int/cdcj-2017-2e-final-rapport-vs-21-06-2018/16808b64ae">majority of people disregard or defer the discussions</a> primarily because they do not know how to raise them, or what to expect.</p> <p>While planning for your eventual demise probably sounds as fun as pulling teeth, it can be empowering. Following from <a href="https://pure.hud.ac.uk/en/publications/advance-directives-rethinking-regulation-autonomy-amp-healthcare-">my recent book</a>, here are five tips for how you can use the law to help you plan for what you want in the future – and make your voice heard when you may no longer have one.</p> <h2>1. Gather information from experts</h2> <p>First, you must think, gather information and talk to experts about how life can unfold in the case of progressive illness. This is important whether you are well but thinking about future incapacity, or whether you have actually been <a href="https://www.4pb.com/case-detail/re-ak-medical-treatment-consent/">diagnosed with illness</a>.</p> <p>A solicitor with expertise in advance directives can help you understand important laws, such as those that dictate when a person has <a href="https://www.legislation.gov.uk/ukpga/2005/9/contents">sufficient “mental capacity”</a> to make lawful decisions. Lawyers can help you draft your will, and advise on how to protect or pass on your estate – including <a href="https://www.gov.uk/inheritance-tax">hidden costs</a>. They can also help you <a href="https://www.gov.uk/power-of-attorney">nominate someone</a> to make medical decisions for you when you become incapacitated, and decide the limits of their power. Do not just assume that your family members automatically have the power to decide for you legally.</p> <p>If you are ill, ask a doctor to inform you how your condition will progress so you can decide how you will deal with future events. For example, with dementia and other progressive illnesses, you must consider what quality of life you would tolerate. Similarly, in the case of pain, what treatment you would accept or refuse?</p> <p>Think big picture about your future life. Would you trade quantity of life for quality, opting for less time but with better quality of life?</p> <h2>2. Setting your decisions in stone</h2> <p>Now you have made some important decisions, the next step is about making these decisions clear in the right way, to the right people, and at the right time.</p> <p>I have <a href="https://www.springer.com/gp/book/9783030009755#aboutBook">documented many cases</a> across England and Wales where advance directives are disputed because they are invalid or inapplicable and there is a dispute about whether they are still legally able to make decisions. Considering your health, you may want to get a <a href="https://www.bma.org.uk/advice/employment/ethics/mental-capacity/assessing-mental-capacity">formal assessment</a> of your mental state and ability to make decisions. You should record any conversations you have in writing. Documents that show you have been supported (by friends, family or professionals) in your decision-making boost the validity of your choices, <a href="https://brill.com/view/journals/ejhl/25/1/article-p24_24.xml?lang=en">making them more binding</a> for healthcare professionals.</p> <p>Legally, just revealing your treatment preferences to your doctor or friends <a href="https://swarb.co.uk/w-healthcare-nhs-trust-v-kh-ca-17-sep-2004/">is not enough</a>. Writing things down is important, though never easy. Ask family or friends to support you in this process. If a loved one is aware of the choices you have made they are less likely to object to your medical decisions because they have been part of the decision process.</p> <h2>3. Update when your situation changes</h2> <p>Many people are caught out when their <a href="https://compassionindying.org.uk/making-decisions-and-planning-your-care/planning-ahead/advance-decision-living-will/review-update/">personal situation changes</a>, but they have failed to update their advance directives to reflect this – such as changing romantic relationships. Family conflict by your bedside is the last thing you want. Even if your circumstances are the same, regularly update to avoid “what was I thinking?” moments when it’s too late.</p> <h2>4. Make sure it gets found</h2> <p>Inform your family, doctors and lawyers what your advance directives are <em>and</em> where to find them. If the right people don’t have access to your directives, they are useless. In a recent example, the family of a Warwickshire woman was granted a £45,000 payout after she was <a href="https://www.bbc.co.uk/news/uk-england-coventry-warwickshire-42240148">kept alive for 22 months against her will</a> – as the relevant documents had been misplaced.</p> <h2>5. Don’t forget your online life</h2> <p>Discussions on social media about how you wish to spend your twilight days may help as <a href="https://brill.com/view/journals/ejhl/25/1/article-p24_24.xml?lang=en">supporting information</a> to ensure the wishes in your advance directives are strengthened. You should also think about who you want to be granted (or denied) access to your online accounts and social media after your death. Streamlining this process, you can now <a href="https://www.theatlantic.com/technology/archive/2013/04/google-death-a-tool-to-take-care-of-your-gmail-when-youre-gone/274934/">create a social media will</a> online.</p> <p>Drafting an advance directive is an exercise in liberty. It allows our beliefs and preferences to be made clear even when we are physically or mentally unable to express them ourselves. An advance directive is our voice when we no longer have one. Use your voice wisely.<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/122296/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/hui-yun-chan-715995">Hui Yun Chan</a>, Senior Lecturer in Law, <a href="https://theconversation.com/institutions/university-of-huddersfield-1226">University of Huddersfield</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/five-things-to-do-before-you-die-because-planning-your-eventual-demise-takes-preparation-122296">original article</a>.</em></p>

Legal

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The hilarious reason Dolly Parton turned down tea with Princess Kate

<p>It's been a remarkable year for country legend Dolly Parton, that she even received an invitation to tea with Princess Kate Middleton. </p> <p>Unfortunately, the icon had to decline and shared the hilarious reason why on her latest interview with <em>BBC Radio 2</em>. </p> <p>“This time, Lordy, I even got invited to have tea with Kate but I couldn’t even go," the country queen revealed about her time in London. </p> <p>“I thought it was very sweet and nice of her to invite me and one of these days I’m going to get to do that – that would be great," she added. </p> <p>When asked why she couldn't attend the prestigious afternoon tea, Parton joked: “She wasn’t going to promote my rock album so I had to say no.”</p> <p>On a more serious note, she said that despite her love for the people and London, she "unfortunately" doesn't have enough time to explore the city while she's there on business. </p> <p>The icon has been booked and busy with an upcoming rock album that is set to be released on November. </p> <p>Earlier this month she released <em>Let It Be</em>, a cover of the iconic Beatles song which she sang with two members of the band Paul McCartney and Ringo Starr.</p> <p>She's also been very active in her charity work, particularly her Imagination Library, which she founded and is currently expanding to help more children get free books up until they turn five. </p> <p><em>Images: Getty</em></p>

Relationships

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Fleetwood Mac legend’s eye-watering fortune revealed

<p dir="ltr">Fleetwood Mac star Christine McVie left behind a $135 million fortune, probate documents revealed.</p> <p dir="ltr">The singer and keyboardist <a href="https://www.oversixty.com.au/news/news/there-are-no-words-fleetwood-mac-star-dies-aged-79" target="_blank" rel="noopener">passed away aged 79</a> in November last year following a short illness. McVie, who was living in London at the time, had suffered a <a href="https://www.oversixty.com.au/health/caring/fleetwood-mac-star-s-cause-of-death-revealed" target="_blank" rel="noopener">stroke and had cancer</a>.</p> <p dir="ltr">A year before her death, she secured a massive deal and sold the rights to her entire back catalogue of 115 songs.</p> <p dir="ltr">McVie played in several bands before joining Fleetwood Mac in 1970, just two years after she married the band’s bassist John McVie.</p> <p dir="ltr">She left the band in 1998 and returned to tour in 2014.</p> <p dir="ltr">Following her death, her former bandmates Mick Fleetwood and Stevie Nicks said: “She was truly one of a kind, special and talented beyond measure.</p> <p dir="ltr">“She was the best musician anyone could have in their band and the best friend anyone could have in their life.</p> <p dir="ltr">“We were so lucky to have a life with her. Individually and together, we cherished Christine deeply and are thankful for the amazing memories we have.</p> <p dir="ltr">“She will be so very missed.”</p> <p dir="ltr">In February this year, Fleetwood admitted that the band was most likely “done” for good following McVie’s death.</p> <p dir="ltr">"I think right now, I truly think the line in the sand has been drawn with the loss of Chris," he told the<em> Los Angeles Times</em>.</p> <p dir="ltr">"I'd say we're done, but then we've all said that before. It's sort of unthinkable right now."</p> <p><em>Image: Instagram</em></p>

Money & Banking

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Diehard fans react as iconic superband quits after 52 years of rocking

<p>The Eagles are hitting the road for the final time after 52 years as a band. </p> <p>On Thursday, the iconic US rock band announced The Long Goodbye tour that is set to kick off on September 7th in New York City.</p> <p>In a statement shared with CNN, the <em>Hotel California</em> hitmakers said, "The Eagles have had a miraculous 52-year odyssey, performing for people all over the globe; keeping the music alive in the face of tragic losses, upheavals and setbacks of many kinds."</p> <p>"We know how fortunate we are, and we are truly grateful. Our long run has lasted far longer than any of us ever dreamed. But, everything has its time, and the time has come for us to close the circle."</p> <p>The band concluded their statement by thanking those who have supported their music, saying, "At the end of the day, you are the reason we have been able to carry on for over five decades. This is our swan song, but the music goes on and on.”</p> <p>According to the statement, The Eagles members Don Henley, Joe Walsh, Timothy B. Schmit, alongside Vince Gill and Deacon Frey "will perform as many shows in each market as their audience demands."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/CuWrpW3ObCZ/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CuWrpW3ObCZ/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Eagles (@eagles)</a></p> </div> </blockquote> <p>Deacon Frey is the son of the late Glenn Frey, who was a founding member and frontman of the band when they began in 1971 before he died in 2015 after a range of health complications. </p> <p>Many were devastated to hear of the band's final tour, with long-time fan of The Eagles Kathryn Packham saying, "I have always loved their music. Great songs with relatable lyrics, fantastic harmonies, and of course the unbelievable guitar riffs from Joe Walsh &amp; exceptional drumming from Don Henley. Their music is timeless."</p> <p>Despite her love for the band, it seems Glenn Frey's legacy lives on as Packham said she would "not go and see them if they were performing for free on the driveway without Glenn."</p> <p>The farewell tour is expected to continue into 2025, with no Oceania dates yet announced. </p> <p><em>Image credits: Getty Images</em></p>

Music

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“Devastated”: Britain's Got Talent star dies at 52

<p dir="ltr"><em>Britain’s Got Talent</em> star Paula Moulton has died at 52-years-old.</p> <p dir="ltr">Paula, who was part of the wheelchair dance act Strictly Wheels, became a fan favourite when she appeared as a contestant on the hit show in 2012 with her dance partner Gary Lyness.</p> <p dir="ltr">Her death was announced on the <em>Strictly Wheels</em> Facebook account on Thursday. “We are devastated to announce the sudden passing of our co-founder Paula,” the post began.</p> <p dir="ltr">“Our thoughts are with her family and friends at this extremely sad time. Paula's legacy will always live in our memories from her utter joy of dance.”</p> <p dir="ltr">Although the cause of death has not yet been confirmed, Paula had been struggling with the effects of her battle with the MRSA superbug, which she contracted in 1995 after suffering from pneumonia.</p> <p dir="ltr">The infection left her with nerve damage which impacted her pelvis, lower spine, hips and femurs.</p> <p dir="ltr">Despite this Paula didn’t let it crush her spirit, and alongside her partner Gary, she has achieved a lot over her lifetime.</p> <p dir="ltr">In 2016 the pair launched the charity <em>Strictly Wheels</em>, as part of their mission to raise the profile of wheelchair dancing and promote “Ability not Disability”.</p> <p dir="ltr">In 2018, they ranked eighth in the world in Latin Wheelchair Dance after competing in the World Para Dance competition at IPC Level.</p> <p dir="ltr">Fans have taken to the comment section to share their condolences.</p> <p dir="ltr">“My heart is broken! My deepest condolences to family and friends! She will be missed,” wrote one fan.</p> <p dir="ltr">“Paula Moulton was a wonderful dancer from Great Britain, who will be missed dearly ♡ she was warm and always welcomed newcomers with open arms. This is a huge shock to everyone involved with paradancesport all around the world. Our deepest condolences to her friends and family.❤️” wrote another.</p> <p dir="ltr">“I’m shocked and saddened to hear this - love and condolences to all, and rest in peace, Paula x” commented a third.</p> <p dir="ltr"><em>Images: Facebook</em></p>

Caring

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Pizza chain's delightfully devilish scheme lets you pay when you die

<p>A delightfully devilish pizza chain is taking the 'buy now, pay later' scheme to the next level, giving customers the chance to pay for their pizza when they die. </p> <p>HELL Pizza is inviting pizza fans to apply for the trial scheme, which involves amending their wills to have their total cost included. </p> <p>The chain has one store in Brisbane, with the rest of its stores located around New Zealand, with customers from both countries able to apply for the scheme, which involves no late fees or penalties.</p> <p>The restaurant will select 666 applicants from each country, who will be invited to sign a real amendment to their wills allowing the cost of their pizza to be collected upon death.</p> <p>According to HELL Pizza CEO Ben Cumming, pizza is one of the simple joys of life, and AfterLife Pay means diners can get their fix without having to dip into the bank account immediately.</p> <p>The scheme emerged after the business was approached by popular 'buy now, pay later' providers who wanted HELL Pizza to offer the service to its customers. </p> <p>The pizza chain's unique AfterLife Pay came as a direct response to this proposal, as a statement against “schemes trapping a growing number of Aussies in spirals of debt”, Cumming said.</p> <p>“We’re seeing a growing number of people using the schemes to buy essential items like food, and we think it’s taking it a step too far when you’ve got quick service restaurants like ours being asked to offer BNPL for what is considered a treat,” he said.</p> <p>“Especially when you consider people are falling behind in their payments and 10.5 percent of loans are in arrears."</p> <p>“AfterLife Pay is a light-hearted campaign that reinforces HELL’s stance on BNPL schemes - you can have your pizza and eat it too without any pesky late fees or penalties.”</p> <p>Applicants can apply for the scheme <a href="https://hellpizza.nz/wickedpedia/2023/05/25/buy-now-pay-much-later/" target="_blank" rel="noopener">online</a>, with the chain's restaurant assuring that you will you won't pay anything for your order until "you're resting six feet under". </p> <p><em>Image credits: HELL Pizza</em></p>

Food & Wine

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6 movie stars who turned down Oscar-winning roles

<p>The Academy Awards is unarguably the most prestigious and sought after award in the movie industry. Actors must carefully select the scripts that will advance their careers and highlight their acting skills. Although the movie stars below have had successful careers in Hollywood, here are the times the roles they walked away from ended up receiving the prestigious golden statuette.</p> <p><strong>1. Julia Roberts</strong></p> <p>Julia Roberts was offered the role of Viola de Lesseps in <em>Shakespeare in Love</em> which took Best Picture in the Academy Awards in 1998. <em>People</em> reported that Julia was one contract away from starring in the film when she found out that Daniel Day-Lewis turned down the role. Julia wanted Daniel to play the role of Bard of Avon so when he turned down the role, she decided to pull out. Gwyneth Paltrow was then given the role and ended up winning an Oscar for Best Actress for the film.</p> <p><strong>2. Harrison Ford</strong></p> <p>Harrison Ford has made a great name for himself in Hollywood. He won an Oscar for his role in <em>The Fugitive</em> and has played two of the greatest action heroes of all time, Hans Solo and Indiana Jones. Harrison could have had one more Oscar on his shelf had he not turned down the offer to act in <em>Syriana</em>. Harrison was offered the role of CIA Agent Robert Barnes but declined the role as he “didn’t feel strongly enough about the truth of the material.” George Clooney ended up with the role and won Best Supporting Actor in 2006. After watching the film, Harrison changed his mind on the film as the issues he had with the material were rectified.</p> <p><strong>3. Gregory Peck</strong></p> <p>Gregory Peck had been nominated for an Oscar four times before he took home Best Actor in 1963 for his portrayal of Atticus Finch in <em>To Kill a Mockingbird</em>. Gregory might have taken home an Oscar sooner had he not passed on the offer to star in <em>High Noon</em>. Gregory passed on the role as he had just starred in a western <em>The Gunfighter</em> and wanted to avoid typecasting. The role was then offered to Gary Cooper who won the Oscar for Best Actor for his performance. Gregory later said, "I don't think I would have been as good as Gary Cooper but I still think it would have been a good film with me in it."</p> <p><strong>4. Gwyneth Paltrow</strong></p> <p>In 2016, <em>The Danish Girl</em> received three nominations and one win at the Academy Awards. The film, however, had been stuck in the development stages for years as actors and directors continually abandoned the project. The role of Gerda Wegner, Lili’s wife, moved from Charlize Theron to Gwyneth Paltrow. Gwyneth was ready to star in the film when a last-minute shooting location changed the actress’ mind. As she didn’t want to spend too much time away from her kids, Gwyneth decided to walk away from the role. Tom Hooper, Eddie Redmayne and Alicia Vikander came on board with the project years later. Alicia played Gerda and won an Oscar for Best Supporting Actress.</p> <p><strong>5. Anne Hathaway</strong></p> <p>In 2013, Jennifer Lawrence won her first Oscar for Best Actress for playing Tiffany Maxwell in <em>Silver Linings Playbook</em>. Even though Jennifer was outstanding in the film, she wasn’t the first pick for the role. Film executive Harvey Weinstein admitted that Anne Hathaway was slated for the lead female role and Bradley Cooper’s role was meant for Mark Wahlberg. Both actors were ready to star in the film until Anne had some “creative differences” with director David O. Russell. The differences couldn’t be resolved so Anne left the project and Mark Wahlberg followed her. Anne Hathaway did end up winning an Oscar that year for Best Supporting Actress in <em>Les Miserables.</em></p> <p><strong>6. Paul Bettany</strong></p> <p>The portrayal of George Vi in <em>The King’s Speech</em> was not originally intended for Colin Firth. Screenwriter David Seidler believed Paul Bettany was perfect for the role and Paul was offered the part but declined as he didn’t want to be separated from his family for a long period of time. Paul had been working for five months so decided to go home to his family instead of working on a new film in Buckingham Palace. Reflecting on his decision to walk away from the role Paul said, “I regret not working with such amazing, amazing actors and directors and writers. But no, I have to do the right by my family every time.” Colin Firth was chosen for the role and in 2011, he won Best Actor in this film.</p> <p><em>Images: Getty</em></p>

Movies

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Turning down the volume of pain – how to retrain your brain when you get sensitised

<p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p>For every feeling we experience, there is a lot of complex biology going on underneath our skin.</p> <p>Pain involves our whole body. When faced with possible threats, the feeling of pain develops in a split second and can help us to “detect and protect”. But over time, our nerve cells can become over-sensitised. This means they can react more strongly and easily to something that normally wouldn’t hurt or would hurt less. This is called “<a href="https://sitn.hms.harvard.edu/flash/2022/sensitization-why-everything-might-hurt/#:%7E:text=When%20neurons%20responsible%20for%20sensing,subset%20of%20chronic%20pain%20patients.">sensitisation</a>”.</p> <p>Sensitisation can affect anyone, but some people may be more prone to it than others due to possible <a href="https://doi.org/10.1111/jabr.12137">genetic factors, environmental factors or previous experiences</a>. Sensitisation can contribute to chronic pain conditions like fibromyalgia, irritable bowel syndrome, migraine or low back pain.</p> <p>But it might be possible to retrain our brains to manage or even reduce pain.</p> <h2>‘Danger!’</h2> <p>Our body senses possible threats via nerve endings called <a href="https://www.sciencedirect.com/topics/neuroscience/nociceptor">nociceptors</a>. We can think of these like a microphones transmitting the word “danger” through wires (nerves and the spinal cord) up to a speaker (the brain). If you sprain your ankle, a range of tiny chemical reactions start there.</p> <p>When sensitisation happens in a sore body part, it’s like more microphones join in over a period of weeks or months. Now the messages can be transmitted up the wire more efficiently. The volume of the danger message gets turned way up.</p> <p>Then, in the spinal cord, chemical reactions and the number of receptors there also adapt to this new demand. The more messages coming up, the more reactions triggered and the louder the messages sent on to the brain.</p> <p>And sensitisation doesn’t always stop there. The brain can also crank the volume up by making use of more wires in the spinal cord that reach the speaker. This is one of the proposed mechanisms of central sensitisation. As time ticks on, a sensitised nervous system will create more and more feelings of pain, seemingly regardless of the amount of bodily damage at the initial site of pain.</p> <p>When we are sensitised, we may experience pain that is out of proportion to the actual damage (<a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hyperalgesia">hyperalgesia</a>), pain that spreads to other areas of the body (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327510/">referred pain</a>), pain that lasts a long time (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573040/">chronic or persistent pain</a>), or pain triggered by harmless things like touch, pressure or temperature (<a href="https://www.ncbi.nlm.nih.gov/books/NBK537129/#:%7E:text=Allodynia%20is%20defined%20as%20%22pain,produce%20sensation%2C%20causing%20pain.">allodynia</a>).</p> <p>Because pain is a biopsychosocial experience (biological and psychological and social), we may also feel other symptoms like fatigue, mood changes, sleep problems or difficulty concentrating.</p> <h2>Neuroplasticity</h2> <p>Around the clock, our bodies and brain are constantly changing and adapting. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557811/">Neuroplasticity</a> is when the brain changes in response to experiences, good or bad.</p> <p>Pain science research suggests we may be able to <a href="https://www.nih.gov/news-events/nih-research-matters/retraining-brain-treat-chronic-pain">retrain</a> ourselves to improve wellbeing and take advantage of neuroplasticity. There are some promising approaches that target the mechanisms behind sensitisation and aim to reverse them.</p> <p>One example is <a href="https://pubmed.ncbi.nlm.nih.gov/21306870/">graded motor imagery</a>. This technique uses mental and physical exercises like identifying left and right limbs, imagery and <a href="https://www.physio-pedia.com/Mirror_Therapy">mirror box therapy</a>. It has been <a href="https://www.tandfonline.com/doi/full/10.1080/24740527.2023.2188899">tested</a> for conditions like <a href="https://www.ninds.nih.gov/health-information/disorders/complex-regional-pain-syndrome">complex regional pain syndrome</a> (a condition that causes severe pain and swelling in a limb after an injury or surgery) and in <a href="https://www.ncbi.nlm.nih.gov/books/NBK448188/#:%7E:text=Phantom%20limb%20pain%20is%20the,underlying%20pathophysiology%20remains%20poorly%20understood.">phantom limb pain</a> after amputation. Very gradual exposure to increasing stimuli may be behind these positive effects on a sensitised nervous system. While results are promising, more research is needed to confirm its benefits and better understand how it works. The same possible mechanisms of graded exposure underpin some recently developed <a href="https://mhealth.jmir.org/2019/2/e13080/">apps</a> for sufferers.</p> <p>Exercise can also retrain the nervous system. Regular physical activity can <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.01317.2012">decrease the sensitivity</a> of our nervous system by changing processes at a cellular level, seemingly re-calibrating danger message transmission. Importantly, exercise doesn’t have to be high intensity or involve going to the gym. Low-impact activities such as walking, swimming, or yoga can be effective in reducing nervous system sensitivity, possibly by providing new evidence of perceived <a href="https://doi.org/10.1097/j.pain.0000000000002244">safety</a>.</p> <p>Researchers are exploring whether learning about the science of pain and changing the way we think about it may foster self-management skills, like pacing activities and graded exposure to things that have been painful in the past. Understanding how pain is felt and why we feel it <a href="https://doi.org/10.1111/1756-185X.14293">can help</a> improve function, reduce fear and lower anxiety.</p> <figure><iframe src="https://www.youtube.com/embed/eakyDiXX6Uc?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>But don’t go it alone</h2> <p>If you have chronic or severe pain that interferes with your daily life, you should consult a health professional like a doctor and/or a pain specialist who can diagnose your condition and prescribe appropriate active treatments.</p> <p>In Australia, a range of <a href="https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/212772/ACI-chronic-pain-services.pdf">multidisciplinary pain clinics</a> offer physical therapies like exercise, psychological therapies like mindfulness and cognitive behavioural therapy. Experts can also help you make lifestyle changes to improve <a href="https://painhealth.csse.uwa.edu.au/pain-module/sleep-and-pain/">sleep</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584994/">diet</a> to manage and reduce pain. A multi-pronged approach makes the most sense given the complexity of the underlying biology.</p> <p>Education could help develop <a href="https://www.sciencedirect.com/science/article/abs/pii/S0738399121006467">pain literacy and healthy habits</a> to prevent sensitisation, even from a young age. Resources, such as children’s books, videos, and board games, are being developed and tested to improve <a href="https://doi.org/10.1016/j.jpain.2022.07.008">consumer and community understanding</a>.</p> <p>Pain is not a feeling anyone should have to suffer in silence or endure alone. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/202850/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a><br /></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/turning-down-the-volume-of-pain-how-to-retrain-your-brain-when-you-get-sensitised-202850">original article</a>.</em></p>

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